Sample records for 2-year retrospective chart

  1. The retrospective chart review: important methodological considerations

    Vassar Matt


    Full Text Available In this paper, we review and discuss ten common methodological mistakes found in retrospective chart reviews. The retrospective chart review is a widely applicable research methodology that can be used by healthcare disciplines as a means to direct subsequent prospective investigations. In many cases in this review, we have also provided suggestions or accessible resources that researchers can apply as a “best practices” guide when planning, conducting, or reviewing this investigative method.

  2. Dermatologic manifestation of hyperandrogenism: a retrospective chart review.

    Clark, Charlotte M; Rudolph, Jennifer; Gerber, Donald A; Glick, Sharon; Shalita, Alan R; Lowenstein, Eve J


    Several studies have described a wide spectrum of hyperandrogenism diseases, many of which are difficult to distinguish from each other. In order to better understand diseases of hyperandrogenism, the authors performed a retrospective study of the cutaneous features and metabolic findings in women with hyperandrogenism. A retrospective chart analysis compiled by three dermatologists in both academic and private settings was performed, including patients presenting with > or = 2 manifestations of hyperandrogenism. Relevant dermatologic and associated manifestations and laboratory and imaging study findings were reviewed. Moderate to severe acne was the most common manifestation. Other common manifestations that patients first presented with include hirsutism, acanthosis nigricans, androgenic alopecia, and skin tags. Oligomenorrhea was the most common systemic presenting sign. Statistical analysis of various clinical markers revealed correlations with hyperandrogenemia. Acanthosis nigricans and hirsutism were found to be useful clinical markers for hyperandrogenism, whereas androgenic alopecia was not. This study provides some insights into the presentation and diverse manifestations seen in hyperandrogenism.

  3. Childhood Learning Disabilities and Atypical Dementia: A Retrospective Chart Review.

    Alon Seifan

    Full Text Available To further our understanding of the association between self-reported childhood learning disabilities (LDs and atypical dementia phenotypes (Atypical Dementia, including logopenic primary progressive aphasia (L-PPA, Posterior Cortical Atrophy (PCA, and Dysexecutive-type Alzheimer's Disease (AD.This retrospective case series analysis of 678 comprehensive neuropsychological assessments compared rates of self-reported LD between dementia patients diagnosed with Typical AD and those diagnosed with Atypical Dementia. 105 cases with neuroimaging or CSF data available and at least one neurology follow-up were identified as having been diagnosed by the neuropsychologist with any form of neurodegenerative dementia. These cases were subject to a consensus diagnostic process among three dementia experts using validated clinical criteria for AD and PPA. LD was considered Probable if two or more statements consistent with prior LD were documented within the Social & Developmental History of the initial neuropsychological evaluation.85 subjects (Typical AD n=68, Atypical AD n=17 were included in the final analysis. In logistic regression models adjusted for age, gender, handedness, education and symptom duration, patients with Probable LD, compared to patients without Probable LD, were significantly more likely to be diagnosed with Atypical Dementia vs. Typical AD (OR 13.1, 95% CI 1.3-128.4. All three of the L-PPA cases reporting a childhood LD endorsed childhood difficulty with language. By contrast, both PCA cases reporting Probable childhood LD endorsed difficulty with attention and/or math.In people who develop dementia, childhood LD may predispose to atypical phenotypes. Future studies are required to confirm whether atypical neurodevelopment predisposes to regional-specific neuropathology in AD and other dementias.

  4. Clozapine Treatment and Cannabis Use in Adolescents with Psychotic Disorders – A Retrospective Cohort Chart Review

    Tang, Sephora M.; Ansarian, Aylar; Courtney, Darren B.


    Objectives To examine the association between clozapine treatment and frequency of cannabis use in adolescents with co-occurring psychotic and cannabis use disorder in a retrospective cohort chart review. Method We conducted a retrospective cohort chart review of patients diagnosed with a psychotic disorder and concurrent cannabis use disorder admitted to a tertiary care youth inpatient unit from 2010–2012. Longitudinal exposure and outcome data was coded month-by-month. Frequency of cannabis use was measured using a 7-point ordinal scale. Severity of psychosis was measured on a 3-point ordinal scale. Mixed effects regression modeling was used to describe the relationship between exposure and outcome variables. Results Thirteen patients had exposure to clozapine and fourteen had no exposure to clozapine. Cannabis use decreased in patients treated with clozapine, compared to patients treated with other antipsychotics (OR 2.8; 95% CI 0.97–7.9). Compared to no medication, clozapine exposure was associated with significantly less cannabis use (OR 7.1; 95% CI 2.3–22.3). Relative to treatment with other antipsychotics, clozapine exposure was significantly associated with lower severity of psychotic symptoms (OR 3.7; 95% CI 1.2–11.8). Conclusions Clozapine may lead to decreased cannabis use and psychotic symptoms in adolescents with concurrent psychosis and substance use. Clinical trials are warranted. PMID:28331504

  5. Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review.

    Jusela, Cheryl; Struble, Laura; Gallagher, Nancy Ambrose; Redman, Richard W; Ziemba, Rosemary A


    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at To obtain contact hours you must: 1. Read the article, "Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review" found on pages 19-28, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 29, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Discuss problematic barriers during care transitions

  6. Methadone for the treatment of Prescription Opioids Dependence. A retrospective chart review.

    Barrio, Pablo; Ezzeldin, Mohamed; Bruguera, Pol; Pérez, Ana; Mansilla, Sara; Fàbrega, Marina; Lligoña, Anna; Mondón, Sílvia; Balcells, Mercè


    Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample. Eleven patients were included, mostly women (81.8%), with a median age of 50 years. The median duration of dependence was 8 years. Dependence on other substances and psychiatric comorbidities were high. Eight patients were monitored during three months. Of these, 7 (87.5%) were abstinent after that period. The results suggest that methadone deserves further exploration as a potentially efficacious treatment option for PO dependence.

  7. Retrospective chart review of duloxetine and pregabalin in the treatment of painful neuropathy.

    Mittal, Manoj; Pasnoor, Mamatha; Mummaneni, Reddiah B; Khan, Saud; McVey, April; Saperstein, David; Herbelin, Laura; Ridings, Larry; Wang, Yunxia; Dimachkie, Mazen M; Barohn, Richard J


    The primary aims of our study were to compare pregabalin and duloxetine in a neuromuscular clinic for diabetic neuropathic pain (DPN) and to study the effect of these medications in cryptogenic sensory polyneuropathy. We performed a retrospective chart review of 143 patients who were started on pregabalin or duloxetine during a 10-month period in a tertiary neuromuscular outpatient center for neuropathic pain. Duloxetine and pregabalin were started in 103 and 91 patients, respectively. Ninety-two patients tried only one of the two medications while both medications were used at different time periods in 51 patients. Follow-up was available for 87 patients on pregabalin and 89 patients on duloxetine. More patients with neuropathic pain reported an improvement with pregabalin (33%) than duloxetine (21%). Duloxetine (38%) had a higher frequency of side effects compared to pregabalin (30%). However, these differences between pregabalin and duloxetine were not statistically significant. Despite the study's limitations of retrospective design, these findings suggest that both pregabalin and duloxetine are probably effective for neuropathic pain, secondary to diabetes or cryptogenic sensory peripheral neuropathy in a tertiary care academic neuromuscular center. Prospective randomized controlled comparative effectiveness studies are required for both drugs in the treatment of neuropathic pain.

  8. Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

    Leonard K. Katalambula


    Full Text Available Background. Colorectal cancer (CRC is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ2 tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06% and females (49.94%, although gender likelihood of diagnosis type (i.e., rectal or colon was significantly different (P=0.027. More than 60% of patients were between 40 and 69 years. Conclusions. Age (P=0.0183 and time (P=0.004 but not gender (P=0.0864 were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P=0.0405, age (P=0.0015, and time (P=0.0075 were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.

  9. A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

    Carl Magnus Sköld


    Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

  10. Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

    Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael


    Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

  11. Patterns of skin disease in a sample of the federal prison population: a retrospective chart review

    Gavigan, Geneviève; McEvoy, Alana; Walker, James


    Background: Dermatology in vulnerable populations is under-researched. Our objective was to analyze the most commonly referred skin diseases affecting the Correctional Service Canada inmates in Ontario. Methods: An observational, cross-sectional, retrospective chart review of inmate patients seen from 2008 until 2013 was performed. Two groups of patients were included in the analysis: those assessed in-person, and those evaluated by e-consult. Results: In the in-person patient group, the 3 most common diagnoses were acne, psoriasis and other superficial mycoses. For the e-consult group, the 3 most frequent diagnoses were acne, psoriasis and rosacea. There was a clear bias toward more inmates being seen in-person where the service was provided (Collins Bay Institution) than from other correctional institutions in Eastern Ontario. Interpretation: Most of the skin diseases that affected the incarcerated population studied were common afflictions, similar to those affecting the general population, which is in agreement with other studies. Future studies investigating skin diseases in male and female inmates across Canada would bestow more generalizable data. PMID:27398381

  12. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

    Cindy L. Lamerson


    Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  13. A Retrospective Chart Review of 10 Hz Versus 20 Hz Repetitive Transcranial Magnetic Stimulation for Depression

    Kristie L. DeBlasio


    Full Text Available We performed a retrospective chart review to examine the progress of patients with depression who received different frequencies of repetitive transcranial magnetic stimulation (rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC. rTMS is a safe and effective alternative treatment for patients with various psychological and medical conditions. During treatment, a coil delivering a time-varying magnetic pulse placed over the scalp penetrates the skull, resulting in clinical improvement. There were 47 patients and three distinct treatment groups found: 10 Hz, 20 Hz, and a separate group who received both frequencies (10/20 Hz. The primary outcome indicator was the difference in Beck Depression Inventory–II (BDI-II scores. Secondary outcomes included categorical indicators of remission, response, and partial response rates as assessed with the BDI-II. In all 3 groups, the majority of patients had depression that remitted, with the highest rate occurring in the 20 Hz group. There were similar response rates in the 10 Hz and 20 Hz groups. There were no patients in the 10/20 Hz group whose depression responded and the highest partial response and nonresponse rates occurred in this group. Although within-group differences were significant from baseline to end of treatment, there were no between-group differences.

  14. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    Slothower Molly P


    Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

  15. The incidence of vitamin D deficiency in the obese: a retrospective chart review

    Deepu Daniel


    Full Text Available Objective: To determine whether the obese population is more likely to be vitamin D deficient compared to healthy and overweight individuals. Patients and methods: A retrospective chart review was performed for patients seen in two ambulatory clinics in South Florida over a 1-year period (n=402. Patients’ vitamin D levels drawn during annual wellness visits were analyzed. Subjects were categorized based on body mass index (BMI as normal (BMI 30.0. Their 25-OH vitamin D status was defined as normal (>30 ng/mL, insufficient (20.0–29.9 ng/mL, and deficient (<20 ng/mL. The study included both men and women of black, white, Hispanic, and Asian races. Other variables in the study included age, history of hypertension, and diabetes. Patients with conditions leading to vitamin D malabsorption (chronic pancreatitis, celiac disease, Crohn's disease, cystic fibrosis, ileocecal resection were excluded. Patients with prior vitamin D supplementation were also excluded. Results: The results of the study indicated a significant association of vitamin D deficiency and obesity (p<0.05. Patients who were obese had a relative risk of 3.36 (95% CI: 1.50–7.54 for vitamin D deficiency compared to subjects with normal BMI. The study also showed a significant association between vitamin D levels and obesity when controlling for age, race, and presence of hypertension (p <0.05, with Asians and blacks more likely to be vitamin D deficient. Conclusion: These results demonstrated that obesity was a risk factor for vitamin D deficiency in all races, especially the Asian and black populations. This suggests that physicians should screen for vitamin D deficiency in the obese populations, especially among Asian and black races.

  16. A retrospective chart review: adolescents with borderline personality disorder, borderline personality traits, and controls.

    Jopling, Ellen N; Khalid-Khan, Sarosh; Chandrakumar, Shivani F; Segal, Shira C


    With an estimated lifetime prevalence as high as 5.9% in the general population, borderline personality disorder (BPD) is a psychiatric disorder characterized by marked impulsivity as well as difficulties in interpersonal relationships, self-image, and affects. The burden on the health care system is immense with BPD patients accounting for 10%-20% of the patients in mental health outpatient facilities and 15%-40% in mental health inpatient facilities. Further, while 75%-80% of BPD patients attempt to commit suicide, 10% succeed; this mortality rate exceeds even that of anorexia nervosa which, with a weighted mortality rate of 5.1%, has often been considered to have the highest mortality rate of any mental disorder. In order to provide treatment and to implement preventative measures, a risk profile as well as clinical features must be identified within the adolescent population. This is presently crucial, as the current criteria for BPD are not developmentally focused, and as a result, criteria initially developed for the adult population are being applied in diagnoses of adolescents. A population of adolescents (n=80) between 16 and 19 years of age meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria either for BPD traits (n=46) or for BPD (n=36) were included in a retrospective chart review; a control group consisting of n=30 mood and anxiety control subjects were included to allow for further comparisons. Complex significant differences were discovered between the three groups in the following areas: history of sexual abuse, suicidal ideation, internalizing/externalizing symptoms, interpersonal difficulties, impulsivity, pre-perinatal stress, bullying, substance abuse, anxiety disorders, disruptive disorders, and finally, learning disorders.

  17. Simple acupoints prescription flow chart based on meridian theory: a retrospective study in 102 dogs.

    Jeong, Jong-Ho; Song, Joo-Young; Jo, Hyo-Gwon; Kim, Ji-Min; Yoon, Samuel-S; Park, Chul; Kim, Seunghyun; Roh, Seong-Soo; Lee, Bong Hyo; Yang, Chae Ha; Kim, Hee Young


    To help the clinicians prescribe acupoints easily and effectively, we developed one simple flow chart to select acupoints. This study aimed to evaluate the usefulness of flow chart to select acupoints in dogs. Total 102 dogs showing intervertebral disc disease (IVDD) (n = 12), vomiting (n = 11), diarrhea (n = 2), abdominal pain (n = 5), cough (n = 66), or epilepsy (n = 6) received acupuncture treatment according to the chart, and its outcomes were evaluated as regards clinical symptoms, duration, treatment numbers, and recovery time. Dogs (8/8) with IVDD from grades I to III recovered over periods of 5 days to 6 weeks after 1-12 treatments, while 1/4 dogs with grade IV recovered over 7 weeks after 15 treatments. Vomiting dogs with acute/subacute (n = 8) and chronic symptoms (n = 3) required about 1 and 7 treatments to recover fully, respectively. All dogs (n = 5) with abdominal pain showed fast relief within 24 hours after acupuncture. Two diarrhea cases recovered over 2-9 days after 1-2 treatments. Fifty-four of 66 coughing dogs were recovered by 1-2 treatments. And 5 of 6 epilepsy dogs under a regular acupuncture treatment had no epileptic episode during followup of 12 months. These results suggest that this flow chart can help the clinicians prescribe acupoints effectively.

  18. Simple Acupoints Prescription Flow Chart Based on Meridian Theory: A Retrospective Study in 102 Dogs

    Jong-Ho Jeong


    Full Text Available To help the clinicians prescribe acupoints easily and effectively, we developed one simple flow chart to select acupoints. This study aimed to evaluate the usefulness of flow chart to select acupoints in dogs. Total 102 dogs showing intervertebral disc disease (IVDD (n=12, vomiting (n=11, diarrhea (n=2, abdominal pain (n=5, cough (n=66, or epilepsy (n=6 received acupuncture treatment according to the chart, and its outcomes were evaluated as regards clinical symptoms, duration, treatment numbers, and recovery time. Dogs (8/8 with IVDD from grades I to III recovered over periods of 5 days to 6 weeks after 1–12 treatments, while 1/4 dogs with grade IV recovered over 7 weeks after 15 treatments. Vomiting dogs with acute/subacute (n=8 and chronic symptoms (n=3 required about 1 and 7 treatments to recover fully, respectively. All dogs (n=5 with abdominal pain showed fast relief within 24 hours after acupuncture. Two diarrhea cases recovered over 2–9 days after 1-2 treatments. Fifty-four of 66 coughing dogs were recovered by 1-2 treatments. And 5 of 6 epilepsy dogs under a regular acupuncture treatment had no epileptic episode during followup of 12 months. These results suggest that this flow chart can help the clinicians prescribe acupoints effectively.

  19. Incidence and Cause of Delirium in Hospitalized Patients between the Ages of 18 and 56: A Retrospective Chart Review

    Michelle T. Weckmann


    Full Text Available Background. Delirium is a common and devastating condition which has been well characterized in elderly cancer patients, but little is known about delirium in cancer patients under the age of 65. Aim. A pilot study to explore the incidence and potential causes of delirium in hospitalized advanced cancer patients at the age of 18–56 years. Design. A retrospective chart review using validated instruments was used to examine the charts of hematology-oncology admissions in a large academic institution. Data was collected as to the likelihood of delirium and potential precipitants. Results. Delirium incidence was 29% among advanced cancer patients. The associated precipitants of delirium were multifactorial, the most common being medications and infection. Delirium was more common in patients admitted for either acute symptom management or the presence of a lung malignancy. Patients with delirium demonstrated significantly increased total hospital cost and a borderline significant result for increased mortality compared to those without delirium. Conclusions. Delirium is common in hospitalized advanced cancer patients (age 18–56 years and the cause is typically multifactorial. Delirium results in a more complicated hospital course and likely increased mortality. Further research is needed to define strategies to prevent and treat this common and distressing condition.

  20. Aripiprazole Augmentation in the Treatment of Military-Related PTSD with Major Depression: a retrospective chart review

    Fikretoglu Deniz


    Full Text Available Abstract Background In this chart review, we attempted to evaluate the benefits of adding aripiprazole in veterans with military-related PTSD and comorbid depression, who had been minimally or partially responsive to their existing medications. Methods A retrospective chart review of patients who received an open-label, flexible-dose, 12- week course of adjunctive aripiprazole was conducted in 27 military veterans meeting DSM-IV criteria for PTSD and comorbid major depression. Concomitant psychiatric medications continued unchanged, except for other antipsychotics which were discontinued prior to initiating aripiprazole. The primary outcome variable was a change from baseline in the PTSD checklist-military version (PCL-M and the Beck Depression Inventory (BDI-II. Results PTSD severity (Total PCL scores decreased from 56.11 at baseline to 46.85 at 12-weeks (p Conclusions The addition of aripiprazole contributed to a reduction in both PTSD and depression symptomatology in a population that has traditionally demonstrated poor pharmacological response. Further investigations, including double-blind, placebo-controlled studies, are essential to confirm and further demonstrate the benefit of aripiprazole augmentation in the treatment of military related PTSD.

  1. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

    Tri Indah Winarni


    Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  2. A retrospective chart review to identify perinatal factors associated with food allergies

    Karpa Kelly


    Full Text Available Abstract Background Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Methods Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Results Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02 were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005. Conclusions Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  3. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Hoffman DA


    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  4. Craniocerebral trauma--congruence between post-mortem computed tomography diagnoses and autopsy results: a 2-year retrospective study

    Jacobsen, Christina; Lynnerup, Niels


    Computed tomography (CT) has been used routinely at the Department of Forensic Medicine, University of Copenhagen since 2002. A retrospective study was performed in order to correlate CT-scan based diagnoses of cranial and cerebral lesions with macroscopic autopsy diagnoses in 56 cases. The CT......-scans were performed by a forensic pathologist. They were obtained by using two different CT-scan protocols. The results showed correct skull fracture diagnoses in 34/56 cases. Fractures were diagnosed partially (9) or missed totally (13) on CT-images in 22 cases. The agreement for fracture diagnoses...

  5. Iron-Folic Acid Supplementation During Pregnancy Reduces the Risk of Stunting in Children Less Than 2 Years of Age: A Retrospective Cohort Study from Nepal

    Yasir Bin Nisar


    Full Text Available The aim of the study was to investigate the effect of antenatal iron-folic acid (IFA supplementation on child stunting in Nepalese children age <2 years. A retrospective cohort study design was used, in which a pooled cohort of 5235 most recent live births 2 years prior to interview from three Nepal Demographic and Health Surveys (2001, 2006 and 2011 was analysed. The primary outcome was stunting in children age <2 years. The main exposure variable was antenatal IFA supplementation. Multivariate Poisson regression analysis was performed. In our sample, 31% and 10% of Nepalese children age <2 years were stunted and severely stunted, respectively. The adjusted relative risk of being stunted was 14% lower in children whose mothers used IFA supplements compared to those whose mothers did not use (aRR = 0.86, 95% CI = 0.77–0.97. Additionally, the adjusted relative risk of being stunted was significantly reduced by 23% when antenatal IFA supplementation was started ≤6 months with ≥90 IFA supplements used during pregnancy (aRR = 0.77, 95% CI = 0.64–0.92. Antenatal IFA supplementation significantly reduced the risk of stunting in Nepalese children age <2 years. The greatest impact on the risk reduction of child stunting was when IFA supplements were started ≤6 months with ≥90 supplements were used.

  6. Role of Postoperative Radiotherapy for Stage I/II/III Thymic Tumor - Results of the ChART Retrospective Database

    Qianwen LIU


    Full Text Available Background and objective Postoperative radiotherapy (PORT for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I/II/III thymic tumor. Methods The database of Chinese Alliance of Research for Thymomas (ChART was retrieved for patients with stage I/II/III thymic tumor who underwent surgical therapy without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death. Results 1,546 stage I/II/III patients were identified from ChART database. Among these patients, 649 (41.98% underwent PORT. PORT was associated with gender, histologic type (World Health Organization, WHO, surgical extent, complete resection, Masaoka stage and adjuvant chemotherapy. The 5-yr and 10-yr overall survival (OS rates and disease-free survival (DFS rate for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001, P<0.001 respectively. In univariate analysis, age, histologic type (WHO, Masaoka stage, completeness of resection, and PORT were associated with OS. Multivariable analysis showed that histologic type (WHO(P=0.001, Masaoka stage (P=0.029 and completeness of resection (P=0.003 were independently prognostic factors of OS. In univariate analysis, gender, myasthenia gravis, histologic type (WHO, Masaoka stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariable analysis showed that histologic type (WHO (P<0.001, Masaoka stage (P=0.005 and completeness of resection (P=0.006 were independently prognostic factors of DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved the better OS and DFS (P=0.010, 0.017, respectively. However, patients with complete resection underwent PORT had the worse OS and DFS (P<0.001, P<0

  7. Craniocerebral trauma--congruence between post-mortem computed tomography diagnoses and autopsy results: a 2-year retrospective study.

    Jacobsen, Christina; Lynnerup, Niels


    Computed tomography (CT) has been used routinely at the Department of Forensic Medicine, University of Copenhagen since 2002. A retrospective study was performed in order to correlate CT-scan based diagnoses of cranial and cerebral lesions with macroscopic autopsy diagnoses in 56 cases. The CT-scans were performed by a forensic pathologist. They were obtained by using two different CT-scan protocols. The results showed correct skull fracture diagnoses in 34/56 cases. Fractures were diagnosed partially (9) or missed totally (13) on CT-images in 22 cases. The agreement for fracture diagnoses of the anterior, medial and posterior cranial fossae was 20%, 52% and 60%, respectively. Fractures involving bilateral bones were diagnosed correctly more frequently. The diagnostic agreement regarding brain injuries varied from 0% to 79%. Both the autopsy-reports and CT-scan descriptions need to be standardized in order to secure more exact comparisons in the future.

  8. Off-label use of transmucosal ketamine as a rapid-acting antidepressant: a retrospective chart review

    Nguyen L


    Full Text Available Linda Nguyen,1,2 Patrick J Marshalek,2 Cory B Weaver,1 Kathy J Cramer,2,3 Scott E Pollard,2,4 Rae R Matsumoto1,2,5 1Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV, USA; 2Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, USA; 3Doctor of Nursing Practice Program, Robert Morris University, Moon Township, PA, USA; 4Department of Behavioral Health, West Park Hospital, Cody, WY, USA; 5College of Pharmacy, Touro University California, Vallejo, CA, USA Objective: This study evaluated the effectiveness and safety of subanesthetic doses of ketamine using an off-label, transmucosal administration route in patients with treatment-resistant depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant major depressive disorder. Seventeen such patients who received subanesthetic doses of ketamine were included. Patient demographics, efficacy (drug refill, clinician notes, side effects, and concurrent medications were assessed.Results: Benefit from low-dose transmucosal ketamine was noted in 76% of subjects (average age 48 years, 88% female, with a dose duration lasting 7–14 days. No notable side effects were noted. The most common classes of concurrent medications to which ketamine was added were serotonin–norepinephrine reuptake inhibitors (59%, stimulants (47%, folate replacement (47%, and benzodiazepines (47%.Conclusion: Our results provide preliminary evidence of the effectiveness and safety of low-dose transmucosal ketamine in treatment-resistant patients. A controlled, prospective pilot study is warranted to validate these findings. Keywords: ketamine, depression, treatment resistance, NMDA receptor, glutamate, mood disorder 

  9. Influence of proton pump inhibitors and histamine H2 receptor antagonists on serum phosphorus level control by calcium carbonate in patients undergoing hemodialysis: a retrospective medical chart review

    Tatsuzawa, Masaomi; Ogawa, Ryuichi; OHKUBO, Atsushi; Shimojima, Kazuyo; Maeda, Kunimi; Echizen, Hirotoshi; Miyazaki, Akihisa


    Background Hyperphosphatemia is one of the common complications in patients undergoing hemodialysis. Although calcium carbonate (CaC) is often used to control serum inorganic phosphorus level in dialysis patients, co-administration of gastric acid reducers (ARs) may interfere with the phosphate binding effect of CaC. We performed a retrospective medical chart review to study whether ARs attenuate the hypophosphatemic effect of CaC in patients undergoing hemodialysis. Methods One hundred and e...

  10. Seriousness, preventability, and burden impact of reported adverse drug reactions in Lombardy emergency departments: a retrospective 2-year characterization

    Perrone V


    Full Text Available Valentina Perrone,1,* Valentino Conti,2,* Mauro Venegoni,2 Stefania Scotto,2 Luca Degli Esposti,3 Diego Sangiorgi,3 Lucia Prestini,4 Sonia Radice,1 Emilio Clementi,5,6 Giuseppe Vighi,2,4 1Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital Luigi Sacco, Università di Milano, Milan, Italy; 2Regional Centre for Pharmacovigilance, Lombardy, Milan, Italy; 3CliCon Srl, Health, Economics and Outcomes Research, Ravenna, Italy; 4Unit of Clinical Pharmacology and Pharmacovigilance, Niguarda Ca’Granda Hospital, Milan, Italy; 5Unit of Clinical Pharmacology, CNR Institute of Neuroscience, Department of Biomedical and Clinical Sciences, University Hospital Luigi Sacco, Università di Milano, Milan, Italy; 6Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy *These authors contributed equally to the work Objective: The purpose of this study was to determine the prevalence of adverse drug reactions (ADRs reported in emergency departments (EDs and carry out a thorough characterization of these to assess preventability, seriousness that required hospitalization, subsequent 30-day mortality, and economic burden. Methods: This was a retrospective cohort study of data from an active pharmacovigilance project at 32 EDs in the Lombardy region collected between January 1, 2010 and December 31, 2011. Demographic, clinical, and pharmacological data on patients admitted to EDs were collected by trained and qualified monitors, and deterministic record linkage was performed to estimate hospitalizations. Pharmacoeconomic analyses were based on Diagnosis-Related Group reimbursement. Results: 8,862 ADRs collected with an overall prevalence rate of 3.5 per 1,000 visits. Of all ADRs, 42% were probably/definitely preventable and 46.4% were serious, 15% required hospitalization, and 1.5% resulted in death. The System Organ Classes most frequently associated with ADRs were: skin and subcutaneous tissue, gastrointestinal

  11. Preoperative Induction Therapy for Locally Advanced Thymic Tumors: A Retrospective Analysis Using the ChART Database

    Yucheng WEI


    Full Text Available Background and objective To evaluate the role of preoperative induction therapy on prognosis of locally advanced thymic malignancies. Methods Between 1994 and 2012, patients received preoperative induction therapies (IT group in the Chinese Alliance for Research in Thymomas (ChART database, were compared with those having surgery directly after preoperative evaluation (DS group. All tumors receiving induction therapies were locally advanced (clinically stage III-IV before treatment and those turned out to be in pathological stage I and II were considered downstaged by induction. Clinical pathological characteristics were retrospectively analyzed. To more accurately study the effect of induction therapies, stage IV patients were then excluded. Only stage I-III tumors in the IT group and stage III cases in the DS group were selected for further comparison in a subgroup analysis. Results Only 68 (4% out of 1,713 patients had induction therapies, with a R0 resection of 67.6%, 5-year recurrence of 44.9%, and 5- and 10-year overall survivals (OS of 49.7% and 19.9%. Seventeen patients (25% were downstaged after induction. Significantly more thymomas were downstaged than thymic carcinomas (38.7% vs 13.9%, P=0.02. Tumors downstaged after induction had significantly higher 5-year OS than those not downstaged (93.8% vs 35.6%, P=0.013. For the subgroup analysis when stage IV patients were excluded, 5-year OS was 85.2% in the DS group and 68.1% in the IT group (P<0.001, although R0 resection were similar (76.4% vs 73.3%, P=0.63. However, 5-year OS in tumors downstaged after induction (93.8% was similar to those in the DS group (85.2%, P=0.438, both significantly higher than those not downstaged after induction (35.6%, P<0.001. Conclusion Only 68 (4% out of 1,713 patients had induction therapies, with a R0 resection of 67.6%, 5-year recurrence of 44.9%, and 5- and 10-year overall survivals (OS of 49.7% and 19.9%. Seventeen patients (25% were downstaged after

  12. Nefazodone in psychotic unipolar and bipolar depression: a retrospective chart analysis and open prospective study on its efficacy and safety versus combined treatment with amitriptyline and haloperidol.

    Grunze, Heinz; Marcuse, Alain; Schärer, Lars O; Born, Christoph; Walden, Jörg


    Although atypical antipsychotics are on the rise, traditional treatment of psychotic (or delusional) depression mostly includes the addition of classical antipsychotics to antidepressants. As there are only few data supporting this approach compared with antidepressant monotherapy, and almost no data comparing it with antidepressants of the latest generation, we conducted a retrospective chart analysis and a prospective, randomized open study on the efficacy and tolerability of nefazodone monotherapy versus combined treatment with amitriptyline and haloperidol in psychotic depression. The results suggest that the addition of classical antipsychotics should be reserved for those with very severe psychotic symptoms, but may not be needed in milder forms.

  13. Impact of poor mental health in adult spinal deformity patients with poor physical function: a retrospective analysis with a 2-year follow-up.

    Bakhsheshian, Joshua; Scheer, Justin K; Gum, Jeffrey L; Hostin, Richard; Lafage, Virginie; Bess, Shay; Protopsaltis, Themistocles S; Burton, Douglas C; Keefe, Malla Kate; Hart, Robert A; Mundis, Gregory M; Shaffrey, Christopher I; Schwab, Frank; Smith, Justin S; Ames, Christopher P


    OBJECTIVE Mental disease burden can have a significant impact on levels of disability and health-related quality of life (HRQOL) measures. Therefore, the authors investigated the significance of mental health status in adults with spinal deformity and poor physical function. METHODS A retrospective analysis of a prospective multicenter database of 365 adult spinal deformity (ASD) patients who had undergone surgical treatment was performed. Health-related QOL variables were examined preoperatively and at the 2-year postoperative follow-up. Patients were grouped by their 36-Item Short Form Health Survey mental component summary (MCS) and physical component summary (PCS) scores. Both groups had PCS scores ≤ 25th percentile for matched norms; however, the low mental health (LMH) group consisted of patients with an MCS score ≤ 25th percentile, and the high mental health (HMH) group included patients with an MCS score ≥ 75th percentile. RESULTS Of the 264 patients (72.3%) with a 2-year follow-up, 104 (28.5%) met the inclusion criteria for LMH and 40 patients (11.0%) met those for HMH. The LMH group had a significantly higher overall rate of comorbidities, specifically leg weakness, depression, hypertension, and self-reported neurological and psychiatric disease processes, and were more likely to be unemployed as compared with the HMH group (p 0.05) except for the greater improvements in the MCS and the Scoliosis Research Society-22r questionnaire (SRS-22r) mental domain (p mental domain (p mental and physical health, according to their MCS and PCS scores, have higher medical comorbidity and unemployment rates, they still demonstrate significant improvements in HRQOL measurements postoperatively. Both LMH and HMH patient groups demonstrated similar improvements in most HRQOL domains, except that the LMH patients had difficulties in obtaining improvements in the PCS domain.

  14. Does pre-ordering tests enhance the value of the periodic examination? Study Design - Process implementation with retrospective chart review

    Stroebel Robert J


    Full Text Available Abstract Background To evaluate the value of a pre-ordering process for the pro-active scheduling and completion of appropriate preventive and chronic disease monitoring tests prior to a periodic health examination (PHE. Methods A standardized template was developed and used by our nursing staff to identify and schedule appropriate tests prior to the patients PHE. Chart reviews were completed on all 602 PHE visits for a 3-month interval in a primary care setting. A patient satisfaction survey was administered to a convenience sample of the PHE patients. Results Of all the patients with tests pre-ordered, 87.8% completed the tests. All providers in the division used the process, but some evolved from one template to another over time. Most patients (61% preferred to get their tests done prior to their PHE appointment. Many of our patients had abnormal test results. With this process, patients were able to benefit from face-to-face discussion of these results directly with their provider. Conclusions A pre-order process was successfully implemented to improve the value of the PHE visit in an internal medicine primary care practice using a standardized approach that allowed for provider autonomy. The process was accepted by patients and providers and resulted in improved office efficiency through reduced message handling. Completion of routine tests before the PHE office visit can help facilitate face-to-face discussions about abnormal results and subsequent management that otherwise may only occur by telephone.

  15. Postoperative Survival for Patients with Thymoma Complicating Myasthenia Gravis
- Preliminary Retrospective Results of the ChART Database

    Fangrui WANG


    Full Text Available Background and objective It is so far not clear that how myasthenia gravis (MG affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG. Methods The Chinese Alliance for Research in Thymomas (ChART registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, Patients were followed and their survival status were analyzed. Results There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05. There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05 in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5 year and 10 year OS rates were both higher in MG group (93% vs 88%; 83% vs 81%, P=0.034 respectively. The survival rate was significantly higher in patients with MG when the Masaoka staging was III/IV (P=0.003. Among patients with advanced stage thymoma (stage III, IVa, IVb, the constituent ratios of III, IVa, IVb were similar between MG and Non-MG group. Histologically, however, there were significantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000. Univariate analyses for all patients showed that MG, WHO classification, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were significant factors, and multivariate analysis showed WHO Classification, Masaoka stage, and resectability were strong independent prognostic indicators. Conclusion Although MG is not an independent prognostic factor, the survival of patients with thymoma was superior when MG was present, especially in late

  16. Iron-Folic Acid Supplementation During Pregnancy Reduces the Risk of Stunting in Children Less Than 2 Years of Age: A Retrospective Cohort Study from Nepal.

    Nisar, Yasir Bin; Dibley, Michael J; Aguayo, Victor M


    The aim of the study was to investigate the effect of antenatal iron-folic acid (IFA) supplementation on child stunting in Nepalese children age pregnancy (aRR = 0.77, 95% CI = 0.64-0.92). Antenatal IFA supplementation significantly reduced the risk of stunting in Nepalese children age <2 years. The greatest impact on the risk reduction of child stunting was when IFA supplements were started ≤6 months with ≥90 supplements were used.

  17. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review.

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin


    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs were susceptible to vancomycin, meropenem, penicillin and ceftriaxone, respectively.

  18. Long-lasting effects of anti-VEGF/photodynamic combination therapy in the treatment of exudative age-related macular degeneration: a retrospective chart review

    Silva-Garcia R


    Full Text Available Rosemary Silva-Garcia, Colleen McLellan, Fadi S Shaya, Kent W Small Macula and Retina Institute, Molecular Insight Research Foundation, Cedars-Sinai Medical Towers, Glendale, CA, USA Purpose: To examine the potential long-term benefit of an anti-VEGF/photodynamic therapy (PDT combination on patients treated for wet age-related macular degeneration (AMD.Methods: A retrospective chart review was conducted on 29 eyes (subjects from 26 patients (eight male and 18 female that showed sustained, positive response to combination therapy for exudative AMD for a minimum of 1 year. Collected data included: visual acuity, central retinal thickness, intraocular pressure and history of glaucoma, wet AMD onset and treatment history, concomitant use of anticoagulants and past history or development of cerebrovascular or cardiovascular disease while receiving combination therapy. Results: Subjects underwent an average of five injections and two PDT treatments in total over 16 months before the choroidal neovascular membrane (CNVM stabilized and became inactive for at least 1 year. Prior to the effective anti-VEGF/PDT combination therapy the median Snellen visual acuity ranged from 20/200 to 20/250 and presented at no worse than 20/200 at 1 year after treatment. Some subjects were followed for up to 5 years and remained inactive.Conclusion: Combination therapy can cause long-lasting closure of the CNVM, even with advanced disease resistant to anti-VEGF monotherapy. Keywords: anti-vascular endothelial growth factor, photodynamic therapy, age-related macular degeneration, bevacizumab, visual acuity, intraocular pressure

  19. Use of basal insulin and the associated clinical outcomes among elderly nursing home residents with type 2 diabetes mellitus: a retrospective chart review study

    Davis KL


    Full Text Available Keith L Davis,1 Wenhui Wei,2 Juliana L Meyers,1 Brett S Kilpatrick,3 Naushira Pandya4 1RTI Health Solutions, Research Triangle Park, NC, USA; 2Sanofi US, Inc, Bridgewater, NJ, USA; 3AnalytiCare, LLC, Glenview, IL, USA; 4Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA Background: The management of type 2 diabetes mellitus in long-term care (LTC settings can be complex as a result of age-related complications. Despite guideline recommendations, sliding scale insulin remains commonplace in the LTC setting and data on basal insulin use are lacking.Methods: This retrospective study used medical chart data and the Minimum Data Set from elderly LTC facility patients who received basal insulin (insulin glargine, insulin detemir, or neutral protamine Hagedorn insulin for the treatment of diabetes, to investigate the practice patterns and associated clinical outcomes.Results: A total of 2,096 elderly, insulin-treated patients in LTC were identified, with 59.5% of them (N=1,247 receiving basal insulin. Of these, more than 50% of patients received sliding scale insulin in co-administration with basal insulin. Despite its ease of use, insulin pen use was very low, at 14.6%. Significant differences were observed between the basal insulin groups for glycated hemoglobin level and dosing frequency. Hypoglycemia was uncommon -17.2% of patients experienced at least one event, and there was no significant difference in the prevalence of hypoglycemia between the groups.Conclusion: These data suggest the underutilization of basal insulin in the LTC setting and worryingly high combinational use with sliding scale insulin. Differences in glycated hemoglobin and dosing frequencies between types of basal insulin warrant further comparative effectiveness studies. Keywords: long-term care, nursing homes, type 2 diabetes mellitus, insulin detemir, insulin glargine, NPH insulin

  20. Changes in Intra-pelvic Obliquity Angle 0-2 Years After Total Hip Arthroplasty and Its Effects on Leg Length Discrepancy:A Retrospective Study

    Yin Zhang; Tao Cheng; Xian-Long Zhang


    Background:Total hip arthroplasty (THA) is one of the most effective treatments for phase Ⅲ and Ⅳ hip arthrosis.Lower limb length balancing is one of the determining factors of a successful surgery,particularly in patients with developmental dysplasia of the hip (DDH).The purpose of this study was to evaluate the postoperative change in intra-pelvic obliquity (intra-PO) angle in the coronal plane and its effects on leg length discrepancy (LLD) within 2 years.Methods:A total of 78 patients (70 females,8 males) were enrolled in this study.All patients were suffering from DDH with varying degrees of LLD.Pelvic plain radiographs were collected before and after the operation.The intra-PO angles were measured 0,0.5,1 and 2 years after THA.At the same time,postoperative LLD was measured with blocking test.Results:PO changed significantly in the first year after THA surgery (0 year vs.0.5 year,P < 0.01;0.5 year vs.1 year,P < 0.01),and the changing value of intra-PO angle (△PO) slowed down substantially during the first 2 years after THA (0.5 year vs.0.5-1 year,P < 0.01;0.5-1 year vs.1-2 years,P < 0.01).With the change in intra-PO angle,LLD also got narrow within the 1st year (0 year vs.0.5 year,P < 0.01;0.5 year vs.1 year,P < 0.01).Elderly patients had a smaller intra-PO angle reduction (Group A vs.Group B,P =0.01;Group B vs.Group C,P< 0.01).Conclusions:Intra-PO angle and LLD gap narrowed with time after THA surgery.In particular,elderly patients had smaller change in intra-PO angle.

  1. 口腔种植术后随访2年回顾研究%Retrospective analysis of 2-year follow-up after oral implanted operation

    谭玉莲; 彭国光; 王科; 吴美珍; 陈有群; 招燕霞


    Objective:To observe the clinical effect of osseointegration of implants for 2 years. Method:From 2011 January to 2012 December,there were 298 osseointegrated implants used in the Hospital of Tradi-tional Chinese Medicine(FSTCM), including 266 cases of ITI system, 32 cases of 3I system. All the im-plants were completed the repair of upper structure before 2013 June and the mean follow-up was 8 month. Result: Of all the patients, 147 patients were satisfied with the treatment effect, but there were food impaction in 10 cases, prosthesis loosening in 5 cases, occlusion discomfort in 3 cases, and 1 case was unable to chew, 1 case was not satisfied with gingival aesthetics, 1 case was maxillary numb after operation, 4 cases were not satisfied with prosthesis (3 cases were satisfied with restoration, 1 cases could accept.). The tatal satisfactory rate was 87.5%. There were peri implantitis in 13 implants (8 pa-tients), and 4 implants dropped off. During the mean follow-up time of 8 months, there were prosthesis loosening in 7 cases, prosthesis fracture in 1 case, 7 cases of porcelain. According to Wheeler standard statistics, The survival rate was 95.20% in 8 months (mean time). Conclusion: The survival rate in os-seointegrated implant restoration is high, which is worth applied.%目的:回顾骨结合种植体应用2年的临床效果观察。方法:2011年1月至2012年12月在佛山市中医院口腔种植中心植入的骨结合种植体共298枚,其中ITI系统有266枚,3I系统有32枚,全部种植体均在2013年6月前完成上部结构修复,平均追踪8个月。观察方法为X线检查和临床检查。采用Wheeler存留标准评估,纳入Kaplan2Meier存留曲线统计。结果:种植修复体完成时147例患者对修复效果满意,10例患者出现食物嵌塞,5例修复体松动,3例咬物不适,1例咀嚼无力,1例牙龈美学不满意,1例患者出现术后上颌麻木,4例患者对修复体欠满意,重做后3

  2. Vitamin Chart

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Vitamin Chart KidsHealth > For Teens > Vitamin Chart A A A en español Tabla de las vitaminas Type Benefits Sources Quantity Vitamin A Vitamin A prevents eye problems, promotes a ...

  3. Vitamin Chart

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  4. MIXMAX charts

    Albers, Willem


    For attribute data with (very) small failure rates control charts based on subsequent groups of r failure times, for some r >= 1, have been shown to be attractive. This especially holds for charts which stop once the maximum (MAX) of such a group is sufficiently small, as this choice allows a nonpar

  5. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey

    Sadosky A


    Full Text Available Alesia Sadosky,1 Caroline Schaefer,2 Rachael Mann,3 Felicia Bergstrom,2 Rebecca Baik,2 Bruce Parsons,1 Srinivas Nalamachu,4 Edward Nieshoff,5 Brett R Stacey,6 Alan Anschel,7 Michael Tuchman81Pfizer Inc, New York, NY, 2Covance Market Access Services Inc, Gaithersburg, MD, 3Covance Market Access Services Inc, San Diego, CA, 4International Clinical Research Institute, Overland Park, KS, 5Rehabilitation Institute of Michigan/Wayne State University, Detroit, MI, 6Oregon Health and Science University, Portland, OR, 7Rehabilitation Institute of Chicago, Chicago, IL, 8Palm Beach Neurological Center, Palm Beach Gardens, FL, USABackground: The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN seeking treatment in the US.Methods: This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.Results: The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%, depressive symptoms (41.1%, and anxiety (35.7%. The mean pain severity score was 5.2 (0–10 scale, and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0–10 scale overall, with 2.0 among mild, 5.1 among moderate, and 7

  6. Chart Series

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) offers several different Chart Series with data on beneficiary health status, spending, operations, and quality...

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    National Oceanic and Atmospheric Administration, Department of Commerce — The Radar Chart collection is an archived product of summarized radar data. The geographic coverage is the 48 contiguous states of the United States. These hourly...

  8. Patient Treatment Tracking Chart

    ... ZIP code here Hepatitis C Treatment Tracking Chart Patient Treatment Tracking Chart Patient Treatment Tracking Chart Sample Chart This chart is ... this website Submit Share this page Related Resource Patient Treatment Tutorial return to top CONNECT Veterans Crisis ...

