Reducing neonatal pain during routine heel lance procedures.

Science.gov (United States)

Morrow, Carla; Hidinger, Andrea; Wilkinson-Faulk, Debbie

2010-01-01

To measure the difference in pain scores for newborns who were held and swaddled while undergoing routine heel lance procedures compared to newborns who were lying on their backs and not swaddled during heel lance. Additionally, we sought to compare the total amount of time it took to collect the specimens in each group. A total of 42 neonates recruited from a large tertiary hospital were enrolled in a randomized controlled trial. Infants in the experimental group (n = 22) were swaddled and held in an upright position during routine heel lance procedures while neonates in the control group (n = 20) remained in a standard care position. Pain was measured with the Neonatal Inventory Pain Scale (NIPS) at two points in time for each group (just before the heel lance procedure and at the completion of the heel lance). Total collection time was measured using a stopwatch accurate to 1/100th of a second. Specimen quality was measured based on the number of rejected specimens for each group. Descriptive statistics and t tests were used to analyze the data. The mean NIPS score for neonates who were swaddled and held during the procedure (experimental group) was significantly lower (M = 1.3, SD = .9) than the score for infants in the standard position (control group) (M = 2.7, SD = 1.3), t (40) = -4.48, p lance procedures offers nurses a nonpharmacologic method of neonatal pain reduction for heel sticks. This technique can be easily implemented on any unit independent of facility protocols. Furthermore, the technique is not associated with any cost or policy development, making it more likely that nurses can use it in practice.

Randomised controlled trial of routine individual feedback to improve rationality and reduce numbers of test requests.

Science.gov (United States)

Winkens, R A; Pop, P; Bugter-Maessen, A M; Grol, R P; Kester, A D; Beusmans, G H; Knottnerus, J A

1995-02-25

Feedback can be described as a way to provide information on doctors' performance to enable changes in future behaviour. Feedback is used with the aim of changing test-ordering behaviour. It can lead to reductions in test usage and cost savings. It is not sufficiently clear, however, whether feedback leads to more appropriate test use. Since 1985, the Diagnostic Coordinating Center Maastricht has been giving feedback on diagnostic tests as a routine health care activity to all family doctors in its region. Both quantity and quality of requests are discussed. In a randomised, controlled trial over 2.5 years, discussion of tests not included previously was added to the existing routine feedback. One group of family doctors (n = 39) received feedback on test-group A (electrocardiography, endoscopy, cervical smears, and allergy tests), the other (n = 40) on test-group B (radiographic and ultrasonographic tests). Thus, each group of doctors acted as a control group for the other. Changes in volume and rationality of requests were analysed. The number of requests decreased during the trial (p = 0.036). Request numbers decreased particularly for test-group A (p = 0.04). The proportion of requests that were non-rational decreased more in the intervention than in the control groups (p = 0.009). Rationality improved predominantly for test-group B (p = 0.043). Thus, routine feedback can change the quantity and quality of requests.

Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear

International Nuclear Information System (INIS)

Degnan, A.J.; Adam, R.J.; Maldjian, C.; Harner, Ch.D.

2014-01-01

The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. Measurements of tibial translation were made in the medial and lateral compartments of patients and controls (10 males, 12 females) without clinical or MRI evidence of ligament injury. Significant medial compartment posterior tibial translation was present in patients with PCL tear compared to controls (+2.93 mm versus +0.03 mm, Ρ=0.002) with excellent interobserver agreement (intraclass correlation coefficient (ICC) = 0.94). No significant difference in lateral compartment tibial translation was observed (+0.17 mm versus -0.57 mm, Ρ=0.366) despite excellent interobserver agreement (ICC = 0.96). Posterior tibial translation in the midmedial compartment may be a secondary sign of isolated PCL tear on routine knee MRI with passive extension without manipulation or weight bearing. Additional work in a larger cohort may better address the accuracy of this finding

40 CFR 63.2251 - What are the requirements for the routine control device maintenance exemption?

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What are the requirements for the routine control device maintenance exemption? 63.2251 Section 63.2251 Protection of Environment... and Composite Wood Products General Compliance Requirements § 63.2251 What are the requirements for...

[Use of PubMed to improve evidence-based medicine in routine urological practice].

Science.gov (United States)

Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

2013-03-01

Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment.

Versatile IEEE-488 data acquisition and control routines for a diode array spectrophotometer

OpenAIRE

Shiundu, Paul M.; Wade, Adrian P.

1991-01-01

The UV-visible diode array spectrophotometer is a work-horse instrument for many laboratories. This article provides simple data acquisition and control routines in Microsoft QuickBasic for a HP-8452A diode array spectrophotometer interfaced to an IBM PC/XT/AT, or compatible, microcomputer. These allow capture of full spectra and measure absorbance at one or several wavelengths at preset time intervals. The variance in absorbance at each wavelength is available as an option.

Verification and quality control of routine hematology analyzers

NARCIS (Netherlands)

Vis, J Y; Huisman, A

2016-01-01

Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and

Are routine pelvic radiographs in major pediatric blunt trauma necessary?

Science.gov (United States)

Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

2012-07-01

Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients.

Versatile IEEE-488 data acquisition and control routines for a diode array spectrophotometer

Science.gov (United States)

Shiundu, Paul M.

1991-01-01

The UV-visible diode array spectrophotometer is a work-horse instrument for many laboratories. This article provides simple data acquisition and control routines in Microsoft QuickBasic for a HP-8452A diode array spectrophotometer interfaced to an IBM PC/XT/AT, or compatible, microcomputer. These allow capture of full spectra and measure absorbance at one or several wavelengths at preset time intervals. The variance in absorbance at each wavelength is available as an option. PMID:18924888

Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli.

OpenAIRE

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf Sommer; Nielsen, Eva M.; Aarestrup, Frank Møller

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

OpenAIRE

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

GC-C-IRMS in routine doping control practice: 3 years of drug testing data, quality control and evolution of the method.

Science.gov (United States)

Polet, Michael; Van Eenoo, Peter

2015-06-01

In order to detect the misuse of endogenous anabolic steroids, doping control laboratories require methods that allow differentiation between endogenous steroids and their synthetic copies. Gas chromatography combustion isotope ratio mass spectrometry (GC-C-IRMS) is capable of measuring the carbon isotope ratio of urinary steroids and this allows differentiation between both. GC-C-IRMS and its application to doping control has evolved a lot during the last decade and so have the World Anti-Doping Agency (WADA) technical documents that describe how GC-C-IRMS should be applied. Especially the WADA technical document of 2014 introduced a number of obligatory quality controls and a fixed methodology that should be used by all the doping control laboratories. This document imposed more uniform methods between the laboratories in order to decrease the interlaboratory standard deviation and acquire similar results for the analysis of the same urine samples. In this paper, 3 years of drug testing data of our GC-C-IRMS method in routine doping control practice is described, with an emphasis on the new WADA technical document and its implementation. Useful data for other doping control laboratories is presented focussing on general method setup, quality control and data collected from routine samples. The paper concentrates on how IRMS results shift or remain similar by switching to the 2014 WADA technical document and gives insight in a straightforward approach to calculate the measurement uncertainty.

Implementation of a physically based water percolation routine in the Crocus/SURFEX (V7.3 snowpack model

Directory of Open Access Journals (Sweden)

C. J. L. D'Amboise

2017-09-01

Full Text Available We present a new water percolation routine added to the one-dimensional snowpack model Crocus as an alternative to the empirical bucket routine. This routine solves the Richards equation, which describes flow of water through unsaturated porous snow governed by capillary suction, gravity and hydraulic conductivity of the snow layers. We tested the Richards routine on two data sets, one recorded from an automatic weather station over the winter of 2013–2014 at Filefjell, Norway, and the other an idealized synthetic data set. Model results using the Richards routine generally lead to higher water contents in the snow layers. Snow layers often reached a point at which the ice crystals' surface area is completely covered by a thin film of water (the transition between pendular and funicular regimes, at which feedback from the snow metamorphism and compaction routines are expected to be nonlinear. With the synthetic simulation 18 % of snow layers obtained a saturation of  >  10 % and 0.57 % of layers reached saturation of  >  15 %. The Richards routine had a maximum liquid water content of 173.6 kg m−3 whereas the bucket routine had a maximum of 42.1 kg m−3. We found that wet-snow processes, such as wet-snow metamorphism and wet-snow compaction rates, are not accurately represented at higher water contents. These routines feed back on the Richards routines, which rely heavily on grain size and snow density. The parameter sets for the water retention curve and hydraulic conductivity of snow layers, which are used in the Richards routine, do not represent all the snow types that can be found in a natural snowpack. We show that the new routine has been implemented in the Crocus model, but due to feedback amplification and parameter uncertainties, meaningful applicability is limited. Updating or adapting other routines in Crocus, specifically the snow compaction routine and the grain metamorphism routine, is needed

Accurate fluid force measurement based on control surface integration

Science.gov (United States)

Lentink, David

2018-01-01

Nonintrusive 3D fluid force measurements are still challenging to conduct accurately for freely moving animals, vehicles, and deforming objects. Two techniques, 3D particle image velocimetry (PIV) and a new technique, the aerodynamic force platform (AFP), address this. Both rely on the control volume integral for momentum; whereas PIV requires numerical integration of flow fields, the AFP performs the integration mechanically based on rigid walls that form the control surface. The accuracy of both PIV and AFP measurements based on the control surface integration is thought to hinge on determining the unsteady body force associated with the acceleration of the volume of displaced fluid. Here, I introduce a set of non-dimensional error ratios to show which fluid and body parameters make the error negligible. The unsteady body force is insignificant in all conditions where the average density of the body is much greater than the density of the fluid, e.g., in gas. Whenever a strongly deforming body experiences significant buoyancy and acceleration, the error is significant. Remarkably, this error can be entirely corrected for with an exact factor provided that the body has a sufficiently homogenous density or acceleration distribution, which is common in liquids. The correction factor for omitting the unsteady body force, {{{ {ρ f}} {1 - {ρ f} ( {{ρ b}+{ρ f}} )}.{( {{{{ρ }}b}+{ρ f}} )}}} , depends only on the fluid, {ρ f}, and body, {{ρ }}b, density. Whereas these straightforward solutions work even at the liquid-gas interface in a significant number of cases, they do not work for generalized bodies undergoing buoyancy in combination with appreciable body density inhomogeneity, volume change (PIV), or volume rate-of-change (PIV and AFP). In these less common cases, the 3D body shape needs to be measured and resolved in time and space to estimate the unsteady body force. The analysis shows that accounting for the unsteady body force is straightforward to non

In search for effective methods of routine formation

Directory of Open Access Journals (Sweden)

Kandora Marcin

2017-05-01

Full Text Available Organizational routines are a frequently researched phenomenon in contemporary management science. Although the available theoretical foundations of Routine Theory seem to have reached a significant degree of maturity over the last thirty years, the same could not be said about the availability of material advice for the management practice. This paper addresses this gap and proposes a framework for an effective routine shaping process. It builds on a brief analysis of available literature on routine formation, supported by case study findings. The approach proposed stresses the importance of the controlled learning process and underlines the importance of deliberate implementation, in contrast to the evolutionary and engineering views on routine emergence.

Organization of students’ knowledge control in the process of distance learning

Directory of Open Access Journals (Sweden)

Miklashevich N. V.

2016-07-01

Full Text Available the article observes the main problems of organizing and carrying out the educational diagnosis in distance learning. Studying different approaches to monitoring showed that such control types as routine control and self-control are more efficient and effective. There is a difficulty of carrying out the control in distance learning: the need for accurate identification of the learner's personality. Despite existing technologies and recent developments in this area, the problem of preventing the test results from falsification is not fully resolved. According to the authors, the basic type of routine control when educating distantly remains the student obligatory attendance.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation

Directory of Open Access Journals (Sweden)

Alberto Baly

Full Text Available Abstract: INTRODUCTION Information regarding the cost of implementing insecticide-treated curtains (ITCs is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. METHODS A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. RESULTS The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h. Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. CONCLUSIONS At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation.

Science.gov (United States)

Baly, Alberto; Toledo, Maria Eugenia; Lambert, Isora; Benítez, Elizabeth; Rodriguez, Karina; Rodriguez, Esther; Vanlerberghe, Veerle; Stuyft, Patrick Van der

2016-01-01

Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

SILHIL Replication of Electric Aircraft Powertrain Dynamics and Inner-Loop Control for V&V of System Health Management Routines

Science.gov (United States)

Bole, Brian; Teubert, Christopher Allen; Cuong Chi, Quach; Hogge, Edward; Vazquez, Sixto; Goebel, Kai; George, Vachtsevanos

2013-01-01

Software-in-the-loop and Hardware-in-the-loop testing of failure prognostics and decision making tools for aircraft systems will facilitate more comprehensive and cost-effective testing than what is practical to conduct with flight tests. A framework is described for the offline recreation of dynamic loads on simulated or physical aircraft powertrain components based on a real-time simulation of airframe dynamics running on a flight simulator, an inner-loop flight control policy executed by either an autopilot routine or a human pilot, and a supervisory fault management control policy. The creation of an offline framework for verifying and validating supervisory failure prognostics and decision making routines is described for the example of battery charge depletion failure scenarios onboard a prototype electric unmanned aerial vehicle.

Making sense of the shadows: priorities for creating a learning healthcare system based on routinely collected data.

Science.gov (United States)

Deeny, Sarah R; Steventon, Adam

2015-08-01

Socrates described a group of people chained up inside a cave, who mistook shadows of objects on a wall for reality. This allegory comes to mind when considering 'routinely collected data'-the massive data sets, generated as part of the routine operation of the modern healthcare service. There is keen interest in routine data and the seemingly comprehensive view of healthcare they offer, and we outline a number of examples in which they were used successfully, including the Birmingham OwnHealth study, in which routine data were used with matched control groups to assess the effect of telephone health coaching on hospital utilisation.Routine data differ from data collected primarily for the purposes of research, and this means that analysts cannot assume that they provide the full or accurate clinical picture, let alone a full description of the health of the population. We show that major methodological challenges in using routine data arise from the difficulty of understanding the gap between patient and their 'data shadow'. Strategies to overcome this challenge include more extensive data linkage, developing analytical methods and collecting more data on a routine basis, including from the patient while away from the clinic. In addition, creating a learning health system will require greater alignment between the analysis and the decisions that will be taken; between analysts and people interested in quality improvement; and between the analysis undertaken and public attitudes regarding appropriate use of data. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A highly accurate method for determination of dissolved oxygen: Gravimetric Winkler method

International Nuclear Information System (INIS)

Helm, Irja; Jalukse, Lauri; Leito, Ivo

2012-01-01

Highlights: ► Probably the most accurate method available for dissolved oxygen concentration measurement was developed. ► Careful analysis of uncertainty sources was carried out and the method was optimized for minimizing all uncertainty sources as far as practical. ► This development enables more accurate calibration of dissolved oxygen sensors for routine analysis than has been possible before. - Abstract: A high-accuracy Winkler titration method has been developed for determination of dissolved oxygen concentration. Careful analysis of uncertainty sources relevant to the Winkler method was carried out and the method was optimized for minimizing all uncertainty sources as far as practical. The most important improvements were: gravimetric measurement of all solutions, pre-titration to minimize the effect of iodine volatilization, accurate amperometric end point detection and careful accounting for dissolved oxygen in the reagents. As a result, the developed method is possibly the most accurate method of determination of dissolved oxygen available. Depending on measurement conditions and on the dissolved oxygen concentration the combined standard uncertainties of the method are in the range of 0.012–0.018 mg dm −3 corresponding to the k = 2 expanded uncertainty in the range of 0.023–0.035 mg dm −3 (0.27–0.38%, relative). This development enables more accurate calibration of electrochemical and optical dissolved oxygen sensors for routine analysis than has been possible before.

Routine environmental monitoring schedule, calendar year 1997

Energy Technology Data Exchange (ETDEWEB)

Markes, B.M., Westinghouse Hanford

1996-12-10

This document provides the Environmental Restorations Contractor (ERC) and the Project Hanford Management Contractor.(PHMC) a schedule in accordance with the WHC-CM-7-5, Environmental Compliance` and BHI- EE-02, Environmental Requirements, of monitoring and sampling routines for the Near-Field Monitoring (NFM) program during calendar year (CY) 1997. Every attempt will be made to consistently follow this schedule; any deviation from this schedule will be documented by an internal memorandum (DSI) explaining the reason for the deviation. The DSI will be issued by the scheduled performing organization and directed to Near-Field Monitoring. The survey frequencies for particular sites are determined by the technical judgment of Near- Field Monitoring and may depend on the site history, radiological status, use, and general conditions. Additional surveys may be requested at irregular frequencies if conditions warrant. All radioactive wastes sites are scheduled to be surveyed at least annually. Any newly discovered wastes sites not documented by this schedule will be included in the revised schedule for CY 1998. The outside perimeter road surveys of 200 East and West Area and the rail survey from the 300 Area to Columbia Center will be performed in the year 2000 per agreement with Department of Energy. Richland Field Office. This schedule does not discuss staffing needs, nor does it list the monitoring equipment to be used in completing specific routines. Personnel performing routines to meet this schedule shall communicate any need for assistance in completing these routines to Radiological Control management and Near-Field Monitoring. After each routine survey is completed, a copy of the survey record, maps, and data sheets will be forwarded to Near-Field Monitoring. These routine surveys will not be considered complete until this documentation is received. At the end of each month, the ERC and PHMC radiological control organizations shall forward a copy of the Routine

Are routine pelvic radiographs in major pediatric blunt trauma necessary?

International Nuclear Information System (INIS)

Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

2012-01-01

Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

Are routine pelvic radiographs in major pediatric blunt trauma necessary?

Energy Technology Data Exchange (ETDEWEB)

Lagisetty, Jyothi [Memorial Hermann Medical Center, Emergency Medicine Department, Houston, TX (United States); Slovis, Thomas [Wayne State University School of Medicine, Department of Radiology, Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Thomas, Ronald [Children' s Hospital of Michigan, Wayne State University of Medicine, Department of Pediatrics, Detroit, MI (United States); Knazik, Stephen; Stankovic, Curt [Wayne State University of Medicine, Division of Emergency Medicine, Children' s Hospital of Michigan, Detroit, MI (United States)

2012-07-15

Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

Implicit memory formation during routine anesthesia in children: a double-masked randomized controlled trial.

Science.gov (United States)

Pham, Xiuzhi; Smith, Katherine R; Sheppard, Suzette J; Bradshaw, Carolyn; Lo, Eric; Davidson, Andrew J

2010-05-01

Implicit memory cannot be consciously recalled but may be revealed by changes in behavior. There is evidence for implicit memory formation during anesthesia in adults, but several studies in children have found no evidence for implicit memory. This may be due to insensitive testing. Also many of these tests were undertaken under controlled conditions. It remains unknown whether implicit memory is formed during routine pediatric anesthesia. The aim of this study was to determine whether there is evidence of implicit memory formation during routine anesthesia in children, using a degraded auditory stimulus recognition task. Three hundred and twelve children, aged 5-12 yr, were randomly assigned to be played either a sheep sound or white noise continuously through headphones during general anesthesia. No attempt was made to standardize the anesthetic. On recovery, children were played a sheep sound degraded by a white noise mask that progressively decreased over 60 s, with the outcome being the time taken to correctly recognize the sheep sound. Three hundred children completed the task. A comparison of the distribution of recognition times between the two groups found little evidence that exposure to a sheep sound during anesthesia was associated with postoperative time to recognition of a degraded sheep sound (hazard ratio 1.14, 95% CI of 0.90-1.43, P = 0.28). No implicit memory formation during routine anesthesia was demonstrated in children. It is increasingly likely that the potential clinical implications of implicit memory formation are less of a concern for pediatric anesthetists.

Hydrogen atoms can be located accurately and precisely by x-ray crystallography.

Science.gov (United States)

Woińska, Magdalena; Grabowsky, Simon; Dominiak, Paulina M; Woźniak, Krzysztof; Jayatilaka, Dylan

2016-05-01

Precise and accurate structural information on hydrogen atoms is crucial to the study of energies of interactions important for crystal engineering, materials science, medicine, and pharmacy, and to the estimation of physical and chemical properties in solids. However, hydrogen atoms only scatter x-radiation weakly, so x-rays have not been used routinely to locate them accurately. Textbooks and teaching classes still emphasize that hydrogen atoms cannot be located with x-rays close to heavy elements; instead, neutron diffraction is needed. We show that, contrary to widespread expectation, hydrogen atoms can be located very accurately using x-ray diffraction, yielding bond lengths involving hydrogen atoms (A-H) that are in agreement with results from neutron diffraction mostly within a single standard deviation. The precision of the determination is also comparable between x-ray and neutron diffraction results. This has been achieved at resolutions as low as 0.8 Å using Hirshfeld atom refinement (HAR). We have applied HAR to 81 crystal structures of organic molecules and compared the A-H bond lengths with those from neutron measurements for A-H bonds sorted into bonds of the same class. We further show in a selection of inorganic compounds that hydrogen atoms can be located in bridging positions and close to heavy transition metals accurately and precisely. We anticipate that, in the future, conventional x-radiation sources at in-house diffractometers can be used routinely for locating hydrogen atoms in small molecules accurately instead of large-scale facilities such as spallation sources or nuclear reactors.

Accurate Detection of Dysmorphic Nuclei Using Dynamic Programming and Supervised Classification.

Science.gov (United States)

Verschuuren, Marlies; De Vylder, Jonas; Catrysse, Hannes; Robijns, Joke; Philips, Wilfried; De Vos, Winnok H

2017-01-01

A vast array of pathologies is typified by the presence of nuclei with an abnormal morphology. Dysmorphic nuclear phenotypes feature dramatic size changes or foldings, but also entail much subtler deviations such as nuclear protrusions called blebs. Due to their unpredictable size, shape and intensity, dysmorphic nuclei are often not accurately detected in standard image analysis routines. To enable accurate detection of dysmorphic nuclei in confocal and widefield fluorescence microscopy images, we have developed an automated segmentation algorithm, called Blebbed Nuclei Detector (BleND), which relies on two-pass thresholding for initial nuclear contour detection, and an optimal path finding algorithm, based on dynamic programming, for refining these contours. Using a robust error metric, we show that our method matches manual segmentation in terms of precision and outperforms state-of-the-art nuclear segmentation methods. Its high performance allowed for building and integrating a robust classifier that recognizes dysmorphic nuclei with an accuracy above 95%. The combined segmentation-classification routine is bound to facilitate nucleus-based diagnostics and enable real-time recognition of dysmorphic nuclei in intelligent microscopy workflows.

Accurate Detection of Dysmorphic Nuclei Using Dynamic Programming and Supervised Classification.

Directory of Open Access Journals (Sweden)

Marlies Verschuuren

Full Text Available A vast array of pathologies is typified by the presence of nuclei with an abnormal morphology. Dysmorphic nuclear phenotypes feature dramatic size changes or foldings, but also entail much subtler deviations such as nuclear protrusions called blebs. Due to their unpredictable size, shape and intensity, dysmorphic nuclei are often not accurately detected in standard image analysis routines. To enable accurate detection of dysmorphic nuclei in confocal and widefield fluorescence microscopy images, we have developed an automated segmentation algorithm, called Blebbed Nuclei Detector (BleND, which relies on two-pass thresholding for initial nuclear contour detection, and an optimal path finding algorithm, based on dynamic programming, for refining these contours. Using a robust error metric, we show that our method matches manual segmentation in terms of precision and outperforms state-of-the-art nuclear segmentation methods. Its high performance allowed for building and integrating a robust classifier that recognizes dysmorphic nuclei with an accuracy above 95%. The combined segmentation-classification routine is bound to facilitate nucleus-based diagnostics and enable real-time recognition of dysmorphic nuclei in intelligent microscopy workflows.

Assessing the structure of non-routine decision processes in Airline Operations Control.

Science.gov (United States)

Richters, Floor; Schraagen, Jan Maarten; Heerkens, Hans

2016-03-01

Unfamiliar severe disruptions challenge Airline Operations Control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of Airline Operations Control professionals' decision process during unfamiliar disruptions by mapping three macrocognitive activities on the decision ladder: sensemaking, option evaluation and action planning. The relationship between this structure and decision quality was measured. A simulated task was staged, based on which think-aloud protocols were obtained. Results show that the general decision process structure resembles the structure of experts working under routine conditions, in terms of the general structure of the macrocognitive activities, and the rule-based approach used to identify options and actions. Surprisingly, high quality of decision outcomes was found to relate to the use of rule-based strategies. This implies that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing. Practitioner Summary: We examined the macrocognitive structure of Airline Operations Control professionals' decision process during a simulated unfamiliar disruption in relation to decision quality. Results suggest that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing.

Do new anesthesia ventilators deliver small tidal volumes accurately during volume-controlled ventilation?