  9. Discoid Lupus and Human Immunodeficiency Virus: A Retrospective Chart Review to Determine the Prevalence and Progression of Co-occurrence of these Conditions at a Single Academic Center

    Two, Aimee; So, Jessica Kim; Paravar, Taraneh


    Context: Discoid lupus erythematosus (DLE) and human immunodeficiency virus (HIV) are both disorders of the immune system. The pathophysiology of these diseases varies greatly as DLE is characterized by an overactive immune system that attacks normal host cells, whereas HIV is characterized by an exogenous attack on the immune system that depletes it of key cell types. Although the reason is unknown, co-occurrence of DLE and HIV is rare. Aims: The goal of this study is to determine the prevalence of co-occurrence of DLE and HIV and to determine whether patients with both DLE and HIV share any clinical feature. Subjects and Methods: The medical records of all patients seen within a single academic health center over a 20-year period were reviewed to determine the prevalence of cutaneous lupus, HIV, and co-occurrence of these conditions. The charts of patients diagnosed with both conditions were further reviewed to determine similarities between them. Results: Of the 10,719 patients diagnosed with HIV and 182 patients diagnosed with cutaneous lupus, only 2 patients were diagnosed with both conditions. Both of these patients were diagnosed with DLE several years after being diagnosed with HIV. They had an undetectable HIV viral load, normal CD4 T-cell counts, and were on antiretroviral therapy when diagnosed with DLE. Conclusion: These results confirm that co-occurrence of DLE and HIV is rare. Although our study population was small, findings from these patients suggest that in HIV-positive patients, DLE manifestations occur when their HIV disease activity is minimal.

  10. Late appearance and exacerbation of primary Raynaud's phenomenon attacks can predict future development of connective tissue disease: a retrospective chart review of 3,035 patients.

    Pavlov-Dolijanovic, Slavica; Damjanov, Nemanja S; Vujasinovic Stupar, Nada Z; Radunovic, Goran L; Stojanovic, Roksanda M; Babic, Dragan


    To assess the prognostic value of the age at onset of Raynaud's (RP) and of a history of exacerbation of RP attacks for the development of connective tissue disease (CTD) in patients initially found to have primary Raynaud's. 3,035 patients with primary RP (2,702 women and 333 men) were followed for an average of 4.8 years (range from 1 to 10 years). At baseline and every 6 months, they were screened for signs and symptoms of CTD. At 4.8 years of follow-up, 54.7 % patients remained as primary RP, 8.1 % had developed suspected secondary RP, and 37.2 % had developed a definite CTD. Primary RP patients had an earlier onset of RP (mean age of 32.2 years) than those with suspected (mean age 36.5 years, P = .007) or definite secondary RP associated with CTD (mean age of 39.8 years, P = .004). RP beginning before the age of forty was not significantly associated with the development of CTD. Conversely, the appearance of RP after the age of 40 was significantly associated with the development of CTD (P = .00001). Worsening of RP attacks predicted the development of CTD, especially systemic sclerosis (relative risk [RR] of 1.42), scleroderma overlap syndrome (RR of 1.18), and mixed CTD (RR of 1.18). Patients whose onset of RP occurred past 40 years of age and those with worsening RP attacks were at risk for the future development of CTD.

  11. Excel 2007 Charts

    Walkenbach, John


    Excel, the top number-crunching tool, now offers a vastly improved charting function to help you give those numbers dimension and relativity. John Walkenbach, a.k.a. Mr. Spreadsheet, clearly explains all these charting features and shows you how to choose the right chart for your needs. You'll learn to modify data within the chart, deal with missing data, format your chart, use trend lines, construct "impossible" charts, create charts from pivot tables, dress them up with graphics, and more. Note: CD-ROM/DVD and other supplementary materials are not included as part of eBook file.

  12. On regional geomagnetic charts

    Alldredge, L.R.


    When regional geomagnetic charts for areas roughly the size of the US were compiled by hand, some large local anomalies were displayed in the isomagnetic lines. Since the late 1960s, when the compilation of charts using computers and mathematical models was started, most of the details available in the hand drawn regional charts have been lost. One exception to this is the Canadian magnetic declination chart for 1980. This chart was constructed using a 180 degrees spherical harmonic model. -from Author

  13. Robust CUSUM control charting

    Nazir, H.Z.; Riaz, M.; Does, R.J.M.M.; Abbas, N.


    Cumulative sum (CUSUM) control charts are very effective in detecting special causes. In general, the underlying distribution is supposed to be normal. In designing a CUSUM chart, it is important to know how the chart will respond to disturbances of normality. The focus of this article is to control

  14. Fractional smith chart theory

    Shamim, Atif


    For the first time, a generalized Smith chart is introduced here to represent fractional order circuit elements. It is shown that the standard Smith chart is a special case of the generalized fractional order Smith chart. With illustrations drawn for both the conventional integer based lumped elements and the fractional elements, a graphical technique supported by the analytical method is presented to plot impedances on the fractional Smith chart. The concept is then applied towards impedance matching networks, where the fractional approach proves to be much more versatile and results in a single element matching network for a complex load as compared to the two elements in the conventional approach. © 2010 IEEE.

  15. Smart Book Charts

    Chinnapongse, Ronald L.


    Smart book charts for TPSM: Heatshield for Extreme Entry Environment Technology (HEEET), Conformal Ablative TPS (CA-TPS), 3D Woven Multifunctional Ablative TPS (3D MAT), and Adaptable, Deployable, Entry and Placement Technology (ADEPT).

  16. Barograms / Barograph Charts

    National Oceanic and Atmospheric Administration, Department of Commerce — Barograms are weekly rectangular charts recording barometric pressure at a given station. The barograph is an instrument that makes a continuous pen and ink trace of...

  17. Great Lakes Ice Charts

    National Oceanic and Atmospheric Administration, Department of Commerce — Charts show ice extent and concentration three times weekly during the ice season, for all lakes except Ontario, from the 1973/74 ice season through the 2001/2002...

  18. CDC Child Growth Charts

    U.S. Department of Health & Human Services — CDC child growth charts consist of a series of percentile curves that illustrate the distribution of selected body measurements in U.S. children. Pediatric growth...

  19. State-Chart Autocoder

    Clark, Kenneth; Watney, Garth; Murray, Alexander; Benowitz, Edward


    A computer program translates Unified Modeling Language (UML) representations of state charts into source code in the C, C++, and Python computing languages. ( State charts signifies graphical descriptions of states and state transitions of a spacecraft or other complex system.) The UML representations constituting the input to this program are generated by using a UML-compliant graphical design program to draw the state charts. The generated source code is consistent with the "quantum programming" approach, which is so named because it involves discrete states and state transitions that have features in common with states and state transitions in quantum mechanics. Quantum programming enables efficient implementation of state charts, suitable for real-time embedded flight software. In addition to source code, the autocoder program generates a graphical-user-interface (GUI) program that, in turn, generates a display of state transitions in response to events triggered by the user. The GUI program is wrapped around, and can be used to exercise the state-chart behavior of, the generated source code. Once the expected state-chart behavior is confirmed, the generated source code can be augmented with a software interface to the rest of the software with which the source code is required to interact.

  20. Language Development: 2 Year Olds

    ... Listen Español Text Size Email Print Share Language Development: 2 Year Olds Page Content Article Body Your ... At this time, there’s more variation in language development than in any other area. While some preschoolers ...

  1. Synthetic growth reference charts

    Hermanussen, Michael; Stec, Karol; Aßmann, Christian; Meigen, Christof; Van Buuren, Stef


    Objectives: To reanalyze the between-population variance in height, weight, and body mass index (BMI), and to provide a globally applicable technique for generating synthetic growth reference charts. Methods: Using a baseline set of 196 female and 197 male growth studies published since 1831, common

  2. Understanding Graphs & Charts.

    Cleary, John J.; Gravely, Mary Liles

    Developed by educators from the Emily Griffith Opportunity School, this teacher's guide was developed for a 4-hour workshop to teach employees how to read the charts and graphs they need in the workplace. The unit covers four types of graphs: pictographs, bar graphs, line graphs, and circle graphs. The guide is divided into four sections: reading…

  3. Weighing Rain Gauge Recording Charts

    National Oceanic and Atmospheric Administration, Department of Commerce — Weighing rain gauge charts record the amount of precipitation that falls at a given location. The vast majority of the Weighing Rain Gauge Recording Charts...

  4. NOAA Raster Navigational Charts (RNC)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA, National Ocean Service, Office of Coast Survey, Marine Chart Division is responsible to build and maintain a suite of more than 1000 nautical charts that are...

  5. Growth Charts (For Parents)

    ... the same pattern until he was 2 years old, then suddenly started growing at a much slower rate than other kids. ... follow along the same growth pattern over time, growing in height and gaining ... curve. So if our 4-year-old boy on the 10th percentile line has always ...

  6. Flash Builder charting and multimedia

    Rocchi, Cesare


    Charting and multimedia are two vital tools for data-driven applications. Learn about the main components of the chart library included in Flash Builder, and see how to build and customize widely used charts. Turning your attention to the multimedia capabilities of the Flex framework, you will review the multimedia components built into the Flex library, and learn how to use ActionScript to manipulate video and audio files. Charting and Multimedia is the third of five articles that will be compiled in the book, Data Visualization with Flash Builder: Designing RIA and AIR Applications with Rem


    K. Thaga


    Full Text Available

    ENGLISH ABSTRACT: This paper proposes an exponentially weighted moving average (EWMA control chart that is capable of detecting changes in both process mean and standard deviation for autocorrelated data (referred to as the Maximum Exponentially Weighted Moving Average Chart for Autocorrelated Process, or MEWMAP chart. This chart is based on fitting a time series model to the data, and then calculating the residuals. The observations are represented as a first-order autoregressive process plus a random error term. The Average Run Lengths (ARLs for fixed decision intervals and reference values (h, k are calculated. The proposed chart is compared with the Max-CUSUM chart for autocorrelated data proposed by Thaga (2003. Comparisons are based on the out-of-control ARLs. The MEWMAP chart detects moderate to large shifts in the mean and/or standard deviation at both low and high levels of autocorrelations more quickly than the Max-CUSUM chart for autocorrelated processes.

    AFRIKAANSE OPSOMMING: Die navorsing stel voor dat 'n eksponensiaal geweegde bewegende gemiddelde kontrolekaart gebruik word om verandering van prosesgemiddelde en – standaardafwyking van outogekorreleerde data te bepaal. Die kontrolekaart word gedryf deur passing van 'n tydreeks as datamodel met bepaling van residuwaardes. Met hierdie gegewens as vertrekpunt word gemiddelde looplengtes vir vaste besluitintervalle en verwysingwaardes (h, k bereken. Die kontrolekaart bepaal matige en groot verskuiwings van waardes vir hoë en lae outokorrelasiewaardes heel snel.

  8. Art/Dance Developmental Chart.

    Kinda, Crystal L., Comp.; Hand, Leslie, Comp.

    A developmental chart of dance and art is presented according to Piaget's three stages of mental development: intuitive thought, concrete operations, and formal operations. Development is charted for dance/movement and art beginning with a sensorimotor unit (1 to 3 years), through self awareness (3 to 5 years), motor skills (5 to 7 years), form (7…

  9. Growth charts of human development

    Van Buuren, Stef


    This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate s

  10. Acuity systems and control charting.

    Shaha, S H


    The strengths of control charting and other statistical process control (SPC) tools have not previously been applied to acuity systems. Intermountain Health Care, Salt Lake City, Utah, developed a new acuity system that relies heavily upon control charting for an array of purposes, including immediate feedback to caregivers regarding decisions, ongoing feedback to managers regarding decision patterns, and longer-term feedback regarding trends and budget-relevant information. The use of control charts has eliminated the need for auditing acuity-based staffing and has maintained the reliability of classifications at levels above 95 percent. Implications for other novel applications are offered.

  11. Charting Transnational Native American Studies

    Hsinya Huang


    Full Text Available Introduction to the Special Forum entitled "Charting Transnational Native American Studies: Aesthetics, Politics, Identity," edited by Hsinya Huang, Philip J. Deloria, Laura M. Furlan, and John Gamber

  12. Inland Electronic Navigational Charts (IENC)

    Army Corps of Engineers, Department of the Army, Department of Defense — These Inland Electronic Navigational Charts (IENCs) were developed from available data used in maintenance of Navigation channels. Users of these IENCs should be...

  13. NOAA Electronic Navigational Charts (ENC)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Coast Survey (OCS) has been involved in the development of a NOAA Electronic Navigational Chart (NOAA ENC) suite to support the marine transportation...

  14. 7 CFR 51.2276 - Color chart.


    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Color chart. 51.2276 Section 51.2276 Agriculture... Standards for Shelled English Walnuts (Juglans Regia) General § 51.2276 Color chart. The color chart (USDA Walnut Color Chart) to which reference is made in §§ 51.2281 and 51.2282 illustrates the four shades...

  15. Fuzzy multinomial control chart and its application

    Wibawati, Mashuri, Muhammad; Purhadi, Irhamah


    Control chart is a technique that has been used widely in industry and services. P chart is the simplest control chart. In this chart, item is classified into two categories as either conforming and non conforming. This chart based on binomial distribution. In practice, each item can classify in more than two categories such as very bad, bad, good and very good. Then to monitor the process we used multinomial p control chart. However, if the classification is an element of vagueness, the fuzzy multinomial control chart (FM) is more appropriately used. Control limit of FM chart obtained multinomial distribution and the degree of membership using fuzzy trianguler are 0, 0.25. 0.5 and 1. This chart will be applied to the data glass and will compare with multinomial p control chart.

  16. Flowcharting with D-charts

    Meyer, D.


    A D-Chart is a style of flowchart using control symbols highly appropriate to modern structured programming languages. The intent of a D-Chart is to provide a clear and concise one-for-one mapping of control symbols to high-level language constructs for purposes of design and documentation. The notation lends itself to both high-level and code-level algorithmic description. The various issues that may arise when representing, in D-Chart style, algorithms expressed in the more popular high-level languages are addressed. In particular, the peculiarities of mapping control constructs for Ada, PASCAL, FORTRAN 77, C, PL/I, Jovial J73, HAL/S, and Algol are discussed.

  17. AMDIS and CHART update. 1

    Murakami, I.; Kato, T. [National Inst. for Fusion Science, Toki, Gifu (Japan); Igarashi, A. [Miyazaki Univ., Miyazaki (JP)] [and others


    A working group for updating atomic and molecular collision data in the NIFS database AMDIS (electron scattering) and CHART (ion scattering) has been organized. This group has searched and reviewed literatures for collecting relevant atomic data with are to be included into the database. This is a summary report of the activities of this working group. (author)

  18. Are estimated control charts in control?

    Albers, W.; Kallenberg, W.C.M.


    Standard control chart practice assumes normality and uses estimated parameters. Because of the extreme quantiles involved, large relative errors result. Here simple corrections are derived to bring such estimated charts under control. As a criterion, suitable exceedance probabilities are used.

  19. NOAA Seamless Raster Navigational Charts (RNC)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Seamless Raster Chart Server provides a seamless collarless mosaic of the NOAA Raster Navigational Charts (RNC). The RNC are a collection of approximately...

  20. Air Emissions Sources, Charts and Maps

    U.S. Environmental Protection Agency — Air Emissions provides (1) interactive charts supporting national, state, or county charts, (2) county maps of criteria air pollutant emissions for a state, and (3)...

  1. Optimality of Non-Restarting CUSUM charts


    We show optimality, in a well-defined sense, using cumulative sum (CUSUM) charts for detecting changes in distributions. We consider a setting with multiple changes between two known distributions. This result advocates the use of non-restarting CUSUM charts with an upper boundary. Typically, after signalling, a CUSUM chart is restarted by setting it to some value below the threshold. A non-restarting CUSUM chart is not reset after signalling; thus is able to signal continuously. Imposing an ...

  2. 7 CFR 51.2946 - Color chart.


    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Color chart. 51.2946 Section 51.2946 Agriculture... Standards for Grades of Walnuts in the Shell General § 51.2946 Color chart. The color chart (USDA Walnut Color Chart) to which reference is made in §§ 51.2948, 51.2949, 51.2950, 51.2954, and...

  3. Improving the performance of CUSUM charts

    Riaz, M.; Abbas, N.; Does, R.J.M.M.


    The control chart is an important statistical technique that is used to monitor the quality of a process. Shewhart control charts are used to detect larger disturbances in the process parameters, whereas CUSUM and EWMA charts are meant for smaller and moderate changes. Runs rules schemes are general

  4. Enhancing the performance of EWMA charts

    Abbas, N.; Riaz, M.; Does, R.J.M.M.


    Control charts are extensively used in processes and are very helpful in determining the special cause variations so that a timely action may be taken to eliminate them. One of the charting procedures is the Shewhart-type control charts, which are used mainly to detect large shifts. Two alternatives

  5. Interstitial inflammatory lesions of the pulmonary allograft: a retrospective analysis of 2697 transbronchial biopsies

    Burton, C.M.; Iversen, M.; Carlsen, J.


    of 2697 biopsies were evaluated corresponding to a mean of 6+/-2 (median 8) completed schedules per patient. Diffuse alveolar damage (DAD) was the second most common histological finding within the first 2 weeks after transplantation. The peak prevalence of bronchiolitis obliterans organizing pneumonia......, incidence and possible associations between commonly identified inflammatory and fibrotic lesions in the pulmonary allograft. METHODS: Retrospective chart review of all transbronchial biopsies performed within the first 2 years of 299 lung-transplanted patients in the period 1996 to 2006. RESULTS: A total.......0001, respectively). Acute cellular rejection was not associated with DAD, and patients with lymphocytic bronchiolitis were not more likely to demonstrate features of organizing pneumonia (DAD or BOOP). CONCLUSIONS: Histologic findings of ACR, lymphocytic bronchiolitis, BOOP, and interstitial pneumonitis were...

  6. Continuity Adjustment for Control Charts for Attributes

    L.K. Chan; T.K. Mak; B. Tao


    A unified approach is proposed for making a continuity adjustment on some control charts for attributes, e.g., np-chart and c-chart, through adding a uniform (0, 1) random observation to the conventional sample statistic (e.g., npi and ci). The adjusted sample statistic then has a continuous distribution. Consequently, given any Type I risk α (the probability that the sample statistic is on or beyond the control limits),control charts achieving the exact value of α can be readily constructed. Guidelines are given for when to use the continuity adjustment control chart, the conventional Shewhart control chart (with ±3 standard deviations control limits), and the control chart based on the exact distribution of the sample statistic before adjustment.

  7. Reference values for frequency volume chart and uroflowmetry parameters in adolescent and adult enuresis patients

    Hofmeester, Ilse; Brinker, Astrid E.; Steffens, Martijn G.; Mulder, Zwaan; van Capelle, Jan Willem; Feitz, Wout F.J.; Blanker, Marco H.


    Aims: Reference values of Frequency Volume Chart (FVC) and uroflowmetry parameters for adolescent and adult enuresis patients are lacking. In this study, we aim to describe those parameters, in order to interpret findings from FVCs and uroflowmetries in those patients. Methods: Retrospective, descri

  8. Process management: two control charts.

    McKenzie, L


    It is not at all surprising that many persons avoid involvement in statistical process control. The statistical procedures developed in industry to monitor production processes are somewhat different from those employed in biostatistics and social science applications. Many find it difficult to adjust to these procedures and to apply statistical process control techniques to situations in health care settings. Not everyone involved in a QI process, however, needs to become versed in statistical process control techniques. At the Indiana University Medical Center several persons from different hospital departments have volunteered to form a cadre of internal statistical process control consultants. The group has come to be known by some as the statistical process control "think tank." No doubt a small group of individuals who are interested in statistics, quality control, and computers can be found in most hospitals. While it is necessary that the large majority of managers and supervisors in any health care organization are knowledgeable about process management and control charts at the concept level of understanding, it takes a relatively few to understand and use such control charts. As internal consultants, these few persons can provide technical assistance when such aid is needed.

  9. A Retrospective Study of Amitriptyline in Youth with Autism Spectrum Disorders

    Bhatti, Irfan; Thome, Andrew; Smith, Patricia Oxler; Cook-Wiens, Galen; Yeh, Hung Wen; Gaffney, Gary R.; Hellings, Jessica A.


    We performed a retrospective chart review of 50 youths with Autism Spectrum Disorder (ASD), prescribed amitriptyline (AMI) for hyperactivity and impulsivity. Data was systematically extracted from 50 outpatient clinic charts, including AMI treatment duration, dose, trough levels and adverse events. Mean age was 9.4 years (4.6-17.9); 40 were males…

  10. Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

    Priya Narang


    Full Text Available Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA, early and late postoperative complications and intraocular pressure (IOP. Ultrasound biomicroscopic (UBM evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR] and CDVA (logMAR was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061 and the mean CMT at 2 years was 192.5 ± 5.54 mm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8% case and postoperative uveitis was seen in 2 (5.7% cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.

  11. Electronic applications of the Smith chart

    Smith, Phillip


    The legendary Smith chart inventor's classic reference book describes how the chart is used for designing lumped element and transmission line circuits. Provides tutorial material on transmission line theory and behavior, circuit representation on the chart, matching networks, network transformations and broadband matching. Includes a new chapter with examples designs and description of the winSMITH software accessory. Many computational instruments have succumbed to the power of the digital computer. This is not the case with the Smith Chart. A testament to Phil's genius is that his Smith Cha

  12. How To Prepare Effective Flip Charts.

    National Audio-Visual Supply, East Rutherford, NJ.

    Designed to help create effective flip chart presentations, this guide contains the basic techniques and helpful hints necessary to produce professional, attention-getting flip charts in a step-by-step procedure format. Five topics are addressed in the guide: (1) eight steps to a successful meeting presentation; (2) advantages of flip chart…

  13. Color Charts, Esthetics, and Subjective Randomness

    Sanderson, Yasmine B.


    Color charts, or grids of evenly spaced multicolored dots or squares, appear in the work of modern artists and designers. Often the artist/designer distributes the many colors in a way that could be described as "random," that is, without an obvious pattern. We conduct a statistical analysis of 125 "random-looking" art and design color charts and…

  14. Robust CUSUM control charting for process dispersion

    Nazir, H.Z.; Riaz, M.; Does, R.J.M.M.


    Process monitoring through control charts is a quite popular practice in statistical process control. From a statistical point of view, a superior control chart is one that has an efficient design structure, but having resistance against unusual situations is of more practical importance. To have a

  15. 49 CFR 236.718 - Chart, dog.


    ... 49 Transportation 4 2010-10-01 2010-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog....

  16. 47 CFR 73.333 - Engineering charts.


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Engineering charts. 73.333 Section 73.333 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES FM Broadcast Stations § 73.333 Engineering charts. This section consists of the following Figures 1, 1a, 2,...

  17. The Conjugate Acid-Base Chart.

    Treptow, Richard S.


    Discusses the difficulties that beginning chemistry students have in understanding acid-base chemistry. Describes the use of conjugate acid-base charts in helping students visualize the conjugate relationship. Addresses chart construction, metal ions, buffers and pH titrations, and the organic functional groups and nonaqueous solvents. (TW)


    M. E. Pakdil


    Full Text Available Civil aviation is developing rapidly, and the number of domestic and international operations is increasing exponentially every year than the previous one. Airline companies with increased air traffic and the number of passengers increase the demand of new aircrafts. An aircraft needs not only fuel but also pilot and aeronautical information (charts, digital navigation information, flight plan, and etc. to perform flight operation. One of the most important components in aeronautical information is the terminal chart. Authorized institution in every state is responsible to publish their terminal charts for certain periods. Although these charts are produced in accordance with ICAO’s Annex 4 and Annex 15, cartographic representation and page layout differs in each state’s publication. This situation makes difficult to read them by pilots. In this paper, standard instrument departure (SID charts are analysed to produce by use of cutting-edge and competitive technologies instead of classical computer-aided drawing and vector based graphic applications that are currently used by main chart producers. The goal is to design efficient and commercial chart management system that is able to produce aeronautical charts with same cartographic representation for all states.

  19. Obtaining the Andersen's chart, triangulation algorithm

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation or stabilizing soil response. The process of obtaining the original chart has...

  20. Sticker charts: a method for improving adherence to treatment of chronic diseases in children.

    Luersen, Kara; Davis, Scott A; Kaplan, Sebastian G; Abel, Troy D; Winchester, Woodrow W; Feldman, Steven R


    Poor adherence is a common problem and may be an underlying cause of poor clinical outcomes. In pediatric populations, positive reinforcement techniques such as sticker charts may increase motivation to adhere to treatment regimens. To review the use of sticker charts to improve adherence in children with chronic disease, Medline and PsycINFO searches were conducted using the key words "positive reinforcement OR behavior therapy" and "adherence OR patient compliance" and "child." Randomized controlled retrospective cohort or single-subject-design studies were selected. Studies reporting adherence to the medical treatment of chronic disease in children using positive reinforcement techniques were included in the analysis. The systematic search was supplemented by identifying additional studies identified through the reference lists and authors of the initial articles found. Positive reinforcement techniques such as sticker charts increase adherence to medical treatment regimens. In several studies, this effect was maintained for months after the initial intervention. Better adherence correlated with better clinical outcomes in some, but not all, studies. Few studies examining the use of sticker charts were identified. Although single-subject-design studies are useful in establishing the effect of a behavioral intervention, larger randomized controlled trials would help determine the precise efficacy of sticker chart interventions. Adherence to medical treatments in children can be increased using sticker charts or other positive reinforcement techniques. This may be an effective means to encourage children with atopic dermatitis to apply their medications and improve clinical outcomes.

  1. FusionCharts Beginner's Guide The Official Guide for FusionCharts Suite

    Nadhani, Sanket; Bhattacharya, Shamasis


    The book is written as a practical, step-by-step guide to using FusionCharts Suite. The book not only teaches you the fundamentals and implementation of FusionCharts Suite, but also makes you the data visualization guru among your friends and colleagues by teaching how to select the right chart type and usability tips. Filled with examples, code samples and practical tips in a no-nonsense way, the book is a breeze to read.This book is both for beginners and advanced web developers who need to create interactive charts for their web applications. No previous knowledge of FusionCharts Suite is a

  2. Isomers chart; Table des isomeres

    Dupont-Gautier, P.; Chantelot, S.; Moisson, N. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires


    The nuclear isomers are nuclides offering the same mass number and the same atomic number, but different energy levels. In the following chart the zero energy ground states are omitted and the metastable isomers, i.e. of non-zero energy, known and of measurable lifetime, are listed. The lower limit of this lifetime was set here to 0.1 x 10{sup -6} s. The various isomers were classified in increasing lifetimes. (authors) [French] Les isomeres nucleaires sont des nucleides presentant le meme nombre de masse et le meme numero atomique, mais des niveaux energetiques differents. Dans la table suivante, on a neglige les etats fondamentaux d'energie nulle et on a recense les isomeres metastables, c'est-a-dire d'energie non nulle, connus et de periode mesurable. La limite inferieure de cette periode a ete fixee ici a 0,1 x 10{sup -6} s. Les differents isomeres ont ete classes par periodes croissantes. (auteurs)

  3. Medical Care and Your 1- to 2-Year-Old

    ... Play, and Your 1- to 2-Year-Old Growth and Your 1- to 2-Year-Old Communication and Your 1- to 2-Year-Old Childproofing and Preventing Household Accidents Movement, Coordination, and Your 1- to 2-Year-Old Sleep and Your 1- to 2-Year-Old Your Child's Checkup: 15 Months Your Child's Checkup: 1.5 ...

  4. Control of psychomotor agitation and aggressive behavior in patients with autistic disorder: a retrospective chart review Controle da agitação psicomotora e agressividade em pacientes com autismo: estudo retrospectivo de revisão de prontuário

    Camila Marinho Novaes


    Full Text Available OBJECTIVE: To evaluate the efficacy of pharmacotherapy on the symptoms of psychomotor agitation and aggressive behavior in a sample of patients with autistic spectrum disorder. METHOD: The charts of all patients with a diagnosis of autistic spectrum disorder, receiving care for psychomotor agitation and/or aggressive behavior in two psychiatric outpatient departments between 2001 and 2006, were reviewed. The Clinical Global Impression-Severity and -Improvement scales (CGI-S and CGI-I were applied to the data retrieved from the charts. RESULTS: The majority of the 26 patients included were treated with second-generation antipsychotics. A positive, statistically significant correlation was found between the implementation of pharmacotherapy and a reduction in CGI-S scores (pOBJETIVO: Avaliar a eficácia do tratamento farmacológico dos sintomas de agitação psicomotora e agressividade em amostra de pacientes com transtorno do espectro autista. MÉTODO: Foram revisados os prontuários de pacientes com diagnóstico de transtorno do espectro autista que procuraram atendimento por apresentarem agitação psicomotora e/ou heteroagressividade, atendidos entre 2001 e 2006, em dois ambulatórios de psiquiatria. Para avaliação da evolução dos pacientes aplicou-se às informações do prontuário a escala de Impressão Clínica Global Sintomas (ICG-S e a Impressão Clínica Global Melhora (ICG-M. RESULTADOS: A maioria dos 26 pacientes estava em tratamento com antipsicóticos de segunda geração. Houve correlação positiva e estatisticamente significativa entre a introdução do tratamento farmacológico e a redução nos escores da ICG-S (p<0,05. A evolução do tratamento farmacológico foi melhor para os pacientes sem retardo mental do que para aqueles com retardo mental (p<0,05. A maioria dos pacientes que obteve melhora clínica com o tratamento participava de ao menos uma intervenção auxiliar ao tratamento principal (p<0,05. CONCLUSÃO: Os

  5. Performance Charts for the Turbojet Engine

    Pinkel, Benjamin; Karp, Irving M.


    Charts are presented for computing the thrust, fuel consumption, and other performance values of a turbojet engine for any given set of operating conditions and component efficiencies. The effects of the pressure losses in the inlet duct and combustion chamber, the variation in the physical properties of the gas as it passes through the cycle, and the change in mass flow by the addition of fuel are included. The principle performance charts show the effects of the primary variables and correction charts provide the effects of the secondary variables.

  6. Construction of Control Charts Using Fuzzy Multinomial Quality


    Control charts are the simplest type of on-line statistical process control techniques. One of the basic control charts is P-chart. In classical P-charts, each item classifies as either "nonconforming" or "conforming" to the specification with respect to the quality characteristic. In practice, one may classify each item in more than two categories such as "bad", "medium", "good", and "excellent". Based on this, we introduce a fuzzy multinomial chart ( FM-chart) for monitoring a multinomial p...

  7. Interactive Financial Charts- Agency Financial Reports

    General Services Administration — For a visual depiction of GSA's Balance Sheet and Statement of Net Cost, please use the interactive charts to view the financial results for fiscal years 2007-2013.

  8. Chart Supplements - Aeronautical Information Services Digital Products

    Department of Transportation — The Chart Supplements are searchable by individual airport in PDF format. They contain data on public and joint use airports, seaplane bases, heliports, VFR airport...

  9. Persistence and compliance to antidepressant treatment in patients with depression: A chart review


    Background Adherence has recently been suggested to be divided into these two components: persistence (i.e., whether patients continue treatment or not) and compliance (i.e., whether patients take doses as instructed). However, no study has yet assessed these two clinically relevant components at the same time in adherence to antidepressant treatment in the clinical outpatient setting. Methods In this retrospective chart-review, 6-month adherence to antidepressants was examined in 367 outpati...

  10. Practical guidance for charting ethics consultations.

    Bruce, Courtenay R; Smith, Martin L; Tawose, Olubukunola Mary; Sharp, Richard R


    It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients' medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation.

  11. Development of Markup Language for Medical Record Charting: A Charting Language.

    Jung, Won-Mo; Chae, Younbyoung; Jang, Bo-Hyoung


    Nowadays a lot of trials for collecting electronic medical records (EMRs) exist. However, structuring data format for EMR is an especially labour-intensive task for practitioners. Here we propose a new mark-up language for medical record charting (called Charting Language), which borrows useful properties from programming languages. Thus, with Charting Language, the text data described in dynamic situation can be easily used to extract information.

  12. Growth and Your 1- to 2-Year-Old

    ... Table: Avoiding Power Struggles Toddlers: Learning by Playing Sleep and Your 1- to 2-Year-Old Feeding Your 1- to 2-Year-Old Movement, Coordination, and Your 1- to 2-Year-Old Learning, Play, and Your 1- to 2-Year-Old Your Child's Growth Your Child's Checkup: 1.5 Years (18 Months) ...

  13. CS-EWMA chart for monitoring process dispersion

    Abbas, N.; Riaz, M.; Does, R.J.M.M.


    Control charts are the most extensively used technique to detect the presence of special cause variations in processes. They can be classified into memory and memoryless control charts. Cumulative sum and exponentially weighted moving average control charts are memory-type control charts as their co

  14. Compressed Aeronautical Chart Processing Operator’s Manual


    the processing thread A4A denotes a CAC ODI build for an (A) aeronautical chart at the (4) operational navigation chart (ONC) (1:1M) scale with...builds when both charts are at the same scale. For example, the processing thread A4A denotes a CAC ODI build for an (A) aeronautical chart at the (4

  15. An Exponentially Weighted Moving Average Control Chart for Bernoulli Data

    Spliid, Henrik


    of the transformation is given and its limit for small values of p is derived. Control of high yield processes is discussed and the chart is shown to perform very well in comparison with both the most common alternative EWMA chart and the CUSUM chart. The construction and the use of the proposed EWMA chart...

  16. Fundamental Particles and Interactions. A Wall Chart of Modern Physics.

    Achor, William T.; And Others


    Discusses a wall chart, "The Standard Model of Fundamental Particles and Interactions," for use in introductory physics courses at either high school or college level. Describes the chart development process, introduction and terminology of particle physics, components of the chart, and suggestions for using the chart, booklet, and…

  17. Process control using reliability based control charts

    J.K. Jacob


    Full Text Available Purpose: The paper presents the method to monitor the mean time between failures (MTBF and detect anychange in intensity parameter. Here, a control chart procedure is presented for process reliability monitoring.Control chart based on different distributions are also considered and were used in decision making. Results anddiscussions are presented based on the case study at different industries.Design/methodology/approach: The failure occurrence process can be modeled by different distributions likehomogeneous Poisson process, Weibull model etc. In each case the aim is to monitor the mean time betweenfailure (MTBF and detect any change in intensity parameter. When the process can be described by a Poissonprocess the time between failures will be exponential and can be used for reliability monitoring.Findings: In this paper, a new procedure based on the monitoring of time to observe r failures is also proposedand it can be more appropriate for reliability monitoring.Practical implications: This procedure is useful and more sensitive when compared with the λ-chart although itwill wait until r failures for a decision. These charts can be regarded as powerful tools for reliability monitoring.λr gives more accurate results than λ-chart.Originality/value: Adopting these measures to system of equipments can increase the reliability and availabilityof the system results in economic gain. A homogeneous Poisson process is usually used to model the failureoccurrence process with certain intensity.

  18. Transmission Line Adapted Analytical Power Charts Solution

    Sakala, Japhet D.; Daka, James S. J.; Setlhaolo, Ditiro; Malichi, Alec Pulu


    The performance of a transmission line has been assessed over the years using power charts. These are graphical representations, drawn to scale, of the equations that describe the performance of transmission lines. Various quantities that describe the performance, such as sending end voltage, sending end power and compensation to give zero voltage regulation, may be deduced from the power charts. Usually required values are read off and then converted using the appropriate scales and known relationships. In this paper, the authors revisit this area of circle diagrams for transmission line performance. The work presented here formulates the mathematical model that analyses the transmission line performance from the power charts relationships and then uses them to calculate the transmission line performance. In this proposed approach, it is not necessary to draw the power charts for the solution. However the power charts may be drawn for the visual presentation. The method is based on applying derived equations and is simple to use since it does not require rigorous derivations.

  19. Chinese chart publishing data updating technique and application

    Liu, G. H.; Peng, R. C.; Chen, Y.; Gao, W. J.; Guo, L. X.; Zheng, Y. D.


    Although the production of nautical chart has developed a lot in China, there are still some defects, such as the long period of producing nautical chart, the continuous correction to the nautical chart published, and so on. On basis of analyzing Chinese chart publishing data and its updating data, this paper researches on the technique of interactively updating server chart publishing data and the technique of automatically updating client chart publishing data, which will lay the foundation for constructing the mode of printing charts on demand in China.

  20. Italian cardiovascular mortality charts of the CUORE project: are they comparable with the SCORE charts?

    Donfrancesco, Chiara


    The aim of this study was to build risk charts for the assessment of cardiovascular mortality of the CUORE project, an Italian longitudinal study, and to compare them with the systematic coronary risk evaluation (SCORE) project charts for low risk European countries.

  1. Construction of Control Charts Using Fuzzy Multinomial Quality

    V. Amirzadeh


    Full Text Available Control charts are the simplest type of on-line statistical process control techniques. One of the basic control charts is P-chart. In classical P-charts, each item classifies as either "nonconforming" or "conforming" to the specification with respect to the quality characteristic. In practice, one may classify each item in more than two categories such as "bad", "medium", "good", and "excellent". Based on this, we introduce a fuzzy multinomial chart ( FM-chart for monitoring a multinomial process. Control limits of FM-chart are obtained by using the multinomial distribution and the degrees of membership which one assigned to the distinct categories. The comparison of the FM-chart and the -chart based on a food production process illustrates that the FM-chart leads to better results.

  2. Statistical Process Control Charts for Public Health Monitoring


    Poisson counts) [21-23].  Cumulative sum ( CUSUM ) and exponentially weighted moving average (EWMA) control charts are often used with Phase II data. These...charts have been shown to more quickly detect small changes than traditional Shewhart charts. There have been several applications of CUSUM charts in...distribution, a CUSUM or EWMA chart would be required.  Risk adjustment for health data has been applied when monitoring variables that can be

  3. Van Gogh and the life chart.

    Rahe, R H


    Adolf Meyer originally devised the life chart in order to chronologically document a person's major life events and significant illness experiences over his or her life span. It is the purpose of this report to update Meyer's life chart through the presentation of the life events and illnesses of the famous artist Vincent Van Gogh. Van Gogh's life illustrates significant early (predisposing) life stresses, as well as clusterings of stressful (precipitating) life events occurring proximal to the occurrence of his several illnesses. Through the use of a life chart an understanding of why an individual becomes ill at a particular time in their life is enlarged. In addition, a systematic basis for formulating prognosis becomes available.

  4. Exploring patterns in European singles charts

    Buda, Andrzej


    European singles charts are important part of the music industry responsible for creating popularity of songs. After modeling and exploring dynamics of global album sales in previous papers, we investigate patterns of hit singles popularity according to all data (1966-2015) from weekly charts (polls) in 12 Western European countries. The dynamics of building popularity in various national charts is more than the economy because it depends on spread of information. In our research we have shown how countries may be affected by their neighbourhood and influenced by technological era. We have also computed correlations with geographical and cultural distances between countries in analog, digital and Internet era. We have shown that time delay between the single premiere and the peak of popularity has become shorter under the influence of technology and the popularity of songs depends on geographical distances in analog (1966-1987) and Internet (2004-2015) era. On the other hand, cultural distances between nation...

  5. Feeding Your 1- to 2-Year-Old

    ... Old Feeding Your 1- to 2-Year-Old Feeding Your 1- to 2-Year-Old KidsHealth > For Parents > Feeding Your 1- to 2-Year-Old Print A ... calories. Your toddler will continue to explore self-feeding, first with fingers and then with utensils at ...

  6. Medical Care and Your 1- to 2-Year-Old

    ... Old Feeding Your 1- to 2-Year-Old Medical Care and Your 1- to 2-Year-Old KidsHealth > For Parents > Medical Care and Your 1- to 2-Year-Old ... A The toddler months continue to bring the medical challenges of colds , scrapes and bruises, and other ...

  7. Progress in the technology of nautical charting

    Joseph, A.

    ". The article skims through the various aspects of safety of navigation such as nautical charts created by the Arabs in the medieval days of stellar navigation in the Indian Ocean; the contributions by the Chinese, the British, and the Portuguese; hydrographic...

  8. Mobile Phone Mood Charting for Adolescents

    Matthews, Mark; Doherty, Gavin; Sharry, John; Fitzpatrick, Carol


    Mobile phones may provide a useful and engaging platform for supporting therapeutic services working with adolescents. This paper examines the potential benefits of the mobile phone for self-charting moods in comparison to existing methods in current practice. The paper describes a mobile phone application designed by the authors which allows…

  9. Charting environmental pollution. [by noise measurements

    Halpert, E.; Bizo, F.; Karacsonyi, Z.


    It is found that areas affected by different noxious agents are within the limits traced for high noise level areas; consequently, it is suggested that high noise pressure levels should be used as the primary indication of environmental pollution. A complex methodology is reported for charting environmental pollution due to physical, chemical and biological noxious agents on the scale of an industrial district.

  10. EWMA control charts in statistical process monitoring

    Zwetsloot, I.M.


    In today’s world, the amount of available data is steadily increasing, and it is often of interest to detect changes in the data. Statistical process monitoring (SPM) provides tools to monitor data streams and to signal changes in the data. One of these tools is the control chart. The topic of this


    Troy Hiltbrand; Sharon Berrett


    The success or failure of a project may be charted in the initiation phase. Therefore, initiation is arguably the most important phase of any project. During the initiation phase, the foundation for the project is established, including the selection of project sponsors and champions and getting their buy-in, which sets the project up for success.

  12. Electronic Chart Display and Information System


    This paper introduces the most advanced form of electronic chart display and information systems (ECDIS) which complies with the Performance Standards for ECDIS established by the International Maritime Organization (IMO) and the International Hydrographic Organization (IHO).It also describes the key features and the important functions of ECDIS.Then the future development of ECDIS in marine is discussed.

  13. Performance Charts for a Turbojet System

    Karp, Irving M.


    Convenient charts are presented for computing the thrust, fuel consumption, and other performance values of a turbojet system. These charts take into account the effects of ram pressure, compressor pressure ratio, ratio of combustion-chamber-outlet temperature to atmospheric temperature, compressor efficiency, turbine efficiency, combustion efficiency, discharge-nozzle coefficient, losses in total pressure in the inlet to the jet-propulsion unit and in the combustion chamber, and variation in specific heats with temperature. The principal performance charts show clearly the effects of the primary variables and correction charts provide the effects of the secondary variables. The performance of illustrative cases of turbojet systems is given. It is shown that maximum thrust per unit mass rate of air flow occurs at a lower compressor pressure ratio than minimum specific fuel consumption. The thrust per unit mass rate of air flow increases as the combustion-chamber discharge temperature increases. For minimum specific fuel consumption, however, an optimum combustion-chamber discharge temperature exists, which in some cases may be less than the limiting temperature imposed by the strength temperature characteristics of present materials.

  14. Population control charts for population data.

    Hansen, John P


    Healthcare managers are beginning to collect full population data, rather than sample data, on some patient and performance measures. For example, hospitals and healthcare systems already gather and store comprehensive data on admissions, ambulatory encounters, and other procedures. And as the electronic medical record is more widely used, complete population data will be collected on an even wider range of clinical measures, such as blood pressure and Laboratory values, in both inpatient and outpatient settings. To correctly monitor process quality when working with full population data, rather than sample data, healthcare managers will need appropriate statistical tools. Traditional control charts, which are used for tracking processes over time, are not suitable for such population data because they are based on the assumption that sample data are being collected. The author proposes a new type of control chart specifically for use with such population data: population control charts. These control charts can be used for monitoring processes that have output measures with continuous, binomial, or nonbinomial rate variables.

  15. Monitoring of Patients Aged 0–2 Years Drug Prescribing Pattern Used Indicator from WHO

    Ahmad Priyadi


    Full Text Available The aim of this study was to evaluate drug used by patients 0–2 years old using five World Health Organization guideline for prescribing indicators, which include average number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotics, injection prescribed, and drugs prescribed from essential drugs list or formulary. Outpatient prescription of patients 0–2 years old period Januari–Desember 2012 were collected retrospectively in one of health facility in Bandung. Average number of drugs per encounter was gained by dividing 6350 drugs with 2741 prescriptions. Percentage of using generic drugs was 9,19 %, antibiotics were 67,53 % and no injections per encounters, whereas percentage of drugs prescribed from essential drugs list was 45,02 %. The result showed that usage of generic drugs and essential drugs were low while the usage of antibiotics is relatively higher than World Health Organization recommendation.

  16. Arctic Sea Ice Charts from Danish Meteorological Institute, 1893 - 1956

    National Oceanic and Atmospheric Administration, Department of Commerce — From 1893 to 1956, the Danish Meteorological Institute (DMI) created charts of observed and inferred sea ice extent for each summer month. These charts are based on...

  17. A Chart Display and Reporting App for Windows

    Poxon, M.


    (Abstract only) Details are presented for a windows application which allows simultaneous display of AAVSO charts and report-formatting software in the hope that other members will offer suggestions from their own experiences with charts and reporting.

  18. JDATAVIEWER – JAVA-Based Charting Library

    Kruk, G


    The JDataViewer is a Java-based charting library developed at CERN, with powerful, extensible and easy to use function editing capabilities. Function edition is heavily used in Control System applications, but poorly supported in products available on the market. The JDataViewer enables adding, removing and modifying function points graphically (using a mouse) or by editing a table of values. Custom edition strategies are supported: developer can specify an algorithm that reacts to the modification of a given point in the function by automatically adapting all other points. The library provides all typical 2D plotting types (scatter, polyline, area, bar, HiLo, contour), as well as data point annotations and data indicators. It also supports common interactors to zoom and move the visible view, or to select and highlight function segments. A clear API is provided to configure and customize all chart elements (colors, fonts, data ranges ...) programmatically, and to integrate non-standard rendering types, inter...

  19. Generalisation of Submarine Features on Nautical Charts

    Guilbert, E.; Zhang, X.


    On most large scale and middle scale maps, relief is represented by contours and spot heights. In order to adapt the representation to the scale, the terrain is generalised either by smoothing or filtering the terrain model or by simplifying the contours. However this approach is not applicable to nautical chart construction where terrain features are selected according to their importance for navigation. This paper presents an approach for the consideration of feature attributes in the generalisation of a set of contours with respect to nautical chart constraints. Features are defined by sets of contours and a set of generalisation operators applied to features is presented. The definitions are introduced in a multi-agent system in order to perform automatic generalisation of a contour set. Results are discussed on a case study and directions for future work are presented.

  20. Orientations of BCFW Charts on the Grassmannian

    Olson, Timothy M


    The Grassmannian formulation of $\\mathcal{N}=4$ super Yang-Mills theory expresses tree-level scattering amplitudes as linear combinations of residues from certain contour integrals. BCFW bridge decompositions using adjacent transpositions simplify the evaluation of individual residues, but orientation information is lost in the process. We present a straightforward algorithm to compute relative orientations between the resulting coordinate charts, and we show how to generalize the technique for charts corresponding to sequences of any not-necessarily-adjacent transpositions. As applications of these results, we demonstrate the existence of a signed boundary operator that manifestly squares to zero and prove via our algorithm that any residues appearing in the tree amplitude sum are decorated with appropriate signs so all non-local poles cancel exactly, not just mod 2 as in previous works.

  1. Charting Secrets Stop Reading Start Practicing

    Bedford, Louise


    It is a common myth that the sharemarket is a fast ticket to the easy life. Buy a few shares and watch them go up. Call your broker for up-to-the-minute price information as you drive the Porsche to the golf club. Yell 'Sell! Sell! Sell' into your mobile as you ski through the Swiss Alps. Nothing could be further from the truth. Louise Bedford believes that the only way to be successful in the market is to spend time studying and putting in the hard work, just like any other job. With this in mind, she has written Charting Secrets. Not just another trading book, Charting Secrets is a workbook

  2. Jean Rotz and the Marine Chart, 1542

    Taylor, E. G. R.

    This paper was first published in the Journal in 1954 (Vol. 7, p. 138). It is followed by comments from Michael Richey.At the time (1542) when Jean Rotz presented Henry VIII with a variation compass, and an accompanying treatise on its making and use, the question of magnetic variation was an acute one. It formed part of a wider controversy concerning the general validity of the sea-chart which had been raised among seamen. As to this, Dr Pedro Nunez, writing a treatise in 1537 addressed to his friend and pupil the Infante Dom Luys of Portugal, said that there were skilled pilots who derided the chart and declared it to be - the falsest thing in the world. Hastening to its defence, Nunez dealt at length with the navigating errors introduced by ignoring the convergence of the meridians, and showed besides that a rhumb, or line of constant bearing was a spiral curve on the globe.

  3. 3D Computer Graphics and Nautical Charts

    Porathe, Thomas


    This paper gives an overview of an ongoing project using real-time 3D visualization to display nautical charts in a way used by 3D computer games. By displaying the map in an egocentric perspective the need to make cognitively demanding mental rotations are suggested to be removed, leading to faster decision-making and less errors. Experimental results support this hypothesis. Practical tests with limited success have been performed this year.

  4. Intelligent bar chart plagiarism detection in documents.

    Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Rehman, Amjad; Alkawaz, Mohammed Hazim; Saba, Tanzila; Al-Rodhaan, Mznah; Al-Dhelaan, Abdullah


    This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR). By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts.

  5. 46 CFR 196.05-5 - Charts and nautical publications.


    ... 46 Shipping 7 2010-10-01 2010-10-01 false Charts and nautical publications. 196.05-5 Section 196... OPERATIONS Notice to Mariners and Aids to Navigation § 196.05-5 Charts and nautical publications. As..., must carry adequate and up-to-date— (a) Charts; (b) Sailing directions; (c) Coast pilots; (d)...

  6. 46 CFR 109.565 - Charts and nautical publications.


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Charts and nautical publications. 109.565 Section 109... OPERATIONS Miscellaneous § 109.565 Charts and nautical publications. The master or person in charge of a self... the intended voyage: (a) Charts. (b) Sailing directions. (c) Coast pilots. (d) Light lists....

  7. 46 CFR 26.03-4 - Charts and nautical publications.


    ... 46 Shipping 1 2010-10-01 2010-10-01 false Charts and nautical publications. 26.03-4 Section 26.03... Operating Requirements § 26.03-4 Charts and nautical publications. (a) As appropriate for the intended voyage, all vessels must carry adequate and up-to-date— (1) Charts of appropriate scale to make...

  8. 46 CFR 97.05-5 - Charts and nautical publications.


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Charts and nautical publications. 97.05-5 Section 97.05... OPERATIONS Notice to Mariners and Aids to Navigation § 97.05-5 Charts and nautical publications. As...) Charts; (b) Sailing directions; (c) Coast pilots; (d) Light lists; (e) Notices to mariners; (f)...

  9. 46 CFR 121.420 - Charts and nautical publications.


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Charts and nautical publications. 121.420 Section 121... AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Navigation Equipment § 121.420 Charts and nautical...) Charts of large enough scale to make safe navigation possible; (2) U.S. Coast Pilot or...

  10. 46 CFR 78.05-5 - Charts and nautical publications.


    ... 46 Shipping 3 2010-10-01 2010-10-01 false Charts and nautical publications. 78.05-5 Section 78.05... Notice to Mariners and Aids to Navigation § 78.05-5 Charts and nautical publications. As appropriate for..., must carry adequate and up-to-date— (a) Charts; (b) Sailing directions; (c) Coast pilots; (d)...

  11. 46 CFR 184.420 - Charts and nautical publications.


    ... 46 Shipping 7 2010-10-01 2010-10-01 false Charts and nautical publications. 184.420 Section 184... Charts and nautical publications. (a) As appropriate for the intended voyage, a vessel must carry adequate and up-to-date: (1) Charts of large enough scale to make safe navigation possible; (2) U.S....

  12. 46 CFR 130.330 - Charts and nautical publications.


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Charts and nautical publications. 130.330 Section 130... CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Navigational Equipment § 130.330 Charts and nautical... voyage, each vessel must carry adequate and up-to-date— (1) Charts of large enough scale to make...

  13. 21 CFR 870.2810 - Paper chart recorder.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Paper chart recorder. 870.2810 Section 870.2810...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2810 Paper chart recorder. (a) Identification. A paper chart recorder is a device used to print on paper, and create a...

  14. Memory-type control charts for monitoring the process dispersion

    Abbas, N.; Riaz, M.; Does, R.J.M.M.


    Control charts have been broadly used for monitoring the process mean and dispersion. Cumulative sum (CUSUM) and exponentially weighted moving average (EWMA) control charts are memory control charts as they utilize the past information in setting up the control structure. This makes CUSUM and EWMA-t

  15. 46 CFR 150.150 - Exceptions to the compatibility chart.


    ... 46 Shipping 5 2010-10-01 2010-10-01 false Exceptions to the compatibility chart. 150.150 Section... CARGOES COMPATIBILITY OF CARGOES § 150.150 Exceptions to the compatibility chart. The Commandant (G-MSO... 1, the Compatibility Chart....

  16. Enhanced cumulative sum charts for monitoring process dispersion.

    Abujiya, Mu'azu Ramat; Riaz, Muhammad; Lee, Muhammad Hisyam


    The cumulative sum (CUSUM) control chart is widely used in industry for the detection of small and moderate shifts in process location and dispersion. For efficient monitoring of process variability, we present several CUSUM control charts for monitoring changes in standard deviation of a normal process. The newly developed control charts based on well-structured sampling techniques - extreme ranked set sampling, extreme double ranked set sampling and double extreme ranked set sampling, have significantly enhanced CUSUM chart ability to detect a wide range of shifts in process variability. The relative performances of the proposed CUSUM scale charts are evaluated in terms of the average run length (ARL) and standard deviation of run length, for point shift in variability. Moreover, for overall performance, we implore the use of the average ratio ARL and average extra quadratic loss. A comparison of the proposed CUSUM control charts with the classical CUSUM R chart, the classical CUSUM S chart, the fast initial response (FIR) CUSUM R chart, the FIR CUSUM S chart, the ranked set sampling (RSS) based CUSUM R chart and the RSS based CUSUM S chart, among others, are presented. An illustrative example using real dataset is given to demonstrate the practicability of the application of the proposed schemes.

  17. Breast augmentation under general anesthesia versus monitored anesthesia care: a retrospective comparative study.

    Eldor, Liron; Weissman, Avi; Fodor, Lucian; Carmi, Nurit; Ullmann, Yehuda


    Breast augmentation is one of the leading esthetic surgeries, enjoying high satisfaction rates. Pain, nausea, and vomiting are frequent shortcomings of the immediate postoperative period. The aim of this study was to compare breast augmentation from the anesthetic point of view: general anesthesia (GA) versus monitored anesthesia care (MAC). The charts of 115 patients were reviewed in this retrospective study performed over a period of 2 years. Sixty-nine women chose to have the surgery done under MAC, and 46 under GA. Statistically significant differences were noted in both postoperative hospital stay (16.1 +/- 6.78 hours vs. 11.7 +/- 6.10 hours) and frequency of vomiting (mean, 0.5 vs. 0.22 times per patient) after GA and MAC, respectively (Mann-Whitney, P < 0.01). Postoperative pain, assessed using the visual analog scale, was significantly higher (mean visual analog scale, 5 vs. 3.27) when the prosthesis was placed in the submuscular plane compared with the subglandular plane (Mann-Whitney, P = 0.043). When offered a choice, more women preferred MAC over GA for their breast augmentation procedure. Less vomiting and shorter postoperative hospitalization were prominent in the MAC group.

  18. Pemoline therapy in college students with attention deficit hyperactivity disorder: a retrospective study.

    Heiligenstein, E; Johnston, H F; Nielsen, J K


    Pemoline, a dopamine agonist, is effective in children with attention deficit hyperactivity disorder (ADHD), but its efficacy in adults is unknown. The authors studied the efficacy and safety of pemoline, using retrospective chart review of treated students with ADHD over a 2-year period. Forty students met diagnostic and treatment criteria; pemoline was associated with much improved or very much improved Clinical Global Impression symptoms scores in 70% of the students during a treatment period of 14 or more days. Severity of illness scores dropped from 4.11 to 3.01 between baseline and subsequent evaluation. Nine evaluable patients had adverse events, most commonly headaches, insomnia, and decreased appetite. Five additional students, who failed to meet the treatment-duration criterion, terminated because of severe initial insomnia. The authors concluded that pemoline is effective and safe in students with ADHD and has a lower abuse potential than methylphenidate and dextroamphetamine, the other two widely used, structurally dissimilar compounds, but controlled studies may be necessary before any final conclusions are reached.

  19. Transgender Voice and Communication Treatment: A Retrospective Chart Review of 25 Cases

    Hancock, Adrienne B.; Garabedian, Laura M.


    Background: People transitioning from male to female (MTF) gender seek speech-language pathology services when they feel their voice is betraying their genuine self or perhaps is the last obstacle to representing their authentic gender. Speaking fundamental frequency (pitch) and resonance are most often targets in treatment because the combination…

  20. Retrospective chart review in a cohort of patients with urticarial dermatitis.

    Banan, Parastoo; Butler, Gregory; Wu, Jason


    Urticarial dermatitis is a poorly understood skin condition while it seems to be much more common than the paucity of reports suggest. It manifests with severely pruritic papules and plaques that resemble eczematous and urticarial lesions morphologically. The key clues to diagnosis are the urticarial appearance and overlap with an eczematous reaction. Here, we present a series of 19 cases (13 women and six men) with urticarial dermatitis clinically and histologically. The patients' average age was 58 and most of the cases were idiopathic. Trunk and proximal extremities were the most common sites involved followed by the distal extremities. Poor response to potent topical corticosteroids and antihistamines was usual and many patients required oral prednisone or other immunosuppressant agents or phototherapy.

  1. Low-dose imipramine for treatment of panic disorder during pregnancy: a retrospective chart review.

    Uguz, Faruk; Sahingoz, Mine; Gungor, Buket; Askin, Rustem


    Although imipramine is one of the antidepressants that could be effective in the treatment of panic disorder, data on its usage for this diagnosis in the pregnancy period are limited. This report presents the results of 16 pregnant women with panic disorder without comorbid diagnosis who underwent low-dose imipramine (10-40 mg/d) treatment. According to the Clinical Global Impression-Improvement Scale, 12 (75%) of 16 women responded to the treatment. The results suggest that low-dose imipramine may be useful for the treatment of panic disorder during pregnancy.

  2. Clinical Infectious Outcomes Associated with Biofilm-related Infections: a Retrospective Chart Review


    analysis of potential clinical risk factors and infectious outcomes of a large data set is an important addition to the understand- ing of adults. Clin Infect Dis. 2005;40(5):643–54. 11. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines ...associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin

  3. Four Experiments on the Perception of Bar Charts.

    Talbot, Justin; Setlur, Vidya; Anand, Anushka


    Bar charts are one of the most common visualization types. In a classic graphical perception paper, Cleveland & McGill studied how different bar chart designs impact the accuracy with which viewers can complete simple perceptual tasks. They found that people perform substantially worse on stacked bar charts than on aligned bar charts, and that comparisons between adjacent bars are more accurate than between widely separated bars. However, the study did not explore why these differences occur. In this paper, we describe a series of follow-up experiments to further explore and explain their results. While our results generally confirm Cleveland & McGill's ranking of various bar chart configurations, we provide additional insight into the bar chart reading task and the sources of participants' errors. We use our results to propose new hypotheses on the perception of bar charts.

  4. Nonparametric Multivariate CUSUM Chart and EWMA Chart Based on Simplicial Data Depth

    Yanting; Li Zhaojun Wang


    Simplicial data depth is a useful tool for describing how central a vector is in a multivariate distribution. If the average simplicial depth of a subgroup of observations from a multivariate distribution is too small, it may indicate that a shift in its location or/both scale occurs. In this paper, we propose two new types of nonparametric control charts which are one-sided CUSUM and EWMA control schemes based on simplicial data depth. We also compute the Average Run Length of the CUSUM chart and the EWMA chart by Markov chain method. Recommendations on how to choose the optimal reference value and the smoothing parameter are also given. Comparisons between these two proposed control schemes and the multivariate EWMA are presented.

  5. The Hill Chart Calculation for Pelton Runner Models using the HydroHillChart - Pelton Module Software

    Adelina Bostan


    Full Text Available The Pelton turbines industrial design is based on the hill chart characteristics obtained by measuring the models. Primary data measurements used to obtain the hill chart can be processed graphically, by hand or by using graphic programs respectively CAD programs; the HydroHillChart - Pelton module software is a specialized tool in achieving the hill chart, using interpolation cubic spline functions. Thereby, based on measurements of several models of Pelton turbines, a computerized library, used to design industrial Pelton turbines can be created. The paper presents the universal characteristics calculated by using the HydroHillChart - Pelton module software for a series of Pelton runners.

  6. Modyfing an attribute control chart: Daudin's methodology

    Pérez Bernabeu, Elena; Sellés Cantó, Miguel Ángel; Carrión García, Andrés; Jabaloyes Vivas, José Manuel


    Copyright (2012) American Institute of Physics. This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics. The following article appeared in Pérez Bernabeu, E.; Sellés Cantó, MÁ.; Carrión García, A.; Jabaloyes Vivas, JM. (2012). Modyfing an attribute control chart: Daudin's methodology. AIP Conference Proceedings. 1431:920-924 and may be found at There are many me...

  7. Feeding patterns and diet -- children 6 months to 2 years

    ... this page: // Feeding patterns and diet - children 6 months to 2 ... development Can help prevent childhood obesity Alternative names Feeding children 6 months to 2 years; Diet - age ...

  8. Clonidine as a First-Line Sedative Agent After Neonatal Cardiac Surgery: Retrospective Cohort Study

    Kleiber, N.; Wildt, S.N. de; Cortina, G.; Clifford, M.; Ducruet, T.; Tibboel, D.; Millar, J.


    OBJECTIVES: To determine the cardiovascular tolerance of clonidine used as a first-line sedative after cardiac surgery in small infants. DESIGN: Retrospective chart review. SETTING: A tertiary and quaternary referral cardiac PICU. PATIENTS: All infants younger than 2 months who received a clonidine

  9. A Literature Review on the Fuzzy Control Chart; Classifications & Analysis

    Mohammad Hossein Zavvar Sabegh


    Full Text Available Quality control plays an important role in increasing the product quality. Fuzzy control charts are more sensitive than Shewhart control chart. Hence, the correct use of fuzzy control chart leads to producing better-quality products. This area is complex because it involves a large scope of industries, and information is not well organized. In this research, we provide a literature review of the control chart under a fuzzy environment with proposing several classifications and analysis. Moreover, our research considered both attribute and variable control chart by analyzing the related researches based on the content analysis method, to classify past and current developments in the fuzzy control chart. This work has included a distribution of articles according to the journal, the case studies related to fuzzy control chart, the percentage of types of fuzzy control charts used in the literature, performance evaluation of the fuzzy control chart and summary of key points of each review paper. Finally, this paper discusses some future research direction and our overviews. The results of this study can help researchers become familiar with well-known journals, fuzzy control charts used in sample case studies, and to extract key points of each paper in minimum time.

  10. Intraspinal synovial cysts: A retrospective study

    Acharya R


    Full Text Available Background: We report the clinical presentation, radiographic studies, intraoperative findings, histopathological analysis, and post-treatment outcome in 26 patients diagnosed with spinal synovial cysts (SSCs. Aims: To describe the clinical presentation, radiographic studies, operative findings, and postoperative follow-up in 26 patients with SSCs. Settings and Design: The study was retrospective in design, involving chart review. Individual patient data was tabulated and patterns were recognized. Materials and Methods: The charts for 26 patients who underwent surgical extirpation of SSC between April 1993 and October 2002 were retrospectively reviewed. Specifically, initial clinical presentation, pertinent radiographs (X-rays, magnetic resonance imaging, computed tomography, intraoperative findings, histopathology, and postoperative follow-up were noted. Statistical Analysis Used: Patient data was tabulated and analyzed for patterns in demographics, symptoms and histopathology. Results: SSCs were more common in females than males (17:9 ratio. Presenting symptoms were back pain with radiculopathy in 13 (50%, radicular pain in the absence of back pain in 10 (38%, and back pain without radicular pain in three (11%. In addition, 17 patients (65% had sensory deficit, and 9 (35% had motor deficit. Most SSCs occurred at the lumbar (19/26 or lumbosacral (5/26 regions, with only 2 (2/26 in the thoracic region. One patient had bilateral SSC at the L4-5 level. Intraoperatively, each cyst was located adjacent to a degenerated facet joint. These lesions could grossly be identified intraoperatively and histopathological confirmation was achieved in all the cases. Conclusions: SSCs are important lesions to consider in the differential diagnosis of lumbar epidural masses and surgical resection leads to significant improvement in the majority of cases.

  11. A paediatric X-ray exposure chart

    Knight, Stephen P, E-mail: [Department of Medical Imaging, Royal Children' s Hospital, Brisbane, Queensland (Australia)


    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.

  12. Quality control chart for crushed granite concrete

    Ewa E. DESMOND


    Full Text Available A chart for assessing in-situ grade (strength of concrete, has been developed in this study. Four grades of concrete after the Nigerian General Specification for Roads and bridges (NGSRB-C20, C25, C30 and C35, is studied at different water-cement ratios for medium and high slump range. The concrete mixes are made from crushed granite rock as coarse aggregate with river sand as fine aggregate. Compression test on specimens are conducted at curing age of 1, 3, 7, 14, 21, 28 and 56 days. Results on concrete workability from slump values, and water-cement ratios revealed that specimens with lower water-cement ratio were less workable but had higher strength, compared to mixes with higher water cement ratio. A simple algorithm using nonlinear regression analysis performed on each experimental data set produced Strength-Age (S-A curves which were used to establish a quality control chart. The accuracy of these curves were evaluated by computing average absolute error (AAS, the error of estimate (EoE and the average absolute error of estimate (Abs EoE for each concrete mix. These were done based on the actual average experimental strengths to measure how close the predicted values are to the experimental data set. The absolute average error of estimate (Abs. EoE recorded was less than ±10% tolerance zone for concrete works.

  13. Dental Charting. Learning Activities, Unit Tests, Progress Chart, and Work Sheet.

    Texas Univ., Austin. Center for Occupational Curriculum Development.

    These materials are part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. These student materials, designed to be used with the Dental Charting Student Manual, consist of learning activities, unit…

  14. Robust Multivariate Control Charts to Detect Small Shifts in Mean

    Habshah Midi


    Full Text Available The classical multivariate CUSUM and EWMA charts are commonly used to detect small shifts in the mean vectors. It is now evident that those charts are easily affected by outliers which may be due to small or moderate changes in the mean vector. In this paper, we propose a robust multivariate CUSUM and Robust multivariate EWMA charts to remedy the problem of small changed in scatter outliers. Both the empirical and simulation results indicate that the proposed robust multivariate CUSUM and EWMA charts offer substantial improvement over other multivariate CUSUM and EWMA charts. This article also discussed the robustness of the proposed charts, when there is a small or moderate sustained shift in the data set.

  15. Low-pressure valves in hydrocephalic children : a retrospective analysis

    Breimer, G. E.; Sival, Deborah; Hoving, E. W.


    A series of 100 children under 2 years of age treated for hydrocephalus is described. All patients received a standard differential low-pressure (SD low) valve as the first cerebrospinal fluid (CSF) shunt treatment. The performance of this group during follow-up is analysed. A retrospective cohort s

  16. EPA Enforcement and Compliance History Online: Water Effluent Charts Details

    U.S. Environmental Protection Agency — Detailed Discharge Monitoring Report (DMR) data supporting effluent charts for one Clean Water Act discharge permit. Includes effluent parameters, amounts discharged...

  17. EPA Enforcement and Compliance History Online: Water Effluent Charts Downloads

    U.S. Environmental Protection Agency — Detailed Discharge Monitoring Report (DMR) data supporting effluent charts for one Clean Water Act discharge permit. Includes effluent parameters, amounts discharged...

  18. Cusum charts for preliminary analysis of individual observations


    textabstractA preliminary Cusum chart based on individual observations is developed from the uniformly most powerful test for the detection of linear trends. This Cusum chart is compared with several of its competitors which are based on the likelihood ratio test and on transformations of standardized recursive residuals on which for instance the Q-chart methodology is based. It turns out that the new proposed Cusum chart is not only superior in the detection of linear trend out-of-control co...

  19. New standardized visual acuity charts in hindi and gujarati

    Khamar Bakulesh


    Full Text Available Conventional Snellen visual acuity chart has unequal difficulty score and irregular progression in letter size causing jumping effect at different visual acuity levels. There is also increase in number of letters from above downwards. Consequently one or two mistakes per line has different meaning of visual acuity at different levels. We designed a new visual acuity chart of fourteen lines in Hindi and Gujarati to facilitate standardization in visual acuity measurement. These charts are designed for use at six meter distance, and the illumination is provided from front. These charts provide a standardized way of measuring visual acuity using local languages.

  20. Converting Basic D3 Charts into Reusable Style Templates.

    Harper, Jonathan; Agrawala, Maneesh


    We present a technique for converting a basic D3 chart into a reusable style template. Then, given a new data source we can apply the style template to generate a chart that depicts the new data, but in the style of the template. To construct the style template we first deconstruct the input D3 chart to recover its underlying structure: the data, the marks and the mappings that describe how the marks encode the data. We then rank the perceptual effectiveness of the deconstructed mappings. To apply the resulting style template to a new data source we first obtain importance ranks for each new data field. We then adjust the template mappings to depict the source data by matching the most important data fields to the most perceptually effective mappings. We show how the style templates can be applied to source data in the form of either a data table or another D3 chart. While our implementation focuses on generating templates for basic chart types (e.g. variants of bar charts, line charts, dot plots, scatterplots, etc.), these are the most commonly used chart types today. Users can easily find such basic D3 charts on the Web, turn them into templates, and immediately see how their own data would look in the visual style (e.g. colors, shapes, fonts, etc.) of the templates. We demonstrate the effectiveness of our approach by applying a diverse set of style templates to a variety of source datasets.


    Duduială Popescu Lorena


    Full Text Available viewed in the context of geopolitical and geostrategic current and through the elements of distinction in terms of identity and cultural institutions, chart Romania - NATO / Israel - EU stands under the sign of the common interest channel, firstly, on common values and hence the collective interests of the partners involved in the two organizational structures. Noteworthy in this context is the extent of bilateral involvement of Romania in the bodies and the politico-military, represented by NATO (the North Atlantic Treaty Organization, which is primarily military values and the construction superstate permanent expansion and development - European Union , both generating as much for our country as obligations of a politico-military security, and economic, social, institutional, cultural.

  2. Individual control charts in paperboard industry

    Grilo, Luís M.; Silva, Daniela S.; Nogueira, Isabel M.; Grilo, Helena L.; Oliveira, Teresa A.


    The stiffness of paperboard is an important continuous variable measured in the labs of paperboard industry to evaluate the quality of the final product. The variable is approximately normal distributed, in this case study, and individual control charts to monitor the stiffness are obtained based on average moving range. Since the available sample size is small we decide to estimate robust control limits using a non-parametric method based on empirical quantiles (that performs also well under the normality of the observations), with the bootstrap procedure. The comparison of the control limits should be made based on the required accuracy. We also compare the output of the stable process (i.e., in statistical control) with the process specifications and we conclude that it is not a capable process.

  3. Live sequence charts to model medical information

    Aslakson Eric


    Full Text Available Abstract Background Medical records accumulate data concerning patient health and the natural history of disease progression. However, methods to mine information systematically in a form other than an electronic health record are not yet available. The purpose of this study was to develop an object modeling technique as a first step towards a formal database of medical records. Method Live Sequence Charts (LSC were used to formalize the narrative text obtained during a patient interview. LSCs utilize a visual scenario-based programming language to build object models. LSC extends the classical language of UML message sequence charts (MSC, predominantly through addition of modalities and providing executable semantics. Inter-object scenarios were defined to specify natural history event interactions and different scenarios in the narrative text. Result A simulated medical record was specified into LSC formalism by translating the text into an object model that comprised a set of entities and events. The entities described the participating components (i.e., doctor, patient and record and the events described the interactions between elements. A conceptual model is presented to illustrate the approach. An object model was generated from data extracted from an actual new patient interview, where the individual was eventually diagnosed as suffering from Chronic Fatigue Syndrome (CFS. This yielded a preliminary formal designated vocabulary for CFS development that provided a basis for future formalism of these records. Conclusions Translation of medical records into object models created the basis for a formal database of the patient narrative that temporally depicts the events preceding disease, the diagnosis and treatment approach. The LSCs object model of the medical narrative provided an intuitive, visual representation of the natural history of the patient’s disease.

  4. Clinical experience of baclofen in alcohol dependence: A chart review

    Abhijit R Rozatkar


    Full Text Available Introduction: Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. Methodology: The study is retrospective chart review of patients (n = 113 who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. Results: The study sample was predominantly male, mean age of 41.49 (±9.75 years, most having a family history of substance use (70.97%, and many reporting binge use pattern in last year (49.46%. Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20–40 mg/day. Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. Conclusion: Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.

  5. HydroHillChart – Francis module. Software used to Calculate the Hill Chart of the Francis Hydraulic Turbines

    Dorian Nedelcu


    Full Text Available The paper presents the Hydro Hill Chart - Francis module application, used to calculate the hill chart of the Pelton, Francis and Kaplan hydraulic turbine models, by processing the data measured on the stand. After describing the interface and menu, the input data is graphically presented and the universal characteristic for measuring scenarios ao=const. and n11=const is calculated. Finally, the two calculated hill charts are compared through a graphical superimposition of the isolines.

  6. Retrospective landscape analysis

    Fritzbøger, Bo


    On the basis of maps from the 18th and 19th centuries, a retrospective analysis was carried out of documentary settlement and landscape data extending back to the Middle Ages with the intention of identifying and dating general structural and dynamic features of the cultural landscape in a selected...

  7. Media use by children younger than 2 years.

    Brown, Ari


    In 1999, the American Academy of Pediatrics (AAP) issued a policy statement addressing media use in children. The purpose of that statement was to educate parents about the effects that media--both the amount and the content--may have on children. In one part of that statement, the AAP recommended that "pediatricians should urge parents to avoid television viewing for children under the age of two years." The wording of the policy specifically discouraged media use in this age group, although it is frequently misquoted by media outlets as no media exposure in this age group. The AAP believed that there were significantly more potential negative effects of media than positive ones for this age group and, thus, advised families to thoughtfully consider media use for infants. This policy statement reaffirms the 1999 statement with respect to media use in infants and children younger than 2 years and provides updated research findings to support it. This statement addresses (1) the lack of evidence supporting educational or developmental benefits for media use by children younger than 2 years, (2) the potential adverse health and developmental effects of media use by children younger than 2 years, and (3) adverse effects of parental media use (background media) on children younger than 2 years.

  8. Childhood Bereavement: Psychopathology in the 2 Years Postparental Death

    Cerel, Julie; Fristad, Mary A.; Verducci, Joseph; Weller, Ronald A.; Weller, Elizabeth B.


    Objective: Although the death of a parent is one of the most significant stressors a child can experience, the psychiatric sequelae of parental death are not fully understood. Method: A total of 360 parent-bereaved children (ages 6-17) and their surviving parents were directly interviewed four times during the first 2 years following the death (at…

  9. Personalized Progress Charts: An Effective Motivation for Reluctant Readers.

    Webre, Elizabeth C.

    Progress charts are an effective means of dramatizing student effort and improvement in reading and are especially important for remedial reading students, who need concrete evidence of progress. Remedial reading students often need extrinsic reward, and since reading is a complex act, progress charts lend themselves to the element of reward and…

  10. 46 CFR 169.809 - Charts and nautical publications.


    ... 46 Shipping 7 2010-10-01 2010-10-01 false Charts and nautical publications. 169.809 Section 169.809 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Operations § 169.809 Charts and nautical publications. As appropriate for the intended voyage,...

  11. Chart it once: innovation in public health documentation.

    Zerwekh, J; Thibodeaux, R; Plesko, R


    The Seattle-King County Department of Public Health implemented a revision in the charting for its Family Support programs with the goal of streamlining the entire charting process, reducing redundancy, improving quality, and improving productivity. This article applies diffusion of innovations theory to the process of changing documentation.

  12. Enhancing the performance of exponentially weighted moving average charts: discussion

    Abbas, N.; Riaz, M.; Does, R.J.M.M.


    Abbas et al. (Abbas N, Riaz M, Does RJMM. Enhancing the performance of EWMA charts. Quality and Reliability Engineering International 2011; 27(6):821-833) proposed the use of signaling schemes with exponentially weighted moving average charts (named as 2/2 and modified − 2/3 schemes) for their impro

  13. 46 CFR Figure 1 to Part 150 - Compatibility Chart


    ... 46 Shipping 5 2010-10-01 2010-10-01 false Compatibility Chart 1 Figure 1 to Part 150 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES COMPATIBILITY OF CARGOES Pt. 150, Fig. 1 Figure 1 to Part 150—Compatibility Chart EC02FE91.079...

  14. Model based control charts in stage 1 quality control

    A.J. Koning (Alex)


    textabstractIn this paper a general method of constructing control charts for preliminary analysis of individual observations is presented, which is based on recursive score residuals. A simulation study shows that certain implementations of these charts are highly effective in detecting assignable

  15. Cusum charts for preliminary analysis of individual observations

    A.J. Koning (Alex); R.J.M.M. Does (Ronald)


    textabstractA preliminary Cusum chart based on individual observations is developed from the uniformly most powerful test for the detection of linear trends. This Cusum chart is compared with several of its competitors which are based on the likelihood ratio test and on transformations of standardiz

  16. US Nuclear Regulatory Commission organization charts and functional statements



    This document is the US NRC organizational structure and chart as of July 1, 1996. It contains the org charts for the Commission, ACRS, ASLAB, Commission staff offices, Executive Director for Operations, Office of the Inspector General, Program offices, and regional offices.

  17. Automated Procedure of making the Andersen’s chart

    Sabaliauskas, Tomas; Ibsen, Lars Bo


    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation stabilizing soil response. The process of obtaining the original chart has been...

  18. Quality Control Charts in Large-Scale Assessment Programs

    Schafer, William D.; Coverdale, Bradley J.; Luxenberg, Harlan; Jin, Ying


    There are relatively few examples of quantitative approaches to quality control in educational assessment and accountability contexts. Among the several techniques that are used in other fields, Shewart charts have been found in a few instances to be applicable in educational settings. This paper describes Shewart charts and gives examples of how…

  19. The making of Andersen’s liquefaction chart

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation stabilizing soil response.The process of obtaining the original chart has bee...

  20. Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME competency in practice-based learning and improvement

    Patel Sangnya


    Full Text Available Abstract Background The Accreditation Council on Graduate Medical Education (ACGME supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. Methods A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin from the charts of patients followed by their physician peers. No formal feedback or education was provided. Results Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33% (p = 0.001, 26% (from 45% to 71% (p Conclusion Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.

  1. Synthetic-type control charts for time-between-events monitoring.

    Fang Yen Yen

    Full Text Available This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr chart and a conforming run length (CRL chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T chart and a group conforming run length (GCRL chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4 charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3 and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts.

  2. The EWMA control chart based on robust scale estimators

    Nadia Saeed


    Full Text Available The exponentially weighted moving average (EWMA chart is very popular in statistical process control for detecting the small shifts in process mean and variance. This chart performs well under the assumption of normality but when data violate the assumption of normality, the robust approaches needed. We have developed the EWMA charts under different robust scale estimators available in literature and also compared the performance of these charts by calculating expected out-of-control points and expected widths under non-symmetric distributions (i.e. gamma and exponential. The simulation studies are being carried out for the purpose and results showed that amongst six robust estimators, the chart based on estimator Q_n relatively performed well for non-normal processes in terms of its shorter expected width and more number of expected out-of-control points which shows its sensitivity to detect the out of control signal.

  3. Ewmareg control chart applied in the monitoring of industrial processes

    Danilo Cuzzuol Pedrini


    Full Text Available If the process quality characteristics are dependent of control variables, and these vary during the process operation, the basic assumptions of control charts are violated. If the values of the control variables are known, it’s possible to apply the regression control chart. One of the most recent works in this area is the EWMAREG chart, which is the monitoring of the standardized residuals using exponentially weighted moving average control chart. In this paper, we present a systematic application of the EWMAREG control chart in monitoring a simulated process of chemical industry. The process characteristic monitored was the corrosion rate of steel pipe in function of four process control variables. The tool applied demonstrated high potential to detect change in surveillance of corrosion rate, ensuring stability process.

  4. On the Mathematics behind the CUSUM Control Charts

    Madsen, Henrik


    This paper describes the mathematics behind CUSUM control charts. An introduction to CUSUM charts is found in (Madsen 1998).CUSUM charts are well suited for checking a measuring system in operation for any departure from some target or specified values. In general they can be used for:- detecting...... a drift (or shift in the level) of the measuring system, and- detecting a change of the precision of the measuring system.In both cases the CUSUM procedure contains methods for estimating the shift such that maintenance (e.g. recalibration) can take place.The CUSUM procedure is described in ISO/CD 7871...... from CEN-TC 69. However the presentation in ISO/CD 7871 concentrates on the level, whereas CUSUM charts for detecting changes in the precision are not discussed.This document outlines the theory of CUSUM control charts, and both CUSUM procedures for detecting a drift as well as CUSUM procedures...

  5. Child abuse diagnosis and the emergency department chart.

    Johnson, C F; Apolo, J; Joseph, J A; Corbitt, T


    Failure to uncover and report nonaccidental injury may have serious consequences for the child and the physician. To determine if the information recorded in the emergency department record was adequate to eliminate the possibility of nonaccidental injury, the charts of 333 children under five years of age were reviewed. No charts contained all the information deemed necessary; in 12.6% a diagnosis of nonaccidental injury could not be eliminated. In three cases, the injury was inconsistent with the history. Missing historical information included where the injury occurred, the presence of witnesses, notation of previous injuries, and old chart review. Information regarding size, color, and age of the injury was incomplete. A complete examination was recorded 22.3% of the time. The private-pay category charts and those recorded by staff were most complete. Remedial actions, guided by periodic chart reviews, are suggested.

  6. Results and complications of vertebrectomy with posterior approach after 2-year follow-up

    Juliano Almeida e Silva


    Full Text Available OBJECTIVE: To describe the surgical technique for vertebrectomy by posterior single approach in the thoracic and thoracolumbar spine with circumferential reconstruction and arthrodesis, and evaluate retrospectively the results and complications after 2 years of follow-up in patients undergoing this technique.METHODS: Retrospective analysis of medical records and imaging studies of 12 patients with vertebrectomy indication for various pathologies, undergoing this surgical technique.RESULTS: Eight (66.67% patients were male and four patients (33.33% were females aged 13-66 years (mean 40 years. There were nine patients with involvement of the thoracic spine and three of the lumbar, and one patient with two consecutive vertebrae affected. All patients had improved or remained with the neurological condition. Surgical complications were two cases of hemothorax, two cases of loosening of the screws, one of them requiring surgical revision, and a case of material failure and pseudarthrosis.CONCLUSION: Vertebrectomy by posterior approach in thoracolumbar spine with circumferential reconstruction and fusion can be performed safely for a variety of indications.

  7. HydroHillChart – Pelton module. Software used to Calculate the Hill Chart of the Pelton Hydraulic Turbines

    Dorian Nedelcu


    Full Text Available The paper presents the HydroHillChart - Pelton module application, used to calculate the hill chart of the Pelton hydraulic turbine models, by processing the data measured on the stand. In addition, the tools offered by the application such as: interface, menu, input data, numerical and graphical results, etc. are described.

  8. Control of wastewater using multivariate control chart

    Nugraha, Jaka; Fatimah, Is; Prabowo, Rino Galang


    Wastewater treatment is a crucial process in industry cause untreated or improper treatment of wastewater may leads some problems affecting to the other parts of environmental aspects. For many kinds of wastewater treatments, the parameters of Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), and the Total Suspend Solid (TSS) are usual parameters to be controlled as a standard. In this paper, the application of multivariate Hotteling T2 Individual was reported to control wastewater treatment. By using wastewater treatment data from PT. ICBP, east Java branch, while the fulfillment of quality standards are based on East Java Governor Regulation No. 72 Year 2013 on Standards of Quality of Waste Water Industry and / or Other Business Activities. The obtained results are COD and TSS has a correlation with BOD values with the correlation coefficient higher than 50%, and it is is also found that influence of the COD and TSS to BOD values are 82% and 1.9% respectively. Based on Multivariate control chart Individual T2 Hotteling, it is found that BOD-COD and BOD-TSS are each one subgroup that are outside the control limits. Thus, it can be said there is a process that is not multivariate controlled, but univariately the variables of BOD, COD and TSS are within specification (standard quality) that has been determined.

  9. From chart tracking to workflow management.

    Srinivasan, P; Vignes, G; Venable, C; Hazelwood, A; Cade, T


    The current interest in system-wide integration appears to be based on the assumption that an organization, by digitizing information and accepting a common standard for the exchange of such information, will improve the accessibility of this information and automatically experience benefits resulting from its more productive use. We do not dispute this reasoning, but assert that an organization's capacity for effective change is proportional to the understanding of the current structure among its personnel. Our workflow manager is based on the use of a Parameterized Petri Net (PPN) model which can be configured to represent an arbitrarily detailed picture of an organization. The PPN model can be animated to observe the model organization in action, and the results of the animation analyzed. This simulation is a dynamic ongoing process which changes with the system and allows members of the organization to pose "what if" questions as a means of exploring opportunities for change. We present, the "workflow management system" as the natural successor to the tracking program, incorporating modeling, scheduling, reactive planning, performance evaluation, and simulation. This workflow management system is more than adequate for meeting the needs of a paper chart tracking system, and, as the patient record is computerized, will serve as a planning and evaluation tool in converting the paper-based health information system into a computer-based system.

  10. Why Collect Retrospective Data?


    chosen to be comparable in 1968, for a nutrition intervention that began in Village A in 1969.[5] Comparing the [5] The figure and accompanying...discussion are from Jean-Pierre Habicht and William P. Butz, "Measurement of Health and Nutrition Effects of Large-scale Nutrition Intervention Projects...villages chosen for a nutrition intervention . Source: Female Retrospective Life History Questionnaire from INCAP-RAND Survey in Guatemala

  11. Design and Application of Economical Process Control Charts

    S.S.N. Murthy


    Full Text Available Statistical quality control techniques are useful in monitoring the process behaviour. Attribute control charts are widely used in process control. The selection of sample size, sampling interval and control width of the control chart is important in minimising the quality costs. Control chart parameters, like 3delta controlimits and fixed fraction sampling at conveniently selected sampling intervals result in deplovable cost penalties in quality control. The best selection of these parameters depends on several process parameters,like frequency of occupancy of a shift in the process, cost of sampling, cost of investigation for finding assignable cause, probability of false alarms, penalty cost of defectives and process correction cost. A general model has been developed to determine the total quality cost as a function of these parameters. Probability of not identifying a process shift (Beeta-risk and probability of wrongly. concluding the process got shifted (alpha-risk are considered in developing the model. This cost equation is optimised to determine optimum values control chart parameters. Fibonacci search is used to quicken the analytical method or determining optimum sampling size and control width. The proposals made by Duncan, Montgomery, Gibra and Chiu for determining the optimum control chart parameters are critically examined and compared with the present model. Case studies were conducted in two foundries. Optimum control chart parameters in casting of cylinder liners and cast plates are determined. It has been found that quality costs are considerably reduced by using optimally designed control chart parameters with proposed method.

  12. Tactile acuity charts: a reliable measure of spatial acuity.

    Patrick Bruns

    Full Text Available For assessing tactile spatial resolution it has recently been recommended to use tactile acuity charts which follow the design principles of the Snellen letter charts for visual acuity and involve active touch. However, it is currently unknown whether acuity thresholds obtained with this newly developed psychophysical procedure are in accordance with established measures of tactile acuity that involve passive contact with fixed duration and control of contact force. Here we directly compared tactile acuity thresholds obtained with the acuity charts to traditional two-point and grating orientation thresholds in a group of young healthy adults. For this purpose, two types of charts, using either Braille-like dot patterns or embossed Landolt rings with different orientations, were adapted from previous studies. Measurements with the two types of charts were equivalent, but generally more reliable with the dot pattern chart. A comparison with the two-point and grating orientation task data showed that the test-retest reliability of the acuity chart measurements after one week was superior to that of the passive methods. Individual thresholds obtained with the acuity charts agreed reasonably with the grating orientation threshold, but less so with the two-point threshold that yielded relatively distinct acuity estimates compared to the other methods. This potentially considerable amount of mismatch between different measures of tactile acuity suggests that tactile spatial resolution is a complex entity that should ideally be measured with different methods in parallel. The simple test procedure and high reliability of the acuity charts makes them a promising complement and alternative to the traditional two-point and grating orientation thresholds.

  13. Risk-Adjusted Control Charts for Health Care Monitoring

    Willem Albers


    the distribution involved is negative binomial. However, in health care monitoring, (groups of patients will often belong to different risk categories. In the present paper, we will show how information about category membership can be used to adjust the basic negative binomial charts to the actual risk incurred. Attention is also devoted to comparing such conditional charts to their unconditional counterparts. The latter do take possible heterogeneity into account but refrain from risk-adjustment. Note that in the risk adjusted case several parameters are involved, which will all be typically unknown. Hence, the potentially considerable estimation effects of the new charts will be investigated as well.

  14. Implementation of Calendar Chart in CICS Mainframes for Business Analysis

    Jayanthi Adilakshmi Visali


    Full Text Available This paper provides a business solution to implement Calendar Chart in Mainframes for analysing the progress of a Bank by giving detailed report of number of new accounts created for the bank. A calendar chart is a visualization used to show activity over the course of a long span of time, such as months or years. They're best used when you want to illustrate how some quantity varies depending on the day of the week. This chart gives us the numerals so as to easily analyse the trends over time.