Science.gov (United States)

Bachiller, Patricia R; McDonough, Joseph M; Feldman, Jeffrey M

2008-05-01

During mechanical ventilation of infants and neonates, small changes in tidal volume may lead to hypo- or hyperventilation, barotrauma, or volutrauma. Partly because breathing circuit compliance and fresh gas flow affect tidal volume delivery by traditional anesthesia ventilators in volume-controlled ventilation (VCV) mode, pressure-controlled ventilation (PCV) using a circle breathing system has become a common approach to minimizing the risk of mechanical ventilation for small patients, although delivered tidal volume is not assured during PCV. A new generation of anesthesia machine ventilators addresses the problems of VCV by adjusting for fresh gas flow and for the compliance of the breathing circuit. In this study, we evaluated the accuracy of new anesthesia ventilators to deliver small tidal volumes. Four anesthesia ventilator systems were evaluated to determine the accuracy of volume delivery to the airway during VCV at tidal volume settings of 100, 200, and 500 mL under different conditions of breathing circuit compliance (fully extended and fully contracted circuits) and lung compliance. A mechanical test lung (adult and infant) was used to simulate lung compliances ranging from 0.0025 to 0.03 L/cm H(2)O. Volumes and pressures were measured using a calibrated screen pneumotachograph and custom software. We tested the Smartvent 7900, Avance, and Aisys anesthesia ventilator systems (GE Healthcare, Madison, WI) and the Apollo anesthesia ventilator (Draeger Medical, Telford, PA). The Smartvent 7900 and Avance ventilators use inspiratory flow sensors to control the volume delivered, whereas the Aisys and Apollo ventilators compensate for the compliance of the circuit. We found that the anesthesia ventilators that use compliance compensation (Aisys and Apollo) accurately delivered both large and small tidal volumes to the airway of the test lung under conditions of normal and low lung compliance during VCV (ranging from 95.5% to 106.2% of the set tidal volume

Quartz fast component opticallystimulated luminescence: Towards routine extraction for dating applications

International Nuclear Information System (INIS)

Shen, Zhixiong; Lang, Andreas

2016-01-01

Using an uncontaminated fast component is a key for improving the reliability of quartz OSL dating for many deposits. So far no approach to extract the fast component of quartz OSL has routinely been adopted for dating practice. Key challenges for extracting fast components are (1) the difficulty of finding a unique solution in curve-fitting deconvolution of OSL decay curves and (2) the relatively poor dating precision when using experimental fast component extraction. Here, a simple mathematic solution for fast component extraction is presented that is not relying on curve-fitting deconvolution and can easily be adopted into routine dating practices. By using specifically selected data points from smoothed OSL decay curves, the precision of equivalent doses calculated using the extracted fast component can be improved over equivalent doses calculated using bulk OSL. The fast component extraction is tested on a group of age-constrained samples containing both insufficiently bleached and sufficiently bleached deposits. Fast component OSL ages are as accurate as bulk OSL ages for the sufficiently bleached deposits, but more accurate for samples where bulk OSL is affected by insufficient bleaching. We also demonstrate how using a curve smoothing procedure can improve dating precision in case of both sufficiently and insufficiently bleached deposits. - Highlights: • A simple mathematical method to extract quartz OSL fast component is presented. • The method can be adopted in D_e calculation programs for routine extraction. • The method leads to an increase in accuracy and precision of D_e. • The method works for relatively dim samples with low signal-to-noise ratios.

The cost of routine Aedes aegypti control and of insecticide-treated curtain implementation.

Science.gov (United States)

Baly, Alberto; Flessa, Steffen; Cote, Marilys; Thiramanus, Thirapong; Vanlerberghe, Veerle; Villegas, Elci; Jirarojwatana, Somchai; Van der Stuyft, Patrick

2011-05-01

Insecticide-treated curtains (ITCs) are promoted for controlling the Dengue vector Aedes aegypti. We assessed the cost of the routine Aedes control program (RACP) and the cost of ITC implementation through the RACP and health committees in Venezuela and through health volunteers in Thailand. The yearly cost of the RACP per household amounted to US$2.14 and $1.89, respectively. The ITC implementation cost over three times more, depending on the channel used. In Venezuela the RACP was the most efficient implementation-channel. It spent US$1.90 (95% confidence interval [CI]: 1.83; 1.97) per curtain distributed, of which 76.9% for the curtain itself. Implementation by health committees cost significantly (P = 0.02) more: US$2.32 (95% CI: 1.93; 2.61) of which 63% for the curtain. For ITC implementation to be at least as cost-effective as the RACP, at equal effectiveness and actual ITC prices, the attained curtain coverage and the adulticiding effect should last for 3 years.

Bulk H analysis using neutrons for routine quality control of cassava and products

International Nuclear Information System (INIS)

Jonah, S.A.; Okunade, I.O.; Abolude, O.; Onyike, E.; Inuwa, I.M.

2011-01-01

Nuclear and related techniques are useful in addressing the issues of food security and safety facing the world today, via quality control of raw materials and products. In this work, experimental investigations were performed to assess the use of total hydrogen content in cassava and products as a quality control indicator of starch and cyanide contents. The work was carried out using a neutron reflection facility at the Centre for Energy Research and Training, Ahmadu Bello University, Zaria, Nigeria. Cassava samples and products were obtained from retail outlets of Ibadan, Umudike and Zaria, representing three major regions of Nigeria. In general, data obtained indicate a total hydrogen content range of 4.47±0.11-10.71±0.27 wt% for the various samples, including raw, dry and processed cassava. Results show that samples having low hydrogen content are generally rich in cyanide compounds and demonstrate an inverse relationship between hydrogen content and cyanide content. The implication of this is that the neutron reflection facility can be used as a quality control setup for routine determination of hydrogen as an indicator of the cyanide content in cassava and products.

Development of an Accurate Feed-Forward Temperature Control Tankless Water Heater

Energy Technology Data Exchange (ETDEWEB)

David Yuill

2008-06-30

The following document is the final report for DE-FC26-05NT42327: Development of an Accurate Feed-Forward Temperature Control Tankless Water Heater. This work was carried out under a cooperative agreement from the Department of Energy's National Energy Technology Laboratory, with additional funding from Keltech, Inc. The objective of the project was to improve the temperature control performance of an electric tankless water heater (TWH). The reason for doing this is to minimize or eliminate one of the barriers to wider adoption of the TWH. TWH use less energy than typical (storage) water heaters because of the elimination of standby losses, so wider adoption will lead to reduced energy consumption. The project was carried out by Building Solutions, Inc. (BSI), a small business based in Omaha, Nebraska. BSI partnered with Keltech, Inc., a manufacturer of electric tankless water heaters based in Delton, Michigan. Additional work was carried out by the University of Nebraska and Mike Coward. A background study revealed several advantages and disadvantages to TWH. Besides using less energy than storage heaters, TWH provide an endless supply of hot water, have a longer life, use less floor space, can be used at point-of-use, and are suitable as boosters to enable alternative water heating technologies, such as solar or heat-pump water heaters. Their disadvantages are their higher cost, large instantaneous power requirement, and poor temperature control. A test method was developed to quantify performance under a representative range of disturbances to flow rate and inlet temperature. A device capable of conducting this test was designed and built. Some heaters currently on the market were tested, and were found to perform quite poorly. A new controller was designed using model predictive control (MPC). This control method required an accurate dynamic model to be created and required significant tuning to the controller before good control was achieved. The MPC

Quality metric for accurate overlay control in <20nm nodes

Science.gov (United States)

Klein, Dana; Amit, Eran; Cohen, Guy; Amir, Nuriel; Har-Zvi, Michael; Huang, Chin-Chou Kevin; Karur-Shanmugam, Ramkumar; Pierson, Bill; Kato, Cindy; Kurita, Hiroyuki

2013-04-01

The semiconductor industry is moving toward 20nm nodes and below. As the Overlay (OVL) budget is getting tighter at these advanced nodes, the importance in the accuracy in each nanometer of OVL error is critical. When process owners select OVL targets and methods for their process, they must do it wisely; otherwise the reported OVL could be inaccurate, resulting in yield loss. The same problem can occur when the target sampling map is chosen incorrectly, consisting of asymmetric targets that will cause biased correctable terms and a corrupted wafer. Total measurement uncertainty (TMU) is the main parameter that process owners use when choosing an OVL target per layer. Going towards the 20nm nodes and below, TMU will not be enough for accurate OVL control. KLA-Tencor has introduced a quality score named `Qmerit' for its imaging based OVL (IBO) targets, which is obtained on the-fly for each OVL measurement point in X & Y. This Qmerit score will enable the process owners to select compatible targets which provide accurate OVL values for their process and thereby improve their yield. Together with K-T Analyzer's ability to detect the symmetric targets across the wafer and within the field, the Archer tools will continue to provide an independent, reliable measurement of OVL error into the next advanced nodes, enabling fabs to manufacture devices that meet their tight OVL error budgets.

A modified space charge routine for high intensity bunched beams

International Nuclear Information System (INIS)

Lapostolle, P.; Garnett, R.W.; Wangler, T.P.

1996-01-01

In 1991 a space charge calculation for bunched beam with a three-dimensional ellipsoid was proposed, replacing the usual SCHEFF routines. It removes the cylindrical symmetry required in SCHEFF and avoids the point to point interaction computation, whose number of simulation points is limited. This routine has now been improved with the introduction of two or three ellipsoids giving a good representation of the complex non-symmetrical form of the bunch (unlike the 3-d ellipsoidal assumption). The ellipsoidal density distributions are computed with a new method, avoiding the difficulty encountered near the centre (the axis in 2-d problems) by the previous method. It also provides a check of the ellipsoidal symmetry for each part of the distribution. Finally, the Fourier analysis reported in 1991 has been replaced by a very convenient Hermite expansion, which gives a simple but accurate representation of practical distributions. Comparisons with other space charge routines have been made, particularly with the ones applying other techniques such as SCHEFF. Introduced in the versatile beam dynamics code DYNAC, it should provide a good tool for the study of the various parameters responsible for the halo formation in high intensity linacs. (orig.)

Non-routine activities in RP Group in 1995

International Nuclear Information System (INIS)

Hoefert, M.; Stevenson, G.R.

1996-01-01

The activities not directly concerned with the daily routine, but nevertheless essential to ensure a steady progress in radiation protection at CERN, concern mostly tests and intercomparisons of existing methods (quality control), development of new ideas, methods, and instruments. New projects, another non-routine activity, require in most cases profound studies to prove their feasibility with respect to radiation protection requirements. All these activities are documented in Divisional Reports, Internal Reports and Technical Memoranda, and are listed

Emotional eating and routine restraint scores are associated with activity in brain regions involved in urge and self-control.

Science.gov (United States)

Wood, Samantha M W; Schembre, Susan M; He, Qinghua; Engelmann, Jeffrey M; Ames, Susan L; Bechara, Antoine

2016-10-15

Researchers have proposed a variety of behavioral traits that may lead to weight gain and obesity; however, little is known about the neurocognitive mechanisms underlying these weight-related eating behaviors. In this study, we measured activation of reward circuitry during a task requiring response and inhibition to food stimuli. We assessed participants' emotional eating, external eating, and two subscales of dietary restraint-routine restraint and compensatory restraint-using the Weight-Related Eating Questionnaire. For routine restraint, we found positive associations with activation in the insula, dorsolateral prefrontal cortex, anterior cingulate cortex, orbitofrontal cortex and ventromedial prefrontal cortex in response to high-calorie versus low-calorie foods. For emotional eating, we found positive associations with insula and dorsolateral prefrontal cortex activation in response to high-calorie versus low-calorie foods. We also found positive associations between emotional eating and dorsolateral prefrontal cortex activation in response to approach versus inhibition towards high-calorie foods. Thus, our results demonstrate an increase in activation across brain regions related to self-control and urges in response to high-calorie food associated with both emotional eating and routine restraint. Overall, these results support the construct validity of both emotional eating and routine restraint and provide preliminary evidence that these subscales have similar neural correlates. Copyright © 2016 Elsevier Inc. All rights reserved.

Intelligent stochastic optimization routine for in-core fuel cycle design

International Nuclear Information System (INIS)

Parks, G.T.

1988-01-01

Any reactor fuel management strategy must specify the fuel design, batch sizes, loading configurations, and operational procedures for each cycle. To permit detailed design studies, the complex core characteristics must necessarily be computer modeled. Thus, the identification of an optimal fuel cycle design represents an optimization problem with a nonlinear objective function (OF), nonlinear safety constraints, many control variables, and no direct derivative information. Most available library routines cannot tackle such problems; this paper introduces an intelligent stochastic optimization routine that can. There has been considerable interest recently in the application of stochastic methods to difficult optimization problems, based on the statistical mechanics algorithms originally attributed to Metropolis. Previous work showed that, in optimizing the performance of a British advanced gas-cooled reactor fuel stringer, a rudimentary version of the Metropolis algorithm performed as efficiently as the only suitable routine in the Numerical Algorithms Group library. Since then the performance of the Metropolis algorithm has been considerably enhanced by the introduction of self-tuning capabilities by which the routine adjusts its control parameters and search pattern as it progresses. Both features can be viewed as examples of artificial intelligence, in which the routine uses the accumulation of data, or experience, to guide its future actions

Alanine/ESR dosimetry system for routine use in radiation processing

International Nuclear Information System (INIS)

Kojima, T.; Haruyama, Y.; Tachibana, H.; Tanaka, R.; Okamoto, J.; Hara, H.; Kashiwazaki, S.

1993-01-01

A new alanine-polystyrene(PS) dosimeter prepared with simplified molding procedure and an automatic desk-top dose-reader of alanine dosimeter were developed for the purpose of routine use. Combination of these two allows us to apply a reliable alanine/ESR dosimetry system to routine dosimetric process control in industrial gamma radiation processing. (Author)

Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure : background, aims and design of the RACE 3 study

NARCIS (Netherlands)

Alings, M.; Smit, M. D.; Moes, M. L.; Crijns, H. J. G. M.; Tijssen, J. G. P.; Brugemann, J.; Hillege, H. L.; Lane, D. A.; Lip, G. Y. H.; Smeets, J. R. L. M.; Tieleman, R. G.; Tukkie, R.; Willems, F. F.; Vermond, R. A.; Van Veldhuisen, D. J.; Van Gelder, I. C.

Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control

Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study

NARCIS (Netherlands)

Alings, M.; Smit, M. D.; Moes, M. L.; Crijns, H. J. G. M.; Tijssen, J. G. P.; Brügemann, J.; Hillege, H. L.; Lane, D. A.; Lip, G. Y. H.; Smeets, J. R. L. M.; Tieleman, R. G.; Tukkie, R.; Willems, F. F.; Vermond, R. A.; van Veldhuisen, D. J.; van Gelder, I. C.

2013-01-01

Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control

Rules and routines in organizations and the management of safety rules

Energy Technology Data Exchange (ETDEWEB)

Weichbrodt, J. Ch.

2013-07-01

This thesis is concerned with the relationship between rules and routines in organizations and how the former can be used to steer the latter. Rules are understood as formal organizational artifacts, whereas organizational routines are collective patterns of action. While research on routines has been thriving, a clear understanding of how rules can be used to influence or control organizational routines (and vice-versa) is still lacking. This question is of particular relevance to safety rules in high-risk organizations, where the way in which organizational routines unfold can ultimately be a matter of life and death. In these organizations, an important and related issue is the balancing of standardization and flexibility – which, in the case of rules, takes the form of finding the right degree of formalization. In high-risk organizations, the question is how to adequately regulate actors’ routines in order to facilitate safe behavior, while at the same time leaving enough leeway for actors to make good decisions in abnormal situations. The railroads are regarded as high-risk industries and also rely heavily on formal rules. In this thesis, the Swiss Federal Railways (SBB) were therefore selected for a field study on rules and routines. The issues outlined so far are being tackled theoretically (paper 1), empirically (paper 2), and from a practitioner’s (i.e., rule maker’s) point of view (paper 3). In paper 1, the relationship between rules and routines is theoretically conceptualized, based on a literature review. Literature on organizational control and coordination, on rules in human factors and safety, and on organizational routines is combined. Three distinct roles (rule maker, rule supervisor, and rule follower) are outlined. Six propositions are developed regarding the necessary characteristics of both routines and rules, the respective influence of the three roles on the rule-routine relationship, and regarding organizational aspects such as

Rules and routines in organizations and the management of safety rules

International Nuclear Information System (INIS)

Weichbrodt, J. Ch.

2013-01-01

This thesis is concerned with the relationship between rules and routines in organizations and how the former can be used to steer the latter. Rules are understood as formal organizational artifacts, whereas organizational routines are collective patterns of action. While research on routines has been thriving, a clear understanding of how rules can be used to influence or control organizational routines (and vice-versa) is still lacking. This question is of particular relevance to safety rules in high-risk organizations, where the way in which organizational routines unfold can ultimately be a matter of life and death. In these organizations, an important and related issue is the balancing of standardization and flexibility – which, in the case of rules, takes the form of finding the right degree of formalization. In high-risk organizations, the question is how to adequately regulate actors’ routines in order to facilitate safe behavior, while at the same time leaving enough leeway for actors to make good decisions in abnormal situations. The railroads are regarded as high-risk industries and also rely heavily on formal rules. In this thesis, the Swiss Federal Railways (SBB) were therefore selected for a field study on rules and routines. The issues outlined so far are being tackled theoretically (paper 1), empirically (paper 2), and from a practitioner’s (i.e., rule maker’s) point of view (paper 3). In paper 1, the relationship between rules and routines is theoretically conceptualized, based on a literature review. Literature on organizational control and coordination, on rules in human factors and safety, and on organizational routines is combined. Three distinct roles (rule maker, rule supervisor, and rule follower) are outlined. Six propositions are developed regarding the necessary characteristics of both routines and rules, the respective influence of the three roles on the rule-routine relationship, and regarding organizational aspects such as

External Agents' Effect on Routine Dynamics:Lack of Compliance Resulting in Routine Breakdown

OpenAIRE

Busse Hansen, Nicolai

2014-01-01

Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic analyses of naturally occurring interactional routine data in the form of recordings of job interviews in an international oil contractor company. The term interactional routine is used to describe recu...

Healthy Habits, Happy Homes: methods and baseline data of a randomized controlled trial to improve household routines for obesity prevention.

Science.gov (United States)

Taveras, Elsie M; McDonald, Julia; O'Brien, Ashley; Haines, Jess; Sherry, Bettylou; Bottino, Clement J; Troncoso, Karen; Schmidt, Marie Evans; Koziol, Renata

2012-11-01

To develop a home-based intervention for parents of 2-5 year old children to promote household routines to prevent overweight/obesity. We recruited 121 children from health centers in Boston between 2011 and 2012 and randomized 62 to intervention and 59 to the control condition. The 6-month intervention included 1) motivational coaching at home and by phone with a health educator, 2) mailed educational materials, and 3) weekly text messages. The intervention promoted three household routines: eating meals as a family, obtaining adequate sleep, and limiting screen time. Of the 121 children, mean (SD) age was 4.0 (1.1) years; 52% were Hispanic, 34% Black, and 14% White/Other. Nearly 60% of the sample had annual household incomes ≤ $20,000. Approximately 64% of families reported eating together ≥ 7 times per week, however, many meals were eaten in front of a TV. Over half of the children slept less than the recommended 11h/night and 78% viewed ≥ 2 h/day of screen time. Household routines that increase obesity risk were prevalent among low-income families in this study. If proven to be effective, promotion of household routines related to family meals, sleep, and screen time may prevent young children from becoming overweight/obese. Copyright © 2012 Elsevier Inc. All rights reserved.

The embeddedness of selfish Routines

DEFF Research Database (Denmark)

Andersen, Poul Houman

2001-01-01

Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well......Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well...

Generating Novelty Through Interdependent Routines: A Process Model of Routine Work

NARCIS (Netherlands)

Deken, F.; Carlile, P.R.; Berends, H.; Lauche, K.

2016-01-01

We investigate how multiple actors accomplish interdependent routine performances directed at novel intended outcomes and how this affects routine dynamics over time. We report findings from a longitudinal ethnographic study in an automotive company where actors developed a new business model around

Screening in veterinary drug analysis and sports doping control based on full-scan, accurate-mass spectrometry

NARCIS (Netherlands)

Peters, R.J.B.; Stolker, A.A.M.; Mol, J.G.J.; Lommen, A.; Lyris, E.; Angelis, Y.S.; Vonaparti, A.; Stamou, M.; Georgakopoulos, C.G.; Nielen, M.W.F.

2010-01-01

A common trend in food contaminants and sports doping control is towards a limited number of targeted, full-scan, accurate-mass spectrometry (MS) methods based on time-of-flight (TOF) or Fourier-transform orbital trap (Orbitrap) mass analyzers. Retrospective analysis of the full-scan datasets of

Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study.

Science.gov (United States)

Alings, M; Smit, M D; Moes, M L; Crijns, H J G M; Tijssen, J G P; Brügemann, J; Hillege, H L; Lane, D A; Lip, G Y H; Smeets, J R L M; Tieleman, R G; Tukkie, R; Willems, F F; Vermond, R A; Van Veldhuisen, D J; Van Gelder, I C

2013-07-01

Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control for prevention of Early AF in heart failure (RACE 3) study hypothesises that aggressive upstream rhythm control increases persistence of sinus rhythm compared with conventional rhythm control in patients with early AF and mild-to-moderate early systolic or diastolic heart failure undergoing electrical cardioversion. RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.

Bedtime routines child wellbeing & development.

Science.gov (United States)

Kitsaras, George; Goodwin, Michaela; Allan, Julia; Kelly, Michael P; Pretty, Iain A

2018-03-21

Bedtime routines has shown important associations with areas associated with child wellbeing and development. Research into bedtime routines is limited with studies mainly focusing on quality of sleep. The objectives of the present study were to examine the relationship between bedtime routines and a variety of factors associated with child wellbeing and to examine possible determinants of bedtime routines. A total of 50 families with children between 3 and 5 years old took part in the study. Data on bedtime routines, parenting styles, school readiness, children's dental health, and executive function were collected. Children in families with optimal bedtime routines showed better performance in terms of executive function, specifically working memory (t (44)= - 8.51, p ≤ .001), inhibition and attention (t (48)= - 9.70, p ≤ .001) and cognitive flexibility (t (48)= - 13.1, p ≤ .001). Also, children in households with optimal bedtime routines scored higher in their readiness for school (t (48)= 6.92, p ≤ .001) and had better dental health (U = 85.5, p = .011). Parents in households with suboptimal bedtime routines showed worse performance on all measures of executive function including working memory (t (48)= - 10.47, p ≤ .001), inhibition-attention (t (48)= - 10.50, p ≤ .001) and cognitive flexibility (t (48)= - 13.6, p ≤ .001). Finally, parents with optimal bedtime routines for their children deployed a more positive parenting style in general (i.e. authoritative parenting) compared to those with suboptimal bedtime routines (t (48)= - 6.45, p ≤ .001). The results of the present study highlight the potentially important role of bedtime routines in a variety of areas associated with child wellbeing and the need for further research.

Using routinely collected data to evaluate a leaflet campaign to increase the presentation of people with memory problems to general practice: a locality based controlled study

Directory of Open Access Journals (Sweden)

Tom Chan

2010-09-01

Conclusions During a leaflet campaign the recording and management ofmemory problems increased. However, there was greater improvement in the control locality. This study demonstrates the importance of including a control group and the strengths of routine primary care data.

Towards accurate emergency response behavior

International Nuclear Information System (INIS)

Sargent, T.O.

1981-01-01

Nuclear reactor operator emergency response behavior has persisted as a training problem through lack of information. The industry needs an accurate definition of operator behavior in adverse stress conditions, and training methods which will produce the desired behavior. Newly assembled information from fifty years of research into human behavior in both high and low stress provides a more accurate definition of appropriate operator response, and supports training methods which will produce the needed control room behavior. The research indicates that operator response in emergencies is divided into two modes, conditioned behavior and knowledge based behavior. Methods which assure accurate conditioned behavior, and provide for the recovery of knowledge based behavior, are described in detail

Children's behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial.

Science.gov (United States)

Bagherian, Ali; Sheikhfathollahi, Mahmood

2016-01-01

Topical anesthesia has been widely advocated as an important component of atraumatic administration of intraoral local anesthesia. The aim of this study was to use direct observation of children's behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia. Forty-eight children participated in this randomized controlled clinical trial. They received two separate inferior alveolar nerve block or primary maxillary molar infiltration injections on contralateral sides of the jaws by both cotton-roll vibration (a combination of topical anesthesia gel, cotton roll, and vibration for physical distraction) and control (routine topical anesthesia) methods. Behavioral pain reactions of children were measured according to the author-developed face, head, foot, hand, trunk, and cry (FHFHTC) scale, resulting in total scores between 0 and 18. The total scores on the FHFHTC scale ranged between 0-5 and 0-10 in the cotton-roll vibration and control methods, respectively. The mean ± standard deviation values of total scores on FHFHTC scale were lower in the cotton-roll vibration method (1.21 ± 1.38) than in control method (2.44 ± 2.18), and this was statistically significant (P anesthesia in reducing behavioral pain reactions in children during local anesthesia administration.

Implementing a routine, voluntary HIV testing program in a Massachusetts county prison.