  15. MDI Synoptic Charts of Magnetic Field: Interpolation of Polar Fields

    Liu, Yang; Hoeksema, J. T.; Zhao, X.; Larson, R. M.


    In this poster, we compare various methods for interpolation of polar field for the MDI synoptic charts of magnetic field. By examining the coronal and heliospheric magnetic field computed from the synoptic charts based on a Potential Field Source Surface model (PFSS), and by comparing the heliospheric current sheets and footpoints of open fields with the observations, we conclude that the coronal and heliospheric fields calculated from the synoptic charts are sensitive to the polar field interpolation, and a time-dependent interpolation method using the observed polar fields is the best among the seven methods investigated.

  16. Create dynamic charts in Microsoft Office Excel 2007 and beyond

    Scheck, Reinhold


    Extend your Excel 2007 skills-and create more-powerful and compelling charts in less time. Guided by an Excel expert, you'll learn how to turn flat, static charts into dynamic solutions-where you can visualize and manipulate data countless ways with a simple mouse click. Get the hands-on practice and examples you need to produce your own, professional-quality results. No programming required! Maximize the impact of your ideas and data! Learn how your design decisions affect perception and comprehensionMatch the right chart type to your communication objectiveVisualize-then build-your solut

  17. Gulf of Mexico IFR Aeronautical Chart Index - Aeronautical Information Services Digital Products

    Department of Transportation — The IFR Enroute Aeronautical Chart series is designed to meet the needs of users who require a digital version chart. This is the visual index to the charts for the...

  18. 49 CFR 236.338 - Mechanical locking required in accordance with locking sheet and dog chart.


    ... locking sheet and dog chart. 236.338 Section 236.338 Transportation Other Regulations Relating to... in accordance with locking sheet and dog chart. Mechanical locking shall be in accordance with locking sheet and dog chart currently in effect....

  19. Social competence at 2 years following child traumatic brain injury.

    Anderson, Vicki; Beauchamp, Miriam Helen; Yeates, Keith Owen; Crossley, Louise; Ryan, Nicholas Peter; Hearps, Stephen J C; Catroppa, Cathy


    Children with traumatic brain injury (TBI) are at risk of social impairment, but research is yet to document the trajectory of these skills post-injury and factors that may predict social problems. The study addressed these gaps in knowledge, reporting on findings from a prospective, longitudinal follow-up study which investigated social outcomes post injury and explored factors contributing to these outcomes at 2 years post-injury. The sample included 113 children, 74 with TBI and 39 typically developing (TD) controls. TBI participants were recruited on presentation to hospital. Parents rated pre-injury function at that time and all children underwent magnetic resonance imaging (MRI) scan. Participants were followed up at 2 years post-injury. Outcomes were social adjustment, social participation, social relationships, and social cognition. Predictors of social outcomes examined included brain lesion characteristics, child cognition (6 months post-TBI) and behavior and environmental factors (pre-injury and 2 years). Reduced social adjustment (p=.011) and social participation (pchildren with TBI compared to TD controls. Poor social adjustment was predicted by externalizing behaviour problems and younger age at injury. Reduced social participation was linked to internalizing behavior problems. Greater lesion volume, lower socioeconomic status and family burden contributed to poorer social relationships, while age at injury predicted social cognition. Within the TBI group, 23% of children exhibited social impairment: younger age at injury, greater pre-injury and current behavior problems and family dysfunction, poorer IQ, processing speed, and empathy were linked to impairment. Further follow-up is required to track social recovery and the influences of cognition, brain, and environment over time.

  20. Borderline personality disorder features predict negative outcomes 2 years later.

    Bagge, Courtney; Nickell, Angela; Stepp, Stephanie; Durrett, Christine; Jackson, Kristina; Trull, Timothy J


    In a sample of 351 young adults, the authors assessed whether borderline personality disorder (BPD) features prospectively predicted negative outcomes (poorer academic achievement and social maladjustment) over the subsequent 2 years, over and above gender and both Axis I and Axis II psychopathology. Borderline traits were significantly related to these outcomes, with impulsivity and affective instability the most highly associated. The present findings suggest that the impulsivity and affective instability associated with BPD leads to impairment in relating well with others, in meeting social role obligations, and in academic or occupational achievement. Therefore, these may be especially important features to target in interventions for BPD.

  1. Hipparcos: a Retrospective

    Perryman, Michael


    The Hipparcos satellite was launched in 1989. It was the first, and remains to date the only, attempt at performing large-scale astrometric measurements from space. Hipparcos marked a fundamentally new approach to the field of astrometry, revolutionising our knowledge of the positions, distances, and space motions of the stars in the solar neighbourhood. In this retrospective, I look back at the processes which led to the mission's acceptance, provide a short summary of the underlying measurement principles and the experiment's scientific achievements, and a conclude with a brief summary of its principal legacy - the Gaia mission.

  2. North Atlantic IFR Route Planning Chart GEO-TIFF - Aeronautical Information Services Digital Products

    Department of Transportation — North Atlantic Route Chart is designed for FAA Controllers to monitor transatlantic flights, this 5-color chart shows oceanic control areas, coastal navigation aids,...

  3. North Atlantic IFR Route Planning Chart PDF File - Aeronautical Information Services Digital Products

    Department of Transportation — North Atlantic Route Chart is designed for FAA Controllers to monitor transatlantic flights, this 5-color chart shows oceanic control areas, coastal navigation aids,...

  4. Another Look at the EWMA Control Chart with Estimated Parameters

    Saleh, N.A.; Mahmoud, M.A.; Jones-Farmer, L.A.; Zwetsloot, I.; Woodall, W.H.


    The authors assess the in-control performance of the exponentially weighted moving average (EWMA) control chart in terms of the SDARL and percentiles of the ARL distribution when the process parameters are estimated.

  5. Grand Canyon VFR Chart - Aeronautical Information Services Digital Products

    Department of Transportation — The Federal Aviation Administration (FAA) digital-Visual Chart series is designed to meet the needs of users who require georeferenced raster images of a FAA Visual...

  6. A European chart review study on early rheumatoid arthritis treatment patterns, clinical outcomes, and healthcare utilization.

    Emery, Paul; Solem, Caitlyn; Majer, Istvan; Cappelleri, Joseph C; Tarallo, Miriam


    This retrospective medical chart review aimed to provide a current, real-world overview of biologic usage in patients with rheumatoid arthritis (RA) in Germany, Spain, and the UK, and estimate clinical and healthcare utilization outcomes associated with early versus late treatment. Adults (≥18 years) with a confirmed RA diagnosis between January 2008 and December 2010, who received biologic treatment for ≥3 months and had ≥12 months of follow-up were included. Early treatment was receipt of biologic agent ≤1 year after RA diagnosis. Outcomes included 28-joint disease activity score (DAS28) reduction of ≥1.2 from biologic start and remission (DAS28 treatment, with a significant difference in Kaplan-Meier curves when indexing on time since diagnosis (p treatment.

  7. Study on Chart Based on Short Production Run


    High intellectual, high flexible automatic manufacturing system based on low volume production is the trend in the future, but the traditional control charts whose control limits are based on at least 20~25 subgroups of five observations each are not suitable in this environment. The paper presents variance control chart used in small batch production in which there are not sufficient observations. The control limits are set reliably without restriction of the number of samples.

  8. Bivariate copulas on the exponentially weighted moving average control chart

    Sasigarn Kuvattana


    Full Text Available This paper proposes four types of copulas on the Exponentially Weighted Moving Average (EWMA control chart when observations are from an exponential distribution using a Monte Carlo simulation approach. The performance of the control chart is based on the Average Run Length (ARL which is compared for each copula. Copula functions for specifying dependence between random variables are used and measured by Kendall’s tau. The results show that the Normal copula can be used for almost all shifts.

  9. Robust control charts in industrial production of olive oil

    Grilo, Luís M.; Mateus, Dina M. R.; Alves, Ana C.; Grilo, Helena L.


    Acidity is one of the most important variables in the quality analysis and characterization of olive oil. During the industrial production we use individuals and moving range charts to monitor this variable, which is not always normal distributed. After a brief exploratory data analysis, where we use the bootstrap method, we construct control charts, before and after a Box-Cox transformation, and compare their robustness and performance.

  10. Sulfur Speciation and Extraction in Jet A (Briefing Charts)


    present in Jet A: • Detrimental to engine performance: coking, clogging, fouling, and deposits possible • SOx emissions are an...Charts 3. DATES COVERED (From - To) July 2015-August 2015 4. TITLE AND SUBTITLE Sulfur Speciation and Extraction in Jet A (Briefing Charts) 5a...T. Reams, Richard C. Lee, Joseph M. Mabry 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER Q0BG 7. PERFORMING ORGANIZATION NAME(S

  11. Economic design of VSI GCCC charts for correlated samples

    Y K Chen


    Full Text Available Generalised cumulative count of conforming (GCCC charts have been proposed for monitoring a high-yield process that allows the items to be inspected sample by sample and not according to the production order. Recent study has shown that the GCCC chart with a variable sampling interval (VSI is superior to the traditional one with a fixed sampling interval (FSI because of the additional flexibility of sampling interval it offers. However, the VSI chart is still costly when used for the prevention of defective products. This paper presents an economic model for the design problem of the VSI GCCC chart, taking into account the correlation of the production outputs within the same sample. In the economic design, a cost function is developed that includes the cost of sampling and inspection, the cost of false alarms, the cost of detecting and removing the assignable cause, and the cost when the process is out-of-control. An evolutionary search method using the cost function is presented for finding the optimal design parameters of the VSI GCCC chart. Comparisons between VSI and FSI charts for expected cost per unit time are also made for various process and cost parameters.

  12. A Combined Control Chart for Identifying Out–Of–Control Points in Multivariate Processes

    Marroquín–Prado E.


    Full Text Available The Hotelling's T2 control chart is widely used to identify out–of–control signals in multivariate processes. However, this chart is not sensitive to small shifts in the process mean vec tor. In this work we propose a control chart to identify out–of–control signals. The proposed chart is a combination of Hotelling's T2 chart, M chart proposed by Hayter et al. (1994 and a new chart based on Principal Components. The combination of these charts identifies any type and size of change in the process mean vector. Us ing simulation and the Average Run Length (ARL, the performance of the proposed control chart is evaluated. The ARL means the average points within control before an out–of–control point is detected, The results of the simulation show that the proposed chart is more sensitive that each one of the three charts individually

  13. Tetanus trismus in a 2 year old child: Case report

    Menon Narayanankutty Sunilkumar, Vadakut Krishnan Parvathy


    Full Text Available Tetanus is still a major cause of mortality and morbidity in developing countries. It occurs in children mainly in the unimmunized, due to parental ignorance and objection to vaccination. This potentially fatal disease caused by a neurotoxin, tetanospasmin released from wounds infected with Clostridium tetani, an anaerobic gram–positive bacillus. As tetanus becomes less common, cases are likely to be misdiagnosed or go unrecognized. In this case report, we present a case of tetanus in a partially immunized 2 year old girl who presented with trismus. She was treated with the recent recommendations and adequate supportive care. Detection of tetanus at a very early stage can favor lifesaving interventions. Trismus, infected wound and partially immunized/unimmunized status of a child were the key features leading to the prompt diagnosis and early treatment.

  14. The retrospective gambler's fallacy

    Daniel M. Oppenheimer


    Full Text Available The gambler's fallacy (Tune, 1964 refers to the belief that a streak is more likely to end than chance would dictate. In three studies, participants exhibited a extit{retrospective gambler's fallacy} (RGF in which an event that seems rare appears to come from a longer sequence than an event that seems more common. Study 1 demonstrates this bias for streaks, while Study 2 does so with single rare events and shows that the appearance of rarity is more important than actual rarity. Study 3 extends these findings from abstract gambling domains into real world domains to demonstrate the generalizability of the effects. The RGF follows from the law of small numbers (Tversky and Kahneman, 1971 and has many applications, from perceptions of the social world to philosophical debates about the existence of multiple universes.

  15. MEAD retrospective analysis report

    Hasager, Charlotte Bay; Carstensen, J.; Frohn, L.M.;


    The retrospective analysis investigates links between atmospheric nitrogen deposition and algal bloom development in the Kattegat Sea from April to September 1989-1999. The analysis is based on atmospheric deposition model results from the ACDEP model,hydrodynamic deep-water flux results...... with an increase above 0.5 µg/l chlorophyll a, but severalconsecutive days of high nitrogen inputs create the potential for blooms. The physical and chemical conditions before and during a bloom revealed that blooms occurred under higher salinity and wind conditions on 2-6 days prior to the observed bloom...... the bottom waters. Yet the cumulative atmospheric deposition is always larger than the marine deep-water flux. The mixing of nutrient-rich water from belowthe pycnocline into the euphotic zone is also a process of highly episodic character and provides sufficient nitrogen to the euphotic zone to sustain...

  16. Diagnostic Value of Run Chart Analysis: Using Likelihood Ratios to Compare Run Chart Rules on Simulated Data Series

    Anhøj, Jacob


    Run charts are widely used in healthcare improvement, but there is little consensus on how to interpret them. The primary aim of this study was to evaluate and compare the diagnostic properties of different sets of run chart rules. A run chart is a line graph of a quality measure over time. The main purpose of the run chart is to detect process improvement or process degradation, which will turn up as non-random patterns in the distribution of data points around the median. Non-random variation may be identified by simple statistical tests including the presence of unusually long runs of data points on one side of the median or if the graph crosses the median unusually few times. However, there is no general agreement on what defines “unusually long” or “unusually few”. Other tests of questionable value are frequently used as well. Three sets of run chart rules (Anhoej, Perla, and Carey rules) have been published in peer reviewed healthcare journals, but these sets differ significantly in their sensitivity and specificity to non-random variation. In this study I investigate the diagnostic values expressed by likelihood ratios of three sets of run chart rules for detection of shifts in process performance using random data series. The study concludes that the Anhoej rules have good diagnostic properties and are superior to the Perla and the Carey rules. PMID:25799549

  17. Growth charts for children with Ellis-van Creveld syndrome.

    Verbeek, Sabine; Eilers, Paul H C; Lawrence, Kate; Hennekam, Raoul C M; Versteegh, Florens G A


    Ellis-van Creveld (EvC) syndrome is a congenital malformation syndrome with marked growth retardation. In this study, specific growth charts for EvC patients were derived to allow better follow-up of growth and earlier detection of growth patterns unusual for EvC. With the use of 235 observations of 101 EvC patients (49 males, 52 females), growth charts for males and females from 0 to 20 years of age were derived. Longitudinal and cross-sectional data were collected from an earlier review of growth data in EvC, a database of EvC patients, and from recent literature. To model the growth charts, the GAMLSS package for the R statistical program was used. Height of EvC patients was compared to healthy children using Dutch growth charts. Data are presented both on a scale for age and on a scale for the square root of age. Compared to healthy Dutch children, mean height standard deviation score values for male and female EvC patients were -3.1 and -3.0, respectively. The present growth charts should be useful in the follow-up of EvC patients. Most importantly, early detection of growth hormone deficiency, known to occur in EvC, will be facilitated.

  18. Historical Map & Chart Collection of NOAA's Nautical Charts, Hydrographic Surveys, Topographic Surveys, Geodetic Surveys, City Plans, and Civil War Battle Maps Starting from the mid 1700's

    National Oceanic and Atmospheric Administration, Department of Commerce — The Historical Map and Chart Collection of the Office of Coast Survey contains over 20000 historical maps and charts from the mid 1700s through the late 1900s. These...

  19. Cartographic Rules and Differences in Nautical Data Visualization on Paper and Electronic Nautical Charts

    Tea Duplančić Leder


    Full Text Available This paper aims to present cartographic rules for the production of paper and electronic navigational charts and main differences in compilation, visualisation and representation of nautical information. Major differences between paper nautical charts and ENC are visualisation of nautical data: colour mixing, resolution of represented nautical objects, human control of display representation and fonts and signatures and chart content are described. It is concluded that electronic navigational charts have many advantages and few shortcomings to paper navigational charts.

  20. Economic design of a nonparametric EWMA control chart for location

    Patil Subhash Hariba

    Full Text Available Abstract In this article, we have proposed an economic design of Exponentially Weighted Moving Average control chart based on sign statistic to control location parameter of the process. The economic performance of the chart is evaluated for different shifts in the location. It is observed that, as shift in the process location increases, sample size to detect the shift and the loss cost from the process decrease. The power of the chart increases with increasing shift. The design gives better economic/statistical performance for large shifts in the process. This economic procedure can be applied to any process having known or unknown process outcome distribution. The sensitivity of the design is also carried out to check the effect on statistical as well as economic performance of the design due to change in different time and cost parameters.




    The aim of this paper is to demonstrate the integration of safety methodology, quality tools, leadership, and teamwork at Hanford and their significant positive impact on safe performance of work. Dashboards, Leading Indicators, Control charts, Pareto Charts, Dr. W. Edward Deming's Red Bead Experiment, and Dr. Deming's System of Profound Knowledge have been the principal tools and theory of an integrated management system. Coupled with involved leadership and teamwork, they have led to significant improvements in worker safety and protection, and environmental restoration at one of the nation's largest nuclear cleanup sites.

  2. Fault detection in electric power systems based on control charts

    Kisić Emilija


    Full Text Available This paper analyzes the control system of the combustion process and protection from explosions in the boiler furnace of thermal power plant using the techniques of control charts. The data from old and newly introduced system for measuring under-pressure differences in boiler furnace at unit B2, TE Nikola Tesla (TENT Obrenovac, were analyzed. The signal of undepressure difference is used for boiler protection function in thermal power plant TENT B. The results that confirm the advantages of the newly introduced system of measurements are presented. A detailed discussion about the benefits and the shortcomings of the control charts application in industrial processes are given in the paper.

  3. Efficiency, Robustness, and Accuracy in Picky Chart Parsing

    Magerman, D M; Magerman, David M.; Weir, Carl


    This paper describes Picky, a probabilistic agenda-based chart parsing algorithm which uses a technique called {\\em probabilistic prediction} to predict which grammar rules are likely to lead to an acceptable parse of the input. Using a suboptimal search method, Picky significantly reduces the number of edges produced by CKY-like chart parsing algorithms, while maintaining the robustness of pure bottom-up parsers and the accuracy of existing probabilistic parsers. Experiments using Picky demonstrate how probabilistic modelling can impact upon the efficiency, robustness and accuracy of a parser.

  4. Refinement-based verification of sequential implementations of Stateflow charts

    Miyazawa, Alvaro; 10.4204/EPTCS.55.5


    Simulink/Stateflow charts are widely used in industry for the specification of control systems, which are often safety-critical. This suggests a need for a formal treatment of such models. In previous work, we have proposed a technique for automatic generation of formal models of Stateflow blocks to support refinement-based reasoning. In this article, we present a refinement strategy that supports the verification of automatically generated sequential C implementations of Stateflow charts. In particular, we discuss how this strategy can be specialised to take advantage of architectural features in order to allow a higher level of automation.

  5. The designer's guide to presenting numbers, figures, and charts

    Bigwood, Sally


    Numbers can tell an exciting story. The trick is to know what story to tell and make it understandable. This compact, practical guide will show everyone who must design numeric data how to transform raw data into readable, relevant information.The Designer's Guide to Presenting Numbers, Figures, and Charts brings together the guidelines established over the last forty years for making effective presentations of figures, tables, and graphs. Included are the straightforward steps designers and other professionals can take to make their tables and charts the most meaningful. The authors define an

  6. Growth charts for children with Ellis–van Creveld syndrome

    Verbeek, Sabine; Eilers, Paul; Lawrence, Karen; Hennekam, Raoul; Versteegh, Florens


    textabstractEllis-van Creveld (EvC) syndrome is a congenital malformation syndrome with marked growth retardation. In this study, specific growth charts for EvC patients were derived to allow better follow-up of growth and earlier detection of growth patterns unusual for EvC. With the use of 235 observations of 101 EvC patients (49 males, 52 females), growth charts for males and females from 0 to 20 years of age were derived. Longitudinal and cross-sectional data were collected from an earlie...

  7. jsGraph and jsNMR—Advanced Scientific Charting

    Norman Pellet


    Full Text Available The jsGraph library is a versatile javascript library that allows advanced charting to be rendered interactively in web browsers without relying on server-side image processing. jsGraph is released under the MIT license and is free of charge. While being highly customizable through an intuitive javascript API, jsGraph is optimized to render a large quantity of data in a short amount of time. jsGraphs can display line, scatter, contour or zone series. Examples can be consulted on the project home page [1]. Customization of the chart, its axis and its series is achieved through simple but comprehensive JSON configurations.

  8. [Ajax-based child growth monitoring chart automatic drawing].

    Geng, Xingyun; Jiang, Kui


    As regards the application of community residents electronics health record system, there is a question of how to draw the child growth monitoring chart quickly and efficiently, which is also the focus of this research for enhancing residents experience in using the system. The system is combined with the current emerging Ajax and GDI+ technology. The client uses the pre-designed Ajax Manager status to deal with residents' request and send XMLHTTP request to the server. Sever responds to the request and makes use of GDI+ programming for implementation of rendering graphics and feedback. The system finally realizes child growth monitoring chart releasing on the Web.

  9. The 'History and Fate of the Universe' chart debuts

    Yarris, L


    A chart that illustrates and summarizes what is now known about the history and fate of the universe has been developed by scientists at the Lawrence Berkeley National Laboratory in collaboration with the Contemporary Physics Education Project (CPEP). More than 11,000 copies will be distributed to high school science teachers across the nation for field-testing with their students (1 page).

  10. Reference chart for relative weight change to detect hypernatraemic dehydration

    Dommelen, P. van; Wouwe, J.P. van; Breuning-Boers, J.M.; Buuren, S. van; Verkerk, P.H.


    Objective: The validity of the rule of thumb that infants may have a weight loss of 10% in the first days after birth is unknown. We assessed the validity of this and other rules to detect breast-fed infants with hypernatraemic dehydration. Design: A reference chart for relative weight change was co

  11. 15 CFR 738.3 - Commerce Country Chart structure.


    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Commerce Country Chart structure. 738.3 Section 738.3 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE EXPORT ADMINISTRATION...

  12. 14 CFR Section 7 - Chart of Profit and Loss Accounts


    ... Profit and Loss Classification Section 7 Chart of Profit and Loss Accounts Objective classification of.... 75.9General ground property 70 70 70. 76Amortization expense, capital leases: 76.1Amortization... Dr, 53 Cr. nonoperating income and expense 81Interest on long-term debt and capital leases:...

  13. Cover Crop Chart: An Intuitive Educational Resource for Extension Professionals

    Liebig, Mark A.; Johnson, Holly; Archer, David; Hendrickson, John; Nichols, Kristine; Schmer, Marty; Tanaka, Don


    Interest in cover crops by agricultural producers has increased the need for information regarding the suitability of crops for addressing different production and natural resource goals. To help address this need, staff at the USDA-ARS Northern Great Plains Research Laboratory developed a decision aid called the Cover Crop Chart (CCC). Visually…

  14. CUSUM Charts with Controlled Conditional Performance Under Estimated Parameters

    Saleh, N.A.; Zwetsloot, I.M.; Mahmoud, M.A.; Woodall, W.H.


    We study the effect of the Phase I estimation error on the cumulative sum (CUSUM) chart. Impractically large amounts of Phase I data are needed to sufficiently reduce the variation in the in-control average run lengths (ARL) between practitioners. To reduce the effect of estimation error on the char

  15. CUSUM Chart with Controlled Conditional Performance Under Estimated Parameters

    Saleh, N.A.; Zwetsloot, I.M.; Mahmoud, M.A.; Woodall, W.H.


    We study the effect of the Phase I estimation error on the cumulative sum (CUSUM) chart. Impractically large amounts of Phase I data are needed to sufficiently reduce the variation in the in-control average run lengths (ARL) between practitioners. To reduce the effect of estimation error on the char

  16. Processing Academic Language through Four Corners Vocabulary Chart Applications

    Smith, Sarah; Sanchez, Claudia; Betty, Sharon; Davis, Shiloh


    4 Corners Vocabulary Charts (FCVCs) are explored as a multipurpose vehicle for processing academic language in a 5th-grade classroom. FCVCs typically display a vocabulary word, an illustration of the word, synonyms associated with the word, a sentence using a given vocabulary word, and a definition of the term in students' words. The use of…

  17. Fiscal output data produce versatile graphic-numeric charts

    Powell, R. W.; Romo, J. J.


    Refined computerized plotting system produces low-cost graphic-numeric charts that illustrate fiscal data on monthly incremental or cumulative basis, or both. Output is in the form of hard copy or microfilm, or visual-aid transparencies prepared from hard copy for rapid management status presentations.

  18. 14 CFR Section 3 - Chart of Balance Sheet Accounts


    ... 2005 Other 2015 Trade accounts payable 2021 Accounts payable—other 2025 Current obligations under... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Chart of Balance Sheet Accounts Section 3... PROCEEDINGS) ECONOMIC REGULATIONS UNIFORM SYSTEM OF ACCOUNTS AND REPORTS FOR LARGE CERTIFICATED AIR...

  19. Constant-Pressure Combustion Charts Including Effects of Diluent Addition

    Turner, L Richard; Bogart, Donald


    Charts are presented for the calculation of (a) the final temperatures and the temperature changes involved in constant-pressure combustion processes of air and in products of combustion of air and hydrocarbon fuels, and (b) the quantity of hydrocarbon fuels required in order to attain a specified combustion temperature when water, alcohol, water-alcohol mixtures, liquid ammonia, liquid carbon dioxide, liquid nitrogen, liquid oxygen, or their mixtures are added to air as diluents or refrigerants. The ideal combustion process and combustion with incomplete heat release from the primary fuel and from combustible diluents are considered. The effect of preheating the mixture of air and diluents and the effect of an initial water-vapor content in the combustion air on the required fuel quantity are also included. The charts are applicable only to processes in which the final mixture is leaner than stoichiometric and at temperatures where dissociation is unimportant. A chart is also included to permit the calculation of the stoichiometric ratio of hydrocarbon fuel to air with diluent addition. The use of the charts is illustrated by numerical examples.

  20. [Study and application of "binocular aniseikonia test chart"].

    Liu, A N; Yan, S M


    With the help of this chart, the image incongruity of simultaneous perception, fusion and stereoscopic vision can be precisely determined. It can objectively evaluate the binocular visual function and possesses important significance for the diagnosis and treatment of anisometropia, amblyopia, strabismus and visual fatigue.

  1. US Nuclear Regulatory Commission organization charts and functional statements



    This document is the organizational chart for the US NRC. It contains organizational structure and functional statements for the following: (1) the Commission, (2) committees and boards, (3) staff offices, (4) office of the Inspector General, (5) executive director for operations, (6) program offices, and (7) regional offices.

  2. Growth charts for children with Ellis-van Creveld syndrome

    S. Verbeek (Sabine); P.H.C. Eilers (Paul); K.A. Lawrence (Karen); R.C.M. Hennekam (Raoul); F.G. Versteegh (Florens)


    textabstractEllis-van Creveld (EvC) syndrome is a congenital malformation syndrome with marked growth retardation. In this study, specific growth charts for EvC patients were derived to allow better follow-up of growth and earlier detection of growth patterns unusual for EvC. With the use of 235 obs

  3. 40 CFR 86.343-79 - Chart reading.


    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Chart reading. 86.343-79 Section 86.343-79 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... reading. (a) A computer or any other automatic data processing device(s) may be used as long as the...

  4. US Nuclear Regulatory Commission organization charts and functional statements



    This document contains organization charts for the U.S. Nuclear Regulatory Commission (NRC) and for the five offices of the NRC. Function statements are provided delineating the major responsibilities and operations of each office. Organization and function are provided to the branch level. The head of each office, division, and branch is also listed.

  5. A Chart Review of Schizotypal Personality Disorders in Children.

    Nagy, Joan; Szatmari, Peter


    The literature on the diagnostic validity of schizotypal personality disorders (SPD) in childhood is reviewed, and the results of a chart review of 20 SPD children meeting Diagnostic and Statistical Manual III criteria are presented suggesting that SPD in childhood exists and warrants study. (Author/CB)

  6. TerCharts: a VBA-MS Excel multiternary and multipurpose charting utility for data analysis, presentation, and modeling in environmental and earth sciences

    Esawi, E. K.


    TerCharts is a comprehensive, fast, flexible, and versatile ternary charting utility that can be used for ternary data presentation analysis and modeling across many scientific disciplines. TerCharts is developed using Microsoft (MS) Excel 2003 and Visual Basic for Applications (VBA) which is an object oriented programming language developed by MS as a tool to enhance the capabilities of MS products. The Excel-VBA interface is important because normally chemical, geochemical, and mineralogical data used in teaching and basic research are processed using Excel spreadsheets, making TerCharts a more convenient tool for generating ternary charts which in turn can be used for data presentation and analysis. Ternary charts generated by this utility can be improved, edited, and modified utilizing MS Excel’s powerful charting and editing techniques.

  7. Semiotic evaluation of Lithuania military air navigation charts

    Ovodas, Donatas; Česnulevičius, Algimantas


    Research of semiotic aspects Lithuanian military air navigation charts was based on the semantic, graphic and information load analysis. The aim of semantic analysis was to determine how the conventional cartographical symbols, used in air navigation charts, correspond with carto-linguistic and carto-semiotic requirements. The analysis of all the markings was performed complex and collected by questionnaire were interviewed various respondents: pilots, cartographers and other chart users. The researches seek two aims: evaluate information and graphical load of military air navigation charts. Information load evaluated to calculate all objects and phenomenon, which was in 25 cm² of map. Charts analysis showed that in low flight charts (LFC) average information load are 4 - 5 times richer than in the operational maps. Map signs optimization on LFC has to be managed very carefully, choosing signs that can reduce the load of information and helps for the information transfer process. Graphical load of maps evaluated of aeronautical maps is not great (5 - 12%) and does not require reduction the information load and generalization of charts. Air navigation charts analysis pointed that not all air navigation sings correspond carto-semiotic requirements and must be improved. The authors suggested some new sings for military air navigation chart, which are simpler, equivalent to human psychophysical perception criteria, creates faster communication and less load on the chart. Badania semiotycznych aspektów litewskich wojskowych map żeglugi powietrznej bazowały na semantycznej, graficznej i informacyjnej analizie treści tych map. Celem analizy semantycznej było określenie na ile tradycyjne symbole kartograficzne stosowane na mapach nawigacji lotniczej są zgodne z wymogami języka kartograficznego oraz zasadami stosowania znaków kartograficznych. Powyższe analizy przeprowadzono w sposób kompleksowy, informacje zebrano za pomocą ankiet, przeprowadzając wywiady w r


    COURNOYER, MICHAEL E. [Los Alamos National Laboratory; LEE, MICHELLE B. [Los Alamos National Laboratory; SCHREIBER, STEPHEN B. [Los Alamos National Laboratory


    At the Los Alamos National Laboratory (LANL) Plutonium Facility, plutonium. isotopes and other actinides are handled in a glovebox environment. The spread of radiological contamination, and excursions of contaminants into the worker's breathing zone, are minimized and/or prevented through the use of glovebox technology. Evaluating the glovebox configuration, the glovebo gloves are the most vulnerable part of this engineering control. Recognizing this vulnerability, the Glovebox Glove Integrity Program (GGIP) was developed to minimize and/or prevent unplanned openings in the glovebox environment, i.e., glove failures and breaches. In addition, LANL implement the 'Lean Six Sigma (LSS)' program that incorporates the practices of Lean Manufacturing and Six Sigma technologies and tools to effectively improve administrative and engineering controls and work processes. One tool used in LSS is the use of control charts, which is an effective way to characterize data collected from unplanned openings in the glovebox environment. The benefit management receives from using this tool is two-fold. First, control charts signal the absence or presence of systematic variations that result in process instability, in relation to glovebox glove breaches and failures. Second, these graphical representations of process variation detennine whether an improved process is under control. Further, control charts are used to identify statistically significant variations (trends) that can be used in decision making to improve processes. This paper discusses performance indicators assessed by the use control charts, provides examples of control charts, and shows how managers use the results to make decisions. This effort contributes to LANL Continuous Improvement Program by improving the efficiency, cost effectiveness, and formality of glovebox operations.

  9. edcc : An R Package for the Economic Design of the Control Chart

    Weicheng Zhu


    Full Text Available The basic purpose of the economic design of the control charts is to find the optimum control charts parameters to minimize the process cost. In this paper, an R package, edcc (economic design of control charts, which provides a numerical method to find the optimum chart parameters is presented using the unified approach of the economic design. Also, some examples are given to illustrate how to use this package. The types of the control chart available in the edcc package are X̅, CUSUM (cumulative sum, and EWMA (exponentially-weighted moving average control charts.

  10. Children's vomiting following posterior fossa surgery: A retrospective study

    Dundon Belinda


    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  11. Persistent pulmonary hypertension – The neonatal period and evaluation at 2 years of age

    Ricardo Mota


    Full Text Available Persistent pulmonary hypertension of the newborn (PPHN is a condition in which the pulmonary vessels fail to dilate at birth. It can be the consequence of a wide array of diseases, such as pneumonia, congenital diaphragmatic hernia, meconium aspiration syndrome and hyaline membrane disease. It has an incidence of 1-2 per 1,000 newborns and it can have pulmonary, neurologic and developmental consequences. We conducted a retrospective study with the aim of analyzing the causes, morbidities and comorbidities, management and mortality of PPHN in newborns hospitalized in our neonatal intensive care unit (NICU and to evaluate respiratory, neurologic and developmental morbidity at 2 years of age. A total of 77 children, born between 1996 and 2012, were studied. Twenty-six (33.8% deceased. The mortality, as well as the need for resuscitation, inhaled nitric oxide (iNO, diuretics, and vasopressor support, was higher in patients with the severe form of PPHN. The need for vasopressor support was the only factor associated with a higher mortality. We found a reduction of 17.8% in mortality rates after the introduction of iNO, sildenafil and extracorporeal membrane oxygenation (ECMO. Congenital diaphragmatic hernia was the most common cause of PPHN. Pneumonia was more frequent before 2003. There was no significant difference in the morbidity and mortality between the two time periods (before and after 2003. On the follow-up of 37 of the remaining 51 patients, we did not find differences in the morbidity of patients comparing those with the severe vs. non-severe forms of the condition.An evaluation over the years of admitted newborns with PPHN in our NICU is mandatory to confirm a relationship between the new treatment strategies and the better outcome of the patients.

  12. A Variable Sampling Interval Synthetic Xbar Chart for the Process Mean.

    Lei Yong Lee

    Full Text Available The usual practice of using a control chart to monitor a process is to take samples from the process with fixed sampling interval (FSI. In this paper, a synthetic X control chart with the variable sampling interval (VSI feature is proposed for monitoring changes in the process mean. The VSI synthetic X chart integrates the VSI X chart and the VSI conforming run length (CRL chart. The proposed VSI synthetic X chart is evaluated using the average time to signal (ATS criterion. The optimal charting parameters of the proposed chart are obtained by minimizing the out-of-control ATS for a desired shift. Comparisons between the VSI synthetic X chart and the existing X, synthetic X, VSI X and EWMA X charts, in terms of ATS, are made. The ATS results show that the VSI synthetic X chart outperforms the other X type charts for detecting moderate and large shifts. An illustrative example is also presented to explain the application of the VSI synthetic X chart.

  13. 56-Day Complete Set of all of the Digital Enroute Charts - Aeronautical Information Services Digital Products

    Department of Transportation — The following ZIP files contain all of the Digital Enroute charts, except for Caribbean charts, for a given effective date range. Due to the large file sizes, it is...

  14. Visualizing Library Statistics using Open Flash Chart 2 and Drupal

    Laura K. Wiegand


    Full Text Available Libraries continue to need to demonstrate their value to stakeholders, and while statistics alone do not represent value, they are an important element. We found ourselves, and our stakeholders, uninspired by our infrequently updated bulleted list of statistics on our website and so set out to create a more dynamic and visually appealing look at our statistics. This article outlines how we used our content management system, Drupal, Open Flash Chart and custom programming to convert library statistics into Flash charts, including how to populate the graphs with dynamic data from external sources. The end result is our Library Statistics Dashboard ( that visually demonstrates the use, activity and resources in the library via interactive and visually interesting graphs.

  15. A Cause-Consequence Chart of a Redundant Protection System

    Nielsen, Dan Sandvik; Platz, O.; Runge, B.


    A cause-consequence chart is applied in analysing failures of a redundant protection system (a core spray system in a nuclear power plant). It is shown how the diagram provides a basis for calculating two probability measures for malfunctioning of the protection system. The test policy of compone...... of components is taken into account. The possibility of using parameter variation as a basis for the choice of test policy is indicated.......A cause-consequence chart is applied in analysing failures of a redundant protection system (a core spray system in a nuclear power plant). It is shown how the diagram provides a basis for calculating two probability measures for malfunctioning of the protection system. The test policy...

  16. Evolving Chart Pattern Sensitive Neural Network Based Forex Trading Agents

    Sher, Gene I


    Though machine learning has been applied to the foreign exchange market for quiet some time now, and neural networks have been shown to yield good results, in modern approaches neural network systems are optimized through the traditional methods, and their input signals are vectors containing prices and other indicator elements. The aim of this paper is twofold, the presentation and testing of the application of topology and weight evolving artificial neural network (TWEANN) systems to automated currency trading, and the use of chart images as input to a geometrical regularity aware indirectly encoded neural network systems. This paper presents the benchmark results of neural network based automated currency trading systems evolved using TWEANNs, and compares the generalization capabilities of these direct encoded neural networks which use the standard price vector inputs, and the indirect (substrate) encoded neural networks which use chart images as input. The TWEANN algorithm used to evolve these currency t...

  17. Fluorinated Silsesquioxanes: Structure, Solubility, and Wetting (Briefing charts)


    values based on Hansen Solubiliy Parameters (for “liquid” surfaces) γlv (dyn / cm) γdlv (dyn / cm) Fluorodecyl T8 (est. HSP) 34.6 24.8 Fluorohexyl T8 (est...Charts 3. DATES COVERED (From - To) July 2015-July 2015 4. TITLE AND SUBTITLE FLUORINATED SILSESQUIOXANES: STRUCTURE, SOLUBILITY , AND WETTING...FLUORINATED SILSESQUIOXANES: STRUCTURE, SOLUBILITY , AND WETTING Joseph Mabry, Andrew Guenthner, Scott Iacono, Raymond Campos, Sean Ramirez, Brian Moore

  18. Paperless system solves problem of lost chart costs.


    Before going paperless, know what you're looking for and what the expected benefits are. The most technologically advanced system in the world is worthless if your doctors can't use it. The system will have greater value if your nurses can chart on it as well. A careful cost-benefit analysis should tell you ahead of time whether the system will pay for itself.

  19. An omnibus CUSUM chart for monitoring time to event data.

    Phinikettos, Ioannis; Gandy, Axel


    A non-parametric method is proposed for monitoring time-to-event data. A cumulative sum chart is constructed that is able to detect an unknown out-of-control state. This method exploits the absolute differences between the Kaplan-Meier estimator and the in-control distribution over specific time intervals. The efficiency of the algorithm is studied via a simulation and a real data study. The new method is also tested via the simulation study against existing methods.

  20. Depreciation accounting in the uniform chart of accounts.

    George, Charles Lee


    Approved for public release; distribution is unlimited This paper examines depreciation's contribution to the total cost of providing health care. In particular it analyzes the depreciation method used to measure the consumption of health care resources, the validity of the depreciation process and the subsequent allocation procedures. As defined by the Uniform Chart of Accounts, the usefulness of depreciation in determining the total cost of providing health care is atte...

  1. CUSUM control charts based on likelihood ratio for preliminary analysis

    Yi DAI; Zhao-jun WANG; Chang-liang ZOU


    To detect and estimate a shift in either the mean and the deviation or both for the preliminary analysis, the statistical process control (SPC) tool, the control chart based on the likelihood ratio test (LRT), is the most popular method.Sullivan and woodall pointed out the test statistic lrt (n1, n2) is approximately distributed as x2 (2) as the sample size n, n1 and n2 are very large, and the value of n1 = 2, 3,..., n- 2 and that of n2 = n- n1.So it is inevitable that n1 or n2 is not large. In this paper the limit distribution of lrt(n1, n2) for fixed n1 or n2 is figured out, and the exactly analytic formulae for evaluating the expectation and the variance of the limit distribution are also obtained.In addition, the properties of the standardized likelihood ratio statistic slr(n1,n) are discussed in this paper. Although slr(n1, n) contains the most important information, slr(i, n)(i ≠ n1) also contains lots of information. The cumulative sum (CUSUM) control chart can obtain more information in this condition. So we propose two CUSUM control charts based on the likelihood ratio statistics for the preliminary analysis on the individual observations. One focuses on detecting the shifts in location in the historical data and the other is more general in detecting a shift in either the location and the scale or both.Moreover, the simulated results show that the proposed two control charts are, respectively, superior to their competitors not only in the detection of the sustained shifts but also in the detection of some other out-of-control situations considered in this paper.

  2. CUSUM control charts based on likelihood ratio for preliminary analysis


    To detect and estimate a shift in either the mean and the deviation or both for the preliminary analysis, the statistical process control (SPC) tool, the control chart based on the likelihood ratio test (LRT), is the most popular method. Sullivan and woodall pointed out the test statistic lrt(n1, n2) is approximately distributed as x2(2) as the sample size n,n1 and n2 are very large, and the value of n1 = 2,3,..., n - 2 and that of n2 = n - n1. So it is inevitable that n1 or n2 is not large. In this paper the limit distribution of lrt(n1, n2) for fixed n1 or n2 is figured out, and the exactly analytic formulae for evaluating the expectation and the variance of the limit distribution are also obtained. In addition, the properties of the standardized likelihood ratio statistic slr(n1, n) are discussed in this paper. Although slr(n1, n) contains the most important information, slr(i, n)(i≠n1) also contains lots of information. The cumulative sum (CUSUM) control chart can obtain more information in this condition. So we propose two CUSUM control charts based on the likelihood ratio statistics for the preliminary analysis on the individual observations. One focuses on detecting the shifts in location in the historical data and the other is more general in detecting a shift in either the location and the scale or both. Moreover, the simulated results show that the proposed two control charts are, respectively, superior to their competitors not only in the detection of the sustained shifts but also in the detection of some other out-of-control situations considered in this paper.

  3. Flood tracking chart for the Illinois River basin

    Avery, Charles F.; Holmes, Jr., Robert R.; Sharpe, Jennifer B.


    This Flood Tracking Chart for the Illinois River Basin in Illinois can be used to record and compare the predicted or current flood-crest stage to past flood-crest information. This information can then be used by residents and emergency-response personnel to make informed decisions concerning the threat of flooding to life and property. The chart shows a map of the Illinois River Basin (see below), the location of real-time streamflow-gaging stations in the basin, graphs of selected historical recorded flood-crest stages at each of the stations, and sea-level conversion (SLC) factors that allow conversion of the current or predicted flood-crest stage to elevation above sea level. Each graph represents a streamflow-gaging station and has a space to record the most current river stage reported for that station by the U.S. Geological Survey (USGS). The National Weather Service (NWS) predicts flood crests for many of the stations shown on this chart.

  4. 33 CFR 209.310 - Representation of submarine cables and pipelines on nautical charts.


    ... cables and pipelines on nautical charts. 209.310 Section 209.310 Navigation and Navigable Waters CORPS OF... of submarine cables and pipelines on nautical charts. (a) The policy of the Corps of Engineers with respect to showing the locations of submarine cables and pipelines on nautical charts published by...

  5. 78 FR 59339 - Intracoastal Waterway Route “Magenta Line” on NOAA Nautical Charts


    ... Nautical Charts AGENCY: National Ocean Service, National Oceanic and Atmospheric Administration. (NOAA), Department of Commerce. ACTION: Request for comments. SUMMARY: Since 1912, a series of nautical charts of the... ``recommended route'' from NOAA nautical charts. We are also issuing a Local Notice to Mariners,...

  6. A critical review of the hypothesis of a medieval origin for portolan charts

    Nicolai, R.


    Portolan charts are nautical charts, which appear suddenly in the thirteenth century Mediterranean world, without any discernable development path or predecessors. These charts are remarkable for the high degree of realism and accuracy with which they render the coastlines of their core coverage are

  7. Filled Radar Charts Should Not Be Used to Compare Social Indicators

    Feldman, Roger


    The use of "radar charts" is an increasingly popular way to present spatial data in a visually interesting format. Some authors recommend using "filled radar charts" to compare the performance of observational units. Filled radar charts are not appropriate for such comparisons because the size of the area within the polygon is not invariant to the…

  8. A Comparative Study of Memory-Type Control Charts under Normal and Contaminated Normal Environments

    Nazir, H.Z.; Abbas, N.; Riaz, M.; Does, R.J.M.M.