Science.gov (United States)

Liddicoat, Rebecca V; Zheng, Hui; Internicola, Jeanne; Werner, Barbara G; Kazianis, Arthur; Golan, Yoav; Rubinstein, Eric P; Freedberg, Kenneth A; Walensky, Rochelle P

2006-11-01

Although U.S. prison inmates have higher rates of HIV infection than the general population, most inmates are not routinely tested for HIV infection at prison entry. The study objective was to implement a routine, voluntary HIV testing program in a Massachusetts county prison. During admission, inmates were given group HIV pre-test counseling and were subsequently offered private HIV testing. This intervention was compared to a control period during which HIV testing was provided only upon inmate or physician request. Between November 2004 and April 2005, 1,004 inmates met inclusion criteria and were offered routine, voluntary HIV testing. Of these, 734 (73.1%) accepted, 2 (0.3%) were HIV-infected, and 457 (45.5%) had been tested for HIV in the previous year. The testing rate of 73.1% was significantly increased from the rate of 18.0% (318 of 1,723) during the control period (pprison setting. Careful attention should be paid to prevent redundancy of testing efforts in the prison population. Implementing a routine HIV testing program among prison inmates greatly increased testing rates compared to on-request testing.

Accuracy of some routine method used in clinical chemistry as judged by isotope dilution-mass spectrometry

International Nuclear Information System (INIS)

Bjoerkhem, I.; Bergman, A.; Falk, O.; Kallner, A.; Lantto, O.; Svensson, L.; Akerloef, E.; Blomstrand, R.

1981-01-01

Serum from patients was pooled, filtered, dispensed, and frozen. This pooled specimen was used for accuracy control in 64 participating laboratories in Sweden. Mean values (state-of-the-art values) were obtained for creatinine, cholesterol, glucose, urea, uric acid, and cortisol. These values were compared with values obtained with highly accurate reference methods based on isotope dilution-mass spectrometry. Differences were marked in the case of determination of creatinine and cortisol. Concerning the other components, the differences between the state-of-the-art value and the values obtained with the reference methods were negligible. Moreover, the glucose oxidase and the oxime methods for determination of glucose and urea were found to give significantly lower values than the hexokinase and urease methods, respectively. Researchers conclude that methods with a higher degree of accuracy are required for routine determination of creatinine and cortisol

The significance of routines in nursing practice.

Science.gov (United States)

Rytterström, Patrik; Unosson, Mitra; Arman, Maria

2011-12-01

The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

Data format translation routines

International Nuclear Information System (INIS)

Burris, R.D.

1981-02-01

To enable the effective connection of several dissimilar computers into a network, modification of the data being passed from one computer to another may become necessary. This document describes a package of routines which permit the translation of data in PDP-8 formats to PDP-11 or DECsystem-10 formats or from PDP-11 format to DECsystem-10 format. Additional routines are described which permit the effective use of the translation routines in the environment of the Fusion Energy Division (FED) network and the Elmo Bumpy Torus (EBT) data base

Routines and Organizational Change

DEFF Research Database (Denmark)

Yi, Sangyoon; Becker, Markus; Knudsen, Thorbjørn

2014-01-01

Routines have been perceived as a source of inertia in the process of organizational change. In this study, we suggest an overlooked, but prevalent, mechanism by which the inertial nature of routines helps, rather than hinders, organizational adaptation. Routine-level inertia plays a hidden role...... to cope with its task environment. In our nuanced perspective, inertia is not only a consequence of adaptation but also a source of adaptation. This logic is helpful to understand why reliable but apparently inertial organizations keep surviving and often exhibit outstanding performance. We conclude...

Immunogenicity and tolerability of recombinant serogroup B meningococcal vaccine administered with or without routine infant vaccinations according to different immunization schedules: a randomized controlled trial.

Science.gov (United States)

Gossger, Nicoletta; Snape, Matthew D; Yu, Ly-Mee; Finn, Adam; Bona, Gianni; Esposito, Susanna; Principi, Nicola; Diez-Domingo, Javier; Sokal, Etienne; Becker, Birgitta; Kieninger, Dorothee; Prymula, Roman; Dull, Peter; Ypma, Ellen; Toneatto, Daniela; Kimura, Alan; Pollard, Andrew J

2012-02-08

In the absence of an effective vaccine, serogroup B Neisseria meningitidis (MenB) remains a major cause of invasive disease in early childhood in developed countries. To determine the immunogenicity and reactogenicity of a multicomponent MenB vaccine (4CMenB) and routine infant vaccines when given either concomitantly or separately. Phase 2b, multicenter, open-label, parallel-group, randomized controlled study of 1885 infants enrolled at age 2 months from August 2008 to July 2010 in Europe. Participants were randomized 2:2:1:1 to receive (1) 4CMenB at 2, 4, and 6 months with routine vaccines (7-valent pneumococcal and combined diphtheria, tetanus, acellular pertussis, inactivated polio, hepatitis B, Haemophilus influenzae type b vaccines); (2) 4CMenB at 2, 4, and 6 months and routine vaccines at 3, 5, and 7 months; (3) 4CMenB with routine vaccines at 2, 3, and 4 months; or (4) routine vaccines alone at 2, 3, and 4 months. Percentage of participants with human complement serum bactericidal activity (hSBA) titer of 1:5 or greater against 3 MenB strains specific for vaccine antigens (NZ98/254, 44/76-SL, and 5/99). After three 4CMenB vaccinations, 99% or more of infants developed hSBA titers of 1:5 or greater against strains 44/76-SL and 5/99. For NZ98/254, this proportion was 79% (95% CI, 75.2%-82.4%) for vaccination at 2, 4, and 6 months with routine vaccines, 86.1% (95% CI, 82.9%-89.0%) for vaccination at 2, 4, and 6 months without routine vaccines, and 81.7% (95% CI, 76.6%-86.2%) for vaccination at 2, 3, and 4 months with routine vaccines. Responses to routine vaccines given with 4CMenB were noninferior to routine vaccines alone for all antigens, except for the responses to pertactin and serotype 6B pneumococcal polysaccharide. Fever was seen following 26% (158/602) to 41% (247/607) of 4CMenB doses when administered alone, compared with 23% (69/304) to 36% (109/306) after routine vaccines given alone and 51% (306/605) to 61% (380/624) after 4CMenB and routine

PAT challenges routine techniques on defect spectroscopy in material science

International Nuclear Information System (INIS)

Badawi, E.A.

2005-01-01

Atomic or Point Defects are the most simple defects in solids. Due to the small size their direct observation by the routine techniques is not possible. A single type of defects (thermal defect) was observed in the quenching process. Using the Arrhenius method and threshold method we recommended the accurate both method of treatments. The calculated values for formation enthalpies and self-diffusion using positron lifetime and Doppler broadening in a good agreement in (A356.0) and (A413.1). Specifically it is show how PAT detect defect concentrations, (formation- migration) enthalpies and grain size for the material under investigation. Most of the these data are reported

Detection of irradiated food - methods and routine applications

International Nuclear Information System (INIS)

Schreiber, G.A.; Helle, N.; Boegl, K.W.

1993-01-01

Irradiation of food for the purposes of extension of shelf life, control of microbial load, reduction of pathogenic microorganisms and disinfection is regarded by many consumers with suspicion. One reason is the lack of methods within food-controlling laboratories which can detect irradiation treatment and which are applied to control correct labelling. This review describes the potential of various methods to reveal irradiation treatment. Special emphasis is given to the three most successful methods, thermoluminescence, electron spin resonance spectroscopy and detection of volatiles. The possibilities and limitations of applying the methods in routine control are discussed. (author)

Master schedule for CY-1984 Hanford environmental surveillance routine sampling program

International Nuclear Information System (INIS)

Blumer, P.J.; Price, K.R.; Eddy, P.A.; Carlile, J.M.V.

1983-12-01

This report provides the current schedule of data collection for the routine Hanford environmental surveillance and ground-water Monitoring Programs at the Hanford Site. The purpose is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. The routine sampling schedule provided herein does not include samples that are planned to be collected during FY-1984 in support of special studies, special contractor support programs, or for quality control purposes

Consensus-based Distributed Control for Accurate Reactive, Harmonic and Imbalance Power Sharing in Microgrids

DEFF Research Database (Denmark)

Zhou, Jianguo; Kim, Sunghyok; Zhang, Huaguang

2018-01-01

This paper investigates the issue of accurate reactive, harmonic and imbalance power sharing in a microgrid. Harmonic and imbalance droop controllers are developed to proportionally share the harmonic power and the imbalance power among distributed generation (DG) units and improve the voltage...... voltage. With the proposed methods, the microgrid system reliability and flexibility can be enhanced and the knowledge of the line impedance is not required. And the reactive, harmonic and imbalance power can be proportionally shared among the DG units. Moreover, the quality of the voltage at PCC can...

Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology

Science.gov (United States)

Smarius, Bram; Loozen, Charlotte; Manten, Wendy; Bekker, Mireille; Pistorius, Lou; Breugem, Corstiaan

2017-01-01

Cleft lip with or without cleft palate (CP) is one of the most common congenital malformations. Ultrasonographers involved in the routine 20-wk ultrasound screening could encounter these malformations. The face and palate develop in a very characteristic way. For ultrasonographers involved in screening these patients it is crucial to have a thorough understanding of the embryology of the face. This could help them to make a more accurate diagnosis and save time during the ultrasound. Subsequently, the current postnatal classification will be discussed to facilitate the communication with the CP teams. PMID:29026689

Sterilization of health care products - Radiation. Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices

International Nuclear Information System (INIS)

2006-01-01

reproducible so that predictions can be made, with reasonable confidence, that there is a low level of probability of there being a viable microorganism present on product after sterilization. Specification of this probability is a matter for regulatory authorities and may vary from country to country (see, for example, EN 556-1 and ANSI/AAMI ST67). Generic requirements of the quality management system for design and development, production, installation and servicing are given in ISO 9001 and particular requirements for quality management systems for medical device production are given in ISO 13485. The standards for quality management systems recognise that, for certain processes used in manufacturing, the effectiveness of the process cannot be fully verified by subsequent inspection and testing of the product. Sterilization is an example of such a process. For this reason, sterilization processes are validated for use, the performance of the sterilization process is monitored routinely and the equipment is maintained. Exposure to a properly validated, accurately controlled sterilization process is not the only factor associated with the provision of reliable assurance that the products are sterile and, in this regard, suitable for its intended use. Attention is therefore given to a number of considerations including: a) the microbiological status of incoming raw materials and/or components; b) the validation and routine control of any cleaning and disinfection procedures used on the product; c) the control of the environment in which the product is manufactured, assembled and packaged; d) the control of equipment and processes; e) the control of personnel and their hygiene; f) the manner and materials in which the product is packaged; g) the conditions under which product is stored. This part of ISO 11137 describes the requirements for ensuring that the activities associated with the process of radiation sterilization are performed properly. These activities are described

Clinical value analysis of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis

Directory of Open Access Journals (Sweden)

Jing-Mei Tuo

2016-01-01

Full Text Available Objective: To study the clinical value of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis. Methods: A total of 60 cases of patients with ulcerative colitis were collected as observation group of research and 60 cases of healthy volunteers were collected as control group of research. Intestinal wall thickness was detected by white light endoscopy, abdominal intestinal ultrasound and endoscopic ultrasonography; TNF-α, IL-1β, IL-4 and IL-10 contents were detected by Elisa kit; Th1, Th2, Th17 and Treg ratios were detected by flow cytometry. Results: (1 intestinal wall thickness: intestinal wall thickness of both active UC patients and quiescent UC patients was significantly higher than that of control group, intestinal wall thickness of active UC patients was significantly higher than that of quiescent UC patients and the higher the degree of activity, the higher the intestinal wall thickness; (2 inflammatory mediators: TNF-α and IL-1β contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; IL-4 and IL-10 contents were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness; (3 T cell contents: Th1 and Th17 cell contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; Th2 and Treg cell contents in intestinal mucosa of active UC patients were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness. Conclusion: Routine ultrasound combined with endoscopic ultrasonography can accurately determine the severity of ulcerative colitis; measured intestinal wall thickness is closely correlated with the degree of inflammation and abnormal immune response.

A modified space charge routine for LINAC beam dynamics codes

International Nuclear Information System (INIS)

Valero, S.; Lapostolle, P.; Lombardi, A.M.; Tanke, E.; Warner, D.

1994-01-01

In 1991 a space charge calculation for bunched beams with three-dimensional ellipsoidal symmetry was proposed for the PARMILA code, replacing the usual SCHEFF routines: it removes the cylindrical symmetry needed for the Fast Fourier Transform method and avoids the point to point interaction computation, where the number of simulation points is limited. This routine has now been improved with the introduction of two (or more) ellipsoids, giving a good representation of actual, pear-shaped bunches (unlike the 3-D ellipsoidal assumption). The ellipsoidal density distributions are computed with a new method, avoiding the difficulty caused by statistical effects, encountered near the centre (the axis in 2-D problems) by the previous method. It also provides a check of the ellipsoidal symmetry for each part of the distribution. Finally, the Fourier analysis reported in 1991 has been replaced by a very convenient Hermite expansion, which gives a simple but accurate representation of practical distributions. Introduced in the new, versatile beam dynamics code, DYNAC, it should provide a good tool for the study of the effects of the various parameters responsible for the halo formation in high intensity linacs. (authors). 11 refs

Increased Exposure to Rigid Routines Can Lead to Increased Challenging Behavior Following Changes to Those Routines

Science.gov (United States)

Bull, Leah E.; Oliver, Chris; Callaghan, Eleanor; Woodcock, Kate A.

2015-01-01

Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to…

The cognitive role of routine activities: the case of familiar field interventions in nuclear power plants

International Nuclear Information System (INIS)

Noizet, A.

2000-01-01

Routine works incorporate part of the environment as their own control (exo-monitoring). The routine activity is itself in the self-monitoring situation of a cognitive control, which moves with the constraints, and which is not in direct relation with the errors made and detected, but which is in relation with the check of mastery. (J.S.)

Use of Ethernet and TCP/IP socket communications library routines for data acquisition and control in the LEP RF system

International Nuclear Information System (INIS)

Ciapala, E.; Collier, P.; Lienard, P.

1991-01-01

A general move is being made at CERN towards the direct connection of intelligent equipment and device controllers to the control room consoles by the use of local Ethernet segments bridged to the main Token Ring networks. Communications is based on standard TCP/IP protocols which allows immediate use of standard software packages. The Data Managers which control the LEP RF accelerating units and transverse feedback systems have recently been connected. The implementation of Ethernet and TCP/IP socket communications routines for RF data acquisition and control is described. The adaptation of almost all of the existing software for RF system control, data acquisition and diagnostics to make use of this means of communication has proved straightforward. Furthermore the transparent transfer of data in the form of 'C' structures from the Data Managers to the control center workstations and other computers has considerably simplified the software required for remote surveillance and data logging with a corresponding increase in speed and reliability

SU-D-BRD-07: Evaluation of the Effectiveness of Statistical Process Control Methods to Detect Systematic Errors For Routine Electron Energy Verification

International Nuclear Information System (INIS)

Parker, S

2015-01-01

Purpose: To evaluate the ability of statistical process control methods to detect systematic errors when using a two dimensional (2D) detector array for routine electron beam energy verification. Methods: Electron beam energy constancy was measured using an aluminum wedge and a 2D diode array on four linear accelerators. Process control limits were established. Measurements were recorded in control charts and compared with both calculated process control limits and TG-142 recommended specification limits. The data was tested for normality, process capability and process acceptability. Additional measurements were recorded while systematic errors were intentionally introduced. Systematic errors included shifts in the alignment of the wedge, incorrect orientation of the wedge, and incorrect array calibration. Results: Control limits calculated for each beam were smaller than the recommended specification limits. Process capability and process acceptability ratios were greater than one in all cases. All data was normally distributed. Shifts in the alignment of the wedge were most apparent for low energies. The smallest shift (0.5 mm) was detectable using process control limits in some cases, while the largest shift (2 mm) was detectable using specification limits in only one case. The wedge orientation tested did not affect the measurements as this did not affect the thickness of aluminum over the detectors of interest. Array calibration dependence varied with energy and selected array calibration. 6 MeV was the least sensitive to array calibration selection while 16 MeV was the most sensitive. Conclusion: Statistical process control methods demonstrated that the data distribution was normally distributed, the process was capable of meeting specifications, and that the process was centered within the specification limits. Though not all systematic errors were distinguishable from random errors, process control limits increased the ability to detect systematic errors

Understanding Smart Home Sensor Data for Ageing in Place Through Everyday Household Routines: A Mixed Method Case Study.

Science.gov (United States)

van Kasteren, Yasmin; Bradford, Dana; Zhang, Qing; Karunanithi, Mohan; Ding, Hang

2017-06-13

An ongoing challenge for smart homes research for aging-in-place is how to make sense of the large amounts of data from in-home sensors to facilitate real-time monitoring and develop reliable alerts. The objective of our study was to explore the usefulness of a routine-based approach for making sense of smart home data for the elderly. Maximum variation sampling was used to select three cases for an in-depth mixed methods exploration of the daily routines of three elderly participants in a smart home trial using 180 days of power use and motion sensor data and longitudinal interview data. Sensor data accurately matched self-reported routines. By comparing daily movement data with personal routines, it was possible to identify changes in routine that signaled illness, recovery from bereavement, and gradual deterioration of sleep quality and daily movement. Interview and sensor data also identified changes in routine with variations in temperature and daylight hours. The findings demonstrated that a routine-based approach makes interpreting sensor data easy, intuitive, and transparent. They highlighted the importance of understanding and accounting for individual differences in preferences for routinization and the influence of the cyclical nature of daily routines, social or cultural rhythms, and seasonal changes in temperature and daylight hours when interpreting information based on sensor data. This research has demonstrated the usefulness of a routine-based approach for making sense of smart home data, which has furthered the understanding of the challenges that need to be addressed in order to make real-time monitoring and effective alerts a reality. ©Yasmin van Kasteren, Dana Bradford, Qing Zhang, Mohan Karunanithi, Hang Ding. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 13.06.2017.

Master schedule for CY-1982 Hanford environmental surveillance routine program

International Nuclear Information System (INIS)

Blumer, P.J.; Sula, M.J.; Eddy, P.A.

1981-12-01

This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. The environmental surveillance program objectives are to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5484.1. The routine sampling schedule provided does not include samples which are planned to be collected during FY-1982 in support of special studies or for quality control purposes. In addition, the routine program outlined in this schedule is subject to modification during the year in response to changes in Site operations, program requirements, or unusual sample results. Sampling schedules are presented for the following: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurements; portable instrument surveys; and surveillance of waste disposal sites

Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist-controlled evaluation of an ACT workshop in a routine practice setting.

Science.gov (United States)

Waters, Cerith S; Frude, Neil; Flaxman, Paul E; Boyd, Jane

2018-03-01

To examine the effects of a 1-day acceptance and commitment therapy (ACT) workshop on the mental health of clinically distressed health care employees, and to explore ACT's processes of change in a routine practice setting. A quasi-controlled design, with participants block allocated to an ACT intervention or waiting list control group based on self-referral date. Participants were 35 health care workers who had self-referred for the ACT workshop via a clinical support service for staff. Measures were completed by ACT and control group participants at pre-intervention and 3 months post-intervention. Participants allocated to the waitlist condition went on to receive the ACT intervention and were also assessed 3 months later. At 3 months post-intervention, participants in the ACT group reported a significantly lower level of psychological distress compared to the control group (d = 1.41). Across the 3-month evaluation period, clinically significant change was exhibited by 50% of ACT participants, compared to 0% in the control group. When the control group received the same ACT intervention, 69% went on to exhibit clinically significant change. The ACT intervention also resulted in significant improvements in psychological flexibility, defusion, and mindfulness skills, but did not significantly reduce the frequency of negative cognitions. Bootstrapped mediation analyses indicated that the reduction in distress in the ACT condition was primarily associated with an increase in mindfulness skills, especially observing and non-reactivity. These findings provide preliminary support for providing brief ACT interventions as part of routine clinical support services for distressed workers. A 1-day ACT workshop delivered in the context of a routine staff support service was effective for reducing psychological distress among health care workers. The brief nature of this group intervention means it may be particularly suitable for staff support and primary care mental

Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology.

Science.gov (United States)

Rossen, J W A; Friedrich, A W; Moran-Gilad, J

2018-04-01

Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. To review the practical aspects of implementing bacterial whole genome sequencing (WGS) in routine diagnostic laboratories. Review of the literature and expert opinion. In this review, we discuss when and how to integrate whole genome sequencing (WGS) in the routine workflow of the clinical laboratory. In addition, as the microbiology laboratories have to adhere to various national and international regulations and criteria for their accreditation, we deliberate on quality control issues for using WGS in microbiology, including the importance of proficiency testing. Furthermore, the current and future place of this technology in the diagnostic hierarchy of microbiology is described as well as the necessity of maintaining backwards compatibility with already established methods. Finally, we speculate on the question of whether WGS can entirely replace routine microbiology in the future and the tension between the fact that most sequencers are designed to process multiple samples in parallel whereas for optimal diagnosis a one-by-one processing of the samples is preferred. Special reference is made to the cost and turnaround time of WGS in diagnostic laboratories. Further development is required to improve the workflow for WGS, in particular to shorten the turnaround time, reduce costs, and streamline downstream data analyses. Only when these processes reach maturity will reliance on WGS for routine patient management and infection control management become feasible, enabling the transformation of clinical microbiology into a genome-based and personalized diagnostic field. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing.

Science.gov (United States)

Whiley, Harriet

2016-12-24

Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups.

42 CFR 493.931 - Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

Routine focal mollusciciding after chemotherapy to control Schistosoma mansoni in Cul de Sac valley, Saint Lucia.

Science.gov (United States)

Barnish, G; Jordan, P; Bartholomew, R K; Grist, E

1982-01-01

Concluding results of a 10-year schistosomiasis control programme in Cul de Sac valley, Saint Lucia, are described. After an area-wide mollusciciding campaign (1970-75), and a surveillance/treatment programme supplemented with selective population chemotherapy in 1975 and 1976, prevalence rates of Schistosoma mansoni were reduced to low levels. To prevent a resurgence of transmission a cost effective routine focal mollusciciding programme, suitable for public health implementation was evaluated from 1977 to 1981. Streams and main collector drains in banana fields, considered to be potential S. mansoni transmission sites, were treated every four weeks with Bayluscide 6076 emulsifiable concentrate (Clonitralide). Snail populations were effectively controlled in the treated areas but large numbers were present where no treatment was given. Only 0 X 06% of sentinel snails became infected. Prevalence of infection in the human population remained low (over-all 5%) and intensity of infection at a level not normally associated with schistosomal disease. Since control started 10 years earlier the level of potential contamination has fallen by 92% in high transmission areas. The four-year programme cost US+12,909 of which 54% was for molluscicide, 27% for labour and 19% for transport, equipment and sundries. The average annual cost per head of population was US+0 X 46.

Competing Stimuli in the Treatment of Multiply Controlled Problem Behavior during Hygiene Routines

Science.gov (United States)

Long, Ethan S.; Hagopian, Louis P.; DeLeon, Iser G.; Marhefka, Jean Marie; Resau, Dawn

2005-01-01

The current study describes the use of noncontingent competing stimuli in the treatment of problem behavior exhibited by three individuals during staff-assisted hygiene routines. Functional analyses revealed that particular topographies of problem behaviors appeared to be maintained by their own sensory consequences, whereas other topographies…

Routine resite of peripheral intravenous devices every 3 days did not reduce complications compared with clinically indicated resite: a randomised controlled trial

Directory of Open Access Journals (Sweden)

Rickard Claire M

2010-09-01

Full Text Available Abstract Background Peripheral intravenous device (IVD complications were traditionally thought to be reduced by limiting dwell time. Current recommendations are to resite IVDs by 96 hours with the exception of children and patients with poor veins. Recent evidence suggests routine resite is unnecessary, at least if devices are inserted by a specialised IV team. The aim of this study was to compare the impact of peripheral IVD 'routine resite' with 'removal on clinical indication' on IVD complications in a general hospital without an IV team. Methods A randomised, controlled trial was conducted in a regional teaching hospital. After ethics approval, 362 patients (603 IVDs were randomised to have IVDs replaced on clinical indication (185 patients or routine change every 3 days (177 patients. IVDs were inserted and managed by the general hospital medical and nursing staff; there was no IV team. The primary endpoint was a composite of IVD complications: phlebitis, infiltration, occlusion, accidental removal, local infection, and device-related bloodstream infection. Results IVD complication rates were 68 per 1,000 IVD days (clinically indicated and 66 per 1,000 IVD days (routine replacement (P = 0.86; HR 1.03; 95% CI, 0.74-1.43. Time to first complication per patient did not differ between groups (KM with log rank, P = 0.53. There were no local infections or IVD-related bloodstream infections in either group. IV therapy duration did not differ between groups (P = 0.22, but more (P = 0.004 IVDs were placed per patient in the routine replacement (mean, 1.8 than the clinical indication group (mean, 1.5, with significantly higher hospital costs per patient (P Conclusions Resite on clinical indication would allow one in two patients to have a single cannula per course of IV treatment, as opposed to one in five patients managed with routine resite; overall complication rates appear similar. Clinically indicated resite would achieve savings in equipment

Routine quality control of high dose rate brachytherapy equipment

International Nuclear Information System (INIS)

Guzman Calcina, Carmen S.; Almeida, Adelaide de; Rocha, Jose R. Oliveira

2001-01-01

A Quality Assurance program should be installed also for High Dose Rate brachytherapy, in the order to achieve a correct dose administration to the patient and for the safety to those involved directly with the treatment. The work presented here has the following purposes: Analyze the types of equipment tests presented by the official protocols (TG40, TG56 e ARCAL XXX), evaluate the brachytherapy routine tests of protocols from various national and international radiotherapy services and compare the latter with those presented in the official protocols. As a result, we conclude the following: TG56 presents a higher number of tests when compared to the other official protocols and most of the tests presented by the analyzed services are present in TG56. A suggestion for a basic protocol is presented, emphasizing the periodicity and tolerance level of each of the tests. (author)

Microfoundations of Routines and Capabilities

DEFF Research Database (Denmark)

Felin, Teppo; Foss, Nicolai Juul; Heimriks, Koen H.

We discuss the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories of micro-level components underlying routines...

Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

Science.gov (United States)

Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-producing Escherichia coli (VTEC). In Denmark, the Statens Serum Institut (SSI) routinely receives all suspected VTEC isolates. During a 7-week period in the fall of 2012, all incoming isolates were concurrently subjected to WGS using IonTorrent PGM. Real-time bioinformatics analysis was performed using web-tools (www.genomicepidemiology.org) for species determination, multilocus sequence type (MLST) typing, and determination of phylogenetic relationship, and a specific VirulenceFinder for detection of E. coli virulence genes was developed as part of this study. In total, 46 suspected VTEC isolates were characterized in parallel during the study. VirulenceFinder proved successful in detecting virulence genes included in routine typing, explicitly verocytotoxin 1 (vtx1), verocytotoxin 2 (vtx2), and intimin (eae), and also detected additional virulence genes. VirulenceFinder is also a robust method for assigning verocytotoxin (vtx) subtypes. A real-time clustering of isolates in agreement with the epidemiology was established from WGS, enabling discrimination between sporadic and outbreak isolates. Overall, WGS typing produced results faster and at a lower cost than the current routine. Therefore, WGS typing is a superior alternative to conventional typing strategies. This approach may also be applied to typing and surveillance of other pathogens. PMID:24574290

Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli.

Science.gov (United States)

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S; Nielsen, Eva M; Aarestrup, Frank M

2014-05-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-producing Escherichia coli (VTEC). In Denmark, the Statens Serum Institut (SSI) routinely receives all suspected VTEC isolates. During a 7-week period in the fall of 2012, all incoming isolates were concurrently subjected to WGS using IonTorrent PGM. Real-time bioinformatics analysis was performed using web-tools (www.genomicepidemiology.org) for species determination, multilocus sequence type (MLST) typing, and determination of phylogenetic relationship, and a specific VirulenceFinder for detection of E. coli virulence genes was developed as part of this study. In total, 46 suspected VTEC isolates were characterized in parallel during the study. VirulenceFinder proved successful in detecting virulence genes included in routine typing, explicitly verocytotoxin 1 (vtx1), verocytotoxin 2 (vtx2), and intimin (eae), and also detected additional virulence genes. VirulenceFinder is also a robust method for assigning verocytotoxin (vtx) subtypes. A real-time clustering of isolates in agreement with the epidemiology was established from WGS, enabling discrimination between sporadic and outbreak isolates. Overall, WGS typing produced results faster and at a lower cost than the current routine. Therefore, WGS typing is a superior alternative to conventional typing strategies. This approach may also be applied to typing and surveillance of other pathogens.

Accurate screening for synthetic preservatives in beverage using high performance liquid chromatography with time-of-flight mass spectrometry

International Nuclear Information System (INIS)

Li Xiuqin; Zhang Feng; Sun Yanyan; Yong Wei; Chu Xiaogang; Fang Yanyan; Zweigenbaum, Jerry

2008-01-01

In this study, liquid chromatography time-of-flight mass spectrometry (HPLC/TOF-MS) is applied to qualitation and quantitation of 18 synthetic preservatives in beverage. The identification by HPLC/TOF-MS is accomplished with the accurate mass (the subsequent generated empirical formula) of the protonated molecules [M + H]+ or the deprotonated molecules [M - H]-, along with the accurate mass of their main fragment ions. In order to obtain sufficient sensitivity for quantitation purposes (using the protonated or deprotonated molecule) and additional qualitative mass spectrum information provided by the fragments ions, segment program of fragmentor voltages is designed in positive and negative ion mode, respectively. Accurate mass measurements are highly useful in the complex sample analyses since they allow us to achieve a high degree of specificity, often needed when other interferents are present in the matrix. The mass accuracy typically obtained is routinely better than 3 ppm. The 18 compounds behave linearly in the 0.005-5.0 mg.kg -1 concentration range, with correlation coefficient >0.996. The recoveries at the tested concentrations of 1.0 mg.kg -1 -100 mg.kg -1 are 81-106%, with coefficients of variation -1 , which are far below the required maximum residue level (MRL) for these preservatives in foodstuff. The method is suitable for routine quantitative and qualitative analyses of synthetic preservatives in foodstuff

Routine-industrial planning in the ATOMMASh enterprise

International Nuclear Information System (INIS)

Zabara, V.N.; Kovalev, B.V.; Bobrov, A.A.; Gostishchev, V.S.; Edikhanov, V.P.

1987-01-01

Structure of automated system for routine-industrial planning, developed at the ATOMMASh enterprise is considered. 11 problems, enabling to calculate the duration of cycles of fabrication and lead of detail putting to departments, schedules of detail production in departments fo year, quater, mounth, production plans in norm-hours, equipment utilization, as well as problems, providing for schedule performance were developed. All operational data on the state of industry are concentrated in the data base of operational control

Consuming technologies - developing routines

DEFF Research Database (Denmark)

Gram-Hanssen, Kirsten

2008-01-01

technologies and in this article these processes will be investigated from three different perspectives: an historical perspective of how new technologies have entered homes, a consumer perspective of how both houses and new technologies are purchased and finally, as the primary part of the article, a user...... perspective of how routines develop while these technologies are being used. In the conclusion these insights are discussed in relation to possible ways of influencing routines....

High infection control rate and function after routine one-stage exchange for chronically infected TKA.

Science.gov (United States)

Jenny, Jean-Yves; Barbe, Bruno; Gaudias, Jeannot; Boeri, Cyril; Argenson, Jean-Noël

2013-01-01

Many surgeons consider two-stage exchange the gold standard for treating chronic infection after TKA. One-stage exchange is an alternative for infection control and might provide better knee function, but the rates of infection control and levels of function are unclear. We asked whether a one-stage exchange protocol would lead to infection control rates and knee function similar to those after two-stage exchange. We followed all 47 patients with chronically infected TKAs treated with one-stage exchange between July 2004 and February 2007. We monitored for recurrence of infection and obtained Knee Society Scores. We followed patients a minimum of 3 years or until death or infection recurrence. Three of the 47 patients (6%) experienced a persistence or recurrence of the index infection with the same pathogen isolated. Three patients (6%) had control of the index infection but between 6 and 17 months experienced an infection with another pathogen. The 3-year survival rates were 87% for being free of any infection and 91% for being healed of the index infection. Twenty-five of the 45 patients (56%) had a Knee Society Score of more than 150 points. While routine one-stage exchange was not associated with a higher rate of infection recurrence failure, knee function was not improved compared to that of historical patients having two-stage exchange. One stage-exchange may be a reasonable alternative in chronically infected TKA as a more convenient approach for patients without the risks of two operations and hospitalizations and for reducing costs. The ideal one stage-exchange candidate should be identified in future studies.

Technique for comparing automatic quadrature routines

Energy Technology Data Exchange (ETDEWEB)

Lyness, J N; Kaganove, J J

1976-02-01

The present unconstrained proliferation of automatic quadrature routines is a phenomenon which is wasteful in human time and computing resources. At the root of the problem is an absence of generally acceptable standards or benchmarks for comparing or evaluating such routines. In this paper a general technique, based on the nature of the performance profile, is described which can be used for evaluation of routines.

Accurate EPR radiosensitivity calibration using small sample masses

Science.gov (United States)

Hayes, R. B.; Haskell, E. H.; Barrus, J. K.; Kenner, G. H.; Romanyukha, A. A.

2000-03-01

We demonstrate a procedure in retrospective EPR dosimetry which allows for virtually nondestructive sample evaluation in terms of sample irradiations. For this procedure to work, it is shown that corrections must be made for cavity response characteristics when using variable mass samples. Likewise, methods are employed to correct for empty tube signals, sample anisotropy and frequency drift while considering the effects of dose distribution optimization. A demonstration of the method's utility is given by comparing sample portions evaluated using both the described methodology and standard full sample additive dose techniques. The samples used in this study are tooth enamel from teeth removed during routine dental care. We show that by making all the recommended corrections, very small masses can be both accurately measured and correlated with measurements of other samples. Some issues relating to dose distribution optimization are also addressed.

Accurate EPR radiosensitivity calibration using small sample masses

International Nuclear Information System (INIS)

Hayes, R.B.; Haskell, E.H.; Barrus, J.K.; Kenner, G.H.; Romanyukha, A.A.

2000-01-01

We demonstrate a procedure in retrospective EPR dosimetry which allows for virtually nondestructive sample evaluation in terms of sample irradiations. For this procedure to work, it is shown that corrections must be made for cavity response characteristics when using variable mass samples. Likewise, methods are employed to correct for empty tube signals, sample anisotropy and frequency drift while considering the effects of dose distribution optimization. A demonstration of the method's utility is given by comparing sample portions evaluated using both the described methodology and standard full sample additive dose techniques. The samples used in this study are tooth enamel from teeth removed during routine dental care. We show that by making all the recommended corrections, very small masses can be both accurately measured and correlated with measurements of other samples. Some issues relating to dose distribution optimization are also addressed

A Sudden Total Loss of Vision After Routine Cataract Surgery ...

African Journals Online (AJOL)

We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post ...

The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial.

Science.gov (United States)

Smit, Janine G; Kasius, Jenneke C; Eijkemans, Marinus J C; Koks, Carolien A M; Van Golde, Ron; Oosterhuis, Jurjen G E; Nap, Annemiek W; Scheffer, Gabrielle J; Manger, Petra A P; Hoek, Annemiek; Kaplan, Mesrure; Schoot, Dick B C; van Heusden, Arne M; Kuchenbecker, Walter K H; Perquin, Denise A M; Fleischer, Kathrin; Kaaijk, Eugenie M; Sluijmer, Alexander; Friederich, Jaap; Laven, Joop S E; van Hooff, Marcel; Louwe, Leonie A; Kwee, Janet; Boomgaard, Jantien J; de Koning, Corry H; Janssen, Ineke C A H; Mol, Femke; Mol, Ben W J; Torrance, Helen L; Broekmans, Frank J M

2012-08-08

In in vitro fertilization (IVF) and intracytoplasmatic sperm injection (ICSI) treatment a large drop is present between embryo transfer and occurrence of pregnancy. The implantation rate per embryo transferred is only 30%. Studies have shown that minor intrauterine abnormalities can be found in 11-45% of infertile women with a normal transvaginal sonography or hysterosalpingography. Two randomised controlled trials have indicated that detection and treatment of these abnormalities by office hysteroscopy after two failed IVF cycles leads to a 9-13% increase in pregnancy rate. Therefore, screening of all infertile women for intracavitary pathology prior to the start of IVF/ICSI is increasingly advocated. In absence of a scientific basis for such a policy, this study will assess the effects and costs of screening for and treatment of unsuspected intrauterine abnormalities by routine office hysteroscopy, with or without saline infusion sonography (SIS), prior to a first IVF/ICSI cycle. Multicenter randomised controlled trial in asymptomatic subfertile women, indicated for a first IVF/ICSI treatment cycle, with normal findings at transvaginal sonography. Women with recurrent miscarriages, prior hysteroscopy treatment and intermenstrual blood loss will not be included. Participants will be randomised for a routine fertility work-up with additional (SIS and) hysteroscopy with on-the-spot-treatment of predefined intrauterine abnormalities versus the regular fertility work-up without additional diagnostic tests. The primary study outcome is the cumulative ongoing pregnancy rate resulting in live birth achieved within 18 months of IVF/ICSI treatment after randomisation. Secondary study outcome parameters are the cumulative implantation rate; cumulative miscarriage rate; patient preference and patient tolerance of a SIS and hysteroscopy procedure. All data will be analysed according to the intention-to-treat principle, using univariate and multivariate logistic regression and

FASTBUS Standard Routines implementation for Fermilab embedded processor boards

International Nuclear Information System (INIS)

Pangburn, J.; Patrick, J.; Kent, S.; Oleynik, G.; Pordes, R.; Votava, M.; Heyes, G.; Watson, W.A. III

1992-10-01

In collaboration with CEBAF, Fermilab's Online Support Department and the CDF experiment have produced a new implementation of the IEEE FASTBUS Standard Routines for two embedded processor FASTBUS boards: the Fermilab Smart Crate Controller (FSCC) and the FASTBUS Readout Controller (FRC). Features of this implementation include: portability (to other embedded processor boards), remote source-level debugging, high speed, optional generation of very high-speed code for readout applications, and built-in Sun RPC support for execution of FASTBUS transactions and lists over the network

The effectiveness of online cognitive behavioral treatment in routine clinical practice

NARCIS (Netherlands)

Ruwaard, Jeroen; Lange, Alfred; Schrieken, Bart; Dolan, Conor V; Emmelkamp, Paul

2012-01-01

CONTEXT: Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. OBJECTIVE: To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. DESIGN: An

The effectiveness of online cognitive behavioral treatment in routine clinical practice

NARCIS (Netherlands)

Ruwaard, J.; Lange, A.; Schrieken, B.; Dolan, C.V.; Emmelkamp, P.

2012-01-01

Context Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. Objective To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. Design An

Active Movement Warm-Up Routines

Science.gov (United States)

Walter, Teri; Quint, Ashleigh; Fischer, Kim; Kiger, Joy

2011-01-01

This article presents warm-ups that are designed to physiologically and psychologically prepare students for vigorous physical activity. An active movement warm-up routine is made up of three parts: (1) active warm-up movement exercises, (2) general preparation, and (3) the energy system. These warm-up routines can be used with all grade levels…

Fit Between Organization Design and Organizational Routines

Directory of Open Access Journals (Sweden)

Constance E. Helfat

2014-07-01

Full Text Available Despite decades of research on both organization design and organizational routines, little research has analyzed the relationship between them. Here we propose a normative theory in which the effectiveness of organization design and redesign depends on the characteristics of routines. The analysis shows which types of organization designs may be useful as well as which design changes may or may not succeed depending on (a the specificity of routines and (b the dynamic versus static purposes of organizational routines.

Logistic Regression Analysis of Operational Errors and Routine Operations Using Sector Characteristics

National Research Council Canada - National Science Library

Pfleiderer, Elaine M; Scroggins, Cheryl L; Manning, Carol A

2009-01-01

...) and routine operation (RO) traffic samples. OE data were derived from SATORI re-creations of OEs occurring at the Indianapolis Air Route Traffic Control Center between 9/17/2001 and 12/10/2003...

Accurate torque control of a bi-directional magneto-rheological actuator considering hysteresis and friction effects

International Nuclear Information System (INIS)

Nguyen, Phuong-Bac; Choi, Seung-Bok

2013-01-01

This paper presents a novel type of magneto-rheological (MR) actuator called a bi-directional magneto-rheological (BMR) actuator and accurate torque control results considering both hysteresis and friction compensation. The induced torque of this actuator varies from negative to positive values. As a result, it can work as either a brake or a clutch depending on the scheme of current input. In our work, the configuration of the actuator as well as its driving system is presented first. Subsequently, a congruency hysteresis based (CBH) model to take account of the effect of the hysteresis is proposed. After that, a compensator based on this model is developed. In addition, the effect of dry friction, which exists inherently with MR actuators in general, is also considered. In order to assess the effectiveness of the hysteresis compensator, several experiments on modeling and control of the actuator with different waveforms are carried out. (paper)

Accurate torque control of a bi-directional magneto-rheological actuator considering hysteresis and friction effects

Science.gov (United States)

Nguyen, Phuong-Bac; Choi, Seung-Bok

2013-05-01

This paper presents a novel type of magneto-rheological (MR) actuator called a bi-directional magneto-rheological (BMR) actuator and accurate torque control results considering both hysteresis and friction compensation. The induced torque of this actuator varies from negative to positive values. As a result, it can work as either a brake or a clutch depending on the scheme of current input. In our work, the configuration of the actuator as well as its driving system is presented first. Subsequently, a congruency hysteresis based (CBH) model to take account of the effect of the hysteresis is proposed. After that, a compensator based on this model is developed. In addition, the effect of dry friction, which exists inherently with MR actuators in general, is also considered. In order to assess the effectiveness of the hysteresis compensator, several experiments on modeling and control of the actuator with different waveforms are carried out.

From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control

Directory of Open Access Journals (Sweden)

Tanner Marcel

2008-07-01

Full Text Available Abstract Background Achieving the Millennium Development Goals for health requires a massive scaling-up of interventions in Sub Saharan Africa. Intermittent Preventive Treatment in infants (IPTi is a promising new tool for malaria control. Although efficacy information is available for many interventions, there is a dearth of data on the resources required for scaling up of health interventions. Method We worked in partnership with the Ministry of Health and Social Welfare (MoHSW to develop an IPTi strategy that could be implemented and managed by routine health services. We tracked health system and other costs of (1 developing the strategy and (2 maintaining routine implementation of the strategy in five districts in southern Tanzania. Financial costs were extracted and summarized from a costing template and semi-structured interviews were conducted with key informants to record time and resources spent on IPTi activities. Results The estimated financial cost to start-up and run IPTi in the whole of Tanzania in 2005 was US$1,486,284. Start-up costs of US$36,363 were incurred at the national level, mainly on the development of Behaviour Change Communication (BCC materials, stakeholders' meetings and other consultations. The annual running cost at national level for intervention management and monitoring and drug purchase was estimated at US$459,096. Start-up costs at the district level were US$7,885 per district, mainly expenditure on training. Annual running costs were US$170 per district, mainly for printing of BCC materials. There was no incremental financial expenditure needed to deliver the intervention in health facilities as supplies were delivered alongside routine vaccinations and available health workers performed the activities without working overtime. The economic cost was estimated at 23 US cents per IPTi dose delivered. Conclusion The costs presented here show the order of magnitude of expenditures needed to initiate and to

Accurately tracking single-cell movement trajectories in microfluidic cell sorting devices.

Science.gov (United States)

Jeong, Jenny; Frohberg, Nicholas J; Zhou, Enlu; Sulchek, Todd; Qiu, Peng

2018-01-01

Microfluidics are routinely used to study cellular properties, including the efficient quantification of single-cell biomechanics and label-free cell sorting based on the biomechanical properties, such as elasticity, viscosity, stiffness, and adhesion. Both quantification and sorting applications require optimal design of the microfluidic devices and mathematical modeling of the interactions between cells, fluid, and the channel of the device. As a first step toward building such a mathematical model, we collected video recordings of cells moving through a ridged microfluidic channel designed to compress and redirect cells according to cell biomechanics. We developed an efficient algorithm that automatically and accurately tracked the cell trajectories in the recordings. We tested the algorithm on recordings of cells with different stiffness, and showed the correlation between cell stiffness and the tracked trajectories. Moreover, the tracking algorithm successfully picked up subtle differences of cell motion when passing through consecutive ridges. The algorithm for accurately tracking cell trajectories paves the way for future efforts of modeling the flow, forces, and dynamics of cell properties in microfluidics applications.

Accurately tracking single-cell movement trajectories in microfluidic cell sorting devices.

Directory of Open Access Journals (Sweden)

Jenny Jeong

Full Text Available Microfluidics are routinely used to study cellular properties, including the efficient quantification of single-cell biomechanics and label-free cell sorting based on the biomechanical properties, such as elasticity, viscosity, stiffness, and adhesion. Both quantification and sorting applications require optimal design of the microfluidic devices and mathematical modeling of the interactions between cells, fluid, and the channel of the device. As a first step toward building such a mathematical model, we collected video recordings of cells moving through a ridged microfluidic channel designed to compress and redirect cells according to cell biomechanics. We developed an efficient algorithm that automatically and accurately tracked the cell trajectories in the recordings. We tested the algorithm on recordings of cells with different stiffness, and showed the correlation between cell stiffness and the tracked trajectories. Moreover, the tracking algorithm successfully picked up subtle differences of cell motion when passing through consecutive ridges. The algorithm for accurately tracking cell trajectories paves the way for future efforts of modeling the flow, forces, and dynamics of cell properties in microfluidics applications.

Improving care coordination using organisational routines.

Science.gov (United States)

Prætorius, Thim

2016-01-01

The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications - The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value - Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

Electrotactile feedback improves performance and facilitates learning in the routine grasping task

Directory of Open Access Journals (Sweden)

Milica Isaković

2016-06-01

Full Text Available Aim of this study was to investigate the feasibility of electrotactile feedback in closed loop training of force control during the routine grasping task. The feedback was provided using an array electrode and a simple six-level spatial coding, and the experiment was conducted in three amputee subjects. The psychometric tests confirmed that the subjects could perceive and interpret the electrotactile feedback with a high success rate. The subjects performed the routine grasping task comprising 4 blocks of 60 grasping trials. In each trial, the subjects employed feedforward control to close the hand and produce the desired grasping force (four levels. First (baseline and the last (validation session were performed in open loop, while the second and the third session (training included electrotactile feedback. The obtained results confirmed that using the feedback improved the accuracy and precision of the force control. In addition, the subjects performed significantly better in the validation vs. baseline session, therefore suggesting that electrotactile feedback can be used for learning and training of myoelectric control.

Electrotactile Feedback Improves Performance and Facilitates Learning in the Routine Grasping Task.

Science.gov (United States)

Isaković, Milica; Belić, Minja; Štrbac, Matija; Popović, Igor; Došen, Strahinja; Farina, Dario; Keller, Thierry

2016-06-13

Aim of this study was to investigate the feasibility of electrotactile feedback in closed loop training of force control during the routine grasping task. The feedback was provided using an array electrode and a simple six-level spatial coding, and the experiment was conducted in three amputee subjects. The psychometric tests confirmed that the subjects could perceive and interpret the electrotactile feedback with a high success rate. The subjects performed the routine grasping task comprising 4 blocks of 60 grasping trials. In each trial, the subjects employed feedforward control to close the hand and produce the desired grasping force (four levels). First (baseline) and the last (validation) session were performed in open loop, while the second and the third session (training) included electrotactile feedback. The obtained results confirmed that using the feedback improved the accuracy and precision of the force control. In addition, the subjects performed significantly better in the validation vs. baseline session, therefore suggesting that electrotactile feedback can be used for learning and training of myoelectric control.

Accurate radiotherapy positioning system investigation based on video

International Nuclear Information System (INIS)

Tao Shengxiang; Wu Yican

2006-01-01

This paper introduces the newest research production on patient positioning method in accurate radiotherapy brought by Accurate Radiotherapy Treating System (ARTS) research team of Institute of Plasma Physics of Chinese Academy of Sciences, such as the positioning system based on binocular vision, the position-measuring system based on contour matching and the breath gate controlling system for positioning. Their basic principle, the application occasion and the prospects are briefly depicted. (authors)

42 CFR 493.1210 - Condition: Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

Fast and accurate modeling of stray light in optical systems

Science.gov (United States)

Perrin, Jean-Claude

2017-11-01

The first problem to be solved in most optical designs with respect to stray light is that of internal reflections on the several surfaces of individual lenses and mirrors, and on the detector itself. The level of stray light ratio can be considerably reduced by taking into account the stray light during the optimization to determine solutions in which the irradiance due to these ghosts is kept to the minimum possible value. Unhappily, the routines available in most optical design software's, for example CODE V, do not permit all alone to make exact quantitative calculations of the stray light due to these ghosts. Therefore, the engineer in charge of the optical design is confronted to the problem of using two different software's, one for the design and optimization, for example CODE V, one for stray light analysis, for example ASAP. This makes a complete optimization very complex . Nevertheless, using special techniques and combinations of the routines available in CODE V, it is possible to have at its disposal a software macro tool to do such an analysis quickly and accurately, including Monte-Carlo ray tracing, or taking into account diffraction effects. This analysis can be done in a few minutes, to be compared to hours with other software's.

Cost-effectiveness of intensive multifactorial treatment compared with routine care for individuals with screen-detected Type 2 diabetes : analysis of the ADDITION-UK cluster-randomized controlled trial

NARCIS (Netherlands)

Tao, L.; Wilson, E. C. F.; Wareham, N. J.; Sandbaek, A.; Rutten, G. E. H. M.; Lauritzen, T.; Khunti, K.; Davies, M. J.; Borch-Johnsen, K.; Griffin, S. J.; Simmons, R. K.