    Cumulative sum (CUSUM) and exponentially weighted moving average (EWMA) control charts are commonly used to detect small changes in the parameters of production processes. Recently, a new control structure was introduced, named as mixed EWMA–CUSUM control chart, which combined both charts. The curre

  9. Three-Dimensional Nuclear Chart--Understanding Nuclear Physics and Nucleosynthesis in Stars

    Koura, Hiroyuki


    Three-dimensional (3D) nuclear charts were created using toy blocks, which represent the atomic masses per nucleon number and the total half-lives for each nucleus in the entire region of the nuclear mass. The bulk properties of the nuclei can be easily understood by using these charts. Subsequently, these charts were used in outreach activities…

  10. Association between the high-dose use of benzodiazepines and rehospitalization in patients with schizophrenia: a 2-year naturalistic study

    Takita, Yukika; Takaesu, Yoshikazu; Ono, Kotaro; Futenma, Kunihiro; Shimura, Akiyoshi; Murakoshi, Akiko; Komada, Yoko; Inoue, Yuichi; Inoue, Takeshi


    Background High-dose use of benzodiazepines (BZPs) reportedly causes adverse effects on cognitive function and quality of life in patients with schizophrenia. However, effects of BZPs on the clinical course of schizophrenia have not been clarified. This study was set out to investigate the association between BZPs and rehospitalization of patients with schizophrenia. Methods In this retrospective study, patients with schizophrenia who were discharged from Tokyo Medical University Hospital between January 2009 and February 2012 were eligible as subjects. One hundred and eight patients who continued treatment for >2 years after hospital discharge were included in this study. Clinical characteristics, doses of prescribed medication such as BZPs and antipsychotics, and Global Assessment of Functioning scores at discharge were investigated. The primary outcome was rehospitalization of patients for any reason. Results In a total of 108 subjects with schizophrenia, 44 subjects (40.7%) experienced rehospitalization during the 2-year study period. A multivariate analysis by the Cox proportional hazards model revealed that low educational history (hazard ratio =2.43, P=0.032), younger onset age of schizophrenia (hazard ratio =2.10, P=0.021), and higher diazepam-equivalent dose (hazard ratio =6.53, P=0.011) were significantly associated with the time to rehospitalization after hospital discharge. Conclusion The results of this study suggest that high-dose use of BZPs at discharge in patients with schizophrenia might be associated with a shorter time to rehospitalization. PMID:28008260

  11. Comparison of Applicability of Different Visual Acuity Charts for Pediatric Outpatient Visual Tests

    Haili Fang; Hongxing Diao; Linxing Chen; Junwen Zeng


    Purpose: To evaluate the applicability of different visual acu-ity charts for outpatient pediatric visual tests. Methods: Fifty-three children (53 eyes) aged 4-8 years un-dergoing visual acuity tests as outpatients were randomly se-lected for this study. The best corrected visual acuity (BCVA) of the eye with better visual acuity was measured for each child using the digital LogMAR visual chart,.the ETDRS vi-sual chart,.and a new standard logarithm visual chart;.all measurements were repeated twice and the BCVA was record-ed. Paired comparisons were made between the LogMAR vi-sual acuity chart and ETDRS chart measurements or between the ETDRS chart and logarithm visual acuity chart measure-ments for statistical analysis of the differences in measurement of visual acuity..The results of different measurements by the same chart were compared to evaluate the consistency of the measurement results..Bland-Altman analysis was employed to evaluate the most suitable chart for outpatient measurement of visual acuity in children. Results:.Bland-Altman analysis revealed that the mean visual acuity measured was. (0.447 ±0.017 LogMAR).by the digital LogMAR chart,.(0.301±0.024 LogMAR).by the standard log-arithm visual acuity chart, and (0.309 ±0.018 LogMAR) by the ETDRS visual acuity chart. The BCVA was significantly lower when measured by the LogMAR visual acuity chart than by the ETDRS chart (P0.05)..The Bland-Altman plot showed that the high-est consistency was obtained with the digital LogMAR chart, with a difference between two repeated measurements of 0.068 LogMAR,.compared to 0.090 and 0.072 LogMAR for the logarithm and ETDRS visual acuity charts, respectively. Conclusion: All three types of visual acuity charts are appli-cable for outpatient measurement of pediatric visual acuity. The ETDRS and logarithm visual acuity charts have a higher consistency, but the LogMAR visual acuity chart shows better reproducibility..Consequently,.it is difficult to identify and

  12. A comprehensive overview of medical error in hospitals using incident-reporting systems, patient complaints and chart review of inpatient deaths.

    Jeantine M de Feijter

    Full Text Available BACKGROUND: Incident reporting systems (IRS are used to identify medical errors in order to learn from mistakes and improve patient safety in hospitals. However, IRS contain only a small fraction of occurring incidents. A more comprehensive overview of medical error in hospitals may be obtained by combining information from multiple sources. The WHO has developed the International Classification for Patient Safety (ICPS in order to enable comparison of incident reports from different sources and institutions. METHODS: The aim of this paper was to provide a more comprehensive overview of medical error in hospitals using a combination of different information sources. Incident reports collected from IRS, patient complaints and retrospective chart review in an academic acute care hospital were classified using the ICPS. The main outcome measures were distribution of incidents over the thirteen categories of the ICPS classifier "Incident type", described as odds ratios (OR and proportional similarity indices (PSI. RESULTS: A total of 1012 incidents resulted in 1282 classified items. Large differences between data from IRS and patient complaints (PSI = 0.32 and from IRS and retrospective chart review (PSI = 0.31 were mainly attributable to behaviour (OR = 6.08, clinical administration (OR = 5.14, clinical process (OR = 6.73 and resources (OR = 2.06. CONCLUSIONS: IRS do not capture all incidents in hospitals and should be combined with complementary information about diagnostic error and delayed treatment from patient complaints and retrospective chart review. Since incidents that are not recorded in IRS do not lead to remedial and preventive action in response to IRS reports, healthcare centres that have access to different incident detection methods should harness information from all sources to improve patient safety.

  13. Time contour expression of limited range phenomena on stack chart; Jugo chart jo deno kyokuchi gensho jikan contour

    Kametani, T.


    Time contour expression of limited range phenomena on stack chart is examined for further improvement on the result of the ultimate interpretation in the seismic reflection survey. The policy is made clear from the beginning that local phenomena are to be discussed, and data prior CMP stacking is interpreted in detail. For this purpose, it is effective to make use of the time contour expression in the midpoint-offset plane simultaneously with the CMP and COP panels. For the review of data prior to CMP stacking, it is convenient to use the CMP (CDP) stacking chart in which the data is arranged methodically. In this chart, all the channels which are crude data prior to stacking are plotted on midpoint-offset coordinates, which plane is called the MOD (Midpoint Offset Domain) panel. Various panels can be chosen unrestrictedly, and their mutual relations can be easily grasped. When data points are given a time axis, they can be expressed in a time contour. Studies are conducted about the underground structure, multiple reflection paths divided by it, and characteristics of detour reflection attributable to faults. 4 refs., 9 figs.

  14. Begg orthodontic therapy in retrospect

    Levin, Raymond Israel


    The purpose of the investigation described in this thesis was to study in retrospect a number of changes of the dentition, its occlusion and the facial skeleton which occurred in the treatment and posttreatment periods in a sample of 30 cases treated with the Begg fixed appliance techniques. Sevente

  15. The CUSUM chart method as a tool for continuous monitoring of clinical outcomes using routinely collected data

    Sibanda Nokuthaba


    Full Text Available Abstract Background The lack of robust systems for monitoring quality in healthcare has been highlighted. Statistical process control (SPC methods, utilizing the increasingly available routinely collected electronic patient records, could be used in creating surveillance systems that could lead to rapid detection of periods of deteriorating standards. We aimed to develop and test a CUmulative SUM (CUSUM based surveillance system that could be used in continuous monitoring of clinical outcomes, using routinely collected data. The low Apgar score (5 minute Apgar score Method A surveillance system based on the Observed minus Expected (O-E as well as the 2-sided Log-Likelihood CUSUM charts was developed. The Log-Likelihood chart was designed to detect a 50% rise (deterioration and halving (improvement in the odds of low Apgar scores. Baseline rates were calculated from data for 2001 to 2004, and were used to monitor deliveries for 2005. Deliveries for nulliparous and multiparous women were monitored separately. All analyses were retrospective. Results The CUSUM system detected periods of increased rates of low Apgar scores for each of the nulliparous and multiparous cohorts. The overall rate for 2005 was eventually found to be 0.67%, which was higher than the baseline reference rate of 0.44% from 2001 to 2004. Conclusion CUSUM methods can be used in continuous monitoring of clinical outcomes using routinely collected data. Used prospectively, they could lead to the prompt detection of periods of suboptimal standards.

  16. Comparing visual acuity in preschool children using the Lea symbols and Sheridan Gardiner charts

    Aghafekokhian B. Osaiyuwu


    Full Text Available Visual acuity measurement is a vital part of an optometric examination. The purpose of the present study was to compare visual acuity in preschool children using two charts – the Lea symbols chart and the Sheridan Gardiner chart. One hundred and fifty-three preschool children (72 boys and 81 girls between the ages of 3 and 5 years (mean age and standard deviation 4.23 ± 0.78 years were recruited from five randomly selected nursery schools. Distance visual acuity was measured monocularly and binocularly after a pre-test was done. An interval of 5 minutes was allowed for testing with both charts. The ages and sexes of each child were documented. Results showed a statistical difference in visual acuities using both charts (p < 0.05. There was also a statistical difference in both charts regarding age. There was no significant gender difference between the results from each chart.

  17. A novel experience in the use of control charts for the detection of nosocomial infection outbreaks

    Isabel Cristina Gomes


    Full Text Available OBJECTIVE: This study aims to compare different control charts to monitor the nosocomial infection rate per 1,000 patient-days. METHODS: The control charts considered in this study were the traditional Shewhart chart and a variation of this, the Cumulative Sum and Exponentially Weighted Moving Average charts. RESULTS: We evaluated 238 nosocomial infections that were registered in the intensive care unit and were detected by the Committee for Nosocomial Infection Control in a university hospital in Belo Horizonte, Brazil, in 2004 and 2005. The results showed that the traditional Shewhart chart was the most appropriate method for monitoring periods with large deviations, while the Exponentially Weighted Moving Average and Cumulative Sum charts were better for monitoring periods with smaller deviations of the mean infection rate. CONCLUSION: The ability to detect nosocomial outbreaks was improved by using the information provided by all three different control charts.

  18. Chart Venture Partners' perspective on dual-use CBRNE technologies

    Van Nice, C. S.; Gardner, P. J.


    Chart Venture Partners' (CVP) approach to investing in Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNE) detection technologies can be best understood in the context of the unique partnership between the firm's two founding institutions. CVP was founded as a partnership between the Chart Group, a New York-based merchant banking and venture capital boutique, and InSitech Incorporated, a 501(c)(3) non-profit commercial partnership intermediary for the U.S. Army's Armament Research Development and Engineering Center (ARDEC) at Picatinny Arsenal in New Jersey. The partnership between Chart Group and Insitech has yielded a new investment model. Unlike most venture funds, CVP operates with a singular focus on early-stage defense and security technologies, with the important caveat that everything we invest in must also have dual-use application in large-scale commercial markets. CVP believes that early-stage CBRNE companies require five qualities to be viable investment candidates and successful start-up companies: Great Science, Strong IP Positions, Recognized Scientific Champions, Identified Dual-Use Market Pull, and "Real World" Technical Performance Data. When earlystage CBRNE companies decide to seek venture capital and pursue higher growth dual-use business models, we often find that certain issues arise that are not always fully contemplated at the outset, and that can create gaps between what the start-up companies are offering to investors and what those investors are seeking from their potential portfolio companies. These same issues can have significant positive or negative impact on shareholder value over time, depending on how they are managed. Specifically, startups should consider carefully their strategies related to business development, market positioning, government funding, and investment syndicate formation.

  19. Monitoring of International Space Station Telemetry Using Shewhart Control Charts

    Fitch, Jeffery T.; Simon, Alan L.; Gouveia, John A.; Hillin, Andrew M.; Hernandez, Steve A.


    Shewhart control charts have been established as an expedient method for analyzing dynamic, trending data in order to identify anomalous subsystem performance as soon as such performance would exceed a statistically established baseline. Additionally, this leading indicator tool integrates a selection methodology that reduces false positive indications, optimizes true leading indicator events, minimizes computer processor unit duty cycles, and addresses human factor concerns (i.e., the potential for flight-controller data overload). This innovation leverages statistical process control, and provides a relatively simple way to allow flight controllers to focus their attention on subtle system changes that could lead to dramatic off-nominal system performance. Finally, this capability improves response time to potential hardware damage and/or crew injury, thereby improving space flight safety. Shewhart control charts require normalized data. However, the telemetry from the ISS Early External Thermal Control System (EETCS) was not normally distributed. A method for normalizing the data was implemented, as was a means of selecting data windows, the number of standard deviations (Sigma Level), the number of consecutive points out of limits (Sequence), and direction (increasing or decreasing trend data). By varying these options, and treating them like dial settings, the number of nuisance alerts and leading indicators were optimized. The goal was to capture all leading indicators while minimizing the number of nuisances. Lean Six Sigma (L6S) design of experiment methodologies were employed. To optimize the results, Perl programming language was used to automate the massive amounts of telemetry data, control chart plots, and the data analysis.

  20. Retrospect

    Weaver, Anthony


    A collection of essays on education printed in The New Era during the 1920-1930 era and written by: Beatrice Ensor, A. S. Neill, G. Bernard Shaw, Adolphe Ferriere, C. G. Jung, Martin Buber, Alfred Adler, Harold Rugg, Ovide Decroly, and Paul Langevin. (SE)

  1. EXIT Chart Analysis of Binary Message-Passing Decoders

    Lechner, Gottfried; Pedersen, Troels; Kramer, Gerhard


    Binary message-passing decoders for LDPC codes are analyzed using EXIT charts. For the analysis, the variable node decoder performs all computations in the L-value domain. For the special case of a hard decision channel, this leads to the well know Gallager B algorithm, while the analysis can...... be extended to channels with larger output alphabets. By increasing the output alphabet from hard decisions to four symbols, a gain of more than 1.0 dB is achieved using optimized codes. For this code optimization, the mixing property of EXIT functions has to be modified to the case of binary message-passing...

  2. Use of national and international growth charts for studying height in European children: development of up-to-date European height-for-age charts.

    Marjolein Bonthuis

    Full Text Available BACKGROUND: Growth charts based on data collected in different populations and time periods are key tools to assess children's linear growth. We analyzed the impact of geographic factors and the secular trend on height-for-age charts currently used in European populations, developed up-to-date European growth charts, and studied the effect of using different charts in a sample of growth retarded children. METHODS AND FINDINGS: In an international survey we obtained 18 unique national height-for-age charts from 28 European countries and compared them with charts from the World Health Organization (WHO, Euro-Growth reference, and Centers of Disease Control and Prevention (CDC. As an example, we obtained height data from 3,534 children with end-stage renal disease (ESRD from 13 countries via the ESPN/ERA-EDTA registry, a patient group generally suffering from growth retardation. National growth charts showed a clear secular trend in height (mean height increased on average 0.6 cm/decade and a North-South height gradient in Europe. For countries without a recent (>1990 national growth chart novel European growth charts were constructed from Northern and Southern European reference populations, reflecting geographic height differences in mean final height of 3.9 cm in boys and 3.8 cm in girls. Mean height SDS of 2- to 17-year-old ESRD patients calculated from recent national or derived European growth charts (-1.91, 95% CI: -1.97 to -1.85 was significantly lower than when using CDC or WHO growth charts (-1.55, 95% CI: -1.61 to -1.49 (P<0.0001. CONCLUSION: Differences between height-for-age charts may reflect true population differences, but are also strongly affected by the secular trend in height. The choice of reference charts substantially affects the clinical decision whether a child is considered short-for-age. Therefore, we advocate using recent national or European height-for-age charts derived from recent national data when monitoring growth

  3. Progressive pituitary hyperplasia over the course of 2 years demonstrated on magnetic resonance imaging in a patient with long standing, profound primary hypothyroidism

    Kathryn J. Stephens


    Full Text Available Pituitary hyperplasia secondary to primary hypothyroidism and subsequent regression following thyroid replacement has been well described. We report a 12 year-old male who was retrospectively found to have progressive pituitary hyperplasia over the course of 2 years prior to his diagnosis of primary hypothyroidism, as documented on annual brain magnetic resonance imaging (MRI for Arnold Chiari Type 1 malformation. He presented to Endocrinology with a 2-year history of fatigue, worsening daily headaches and linear growth deceleration. The diagnosis of primary hypothyroidism as the cause for his pituitary hyperplasia was made. He was started on levothyroxine with subsequent regression of pituitary hyperplasia demonstrated on repeat brain MRI six months later. This case is the first that demonstrates progressive pituitary hyperplasia from early in the course to diagnosis of hypothyroidism. It also illustrates that pituitary hyperplasia noted on routine brain MRI can be a presenting sign of primary hypothyroidism that should prompt endocrinologic evaluation.

  4. Nuclide Guide and International Chart of Nuclides - 2008

    Golashvili, T.


    New versions of Nuclide Guide and Chart of the Nuclides were developed as a result of Russian-Chinese collaboration. The Nuclide Guide contains the basic information on more than 3000 radioactive and stable nuclides. The characteristics of isomers with half-lives more than 1 ms are included. For each nuclide spin, parity, mass of nuclide, magnetic moment (if available), mass excess, half-life or abundance, decay modes, branching ratios, emitted particles, energies of most intense gamma-rays and their intensities, decay energies and mean values of radiation energy per decay are given. For stable and natural long-lived nuclides cross-sections of thermal neutron induced activation are indicated. The information presented in the Guide was compiled from 5 sources: 1) ENSDF-2008, 2) atomic mass evaluation-2005 by Audi and Wapstra, 3) interactive data bases at web-sites , , 4) original evaluations of authors, 5) recent publications. The International Chart ot Nuclides was developed on the basis of information presented in Nuclide Guide.

  5. An efficiency comparison of control chart for monitoring process variance: Non-normality case

    Sangkawanit, R.


    Full Text Available The purposes of this research are to investigate the relation between upper control limit and parameters of weighted moving variance linear weight control chart (WMVL, weighted moving variance: exponential weight control chart (WMVE , successive difference cumulative sum control chart (Cusum-SD and current sample mean cumulative sum control chart (Cusum-UM and to compare efficiencies of these control charts for monitoring increases in process variance, exponentially distributed data with unit variance and Student's t distributed data with variance 1.071429 (30 degrees of freedom as the in control process. Incontrol average run lengths (ARL0 of 200, 400 and 800 are considered. Out-of-control average run lengths (ARL1 obtained via simulation 10,000 times are used as a criteria.The main results are as follows: the upper control limit of WMVL has a negative relation with moving span while the upper control limit of WMVE has a negative relation with moving span and a positive relation with exponential weight. Both the upper control limits of Cusum-SD and Cusum-UM have a negative relation with reference value in which such relation looks like an exponential curve.The results of efficiency comparisons in case of exponentially distributed data for ARL0 of 200, 400 and 800 turned out to be quite similar. When standard deviation changes less than 50%, Cusum-SD control chart and Cusum-UM control chart have ARL1 less than those of WMVL control chart and WMVE control chart. However, when standard deviation changes more than 50%, WMVL control chart and WMVE control chart have ARL1 less than those of Cusum-SD control chart and Cusum-UM control chart. The results are different from the normally distributed data case, studied by Sparks in 2003. In case of Student's t distributed data for ARL0 of 200 and 400 when process variance shifts by a small amount (less than 50%, Cusum- UM control chart has the lowest ARL1 but when process variance shifts by a large amount

  6. Sleep duration, but not insomnia, predicts the 2-year course of depressive and anxiety disorders

    J. van Mill; N. Vogelzangs (Nicole); E.J.W. van Someren (Eus); W.J.G. Hoogendijk (Witte); B.W.J.H. Penninx (Brenda)


    textabstractObjective: To examine the predictive role of insomnia andsleep duration on the 2-year course of depressive andanxiety disorders. Method: This study is a secondary data analysis based ondata from the baseline (2004-2007) and 2-year assessmentof the Netherlands Study of Depression and Anxi

  7. Sleep duration, but not insomnia, predicts the 2-year course of depressive and anxiety disorders

    van Mill, Josine G; Vogelzangs, Nicole; van Someren, Eus J W; Hoogendijk, Witte J G; Penninx, Brenda W J H


    OBJECTIVE: To examine the predictive role of insomnia and sleep duration on the 2-year course of depressive and anxiety disorders. METHOD: This study is a secondary data analysis based on data from the baseline (2004-2007) and 2-year assessment of the Netherlands Study of Depression and Anxiety. Par

  8. Night-vision goggles for night-blind subjects : subjective evaluation after 2 years of use

    Hartong, D. T.; Kooijman, A. C.


    Purpose: To evaluate the usefulness of night-vision goggles (NVG) for night-blind subjects after 1 and 2 years of use. Methods: Eleven night-blind subjects with retinitis pigmentosa used NVG for a 2-year period. At the end of each year, they were requested to fill-in two questionnaires regarding the

  9. Sleep Duration, but Not Insomnia, Predicts the 2-Year Course of Depressive and Anxiety Disorders

    van Mill, Josine G.; Vogelzangs, Nicole; van Someren, Eus J. W.; Hoogendijk, Witte J. G.; Penninx, Brenda W. J. H.


    Objective: To examine the predictive role of insomnia and sleep duration on the 2-year course of depressive and anxiety disorders. Method: This study is a secondary data analysis based on data from the baseline (2004-2007) and 2-year assessment of the Netherlands Study of Depression and Anxiety. Par

  10. 7 CFR 25.403. - Ongoing 2-year work plan requirement.


    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Ongoing 2-year work plan requirement. 25.403. Section... COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment Zone and Enterprise Community shall prepare and submit annually, work plans for the subsequent...

  11. Prospective multicenter assessment of perioperative and minimum 2-year postoperative complication rates associated with adult spinal deformity surgery.

    Smith, Justin S; Klineberg, Eric; Lafage, Virginie; Shaffrey, Christopher I; Schwab, Frank; Lafage, Renaud; Hostin, Richard; Mundis, Gregory M; Errico, Thomas J; Kim, Han Jo; Protopsaltis, Themistocles S; Hamilton, D Kojo; Scheer, Justin K; Soroceanu, Alex; Kelly, Michael P; Line, Breton; Gupta, Munish; Deviren, Vedat; Hart, Robert; Burton, Douglas C; Bess, Shay; Ames, Christopher P


    OBJECTIVE Although multiple reports have documented significant benefit from surgical treatment of adult spinal deformity (ASD), these procedures can have high complication rates. Previously reported complications rates associated with ASD surgery are limited by retrospective design, single-surgeon or single-center cohorts, lack of rigorous data on complications, and/or limited follow-up. Accurate definition of complications associated with ASD surgery is important and may serve as a resource for patient counseling and efforts to improve the safety of patient care. The authors conducted a study to prospectively assess the rates of complications associated with ASD surgery with a minimum 2-year follow-up based on a multicenter study design that incorporated standardized data-collection forms, on-site study coordinators, and regular auditing of data to help ensure complete and accurate reporting of complications. In addition, they report age stratification of complication rates and provide a general assessment of factors that may be associated with the occurrence of complications. METHODS As part of a prospective, multicenter ASD database, standardized forms were used to collect data on surgery-related complications. On-site coordinators and central auditing helped ensure complete capture of complication data. Inclusion criteria were age older than 18 years, ASD, and plan for operative treatment. Complications were classified as perioperative (within 6 weeks of surgery) or delayed (between 6 weeks after surgery and time of last follow-up), and as minor or major. The primary focus for analyses was on patients who reached a minimum follow-up of 2 years. RESULTS Of 346 patients who met the inclusion criteria, 291 (84%) had a minimum 2-year follow-up (mean 2.1 years); their mean age was 56.2 years. The vast majority (99%) had treatment including a posterior procedure, 25% had an anterior procedure, and 19% had a 3-column osteotomy. At least 1 revision was required in 82

  12. Web Dynamic Charts Implementation Techniques Based on Chart Control%基于Chart控件的Web动态图表实现技术



    Chart control for drawing dynamic charts based on .NET platform developed by Microsoft Corporation is a powerful, beautiful and practical control.This paper discusses how to use this control to bind data source for the chart, export data of the chart , process the data series and draw all kinds of bar charts, pie charts and radar charts. It provides a good solution to the ASP. NET Web systems to show, statistify and analysize information.%微软公司基于.NET平台所开发的用于绘制动态图表的chart控件,具有功能强大,美观实用的特点。该文探讨了如何在Web系统中运用这一控件绑定图表的数据源、导出图表数据、处理数据系列以及绘制各类柱形图、圆饼图、雷达图等图表技术,为ASP.NET的Web系统中图形信息的显示、统计和分析提供了一种良好的解决方案。

  13. Development of bioclimatic chart for passive building design in Muscat, Oman

    Al-Azri, N. A.; Zurigat, Y. H.; Al-Rawahi, N. Z. [Department of Mechanical and Industrial Engineering, Sultan Qaboos University (Oman)], email:, email:, email:


    With the energy crisis and the rising concerns about the environment it is important to incorporate sustainable designs into buildings. Using passive thermal strategies in a sustainable solution whose performance depends on the local climatic conditions. Bioclimatic charts can be used to select the best passive thermal strategy, however the charts are only available for sea level and it is time-consuming to use it manually. The aim of this paper is to present the development of a chart for Muscat, Oman. This chart has been developed using Muscat's typical meteorological year data and MATLAB. It was found that the climate in Muscat is hot-humid and that high thermal mass is an efficient strategy for 4 months of the year when evaporative cooling is not efficient because of the high humidity. A bioclimatic chart for Muscat was developed herein along with a calculation tool which can build a bioclimatic chart for any part of Oman.

  14. Validation of Hoek-Brown failure criterion charts for rock slopes

    A.M. Nekouei; K. Ahangari


    Although stability charts suggested by Hoek and Bray on the basis of Mohr-Coulomb criterion are used for rock slopes, but complete and precise recognition is required for distinguishing cohesive strength and Mohr-Coulomb equivalent internal friction angle for rock mass. The paper by Lia et al. [6] is the only one that introduced rock slope charts according to Hoek-Brown failure criterion. In this paper, at first, this type of charts is introduced. Then, Mohr-Coulomb failure criterion charts [2] are compared and validated with Hoek-Brown failure criterion ones [6]. Next, Bishop method utilizing Slide software is compared with Hoek-Brown failure criterion stability charts. Average standard deviation (ASD), root mean square error (RMSE) and variance account for (VAF) were used for the comparison. According to the results, because of high distribution and very low correlation among the comparisons, Hoek-Brown failure crite-rion charts are not efficient.

  15. Association between the high-dose use of benzodiazepines and rehospitalization in patients with schizophrenia: a 2-year naturalistic study

    Takita Y


    Full Text Available Yukika Takita,1 Yoshikazu Takaesu,1 Kotaro Ono,1 Kunihiro Futenma,1 Akiyoshi Shimura,1 Akiko Murakoshi,1 Yoko Komada,2 Yuichi Inoue,1,2 Takeshi Inoue1 1Department of Psychiatry, 2Department of Somnology, Tokyo Medical University, Tokyo, Japan Background: High-dose use of benzodiazepines (BZPs reportedly causes adverse effects on cognitive function and quality of life in patients with schizophrenia. However, effects of BZPs on the clinical course of schizophrenia have not been clarified. This study was set out to investigate the association between BZPs and rehospitalization of patients with schizophrenia.Methods: In this retrospective study, patients with schizophrenia who were discharged from Tokyo Medical University Hospital between January 2009 and February 2012 were eligible as subjects. One hundred and eight patients who continued treatment for >2 years after hospital discharge were included in this study. Clinical characteristics, doses of prescribed medication such as BZPs and antipsychotics, and Global Assessment of Functioning scores at discharge were investigated. The primary outcome was rehospitalization of patients for any reason.Results: In a total of 108 subjects with schizophrenia, 44 subjects (40.7% experienced rehospitalization during the 2-year study period. A multivariate analysis by the Cox proportional hazards model revealed that low educational history (hazard ratio =2.43, P=0.032, younger onset age of schizophrenia (hazard ratio =2.10, P=0.021, and higher diazepam-equivalent dose (hazard ratio =6.53, P=0.011 were significantly associated with the time to rehospitalization after hospital discharge.Conclusion: The results of this study suggest that high-dose use of BZPs at discharge in patients with schizophrenia might be associated with a shorter time to rehospitalization. Keywords: schizophrenia, rehospitalization, risk factor, high-dose benzodiazepine, Cox proportional hazards model

  16. A Retrospective Review of Outcomes of Dental Treatment Performed for Special Needs Patients under General Anaesthesia: 2-Year Follow-Up

    Sreekanth Kumar Mallineni


    Full Text Available Objective. The purpose of the study was to evaluate the follow-up pattern of special needs patients (SNP treated under general anaesthesia (GA and the failure rates of different treatment procedures and restorative materials. Study Design. The treatment records of the patients who received dental treatment under GA during 2005 to 2009 were reviewed. The duration of follow-up periods, the outcomes of different treatment procedures, and the quality of different restorative materials were recorded and evaluated. Statistics were used for the comparison (SPSS 20.0. Pearson’s chi-square test and post hoc analysis were used to evaluate the attendance of postoperative appointments and the associations of failure rates of different treatment procedures and restorative materials. Cohen kappa statistics was used for intraexaminer reliability. Results. A total of 177 patients were included in the study. The attendance of postoperative appointments showed a gradual decrease from 96% to 36% within 24 months (P<0.05. Restorative procedures had the highest failure rates among all treatment procedures (P<0.05. Stainless steel crowns showed higher survival rates among different restorative materials (P<0.05. Pulp treatment in primary molars has higher success rate than primary incisors and canines. Composite restorations placed in primary canines have low survival rates. The intraexaminer reliability was good (k=0.94. Conclusion. The attendance for postoperative follow-up appointments declined within two years. Restorative treatment was less successful when compared to preventive and pulp treatments. Stainless steel crowns were more reliable restorations with higher survival rates and composite restorations were less durable.

  17. Designing business charts with Excel based on the standards of HICHERT SUCCESS

    Gerths, Holger


    This e-book offers a comprehensive range of knowledge for creating professional business charts based on the concept of HICHERT®SUCCESS. Given this knowledge, the SUCCESS rules of designing good business charts can be followed easily. This training is based on one complex example. The tips and trick learned can be transferred to other Excel chart types easily. Contents: Introduction to the HICHERT®SUCCESS design rules.Tips and tricks for Excel 2003 and 2007/2010.Comprehensive trai

  18. Design of inspection and maintenance models based on the CCC-chart

    Chan, LY


    In this research, six maintenance models are constructed based on whether minor inspection, major inspection, minor maintenance and major maintenance are performed on a system. The system to study is a production process in which items produced can be classified as either conforming or nonconforming, and a statistical process control chart called CCC-chart (cumulative count control chart) can be applied to monitor the process. The maintenance models are analyzed quantitatively, and selection ...

  19. Cartographic Rules and Differences in Nautical Data Visualization on Paper and Electronic Nautical Charts

    Tea Duplančić Leder


    This paper aims to present cartographic rules for the production of paper and electronic navigational charts and main differences in compilation, visualisation and representation of nautical information. Major differences between paper nautical charts and ENC are visualisation of nautical data: colour mixing, resolution of represented nautical objects, human control of display representation and fonts and signatures and chart content are described. It is concluded that electronic navigational...


    Mike Cox


    Full Text Available The exponentially weighted moving average chart (EWMA is widely employed in quality control to monitor a process or to evaluate historic data. EWMA charts are designed to exhibit acceptable average run lengths both when the process is in and out of control. This paper introduces a functional technique for generating the parameters λ and Δ for such a chart that will have specified average run lengths. The parameters are estimated using regression plus an artificial neural network.

  1. A comparison of control charts for the average of autocorrelated processes

    Fabiane R. S. Yassukawa


    Full Text Available Control charts are extensively used with the purpose of monitoring some parameters of the process. In general these charts are based on the normality and independence assumptions of the sample observations. However, there are situations where the independence is not valid such as in chemical processes or sampling on-line. In this paper we compared the control charts based on geostatistics and time series methodologies with the well-known charts Shewhart, CUSUM and EWMA, when used to monitor the average of autocorrelated processes. The comparison was performed by using Monte Carlo simulation implemented in the software R for Windows.

  2. Percentile growth charts for biomedical studies using a porcine model.

    Corson, A M; Laws, J; Laws, A; Litten, J C; Lean, I J; Clarke, L


    Increasing rates of obesity and heart disease are compromising quality of life for a growing number of people. There is much research linking adult disease with the growth and development both in utero and during the first year of life. The pig is an ideal model for studying the origins of developmental programming. The objective of this paper was to construct percentile growth curves for the pig for use in biomedical studies. The body weight (BW) of pigs was recorded from birth to 150 days of age and their crown-to-rump length was measured over the neonatal period to enable the ponderal index (PI; kg/m3) to be calculated. Data were normalised and percentile curves were constructed using Cole's lambda-mu-sigma (LMS) method for BW and PI. The construction of these percentile charts for use in biomedical research will allow a more detailed and precise tracking of growth and development of individual pigs under experimental conditions.

  3. A wind chart to characterize potential offshore wind energy sites

    del Jesus, F.; Menéndez, M.; Guanche, R.; Losada, I. J.


    Offshore wind industry needs to improve wind assessment in order to decrease the uncertainty associated to wind resource and its influence on financial requirements. Here, several features related to offshore wind resource assessment are discussed, such as input wind data, estimation of long-term and extreme wind statistics, the wind profile and climate variations. This work proposes an analytical method to characterize wind resource. Final product is a wind chart containing useful wind information that can be applied to any offshore sites. Using long-term time series of meteorological variables (e.g. wind speed and direction at different heights), the methodology is applied to five pilot sites in different countries along European Atlantic corridor and it is used to describe and compare offshore wind behavior.

  4. Energy predictions. [Briefs on 33 charts, figures, and graphs

    Freiwald, D.A.


    Briefs describe 33 charts, graphs, and schematics offering some recent history and perspectives on the world and U.S. energy situation and the problems for survival facing the world. Of interest is Figure 28, showing the Club of Rome's model of the earth in terms of resource consumption, food, money, people, pollution, etc. A computer was asked to extend recent history into the future and results indicate a collapse of the industrialized system towards an agrarian culture around the year 2025. It is noted that the model did not consider technological initiative or man's willingness to change lifestyles. The final (33) schematic is a guesstimate of noticeable impact timescales, indicating when research projects on transition or ultimate energy sources at LASL might be expected to yield impact. (MCW)

  5. Toward detailed prominence seismology - II. Charting the continuous magnetohydrodynamic spectrum

    Blokland, J W S


    Starting from accurate MHD flux rope equilibria containing prominence condensations, we initiate a systematic survey of their linear eigenoscillations. To quantify the full spectrum of linear MHD eigenmodes, we require knowledge of all flux-surface localized modes, charting out the continuous parts of the MHD spectrum. We combine analytical and numerical findings for the continuous spectrum for realistic prominence configurations. The equations governing all eigenmodes for translationally symmetric, gravitating equilibria containing an axial shear flow, are analyzed, along with their flux-surface localized limit. The analysis is valid for general 2.5D equilibria, where either density, entropy, or temperature vary from one flux surface to another. We analyze the mode couplings caused by the poloidal variation in the flux rope equilibria, by performing a small gravity parameter expansion. We contrast the analytical results with continuous spectra obtained numerically. For equilibria where the density is a flux ...


    Radu-Daniel LOGHIN


    Full Text Available Empirical research in accounting history can help the scholar gain a better insight into the various cultural influences that shape the reasoning of accounting professionals. An empirical approach to accounting history can provide an additional dimension to the context which shapes the underlying principles and practices. For the purpose of this paper, an etymological analysis was performed on the chart of accounts from the Republic of Moldova since March 2015, with the purpose of identifying the various layers of the accounting terminology and their probable corresponding periods in history. The research reveals a surprising linguistic profile which has not been influenced significantly by the Soviet Union, with major influences being drawn from the 19th and early 20th centuries.

  7. Interpretation models and charts of production profiles in horizontal wells


    Stratified flow is common for the gravity segregation and flow regimes are very complex because of borehole inclination,therefore,all the conventional production logging tools cannot be effectively applied in horizontal wells,thus significantly increasing the difficulties in log interpretation. In this paper,firstly,the overseas progress in updated integration tools for horizontal wells and production profile interpretation methods has been discussed in brief. Secondly,by means of theory study and experimental simulations,we have obtained the production profile interpretation model and experimental interpretation charts,which have been calibrated by the improved downhole technology and optimization methods. Finally,we have interpreted X-well with the production profile interpretation software designed by us,and it proves that the methods are useful for the production profile interpretation in horizontal wells.

  8. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

    Harald Schrem

    Full Text Available The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers.1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences.Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21. Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46, post-transplant lymphoproliferative disorder (SIR = 8.36, prostate cancer (SIR = 2.22, bladder cancer (SIR = 3.24, thyroid cancer (SIR = 10.13 and melanoma (SIR = 3.08. Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29, polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD (p = 0.001, HR: 0.68, high body mass index in kg/m2 (p<0.001, HR: 1.04, ADPKD (p = 0.008, HR: 1.26 and diabetic nephropathy (p = 0.004, HR = 1.51. G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05.Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes

  9. Persistence and compliance to antidepressant treatment in patients with depression: A chart review

    Sawada Norifusa


    Full Text Available Abstract Background Adherence has recently been suggested to be divided into these two components: persistence (i.e., whether patients continue treatment or not and compliance (i.e., whether patients take doses as instructed. However, no study has yet assessed these two clinically relevant components at the same time in adherence to antidepressant treatment in the clinical outpatient setting. Methods In this retrospective chart-review, 6-month adherence to antidepressants was examined in 367 outpatients with a major depressive disorder (ICD-10 (170 males; mean ± SD age 37.6 ± 13.9 years, who started antidepressant treatment from April 2006 through March 2007. Additionally, we evaluated Medication Possession Rate (MPR, defined as the total days a medication was dispensed to patients divided by the treatment period. Results Only 161 patients (44.3% continued antidepressant treatment for 6 months. Among 252 patients who discontinued their initial antidepressant, 63.1% of these patients did so without consulting their physicians. Sertraline use was associated with a higher persistence rate at month 6 (odds ratio 2.59 in comparison with sulpiride, and the use of anxiolytic benzodiazepines had a positive effect on persistence to antidepressant treatment only at month 1 (odds ratio 2.14. An overall MPR was 0.77; 55.6% of patients were considered compliant (i.e., a MPR of ≥ 0.8. Conclusion Given a high rate of antidepressant discontinuation without consulting their physicians, closer communication between patients and their physicians should be encouraged. Although the use of anxiolytic benzodiazepines was associated with a higher persistence to antidepressant treatment at month 1, the use of these drugs should be avoided as a rule, given their well-known serious adverse effects.

  10. Clopidogrel plus long-term aspirin after femoro-popliteal stenting. The CLAFS project: 1- and 2-year results

    Strecker, Ernst-Peter K.; Boos, Irene B.L.; Goettmann, Dieter; Vetter, Sylvia [Department of Imaging, Interventional Radiology, and Nuclear Medicine, Diakonissen Hospital, Diakonissenstrasse 28, 76199, Karlsruhe (Germany)


    The aim of this study was to determine the patency rate after femoro-popliteal stenting followed by oral clopidogrel plus long-term aspirin. In a prospective trial, 31 patients with a total of 33 femoro-popliteal artery lesions (21 stenoses, 12 occlusions; 24 femoral, 9 popliteal) were treated with flexible tantalum stents after unsuccessful percutaneous transluminal angioplasty (PTA) preceded by local fibrinolysis in 5 of 12 patients with total occlusion. Post-interventionally, oral aspirin 100 mg was started simultaneously for the long term and was combined with an oral loading dose of 300 mg clopidogrel, followed by 75 mg clopidogrel daily for 28 days. Patients were followed for at least 12 months (maximum 34 months) by clinical examination, Doppler pressure measurement, color and duplex sonography, and angiography in case of suspicion of restenosis. In a retrospective analysis, the results were compared with those of historical groups of patients having received aspirin only (41 patients) or a long-term high-dose low molecular weight heparin (LMWH)+aspirin treatment (42 patients). Three small puncture aneurysms were treated successfully by conservative means and were categorized as minor bleeding complication. Cumulative primary patency rate (PPR) was 76{+-}7.5% (1 year), and 70{+-}9.6% (2 years) in the clopidogrel+aspirin group, thus being tendentiously better than in the aspirin-only group showing 75{+-}4.6% (1 year), and 50{+-}8.1% (2 years). Long-term high-dose LMWH+aspirin treatment showed 87{+-}5.8% (1 year), and 72{+-}9.1% (2 years), thus being superior to the other treatment regimes, with a statistically significant difference (p<0.05) between the LMWH+aspirin and the aspirin group. Clopidogrel plus aspirin is a safe medication regimen and may be effective in the prevention of early stent thrombosis. Mid- and long-term patency rate seems to be intermediate as compared with other therapeutic regimens. The LMWH+aspirin seems to be superior compared with

  11. Factors associated with seclusion in a statewide forensic psychiatric service in Australia over a 2-year period.

    Thomas, Stuart D M; Daffern, Michael; Martin, Trish; Ogloff, James R P; Thomson, Lindsay D G; Ferguson, Murray


    Despite seclusion being described as one of the most ethically- and legally-controversial management options available, it remains a widely-used clinical strategy for managing disruptive, aggressive, and violent behaviour. This study sought to determine how frequently seclusion was used, the common characteristics of those secluded and not secluded, and the degree to which the Level of Service Inventory - Revised: Screening Version (LSI-R: SV) could predict seclusion. The study was retrospective, covering the first 2 years of operation of a statewide forensic psychiatry hospital in Victoria, Australia. Data were collected from individual case files, electronic databases, and paper copies of records pertaining to violent incidents and episodes of seclusion. Eighty five (44%) of the 193 patients admitted during this period were secluded. Those secluded were significantly younger and had a more established psychiatric history. LSI-R: SV scores were significantly and positively associated with being secluded. A statistical model containing three LSI-R: SV items, along with age on admission and psychiatric history, achieved an area under the curve of 0.74. Seclusion is used on a regular basis in response to a range of different forms of aggressive behaviour of different severity. The LSI-R: SV demonstrated moderate-to-good accuracy in predicting seclusion and warrants further research using detailed prospective methodologies.

  12. Double half-cone flap umbilicoplasty for proboscoid umbilical hernia in a 2 years old child with satisfactory results 2 years later.

    Ashu, Eseme Ebai; Leroy, Guifo Marc; Aristide, Bang Guy; Joss, Bitang Mafok Louis; Bonaventure, Jemea; Patrick, Savom Eric; Myriam, Fotso Guegne


    Surgical repair of large umbilical hernias may present a challenging surgical problem; standard surgical techniques have proven to be inadequate for both closing the fascial defect of the umbilicus and providing a satisfactory cosmetic result. We describe here a case of double half-cone flap umbilicoplasty that was performed in a 2 years old boy. The case of a 2 years old child with proboscoid umbilical hernia. The protruding umbilical skin was excised sharply by two V-shaped cuts leaving two half cones, a short cephalic (0.5cm) and a long caudal (1cm). A classic herniotomy was carried out, with repair of the facial defect. The caudal half cone was sutured from its apex till half it's length upon itself with interrupted sutures and it was anchored deeply to the fascia. Then we inverted the cephalic half cone which was sutured to the caudal cone to form the new umbilicus. The early result was excellent with no complications and the result after 2years revealed a cosmetically satisfactory shape of the umbilicus. this technique provides a good solution for reconstruction of the protruding umbilical skin and it is easy to learn, easy to be taught and perform in surgical environments and may be applicable for any kind of umbilical reconstruction.

  13. Development of a fetal weight chart using serial trans-abdominal ultrasound in an East African population

    Schmiegelow, Christentze; Scheike, Thomas Harder; Oesterholt, Mayke


    trans-abdominal ultrasound. All pregnancies with pathology were excluded and a chart representing the optimal growth potential was developed using fetal weights and birth weights. The weight chart was compared to a chart from Congo, a chart representing a white population, and a chart representing......Objective: To produce a fetal weight chart representative of a Tanzanian population, and compare it to weight charts from Sub-Saharan Africa and the developed world. Methods: A longitudinal observational study in Northeastern Tanzania. Pregnant women were followed throughout pregnancy with serial......, in the end of pregnancy, the 10th percentiles deviated substantially causing an overestimation of the true prevalence of SGA newborns if our chart had not been used. Conclusions: We developed a weight chart representative for a Tanzanian population and provide evidence for the necessity of developing...

  14. Retrospective Evaluation of Colonoscopy Results

    Yaşar M et al.


    Full Text Available Aim: The aim of this study is the retrospective evaluation of colonoscopy results between 2005 January- 2009 December in General Surgery Department of Düzce University.Materials and Methods: Admitted to our department with lower gastrointestinal symptoms, and colonoscopy is indicated 500 male and 538 female total 1038 patients were performed flexible colonoscopic examinations after bowel cleansing.Results: According to results of colonoscopic findings, 42.9% No pathology, 32.5% Hemorrhoids, 17.6% Anal fissures were detected.Conclusion: As a result of this study, half of patients admitted to our surgical clinic with lower gastrointestinal complaints have no pathology and in the other half of patients have various pathologies such as hemorrhoids and anal fissures.