Aims To examine the short- and long-term cost-effectiveness of intensive multifactorial treatment compared with routine care among people with screen-detected Type 2 diabetes. Methods Cost-utility analysis in ADDITION-UK, a cluster-randomized controlled trial of early intensive treatment in people

Underdiagnosis of Vertebral Collapse on Routine Multidetector Computed Tomography Scan of the Abdomen

International Nuclear Information System (INIS)

Obaid, H.; Husamaldin, Z.; Bhatt, R.

2008-01-01

Background: Vertebral fractures are commonly associated with osteoporosis and have significant morbidity and mortality rates. Osteoporotic vertebral fractures are presently considered as a treatable and preventable condition, and early detection is vital for further management. The evaluation of vertebral compression on multidetector computed tomography (MDCT) scans of the abdomen has, to our knowledge, not been reported before. Purpose: To assess the prevalence of vertebral collapse on routine abdominal CT scans, and to evaluate the usefulness of the multiplanar reconstruction (MPR) capability of MDCT scans in accurately identifying vertebral abnormalities such as vertebral collapse, spondylolisthesis, and retrolisthesis. Material and Methods: A retrospective review of 307 MDCT scans of the abdomen was carried out at a university teaching hospital. Identifiable patient information was anonymized for data protection. All images were reviewed on a picture archiving and communications system (PACS) using sagittal MPR and bone window for the assessment of the vertebrae. Data were collected from the Computerized Radiology Information System (CRIS). Results: Vertebral collapse was seen in 42 (13.6%) of the 307 patients undergoing routine MDCT of the abdomen. Multilevel and single-level collapses were seen in 24 and 18 patients, respectively. Spondylolisthesis was identified in 5.5% (n=17), and retrolisthesis was seen in 0.6% (n=2). All patients with vertebral fracture were older than 50 years. Women were more commonly affected than men. Conclusion: A significant number of patients with vertebral collapse were diagnosed using MPR on MDCT routine scans of the abdomen

Routines Are the Foundation of Classroom Management

Science.gov (United States)

Lester, Robin Rawlings; Allanson, Patricia Bolton; Notar, Charles E.

2017-01-01

Classroom management is the key to learning. Routines are the foundation of classroom management. Students require structure in their lives. Routines provide that in all of their life from the time they awake until the time they go to bed. Routines in a school and in the classroom provide the environment for learning to take place. The paper is…

The additional benefit of residual spraying and insecticide-treated curtains for dengue control over current best practice in Cuba: Evaluation of disease incidence in a cluster randomized trial in a low burden setting with intensive routine control.

Science.gov (United States)

Toledo, Maria Eugenia; Vanlerberghe, Veerle; Rosales, Julio Popa; Mirabal, Mayelin; Cabrera, Pedro; Fonseca, Viviana; Gómez Padrón, Tania; Pérez Menzies, Mirtha; Montada, Domingo; Van der Stuyft, Patrick

2017-11-01

Aedes control interventions are considered the cornerstone of dengue control programmes, but there is scarce evidence on their effect on disease. We set-up a cluster randomized controlled trial in Santiago de Cuba to evaluate the entomological and epidemiological effectiveness of periodical intra- and peri-domiciliary residual insecticide (deltamethrin) treatment (RIT) and long lasting insecticide treated curtains (ITC). Sixty three clusters (around 250 households each) were randomly allocated to two intervention (RIT and ITC) and one control arm. Routine Aedes control activities (entomological surveillance, source reduction, selective adulticiding, health education) were applied in the whole study area. The outcome measures were clinical dengue case incidence and immature Aedes infestation. Effectiveness of tools was evaluated using a generalized linear regression model with a negative binomial link function. Despite significant reduction in Aedes indices (Rate Ratio (RR) 0.54 (95%CI 0.32-0.89) in the first month after RIT, the effect faded out over time and dengue incidence was not reduced. Overall, in this setting there was no protective effect of RIT or ITC over routine in the 17months intervention period, with for house index RR of 1.16 (95%CI 0.96-1.40) and 1.25 (95%CI 1.03-1.50) and for dengue incidence RR of 1.43 (95%CI 1.08-1.90) and 0.96 (95%CI 0.72-1.28) respectively. The monthly dengue incidence rate (IR) at cluster level was best explained by epidemic periods (Incidence Rate Ratio (IRR) 5.50 (95%CI 4.14-7.31)), the IR in bordering houseblocks (IRR 1.03 (95%CI 1.02-1.04)) and the IR pre-intervention (IRR 1.02 (95%CI 1.00-1.04)). Adding RIT to an intensive routine Aedes control programme has a transient effect on the already moderate low entomological infestation levels, while ITC did not have any effect. For both interventions, we didn't evidence impact on disease incidence. Further studies are needed to evaluate impact in settings with high Aedes

Routine sputum culture

Science.gov (United States)

Sputum culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria ... Elsevier; 2018:chap 36. Chernecky CC, Berger BJ. Culture, routine. In: Chernecky CC, Berger BJ, eds. Laboratory ...

Optimisation of the Future Routine Orbit for Mars Express

Science.gov (United States)

Carranza, Manuel; Companys, Vincente

2007-01-01

the aim at preserving propellant resources for a long time extension it has been agreed to stop the ground-track control. This requires now a more accurate science operation planning, with improved attitude pointing control. Finally, the approach to phase Mars Express to provide back-up relay functions for NASA Phoenix landing is explained. In the context of the routine trajectory optimisation a new requirement for close fly-bys at Phobos, with different observation geometries, has been specified. The approach to fulfill this requirement is explained.

Diagnosis of antiphospholipid syndrome in routine clinical practice

Science.gov (United States)

Hills, J; Machin, SJ; Cohen, H

2013-01-01

The updated international consensus criteria for definite antiphospholipid syndrome (APS) are useful for scientific clinical studies. However, there remains a need for diagnostic criteria for routine clinical use. We audited the results of routine antiphospholipid antibodies (aPLs) in a cohort of 193 consecutive patients with aPL positivity-based testing for lupus anticoagulant (LA), IgG and IgM anticardiolipin (aCL) and anti-ß2glycoprotein-1 antibodies (aß2GPI). Medium/high-titre aCL/aβ2GPI was defined as >99th percentile. Low-titre aCL/aβ2GPI positivity (>95th < 99th percentile) was considered positive for obstetric but not for thrombotic APS. One hundred of the 145 patients fulfilled both clinical and laboratory criteria for definite APS. Twenty-six women with purely obstetric APS had persistent low-titre aCL and/or aβ2GPI. With the inclusion of these patients, 126 of the 145 patients were considered to have APS. Sixty-seven out of 126 patients were LA-negative, of whom 12 had aCL only, 37 had aβ2GPI only and 18 positive were for both. The omission of aCL or aβ2GPI testing from investigation of APS would have led to a failure to diagnose APS in 9.5% and 29.4% of patients, respectively. Our data suggest that LA, aCL and aβ2GPI testing are all required for the accurate diagnosis of APS and that low-titre antibodies should be included in the diagnosis of obstetric APS. PMID:22988029

Routine production of H11CN and :11C:-1-aminocyclopentanecarboxylic acid

International Nuclear Information System (INIS)

Sambre, J.; Vandecasteele, C.; Geothals, P.; Rabi, N.A.; Haver, D. van; Slegers, G.

1985-01-01

The production of H 11 CN using the 14 N(p,α) 11 C reaction, was studied. The yield is 140 mCi/μA at saturation (EOB). From 1.8 Ci of H 11 CN 140 mCi of [ 11 C]ACPC are produced routinely and under remote-control. Chemical and pharmaceutical controls showed that the product is suitable for injection. (author)

FASTPLOT, Interface Routines to MS FORTRAN Graphics Library

International Nuclear Information System (INIS)

1999-01-01

1 - Description of program or function: FASTPLOT is a library of routines that can be used to interface with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). The FASTPLOT routines simplify the development of graphics applications and add capabilities such as histograms, Splines, symbols, and error bars. FASTPLOT also includes routines that can be used to create menus. 2 - Methods: FASTPLOT is a library of routines which must be linked with a user's FORTRAN programs that call any FASTPLOT routines. In addition, the user must link with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). 3 - Restrictions on the complexity of the problem: None noted

External Agents' Effect on Routine Dynamics

DEFF Research Database (Denmark)

Busse Hansen, Nicolai

Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic...... and affiliation are central to how routines are maintained but also susceptible to disruption in case of mis- management. Also the paper contributes with a more fine-tuned understanding of action in terms of them being organized in accordance with preference, which basically means that some actions are preferred...... over others. In producing an action, the relevant next action is projected. However the relevant next action is projected in a specific way and if this is not taken in to account then the routine becomes disrupted. Another core aspect is the notion of deontics that lends itself towards describing who...

Routine general practice care for panic disorder within the lifestyle approach to managing panic study

Directory of Open Access Journals (Sweden)

Rodney A. Lambert

2012-07-01

Full Text Available Routine general practice (GP care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts. Participants met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PD with/without agoraphobia. Follow-up measures recorded at 20 weeks/10 months following randomisation. Control arm, unrestricted routine GP care (practice appointments, referrals and prescriptions. Trial arm, occupational therapyled lifestyle treatment comprising lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine. Primary outcome measure: beck anxiety inventory. At baseline, participants attended 2-3 times more GP appointments than population average, reducing at 10 months to 1.6 times population average for routine GP care and 0.97 population average for lifestyle arm. At 10 months, 33% fewer referrals (6 referrals; 0 mental health than at baseline (9 referrals; 2 mental health were made for lifestyle arm patients compared with 42% increase (from 12 referrals; 8 mental health at baseline to 17 referrals; 7 mental health in GP care arm. Selective serotonin reuptake inhibitors were prescribed most often. Benzodiazepines and beta-blockers were prescribed more often than tricyclic against current clinical guidelines. In conclusion, we found that PD patients at baseline were high healthcare resource users. Treatment in both study arms reduced resource use. Routine GP care requires further review for this patient group.

Effectiveness of routine antihelminthic treatment on anaemia in pregnancy in Rufiji District, Tanzania: a cluster randomised controlled trial.

Science.gov (United States)

Urassa, David P; Nystrom, Lennarth; Carlsted, Anders

2011-09-01

The aim of this study was to estimate the effect of an antihelminthic drug, given at booking and at term to antenatal care visits, on the prevalence of anaemia at term and 4 months post-partum in Rufiji district, Tanzania, the area with high prevalence of intestinal parasites. A cluster randomised controlled trial was conducted on 3080 pregnant women. Out of these 1475 (study arm) received albendazole and 1605 (control arm) placebo. All women also received routine daily iron folate supplements (36 mg iron and 5 mg folate), and sulphadoxine pyramethamine (SP) to prevent malaria. Haemoglobin levels were assessed at booking, at term and 4 months post-partum. At term, median and mean haemoglobin level and the prevalence of severe (anaemia did not differ. The reduction in the prevalence of anaemia from booking to term, was significantly larger in the study arm compared to control arm (26.1% vs. 18.8%; p anaemia (Hb pregnancy. However benefits for deworming may be limited in areas with an antenatal iron supplementation programme or low intensity of hookworm infections and hence future research should be directed towards the cost-effectiveness of the de-worming compared to other interventions for reducing anaemia in pregnancy.

Routine Radiological Environmental Monitoring Plan

International Nuclear Information System (INIS)

Bechtel Nevada

1998-01-01

The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs

The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial

Directory of Open Access Journals (Sweden)

Smit Janine G

2012-08-01

Full Text Available Abstract Background In in vitro fertilization (IVF and intracytoplasmatic sperm injection (ICSI treatment a large drop is present between embryo transfer and occurrence of pregnancy. The implantation rate per embryo transferred is only 30%. Studies have shown that minor intrauterine abnormalities can be found in 11–45% of infertile women with a normal transvaginal sonography or hysterosalpingography. Two randomised controlled trials have indicated that detection and treatment of these abnormalities by office hysteroscopy after two failed IVF cycles leads to a 9–13% increase in pregnancy rate. Therefore, screening of all infertile women for intracavitary pathology prior to the start of IVF/ICSI is increasingly advocated. In absence of a scientific basis for such a policy, this study will assess the effects and costs of screening for and treatment of unsuspected intrauterine abnormalities by routine office hysteroscopy, with or without saline infusion sonography (SIS, prior to a first IVF/ICSI cycle. Methods/design Multicenter randomised controlled trial in asymptomatic subfertile women, indicated for a first IVF/ICSI treatment cycle, with normal findings at transvaginal sonography. Women with recurrent miscarriages, prior hysteroscopy treatment and intermenstrual blood loss will not be included. Participants will be randomised for a routine fertility work-up with additional (SIS and hysteroscopy with on-the-spot-treatment of predefined intrauterine abnormalities versus the regular fertility work-up without additional diagnostic tests. The primary study outcome is the cumulative ongoing pregnancy rate resulting in live birth achieved within 18 months of IVF/ICSI treatment after randomisation. Secondary study outcome parameters are the cumulative implantation rate; cumulative miscarriage rate; patient preference and patient tolerance of a SIS and hysteroscopy procedure. All data will be analysed according to the intention-to-treat principle

A simple and accurate method for the quality control of the I.I.-DR apparatus using the CCD camera

International Nuclear Information System (INIS)

Igarashi, Hitoshi; Shiraishi, Akihisa; Kuraishi, Masahiko

2000-01-01

With the advancing development of CCD cameras, the I.I.-DR apparatus has been introduced into the x-ray fluoroscopy television system. Consequently, quality control of the system has become a complicated task. We developed a simple, accurate method for quality control of the I.I.-DR apparatus using the CCD camera. Experiments were separately performed for the imager system [laser imager, DDX (dynamic digital x-ray system)] and the imaging system (I.I., ND-filter, IRIS, CCD camera). Quality control of the imager system was done by simply examining both input and output characteristics with a sliding pattern. Quality control of the imaging system was also conducted by estimating AVE (the average volume element), which was obtained using a phantom under the constant conditions. The results indicated that this simplified method is useful as a weekly quality control check of the I.I.-DR apparatus using the CCD camera. (author)

Health status in routine clinical practice: validity of the clinical COPD questionnaire at the individual patient level

Directory of Open Access Journals (Sweden)

de Vos Barbara

2010-11-01

Full Text Available Abstract Background There is a growing interest to use health status or disease control questionnaires in routine clinical practice. However, the validity of most questionnaires is established using techniques developed for group level validation. This study examines a new method, using patient interviews, to validate a short health status questionnaire, the Clinical COPD Questionnaire (CCQ, at the individual patient level. Methods Patients with COPD who visited an outpatient clinic completed the CCQ before the consultation, and the specialist physician completed it after the consultation. After the consultation all patients had a semi-structured in-depth interview. The patients' CCQ scores were compared with those of the treating clinician, and with mean scores from 5 clinicians from a pool of 20 who scored the CCQ after reading the transcript of the in-depth interviews only. Agreement was assessed using Lin's concordance correlation coefficient (CCC, and Blant and Altman plots. Interviews with patients with low agreement were reviewed for possible explanations. Results A total of 44 COPD patients (32 male, mean age 66 years, FEV1 45% of predicted participated. Agreement between the patients' CCQ scores and those of the treating clinicians (CCC = 0.87 and the mean score of the reviewing clinicians (CCC = 0.86 was very high. No systematic error was detected. No explanation for individuals with low agreement was found. Conclusion The validity of the CCQ on the individual patient level, as assessed by these methods, is good. Individual health status assessment with the CCQ is therefore sufficiently accurate to be used in routine clinical practice.

NF EN ISO 11137-1, July 2006. Sterilization of health care products - Irradiation - Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices

International Nuclear Information System (INIS)

2006-01-01

This part of the ISO 11137 standard specifies requirements for the development, validation and routine control of a radiation sterilization process for medical devices. Although the scope of this part of the ISO 11137 standard is limited to medical devices, it specifies requirements and provides guidance that may be applicable to other products and equipment. This part of the international standard covers radiation processes employing irradiators using the radionuclide 60 Co or 137 Cs, a beam from an electron generator or a beam from an X-ray generator. This part of the international standard does not: - specify requirements for development, validation and routine control of a process for inactivating the causative agents of spongiform encephalopathies such as scrapie, bovine spongiform encephalopathy and Creutzfeldt-Jakob disease; - detail specified requirements for designating a medical device as sterile; - specify a quality management system for the control of all stages of production of medical devices; - specify requirements for occupational safety associated with the design and operation of irradiation facilities; - specify requirements for the sterilization of used or reprocessed devices

40 CFR 141.621 - Routine monitoring.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Routine monitoring. 141.621 Section....621 Routine monitoring. (a) Monitoring. (1) If you submitted an IDSE report, you must begin monitoring..., you must monitor at the location(s) and dates identified in your monitoring plan in § 141.132(f...

Comparison of performance of tile drainage routines in SWAT 2009 and 2012 in an extensively tile-drained watershed in the Midwest

Science.gov (United States)

Guo, Tian; Gitau, Margaret; Merwade, Venkatesh; Arnold, Jeffrey; Srinivasan, Raghavan; Hirschi, Michael; Engel, Bernard

2018-01-01

Subsurface tile drainage systems are widely used in agricultural watersheds in the Midwestern US and enable the Midwest area to become highly productive agricultural lands, but can also create environmental problems, for example nitrate-N contamination associated with drainage waters. The Soil and Water Assessment Tool (SWAT) has been used to model watersheds with tile drainage. SWAT2012 revisions 615 and 645 provide new tile drainage routines. However, few studies have used these revisions to study tile drainage impacts at both field and watershed scales. Moreover, SWAT2012 revision 645 improved the soil moisture based curve number calculation method, which has not been fully tested. This study used long-term (1991-2003) field site and river station data from the Little Vermilion River (LVR) watershed to evaluate performance of tile drainage routines in SWAT2009 revision 528 (the old routine) and SWAT2012 revisions 615 and 645 (the new routine). Both the old and new routines provided reasonable but unsatisfactory (NSE runoff. The calibrated monthly tile flow, surface flow, nitrate-N in tile and surface flow, sediment and annual corn and soybean yield results from SWAT with the old and new tile drainage routines were compared with observed values. Generally, the new routine provided acceptable simulated tile flow (NSE = 0.48-0.65) and nitrate in tile flow (NSE = 0.48-0.68) for field sites with random pattern tile and constant tile spacing, while the old routine simulated tile flow and nitrate in tile flow results for the field site with constant tile spacing were unacceptable (NSE = 0.00-0.32 and -0.29-0.06, respectively). The new modified curve number calculation method in revision 645 (NSE = 0.50-0.81) better simulated surface runoff than revision 615 (NSE = -0.11-0.49). The calibration provided reasonable parameter sets for the old and new routines in the LVR watershed, and the validation results showed that the new routine has the potential to accurately

Routine operation of an Elliott 903 computer in a clinical chemistry laboratory

Science.gov (United States)

Whitby, L. G.; Simpson, D.

1973-01-01

Experience gained in the last four years concerning the capabilities and limitations of an 8K Elliott 903 (18-bit word) computer with magnetic tape backing store in the routine operation of a clinical chemistry laboratory is described. Designed as a total system, routine operation has latterly had to be confined to data acquisition and process control functions, due primarily to limitations imposed by the choice of hardware early in the project. In this final report of a partially successful experiment the opportunity is taken to review mistakes made, especially at the start of the project, to warn potential computer users of pitfalls to be avoided. PMID:4580240

How does routinely delivered cognitive-behavioural therapy for gambling disorder compare to "gold standard" clinical trial?

Science.gov (United States)

Smith, David P; Fairweather-Schmidt, A Kate; Harvey, Peter W; Battersby, Malcolm W

2018-03-01

Currently, it is unknown whether treatment outcomes derived from randomized controlled trials (RCTs) of cognitive-behavioural therapy (CBT) for problem gamblers still hold when applied to patients seen in routine practice. Thus, data from an RCT of cognitive therapy versus exposure therapy for problem gambling versus patients of a gambling help service were compared. Assessments of problem gambling severity, psychosocial impairment, and alcohol use were undertaken at baseline and post-treatment and evaluated within a counterfactual framework. Findings showed that the contrast between routine CBT for pokies and horse betting had a significant effect, indicative of a 62% lower gambling urge score if routine CBT recipients had all been horse/track betters opposed to gambling with "pokies." However, the majority of contrasts indicated therapeutic outcomes achieved in routine CBT treatments were of equivalent robustness relative to RCT conditions. The present findings infer routine practice treatment outcomes are as efficacious as those generated in RCT contexts. Copyright © 2017 John Wiley & Sons, Ltd.

SPIRIT: Systematic Planning of Intelligent Reuse of Integrated Clinical Routine Data. A Conceptual Best-practice Framework and Procedure Model.

Science.gov (United States)

Hackl, W O; Ammenwerth, E

2016-01-01

Secondary use of clinical routine data is receiving an increasing amount of attention in biomedicine and healthcare. However, building and analysing integrated clinical routine data repositories are nontrivial, challenging tasks. As in most evolving fields, recognized standards, well-proven methodological frameworks, or accurately described best-practice approaches for the systematic planning of solutions for secondary use of routine medical record data are missing. We propose a conceptual best-practice framework and procedure model for the systematic planning of intelligent reuse of integrated clinical routine data (SPIRIT). SPIRIT was developed based on a broad literature overview and further refined in two case studies with different kinds of clinical routine data, including process-oriented nursing data from a large hospital group and high-volume multimodal clinical data from a neurologic intensive care unit. SPIRIT aims at tailoring secondary use solutions to specific needs of single departments without losing sight of the institution as a whole. It provides a general conceptual best-practice framework consisting of three parts: First, a secondary use strategy for the whole organization is determined. Second, comprehensive analyses are conducted from two different viewpoints to define the requirements regarding a clinical routine data reuse solution at the system level from the data perspective (BOTTOM UP) and at the strategic level from the future users perspective (TOP DOWN). An obligatory clinical context analysis (IN BETWEEN) facilitates refinement, combination, and integration of the different requirements. The third part of SPIRIT is dedicated to implementation, which comprises design and realization of clinical data integration and management as well as data analysis solutions. The SPIRIT framework is intended to be used to systematically plan the intelligent reuse of clinical routine data for multiple purposes, which often was not intended when the

Reliability of unstable periodic orbit based control strategies in biological systems

Energy Technology Data Exchange (ETDEWEB)

Mishra, Nagender; Singh, Harinder P. [Department of Physics and Astrophysics, University of Delhi, Delhi 110007 (India); Hasse, Maria [Institut für Höchstleistungsrechnen, Universität Stuttgart, D-70569 Stuttgart (Germany); Biswal, B. [Cluster Innovation Center, University of Delhi, Delhi 110007 (India); Sri Venkateswara College, University of Delhi, Delhi 110021 (India)

2015-04-15

Presence of recurrent and statistically significant unstable periodic orbits (UPOs) in time series obtained from biological systems is now routinely used as evidence for low dimensional chaos. Extracting accurate dynamical information from the detected UPO trajectories is vital for successful control strategies that either aim to stabilize the system near the fixed point or steer the system away from the periodic orbits. A hybrid UPO detection method from return maps that combines topological recurrence criterion, matrix fit algorithm, and stringent criterion for fixed point location gives accurate and statistically significant UPOs even in the presence of significant noise. Geometry of the return map, frequency of UPOs visiting the same trajectory, length of the data set, strength of the noise, and degree of nonstationarity affect the efficacy of the proposed method. Results suggest that establishing determinism from unambiguous UPO detection is often possible in short data sets with significant noise, but derived dynamical properties are rarely accurate and adequate for controlling the dynamics around these UPOs. A repeat chaos control experiment on epileptic hippocampal slices through more stringent control strategy and adaptive UPO tracking is reinterpreted in this context through simulation of similar control experiments on an analogous but stochastic computer model of epileptic brain slices. Reproduction of equivalent results suggests that far more stringent criteria are needed for linking apparent success of control in such experiments with possible determinism in the underlying dynamics.

Reliability of unstable periodic orbit based control strategies in biological systems

International Nuclear Information System (INIS)

Mishra, Nagender; Singh, Harinder P.; Hasse, Maria; Biswal, B.

2015-01-01

Presence of recurrent and statistically significant unstable periodic orbits (UPOs) in time series obtained from biological systems is now routinely used as evidence for low dimensional chaos. Extracting accurate dynamical information from the detected UPO trajectories is vital for successful control strategies that either aim to stabilize the system near the fixed point or steer the system away from the periodic orbits. A hybrid UPO detection method from return maps that combines topological recurrence criterion, matrix fit algorithm, and stringent criterion for fixed point location gives accurate and statistically significant UPOs even in the presence of significant noise. Geometry of the return map, frequency of UPOs visiting the same trajectory, length of the data set, strength of the noise, and degree of nonstationarity affect the efficacy of the proposed method. Results suggest that establishing determinism from unambiguous UPO detection is often possible in short data sets with significant noise, but derived dynamical properties are rarely accurate and adequate for controlling the dynamics around these UPOs. A repeat chaos control experiment on epileptic hippocampal slices through more stringent control strategy and adaptive UPO tracking is reinterpreted in this context through simulation of similar control experiments on an analogous but stochastic computer model of epileptic brain slices. Reproduction of equivalent results suggests that far more stringent criteria are needed for linking apparent success of control in such experiments with possible determinism in the underlying dynamics

Modeling Routinization in Games: An Information Theory Approach

DEFF Research Database (Denmark)

Wallner, Simon; Pichlmair, Martin; Hecher, Michael

2015-01-01

Routinization is the result of practicing until an action stops being a goal-directed process. This paper formulates a definition of routinization in games based on prior research in the fields of activity theory and practice theory. Routinization is analyzed using the formal model of discrete......-time, discrete-space Markov chains and information theory to measure the actual error between the dynamically trained models and the player interaction. Preliminary research supports the hypothesis that Markov chains can be effectively used to model routinization in games. A full study design is presented...