  15. Retrospective Birth Dating of Cells

    L.Spalding, K; Bhardwaj, R D; Buchholz, B A; Druid, H; Frisen, J


    The generation of cells in the human body has been difficult to study and our understanding of cell turnover is limited. Extensive testing of nuclear weapons resulted in a dramatic global increase in the levels of the isotope {sup 14}C in the atmosphere, followed by an exponential decrease after the test ban treaty in 1963. We show that the level of {sup 14}C in genomic DNA closely parallels atmospheric levels, and can be used to establish the time point when the DNA was synthesized and cells were born. We use this strategy to determine the age of cells in the cortex of the adult human brain, and show that whereas non-neuronal cells are exchanged, occipital neurons are as old as the individual, supporting the view that postnatal neurogenesis does not take place in this region. Retrospective birth dating is a generally applicable strategy that can be used to measure cell turnover in man under physiological and pathological conditions.

  16. A New Spin on Miscue Analysis: Using Spider Charts to Web Reading Processes

    Wohlwend, Karen E.


    This article introduces a way of seeing miscue analysis data through a "spider chart", a readily available digital graphing tool that provides an effective way to visually represent readers' complex coordination of interrelated cueing systems. A spider chart is a standard feature in recent spreadsheet software that puts a new spin on miscue…

  17. Rate-optimal scheduling of recursive DSP algorithms based on the scheduling-range chart

    Heemstra de Groot, Sonia M.; Herrmann, Otto E.


    A method for rate-optimal scheduling of recursive DSP algorithms is presented. The approach is based on the determination of the scheduling window of each operation and the construction of a scheduling-range chart. The information in the chart is used during scheduling to optimize some quality crite

  18. Mixed exponentially weighted moving average-cumulative sum charts for process monitoring

    Abbas, N.; Riaz, M.; Does, R.J.M.M.


    The control chart is a very popular tool of statistical process control. It is used to determine the existence of special cause variation to remove it so that the process may be brought in statistical control. Shewhart-type control charts are sensitive for large disturbances in the process, whereas

  19. An EWMA-type control chart for monitoring the process mean using auxiliary information

    Abbas, N.; Riaz, M.; Does, R.J.M.M.


    Statistical process control (SPC) is an important application of statistics in which the outputs of production processes are monitored. Control charts are an important tool of SPC. A very popular category is the Shewhart's x-chart used to monitor the mean of a process characteristic. Two alternative

  20. No Humble Pie: The Origins and Usage of a Statistical Chart

    Spence, Ian


    William Playfair's pie chart is more than 200 years old and yet its intellectual origins remain obscure. The inspiration likely derived from the logic diagrams of Llull, Bruno, Leibniz, and Euler, which were familiar to William because of the instruction of his mathematician brother John. The pie chart is broadly popular but--despite its common…

  1. The Self-Monitoring Mood Chart: Measuring Affect in the Classroom.

    Safran, Stephen; Safran, John


    A mood chart allows learning and/or behavior disabled students (8-12 years old) to evaluate and monitor their present mood. The chart can also be used to analyze the relationship between mood and inappropriate behavior, to communicate with parents, and to promote children's awareness and understanding of each other's feelings. (CL)

  2. Use of a PERT Chart to Improve Efficiency of the Dissertation.

    Hudson, Shannon M; Laken, Marilyn A


    Efficiencies are needed to speed the dissertation process and graduation of prospective new faculty. We used a workflow process, the PERT chart, to organize and manage the many time-delimited tasks necessary for a complex dissertation. This article presents a case example that describes our experience and timely completion of the dissertation. PERT charts are useful tools to improve efficiency in nursing education.

  3. Calculation of One-Valued Control Limits by Control Chart of Angles

    李元生; 方英; 朱险峰


    The data we use to express angle or direction are entitled directional data. In a plan right-an-gled coordinate system the traditional control chart can't solve the quality control problem which the characteristic value is angle. This paper analyses and calculates the one-valued control limits by control chart of angles.

  4. Weight Loss Maintenance for 2 Years after a 6-Month Randomised Controlled Trial Comparing Education-Only and Group-Based Support in Japanese Adults

    Yoshio Nakata


    Full Text Available Objective: Our previous study, a 6-month randomised controlled trial, demonstrated that a group-based support promoted weight loss as compared to an education-only intervention. The purpose of this study was to examine weight loss maintenance for 2 years. Methods: Originally, 188 overweight Japanese adults, aged 40-65 years, were randomly assigned to 3 groups: control, education-only or group-based support. After the 6-month intervention, 125 participants in the education-only and the group-based support groups were followed up for 2 years. The primary outcome was the amount of weight lost. The participants were retrospectively grouped into quartiles of percent weight loss for secondary analyses. Results: At the end of follow-up, the amount of weight lost in the education-only and the group-based support groups was the same (3.3 kg. Secondary analyses using data of those who completed the study (n = 100 revealed that the participants in the highest quartile of percent weight loss significantly increased their step counts and moderate-to-vigorous physical activity compared with the lowest quartile. No significant differences were observed in the energy intake among the four groups. Conclusion: The effects of group-based support disappear within 2 years. Increasing physical activity may be a crucial factor for successful maintenance of weight loss.

  5. Safety and Visual Outcome of Visian Toric ICL Implantation after Corneal Collagen Cross-Linking in Keratoconus: Up to 2 Years of Follow-Up.

    Antonios, Rafic; Dirani, Ali; Fadlallah, Ali; Chelala, Elias; Hamade, Adib; Cherfane, Carole; Jarade, Elias


    Purpose. To evaluate the long-term safety and clinical outcome of phakic Visian toric implantable collamer lens (ICL) insertion after corneal collagen cross-linking (CXL) in progressive keratoconus. Methods. This was a retrospective study of 30 eyes (19 patients), with progressive keratoconus, who underwent sequential CXL followed by Visian toric ICL implantation after 6 months. Results. At baseline, 6 eyes had stage I, 14 eyes stage II, and 10 eyes stage III keratoconus graded by Amsler-Krumeich classification. At 6 months after CXL, only K (steep) and K (max) decreased significantly from baseline, with no change in visual acuity or refraction. Flattening in keratometric readings was stable thereafter. There was significant improvement in mean uncorrected distance visual acuity (1.57 ± 0.56 to 0.17 ± 0.06 logMAR, P ICL implantation that was maintained at the 2-year follow-up. Mean cylinder power and mean spherical equivalent (SE) also decreased significantly after ICL implantation. A small hyperopic shift in SE (+0.25 D) was observed at 2 years that did not alter visual outcomes. Conclusions. Visian toric ICL implantation following CXL is an effective option for improving visual acuity in patients with keratoconus up to 2 years.

  6. Non-inferiority of retrospective data collection for assessing perioperative morbidity

    Patel, Amour B.U.; Reyes, Anna


    Background. Postoperative morbidity has immediate and delayed consequences for surgical patients, including excess risk of premature death. Capturing these data objectively and routinely in large electronic databases using tools such as the Postoperative Morbidity Survey (POMS) would offer tremendous clinical and translational potential. However, POMS has thus far only utilised prospective data collection by research staff. We hypothesised that retrospective data collection from routinely collated hospital data from paper and electronic charts, medical and nursing notes was non-inferior to prospective data collection requiring research staff capturing POMS-defined morbidity in real-time. Methods. Morbidity was recorded by a trained investigator as defined by POMS prospectively on postoperative days 3 and 7. Separately, an independent investigator blinded to prospectively acquired data retrospectively assessed the same patients’ morbidity as defined by POMS criteria, using medical charts, nursing summaries and electronic data. Equivalence was accepted when the confidence limits for both modes of data collection fell completely inside the equivalence bounds, with the maximum equivalence difference (i.e., the largest value of the difference in sensitivities deemed to reach a conclusion of equivalence) set a priori at 0.2. Differences for confidence limits between retrospective and prospective data collection were based on Nam’s RMLE method. The relationship between morbidity on postoperative day 3 as recorded by each data collection method on time to become morbidity free and length of hospital stay was compared using the log-rank test. Results. POMS data from 85 patients undergoing elective or emergency surgery were analyzed. At postoperative day 3, POMS-defined morbidity was similar regardless of whether data were collected prospectively or retrospectively (95% CI [−0.13–0.013]; p < 0.001). Non-inferiority for sensitivity was observed for all other POMS

  7. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis.

    Asseray, Nathalie; Papin, Christophe; Touchais, Sophie; Bemer, Pascale; Lambert, Chantal; Boutoille, David; Tequi, Brigitte; Gouin, François; Raffi, François; Passuti, Norbert; Potel, Gilles


    The identification of Propionibacterium acnes in cultures of bone and joint samples is always difficult to interpret because of the ubiquity of this microorganism. The aim of this study was to propose a diagnostic strategy to distinguish infections from contaminations. This was a retrospective analysis of all patient charts of those patients with >or=1 deep samples culture-positive for P. acnes. Every criterion was tested for sensitivity, specificity, and positive likelihood ratio, and then the diagnostic probability of combinations of criteria was calculated. Among 65 patients, 52 (80%) were considered truly infected with P. acnes, a diagnosis based on a multidisciplinary process. The most valuable diagnostic criteria were: >or=2 positive deep samples, peri-operative findings (necrosis, hardware loosening, etc.), and >or=2 surgical procedures. However, no single criterion was sufficient to ascertain the diagnosis. The following combinations of criteria had a diagnostic probability of >90%: >or=2 positive cultures + 1 criterion among: peri-operative findings, local signs of infection, >or=2 previous operations, orthopaedic devices; 1 positive culture + 3 criteria among: peri-operative findings, local signs of infection, >or=2 previous surgical operations, orthopaedic devices, inflammatory syndrome. The diagnosis of P. acnes osteomyelitis was greatly improved by combining different criteria, allowing differentiation between infection and contamination.


    Chin, W. S.


    Full Text Available The exponentially weighted moving average (EWMA chart is effective in detecting small shifts. However, the EWMA chart is not robust enough to prevent errors in estimating the process standard deviation or a changing standard deviation. To overcome this problem, Zhang et al. suggested the EWMA t chart in 2009. The existing optimal design of the EWMA t chart is based on the average run length (ARL criterion. This paper proposes that the optimal design of the EWMA t chart be based on the median run length (MRL. The MRL performances of the optimal EWMA and optimal EWMA t charts are compared.

  9. Dually diagnosed: a retrospective study of the process of diagnosing autism spectrum disorders in children who are deaf and hard of hearing.

    Szarkowski, Amy; Flynn, Suzanne; Clark, Terrell


    Utilizing a retrospective chart review of 30 children who have been dually diagnosed with hearing loss and autism spectrum disorders (ASDs), this study explores the process of arriving at the diagnosis of ASD in this population. Factors of interest include the age of ASD diagnosis in children who are deaf and hard of hearing, the types of professionals involved in making the diagnosis, and the measures used for assessment. Complications in the diagnostic process are highlighted.


    Simona BUTA


    Full Text Available Since Adam Smith , FW Taylor, H. Fayol and recently , whether we are referring to Peter Drucker, Harrington & Harrington, and other authors consecrated in the literature of management / economics, the organization issues in an organization have grown much in complexity. The manner in which the firm / company constitutes the organization chart induces subsequently, explicitly or not, multiple conditionings in the daily practice of the organization (both in the sense that it may favour certain efforts / strategies or on the contrary it may block such efforts. The size of the company, the market and the technology are the most popular factors that will influence an organization chart.. However, in the context of global crisis and chaotic business environment, new questions arise regarding the model of organization charts and associated management strategies. What are the predictable directions regarding the type of organization chart in the current business environment? How does social competition influence the shape of organization charts in different countries?

  11. A two-part process for assessing the adequacy of hydrographic surveys and nautical chart coverage

    Azuike, Chukwuma

    IHO Publication C-55 contains information about the progress of hydrographic surveying and nautical charting for littoral states. Listed primarily as percent coverage, it is difficult to use this information to determine: 1) if the current level of surveying or charting is adequate or in need of action, or 2) can be used to compare different locations. An analysis methodology has been developed to assess the adequacy of hydrographic surveying and nautical charting coverage. Indications of chart adequacy as depicted on charts or sailing directions are spatially correlated with significant maritime areas associated with navigational/national interest. However, an analysis based solely on these datasets is limited without access to the current depth information. Publically-available, multi-spectral satellite imagery can be used to derive estimates of bathymetry and provide information in previously unsurveyed areas. Preliminary results show that multi-spectral satellite remote sensing is potentially beneficial as a reconnaissance tool prior to a hydrographic survey.

  12. Updating coastal and navigational charts using ERTS-1 data. [Lake Michigan and Little Bahama Bank

    Polcyn, F. C.; Lyzenga, D. R.


    A successful processing algorithm for extracting water depth information from ERTS data has been developed. Depth charts for two geographical areas have been constructed representing different solar illumination and water transparency conditions. Absolute depth calculations for water depth to 4.5 fathoms have been demonstrated for the Little Bahama Bank. Depth Charts also were constructed using data in Band 4 and 5 of the ERTS-1 MSS for areas in Lake Michigan. This data represented a low sun angle, poor light transmission in water conditions and gave useful results to 200 meters. In both cases, the ERTS map represented an update in shallow water detail in comparison with available navigation charts for the areas tested. Present processing costs to provide MSS depth charts are estimated to be on the order of $1.50 per sq. mile. The updating of navigation charts for areas hazardous to shipping is an achievable direct application.

  13. Application of a binomial cusum control chart to monitor one drinking water indicator

    Elisa Henning


    Full Text Available The aim of this study is to analyze the use of a binomial cumulative sum chart (CUSUM to monitor the presence of total coliforms, biological indicators of quality of water supplies in water treatment processes. The sample series were monthly taken from a water treatment plant and were analyzed from 2007 to 2009. The statistical treatment of the data was performed using GNU R, and routines were created for the approximation of the upper limit of the binomial CUSUM chart. Furthermore, a comparative study was conducted to investigate whether there is a significant difference in sensitivity between the use of CUSUM and the traditional Shewhart chart, the most commonly used chart in process monitoring. The results obtained demonstrate that this study was essential for making the right choice in selecting a chart for the statistical analysis of this process.

  14. Manufacturer-provided effective orifice area index charts and the prevention of prosthesis-patient mismatch.

    House, Chad M; Nelson, William B; Kroshus, Timothy J; Dahiya, Ranjan; Pibarot, Philippe


    Prosthesis-patient mismatch (PPM) occurs when an implanted prosthesis is too small relative to the patient's body surface area (BSA). However, mismatch can often be prevented by indexing the expected effective orifice area (EOA) of a prosthesis to the patient's BSA and then selecting the largest implantable prosthesis to avoid mismatch. Previously, prosthesis manufacturers have attempted to simplify this process by providing charts that include the expected EOA for their prosthesis, already indexed into an array of BSA values. One caveat with these charts is that the expected EOA data must truly be reliable, or the charts will misguide the implanting surgeon. Manufacturer-provided charts could be improved by standardizing the EOA data, with one potential source being the hemodynamic data submitted to the United States Food and Drug Administration. This review discusses PPM, manufacturer-provided EOA charts, and the regulation of EOA data.

  15. Applying heuristic evaluation to observation chart design to improve the detection of patient deterioration.

    Preece, Megan H W; Hill, Andrew; Horswill, Mark S; Karamatic, Rozemary; Hewett, David G; Watson, Marcus O


    A key goal for patient safety is to improve the early recognition and management of patients whose conditions deteriorate whilst in hospital. Paper-based observation charts are the main means of recording and monitoring patients' physiological stability, yet observations (e.g., blood pressure, heart rate, and respiratory rate) are not always correctly recorded or appropriately acted upon. No prior published study has applied usability heuristics to systematically compare the usability of multiple observation chart designs. In this study, five evaluators with human factors, applied psychology, or medical expertise inspected 25 observation charts for usability problems. Every chart was found to have substantial usability problems, potentially affecting the ability of hospital staff to accurately record observations or recognize patient deterioration. We proposed a new observation chart design, which avoids many of the previously observed usability problems.

  16. Multi-Tiered Observation and Response Charts: Prevalence and Incidence of Triggers, Modifications and Calls, to Acutely Deteriorating Adult Patients.

    Arthas Flabouris

    Full Text Available Observation charts are the primary tool for recording patient vital signs. They have a critical role in documenting triggers for a multi-tiered escalation response to the deteriorating patient. The objectives of this study were to ascertain the prevalence and incidence of triggers, trigger modifications and escalation response (Call amongst general medical and surgical inpatients following the introduction of an observation and response chart (ORC.Prospective (prevalence, over two 24-hour periods, and retrospective (incidence, over entire hospital stay, observational study of documented patient observations intended to trigger one of three escalation responses, being a MER-Medical Emergency Response [highest tier], MDT-Multidisciplinary Team [admitting team], or Nurse-senior ward nurse [lowest tier] response amongst adult general medical and surgical patients.416 patients, 321 (77.2% being medical admissions, median age 76 years (IQR 62, 85 and 95 (22.8% Not for Resuscitation (NFR. Overall, 193 (46.4% patients had a Trigger, being 17 (4.1% MER, 45 (10.8% MDT and 178 (42.8% Nurse triggers. 60 (14.4% patients had a Call, and 72 (17.3% a modified Trigger.206 patients, of similar age, of whom 166 (80.5% had a Trigger, 122 (59.2% a Call, and 91 (44.2% a modified Trigger. PREVALENCE and incidence of failure to Call was 33.2% and 68% of patients, respectively, particular for Nurse Triggers (26.7% and 62.1%, respectively. The number of Modifications, Calls, and failure to Call, correlated with the number of Triggers (0.912 [p<0.01], 0.631 [p<0.01], 0.988 [p<0.01].Within a multi-tiered response system for the detection and response to the deteriorating patient Triggers, their Modifications and failure to Call are common, particularly within the lower tiers of escalation. The number of Triggers and their Modifications may erode the structure, compliance, and potential efficacy of structured observation and response charts within a multi-tiered response

  17. Kornati Islands on Old Geographic Maps and Charts

    Josip Faričić


    Full Text Available Based on the analysis of cartographic sources, the paper analyses the historical and geographical development of the Kornati islands, the largest group of Croatian islands. The old maps were used first of all as the means of geographic research that, being necessarily correlated to the simultaneous historical written sources and modern topographic and maritime maps, make the basis for creating a research platform for relevant scientific results to be achieved. On the basis of the old maps it is possible, among other things to anticipate that the Kornati islands used to have great geotraffic significance on the eastern Adriatic sailing route. According to the development of geographic concepts and cartographic methods, the geographic vision of the Kornati islands has been gradually clarified ever since the 16th century. The chart from the Carta di cabotaggio del Mare Adriatico edition published by the Military and Geographic Institute from Milan (1822-1824 presents the turning point with the first complete and mostly precise presentation of the Kornati islands group on the basis of hydrographic and topographic field measurements.

  18. Digital waterway construction based on inland electronic navigation chart

    Wang, Xue; Pan, Junfeng; Zhu, Weiwei


    With advantages of large capacity, long distance, low energy consumption, low cost, less land occupation and light pollution, inland waterway transportation becomes one of the most important constituents of the comprehensive transportation system and comprehensive water resources utilization in China. As one of "three elements" of navigation, waterway is the important basis for the development of water transportation and plays a key supporting role in shipping economic. The paper discuss how to realize the informatization and digitization of waterway management based on constructing an integrated system of standard inland electronic navigation chart production, waterway maintenance, navigation mark remote sensing and control, ship dynamic management, and water level remote sensing and report, which can also be the foundation of the intelligent waterway construction. Digital waterway construction is an information project and also has a practical meaning for waterway. It can not only meet the growing high assurance and security requirements for waterway, but also play a significant advantage in improving transport efficiency, reducing costs, promoting energy conservation and so on. This study lays a solid foundation on realizing intelligent waterway and building a smooth, efficient, safe, green modern inland waterway system, and must be considered as an unavoidable problem for the coordinated development between "low carbon" transportation and social economic.

  19. Astrobiology: A Roadmap for Charting Life in the Universe

    DesMarais, David J.; DeVincezi, D. (Technical Monitor)


    Astrobiology is the study of the origin, evolution and distribution of life in the universe. It provides a biological perspective to many areas of NASA research. It links such endeavors as the search for habitable planets, exploration missions to Mars and the outer Solar System, efforts to understand the origins and early evolution of life, and charting the potential of life to adapt to future challenges, both on Earth and in space. Astrobiology addresses the following three basic questions, which have been asked in some form for generations. How does life begin and evolve? Does life exist elsewhere in the universe? What is future of life on Earth and beyond? The NASA Astrobiology Roadmap provides guidance for research and technology development across several NASA Enterprises: Space Science, Earth Science, and the Human Exploration and Development of Space. The Roadmap is formulated in terms of eight Science Goals that outline key domains of investigation that might require perhaps decades of effort to consolidate. For each of these goals, Science Objectives outline more specific high priority near-term efforts for the next three to five years. These twenty objectives will be integrated with NASA strategic planning.

  20. Off the Chart: The Crimean War in British Public Consciousness

    A. L. Berridge


    Full Text Available The Crimean War revealed in this issue of '19' is of such rich and varied historical interest as to make a mystery of its relative obscurity with the general public in the UK. My own article adopts a novelist’s perspective to chart some aspects of this popular decline, exploring the treatment of the Siege of Sebastopol through the media of painting, literature, and cinema, and considering whether those aspects of the war that have made the greatest impression on the public mind are also those that make it least commercially attractive. It also examines the more official legacy, from the treatment of war dead to the changing face of sculpted memorials, and by comparing British commemoration with that of Russians in Crimea, discusses the possible role played in national memory by both shame and pride. In a final brief analysis of the 1968 film 'The Charge of the Light Brigade', I consider the extent to which modern rejection of Victorian values has created historical distortion, and whether a more truthful presentation might better serve the cause of preserving an important war in the British public consciousness.

  1. Charting the Research Course for Sustainable Aquaculture in Sabah, Malaysia

    Vun L. W.


    Full Text Available Due to arising needs and demands, aquaculture is currently the fastest growing food production sector. In order to increase yield and yet to remain sustainable, the challenges would be to minimise impact on the environment and ecosystem services. Aquaculture activity contributes significantly to Malaysia and also the state of Sabah’s economy and food security. Hence, the future changes in the environment as a result of rapid population growth and development would pose as threats to this industry in terms of quality, quantity and sustainability. Unforeseen environmental changes such as environmental pollution from other sources, climate change and the changes in policies would jeopardize the sustainability of this industry. In order to anticipate such impacts to the aquaculture activities, this paper set to chart a sustainable course for its development. Four important research courses were proposed: establishment of a sustainable framework, assessment of impacts of climate change, viability and vulnerability assessment due to future environmental changes and food security. Such findings would eventually allow the stakeholders to plan and manage the resources and aquaculture activities in such a way that foster sustainable food security and resilient aquatic ecosystems.

  2. Astronomical Books and Charts in the Book of Bibliographie Coreenne

    Lee, Ki-Won; Yang, Hong-Jin; Park, Myeong-Gu


    We investigate astronomical materials listed in the book of Bibliographie Coréenne written by Maurice Courant. He classified ancient Korean books into nine Divisions (?) and thirty six Classes (?), and published them as three volumes (ranging from 1894 to 1896) and one supplement (in 1901). In total, 3,821 books including astronomical ones are listed together with information on physical size, possessional place, bibliographical note, and so forth. Although this book is an essential one in the field of Korea bibliography and contains many astronomical materials such as Cheon-Mun-Ryu-Cho ????, Si-Heon-Seo ??????, and Cheon-Sang-Yeol-Cha-Bun-Ya-Ji-Do ????????, it has not been well known to the public nor to astronomical society. Of 3,821 catalogues, we found that about 50 Items (?) are related to astronomy or astrology, and verified that most ! of them are located in the Kyujanggak Royal Library ???. We also found an unknown astronomical chart, Hon-Cheon-Chong-Seong-Yeol-Cha-Bun-Ya-Ji-Do ??????????. Because those astronomical materials are not well known to international astronomical community and there have been few studies on the materials in Korea, we here introduce and review them, particularly with the astronomical viewpoint.

  3. The use of principal components and univariate charts to control multivariate processes

    Marcela A. G. Machado


    Full Text Available In this article, we evaluate the performance of the T² chart based on the principal components (PC X chart and the simultaneous univariate control charts based on the original variables (SU charts or based on the principal components (SUPC charts. The main reason to consider the PC chart lies on the dimensionality reduction. However, depending on the disturbance and on the way the original variables are related, the chart is very slow in signaling, except when all variables are negatively correlated and the principal component is wisely selected. Comparing the SU , the SUPC and the T² charts we conclude that the SU X charts (SUPC charts have a better overall performance when the variables are positively (negatively correlated. We also develop the expression to obtain the power of two S² charts designed for monitoring the covariance matrix. These joint S² charts are, in the majority of the cases, more efficient than the generalized variance chart.Neste artigo, avaliamos o desempenho do gráfico de T² baseado em componentes principais (gráfico PC e dos gráficos de controle simultâneos univariados baseados nas variáveis originais (gráfico SU X ou baseados em componentes principais (gráfico SUPC. A principal razão para o uso do gráfico PC é a redução de dimensionalidade. Entretanto, dependendo da perturbação e da correlação entre as variáveis originais, o gráfico é lento em sinalizar, exceto quando todas as variáveis são negativamente correlacionadas e a componente principal é adequadamente escolhida. Comparando os gráficos SU X, SUPC e T² concluímos que o gráfico SU X (gráfico SUPC tem um melhor desempenho global quando as variáveis são positivamente (negativamente correlacionadas. Desenvolvemos também uma expressão para obter o poder de detecção de dois gráficos de S² projetados para controlar a matriz de covariâncias. Os gráficos conjuntos de S² são, na maioria dos casos, mais eficientes que o gr

  4. Treatment of painful bone metastases by Quadramet: retrospective study in 77 patients 2-year experience; Traitement des metastases osseuses douloureuses par Quadramet: experience retrospective ches 77 patients sur 2 ans

    Klingelschmitt, S.; Boulahdour, H.; Blagosklonov, O.; Rudenko, B.; Aubry, R.; Bidet, A.C.; Bosset, J.F.; Cardot, J.C. [Centre Hospitalier Universitaire, 25 - Besancon (France)


    Metabolic radiotherapy offers an alternative therapeutic tactic in patients with painful bone metastases. The efficacy and toxicity of Quadramet were evaluated in 77 patients. All patients received a 37 MBq/kg dose of Quadramet, and 13 patients received the dose twice. Then, the efficacy of treatment was evaluated according to WHO/OMS score, to pain relief and modification of opioid treatment. The WHO/OMS score was not changed or increased in 87.5 % (63172) of patients. The pain relief was observed in 77.8 % (56/72) of patients. The antalgic treatment decreased in 76.4 % (55/72) of patients. In patients with prostatic cancer, pain relief (79.2 % of patients) was more noticeable than in patients with breast cancer (76.9 % of patients). An opposite response was observed in 8.3 % (6/72) of patients. The rate of PSA decreased in 42.8 % (12/28) of patients with prostatic cancer. The only toxicity observed was myelo-toxicity. This toxicity was moderate and recovered by 8 weeks. After the second administration of Quadramet as well as after the first, we observed the pain relief in 76.9 % of patients. The results of our study confirm the efficacy and the safety of Quadramet in early painful bone metastases treatment. This treatment can be repeated without decrease of the efficacy. (authors)

  5. A retrospective study of pheochromocytoma

    Larigani B


    Full Text Available Pheochromocytoma is a rare disease. A retrospective study of the signs and clinical course of this disorder was performed by evaluating medical records. Our fidings indicate that the prevalence of pheochromocytoma was equal in men and women, and most patients (56% were in their second and third decades of life. In 10% of the cases, the disease was bilateral, and in 13% it was outside the adrenal (totally para-aortic. The tumor was more common on the right side (8%, and 3.5% were familial. Almost all cases had a history of hypertension and hypertensive crises. Attack-like episodes of clinical symptoms and signs and hypertension were observed in 98%, headache in 71% and profuse perspiration in 68% of the cases. An abdominal mass was palapated in 13% of the cases, 26% had overt diabetes, 23% had ECG changes. Malignancy was observed in 4%, with metastases to the liver (n=2 lung (n=1 and spine (n=1. In the latter four cases, the metastic lesion was histologically proven to be pheochromocytoma. In three of the 28 female cases, the first hypertensive crisis occurred during pregnancy causing abortion in one case.

  6. A retrospective of VAWT technology.

    Ashwill, Thomas D.; Sutherland, Herbert J. (HJS Consulting, Albuquerque, NM); Berg, Dale E.


    The study of Vertical-Axis Wind Turbine (VAWT) technology at Sandia National Laboratories started in the 1970's and concluded in the 1990's. These studies concentrated on the Darrieus configurations because of their high inherent efficiency, but other configurations (e.g., the Savonius turbine) were also examined. The Sandia VAWT program culminated with the design of the 34-m 'Test Bed' Darrieus VAWT. This turbine was designed and built to test various VAWT design concepts and to provide the necessary databases to validate analytical design codes and algorithms. Using the Test Bed as their starting point, FloWind Corp. developed a commercial VAWT product line with composite blades and an extended height-to-diameter ratio. The purpose of this paper is to discuss the design process and results of the Sandia 34-m VAWT Test Bed program and the FloWind prototype development program with an eye toward future offshore designs. This paper is our retrospective of the design, analysis, testing and commercial process. Special emphasis is given to those lessons learned that will aid in the development of an off-shore VAWT.

  7. Hand infections: a retrospective analysis

    Tolga Türker


    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  8. News from the Library: The 8th edition Karlsruhe nuclide chart has been released

    CERN Library


    The 8th edition of the Karlsruhe Nuclide Chart contains new data not found in the 7th edition.   Since 1958, the well-known Karlsruhe Nuclide Chart has provided scientists with structured, valuable information on the half-lives, decay modes and energies of radioactive nuclides. The chart is used in many disciplines in physics (health physics, radiation protection, nuclear and radiochemistry, astrophysics, etc.) but also in the life and earth sciences (biology, medicine, agriculture, geology, etc.). The 8th edition of the Karlsruhe Nuclide Chart contains new data on 737 nuclides not found in the 7th edition. In total, nuclear data on 3847 experimentally observed ground states and isomers are presented. A new web-based version of this chart is in the final stages of development for use within the Nucleonica Nuclear Science Portal - a portal for which CERN has an institutional license. The chart is also available in paper format.   If you want to buy a paper version of the chart, ple...

  9. Performance of Statistical Control Charts with Bilateral Limits of Probability to Monitor Processes Weibull in Maintenance

    Quintana Alicia Esther


    Full Text Available Manufacturing with optimal quality standards is underpinned to the high reliability of its equipment and systems, among other essential pillars. Maintenance Engineering is responsible for planning control and continuous improvement of its critical equipment by any approach, such as Six Sigma. This is nourished by numerous statistical tools highlighting, among them, statistical process control charts. While their first applications were in production, other designs have emerged to adapt to new needs as monitoring equipment and systems in the manufacturing environment. The time between failures usually fits an exponential or Weibull model. The t chart and adjusted t chart, with probabilistic control limits, are suitable alternatives to monitor the mean time between failures. Unfortunately, it is difficult to find publications of them applied to the models Weibull, very useful in contexts such as maintenance. In addition, literature limits the study of their performance to the analysis of the standard metric average run length, thus giving a partial view. The aim of this paper is to explore the performance of the t chart and adjusted t chart using three metrics, two unconventional. To do this, it incorporates the concept of lateral variability, in their forms left and right variability. Major precisions of the behavior of these charts allow to understand the conditions under which are suitable: if the main objective of monitoring lies in detecting deterioration, the t chart with adjustment is recommended. On the other hand, when the priority is to detect improvements, the t chart without adjustment is the best choice. However, the response speed of both charts is very variable from run to run.

  10. Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts As Visual Acuity Measurement Devices.

    I A T Livingstone

    Full Text Available Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc. and three ETDRS (Early Treatment Diabetic Retinopathy Study visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2 providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90% regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%. Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off had adequate mean luminance (≥ 120 cd/m2 and Weber contrast (≥ 90%, but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%. Two charts were operating beyond manufacturer's recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out

  11. The first published chart of the Andromeda Nebula, 1667

    Gingerich, Owen


    The Parisian astronomer Ismaél Bullialdus (1605-1694) is known for his planetary tables (Astronomia philolaica, 1645) based on a geometrical approximation to the Keplerian ellipse, and for his long correspondence with the Danzig astronomer Johannes Hevelius and with Christiaan Huygens. Bullialdus became interested in the nascent study of variable stars, and in 1667 published a small pamphlet with two contributions, one on Mira Ceti and the other on the nebula in Andromeda. He found a manuscript portraying the nebula with the date 1428, and because Tycho Brahe never mentioned a nebula in Andromeda, Bullialdus conjectured that this object was a variable that had disappeared in the intervening era. “We conclude this since this conglomeration was observed neither by Hipparchus nor anyone else in antiquity, nor in the previous age by Tycho, nor in the age of our forefathers like Bayer.” His publication included a handsome engraving of the image of Andromeda and the position of the nebula, its first printed chart. I recently acquired a copy of this rare pamphlet, Ad astronomos monita duo, and realized that the image matched a manuscript now in the Gotha Research Library, a 15th-century Latin version based on the work of the tenth-century Islamic astronomer, al-Sufi. The manuscript does not carry the name of al-Sufi, and hence Bullialdus had no real clue about its origin or its date of composition. Paul Kunitzsch (The Arabs and the Stars, 1989, Article XI, “The Astronomer Abu ’l-Husayn al-Sufi”) has identified a group of eight “Latin al-Sufi” manuscripts from this period, scattered in European libraries, but only the one now in Gotha is an exact match to Bullialdus’ engraving. The al-Sufi manuscript was given to the Gotha Library in 1798 by Duke Ernst II of Saxonia-Gotha-Altenburg, who must have acquired it from France sometime in the 18th century.


    Ashit Chakraborty


    Full Text Available Measurement error is the difference between the true value and the measured value of a quantity that exists in practice and may considerably affect the performance of control charts in some cases. Measurement error variability has uncertainty which can be from several sources. In this paper, we have studied the effect of these sources of variability on the power characteristics of control chart and obtained the values of average run length (ARL for zero-truncated Poisson distribution (ZTPD. Expression of the power of control chart for variable sample size under standardized normal variate for ZTPD is also derived.


    Michael Anthony Arnold Cox


    Full Text Available The cumulative sum (CUSUM chart is widely employed in quality control. These charts are designed to exhibit acceptable average run lengths (ARL both when the process is in and out of control. For such a chart, for specified ARLs, this paper introduces a technique employing a simple linear approximation for parameter selection. Graphs are produced to provide the coefficients for the fit. The simplicity of this approach should encourage its adoption as an additional tool in the statistical process control kit.

  14. User's Guide to the Energy Charting and Metrics Tool (ECAM)

    Taasevigen, Danny J.; Koran, William


    The intent of this user guide is to provide a brief description of the functionality of the Energy Charting and Metrics (ECAM) tool, including the expanded building re-tuning functionality developed for Pacific Northwest National laboratory (PNNL). This document describes the tool's general functions and features, and offers detailed instructions for PNNL building re-tuning charts, a feature in ECAM intended to help building owners and operators look at trend data (recommended 15-minute time intervals) in a series of charts (both time series and scatter) to analyze air-handler, zone, and central plant information gathered from a building automation system (BAS).

  15. 33 CFR 164.72 - Navigational-safety equipment, charts or maps, and publications required on towing vessels.


    ... waters of the U.S. or more than three nautical miles from shore on the Great Lakes. (iii) The charts or..., charts or maps, and publications required on towing vessels. 164.72 Section 164.72 Navigation and... NAVIGATION SAFETY REGULATIONS § 164.72 Navigational-safety equipment, charts or maps, and...

  16. Control charts for identifying systematic errors using control sera to detect antibody to Salmonella in an indirect ELISA

    Bak, H.; Barfod, Kristen


    This study evaluated the preparation of Shewhart's control charts using the concept of rational subgroups for monitoring the Salmonella antibody ELISA used for surveillance of Danish pig herds. Control charts were prepared for a buffer control sample, a negative serum sample and a positive serum ...... charts could reveal systematic analytical errors....

  17. Clustering of Dietary Intake and Sedentary Behavior in 2-Year-Old Children

    Gubbels, J.S.; Kremers, S.P.J.; Stafleu, A.; Dagnelie, P.C.; Vries,; Vries,; Thijs, C.


    Objective: To examine clustering of energy balance-related behaviors (EBRBs) in young children. This is crucial because lifestyle habits are formed at an early age and track in later life. This study is the first to examine EBRB clustering in children as young as 2 years. Study design: Cross-section

  18. Improving Social Competence through Emotion Knowledge in 2-Year-Old Children: A Pilot Study

    Giménez-Dasí, Marta; Fernández-Sánchez, Marta; Quintanilla, Laura


    Research Findings: The goal of this study was to determine the efficacy of an educational intervention program to improve emotion knowledge, emotion regulation, and social competence in 2-year-old Spanish children. This study makes two original contributions because there are no validated education programs for such young children and because it…




    Thirty-eight girls with Turner syndrome were treated for 2 years with human growth hormone. Both parents and patients carried out assessments of the effects of treatment on various aspects of psychosocial functioning. The children used the Piers-Harris Self-Concept Scale and the Social Anxiety Scale

  20. Persistence by 2-Year College Graduates to 4-Year Colleges and Universities.

    Dworkin, Stephen L.


    Presents findings from a study of the relationship between the characteristics of 3,762 Connecticut 2-year college students 25 or older and their persistence to 4-year colleges. Reports that students with higher perceptions of social and institutional support and those over 35 were more likely to persist to 4-year institutions. (10 citations) (AJL)

  1. Weight and Weight-Related Behaviors among 2-Year College Students

    Nanney, Marilyn S.; Lytle, Leslie A.; Farbakhsh, Kian; Moe, Stacey G.; Linde, Jennifer A.; Gardner, Jolynn K.; Laska, Melissa N.


    Objectives and Participants: The purpose of this article is to describe weight indicators and weight-related behaviors of students enrolled in 2-year colleges, including sex differences. Methods: During Fall 2011 and Spring 2012, 441 students from 3 Minnesota community colleges enrolled in the Choosing Healthy Options in College Environments and…

  2. Slowly but Surely: Adverbs Support Verb Learning in 2-Year-Olds

    Syrett, Kristen; Arunachalam, Sudha; Waxman, Sandra R.


    To acquire the meanings of verbs, toddlers make use of the surrounding linguistic information. For example, 2-year-olds successfully acquire novel transitive verbs that appear in semantically rich frames containing content nouns ("The boy is gonna pilk a balloon"), but they have difficulty with pronominal frames ("He is gonna pilk…

  3. Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years

    Dahl, Ronald; Kapp, Alexander; Colombo, Giselda; De Monchy, Jan G. R.; Rak, Sabina; Emminger, Waltraud; Riis, Bente; Gronager, Pernille M.; Durham, Stephen R.


    Background: This is an interim analysis of a randomized, double-blind, placebo-controlled phase III trial with 3 years of daily treatment with grass tablet immunotherapy (GRAZAX; ALK-Abello A/S, Horsholm, Denmark) or placebo, followed by 2 years of follow-up to assess the persistent efficacy. Object

  4. Gender differences in outcome at 2-year follow-up of treated bipolar and depressed alcoholics.

    Farren, Conor K


    Alcohol dependence and affective disorders are significant health problems, and their co-occurrence is mutually detrimental. There are few long-term studies on the impact of treatment on the prognosis of these comorbid disorders. We wished to study if the impact of effective inpatient integrated treatment for these co-occurring disorders was maintained 2 years after discharge from the hospital.

  5. Course of neuropsychiatric symptoms in residents with dementia in nursing homes over 2-year period

    Wetzels, Roland B; Zuidema, Sytse U; de Jonghe, Jos F M; Verhey, Frans R J; Koopmans, Raymond T C M


    OBJECTIVE: To determine the course of neuropsychiatric symptoms (NPSs) in nursing home residents with dementia and to determine their variability across diagnosis. DESIGN: Prospective cohort study over 2 years. SETTING: Fourteen dementia special care units in nine nursing homes in The Netherlands. P

  6. Sexual Identity, Attractions, and Behavior among Young Sexual-Minority Women over a 2-Year Period.

    Diamond, Lisa M.


    Examined sexual identities, attractions, and behaviors of sexual-minority women in 2-year follow-up of women first interviewed at 16-23 years. Found half the participants had changed sexual-minority orientations more than once; one- third changed identities since the first interview. Found changes in sexual attractions were larger among bisexuals…

  7. Correlates of Physical Activity in 2-Year-Old Toddlers : The Generation R Study

    Wijtzes, Anne I.; Kooijman, Marjolein N.; Kiefte-de Jong, Jessica C.; de Vries, Sanne I.; Henrichs, Jens; Jansen, Wilma; Jaddoe, Vincent W. V.; Hofman, Albert; Moll, Henriette A.; Raat, Hein


    Objective To describe and identify correlates of objectively measured physical activity and sedentary behavior in 2-year-old toddlers. Study design A total of 347 children participating in a birth cohort study wore a unaxial ActiGraph accelerometer during 1 weekday and 1 weekend day. Information on

  8. Induced Bone by Calcium Ohosphate(Ca-P) Ceramics after 2-years Implantation

    ZHANG Zhiyong; KURITA Hiroshi; KOBAYASHI Hiroichi; KURASHINA Kenji


    The changes of induced bone with four kinds of Ca-P ceramics after 2 years im-plantation in the dorsal muscles of rabbits were investigated.After 2 years implantation,mature bone (with a lamellar structure after the remodeling process)with bone marrow was observed in HA1100 (HA,micro+macro porous),HA900(HA,micro+macro porous)and BCP(HA/TCP=7:3,mi-cro+macro porous),and no bone formation was observed in HA1200(HA,macro porous)ceramics. The induced bone neither disappeared nor grew uncontrollably,and was seen inside the pores of the implants or on the outer surface under the fibrous layer after 2 years.No bone formation was ob-served in the soft tissues distant from the implants.These results indicate that heterotopic bone for-mation induced by Ca-P materials did not give rise to uncontrolled growth over time,and the induced bone is limited to the inside or around the implants.Moreover,ectopic bone formation on the outer surface of the implants was detected in rabbits after 2 years.

  9. Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study

    Zwart, J.J.; Dupuis, J.R.O.; Richters, A.; Öry, F.; Roosmalen, J. van


    Purpose: As part of a larger nationwide enquiry into severe maternal morbidity, our aim was to assess the incidence and possible risk factors of obstetric intensive care unit (ICU) admission in the Netherlands. Methods: In a 2-year nationwide prospective population-based cohort study, all ICU admiss

  10. Single-tooth replacement by osseointegrated Astra Tech dental implants: a 2-year report

    Karlsson, U; Gotfredsen, K; Olsson, C


    This study presents the outcome of single-tooth restorations supported by Astra Tech single-tooth implants followed for 2 years. Forty-seven implants were placed in the same number of patients. Forty-three patients attended the second recall visit, and none of the evaluated implants have been...

  11. Increased time to pregnancy is associated with suboptimal neurological condition of 2-year-olds

    Seggers, Jorien; Schendelaar, Pamela; Bos, Arend F.; Heineman, Maas Jan; Middelburg, Karin J.; Haadsma, Maaike L.; Hadders-Algra, Mijna


    Objective To evaluate whether time to pregnancy (TTP) is associated with neurological condition of 2-year-old children born to subfertile parents. Design Data collected in a prospective, assessor-blinded follow-up study were used for cross-sectional analyses. Patients Participants were the singleton

  12. Correlates of physical activity in 2-year-old toddlers: The generation R study

    Wijtzes, A.I.; Kooijman, M.N.; Kiefte-de Jong, J.C.; Vries, S.I. de; Henrichs, J.; Jansen, W.; Jaddoe, V.W.V.; Hofman, A.; Moll, H.A.; Raat, H.


    Objective: To describe and identify correlates of objectively measured physical activity and sedentary behavior in 2-year-old toddlers. Study design: A total of 347 children participating in a birth cohort study wore a unaxial ActiGraph accelerometer during 1 weekday and 1 weekend day. Information o

  13. Predictors of the 2-year recurrence and persistence of alcohol dependence

    Boschloo, Lynn; Vogelzangs, Nicole; van den Brink, Wim; Smit, Johannes H.; Beekman, Aartjan T. F.; Penninx, Brenda


    Aims To identify independent risk factors of the recurrence of alcohol dependence (AD) in people with a remitted disorder at baseline and persistence of AD in people with a current disorder at baseline. Design Prospective cohort study with assessments at baseline and 2-year follow-up. Setting Recrui

  14. Intermittent pancreatitis in a 2-year-old chihuahua mixed breed dog.

    Chan, Alice K Y


    A 2-year-old, female, Chihuahua mixed breed was presented on multiple occasions with vomiting and diarrhea. Diagnostic tests, including blood analyses and ultrasonography, established pancreatitis as the cause of gastrointestinal irritation. Hospitalization and supportive care, followed by maintenance of a prescription gastrointestinal diet, allowed management of the disease.