Safety of a quadrivalent meningococcal serogroups A, C, W and Y conjugate vaccine (MenACWY-CRM) administered with routine infant vaccinations: results of an open-label, randomized, phase 3b controlled study in healthy infants.

Science.gov (United States)

Abdelnour, Arturo; Silas, Peter E; Lamas, Marta Raquel Valdés; Aragón, Carlos Fernándo Grazioso; Chiu, Nan-Chang; Chiu, Cheng-Hsun; Acuña, Teobaldo Herrera; Castrejón, Tirza De León; Izu, Allen; Odrljin, Tatjana; Smolenov, Igor; Hohenboken, Matthew; Dull, Peter M

2014-02-12

The highest risk for invasive meningococcal disease (IMD) is in infants aged CRM, a quadrivalent meningococcal conjugate vaccine, concomitantly administered with routine vaccinations to healthy infants. Two-month-old infants were randomized 3:1 to receive MenACWY-CRM with routine vaccines or routine vaccines alone at ages 2, 4, 6 and 12 months. Adverse events (AEs) that were medically attended and serious adverse events (SAEs) were collected from all subjects from enrollment through 18 months of age. In a subset, detailed safety data (local and systemic solicited reactions and all AEs) were collected for 7 days post vaccination. The primary objective was a non-inferiority comparison of the percentages of subjects with ≥1 severe systemic reaction during Days 1-7 after any vaccination of MenACWY-CRM plus routine vaccinations versus routine vaccinations alone (criterion: upper limit of 95% confidence interval [CI] of group difference CRM plus routine vaccines and 13% after routine vaccines alone (group difference 3.0% (95% CI -0.8, 6.4%). Although the non-inferiority criterion was not met, post hoc analysis controlling for significant center and group-by-center differences revealed that MenACWY-CRM plus routine vaccinations was non-inferior to routine vaccinations alone (group difference -0.1% [95% CI -4.9%, 4.7%]). Rates of solicited AEs, medically attended AEs, and SAEs were similar across groups. In a large multinational safety study, a 4-dose series of MenACWY-CRM concomitantly administered with routine vaccines was clinically acceptable with a similar safety profile to routine vaccines given alone. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial.

Science.gov (United States)

Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

2017-01-01

Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain. This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2 nd , 4 th and 6 th week post treatment. The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2 nd , 4 th and 6 th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively. Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with

Numerical solution of the state-delayed optimal control problems by a fast and accurate finite difference θ-method

Science.gov (United States)

Hajipour, Mojtaba; Jajarmi, Amin

2018-02-01

Using the Pontryagin's maximum principle for a time-delayed optimal control problem results in a system of coupled two-point boundary-value problems (BVPs) involving both time-advance and time-delay arguments. The analytical solution of this advance-delay two-point BVP is extremely difficult, if not impossible. This paper provides a discrete general form of the numerical solution for the derived advance-delay system by applying a finite difference θ-method. This method is also implemented for the infinite-time horizon time-delayed optimal control problems by using a piecewise version of the θ-method. A matrix formulation and the error analysis of the suggested technique are provided. The new scheme is accurate, fast and very effective for the optimal control of linear and nonlinear time-delay systems. Various types of finite- and infinite-time horizon problems are included to demonstrate the accuracy, validity and applicability of the new technique.

Improving care coordination using organisational routines

DEFF Research Database (Denmark)

Prætorius, Thim

2016-01-01

Purpose – The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change......: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications – The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research....... Practical implications – The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality...

[The controversy of routine articulator mounting in orthodontics].

Science.gov (United States)

Wang, Li; Han, Xianglong; Bai, Ding

2013-06-01

Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

Adaptive intrusion data system (AIDS) software routines

International Nuclear Information System (INIS)

Corlis, N.E.

1980-07-01

An Adaptive Intrusion Data System (AIDS) was developed to collect information from intrusion alarm sensors as part of an evaluation system to improve sensor performance. AIDS is a unique digital data-compression, storage, and formatting system; it also incorporates a capability for video selection and recording for assessment of the sensors monitored by the system. The system is software reprogrammable to numerous configurations that may be used for the collection of environmental, bilevel, analog, and video data. This report describes the software routines that control the different AIDS data-collection modes, the diagnostic programs to test the operating hardware, and the data format. Sample data printouts are also included

The Endogenous Origins of Experience, Routines and Organizational Capabilities

DEFF Research Database (Denmark)

Foss, Nicolai Juul; Felin, Teppo

2011-01-01

In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically,...... or rationalist, choice-based approach can provide a more fruitful (though preliminary) foundation for understanding organizational behavior and capabilities.......In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically......, we explicate the behaviorist and empiricist foundations of the organizational routines and capabilities literature and the extant emphasis placed on experience, repetition, and observation as the key antecedents and mechanisms of routines and capabilities. Based on this discussion we highlight...

Internet-based CBT for social phobia and panic disorder in a specialised anxiety clinic in routine care: Results of a pilot randomised controlled trial

Directory of Open Access Journals (Sweden)

Kim Mathiasen

2016-05-01

This study was not able to document statistically significant clinical effect of iCBT with minimal therapist contact compared to a waiting list control group in a specialised anxiety clinic in routine care. However, a large and significant effect was seen on self-reported quality of life. Although these results offer an interesting perspective on iCBT in specialised care, they should be interpreted with caution, due to the limitations of the study. A large scale fully powered RCT is recommended.

COPD management: role of symptom assessment in routine clinical practice

Science.gov (United States)

van der Molen, Thys; Miravitlles, Marc; Kocks, Janwillem WH

2013-01-01

Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients’ everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed. PMID:24143085

Cost-effectiveness of duloxetine versus routine treatment for U.S. patients with diabetic peripheral neuropathic pain.

Science.gov (United States)

Wu, Eric Q; Birnbaum, Howard G; Mareva, Milena N; Le, T Kim; Robinson, Rebecca L; Rosen, Amy; Gelwicks, Steve

2006-06-01

The purpose of this study was to compare the cost-effectiveness of duloxetine versus routine treatment in management of diabetic peripheral neuropathic pain (DPNP). Two hundred thirty-three patients with DPNP who completed a 12-week, double-blind, placebo-controlled, randomized, multicenter duloxetine trial were re-randomized into a 52-week, open-label trial of duloxetine 60 mg twice daily versus routine treatment. Routine treatment included pain management therapies. Effectiveness was measured by using the bodily pain domain (BP) of the Medical Outcomes Study Short Form 36 (SF-36). Costs were analyzed from 3 perspectives: third party payer (direct medical costs), employer (direct and indirect medical costs), and societal (patient's out-of-pocket costs and total medical costs). Costs of study medications were not included because of limited data. Bootstrap method was applied to calculate statistical inference of the incremental cost-effectiveness ratio (ICER). Routine treatment most frequently used included gabapentin (56%), venlafaxine (36%), and amitripytline (15%). From employer and societal perspectives, duloxetine was cost-effective (ICER= -342 dollars and -429 dollars, respectively, per unit of SF-36 BP; both P routine DPNP treatment (both P < .05). From payer perspective, duloxetine trended toward cost-effectiveness (ICER= -249 dollars per unit of SF-36 BP; P controlled environment of a clinical trial. An analysis of real-world data would be beneficial. Evaluation of the cost and benefit of new pharmacologic treatments is highly desired by decision makers. From both employer perspective and societal perspective (including patient's out-of-pocket costs), this study demonstrated that duloxetine was more cost-effective than routine treatment in management of DPNP.

Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

Science.gov (United States)

Tan, S G; Lim, S H; Malathi, I

1995-11-01

A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

Factors related to women's childbirth satisfaction in physiologic and routine childbirth groups

Directory of Open Access Journals (Sweden)

Elham Jafari

2017-01-01

Full Text Available Background: Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. Materials and Methods: This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS, satisfied with birth setting, Labor Agentry Scale (LAS, and Visual Analogue Scale (VAS, which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t-test, analysis of variance, and linear, multivariate regression model at the significant level of P 0.05. Conclusions: Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

The institutionalization of a routine

DEFF Research Database (Denmark)

Nickelsen, Niels Christian

2008-01-01

-which has before largely been treated in overview by institutionalism-plays an important role in the making of a routine. In my empirical study, I demonstrate that the concept and practice of the valve changes, and that it is identified in a number of ways, as it passes through the testing phase...... of production. I argue that the negotiation of these changes during test production is the fulcrum in the routinization of the production procedure. It is through these identity shifts that the valve is both reified, and rendered producible and applicable in the customer world....

Milne, a routine for the numerical solution of Milne's problem

Science.gov (United States)

Rawat, Ajay; Mohankumar, N.

2010-11-01

The routine Milne provides accurate numerical values for the classical Milne's problem of neutron transport for the planar one speed and isotropic scattering case. The solution is based on the Case eigen-function formalism. The relevant X functions are evaluated accurately by the Double Exponential quadrature. The calculated quantities are the extrapolation distance and the scalar and the angular fluxes. Also, the H function needed in astrophysical calculations is evaluated as a byproduct. Program summaryProgram title: Milne Catalogue identifier: AEGS_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEGS_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 701 No. of bytes in distributed program, including test data, etc.: 6845 Distribution format: tar.gz Programming language: Fortran 77 Computer: PC under Linux or Windows Operating system: Ubuntu 8.04 (Kernel version 2.6.24-16-generic), Windows-XP Classification: 4.11, 21.1, 21.2 Nature of problem: The X functions are integral expressions. The convergence of these regular and Cauchy Principal Value integrals are impaired by the singularities of the integrand in the complex plane. The DE quadrature scheme tackles these singularities in a robust manner compared to the standard Gauss quadrature. Running time: The test included in the distribution takes a few seconds to run.

ORGANIZATIONAL ROUTINES IN RUSSIAN COMPANIES: REVIEW OF PRACTICES

Directory of Open Access Journals (Sweden)

Olga Valieva

2014-10-01

Full Text Available Results of the first stage of the researches conducted in 2012-2013 are presented in article. Researches are connected with studying of transformational processes intra corporate of managemetn practices in the Russian companies and their subsequent institutionalization. Preliminary results showed that in the companies there is a standard set of organizational routines which part are information, and administrative routines, routines of the power of the founder, genetic, institutional and development routines. During research statistically significant connection between types of organizational structures, the sizes of the organization, information processing and administrative practices is established. It is revealed as change of approaches to management of the organization can affect a corruption component.

ADVANCED TOKAMAK OPERATION USING THE DIII-D PLASMA CONTROL SYSTEM

International Nuclear Information System (INIS)

HUMPHREYS, DA; FERRON, JR; GAROFALO, AM; HYATT, AW; JERNIGAN, TC; JOHNSON, RD; LAHAYE, RJ; LEUER, JA; OKABAYASHI, M; PENAFLOR, BG; SCOVILLE, JT; STRAIT, EJ; WALKER, ML; WHYTE, DG

2002-01-01

A271 ADVANCED TOKAMAK OPERATION USING THE DIII-D PLASMA CONTROL SYSTEM. The principal focus of experimental operations in the DIII-D tokamak is the advanced tokamak (AT) regime to achieve, which requires highly integrated and flexible plasma control. In a high performance advanced tokamak, accurate regulation of the plasma boundary, internal profiles, pumping, fueling, and heating must be well coordinated with MHD control action to stabilize such instabilities as tearing modes and resistive wall modes. Sophisticated monitors of the operational regime must provide detection of off-normal conditions and trigger appropriate safety responses with acceptable levels of reliability. Many of these capabilities are presently implemented in the DIII-D plasma control system (PCS), and are now in frequent or routine operational use. The present work describes recent development, implementation, and operational experience with AT regime control elements for equilibrium control, MHD suppression, and off-normal event detection and response

42 CFR 493.1267 - Standard: Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

Breaking the Waves: Routines and Rituals in Entrepreneurship Education

Science.gov (United States)

Neergaard, Helle; Christensen, Dorthe Refslund

2017-01-01

Learning is related to the environment created for the learning experience. This environment is often highly routinized and involves a certain social structure, but in entrepreneurship education, such routinization and structure may actually counteract the learning goals. This article investigates how classroom routines and rituals impact on…

42 CFR 493.841 - Standard; Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

Bayesian estimation of test characteristics of real-time PCR, bacteriological culture and California mastitis test for diagnosis of intramammary infections with Staphylococcus aureus in dairy cattle at routine milk recordings.

Science.gov (United States)

Mahmmod, Yasser S; Toft, Nils; Katholm, Jørgen; Grønbæk, Carsten; Klaas, Ilka C

2013-11-01

Danish farmers can order a real-time PCR mastitis diagnostic test on routinely taken cow-level samples from milk recordings. Validation of its performance in comparison to conventional mastitis diagnostics under field conditions is essential for efficient control of intramammary infections (IMI) with Staphylococcus aureus (S. aureus). Therefore, the objective of this study was to estimate the sensitivity (Se) and specificity (Sp) of real-time PCR, bacterial culture (BC) and California mastitis test (CMT) for the diagnosis of the naturally occurring IMI with S. aureus in routinely collected milk samples using latent class analysis (LCA) to avoid the assumption of a perfect reference test. Using systematic random sampling, a total of 609 lactating dairy cows were selected from 6 dairy herds with bulk tank milk PCR cycle threshold (Ct) value ≤39 for S. aureus. At routine milk recordings, automatically obtained cow-level (composite) milk samples were analyzed by PCR and at the same milking, 2436 quarter milk samples were collected aseptically for BC and CMT. Results showed that 140 cows (23%) were positive for S. aureus IMI by BC while 170 cows (28%) were positive by PCR. Estimates of Se and Sp for PCR were higher than test estimates of BC and CMT. SeCMT was higher than SeBC however, SpBC was higher than SpCMT. SePCR was 91%, while SeBC was 53%, and SeCMT was 61%. SpPCR was 99%, while SpBC was 89%, and SpCMT was 65%. In conclusion, PCR has a higher performance than the conventional diagnostic tests (BC and CMT) suggesting its usefulness as a routine test for accurate diagnosis of S. aureus IMI from dairy cows at routine milk recordings. The use of LCA provided estimates of the test characteristics for two currently diagnostic tests (BC, CMT) and a novel technique (real-time PCR) for diagnosing S. aureus IMI under field conditions at routine milk recordings in Denmark. Copyright © 2013 Elsevier B.V. All rights reserved.

Accurate automatic tuning circuit for bipolar integrated filters

NARCIS (Netherlands)

de Heij, Wim J.A.; de Heij, W.J.A.; Hoen, Klaas; Hoen, Klaas; Seevinck, Evert; Seevinck, E.

1990-01-01

An accurate automatic tuning circuit for tuning the cutoff frequency and Q-factor of high-frequency bipolar filters is presented. The circuit is based on a voltage controlled quadrature oscillator (VCO). The frequency and the RMS (root mean square) amplitude of the oscillator output signal are

Incidental perifissural nodules on routine chest computed tomography. Lung cancer or not?

Energy Technology Data Exchange (ETDEWEB)

Mets, Onno M.; Veldhuis, Wouter B.; Jong, Pim A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Chung, Kaman; Scholten, Ernst T.; Ginneken, Bram van [Radboud University Nijmegen Medical Centre, Diagnostic Image Analysis Group, Nijmegen (Netherlands); Prokop, M. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Schaefer-Prokop, Cornelia M. [Radboud University Nijmegen Medical Centre, Diagnostic Image Analysis Group, Nijmegen (Netherlands); Meander Medical Center, Department of Radiology, Amersfoort (Netherlands)

2018-03-15

Perifissural nodules (PFNs) are a common finding on chest CT, and are thought to represent non-malignant lesions. However, data outside a lung cancer-screening setting are currently lacking. In a nested case-control design, out of a total cohort of 16,850 patients ≥ 40 years of age who underwent routine chest CT (2004-2012), 186 eligible subjects with incident lung cancer and 511 controls without were investigated. All non-calcified nodules ≥ 4 mm were semi-automatically annotated. Lung cancer location and subject characteristics were recorded. Cases (56 % male) had a median age of 64 years (IQR 59-70). Controls (60 % male) were slightly younger (p<0.01), median age of 61 years (IQR 51-70). A total of 262/1,278 (21 %) unique non-calcified nodules represented a PFN. None of these were traced to a lung malignancy over a median follow-up of around 4.5 years. PFNs were most often located in the lower lung zones (72 %, p<0.001). Median diameter was 4.6 mm (range: 4.0-8.1), volume 51 mm{sup 3} (range: 32-278). Some showed growth rates < 400 days. Our data show that incidental PFNs do not represent lung cancer in a routine care, heterogeneous population. This confirms prior screening-based results. (orig.)

Parent-Implemented Bedtime Fading and Positive Routines for Children with Autism Spectrum Disorders

Science.gov (United States)

Delemere, Emma; Dounavi, Katerina

2018-01-01

Sleep disorders affect a large portion of those with autism spectrum disorder. Behavioural interventions have been found to increase appropriate sleep behaviours. This study sought to examine the efficacy of two stimulus control interventions (bedtime fading and positive routines) on total sleep duration, sleep onset latency and frequency and…

Treatment goals in psoriasis routine care.

Science.gov (United States)

Radtke, M A; Reich, K; Spehr, C; Augustin, Matthias

2015-07-01

The treatment goal algorithm for psoriasis, first originated in 2007, has ever since been adopted into treatment guidelines. It remained unclear how many patients have experienced the use of treatment goals in routine care and how these are perceived. The aim of the pilot study was to get first insight in the use and impact of therapeutic goals in a large cohort of patients with psoriasis in routine care. This study is a multicenter, non-interventional, cross-sectional health care study in n = 213 dermatology centers across Germany. A standardized physician and patient questionnaire was used, including demographics, disease and treatment characteristics. To evaluate patient treatment perception and satisfaction, a questionnaire (PsoSat) addressing 8 specific items was designed. Consistency and validity of the questionnaire were controlled by factor analyses and reliability tests. In total n = 1,883 patients were included for analysis (54.2% male). Mean age was 52 years, mean disease duration 19 years. In total 45.5% (n = 856) stated an improvement of psoriatic symptoms in the last 4 weeks. In patients including treatment goals, the course of psoriasis in the last 4 weeks was rated significantly better and predicted significantly higher patient satisfaction. Patients reporting periodic outcomes measurement of psoriasis treatment, also had significantly better course of disease, higher satisfaction and a lower psoriasis severity. A majority of patients experienced the use of treatment goals in practice. The association of using treatment goals with clinical outcomes and treatment satisfaction was markedly positive. These findings indicate that the use of treatment goals and outcome measurements in fact improve psoriasis management.

Are daily routine chest radiographs useful in critically ill, mechanically ventilated patients? A randomized study.

Science.gov (United States)

Clec'h, Christophe; Simon, Paul; Hamdi, Aïcha; Hamza, Lilia; Karoubi, Philippe; Fosse, Jean-Philippe; Gonzalez, Frédéric; Vincent, François; Cohen, Yves

2008-02-01

Whether chest radiographs (CXRs) in mechanically ventilated patients should be routinely obtained or only when an abnormality is anticipated remains debated. We aimed to compare the diagnostic, therapeutic and outcome efficacy of a restrictive prescription of CXRs with that of a routine prescription, focusing on delayed diagnoses and treatments potentially related to the restrictive prescription. Randomized controlled trial. Intensive care unit of the Avicenne Teaching Hospital, Bobigny, France. All consecutive patients mechanically ventilated for > or = 48h between January and June 2006. Patients were randomly assigned to have daily routine CXRs (routine prescription group) or clinically indicated CXRs (restrictive prescription group). For each CXR, a questionnaire was completed addressing the reason for the CXR, the new findings, and any subsequent therapeutic intervention. The endpoints were the rates of new findings, the rates of new findings that prompted therapeutic intervention, the rate of delayed diagnoses, and mortality. Eighty-four patients were included in the routine prescription group and 81 in the restrictive prescription group. The rates of new findings and the rates of new findings that prompted therapeutic intervention in the restrictive prescription group and in the routine prescription group were 66% vs. 7.2% (p < 0.0001), and 56.4% vs. 5.5% (p < 0.0001) respectively. The rate of delayed diagnoses in the restrictive prescription group was 0.7%. Mortality was similar. Restrictive use of CXRs in mechanically ventilated patients was associated with better diagnostic and therapeutic efficacies without impairing outcome.

NF EN ISO 11137-1, July 2006. Sterilization of health care products - Irradiation - Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices; NF EN ISO 11137-1, Juillet 2006. Sterilisation des produits de sante - Irradiation - Partie 1: exigences relatives a la mise au point, a la validation et au controle de routine d'un procede de sterilisation pour les dispositifs medicaux

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-07-01

This part of the ISO 11137 standard specifies requirements for the development, validation and routine control of a radiation sterilization process for medical devices. Although the scope of this part of the ISO 11137 standard is limited to medical devices, it specifies requirements and provides guidance that may be applicable to other products and equipment. This part of the international standard covers radiation processes employing irradiators using the radionuclide {sup 60}Co or {sup 137}Cs, a beam from an electron generator or a beam from an X-ray generator. This part of the international standard does not: - specify requirements for development, validation and routine control of a process for inactivating the causative agents of spongiform encephalopathies such as scrapie, bovine spongiform encephalopathy and Creutzfeldt-Jakob disease; - detail specified requirements for designating a medical device as sterile; - specify a quality management system for the control of all stages of production of medical devices; - specify requirements for occupational safety associated with the design and operation of irradiation facilities; - specify requirements for the sterilization of used or reprocessed devices.

Accurate Classification of Chronic Migraine via Brain Magnetic Resonance Imaging

Science.gov (United States)

Schwedt, Todd J.; Chong, Catherine D.; Wu, Teresa; Gaw, Nathan; Fu, Yinlin; Li, Jing

2015-01-01

Background The International Classification of Headache Disorders provides criteria for the diagnosis and subclassification of migraine. Since there is no objective gold standard by which to test these diagnostic criteria, the criteria are based on the consensus opinion of content experts. Accurate migraine classifiers consisting of brain structural measures could serve as an objective gold standard by which to test and revise diagnostic criteria. The objectives of this study were to utilize magnetic resonance imaging measures of brain structure for constructing classifiers: 1) that accurately identify individuals as having chronic vs. episodic migraine vs. being a healthy control; and 2) that test the currently used threshold of 15 headache days/month for differentiating chronic migraine from episodic migraine. Methods Study participants underwent magnetic resonance imaging for determination of regional cortical thickness, cortical surface area, and volume. Principal components analysis combined structural measurements into principal components accounting for 85% of variability in brain structure. Models consisting of these principal components were developed to achieve the classification objectives. Ten-fold cross validation assessed classification accuracy within each of the ten runs, with data from 90% of participants randomly selected for classifier development and data from the remaining 10% of participants used to test classification performance. Headache frequency thresholds ranging from 5–15 headache days/month were evaluated to determine the threshold allowing for the most accurate subclassification of individuals into lower and higher frequency subgroups. Results Participants were 66 migraineurs and 54 healthy controls, 75.8% female, with an average age of 36 +/− 11 years. Average classifier accuracies were: a) 68% for migraine (episodic + chronic) vs. healthy controls; b) 67.2% for episodic migraine vs. healthy controls; c) 86.3% for chronic

Engineering Task Plan for Routine Engineering Support for Core Sampler System

International Nuclear Information System (INIS)

BOGER, R.M.

1999-01-01

Routine engineering support is required during normal operation of the core sampler trucks and associated ancillary equipment. This engineering support consists of, but is not limited to, troubleshooting operation problems, correcting minor design problems, assistance with work package preparation, assistance with procurement, fabrication shop support, planning of engineering tasks and preparation of associated Engineering Task Plans (ETP) and Engineering Service Requests (ESR). This ETP is the management plan document for implementing routine engineering support. Any additional changes to the scope of this ETP shall require a Letter of Instruction from Lockheed Martin Hanford Corp (LMHC). This document will also be the Work Planning Document for Development Control (HNF 1999a). The scope of this task will be to provide routine engineering support for Characterization equipment as required to support Characterization Operations. A task by task decision will be made by management to determine which tasks will be done per this ETP and if additional ETPs and/or ESRs are required. Due to the unique nature of this task, the only identifiable deliverable is to provide support as requested. Deliverables will be recorded in a task logbook as activities are identified. ESRs will be generated for tasks that require more than 40 person hours to complete, per Characterization Engineering Desk Instructions (DI 1999a)

Effect of Mobile Phone Text Message Reminders on Routine Immunization Uptake in Pakistan: Randomized Controlled Trial.