  15. Oral lichen planus: A retrospective study of 633 patients from Bucharest, Romania

    Parlatescu, Ioanina; Gheorghe, Carmen; Tovaru, Mihaela; Costache, Mariana; Sardella, Andrea


    Objective: In this retrospective study, patients’ medical records were reviewed to investigate the profiles of 633 OLP cases in a group of Romania. Material and Methods: In this retrospective study, the following clinical data were obtained from the medical charts of patients: gender, age, clinical presentation of OLP, site affected, presence of symptoms, extraoral manifestations of lichen planus, presence of systemic diseases, and history of medications. Results: Most (78.67%) OLP patients were female and the mean age at presentation was 52 years. The white type of the disease (reticular/papular/plaque lesions) was the main form encountered in this sample (48.97%). Among patients with available hepatitis C virus test results, 9.6% were serum-positive. OLP was associated with gallbladder disease (i.e. cholecystitis, cholelithiasis) in 19% of patients. Six patients (0.95%) developed squamous cell carcinoma at a site with confirmed OLP lesions. Conclusions: To the best of our knowledge, no similar study has been conducted in a Romanian population. The present investigation revealed the predominance of OLP among middle-aged white women and the prevalence of bilateral involvement of the buccal mucosa with reticular white lesions. Anti-HCV circulating antibodies were more common in patients with OLP than in the general population and, notably, OLP was associated with gallbladder disease (cholecystitis, cholelithiasis) in 19% of patients. Key words:Oral lichen planus, oral mucosal diseases, retrospective study. PMID:23229244

  16. Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

    Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D


    Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

  17. Increased Food Insecurity Among Mothers of 2 Year Olds with Special Health Care Needs.

    Adams, Elizabeth J; Hoffmann, Laurel M; Rosenberg, Kenneth D; Peters, Dawn; Pennise, Melissa


    The objective of this study is to explore the association between having a child with special health care needs (CSHCN) and food insecurity when the child is 2 years old. We studied women who had a live birth in 2004-2005 and responded to Oregon's Pregnancy Risk Assessment Monitoring System (PRAMS) survey 3 months postpartum (Time 1) and the follow-up survey (PRAMS-2), when the child was 2 years old (Time 2). Women answering affirmatively to the PRAMS-2 question, "In the last 12 months, did you ever eat less than you felt you should because there was not enough money for food?" were considered food insecure. CSHCN status was identified by affirmative responses to questions about needs for ongoing services (Time 2). PRAMS and PRAMS-2 responses were weighted for study design and non-response. Results report weighted analyses, unless noted. Among 1812 mothers completing PRAMS-2, 13.6 % (unweighted) had a 2-year-old CSHCN and 11.9 % (unweighted) were food insecure at Time 2. The estimated prevalence of food insecurity at 2-year follow-up was 20.7 % among families of CSHCN and 9.7 % for others. After adjustment for Time 2 marital status, education, lifetime U.S. residence, income and health conditions, multivariable logistic regression revealed that odds of food insecurity were more than two times as great for CSHCN mothers 2 years post-partum compared to non-CSHCN mothers (adjusted odds ratio 2.6, 95 % confidence interval 1.3, 4.6). Families of CSHCN face increased risk for food insecurity. Improved understanding of causal determinants of food insecurity among households of CSHCN is needed.

  18. Sea Ice Charts of the Russian Arctic in Gridded Format, 1933-2006

    National Oceanic and Atmospheric Administration, Department of Commerce — The Arctic and Antarctic Research Institute (AARI) in St. Petersburg, Russia, produces sea ice charts for safety of navigation in the polar regions and for other...

  19. Accident investigation of construction sites in Qom city using Pareto chart (2009-2012

    M. H. Beheshti


    .Conclusions: Employing Pareto charts as a method for analyzing and identification of accident causes can have an effective role in the management of work-related accidents, proper allocation of funds and time.

  20. Accuracy of Sea Charts and Navigational Publications and the Influence of Printing

    Josip Kasun


    Full Text Available The main printed products of hydrographic organizations are sea charts and navigational publications. The disproportion of their information content with the actual data is a direct consequence of processes applied in their production, updating and actual changes. The information content of sea charts and navigational publications contains inherent and influent deviations. The accuracy of sea charts and navigational publications changes and decreases in the course of time. It equals the maximum accuracy of applied technology, including the graphic technology during the process of production, i.e. printing. The accuracy is in the function of time and updating procedure. The role of printing in the process of production is to increase the accuracy of sea charts and navigational publications by applying appropriate technology, standardization and reducing the time of graphic preparations and printing.

  1. Capabilities of Statistical Residual-Based Control Charts in Short- and Long-Term Stock Trading

    Žmuk Berislav


    Full Text Available The aim of this paper is to introduce and develop additional statistical tools to support the decision-making process in stock trading. The prices of CROBEX10 index stocks on the Zagreb Stock Exchange were used in the paper. The conducted trading simulations, based on the residual-based control charts, led to an investor’s profit in 67.92% cases. In the short run, the residual-based cumulative sum (CUSUM control chart led to the highest portfolio profits. In the long run, when average stock prices were used and 2-sigma control limits set, the residual-based exponential weighted moving average control chart had the highest portfolio profit. In all other cases in the long run, the CUSUM control chart appeared to be the best choice. The acknowledgment that the SPC methods can be successfully used in stock trading will, hopefully, increase their use in this field.

  2. A Comparison on the MRL Performances of Optimal MEWMA and Optimal MCUSUM Control Charts

    Khoo Michael Boon Chong


    Full Text Available The MEWMA (called the multivariate exponentially weighted moving average chart and the MCUSUM (called the multivariate cumulative sum chart are used in process monitoring when a quick detection of small or moderate shifts in the mean vector is desired. The primary objective of this study is to compare the performances of the optimal MEWMA and optimal MCUSUM charts based on their median run length (MRL profiles. The number of quality characteristics considered is p = 2. Two cases are studied, i.e., Case 1 (a shift in only one variable and Case 2 (a shift in two variables. A Monte Carlo simulation is conducted using Statistical Analysis Software (SAS to study and compare the MRL performances for various magnitudes of mean shifts when the process is normally distributed. Overall, the results show that the MRL performances of the MEWMA and MCUSUM charts are comparable.

  3. 7 CFR Appendix 1 to Part 799 - Organization Chart FSA-USDA



  4. Identifying the stars on Johann Bayer's Chart of the South Polar Sky

    Ridpath, I.


    The first chart of the stars in the region around the south celestial pole was published in 1603 by Johann Bayer (1572-1625) as part of his monumental star atlas called Uranometria. This south polar chart depicted 12 entirely new constellations that had been created only a few years earlier from stars observed during the first Dutch expedition to the East Indies in 1595-97. Bayer's chart plotted 121 stars in the 12 newly invented constellations. Five more stars formed a southern extension of the existing constellation Eridanus, while another twelve stars were left 'unformed', i.e. unattached to any constellation. Whereas Bayer famously applied Greek or Roman letters to the stars in the 48 Ptolemaic constellations, he left the stars in the newly invented constellations unlabelled. This paper attempts to identify the stars plotted on Bayer's chart. It also discusses the source of Bayer's data and the origin of the 12 new southern constellations.

  5. Applying Nightingale charts to evaluate the heterogeneity of biomedical waste in a Hospital

    Janini Cristina Paiz


    Full Text Available OBJECTIVES: to evaluate the heterogeneity of biomedical waste (BW using Nightingale charts.METHOD: cross-sectional study consisting of data collection on wastes (direct observation of receptacles, physical characterisation, and gravimetric composition, development of a Management Information System, and creation of statistical charts.RESULTS: the wastes with the greatest degree of heterogeneity are, in order, recyclable, infectious, and organic wastes; chemical waste had the most efficient segregation; Nightingale charts are useful for quick visualisation and systematisation of information on heterogeneity.CONCLUSION: the development of a management information system and the use of Nightingale charts allows for the identification and correction of errors in waste segregation, which increase health risks and contamination by infectious and chemical wastes and reduce the sale and profit from recyclables.

  6. Content knowledge and problem-solving skill in reviewing medical charts.

    Dawson-Saunders, B; Mast, T A; Finch, W T; Konrad, H R; Folse, J R


    Skills in reviewing medical charts have been demonstrated components of clinical competence related to knowledge base, level of clinical experience, and basic observational skills. A study of the generalizability of performance on chart review exercises, which controlled for knowledge in the content area, was undertaken to determine their potential in evaluating students' problem-solving ability. Results of the study indicate that the case specificity which has characterized simulated problem-solving tasks is largely case, rather than content, specificity: correlations between scores on single charts demonstrated no consistent relationships for measures of proficiency, efficiency, and diagnostic accuracy. However, averaging the scores on two charts and then computing correlations resulted in significant positive measures for both proficiency and efficiency. The effects of length and difficulty level on the generalizability of tests of problem-solving ability are areas suggested for future research.

  7. The Dehn Collection of Arctic Sea Ice Charts, 1953-1986

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Snow and Ice Data Center holds a collection of charts depicting ice conditions in the seas off Alaska and western Canada coasts. Ice edge position and...

  8. Adoption and Foster Care Analysis and Reporting System Trends Chart and Table

    U.S. Department of Health & Human Services — The AFCARS Trends Chart tracks children in Foster Care from FY 2002 through the most recent year. A table of data and a graphic depiction of trends are shown for...

  9. Office of Coast Survey's Collection of Print on Demand Charts (POD)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA, National Ocean Service, Office of Coast Survey is responsible to build and maintain a suite of more than 1000 nautical charts that are used by commercial and...

  10. Canadian Ice Service Arctic Regional Sea Ice Charts in SIGRID-3 Format

    National Oceanic and Atmospheric Administration, Department of Commerce — The Canadian Ice Service (CIS) produces digital Arctic regional sea ice charts for marine navigation, climate research, and input to the Global Digital Sea Ice Data...

  11. Coordinates and 2MASS and OGLE identifications for all stars in Arp's 1965 finding chart for Baade's Window

    Church, Ross P; Feltzing, Sofia


    Aims: We seek to provide 2MASS and OGLE identifications and coordinates for all stars in the finding chart published by Arp\\,(1965). This chart covers the low extinction area around NGC 6522, also known as Baade's window, at coordinates (l,b)=(1.02,-3.92). Methods: A cross correlation, using numerical techniques, was performed between a scan of the original finding chart from Arp (1965) and 2MASS and OGLE-II images and stellar coordinates. Results: We provide coordinates for all stars in Arp's finding chart and 2MASS and OGLE identifications wherever possible. Two identifications in quadrant II do not appear in the original finding chart.

  12. Optimal design for inspection and maintenance policy based on the CCC chart

    Chan, Ling-Yau; Wu, Shaomin


    In this paper, the concept of cumulative count of conforming chart (CCC chart) is applied in inspection and maintenance planning for systems where minor inspection, major inspection, minor maintenance and major maintenance are available. Several inspection and maintenance plans are defined and studied quantitatively. Analytic expressions of relevant statistics and their expectations are derived. These inspection and maintenance plans are optimized from an economic consideration.

  13. An Ontology of the Submarine Relief for Analysis and Representation on Nautical Charts

    YAN, Jingya; Guilbert, Eric; Saux, Eric


    A nautical chart is a kind of map used to describe the seafloor morphology and shoreline of adjacent lands. One of its main purposes is to guaranty safety of navigation. As a consequence, construction of a nautical chart follows very specific rules. The cartographer has to select and highlight undersea features according to their relevance to navigation. In an automated process, the system must be able to identify and classify these features from the terrain model. This paper aims therefore a...

  14. Charts of episodes and chronometric duration have implications for provinces such as the Kaapvaal

    H. de la R. Winter


    Full Text Available An accurate basin analysis and knowledge of its evolutionary development being a prerequisite framework for metallogenic model­ling, a procedure was developed for the Kaapvaal Province to maximise quantitative observational data and constrain assumptions and interpretations. Employing an episodes chart to display various events interactively and its conversion to a geochronometric chart as the geological model, the method was applied to existing stratigraphic studies.

  15. Ab initio Quantum Chemical Reaction Kinetics: Recent Applications in Combustion Chemistry (Briefing Charts)

    2015-06-28 Ab initio Quantum Chemical Reaction Kinetics: Recent Applications in Combustion Chemistry Ghanshyam L. Vaghjiani* DISTRIBUTION A...Charts 3. DATES COVERED (From - To) June 2015-June 2015 4. TITLE AND SUBTITLE AB INITIO QUANTUM CHEMICAL REACTION KINETICS: RECENT APPLICATIONS IN...COMBUSTION CHEMISTRY (Briefing Charts) 5a. CONTRACT NUMBER In-House 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Ghanshyam L

  16. On-the-Fly Massively Multitemporal Change Detection Using Statistical Quality Control Charts and Landsat Data


    One challenge to implementing spectral change detection algorithms using multitemporal Landsat data is that key dates and periods are often missing from the record due to weather disturbances and lapses in continuous coverage. This paper presents a method that utilizes residuals from harmonic regression over years of Landsat data, in conjunction with statistical quality control charts, to signal subtle disturbances in vegetative cover. These charts are able to detect changes from both defores...

  17. Pathfinder, Volume 7, Number 5, September/October 2009. Charting the Sea and Sky


    tsunamis and military exercises. Technology has also accelerated support for maritime missions: our Digital Nautical Chart ( DNC ®) is the only digital chart set in the world. The DNC ®, updated every 28 days, aggregates hydrographic and bathymetric data along with information about...harbor and port facilities, imagery, surveys and user feedback. The DNC ® is available via CD and the World Wide Web. To support our mission partners in

  18. p-charts in the quality control of the grading process in the high education

    Savić Mirko


    Full Text Available European countries are making efforts to change their educational system These changes include implementation of the ECTS (European Credit Transfer and Accumulation System and are based on the Bologna Declaration. Adoption of ECTS will necessitate new quality standards in higher education especially in grading procedures. With only small modifications, the control charts(such as p-charts used in production and distribution applications can be applied to educational purposes.

  19. A chart for the energy levels of the square quantum well

    Chiani, M


    A chart for the quantum mechanics of a particle of mass $m$ in a one-dimensional potential well of width $w$ and depth $V_0$ is derived. The chart is obtained by normalizing energy and potential through multiplication by ${8 m}{h^2} / w^2$, and gives directly the allowed couples (potential, energy), providing insights on the relation between the parameters and the number of allowed energy levels.

  20. 9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...


    ... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate...

  1. Minimal adverse effects profile following implantation of periauricular percutaneous electrical nerve field stimulators: a retrospective cohort study

    Roberts, Arthur; Sithole, Alec; Sedghi, Marcos; Walker, Charles A; Quinn, Theresa M


    The periauricular percutaneous implantation of the Neuro-Stim System™ family of devices EAD, MFS, and BRIDGE is a procedure involving the use of a non-opiate, neuromodulation analgesic for relieving acute and chronic pain. It has been approved as a minimal-risk procedure by multiple governmental and institutional facilities. This retrospective report of findings will help quantify the incidence of clinically observed bleeding, localized dermatitis, and infections at the implantation sites of the electrode/needle arrays, dermatitis at the site of the generator, and patient syncope. A total of 1,207 devices, each producing up to 16 percutaneous punctures, for a total of 19,312 punctures were monitored for adverse effects, based on retrospective chart audits conducted at six clinical facilities over a 1-year period. PMID:27843360

  2. Everolimus-Based Therapy versus Chemotherapy among Patients with HR+/HER2- Metastatic Breast Cancer: Comparative Effectiveness from a Chart Review Study.

    Li, Nanxin; Hao, Yanni; Xie, Jipan; Lin, Peggy L; Koo, Valerie; Ohashi, Erika; Wu, Eric Q


    Objective. To compare the real-world effectiveness of everolimus-based therapy and chemotherapy in postmenopausal women with hormone-receptor-positive/human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC). Methods. This retrospective chart review examined a nationwide sample of postmenopausal HR+/HER2- mBC women in community-based oncology practices. Patients received everolimus-based therapy or chemotherapy for mBC between 07/01/2012 and 04/15/2013, after failure of a non-steroidal aromatase inhibitor. Overall survival (OS), progression-free survival (PFS), and time on treatment (TOT) were compared using Kaplan-Meier analysis and Cox proportional hazards models adjusting for line of therapy and baseline characteristics. Results. 234 and 137 patients received everolimus-based therapy and chemotherapy. Patients treated with everolimus-based therapy tended to have less aggressive mBC than patients treated with chemotherapy. Multivariate-adjusted Cox models showed that everolimus-based therapy was associated with significantly longer OS [hazard ratio (HR) = 0.37, 95% confidence interval (CI): 0.22-0.63], PFS (HR = 0.70, 95% CI = 0.50-0.97), and TOT (HR = 0.34, 95% CI: 0.25-0.45) than chemotherapy. Adjusted comparative effectiveness results were generally consistent across lines of therapy. Conclusion. In this retrospective chart review of postmenopausal HR+/HER2- mBC patients, treatment with everolimus-based therapy was associated with longer OS, PFS, and TOT than chemotherapy.

  3. Fusing Multiscale Charts into 3D ENC Systems Based on Underwater Topography and Remote Sensing Image

    Tao Liu


    Full Text Available The purpose of this study is to propose an approach to fuse multiscale charts into three-dimensional (3D electronic navigational chart (ENC systems based on underwater topography and remote sensing image. This is the first time that the fusion of multiscale standard ENCs in the 3D ENC system has been studied. First, a view-dependent visualization technology is presented for the determination of the display condition of a chart. Second, a map sheet processing method is described for dealing with the map sheet splice problem. A process order called “3D order” is designed to adapt to the characteristics of the chart. A map sheet clipping process is described to deal with the overlap between the adjacent map sheets. And our strategy for map sheet splice is proposed. Third, the rendering method for ENC objects in the 3D ENC system is introduced. Fourth, our picking-up method for ENC objects is proposed. Finally, we implement the above methods in our system: automotive intelligent chart (AIC 3D electronic chart display and information systems (ECDIS. And our method can handle the fusion problem well.

  4. LBL Socio-Economic Environmental-Demographic Information System (SEEDIS). Chart: graphic analysis and display system

    Sventek, V.A.


    The Chart Graphic Analysis and Display System was developed as part of Lawrence Berkeley Laboratory's Socio-Economic-Environmental-Demographic Information System (SEEDIS) to provide a tool with which users could draw graphs, print tables of numbers, do analysis, and perform basic statistical operations on the same set of data from a terminal in their own office. The Chart system's operation is completely independent of the type of data being entered and has been used for applications ranging from employment to energy data. Users frequently save the data they put into Chart and add to it on a regular basis, and thereby create personal databases which can be blended with information from the formal databases maintained at LBL. Using any computer system requires that the user learn a set of instructions, which at the onset often seems overwhelming. It is the purpose of this workbook to make this initial learning process less traumatic. The typical use of Chart is to enter a set of numbers, and then tell Chart what should be done with them. Chart commands take the form of gruff pidgin English. There are approximately 50 commands available. This workbook illustrates the basic commands. (RWR)

  5. Recurrence Plot Based Damage Detection Method by Integrating  Control Chart

    Cheng Zhou


    Full Text Available Because of the importance of damage detection in manufacturing systems and other areas, many fault detection methods have been developed that are based on a vibration signal. Little work, however, has been reported in the literature on using a recurrence plot method to analyze the vibration signal for damage detection. In this paper, we develop a recurrence plot based fault detection method by integrating the statistical process control technique. The recurrence plots of the vibration signals are derived by using the recurrence plot (RP method. Five types of features are extracted from the recurrence plots to quantify the vibration signals’ characteristic. Then, the  control chart, a multivariate statistical process control technique, is used to monitor these features. The  control chart technique, however, has the assumption that all the data should follow a normal distribution. The RP based  bootstrap control chart is proposed to estimate the control chart parameters. The performance of the proposed RP based  bootstrap control chart is evaluated by a simulation study and compared with other univariate bootstrap control charts based on recurrence plot features. A real case study of rolling element bearing fault detection demonstrates that the proposed fault detection method achieves a very good performance.

  6. Statistical Control Charts: Performances of Short Term Stock Trading in Croatia

    Dumičić Ksenija


    Full Text Available Background: The stock exchange, as a regulated financial market, in modern economies reflects their economic development level. The stock market indicates the mood of investors in the development of a country and is an important ingredient for growth. Objectives: This paper aims to introduce an additional statistical tool used to support the decision-making process in stock trading, and it investigate the usage of statistical process control (SPC methods into the stock trading process. Methods/Approach: The individual (I, exponentially weighted moving average (EWMA and cumulative sum (CUSUM control charts were used for gaining trade signals. The open and the average prices of CROBEX10 index stocks on the Zagreb Stock Exchange were used in the analysis. The statistical control charts capabilities for stock trading in the short-run were analysed. Results: The statistical control chart analysis pointed out too many signals to buy or sell stocks. Most of them are considered as false alarms. So, the statistical control charts showed to be not so much useful in stock trading or in a portfolio analysis. Conclusions: The presence of non-normality and autocorellation has great impact on statistical control charts performances. It is assumed that if these two problems are solved, the use of statistical control charts in a portfolio analysis could be greatly improved.

  7. The properties of the geometric-Poisson exponentially weighted moving control chart with estimated parameters

    Aamir Saghir


    Full Text Available The geometric-Poisson exponentially weighted moving average (EWMA chart has been shown to be more effective than the Poisson EWMA chart in monitoring the number of defects in the production processes. In these applications, it is assumed that the process parameters are known or have been accurately estimated. However, in practice, the process parameters are rarely known and must be estimated from reference sample to construct the geometric-Poisson EWMA chart. The performance of the given chart, due to variability in the parameter estimation, might differ from known parameters’ case. This article explored the effect of estimated parameters on the conditional and marginal performance of the geometric-Poisson EWMA chart. The run length characteristics are calculated using a Markov chain approach and the effect of estimation on the performance of the given chart is shown to be significant. Recommendations about the proposer choice of sample size, smoothing constant, and dispersion parameter are made. Results of this study highlight the practical implications of estimation error, and to offer advice to practitioners when constructing/analyzing a phase-I sample.

  8. Overview of the consortium of hospitals advancing research on tobacco (chart

    Riley William T


    Full Text Available Abstract Background The Consortium of Hospitals Advancing Research on Tobacco (CHART is a network of six projects and a research coordinating unit funded by the National Heart, Lung, and Blood Institute, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institutes of Health (NIH Office of Behavioral and Social Science Research. The CHART projects will assess the effectiveness and cost-effectiveness of smoking cessation interventions initiated during hospitalization and continued post-discharge. Methods/design Along with a seventh project funded previously under the NIH Challenge grants, the CHART projects will assess smoking cessation strategies delivered to approximately 10,000 hospitalized smokers across a geographically diverse group of nearly 20 private, public, academic, and community hospitals. The CHART research coordinating unit at Kaiser Permanente Center for Health Research provides organizational and data coordination support, facilitating the development of common measures for combining data from multiple CHART projects. Discussion The targeted enrollment in CHART, if achieved, will represent the largest, most diverse pooled dataset of hospitalized smokers receiving smoking cessation assistance, and is designed to contribute to the dissemination and implementation of smoking cessation interventions provided by hospital systems.

  9. Dynamic probability control limits for risk-adjusted Bernoulli CUSUM charts.

    Zhang, Xiang; Woodall, William H


    The risk-adjusted Bernoulli cumulative sum (CUSUM) chart developed by Steiner et al. (2000) is an increasingly popular tool for monitoring clinical and surgical performance. In practice, however, the use of a fixed control limit for the chart leads to a quite variable in-control average run length performance for patient populations with different risk score distributions. To overcome this problem, we determine simulation-based dynamic probability control limits (DPCLs) patient-by-patient for the risk-adjusted Bernoulli CUSUM charts. By maintaining the probability of a false alarm at a constant level conditional on no false alarm for previous observations, our risk-adjusted CUSUM charts with DPCLs have consistent in-control performance at the desired level with approximately geometrically distributed run lengths. Our simulation results demonstrate that our method does not rely on any information or assumptions about the patients' risk distributions. The use of DPCLs for risk-adjusted Bernoulli CUSUM charts allows each chart to be designed for the corresponding particular sequence of patients for a surgeon or hospital.

  10. The Usage of Time Series Control Charts for Financial Process Analysis

    Kovářík Martin


    Full Text Available We will deal with financial proceedings of the company using methods of SPC (Statistical Process Control, specifically through time series control charts. The paper will outline the intersection of two disciplines which are econometrics and statistical process control. The theoretical part will discuss the methodology of time series control charts and in the research part there will be this methodology demonstrated in three case studies. The first study will focus on the regulation of simulated financial flows for a company by CUSUM control chart. The second study will involve the regulation of financial flows for a heteroskedastic financial process by EWMA control chart. The last case study of our paper will be devoted to applications of ARIMA, EWMA and CUSUM control charts in the financial data that are sensitive to the mean shifting while calculating the autocorrelation in the data. In this paper, we highlight the versatility of control charts not only in manufacturing but also in managing the financial stability of cash flows.

  11. Multivariate control charts based on net analyte signal (NAS) and Raman spectroscopy for quality control of carbamazepine.

    Rocha, Werickson Fortunato de Carvalho; Poppi, Ronei Jesus


    Raman spectroscopy and control charts based on the net analyte signal (NAS) were applied to polymorphic characterization of carbamazepine. Carbamazepine presents four polymorphic forms: I-IV (dihydrate). X-ray powder diffraction was used as a reference technique. The control charts were built generating three charts: the NAS chart that corresponds to the analyte of interest (form III in this case), the interference chart that corresponds to the contribution of other compounds in the sample and the residual chart that corresponds to nonsystematic variations. For each chart, statistical limits were developed using samples within the quality specifications. It was possible to identify the different polymorphic forms of carbamazepine present in pharmaceutical formulations. Thus, an alternative method for the quality monitoring of the carbamazepine polymorphic forms after the crystallization process is presented.

  12. The Prescription of Off-Label Drugs towards 0–2 Years Old Pediatric Patients in Community Pharmacy in Bandung City

    Ami A. Pratiwi


    Full Text Available Off-label drug is a drug which is not prescribed in accordance with official drug information, including patient age, drug indications didn’t match with the marketing authorization, dosage and route of administration are not appropriate. This study was conducted to determine the percentage of patients pediatrician who prescribed with containing drugs off-label in pediatric patients aged 0 to 2 years at pharmacy in Bandung and determine the pattern of use through an observational study with retrospective data collection. Identification of medications that are prescribed off-label category or not based on the Pediatric Dosage Handbook 2007, Drug Information Handbook (DIH in 2012, the British National Formulary (BNF in 2009, MIMS USA 2013, MIMS Indonesia in 2013, and ISO 2012–2013. Based on the results obtained 542 pieces of off-label prescriptions (19.77% of the 2741 total pieces recipes, as well as 699 (7.89% of off-label drug items from 8861 drug, the percentage of off-label age category 70.53%, off-label doses of 19.74% and off-label contraindication 9.73%. The results of this study indicate that the uses of off-label drugs for children is high at Pharmacy in Bandung. This study is expected to be basic consideration in examining the efficacy and safety in off-label drug uses for children aged 0 to 2 years.

  13. Complete Response to Bicalutamide Withdrawal Prolonged for Almost 2 Years in Patients With Metastatic Prostate Cancer.

    Hongo, Hiroshi; Kosaka, Takeo; Oya, Mototsugu


    This is the first case report describing a complete response to bicalutamide withdrawal that lasted for almost 2 years in a patient with metastatic prostate cancer. An 80-year-old man who had prostate-specific antigen (PSA) level elevation (168.1 ng/mL) visited our hospital in February 2010. Bone scintigraphy showed pelvic metastases. We started hormonal therapy with leuprorelin and bicalutamide. The PSA concentration decreased to <0.1 ng/mL but started increasing again and reached 1.64 ng/mL in October 2012, at which time bicalutamide administration was discontinued. The PSA concentration decreased again and has remained below the limit of sensitivity for almost 2 years.

  14. Occupational allergic contact dermatitis in a 2-year follow-up study

    Brok, Line; Clemmensen, Kim Katrine Bjerring; Carøe, Tanja Korfitsen


    results and the results of natural rubber latex protein allergy after 2 years. METHODS: One hundred and ninety-nine patients diagnosed with relevant occupational epoxy or rubber chemical contact allergy, or allergy to natural rubber latex protein, were invited to participate in a questionnaire study about...... >60 years (p natural rubber latex proteins, 50% remembered this correctly. CONCLUSIONS: The impact of patch testing depends on the patients' ability to understand and remember the results...... their knowledge of contact allergies after 2 years. RESULTS: The response rate was 75%. Of the respondents, 13% did not remember their occupational contact allergy to rubber chemicals or epoxy. Ability to remember was not significantly influenced by sex or Dermatology Life Quality Index, but was decreased by age...

  15. 2 years versus 1 year of adjuvant trastuzumab for HER2-positive breast cancer (HERA)

    Goldhirsch, Aron; Gelber, Richard D; Piccart-Gebhart, Martine J


    Trastuzumab has established efficacy against breast cancer with overexpression or amplification of the HER2 oncogene. The standard of care is 1 year of adjuvant trastuzumab, but the optimum duration of treatment is unknown. We compared 2 years of treatment with trastuzumab with 1 year of treatmen......, and updated the comparison of 1 year of trastuzumab versus observation at a median follow-up of 8 years, for patients enrolled in the HERceptin Adjuvant (HERA) trial....

  16. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis


    A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, wit...

  17. Complete paroxysmal atrioventricular block in a 2-year-old girl

    Holst, Line M; Dixen, Ulrik; Jeppesen, Dorthe L


    We present a case of atypical syncope in a 2-year-old, otherwise healthy girl. The patient presented with three episodes of syncope without any precipitating factors and no family history of sudden unexpected death. Holter monitoring revealed 24 events of complete atrioventricular block lasting u...... to 6 seconds. A normal 12-lead electrocardiogram does not necessarily exclude cardiac disease, and Holter monitoring is warranted in children with atypical syncope....

  18. Giant epicardial cyst presenting as acute cardiac tamponade in a 2-year-old boy.

    Masuoka, Ayumu; Sakurai, Hayato; Shiraishi, Masahisa; Yoshiba, Shigeki; Katogi, Toshiyuki; Suzuki, Takaaki


    Cystic structures within the pericardial cavity are rare. They are divided into epicardial and pericardial variants. Pericardial and epicardial cysts rarely cause symptoms. This report describes a case of epicardial cyst with acute cardiac tamponade in a 2-year-old boy with no previous cardiac history who was transferred to our hospital because of hemodynamic instability. Emergency drainage of the pericardial effusion and complete excision of the cyst were performed through a median full sternotomy.

  19. Pial synangiosis in patients with moyamoya younger than 2 years of age.

    Jackson, Eric M; Lin, Ning; Manjila, Sunil; Scott, R Michael; Smith, Edward R


    Object Patients with moyamoya who are younger than 2 years of age represent a therapeutic challenge because of their frequent neurological instability and concomitant anesthetic risks. The authors report their experience with pial synangiosis revascularization in this population. Methods The authors reviewed the clinical and radiographic records of all patients with moyamoya in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results During a 12-year period (1994-2005), 34 procedures (bilateral in 15 patients, unilateral in 4) were performed in 19 patients younger than 2 years (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or transient ischemic attack. The average age of the 19 patients at first surgery was 1.4 years (range 6 months-1.9 years). Unanticipated staged operations occurred in 3 patients, due to persistent electroencephalographic changes during the initial surgery in 2 cases and due to brain swelling during the procedure requiring ventriculostomy in the other. There were 2 perioperative strokes; both patients had postoperative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14 years). Long term, at follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures performed years later for frontal lobe ischemia (2), late infarction (1), and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre- and postoperative angiography demonstrated progression of disease. Conclusions Despite the challenges inherent to this population, the majority of children with moyamoya under the age of 2 years have a good long-term prognosis. The data from this study support the use of pial

  20. Mycophenolate mofetil (MMF) does not slow the progression of subclinical atherosclerosis in SLE over 2 years

    KIANI, ADNAN N.; Magder, Laurence S.; Petri, Michelle


    Accelerated atherosclerosis is a major cause of mortality in SLE. Mycophenolate mofetil (MMF) has been shown to suppress growth factor-induced proliferation of vascular smooth muscle and endothelial cells in animal models. We hypothesized that MMF might modify the inflammatory component of atherosclerosis in SLE. We examined the effect of MMF on atherosclerosis as measured by changes in carotid intima–media thickness (IMT) or coronary artery calcium (CAC) over 2 years. CAC and carotid IMT wer...

  1. Filariasis presenting as a scrotal nodule in a 2 year old child:A case report

    Kiran Yagain; Mary Mathew


    A two year old boy from southwestern village of India presented with a2 cm í1 cm size swelling in scrotum for8 months. It was excised surgically and the histopathological examination revealed a gravid filarial worm. The occurrence of adult filarial worm in2 year old boy signifies the endemicity and high larval load of insect vectors in western coast of south India.

  2. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis

    Michael B Pryor


    Full Text Available A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, with new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1-2 h daily for 6-24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer (30.8% or the same (46.2% as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject (96.5% was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant.

  3. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis.

    Pryor, Michael B; Carrion, Rafael; Wang, Run; Henry, Gerard


    A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, with new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1-2 h daily for 6-24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer (30.8%) or the same (46.2%) as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject (96.5%) was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant.

  4. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis

    Pryor, Michael B; Carrion, Rafael; Wang, Run; Henry, Gerard


    A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, with new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1–2 h daily for 6–24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer (30.8%) or the same (46.2%) as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject (96.5%) was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant. PMID:26459782

  5. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos


    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19–75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  6. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    Pinto, José Antonio


    Full Text Available Introduction Obstructive sleep apnea (OSA is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women with a mean age of 50.05 years (range 19–75 years. The prevalence of comorbidities were hypertension (39%, obesity (34%, depression (19%, gastroesophageal reflux disease (GERD (18%, diabetes mellitus (15%, hypercholesterolemia (10%, asthma (4%, and no comorbidities (33%. Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations.

  7. Myomectomy at time of cesarean delivery: a retrospective cohort study

    Tabsh Khalil MA


    Full Text Available Abstract Background Myomectomy at time of cesarean delivery is traditionally discouraged because of the risk of hemorrhage. A retrospective cohort study was performed to determine whether myomectomy at time of cesarean delivery leads to an increased incidence of intrapartum and short-term postpartum complications. Methods A computer search of medical records from May 1991 to April 2001 identified a total of 111 women who underwent myomectomy at time of cesarean delivery and 257 women with documented fibroids during the index pregnancy who underwent cesarean delivery alone. Charts were reviewed for the following outcome variables: change in hematocrit from preoperative to postoperative period, length of operation, length of postpartum stay, incidence of postpartum fever, and incidence of hemorrhage. Hemorrhage was defined as a change in hematocrit of 10 points or the need for intraoperative blood transfusion. Results The incidence of hemorrhage in the study group was 12.6% as compared with 12.8% in the control group (p = 0.95. There was also no statistically significant increase in the incidence of postpartum fever, operating time, and length of postpartum stay. No patient in either group required hysterectomy or embolization. Size of fibroid did not appear to affect the incidence of hemorrhage. After stratifying the procedures by type of fibroid removed, intramural myomectomy was found to be associated with a 21.2% incidence of hemorrhage compared with 12.8% in the control group, but this difference was not statistically significant (p = 0.08. This study had 80% power to detect a two-fold increase in the overall incidence of hemorrhage. Conclusion In selected patients, myomectomy during cesarean delivery does not appear to result in an increased risk of intrapartum or short-term postpartum morbidity.

  8. Semantic Verbal Fluency test in dementia: Preliminary retrospective analysis

    Marcos Lopes

    Full Text Available Abstract The Semantic Verbal Fluency (SVF test entails the generation of words from a given category within a pre-set time of 60 seconds. Objectives: To verify whether socio-demographic and clinical data of individuals with dementia correlate with the performance on the SVF test and to ascertain whether differences among the criteria of number of answers, clusters and data spread over the intervals, predict clinical results. Methods: This was a retrospective study of 49 charts of demented patients classified according to the Clinical Dementia Rating (CDR scale. We correlated education, age and gender, as well as CDR and Mini-Mental State Exam (MMSE scores with the number of answers, clustering and switching distributed over four 15-second intervals on the SVF test. Results: The correlation between number of answers and quartiles was weak (r=0.407, p=0.004; r=0.484, p<0.001 but correlation between the number of clusters and responses was strong (r=0.883, p<0.001. The number of items on the SVF was statistically significant with MMSE score (p=0.01 and there was a tendency for significance on the CDR (p=0.06. The results indicated little activity regarding what we propose to call cluster recalling in the two groups. Discussion: The SVF test, using number of items generated, was found to be more effective than classic screening tests in terms of speed and ease of application in patients with CDR 2 and 3.

  9. Retrospective study of prognostic factors in pediatric invasive pneumococcal disease

    Peng, Chun-Chih; Chang, Hung-Yang; Huang, Daniel Tsung-Ning; Chang, Lung; Lei, Wei-Te


    Streptococcus pneumoniae remains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei. The hospitalized pediatric patients with the diagnosis of pneumonia, arthritis, infectious endocarditis, meningitis or sepsis were recruited. Among them, 50 patients were pneumococcal infections proved by positive culture results or antigen tests. Clinical manifestations, laboratory data and hospitalization courses were analyzed. The median age was 3.5-year-old and there were 30 male patients (60%). Eight patients (16%) had underlying disease such as leukemia or congenital heart disease. Hemolytic uremic syndrome (HUS) was observed in ten patients and extracorporeal membrane oxygenation (ECMO) was performed in three patients. Leukocytosis, elevated C-reactive protein and AST level were noted in most of the patients. The overall mortality rate was 10%. We found that leukopenia, thrombocytopenia and high CRP level were significant predictors for mortality. In conclusion, S. pneumoniae remains an important health threat worldwide and IPD is life-threatening with high mortality rate. We found leukopenia, thrombocytopenia, and high CRP levels to be associated with mortality in pediatric IPD, and these factors are worthy of special attention at admission. Although we failed to identify a statistically significant prognostic factor in multivariate analysis due to relatively small sample size, we suggest an aggressive antibiotic treatment in patients with these factors at admission

  10. Vector Magnetic Field Synoptic Charts from the Helioseismic and Magnetic Imager (HMI)

    Liu, Yang; Hoeksema, J. Todd; Sun, Xudong; Hayashi, Keiji


    Vector magnetic field synoptic charts from the Helioseismic and Magnetic Imager (HMI) are now available for each Carrington Rotation (CR) starting from CR 2097 in May 2010. Synoptic charts are produced using 720-second cadence full-disk vector magnetograms remapped to Carrington coordinates. The vector field is derived from the Stokes parameters (I, Q, U, V) using a Milne-Eddington-based inversion model. The 180° azimuth ambiguity is resolved using the minimum energy algorithm for pixels in active regions and for strong-field pixels (the field is greater than about 150 G) in quiet-Sun regions. Three other methods are used for the rest of the pixels: the potential-field method, the radial acute-angle method, and the random method. The vector field synoptic charts computed using these three disambiguation methods are evaluated. The noise in the three components of the vector magnetic field is generally much higher in the potential-field method charts. The component noise levels are significantly different in the radial-acute charts. However, the noise levels in the random-method charts are lower and comparable. The assumptions used in the potential-field and radial-acute methods to disambiguate the weak transverse field introduce bias that propagates differently into the three vector-field components, leading to unreasonable pattern and artifacts, whereas the random method appears not to introduce any systematic bias. The current sheet on the source surface, computed using the potential-field source-surface model applied to random-method charts, agrees with the best solution (the result computed from the synoptic charts with the minimum energy algorithm applied to each and every pixel in the vector magnetograms) much better than the other two. Differences in the synoptic charts determined with the best method and the random method are much smaller than those from the best method and the other two. This comparison indicates that the random method is better for vector

  11. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control.

    Emilio Mezzenga

    Full Text Available The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system.

  12. Annual performance appraisal: one organization's process and retrospective analysis of outcomes.

    Geddes, E Lynne; Gill, Caroline


    Performance assessment of personnel is an important component of an organization's quality management program, benefiting the organization, individuals and clients. Performance appraisal is the most common method. This article describes the three-part performance appraisal tool used at the authors' organization, a private inter-professional healthcare agency providing rehabilitation services to clients in the community, and presents the results of a retrospective analysis of the outcomes. Performance appraisals of 13 personnel were randomly selected, representing 39 chart audits and 25 joint client visits. The achievement of mandatory chart audit standards demonstrated 95 ± 7.2% compliance; expected standards showed 96 ± 3.3% compliance. Qualitative findings from the joint visits and interviews showed that therapists enjoyed the process and experience, valued the feedback and appreciated the support they received. Benefits and challenges of the process were identified, resulting in new initiatives being implemented. The authors confirmed that the tool achieves its intended purpose and is relevant in the home care setting.

  13. Safety of intralesional cidofovir in patients with recurrent respiratory papillomatosis: an international retrospective study on 635 RRP patients.

    Tjon Pian Gi, R E A; Ilmarinen, T; van den Heuvel, E R; Aaltonen, L M; Andersen, J; Brunings, J W; Chirila, M; Dietz, A; Ferran Vilà, F; Friedrich, G; de Gier, H H W; Golusinski, W; Graupp, M; Hantzakos, A; Horcasitas, R; Jackowska, J; Koelmel, J C; Lawson, G; Lindner, F; Remacle, M; Sittel, C; Weichbold, V; Wierzbicka, M; Dikkers, F G


    Intralesional use of cidofovir (Vistide(®)) has been one of the mainstays of adjuvant therapy in patients with recurrent respiratory papillomatosis (RRP) since 1998. In 2011, a communication provided by the producer of cidofovir addressed very serious side effects concerning its off-label use. As this was a general warning, it was inconclusive whether this would account for its use in RRP. The aim of this study is to determine whether nephrotoxic, neutropenic, or oncogenic side effects have occurred after intralesional use of cidofovir in patients with RRP. Update of recent developments in RRP, a multicentre questionnaire and a multicentre retrospective chart review. Sixteen hospitals from eleven countries worldwide submitted records of 635 RRP patients, of whom 275 were treated with cidofovir. RRP patients received a median of three intralesional injections (interquartile range 2-6). There were no statistical differences in occurrence of neutropenia or renal dysfunction before and after cidofovir. There was no statistical difference in occurrence of upper airway and tracheal malignancies between the cidofovir and the non-cidofovir group. In this retrospective patient chart review, no clinical evidence was found for more long-term nephrotoxicity, neutropenia or laryngeal malignancies after the administration of intralesional cidofovir in RRP patients.

  14. Nursing care gestion of chronically ill elderly people. Policlinico 2, year 2007

    Liudmila Carbonell Sanamé


    Full Text Available A descriptive prospective study was made to those patients aged more than 60 years who are attended in the Policlinico 2 “Leonilda Tamayo Matos” in Isla de la Juventud during the year 2007. The study population was 1254 and 700 chronically ill elderly people were taken as representative sample, using a simple random sampling. The Mini Mental State Examination and a satisfaction survey was made to old people, all these with their informed consent. The main variables to study were: sex, age, race, civil state, educational level, work, assistance to the Grandparent’s Circle and satisfaction level. There exists a feminine predominance (61% over male, as well as the age group from 60 to 64 years old. Mixed race is the most common one (43%, followed by black (35%. 43% of these elders have secondary studies, and 64% of them are retired. The assistance to the Grandparent’s Circle is good, 338 of all the elders studied (48.2% assist to it. The results were expressed with real numbers and percentages, and were represented in bar and pie charts. There exists a predominance of arterial hypertension and diabetes mellitus in the elders studied. The quality of the nursing cares to the chronically ill old people of the policlinic 2 in 2007 was good.