Science.gov (United States)

Kazi, Abdul Momin; Ali, Murtaza; Zubair, Khurram; Kalimuddin, Hussain; Kazi, Abdul Nafey; Iqbal, Saleem Perwaiz; Collet, Jean-Paul; Ali, Syed Asad

2018-03-07

Improved routine immunization (RI) coverage is recommended as the priority public health strategy to decrease vaccine-preventable diseases and eradicate polio in Pakistan and worldwide. The objective of this study was to ascertain whether customized, automated, one-way text messaging (short message service, SMS) reminders delivered to caregivers via mobile phones when a child is due for an RI visit can improve vaccination uptake and timelines in Pakistan. This was a randomized controlled trial, conducted in an urban squatter settlement area of Karachi, Pakistan. Infants less than 2 weeks of age with at least one family member who had a valid mobile phone connection and was comfortable receiving and reading SMS text messages were included. Participants were randomized to the intervention (standard care + one-way SMS reminder) or control (standard care) groups. The primary outcome was to compare the proportion of children immunized up to date at 18 weeks of age. Vaccine given at 6, 10, and 14 weeks schedule includes DPT-Hep-B-Hib vaccine (ie, diphtheria, pertussis, and tetanus; hepatitis B; and Haemophilus influenza type b) and oral poliovirus vaccine (OPV). Data were analyzed using chi-square tests of independence and tested for both per protocol (PP) and intention-to-treat (ITT) analyses. Out of those approached, 84.3% (300/356) of the participants were eligible for enrollment and 94.1% (318/338) of the participants had a working mobile phone. Only children in the PP analyses, who received an SMS reminder for vaccine uptake at 6 weeks visit, showed a statistically significant difference (96.0%, 86/90 vs 86.4%, 102/118; P=.03).The immunization coverage was consistently higher in the intervention group according to ITT analyses at the 6 weeks scheduled visit (76.0% vs 71.3%, P=.36). The 10 weeks scheduled visit (58.7% vs 52.7%, P=.30) and the 14 weeks scheduled visit (31.3% vs 26.0%, P=.31), however, were not statistically significant. Automated simple one-way SMS

Detection of irradiated cheese and exotic fruits by a simple routine control method

International Nuclear Information System (INIS)

Spiegelberg, A.; Schulzki, G.; Helle, N.; Boegl, K.W.; Schreiber, G.A.

1993-01-01

The results demonstrate very clearly that Florisil chromatography is a suitable routine method to detect irradiation treatment in Camembert, mango seeds and avocado flesh. Inspite of excluding 1-14:1 as marker for irradiation treatment on account of fat attendant flavour compounds in fruits, an unequivocal revelation of irradiated samples was possible because the most important radiation-induced hydrocarbons 1,7-26:2 and 8-14:1 (arising from oleic acid) could be clearly detected in both fruits. In addition, high amounts of 1-16:1 from stearic acid are present in irradiated mango and 6,9-17:2 from linoleic acid in avocado. (orig.)

Magnetic dipole moment estimation and compensation for an accurate attitude control in nano-satellite missions

Science.gov (United States)

Inamori, Takaya; Sako, Nobutada; Nakasuka, Shinichi

2011-06-01

Nano-satellites provide space access to broader range of satellite developers and attract interests as an application of the space developments. These days several new nano-satellite missions are proposed with sophisticated objectives such as remote-sensing and observation of astronomical objects. In these advanced missions, some nano-satellites must meet strict attitude requirements for obtaining scientific data or images. For LEO nano-satellite, a magnetic attitude disturbance dominates over other environmental disturbances as a result of small moment of inertia, and this effect should be cancelled for a precise attitude control. This research focuses on how to cancel the magnetic disturbance in orbit. This paper presents a unique method to estimate and compensate the residual magnetic moment, which interacts with the geomagnetic field and causes the magnetic disturbance. An extended Kalman filter is used to estimate the magnetic disturbance. For more practical considerations of the magnetic disturbance compensation, this method has been examined in the PRISM (Pico-satellite for Remote-sensing and Innovative Space Missions). This method will be also used for a nano-astrometry satellite mission. This paper concludes that use of the magnetic disturbance estimation and compensation are useful for nano-satellites missions which require a high accurate attitude control.

Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups.

Science.gov (United States)

Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

2017-01-01

Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t -test, analysis of variance, and linear, multivariate regression model at the significant level of P toward the recent pregnancy ( P = 0.007), and perceived severity of pain ( P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy ( P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth ( P > 0.05). Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

Directory of Open Access Journals (Sweden)

Esbensen Bente

2011-06-01

Full Text Available Abstract Background Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus a barrier for health care providers (HCPs to overcome in their attempts to involve both adolescents and parents in improvement of glycaemic control. Evidence-based interventions that involve all three parties (i.e., adolescents, parents and HCPs and are integrated into routine outpatient clinic visits are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic visits will reduce haemoglobin A1c (HbA1c concentrations and improve adolescents' life skills compared with a control group. Methods/Design Using a mixed methods design comprising a randomised controlled trial and a nested qualitative evaluation, we will recruit 68 adolescents age 13 - 18 years with type 1 diabetes (HbA1c > 8.0% and their parents from 2 Danish hospitals and randomise into GSD-Y or control groups. During an 8-12 month period, the GSD-Y group will complete 8 outpatient GSD-Y visits, and the control group will completes an equal number of standard visits. The primary outcome is HbA1c. Secondary outcomes include the following: number of self-monitored blood glucose values and levels of autonomous motivation, involvement and autonomy support from parents, autonomy support from HCPs, perceived competence in managing diabetes, well-being, and diabetes-related problems. Primary and secondary outcomes will be evaluated within and between groups by comparing data from baseline, after completion of the visits, and again after a 6-month follow-up. To

Who should be performing routine abdominal ultrasound? A prospective double-blind study comparing the accuracy of radiologist and radiographer

International Nuclear Information System (INIS)

Leslie, A.; Lockyer, H.; Virjee, J.P.

2000-01-01

AIM: To compare the accuracy of radiographers and radiologists in routine abdominal ultrasound. MATERIALS AND METHODS: One hundred consecutive patients attending for routine abdominal ultrasound were included. Each patient was examined by both a radiographer and radiologist. Both operators noted their findings and wrote a concluding report without conferring. Reports were compared. Where there was disagreement the patient was either re-examined by another radiologist or had further investigation. RESULTS: Of 100 patients, 52 were men and 48 were women. The age range was 19-88 years (median 52 years). Thirty-seven patients had renal tract ultrasound, one had an aortic ultrasound and 62 had general upper abdominal ultrasound. In 44 cases both operators reported the examination as normal. In 49 cases both operators reported the examinations as abnormal and there was complete agreement between the operators. In seven cases there was not complete agreement between operators. Three of these disagreements were considered minor and four major. In three of the seven cases the radiographer was correct, and in four the radiologist was correct. CONCLUSION: Experienced radiographers and radiologists are highly accurate in performing and interpreting routine abdominal sonography. Both operators missed a small minority of abnormalities. There was no statistically significant difference in the accuracy of radiographers and radiologist. Leslie, A. (2000)

Effect of Corbrin Capsule combined with routine western medicine on the airway remodeling process in patients with stable COPD

Directory of Open Access Journals (Sweden)

Su-Li Song

2017-08-01

Full Text Available Objective: To explore the effect of Corbrin Capsule combined with routine western medicine on the airway remodeling process in patients with stable COPD. Methods: A total of 120 patients with stable COPD who were treated in the hospital between May 2014 and December 2016 were collected and divided into control group and observation group according to the random number table method, 60 cases in each group. The control group received routine western medicine treatment, and the observation group received Corbrin Capsule combined with routine western medicine treatment. The differences in serum levels of inflammatory factors, growth factors and fibrosis indexes were compared between the two groups before and after treatment. Results: Before treatment, difference in serum levels of inflammatory factors, growth factors and fibrosis indexes were not statistically significant between the two groups of patients. After 8 weeks of treatment, serum IL-2, IL-4, IL-8, IL-18, VEGF, b-FGF, NGF, LN, HA, PⅢNP and C-Ⅳ levels of both groups of patients were significantly lower than those before treatment, and serum IL-2, IL-4, IL-8, IL-18, VEGF, b-FGF, NGF, LN, HA, PⅢNP and C-Ⅳ levels of observation group were lower than those of control group. Conclusion: Corbrin Capsule combined with routine western medicine treatment can effectively inhibit the fibrosis process in patients with stable COPD.

Rapid targeted somatic mutation analysis of solid tumors in routine clinical diagnostics.

Science.gov (United States)

Magliacane, Gilda; Grassini, Greta; Bartocci, Paola; Francaviglia, Ilaria; Dal Cin, Elena; Barbieri, Gianluca; Arrigoni, Gianluigi; Pecciarini, Lorenza; Doglioni, Claudio; Cangi, Maria Giulia

2015-10-13

Tumor genotyping is an essential step in routine clinical practice and pathology laboratories face a major challenge in being able to provide rapid, sensitive and updated molecular tests. We developed a novel mass spectrometry multiplexed genotyping platform named PentaPanel to concurrently assess single nucleotide polymorphisms in 56 hotspots of the 5 most clinically relevant cancer genes, KRAS, NRAS, BRAF, EGFR and PIK3CA for a total of 221 detectable mutations. To both evaluate and validate the PentaPanel performance, we investigated 1025 tumor specimens of 6 different cancer types (carcinomas of colon, lung, breast, pancreas, and biliary tract, and melanomas), systematically addressing sensitivity, specificity, and reproducibility of our platform. Sanger sequencing was also performed for all the study samples. Our data showed that PentaPanel is a high throughput and robust tool, allowing genotyping for targeted therapy selection of 10 patients in the same run, with a practical turnaround time of 2 working days. Importantly, it was successfully used to interrogate different DNAs isolated from routinely processed specimens (formalin-fixed paraffin embedded, frozen, and cytological samples), covering all the requirements of clinical tests. In conclusion, the PentaPanel platform can provide an immediate, accurate and cost effective multiplex approach for clinically relevant gene mutation analysis in many solid tumors and its utility across many diseases can be particularly relevant in multiple clinical trials, including the new basket trial approach, aiming to identify appropriate targeted drug combination strategies.

Adoption of routine telemedicine in Norway: the current picture

Science.gov (United States)

Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

2014-01-01

Background Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow. Objective We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals. Results Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference. Conclusions Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates. PMID:24433942

Understanding teachers’ routines to inform classroom technology design

NARCIS (Netherlands)

An, P.; Bakker, S.; Eggen, J.H.

2017-01-01

Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer

Lunate chondromalacia: evaluation of routine MRI sequences.

Science.gov (United States)

Bordalo-Rodrigues, Marcelo; Schweitzer, Mark; Bergin, Diane; Culp, Randall; Barakat, Mohamed S

2005-05-01

Chondromalacia is a commonly encountered abnormality at arthroscopy and may be responsible for significant clinical symptoms and disability. In the wrist, the most common location for chondromalacia is the lunate bone. Consequently, we sought to study the accuracy of clinical MRI in the assessment of lunate articular cartilage. MR images of 34 patients who underwent arthroscopy and had an MRI examination within 1 month of surgery were evaluated by two reviewers for the presence and location of lunate cartilage defects and subchondral edema. Lunate cartilage defects were seen on MRI in 10 of the 13 patients with chondromalacia, but these defects were also incorrectly noted in three of 21 of patients without chondromalacia. The visible locations for cartilage defects were the ulnar aspect of the proximal lunate bone (n = 3), radial aspect of the proximal lunate bone (n = 4), ulnar aspect of the distal lunate bone (n = 2), and radial aspect of the distal lunate bone (n = 1). Subchondral marrow edema was observed in six of the 10 patients with chondromalacia seen on MRI; in all six patients, the edema was seen in the same quadrant as the cartilage defect. Marrow edema was detected in one patient without chondromalacia. We conclude that lunate chondromalacia can be accurately assessed using routine MRI sequences, although there are occasional false-positive interpretations.

DEVELOPING AND INSTRUCTING PRE-PERFORMANCE ROUTINES FOR TENPIN BOWLING COMPETITIONS (1).

Science.gov (United States)

Lee, Seungmin; Lee, Keunchul; Kwon, Sungho

2015-06-01

This preliminary study developed pre-performance routines for tenpin bowlers and instructed them. To develop the routine, the situations before throwing the ball were divided into four phases; participants were examined through interviews and observations. This study used an A-B design; the A stage included the development of the routines for 3 wk., while the B stage included the instruction and two evaluations of the routine consistency. Practice was implemented for 4 hr. per day for 9 wk. The participants noted they understood the developed routine easily and experienced an atmosphere similar to that of a competition during training through the routines. They found it difficult to practice the relaxation phase, but emphasized that the relaxation phase was helpful. Consistent routines were associated with an improved mental state and performance in a competition. This study suggests that pre-performance routines stabilize the mental state of the athletes, apparently giving them a competitive advantage.

The emergence and change of management accounting routines

NARCIS (Netherlands)

van der Steen, M.P.

2011-01-01

Purpose - The purpose of this paper is to explore the dynamics involved in the emergence and change of management accounting routines. It seeks to provide an understanding of the ways in which these complex routines foster stability and change in management accounting practices.

Comparison of performance of tile drainage routines in SWAT 2009 and 2012 in an extensively tile-drained watershed in the Midwest

Directory of Open Access Journals (Sweden)

T. Guo

2018-01-01

provided reasonable parameter sets for the old and new routines in the LVR watershed, and the validation results showed that the new routine has the potential to accurately simulate hydrologic processes in mildly sloped watersheds.

[Everyday stress, routines and bipolar spectrum].

Science.gov (United States)

Gindre, C; Swendsen, J

2010-06-01

Bipolar patients relapse more frequently under conditions of stress, even when compliant with prescribed medication. Although the biological bases of stress reactivity remain widely debated, the disruption of biological or circadian rhythms has been suggested as one possible mechanism through which stress increases the risk of episodes. This hypothesis has gained support from recent evidence demonstrating that the disruption of social rhythms is particularly implicated in the onset of manic episodes. However, it is currently unknown to what extent bipolar patients may differ from normal controls in terms of the basic prevalence and nature of daily life routines, or if such individuals are more sensitive to the disruption of such rhythms following exposure to stress. Using a dimensional perspective of bipolar disorder, 1728 French university students were first screened concerning diverse psychological and clinical characteristics. Two hundred and twelve individuals at high or low-risk for mood and substance use disorders were then invited to participate in a week-long period of ambulatory monitoring using the experience sampling method (ESM). During this phase, participants were given a preprogrammed PDA microcomputer which provided ambulatory assessments of behaviour and stress at fixed intervals (randomized across participants). At the end of the ESM phase, the microcomputers were collected and structured diagnostic interviews were administered to each participant. For the purposes of the current study, analyses focused on a subsample of 92 individuals, reflecting the 28 participants who met lifetime criteria for a manic (n=15) or hypomanic episode (n=13), and the 64 individuals who were free of any lifetime disorder. Data were analyzed using hierarchical nonlinear (Bernoulli) models for repeated measures. Covariates included age, sex, frequency of substance use and cognitive vulnerabilities assessed at screening. A Bonferroni correction was applied to adjust

Decontaminating products for routine decontamination in nuclear power plants

International Nuclear Information System (INIS)

Henning, K.

2001-01-01

Routine decontamination work that has to be carried out in practical operation includes the cleaning of all kinds of surfaces such as floors, walls and apparatus, the decontamination of professional clothes and of the personnel. In order to ensure a trouble-free functioning of plants for the treatment of waste water and concentrate in nuclear power plants, radioactive liquid wastes appearing in the controlled area should be compatible with the treatment methods in practice. Radioactive concentrates and resides obtained from the treatment methods are mixed with matrix materials like cement or bitumen or treated by roller frame drying and thus are conditioned for intermediate or final storage. Several requirements should be made on decontaminating agents used in the controlled area. Some of these physical-chemical criteria will be described in detail. (R.P.)

On transcending the impasse of respiratory motion correction applications in routine clinical imaging - a consideration of a fully automated data driven motion control framework

International Nuclear Information System (INIS)

Kesner, Adam L; Schleyer, Paul J; Büther, Florian; Walter, Martin A; Schäfers, Klaus P; Koo, Phillip J

2014-01-01

Positron emission tomography (PET) is increasingly used for the detection, characterization, and follow-up of tumors located in the thorax. However, patient respiratory motion presents a unique limitation that hinders the application of high-resolution PET technology for this type of imaging. Efforts to transcend this limitation have been underway for more than a decade, yet PET remains for practical considerations a modality vulnerable to motion-induced image degradation. Respiratory motion control is not employed in routine clinical operations. In this article, we take an opportunity to highlight some of the recent advancements in data-driven motion control strategies and how they may form an underpinning for what we are presenting as a fully automated data-driven motion control framework. This framework represents an alternative direction for future endeavors in motion control and can conceptually connect individual focused studies with a strategy for addressing big picture challenges and goals. The online version of this article (doi:10.1186/2197-7364-1-8) contains supplementary material, which is available to authorized users.

Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: pilot study.

Science.gov (United States)

Keser, Ilke; Kirdi, Nuray; Meric, Aydin; Kurne, Asli Tuncer; Karabudak, Rana

2013-01-01

This study compared trunk exercises based on the Bobath concept with routine neurorehabilitation approaches in multiple sclerosis (MS). Bobath and routine neurorehabilitation exercises groups were evaluated. MS cases were divided into two groups. Both groups joined a 3 d/wk rehabilitation program for 8 wk. The experimental group performed trunk exercises based on the Bobath concept, and the control group performed routine neurorehabilitation exercises. Additionally, both groups performed balance and coordination exercises. All patients were evaluated with the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), and Multiple Sclerosis Functional Composite (MSFC) before and after the physiotherapy program. In group analysis, TIS, BBS, ICARS, and MSFC scores and strength of abdominal muscles were significantly different after treatment in both groups (p 0.05). Although trunk exercises based on the Bobath concept are rarely applied in MS rehabilitation, the results of this study show that they are as effective as routine neurorehabilitation exercises. Therefore, trunk exercises based on the Bobath concept can be beneficial in MS rehabilitation programs.

Effectiveness of behavioral parent training for children with ADHD in routine clinical practice : A randomized controlled study

NARCIS (Netherlands)

van den Hoofdakker, Barbara J.; Van der Veen-Mulders, Lianne; Sytema, Sjoerd; Emmelkamp, Paul M. G.; Minderaa, Ruud B.; Nauta, Maaike H.

2007-01-01

Objective: To investigate the effectiveness of behavioral parent training (BPT) as adjunct to routine clinical care (RCC). Method: After a first phase of RCC, 94 children with attention-deficit/hyperactivity disorder (ADHD) ages 4-12, all referred to a Dutch outpatient mental health clinic, were

An accurately controllable imitative stress corrosion cracking for electromagnetic nondestructive testing and evaluations

International Nuclear Information System (INIS)

Yusa, Noritaka; Uchimoto, Tetsuya; Takagi, Toshiyuki; Hashizume, Hidetoshi

2012-01-01

Highlights: ► We propose a method to simulate stress corrosion cracking. ► The method offers nondestructive signals similar to those of actual cracking. ► Visual and eddy current examinations validate the method. - Abstract: This study proposes a simple and cost-effective approach to fabricate an artificial flaw that is identical to stress corrosion cracking especially from the viewpoint of electromagnetic nondestructive evaluations. The key idea of the approach is to embed a partially-bonded region inside a material by bonding together surfaces that have grooves. The region is regarded as an area of uniform non-zero conductivity from an electromagnetic nondestructive point of view, and thus simulates the characteristics of stress corrosion cracking. Since the grooves are introduced using electro-discharge machining, one can control the profile of the imitative stress corrosion cracking accurately. After numerical simulation to evaluate the spatial resolution of conventional eddy current testing, six specimens made of type 316L austenitic stainless steel were fabricated on the basis of the results of the simulations. Visual and eddy current examinations were carried out to demonstrate that the artificial flaws well simulated the characteristics of actual stress corrosion cracking. Subsequent destructive test confirmed that the bonding did not change the depth profiles of the artificial flaw.

Accurate measurement of mitochondrial DNA deletion level and copy number differences in human skeletal muscle.

Directory of Open Access Journals (Sweden)

John P Grady

Full Text Available Accurate and reliable quantification of the abundance of mitochondrial DNA (mtDNA molecules, both wild-type and those harbouring pathogenic mutations, is important not only for understanding the progression of mtDNA disease but also for evaluating novel therapeutic approaches. A clear understanding of the sensitivity of mtDNA measurement assays under different experimental conditions is therefore critical, however it is routinely lacking for most published mtDNA quantification assays. Here, we comprehensively assess the variability of two quantitative Taqman real-time PCR assays, a widely-applied MT-ND1/MT-ND4 multiplex mtDNA deletion assay and a recently developed MT-ND1/B2M singleplex mtDNA copy number assay, across a range of DNA concentrations and mtDNA deletion/copy number levels. Uniquely, we provide a specific guide detailing necessary numbers of sample and real-time PCR plate replicates for accurately and consistently determining a given difference in mtDNA deletion levels and copy number in homogenate skeletal muscle DNA.

Selective versus routine use of episiotomy for vaginal birth

Science.gov (United States)

Jiang, Hong; Qian, Xu; Carroli, Guillermo; Garner, Paul

2017-01-01

Background Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. Objectives To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies. Selection criteria Randomised controlled trials (RCTs) comparing selective versus routine use of episiotomy, irrespective of parity, setting or surgical type of episiotomy. We included trials where either unassisted or assisted vaginal births were intended. Quasi-RCTs, trials using a cross-over design or those published in abstract form only were not eligible for inclusion in this review. Data collection and analysis Two authors independently screened studies, extracted data, and assessed risk of bias. A third author mediated where there was no clear consensus. We observed good practice for data analysis and interpretation where trialists were review authors. We used fixed-effect models unless heterogeneity precluded this, expressed results as risk ratios (RR) and 95% confidence intervals (CI), and assessed the certainty of the evidence using GRADE. Main results This updated review includes 12 studies (6177 women), 11 in women in labour for whom a vaginal birth was intended, and one in women where an assisted birth was anticipated. Two were trials each with more than 1000 women (Argentina and the UK), and the rest were smaller (from Canada, Germany, Spain, Ireland, Malaysia, Pakistan, Columbia and Saudi Arabia). Eight trials included primiparous women only, and four trials were in both primiparous and multiparous women. For risk of bias, allocation was adequately concealed and reported in nine trials; sequence

Laser Guided Automated Calibrating System for Accurate Bracket ...

African Journals Online (AJOL)

Background: The basic premise of preadjusted bracket system is accurate bracket positioning. ... using MATLAB ver. 7 software (The MathWorks Inc.). These images are in the form of matrices of size 640 × 480. 650 nm (red light) type III diode laser is used as ... motion control and Pitch, Yaw, Roll degrees of freedom (DOF).

Understanding Teachers' Routines to Inform Classroom Technology Design

Science.gov (United States)

An, Pengcheng; Bakker, Saskia; Eggen, Berry

2017-01-01

Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers' daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction…

Evaluation of Eigenvalue Routines for Large Scale Applications

Directory of Open Access Journals (Sweden)

V.A. Tischler

1994-01-01

Full Text Available The NASA structural analysis (NASTRAN∗ program is one of the most extensively used engineering applications software in the world. It contains a wealth of matrix operations and numerical solution techniques, and they were used to construct efficient eigenvalue routines. The purpose of this article is to examine the current eigenvalue routines in NASTRAN and to make efficiency comparisons with a more recent implementation of the block Lanczos aLgorithm. This eigenvalue routine is now availabLe in several mathematics libraries as well as in severaL commerciaL versions of NASTRAN. In addition, the eRA Y library maintains a modified version of this routine on their network. Several example problems, with a varying number of degrees of freedom, were selected primarily for efficiency bench-marking. Accuracy is not an issue, because they all gave comparable results. The block Lanczos algorithm was found to be extremely efficient, particularly for very large problems.

Effectiveness of community service models for increasing routine immunization coverage at primary healthcare facilities in a rural district of Pakistan: a quasi-experimental study

International Nuclear Information System (INIS)

Ali, Z.; Pongpanich, S.; Kumar, R.

2015-01-01

Background: In Pakistan Routine Immunization coverage has been reported to be significantly low due to multiple factors that results in high number of deaths in children under 5. This study was conducted to assess the effectiveness of integrating Community Services to improve Routine immunization coverage in rural district of Pakistan. Methods: A quasi-experimental study with control and intervention arms was conducted in government Basic Health units catchment population of Panjgur by interviewing household head/Fathers. Total 234 household head including fathers were interviewed during this baseline survey. Community service model was used for to increase routine immunization coverage at catchment area of Basic Health unit (BHU) in intervention group while routine services were given in control BHU. Results: 230 parents completed the questionnaire during the end line after three months of intervention. There were no significant differences found between two groups at baseline but after the intervention, there was statistically significance difference (<0.05) between both groups knowledge and practices regarding routine immunization. Moreover, there was no statistically significant difference in control group reported (>0.05) after the intervention period. Overall immunization status after intervention where fully immunization status in intervention group after intervention was 88.8% as compared to control group after intervention was 13.6% for partial immunization status in intervention group after intervention was 11.1% as compared to control group after intervention was 81.1 for the Non-Immunization status in intervention group after intervention was 0% as compared to control group after intervention was 5.1%. Conclusions: Community Service Model has significantly improved the Knowledge and Practices among households/parents of children under 5 in the intervention arm. (author)

Managing routine food choices in UK families: the role of convenience consumption.