  15. Oncological results at 2 years after robotic radical prostatectomy – the Romanian experience

    Andras, Iulia; Coman, Radu-Tudor; Logigan, Horia; Epure, Flavia; Stanca, Dan Vasile; Coman, Ioan


    Introduction To assess the oncological outcomes of robotic radical prostatectomy in a country where there are no on-going national screening programs for prostate cancer. Material and methods Between November 2009 and November 2014, 220 robotic radical prostatectomies were performed at our Robotic Surgery Center. We already have the complete data for the 2-year follow-up of the first 105 patients, who were therefore included in the study group. Pre-operative (age, prostate-specific antigen, body-mass index, prostate volume, clinical staging, biopsy characteristics), post-operative (surgical technique, surgical margin status, lymph node status, pathological stage, Gleason score) and follow-up parameters (biochemical recurrence) were assessed. Results The global rate of positive surgical margins was 34.3%, with rates of 17.2% in stage pT2 and 55.3% in stage pT3. The most frequent localization for positive surgical margins was at the base and apex of the prostate. The positive surgical margins rate was correlated with the pre-operative prostate-specific antigen, clinical and pathological Gleason score, lymph node status and the number of positive biopsy cores. The rate of biochemical recurrence at the 2-year follow-up was 11.8%. The most important predictors for the biochemical recurrence were the positive surgical margins, pathological staging and Gleason score on the prostatectomy specimen. Conclusions Robotic surgery is validated by the oncological results at medium follow-up (2 years) for localized and locally advanced prostate cancer, even in countries where there is no on-going national screening program. PMID:27123326

  16. Practical prediction model for the risk of 2-year mortality of individuals in the general population.

    Goldfarb-Rumyantzev, Alexander; Gautam, Shiva; Brown, Robert S


    This study proposed to validate a prediction model and risk-stratification tool of 2-year mortality rates of individuals in the general population suitable for office practice use. A risk indicator (R) derived from data in the literature was based on only 6 variables: to calculate R for an individual, starting with 0, for each year of age above 60, add 0.14; for a male, add 0.9; for diabetes mellitus, add 0.7; for albuminuria > 30 mg/g of creatinine, add 0.7; for stage ≥ 3 chronic kidney disease (CKD), add 0.9; for cardiovascular disease (CVD), add 1.4; or for both CKD and CVD, add 1.7. We developed a univariate logistic regression model predicting 2-year individual mortality rates. The National Health and Nutrition Examination Survey (NHANES) data set (1999-2004 with deaths through 2006) was used as the target for validation. These 12,515 subjects had a mean age of 48.9 ± 18.1 years, 48% males, 9.5% diabetes, 11.7% albuminuria, 6.8% CVD, 5.4% CKD, and 2.8% both CKD and CVD. Using the risk indicator R alone to predict mortality demonstrated good performance with area under the receiver operating characteristic (ROC) curve of 0.84. Dividing subjects into low-risk (R=0-1.0), low intermediate risk (R > 1.0-3.0), high intermediate risk (R > 3.0-5.0) or high-risk (R > 5.0) categories predicted 2-year mortality rates of 0.52%, 1.44%, 5.19% and 15.24%, respectively, by the prediction model compared with actual mortality rates of 0.29%, 2.48%, 5.13% and 13.40%, respectively. We have validated a model of risk stratification using easily identified clinical characteristics to predict 2-year mortality rates of individuals in the general population. The model demonstrated performance adequate for its potential use for clinical practice and research decisions.

  17. Mycophenolate mofetil (MMF) does not slow the progression of subclinical atherosclerosis in SLE over 2 years.

    Kiani, Adnan N; Magder, Laurence S; Petri, Michelle


    Accelerated atherosclerosis is a major cause of mortality in SLE. Mycophenolate mofetil (MMF) has been shown to suppress growth factor-induced proliferation of vascular smooth muscle and endothelial cells in animal models. We hypothesized that MMF might modify the inflammatory component of atherosclerosis in SLE. We examined the effect of MMF on atherosclerosis as measured by changes in carotid intima-media thickness (IMT) or coronary artery calcium (CAC) over 2 years. CAC and carotid IMT were measured at baseline and 2 years later in a cohort of 187 patients with SLE. The cohort was 91% women, 59% Caucasian, and 35% African-American, with a mean age of 45 ± 11 years. Of these, 12.5% (n = 25) received MMF during follow-up. The daily dose ranged from 500 to 3,000 mg/day, and duration ranged from 84 days to the entire 2 years. We divided MMF users into three groups: low exposure (MMF (MMF: 1.17-1.28, low MMF: 1.02-1.13, high MMF: 1.44-1.61, and any MMF: 1.21-1.34 log-Agatston units. Compared to no MMF, there was no statistically different change between the three groups (p = 0.99, 0.87, and 0.91). Similarly, mean carotid IMT increased in all four groups: no MMF: 0.58-0.66, low MMF: 0.55-0.60, high MMF: 0.56-0.71, and any MMF: 0.56-0.66. We then adjusted for statin use, lupus nephritis, body mass index, systolic blood pressure, cholesterol, and age during the 2-year follow-up. The association between MMF exposure and change in CAC or carotid IMT was not statistically significant (p = 0.63 for CAC, and p = 0.085 for carotid IMT). There was no evidence that MMF slowed or decreased the progression of atherosclerosis as measured by carotid IMT or CAC. Because the number of patients taking MMF was only twenty-five, larger studies for longer time periods are needed to explore any effect of MMF on subclinical atherosclerosis in SLE.

  18. Vincristine-Induced Neuropathy Presenting as Ptosis and Ophthalmoplegia in a 2-Year-Old Boy.

    Palkar, Amit H; Nair, Akshay Gopinathan; Desai, Roshani J; Potdar, Nayana A; Shinde, Chhaya A


    Vincristine is used in the treatment of leukemias, solid tumors, and lymphomas. A case of a 2-year-old boy undergoing treatment for leukemia who developed sudden onset bilateral ptosis and ophthalmoplegia along with generalized neuropathy due to vincristine's neurotoxic effects is presented. He was successfully treated with pyridoxine and pyridostigmine. The possible mechanisms of action and the treatment for vincristine-induced neuropathy are discussed. Prompt treatment and close follow-up is needed, especially in children because prolonged ptosis and motility restriction may have a profound effect on a child's visual function.

  19. Development of an AR chart tool for understanding invisible physical phenomena

    Manabe, S.; Mouri, C.; Tenzou, H.; Kasuga, T.; Motoki, K.


    The purpose of this study was to develop a tool to overlay a 3D chart on a real measurement field by using ARToolKit library and AR SDK. The tool was also designed to receive measurement data from any device as TCP/IP packets sent through a LAN. The tool is capable of drawing five types of charts; bar, bubble, red-line, spectrum-line and 3D-area. The tool requires a conventional PC, a USB camera, and an AR tag printed on a paper. The AR tag is laid on the measurement area and is recognized as the base level from where to draw the chart. 3D CG objects of the charts are overlaid on the images captured by the USB camera through recognition of the AR tag. A sample code was also prepared to manage DAQ data. The sample code for Windows OS can send the data as CSV text data via TCP/IP to the AR chart tool.

  20. An ontology for the generalisation of the bathymetry on nautical charts

    Yan, J.; Guilbert, E.; Saux, E.


    On nautical charts, undersea features are portrayed by sets of soundings (depth points) and isobaths (depth contours) from which map readers can interpret landforms. Different techniques were developed for automatic soundings selection and isobath generalisation from a sounding set. These methods are mainly used to generate a new chart from the bathymetric database or from a large scale chart through selection and simplification however a part of the process consists in selecting and emphasising undersea features on the chart according to their relevance to navigation. Its automation requires classification of the features from the set of isobaths and soundings and their generalisation through the selection and application of a set of operators according not only to geometrical constraints but also to semantic constraints. The objective of this paper is to define an ontology formalising undersea feature representation and the generalisation process achieving this representation on a nautical chart. The ontology is built in two parts addressing on one hand the definition of the features and on the other hand their generalisation. The central concept is the undersea feature around which other concepts are organised. The generalisation process is driven by the features where the objective is to select or emphasise information according to their meaning for a specific purpose. The ontologies were developed in Protégé and a bathymetric database server integrating the ontology was implemented. A generalisation platform was also developed and examples of representations obtained by the platform are presented. Finally, current results and on-going research are discussed.

  1. Weight charts of infants dying of sudden infant death in England.

    Scheimberg, Irene; Ashal, Husna; Kotiloglu-Karaa, Esin; French, Paul; Kay, Philippa; Cohen, Marta C


    The organ weights in cases of sudden infant death syndrome (SIDS) and undetermined deaths in previously healthy infants do not correspond to "the normal range" of organ weights in international standard charts for infants currently in use in some institutions. The aim of our study was to ascertain the organ weights of infants dying suddenly and unexpectedly in England and for whom a cause of death was not found, therefore falling under the category of SIDS or undetermined. We collated the organs weights from 2 institutions covering between them the South East and North of England including London, Yorkshire, and Derbyshire. The cases from The Royal London Hospital were autopsied between 1997 and 2013, and the cases from Sheffield Children's Hospital were autopsied between 2006 and 2013. There were 188 babies who had been born at term (62 female and 126 male) and 26 ex-premature babies (15 female and 11 male). Organs of male babies were slightly heavier than those of female babies but as there was no significant differences male and female babies were considered together. Comparison with standard charts (from 1932 and 1962) and with more recent charts confirmed the discrepancy between the older charts commonly in use with more recent measurements, including ours. The main reason for these differences is that babies in the recent charts were previously healthy babies with no long term disease and improved in the health of the population.

  2. Critical decision points in crisis support: using checklists and flow charts in psychological crises.

    Mitchell, Jeffrey T


    The field of crisis intervention has grown dramatically during the last hundred years. Many new procedures and techniques have been added to the crisis intervention repertoire. Periodically, providers of crisis intervention, psychological first aid, critical incident stress management, or Peer Support overlook important elements of crisis intervention or make inadvertent mistakes as they attempt to intervene. The use of checklists and flow charts, similar to those used in aviation and medicine, may assist crisis intervention personnel in properly assessing a traumatic event and its impact on the people involved. Simple checklists and flow charts may significantly decrease the potential for mistakes in crisis intervention. This article provides background on the development of flip charts in aviation and medicine and suggests how these tools may be utilized within the field of crisis intervention. Examples of checklists and flow charts that are relevant to crisis intervention are provided. The article also provides guidelines for developing additional checklists and flow charts for use in crisis intervention services.

  3. Exact run length distribution of the double sampling x-bar chart with estimated process parameters

    Teoh, W. L.


    Full Text Available Since the run length distribution is generally highly skewed, a significant concern about focusing too much on the average run length (ARL criterion is that we may miss some crucial information about a control chart’s performance. Thus it is important to investigate the entire run length distribution of a control chart for an in-depth understanding before implementing the chart in process monitoring. In this paper, the percentiles of the run length distribution for the double sampling (DS X chart with estimated process parameters are computed. Knowledge of the percentiles of the run length distribution provides a more comprehensive understanding of the expected behaviour of the run length. This additional information includes the early false alarm, the skewness of the run length distribution, and the median run length (MRL. A comparison of the run length distribution between the optimal ARL-based and MRL-based DS X chart with estimated process parameters is presented in this paper. Examples of applications are given to aid practitioners to select the best design scheme of the DS X chart with estimated process parameters, based on their specific purpose.

  4. CUSUM chart to monitor autocorrelated counts using Negative Binomial GARMA model.

    Albarracin, Orlando Yesid Esparza; Alencar, Airlane Pereira; Lee Ho, Linda


    Cumulative sum control charts have been used for health surveillance due to its efficiency to detect soon small shifts in the monitored series. However, these charts may fail when data are autocorrelated. An alternative procedure is to build a control chart based on the residuals after fitting autoregressive moving average models, but these models usually assume Gaussian distribution for the residuals. In practical health surveillance, count series can be modeled by Poisson or Negative Binomial regression, this last to control overdispersion. To include serial correlations, generalized autoregressive moving average models are proposed. The main contribution of the current article is to measure the impact, in terms of average run length on the performance of cumulative sum charts when the serial correlation is neglected in the regression model. Different statistics based on transformations, the deviance residual, and the likelihood ratio are used to build cumulative sum control charts to monitor counts with time varying means, including trend and seasonal effects. The monitoring of the weekly number of hospital admissions due to respiratory diseases for people aged over 65 years in the city São Paulo-Brazil is considered as an illustration of the current method.

  5. Uncovering the Problem-Solving Process: Cued Retrospective Reporting Versus Concurrent and Retrospective Reporting

    van Gog, Tamara; Paas, Fred; Merrienboer, Jeroen J. G.; Witte, Puk


    This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The…

  6. Statistical Design of an Adaptive Synthetic X- Control Chart with Run Rule on Service and Management Operation

    Shucheng Yu


    Full Text Available An improved synthetic X- control chart based on hybrid adaptive scheme and run rule scheme is introduced to enhance the statistical performance of traditional synthetic X- control chart on service and management operation. The proposed scientific hybrid adaptive schemes consider both variable sampling interval and variable sample size scheme. The properties of the proposed chart are obtained using Markov chain approach. An extensive set of numerical results is presented to test the effectiveness of the proposed model in detecting small and moderate shifts in the process mean. The results show that the proposed chart is quicker than the standard synthetic X- chart and CUSUM chart in detecting small and moderate shifts in the process of service and management operation.

  7. Breastfeeding and complementary feeding of children up to 2 years of age.

    Brown, Kenneth H


    Appropriate breastfeeding and complementary feeding practices are fundamental to children's nutrition, health, and survival during the first 2 years of life. The World Health Organization recommends exclusive breastfeeding until 6 months of age and continued breastfeeding for at least 2 years, along with the timely introduction of adequate amounts of complementary foods of suitable nutritional and microbiological quality. The amounts of energy and micronutrients required from complementary foods have been estimated as the difference between the total physiological requirements of these food components and the amounts transferred to the child in breast milk. Recommendations for the energy density of complementary foods and their frequency of feeding have also been proposed. Intakes of several micronutrients, including iron, zinc, calcium, selected B vitamins and (in some settings) vitamin A, remain problematic because commonly available, low-cost foods contain inadequate amounts of these nutrients to provide the shortfall in breast milk. Alternative strategies to provide these nutrients include adding animal source foods to the diet, providing fortified, processed complementary foods, administering micronutrient supplements, or offering some combination of these approaches. Advantages, disadvantages, and possible risks of these different strategies are discussed.

  8. Contrastive voicing acquisition in 2-year-old children: Preliminary data

    Hitchcock, Elaine R.; Koenig, Laura L.


    Earlier studies using voice-onset time (VOT) as the acoustic marker of contrastive voicing acquisition in English have differed widely in method and statistical procedures. Research in this area has shown three primary patterns of voicing acquisition for English stop consonants. One report indicates children demonstrate discrete voicing categories with adult-like VOT values as early as 2 years old. Other reports suggest a subperceptual distinction of the voicing contrast, followed by an exaggerated voicing contrast with evidence of more adult-like discrete categories by 3 years old. Still other reports suggest no distinction between the voicing categories until approximately 3 years. This work investigates voicing acquisition in three typically developing, English-speaking 2-year-old children. The subjects were recorded every 2 weeks for 4-6 months. Approximately 15-20 tokens were elicited for four target utterances containing initial /b p t d/. Frequency distribution, measures of central tendency, and skewness will be calculated for every recording session of each child. Discussion will focus on the development of contrastive VOT categories and their stability over time. These data will contribute to our understanding of laryngeal timing for English stop consonants in young children.

  9. Comparison of wear and clinical performance between amalgam, composite and open sandwich restorations: 2-year results.

    Sachdeo, A; Gray, Gordon B; Sulieman, M A; Jagger, Daryll C


    There has been some disquiet over the use of mercury containing restorative materials. The most commonly used alternative is composite resin but this has the potential disadvantage associated with wear and marginal leakage, which in turn, has proven to result in secondary caries and sensitivity. To overcome the shortcomings of a directly placed composite restoration, the glass-ionomer/composite open sandwich technique was introduced followed by the subsequent introduction of compomer systems. The aims of this study were to evaluate the wear and clinical performance of a control group of amalgam restorations compared with that of a group of posterior composite resin restorations fillings and a group of compomer/composite open sandwich restorations placed by a single general dental practitioner. The duration of the study was 2 years. One hundred and thirty three (71.4%) patients were successfully recalled and the wear and clinical performance of each restoration after 6, 12 and 24 months was measured, indirectly. There was no statistically significant difference recorded between the groups at 6 months or 1 year (p > 0.05). However, at the end of the 2-year study, there was a significantly lower rate of wear recorded for the control amalgam restorations compared with other two groups (p = 0.033). There was no statistically significant difference in wear recorded between the two groups of tooth-coloured restorations (p > 0.05). With regards to clinical performance of the restorations, occlusal and proximal contacts in each group of restoration remained satisfactory throughout the study.

  10. A model of Earth's magnetic field derived from 2 years of Swarm satellite constellation data

    Olsen, Nils; Finlay, Christopher C.; Kotsiaros, Stavros; Tøffner-Clausen, Lars


    More than 2 years of magnetic field data taken by the three-satellite constellation mission Swarm are used to derive a model of Earth's magnetic field and its time variation. This model is called SIFMplus. In addition to the magnetic field observations provided by each of the three Swarm satellites, explicit advantage is taken of the constellation aspect of Swarm by including East-West magnetic intensity and vector field gradient information from the lower satellite pair. Along-track differences of the magnetic intensity as well as of the vector components provide further information concerning the North-South gradient. The SIFMplus model provides a description of the static lithospheric field that is very similar to models determined from CHAMP data, up to at least spherical harmonic degree n=75. Also the core field part of SIFMplus, with a quadratic time dependence for n ≤ 6 and a linear time dependence for n=7-15, demonstrates the possibility to determine high-quality field models from only 2 years of Swarm data, thanks to the unique constellation aspect of Swarm. To account for the magnetic signature caused by ionospheric electric currents at polar latitudes we co-estimate, together with the model of the core, lithospheric and large-scale magnetospheric fields, a magnetic potential that depends on quasi-dipole latitude and magnetic local time.

  11. Irrigation effects on diameter growth of 2-year-old Paulownia tomentosa saplings

    Javad Eshaghi Rad; Seyed Rostam Mousavi Mirkala


    Species of Paulownia are fast-growing trees that are planted in many countries in green spaces and agroforestry systems. We studied the influence of irrigation on the diameter growth of 2-year-old Paulownia tomentosa saplings planted in 3 m × 3 m grids at Nazlou Campus of Urmia University, Iran. Completely randomized experi-mental design was used with four irrigation amount, viz. 10, 15, 20 and 25 L, and three irrigation intervals, viz. 3-and 6-days, in 8 replications. During the growth season, we measured collar diameters of all saplings at the end of each month. Diameter growth declined with reduced irrigation amount and increased irrigation interval. The lowest average diameter growth (9 mm) was recorded for 10 L water at 6-day intervals and maximum average diameter growth (28.7 mm) was recorded for 25 L volume at 3-day intervals. The latter treatment resulted in significantly greater diameter growth than any other treatment (except 20 L at 3-day intervals). More than 80% of diameter growth was achieved in the first 3 months. Therefore, it is essential to irrigate with 25 L of water at 3-day intervals during the first three growth months to achieve maximum diameter growth for 2-year-old P. tomentosa saplings.

  12. Live pups from evaporatively dried mouse sperm stored at ambient temperature for up to 2 years.

    Jie Liu

    Full Text Available The purpose of this study is to develop a mouse sperm preservation method based on evaporative drying. Mouse sperm were evaporatively dried and stored at 4°C and ambient temperature for 3 months to 2 years. Upon rehydration, a single sperm was injected into a mature oocyte to develop into a blastocyst after culture or a live birth after embryo transfer to a recipient female. For the samples stored at 4°C for 3, 6, 12, 18, and 24 months, the blastocyst formation rate was 61.5%, 49.1%, 31.5%, 32.2%, and 41.4%, respectively. The blastocyst rate for those stored at ambient temperature (∼22°C for 3, 6, 12, and 18 months was 57.8%, 36.2%, 33.6%, and 34.4%, respectively. Fifteen, eight and three live pups were produced from sperm stored at room temperature for 12, 18, and 24 months, respectively. This is the first report of live offspring produced from dried mouse sperm stored at ambient temperature for up to 2 years. Based on these results, we suggest that evaporative drying is a potentially useful method for the routine preservation of mouse sperm.

  13. The role of isotropic diffusion MRI in children under 2 years of age

    Gelal, F.M.; Grant, P.E.; Fischbein, N.J.; Henry, R.G.; Vigneron, D.B.; Barkovich, A.J. [Dept. of Radiology, University of California, San Francisco, CA (United States)


    Our objective was to determine the contribution of diffusion MR imaging to standard MR imaging in the neuroradiological evaluation of children less than 2 years of age. Echo-planar diffusion MR imaging was added to standard MR exams in 75 consecutive patients under the age of 2 years. Single-shot echo-planar spin-echo T2 weighted images (EPSE-T2) were acquired. Isotropic diffusion-weighted images (DWI), attenuation coefficient maps (ACM), and apparent diffusion coefficient (ADC) maps were calculated offline from images obtained with diffusion gradients (b=1000 s/mm{sup 2}) in three orthogonal directions. Two neuroradiologists determined if EPSE-T2, DWI, or ACM contributed new information to spin-echo proton density (SE PD) and T2 studies. In 15 of 18 abnormalities detected in 8 patients with symptoms less than 1 week in duration, DWI and/or ACM added information to SE PD and T2. Diffusion sequences detected five new lesions, showed six lesions with greater conspicuity, and identified four lesions with different diffusion character. In patients with symptoms of more than 7 days duration, diffusion studies added no information. Isotropic diffusion MR contributed to lesion detection and characterization in infants when symptoms were less than 1 week in duration. Diffusion MR is useful in patients with leukodystrophies, metabolic disorders, and patients with acute ischemic lesions. (orig.)

  14. Left ventricular deformation by speckle tracking echocardiography at 2-year follow-up in treatment naive rheumatoid arthritis patients

    Logstrup, B. B.; Masic, D.; Laurberg, T. B.


    -CCP titers were evaluated by standardized techniques at baseline and 2-year follow-up. We performed a novel advanced echocardiography by speckle tracking in means of global LV systolic deformation (GLS) imaging. One experienced senior rheumatologist and one experienced cardiologist performed all the clinical...... anti-CCP positive (anti-CCP >340) at baseline and 12 patients (30.8%) at 2-year follow-up. We found global LV systolic deformation (GLS) assessed by speckle tracking similar at baseline and after 2-year follow-up (GLSBASELINE: -16.56+/-3.1% vs. GLS2 YEAR: -16.27+/-2.8%; p=0.66). However in patients...

  15. Detecting the start of an influenza outbreak using exponentially weighted moving average charts

    Coory Michael


    Full Text Available Abstract Background Influenza viruses cause seasonal outbreaks in temperate climates, usually during winter and early spring, and are endemic in tropical climates. The severity and length of influenza outbreaks vary from year to year. Quick and reliable detection of the start of an outbreak is needed to promote public health measures. Methods We propose the use of an exponentially weighted moving average (EWMA control chart of laboratory confirmed influenza counts to detect the start and end of influenza outbreaks. Results The chart is shown to provide timely signals in an example application with seven years of data from Victoria, Australia. Conclusions The EWMA control chart could be applied in other applications to quickly detect influenza outbreaks.

  16. Application of CUSUM charts to detect lameness in a milking robot

    Pastell, Matti; Madsen, Henrik


    In the year 2006 about 4000 farms worldwide used over 6000 milking robots. With increased automation the time that the cattle keeper uses for monitoring animals has decreased. This has created a need for automatic health monitoring systems. Lameness is a crucial welfare and economic issue in modern...... dairy husbandry. It causes problems especially in loose housing of cattle. This could be greatly reduced by early identification and treatment. A four-balance system for automatically measuring the load on each leg of a cow during milking in a milking robot has been developed. It has been previously...... shown that the weight distribution between limbs changes when cow get lame. In this paper we suggest CUSUM charts to automatically detect lameness based on the measurements. CUSUM charts are statistical based control charts and are well suited for checking a measuring system in operation for any...

  17. Determination of Egg Shell Quality with P Control Charts in Poultry

    Melis Çelik Güney


    Full Text Available Broken or cracked eggs are important factor in determining the quality of the egg shell. Manufacturers are experience great losses because broken or cracked eggs aren’t evaluated. The manufacturers need control charts throughout the production to determine whether process is under control. In this study, broken and cracked eggs which are taken Cukurova University, Faculty of Agriculture, Department of Animal Science, Poultry Businesses during 52 weeks are determined. P control charts of the data’s are taken in poultry business during 52 weeks is drawn due to determining whether there is under the control. Three methods were used for drawing control charts. In the end of this study, it has been determined to be not under control of the process.

  18. Poor predictive ability of the risk chart SCORE in a Danish population

    Saidj, Madina; Jørgensen, Torben; Prescott, Eva;


    In Denmark, the European risk chart Systematic COronary Risk Evaluation (SCORE) from the European Society of Cardiology is recommended for use in cardiovascular prevention. Nevertheless, its predictive ability in a Danish population has never been investigated. The purpose of this study was there...... was therefore to assess the predictive ability of the SCORE risk chart with regard to fatal cardiovascular risk according to the socio-demographic factors of age, sex, income and education in a Danish population.......In Denmark, the European risk chart Systematic COronary Risk Evaluation (SCORE) from the European Society of Cardiology is recommended for use in cardiovascular prevention. Nevertheless, its predictive ability in a Danish population has never been investigated. The purpose of this study...

  19. An Efficient Novel Compensatory Multi-attribute Control Chart for Correlated Multinomial Processes

    Sadigh Raissi


    Full Text Available Monitoring multi-attribute processes is an important issue in many quality control environments. Almost all the priory proposed control charts utilize equal weights for each Attribute Quality Characteristics (AQCs. In such condition, there is no priority among AQCs. But in real-world, compensatory may exist. Hence due to some applied reasons such as function or efficiency, unequal weights for each AQC are possible. This study proposed a novel efficient control chart for simultaneous monitoring of weighted AQC when data expressed by linguistic terms. Correspondingly a new procedure to interpret out-of-control signals is presented. Performance and comparison advantage of the proposed control chart is measured in terms of Average Run Length (ARL using a real case which priory was expressed. Consequences displayed that considering weight could efficiently extend the prior research for practical circumstancese.

  20. Prospective Evaluation of Visual Acuity Assessment: A Comparison of Snellen Versus ETDRS Charts in Clinical Practice (An AOS Thesis)

    Kaiser, Peter K.


    Purpose: The purpose of this study was twofold: first, to prospectively compare visual acuity (VA) scores obtained with Snellen charts versus Early Treatment Diabetic Retinopathy Study (ETDRS) charts in a “real world” retinal practice, and second, to see if there was a difference in visual acuity measurements obtained with ETDRS charts starting at 4 or 2 meters. Methods: Prospective, consecutive evaluation of patients who underwent best-corrected visual acuity testing of their right eye performed at a single seating by the same experienced, certified vision examiner in the same room with standardized low light conditions using a projected Snellen chart at 20 feet, and two different back-illuminated ETDRS charts placed 4 and 2 meters from the patient. Results: One hundred sixty-three eyes were included in the study. The mean Snellen VA was 0.67 logMAR (20/94), ETDRS VA at 4 meters was 0.54 logMAR (~20/69), and ETDRS VA at 2 meters was 0.51 logMAR (~20/65). The mean difference was 6.5 letters better on the ETDRS chart (P=.000000001). As the VA worsened, there was increased variability between the charts and the mean discrepancy between charts also increased. Subgroup analysis revealed the greatest difference between charts was in the poor vision subgroup (<20/200) with a difference of 0.2 logMAR (10 letters; P=.0000002). Patients with exudative age-related macular degeneration (AMD) had the greatest disparity on vision testing, but patients with dry AMD and diabetic retinopathy also exhibited significant differences. Conclusions: Visual acuity scores were significantly better on ETDRS charts compared to Snellen charts. The difference was greatest with poor visual acuity (<20/200) and in patients with exudative AMD. Thus, caution should be exercised when comparing data using the different charts. PMID:20126505

  1. CHART: An Online Workshop About the Future of Scientific Ocean Drilling

    Meth, C. E.; Ravelo, A. C.


    The CHART (Charting the Future Course of Scientific Ocean Drilling) workshop was a six-week on-line meeting that gathered input from the U.S. science community regarding future research directions for scientific ocean drilling. The CHART workshop was hosted and implemented by the Consortium for Ocean Leadership, under the U.S. Science Support Program associated with IODP. The online format allowed researchers who would normally not have the time or resources to travel to a physical meeting to participate in this discussion and allowed Ocean Leadership to archive, in written form, input from every participant, instead of just preserving popular or consensus views. The meeting had six discussion boards, each with initial questions intended to stimulate discussion on current emerging fields, unanswered research questions, implementation strategies, and potential future directions for scientific ocean drilling. The moderators read the posts on a daily basis, interjected comments or questions to stimulate more discussion, and wrote short weekly summaries. Interest in the CHART discussions increased over the course of the workshop and prompted the steering committee to extend the meeting to the final sixth week, allowing time for the participants to complete reading and responding to the new activity. In all, the CHART discussion boards were visited 2,242 times by 695 visitors and resulted in 535 posts. The visitors came to the site from 37 states, the District of Columbia, and 17 countries. The CHART workshop represented the first step in garnering input from U.S. scientists to plan for scientific ocean drilling beyond 2013. The resulting white paper became part of the planning process for the international meeting, INVEST, and will be used to write the science plan for the next scientific drilling program. The white paper also allowed U.S. participants at INVEST to better represent and express the collective vision of the their community.

  2. Ethical and legal questions as regards filling out dental clinical charts

    Mauro Henrique Nogueira Guimarãe de Abreu

    Full Text Available Objective: Evaluate imperfections in filling out dental clinical history charts of patients attended at the “Universidade Estadual de Montes Claros – Unimontes”, in 2005, from the ethical and legal aspects. Method: Descriptive statistical analysis, Pearson’s correlation, Chi-Square test (p<0.05 with Bonferroni correction in a contingency table (p<0.003 tests were performed, and Anova – Tukey (p<0.05 were calculate using SPSS software. This study was conducted using 881 clinical history charts of 19 subjects. Results: The highest percentage of charts concerned Stomatology (12% and 8 th period of the course (25%. The majority (63.3% of chartshad fields left blank and in 68% the handwriting was illegible. Unjustifiable erasures were found in 74.7% of charts. The majority of charts (98% were filled out in ink. The treatment plan was signed by course tutor in 83% of the cases. The term of consent was signed in the 94.9 % of the charts. As regards mistakes, 5.1% of documents had one error; 42% two errors; 23.5% three or more errors (average 1.89(± 0.9; percentile 25%=1; 50%=2 and 75%=2. The difference in the proportion of errors as regards filling out all fields differed statistically among the periods (p<0.05. Conclusion: It was concluded that an alarming number of documents were filled out incorrectly. The worst filling out performance was shown in the 5th, 6th and 7th periods (p<0.05.

  3. Predicting 10-Year Risk of Fatal Cardiovascular Disease in Germany: An Update Based on the SCORE-Deutschland Risk Charts

    Rücker, Viktoria; Keil, Ulrich; Fitzgerald, Anthony P; Malzahn, Uwe; Prugger, Christof; Ertl, Georg; Heuschmann, Peter U; Neuhauser, Hannelore


    Estimation of absolute risk of cardiovascular disease (CVD), preferably with population-specific risk charts, has become a cornerstone of CVD primary prevention. Regular recalibration of risk charts may be necessary due to decreasing CVD rates and CVD risk factor levels. The SCORE risk charts for fatal CVD risk assessment were first calibrated for Germany with 1998 risk factor level data and 1999 mortality statistics. We present an update of these risk charts based on the SCORE methodology including estimates of relative risks from SCORE, risk factor levels from the German Health Interview and Examination Survey for Adults 2008–11 (DEGS1) and official mortality statistics from 2012. Competing risks methods were applied and estimates were independently validated. Updated risk charts were calculated based on cholesterol, smoking, systolic blood pressure risk factor levels, sex and 5-year age-groups. The absolute 10-year risk estimates of fatal CVD were lower according to the updated risk charts compared to the first calibration for Germany. In a nationwide sample of 3062 adults aged 40–65 years free of major CVD from DEGS1, the mean 10-year risk of fatal CVD estimated by the updated charts was lower by 29% and the estimated proportion of high risk people (10-year risk > = 5%) by 50% compared to the older risk charts. This recalibration shows a need for regular updates of risk charts according to changes in mortality and risk factor levels in order to sustain the identification of people with a high CVD risk. PMID:27612145

  4. An Improved Multivariate T2 Control Chart for Individual Observations in Low Volume Manufacturing

    Miao Rui(苗瑞); Wang Dongpeng; Yao Yingxue


    For multivariate statistical process quality control with individual observations, the usually recommended procedure is Hotelling's T2 control chart. Using the T2 statistic based on β distribution is an exact method for constructing multivariate control limits in low volume manufacturing, but it is not convenient in that the variation of sample size leads to a change in control limit. This paper presents an improved multivariate T2 control chart whose control limit does not change with sample size, which is especially useful when the sample size is small.

  5. The problem of the availability of nautical charts and publications on the Northern Sea Route

    Pastusiak Tadeusz


    Full Text Available Statistical studies of marine accidents and unfortunate events in ice-covered areas in 1995–2004 and 2004–2011 showed a general lack of information from the area under the jurisdiction of the Russian Federation. The author’s research for the period 2004–2011 showed a large number of unfortunate events caused by lack of adequate provision of nautical charts, shortage of accurate position systems on board vessels as well as weak technical condition of these vessels. The author examined the problem of navigation safety on the Northern Sea Route in terms of availability of the official nautical charts and publications.

  6. Monitoring Actuarial Present Values of Term Life Insurance By a Statistical Process Control Chart

    Hafidz Omar, M.


    Tracking performance of life insurance or similar insurance policy using standard statistical process control chart is complex because of many factors. In this work, we present the difficulty in doing so. However, with some modifications of the SPC charting framework, the difficulty can be manageable to the actuaries. So, we propose monitoring a simpler but natural actuarial quantity that is typically found in recursion formulas of reserves, profit testing, as well as present values. We shared some simulation results for the monitoring process. Additionally, some advantages of doing so is discussed.

  7. Derivation of charts for determining the horizontal tail load variation with any elevator motion

    Pearson, Henry A


    The equations relating the wing and tail loads are derived for a unit elevator displacement. These equations are then converted into a nondimensional form and charts are given by which the wing- and tail-load-increment variation may be determined under dynamic conditions for any type of elevator motion and for various degrees of airplane stability. In order to illustrate the use of the charts, several examples are included in which the wing and tail loads are evaluated for a number of types of elevator motion. Methods are given for determining the necessary derivatives from results of wind-tunnel tests when such tests are available.

  8. Excel Data Analysis your visual blueprint for creating and analyzing data, charts and PivotTables

    Etheridge, Denise


    Advanced techniques for Excel power users. Crunch and analyze Excel data the way the professionals do with this clean, uncluttered, visual guide to advanced Excel techniques. Using numerous screenshots and easy-to-follow numbered steps, this book clearly shows you how to perform professional-level modeling, charting, data access, data slicing, and other functions. You'll find super techniques for getting the most out of Excel's statistical and financial functions, Excel PivotTables and PivotCharts, Excel Solver and BackSolver, and more.: Provides a clear look at power-using Excel, the world's

  9. Evaluation of 2-year-old intrasplenic fetal liver tissue transplants in rats.

    Lupp, Amelie; Danz, Manfred; Müller, Dieter


    Liver cell transplantation into host organs like the spleen may possibly provide a temporary relief after extensive liver resection or severe liver disease or may enable treatment of an enzyme deficiency. With time, however, dedifferentiation or malignant transformation of the ectopically transplanted cells may be possible. Thus, in the present study syngenic fetal liver tissue suspensions were transplanted into the spleen of adult male rats and evaluated 2 years thereafter in comparison to orthotopic livers for histopathological changes and (as markers for preneoplastic transformation) for cytochrome P450 (P450) and glutathione S-transferase (GST) isoform expression. Because inducibility of P450 and GST isoforms may be changed in preneoplastic foci, prior to sacrifice animals were additionally treated either with beta-naphthoflavone, phenobarbital, dexamethasone, or the respective solvent. In the 2-year-old grafts more than 70% of the spleen mass was occupied by the transplant. The transplanted hepatocytes were arranged in cord-like structures. Also few bile ducts were present. Morphologically, no signs of malignancy were visible. With all rats, transplant recipients as well as controls, however, discrete nodular structures were seen in the livers. Due to age, both livers and transplants displayed only a low P450 2B1 and 3A2 and GST class alpha and mu isoform expression. No immunostaining for P450 1A1 was visible. At both sites, beta-naphthoflavone, phenobarbital, or dexamethasone treatment enhanced P450 1A1, P450 2B1 and 3A2, or P450 3A2 expression, respectively. No immunostaining for GST class pi isoforms was seen in the transplants. The livers of both transplant recipients and control rats, however, displayed GST pi-positive foci, corresponding to the nodular structures seen histomorphologically. Compared to the surrounding tissue, these foci also exhibited a more pronounced staining for GST class alpha and mu isoforms and a stronger inducibility of the P450 1A

  10. Prevention of meningococcal infections in the first 2 years of life.

    Woods, Charles R


    The spectrum of disease caused by Neisseria meningitidis includes bacteremia, fulminant sepsis (meningococcemia), meningitis, and pneumonia. The incidence of meningococcal infection has long been higher in infancy than adolescents or adults older than 65 years (a third group with an increased risk based on age). Five meningococcal serogroups (A, B, C, Y, and W135) cause the great majority of human disease. Serogroup B strains cause about two-thirds of disease in children younger than 6 years. For this reason, new meningococcal vaccine formulations have been developed and evaluated in children younger than 2 years. Of four meningococcal vaccines currently licensed in the United States, two conjugate products, (MenACWY-D [Menactra], Sanofi Pasteur; HibMenCY-TT [MenHibrix], GlaxoSmithKline), are recommended for infants and toddlers younger than 2 years who have an increased risk for invasive meningococcal disease. High-risk conditions are complement deficiencies, community outbreaks, functional or anatomic asplenia, and travel to high-risk areas in which serogroup A infection is prevalent. Recommendations vary by age, dosing, and indication between these two products. Both licensed products are immunogenic and have side-effect profiles that are considered safe for use. In most cases, concomitant use with other recommended childhood vaccines does not interfere with responses to these vaccines. As of yet, there has not been universal adoption of this immunization in the infant population by parents or providers. Factors that weigh against the implementation of a national routine infant program include the prevention of only 40 to 50 meningococcal cases, two to four deaths per year, and a relatively low case fatality among infants. Some argue that costs should not be considered a barrier because infant deaths and morbidity would be prevented. The availability of a serogroup B vaccine would improve impact and cost-effectiveness of a routine infant meningococcal vaccine

  11. Manipulation in the Treatment of Plantar Digital Neuralgia: A Retrospective Study of 38 Cases

    Cashley, David G.; Cochrane, Lynda


    Objective The purpose of this retrospective case series is to describe treatment outcomes for patients with plantar digital neuralgia (PDN) (Morton’s neuroma) who were treated using foot manipulation. Methods Charts were reviewed retrospectively for patients with a diagnosis of PDN and who received a minimum of 6 treatments consisting of manipulation alone. Visual analogue pain scales (VAS) and pressure threshold meter readings (PTM) were extracted as outcome measures. Results Thirty-eight cases met inclusion criteria. Mean pretreatment duration of pain was 28 months. Mean pretreatment VAS was 69.5/100 mm. Mean pretreatment PTM was 2.54 Kp. By the sixth treatment, 30 (79%) of the 38 patients scored a VAS of 0 mm and a further 4 (10%) were below 10 mm. Contralateral limb PTM showed a mean pre-treatment score of 5.5 Kp, which rose slightly to 5.85 Kp. This compared to a pre-treatment score of 2.54 Kp rising to 5.86 Kp in the affected limb. This represents a 126% increase in the affected side compared to 6.5% in the unaffected limb. Statistical analysis demonstrated a significant linear trend between decreasing VAS and manipulation (P < .001). Conclusion The patients with PDN who were included in this case series improved with conservative care that included only foot manipulation. PMID:26257593

  12. The menstrual cycle regularization following D-chiro-inositol treatment in PCOS women: a retrospective study.

    La Marca, Antonio; Grisendi, Valentina; Dondi, Giulia; Sighinolfi, Giovanna; Cianci, Antonio


    Polycystic ovary syndrome is characterized by irregular cycles, hyperandrogenism, polycystic ovary at ultrasound and insulin resistance. The effectiveness of D-chiro-inositol (DCI) treatment in improving insulin resistance in PCOS patients has been confirmed in several reports. The objective of this study was to retrospectively analyze the effect of DCI on menstrual cycle regularity in PCOS women. This was a retrospective study of patients with irregular cycles who were treated with DCI. Of all PCOS women admitted to our centre, 47 were treated with DCI and had complete medical charts. The percentage of women reporting regular menstrual cycles significantly increased with increasing duration of DCI treatment (24% and 51.6% at a mean of 6 and 15 months of treatment, respectively). Serum AMH levels and indexes of insulin resistance significantly decreased during the treatment. Low AMH levels, high HOMA index, and the presence of oligomenorrhea at the first visit were the independent predictors of obtaining regular menstrual cycle with DCI. In conclusion, the use of DCI is associated to clinical benefits for many women affected by PCOS including the improvement in insulin resistance and menstrual cycle regularity. Responders to the treatment may be identified on the basis of menstrual irregularity and hormonal or metabolic markers.

  13. Bisphosphonates in Langerhans Cell Histiocytosis: An International Retrospective Case Series

    Chellapandian, Deepak; Makras, Polyzois; Kaltsas, Gregory; van den Bos, Cor; Naccache, Lamia; Rampal, Raajit; Carret, Anne-Sophie; Weitzman, Sheila; Egeler, R. Maarten; Abla, Oussama


    Background Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH), which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results Ten patients (77%) had a single system bone disease, and 3 (23%) had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years). Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve (92%) achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years). One patient did not respond. No major adverse effects were reported in this series. Conclusion Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted. PMID:27413525

  14. Chronic Granulomatous Disease Presenting as Aseptic Ascites in a 2-Year-Old Child

    J. F. Moreau


    Full Text Available Chronic granulomatous disease (CGD is a rare inherited immunodeficiency syndrome that results from abnormal nicotinamide adenine dinucleotide phosphate (NADPH oxidase function. This defect leads to recurrent catalase-positive bacterial and fungal infections as well as associated granuloma formation. We review the case of a 2-year-old boy who presented with ascites and fever of an unknown origin as manifestations of CGD. Cultures were negative for infection throughout his course, and CGD was suspected after identification of granulomas on peritoneal biopsy. Genetic testing revealed a novel mutation in the CYBB gene underlying his condition. This paper highlights the importance of considering CGD in the differential diagnosis of fever of unknown origin and ascites in children.

  15. Management of hereditary gingival fibromatosis: A 2 years follow-up case report.

    Tripathi, Amitandra Kumar; Dete, Gopal; Saimbi, Charanjeet Singh; Kumar, Vivek


    Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up.

  16. Periodontal ligament distraction: esthetics and occlusal stability at the 2-year follow-up.

    Allgayer, Susiane; Rosenbach, Gabriella; Tavares, Carlos Alberto Estevanell; Polido, Waldemar Daudt


    Dental distraction is an orthodontic tooth movement technique that allows closure of extraction spaces, usually of premolars, in periods from 1 to 3 weeks, by bodily retraction of the canine. This article reports on canine distalization by using a distractor device obtained from a conventional hyrax screw. The patient was an adolescent boy, aged 17 years 9 months, who came to the clinic with the chief complaint of tooth crowding. The clinical examination showed a convex profile, retroclined and protruded maxillary incisors, buccally tipped and protruded mandibular incisors, and a Class I malocclusion. The treatment comprised extractions and rapid canine distraction procedures. Pretreatment, posttreatment, and 2-year follow-up records are shown and demonstrate that dental distraction is a viable alternative of treatment. With this treatment strategy, satisfactory results were obtained without additional anchorage devices, achieving an attractive smile and optimal occlusion. The main considerations about the treatment alternatives and their clinical concerns are discussed.

  17. Management of hereditary gingival fibromatosis: A 2 years follow-up case report

    Amitandra Kumar Tripathi


    Full Text Available Hereditary gingival fibromatosis (HGF is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up.

  18. [Systematization of the experiences of 2 years of work. Arimao Population Council].

    Martínez Pérez, M


    The community and social participation as an action has been part of the daily life every group and community. A descriptive and qualitative study of the 2-year period 1994-1996 was conducted to determine the hygienic, sanitary, socioeconomic, sports, cultural and health transformation occurred at the circumscription # 73 of the ABalcón Arimao@ People's Council, in La Lisa municipality, which is located in an insalubrious suburb with a high criminal rate, school dropout and unemployment, that is subjected to social actions. The method of Experience Systematization of Oscar Hara in 5 times was applied and included in the living process of this community in addition to life histories. The most important achievement was to gather all the social members of the community, with their mobilization capacity, under the leadership of the main conductors of the process through an innovative methodology starting from its context. Positive changes were observed in the life style and the health status of the population.

  19. Hereditary gingival fibromatosis and its management: 2-year follow-up

    Amitandra Kumar Tripathi


    Full Text Available Hereditary gingival fibromatosis (HGF is a rare hereditary condition characterised by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva caused by increase in sub-mucosal connective tissue component. This paper presents a case report of a 14-year-old male suffering from HGF with positive family history. After through clinical examination, routine blood investigation was advised. All the parameters were within normal physiological limits. Surgical excision of enlarged gingival mass was planned after meticulous scaling and root planning. Patient was recalled 1-week after surgery. Postoperative healing was good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems. There was no recurrence of the disease even after 2 years follow-up.

  20. Management of hereditary gingival fibromatosis: A 2 years follow-up case report

    Tripathi, Amitandra Kumar; Dete, Gopal; Saimbi, Charanjeet Singh; Kumar, Vivek


    Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up. PMID:26229281