Science.gov (United States)

Carrigan, Marylyn; Szmigin, Isabelle; Leek, Sheena

2006-11-01

The paper explores the meaning of convenience food for UK mothers, investigating the relationship between mothers and their families' food. The study examines the role of convenience food within the food strategies of contemporary UK families, and aims to elicit consumption meanings in the broader social context of family relationships with food, their rituals, routines and conventions. The findings reveal convenience has multiple meanings for UK women, and that convenience food has been incorporated into reinterpreted versions of homemade and "proper" meals. A hierarchy of acceptable convenience food is presented by the mothers, who tackle complex and conflicting family routines by introducing convenience solutions. Rules of eating have evolved, yet remain essentially controlled by the mother in terms of nutrition. While the traditional model of "proper" food remains aspirational, contemporary family lifestyles require that convenience food become part of the equation.

Computer-aided diagnosis in routine mammography

International Nuclear Information System (INIS)

Sittek, H.; Perlet, C.; Helmberger, R.; Linsmeier, E.; Kessler, M.; Reiser, M.

1998-01-01

Purpose: Computer-aided diagnosis in mammography is a topic many study groups have been concerned with since the first presentation of a system for computer-aided interpretation in 1967. Currently, there is only one system avilable for clinical use in mammography, the CAD-System Image Checker (R2 Technology). The purpose of our prospective study was to evaluate whether the integration of the CAD-system into the routine of a radiological breast diagnosis unit is feasible. Results: After the installation of the CAD-system, 300 patients with 1110 mammograms were included for evaluation in the present study. In 54 of these cases histological examination was indicated due to suspect criteria on conventional mammography. In 39 of 54 cases (72,2%) malignancy could be proven histologically. The CAD-system marked 82,1% of the histologically verified carcinomas correctly 94,3% of all 1797 marks made by the CAD-system indicated normal or benign structures. Routinely performed CAD analysis prolonged patients waiting time by about 15 min because the marks of the CAD system had to be interpreted in addition to the routine diagnostic investigations. Conclusion: Our experience with the use of the CAD-system in daily routine showed that CAD analysis can easily be integrated into a preexisting mammography unit. However, the diagnostic benefit is not yet clearly established. Since the rate of false negative marks by the CAD-system Image Checker is still high, the results of CAD analysis must be checked and corrected by an observer well experienced in mammography reading. (orig.) [de

User manual for two simple postscript output FORTRAN plotting routines

Science.gov (United States)

Nguyen, T. X.

1991-01-01

Graphics is one of the important tools in engineering analysis and design. However, plotting routines that generate output on high quality laser printers normally come in graphics packages, which tend to be expensive and system dependent. These factors become important for small computer systems or desktop computers, especially when only some form of a simple plotting routine is sufficient. With the Postscript language becoming popular, there are more and more Postscript laser printers now available. Simple, versatile, low cost plotting routines that can generate output on high quality laser printers are needed and standard FORTRAN language plotting routines using output in Postscript language seems logical. The purpose here is to explain two simple FORTRAN plotting routines that generate output in Postscript language.

Level-3 Cholesky Factorization Routines Improve Performance of Many Cholesky Algorithms

DEFF Research Database (Denmark)

Gustavson, Fred G.; Wasniewski, Jerzy; Dongarra, Jack J.

2013-01-01

Four routines called DPOTF3i, i = a,b,c,d, are presented. DPOTF3i are a novel type of level-3 BLAS for use by BPF (Blocked Packed Format) Cholesky factorization and LAPACK routine DPOTRF. Performance of routines DPOTF3i are still increasing when the performance of Level-2 routine DPOTF2 of LAPACK...

Thinking Routines: Replicating Classroom Practices within Museum Settings

Science.gov (United States)

Wolberg, Rochelle Ibanez; Goff, Allison

2012-01-01

This article describes thinking routines as tools to guide and support young children's thinking. These learning strategies, developed by Harvard University's Project Zero Classroom, actively engage students in constructing meaning while also understanding their own thinking process. The authors discuss how thinking routines can be used in both…

First evaluation of automated specimen inoculation for wound swab samples by use of the Previ Isola system compared to manual inoculation in a routine laboratory: finding a cost-effective and accurate approach.

Science.gov (United States)

Mischnik, Alexander; Mieth, Markus; Busch, Cornelius J; Hofer, Stefan; Zimmermann, Stefan

2012-08-01

Automation of plate streaking is ongoing in clinical microbiological laboratories, but evaluation for routine use is mostly open. In the present study, the recovery of microorganisms from the Previ Isola system plated polyurethane (PU) swab samples is compared to manually plated control viscose swab samples from wounds according to the CLSI procedure M40-A (quality control of microbiological transport systems). One hundred twelve paired samples (224 swabs) were analyzed. In 80/112 samples (71%), concordant culture results were obtained with the two methods. In 32/112 samples (29%), CFU recovery of microorganisms from the two methods was discordant. In 24 (75%) of the 32 paired samples with a discordant result, Previ Isola plated PU swabs were superior. In 8 (25%) of the 32 paired samples with a discordant result, control viscose swabs were superior. The quality of colony growth on culture media for further investigations was superior with Previ Isola inoculated plates compared to manual plating techniques. Gram stain results were concordant between the two methods in 62/112 samples (55%). In 50/112 samples (45%), the results of Gram staining were discordant between the two methods. In 34 (68%) of the 50 paired samples with discordant results, Gram staining of PU swabs was superior to that of control viscose swabs. In 16 (32%) of the 50 paired samples, Gram staining of control viscose swabs was superior to that of PU swabs. We report the first clinical evaluation of Previ Isola automated specimen inoculation for wound swab samples. This study suggests that use of an automated specimen inoculation system has good results with regard to CFU recovery, quality of Gram staining, and accuracy of diagnosis.

Evaluation of the Need for Antibiotic Prophylaxis During Routine Intra-alveolar Dental Extractions in Healthy Patients: A Randomized Double-Blind Controlled Trial.

Science.gov (United States)

Sidana, Sunil; Mistry, Yusuf; Gandevivala, Adil; Motwani, Nitesh

2017-09-01

The aim of this randomized double-blind controlled trial was to evaluate the role of antibiotics in the perioperative period of dental extractions in healthy patients. The study population included patients visiting the outpatient department of our institute. Four hundred patients were selected and randomly divided into 4 groups and underwent routine dental extraction. In group A, patients were prescribed only anti-inflammatory drugs in the postoperative period. In group B, patients were prescribed antibiotics for 3 days and concomitant anti-inflammatory drugs in the postoperative period only. In group C, patients were prescribed a single dose of antibiotic 1 hour before the extraction procedure with no postoperative antibiotics, and only anti-inflammatory drugs were prescribed in the postoperative period. In group D, patients were prescribed mouthwash starting 15 minutes before the procedure and continuing twice daily for a period of 7 days along with anti-inflammatory drugs in the postoperative period. Patients were asked to follow up on the seventh postoperative day for suture removal and were evaluated for pain, swelling, dry socket, and local signs of infection. The study was approved by the Internal Ethics Review Committee of the institute. No significant differences were seen among the groups with respect to pain (χ 2  [1, N = 171] = 4.939, P = .552), swelling (χ 2 [1, N = 171] = 10.048, P = .347), or postextraction complications. Prophylactic antibiotics are not required during routine dental extractions in healthy patients. The use of antibiotic therapy without appropriate indications can result in the development of resistant organisms. However, a clear trend is seen in which practitioners overprescribe antibiotics as well as medications in general. The current evidence questions the benefits of prophylactic antibiotic therapy for patients undergoing dental extractions. In our opinion, there is no justification for routine antibiotic

Routine Radiological Environmental Monitoring Plan. Volume 1

Energy Technology Data Exchange (ETDEWEB)

Bechtel Nevada

1999-12-31

The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs.

Impact of psychological screening on routine outpatient care of hematopoietic cell transplantation survivors.

Science.gov (United States)

Hoodin, Flora; Zhao, Lili; Carey, Jillian; Levine, John E; Kitko, Carrie

2013-10-01

Hematopoietic cell transplantation recipients are at high risk for psychological distress, with reported prevalence rates as high as 40%. Although published guidelines advocate periodic routine screening, it is unclear how screening affects management of psychological symptoms at routine post-HCT outpatient clinic visits. We hypothesized that providers will be more likely to act on patients' psychological symptoms if a screening survey is completed and reviewed before a clinic visit. We used a brief, diagnostically focused Patient Health Questionnaire (PHQ), to assess for depressive disorders, anxiety, substance abuse, and problems in occupational or interpersonal functioning (functional disruption). Adult HCT survivors were randomized to complete the PHQ before meeting with their medical provider (n = 50; experimental group) or afterwards (n = 51; control group). Providers used the experimental group PHQ results at their discretion during the visits. Both providers and patients rated their satisfaction with management of psychological concerns after the visit. The prevalence of clinically significant depression (21%), anxiety (14%), or suicidal ideation (8%) did not differ between the 2 groups. Patients in the experimental group were significantly more likely to have discussion of psychological symptoms than the control group (68% versus 49%, P = .05). Medical providers were significantly more satisfied with the management of psychological issues for the experimental group (P routine care of hematopoietic cell transplantation survivors, stimulates discussion of psychological symptoms, and improves provider satisfaction with psychological symptom management. Future research will evaluate whether serial prospective administration improves patient outcomes. Copyright © 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Comparing childhood meal frequency to current meal frequency, routines, and expectations among parents.

Science.gov (United States)

Friend, Sarah; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Flattum, Colleen Freeh; Draxten, Michelle

2015-02-01

Little is known about the continuation of family meals from childhood to parenthood. This study aims to examine associations between parents' report of eating family meals while growing up and their current family meal frequency, routines, and expectations. Baseline data were used from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, a randomized controlled trial with a program to promote healthful behaviors and family meals at home. Participants (160 parent/child dyads) completed data collection in 2011-2012 in the Minneapolis/St. Paul, MN metropolitan area. Parents were predominately female (95%) and white (77%) with a mean age of 41.3 years. General linear modeling examined relationships between parents' report of how often they ate family meals while growing up and their current family meal frequency, routines, and expectations as parents, controlling for parent age, education level, and race. Parental report of eating frequent family meals while growing up was positively and significantly associated with age, education, and self-identification as white (all p meals less than three times/week or four to five times/week, parents who ate six to seven family meals/week while growing up reported significantly more frequent family meals with their current family (4.0, 4.2 vs. 5.3 family meals/week, p = .001). Eating frequent family meals while growing up was also significantly and positively associated with having current regular meal routines and meal expectations about family members eating together (both p meals with children may have long-term benefits over generations. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Fat-Suppressed T2* Sequences for Routine 3.0-Tesla Lumbar Spine Magnetic Resonance Imaging: A Preliminary Report

International Nuclear Information System (INIS)

McKinney, A. M.; Gadani, S.; Palmer, C. S.; Vidarsson, L.

2008-01-01

Background: Clear depiction of the ligamentum flavum on routine lumbar magnetic resonance imaging (MRI) is essential in accurately describing the extent of degenerative disease. In routine, noncontrast evaluations, focal fatty deposition or hemangiomas can be difficult to distinguish from malignant foci on fast spin-echo (FSE) T2-weighted images. Purpose: To describe the use of T2* fast field echo (T2FFE) in combination with spectral presaturation inversion recovery (SPIR) fat suppression for noncontrast, routine lumbar spine outpatient MR imaging at 3.0 Tesla (3T). Material and Methods: An axial gradient echo (GE) T2FFE sequence was combined with SPIR fat suppression (T2FFE-SPIR), via a 3T Philips Intera (Philips Medical Systems, Best, The Netherlands) scanner, and added to the routine, noncontrast lumbar MRI examinations, which included sagittal FSE T1-weighted (T1WI), T2-weighted (T2WI), short-tau inversion recovery (STIR), and axial FSE T2WI. The sequence was performed in over 500 patients over a 1-year period, without intravenous contrast, and with slice thickness and planes of section identical to the axial FSE T1WI and T2WI images. The sequence typically lasted about 4.5-6 min. Results: The use of T2FFE-SPIR enabled visualization of the ligamentum flavum in degenerative disease, and the exclusion of focal fatty lesions on FSE T2WI. Other benefits included: the identification of malignant foci, the uncommon detection of hemorrhage, and the elimination of spurious flow voids. Several brief examples are provided to demonstrate the utility of this technique. Conclusion: The addition of T2FFE-SPIR to routine, noncontrast protocols in outpatients could provide further confidence in the visualization of the ligamentum flavum in degenerative disease, and can exclude malignancy in T2-bright areas of focal fatty marrow. Larger studies would be helpful to evaluate the accuracy of this technique versus FSE techniques in depicting degenerative, malignant, or inflammatory

Fat-Suppressed T2 Sequences for Routine 3.0-Tesla Lumbar Spine Magnetic Resonance Imaging: A Preliminary Report

Energy Technology Data Exchange (ETDEWEB)

McKinney, A. M.; Gadani, S.; Palmer, C. S.; Vidarsson, L. (Dept. of Radiology, Hennepin County and Univ. of Minnesota Medical Centers, Minneapolis, MN (United States))

2008-09-15

Background: Clear depiction of the ligamentum flavum on routine lumbar magnetic resonance imaging (MRI) is essential in accurately describing the extent of degenerative disease. In routine, noncontrast evaluations, focal fatty deposition or hemangiomas can be difficult to distinguish from malignant foci on fast spin-echo (FSE) T2-weighted images. Purpose: To describe the use of T2 fast field echo (T2FFE) in combination with spectral presaturation inversion recovery (SPIR) fat suppression for noncontrast, routine lumbar spine outpatient MR imaging at 3.0 Tesla (3T). Material and Methods: An axial gradient echo (GE) T2FFE sequence was combined with SPIR fat suppression (T2FFE-SPIR), via a 3T Philips Intera (Philips Medical Systems, Best, The Netherlands) scanner, and added to the routine, noncontrast lumbar MRI examinations, which included sagittal FSE T1-weighted (T1WI), T2-weighted (T2WI), short-tau inversion recovery (STIR), and axial FSE T2WI. The sequence was performed in over 500 patients over a 1-year period, without intravenous contrast, and with slice thickness and planes of section identical to the axial FSE T1WI and T2WI images. The sequence typically lasted about 4.5-6 min. Results: The use of T2FFE-SPIR enabled visualization of the ligamentum flavum in degenerative disease, and the exclusion of focal fatty lesions on FSE T2WI. Other benefits included: the identification of malignant foci, the uncommon detection of hemorrhage, and the elimination of spurious flow voids. Several brief examples are provided to demonstrate the utility of this technique. Conclusion: The addition of T2FFE-SPIR to routine, noncontrast protocols in outpatients could provide further confidence in the visualization of the ligamentum flavum in degenerative disease, and can exclude malignancy in T2-bright areas of focal fatty marrow. Larger studies would be helpful to evaluate the accuracy of this technique versus FSE techniques in depicting degenerative, malignant, or inflammatory

Variation in the costs of delivering routine immunization services in Peru.

Science.gov (United States)

Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

2004-09-01

Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

Intelligent Routines

CERN Document Server

Anastassiou, George A

“Intelligent Routines II: Solving Linear Algebra and Differential Geometry with Sage” contains numerous of examples and problems as well as many unsolved problems. This book extensively applies the successful software Sage, which can be found free online http://www.sagemath.org/. Sage is a recent and popular software for mathematical computation, available freely and simple to use. This book is useful to all applied scientists in mathematics, statistics and engineering, as well for late undergraduate and graduate students of above subjects. It is the first such book in solving symbolically with Sage problems in Linear Algebra and Differential Geometry. Plenty of SAGE applications are given at each step of the exposition.

An intelligent stochastic optimization routine for nuclear fuel cycle design

International Nuclear Information System (INIS)

Parks, G.T.

1990-01-01

A simulated annealing (Metropolis algorithm) optimization routine named AMETROP, which has been developed for use on realistic nuclear fuel cycle problems, is introduced. Each stage of the algorithm is described and the means by which it overcomes or avoids the difficulties posed to conventional optimization routines by such problems are explained. Special attention is given to innovations that enhance AMETROP's performance both through artificial intelligence features, in which the routine uses the accumulation of data to influence its future actions, and through a family of simple performance aids, which allow the designer to use his heuristic knowledge to guide the routine's essentially random search. Using examples from a typical fuel cycle optimization problem, the performance of the stochastic Metropolis algorithm is compared to that of the only suitable deterministic routine in a standard software library, showing AMETROP to have many advantages

Absorptive routines and international patent performance

Directory of Open Access Journals (Sweden)

Fernando E. García-Muiña

2017-04-01

We enrich the treatment of the absorptive capacity phases including the moderating effects between routines associated to the traditional potential-realized absorptive capacities. Taking into account external knowledge search strategies, the deeper external relationships, the better transference and appropriation of specific external knowledge. Nevertheless, when the moderating role of assimilation is included, cooperation agreements appear as the most efficient source of external knowledge. Finally, we show that technological tools let firms store and structure the information making easier its use for international patenting. This positive effect is reinforced in the presence of exploitation routines, since technological knowledge will better fit to the industry's key factors of success.

ROUTINE IMMUNIZATION IN INDIA: A PERSPECTIVE

Directory of Open Access Journals (Sweden)

G Taneja

2013-08-01

Full Text Available The Universal Immunization Programme is possibly the longest and one of the biggest public health intervention measures undertaken in India. To improve immunization coverage in the country various initiatives have been undertaken since the inception of the programme in 1985; key inputs being strengthening and expanding the cold chain system, establishing a network of outreach immunization sites, alternate vaccine delivery model, capacity building of health functionaries and medical officers and intensified polio control measures. Introduction of new and underutilized vaccines, drafting of the national vaccine policy, tracking of beneficiaries through the Maternal and Child Tracking system are some of the recent developments. However in spite of more than 25 years since inception the programme is still adversely impacted by challenges across key thematic areas of programme management, cold chain and vaccine management, recording and reporting and injection safety. To further strengthen and improve service delivery 2012-13 has been declared as the “Year of Intensification of Routine Immunization” with the objective of improving immunization coverage rates across poor performing districts and states so as to attain Global Immunization Vision and Strategy goals of 90% coverage at national and more than 80% coverage at district level. Key activities planned during the year include sustained advocacy at all levels, improved communication and social mobilization, robust and regular program reviews, comprehensive microplanning, strengthening cold chain and vaccine logistics system, special catch up rounds through immunization weeks, piloting the teeka express, improved surveillance systems, strengthened partnerships and operational research activities. The current review pertains to the existing scenario of Universal Immunization Program in the country with impetus on the existing challenges, progress achieved till date as a result of various

Individual values, learning routines and academic procrastination.

Science.gov (United States)

Dietz, Franziska; Hofer, Manfred; Fries, Stefan

2007-12-01

Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. The model tested in this study posits that postmodern value orientations are positively related to procrastination and to a lack of daily routines concerning the performance of academic activities. In contrast, modern values are negatively related to procrastination and positively to learning routines. Academic procrastination, in-turn, should be associated with the tendency to prefer leisure activities to schoolwork in case of conflicts between these two life domains. Seven hundred and four students from 6th and 8th grade with a mean age of 13.5 years participated in the study. The sample included students from all tracks of the German educational system. Students completed a questionnaire containing two value prototypes as well as scales on learning routines and procrastination. Decisions in motivational conflicts were measured using two vignettes. Results from structural equation modelling supported the proposed model for the whole sample as well as for each school track. A planned course of the day can prevent procrastination and foster decisions for academic tasks in case of conflicts. Students' learning takes place within a societal context and reflects the values held in the respective culture.

Can reinforcement-based interventions to reduce drug use successfully be adapted to routine opioid maintenance treatment?

Directory of Open Access Journals (Sweden)

Michael Specka

2013-12-01

Full Text Available INTRODUCTION: Comorbid substance related disorders are a major health problem for patients in opioid maintenance treatment (OMT. It was investigated whether a reinforcement scheme adapted to the regulatory and financial restrictions of routine treatment reduces concomitant drug use. METHODS: OMT patients from 7 clinics who were using cocaine, benzodiazepines, heroin or amphetamines were randomly allocated to either treatment as usual (n = 64 or treatment with an additional escalating reinforcement scheme (n = 72 in which a patient's number of weekly take-home dosages was increased after 1, 4, 8 and 12 consecutive weeks with drug-free urine specimens. Trial duration was 26 weeks. RESULTS: Completion rates were 64% for controls and 62.5% in the experimental group. Mean number of drug-free weeks was 11.3 (SD 8.5 for the control group and 9.8 (8.9 for the experimental group (p = 0.30. CONCLUSION: The intervention was not effective compared to routine treatment. Additional features might be necessary to achieve an effect, e.g. a higher frequency of urine sampling or use of other reinforcers. It has to be further investigated how interventions which have been proven effective in experimental studies can successfully be adapted to routine care conditions.

Daily life activity routine discovery in hemiparetic rehabilitation patients using topic models.

Science.gov (United States)

Seiter, J; Derungs, A; Schuster-Amft, C; Amft, O; Tröster, G

2015-01-01

Monitoring natural behavior and activity routines of hemiparetic rehabilitation patients across the day can provide valuable progress information for therapists and patients and contribute to an optimized rehabilitation process. In particular, continuous patient monitoring could add type, frequency and duration of daily life activity routines and hence complement standard clinical scores that are assessed for particular tasks only. Machine learning methods have been applied to infer activity routines from sensor data. However, supervised methods require activity annotations to build recognition models and thus require extensive patient supervision. Discovery methods, including topic models could provide patient routine information and deal with variability in activity and movement performance across patients. Topic models have been used to discover characteristic activity routine patterns of healthy individuals using activity primitives recognized from supervised sensor data. Yet, the applicability of topic models for hemiparetic rehabilitation patients and techniques to derive activity primitives without supervision needs to be addressed. We investigate, 1) whether a topic model-based activity routine discovery framework can infer activity routines of rehabilitation patients from wearable motion sensor data. 2) We compare the performance of our topic model-based activity routine discovery using rule-based and clustering-based activity vocabulary. We analyze the activity routine discovery in a dataset recorded with 11 hemiparetic rehabilitation patients during up to ten full recording days per individual in an ambulatory daycare rehabilitation center using wearable motion sensors attached to both wrists and the non-affected thigh. We introduce and compare rule-based and clustering-based activity vocabulary to process statistical and frequency acceleration features to activity words. Activity words were used for activity routine pattern discovery using topic models

Time-Accurate Simulations of Synthetic Jet-Based Flow Control for An Axisymmetric Spinning Body

National Research Council Canada - National Science Library

Sahu, Jubaraj

2004-01-01

.... A time-accurate Navier-Stokes computational technique has been used to obtain numerical solutions for the unsteady jet-interaction flow field for a spinning projectile at a subsonic speed, Mach...

Development of routines for simultaneous in situ chemical composition and stable Si isotope ratio analysis by femtosecond laser ablation inductively coupled plasma mass spectrometry

Energy Technology Data Exchange (ETDEWEB)

Frick, Daniel A., E-mail: dfrick@gfz-potsdam.de [GFZ German Research Centre for Geosciences, 14473 Potsdam (Germany); Schuessler, Jan A. [GFZ German Research Centre for Geosciences, 14473 Potsdam (Germany); Blanckenburg, Friedhelm von [GFZ German Research Centre for Geosciences, 14473 Potsdam (Germany); Institute of Geological Science, Freie Universität Berlin, 12249 Berlin (Germany)

2016-09-28

Stable metal (e.g. Li, Mg, Ca, Fe, Cu, Zn, and Mo) and metalloid (B, Si, Ge) isotope ratio systems have emerged as geochemical tracers to fingerprint distinct physicochemical reactions. These systems are relevant to many Earth Science questions. The benefit of in situ microscale analysis using laser ablation (LA) over bulk sample analysis is to use the spatial context of different phases in the solid sample to disclose the processes that govern their chemical and isotopic compositions. However, there is a lack of in situ analytical routines to obtain a samples' stable isotope ratio together with its chemical composition. Here, we evaluate two novel analytical routines for the simultaneous determination of the chemical and Si stable isotope composition (δ{sup 30}Si) on the micrometre scale in geological samples. In both routines, multicollector inductively coupled plasma mass spectrometry (MC-ICP-MS) is combined with femtosecond-LA, where stable isotope ratios are corrected for mass bias using standard-sample-bracketing with matrix-independent calibration. The first method is based on laser ablation split stream (LASS), where the laser aerosol is split and introduced simultaneously into both the MC-ICP-MS and a quadrupole ICP-MS. The second method is based on optical emission spectroscopy using direct observation of the MC-ICP-MS plasma (LA-MC-ICP-MS|OES). Both methods are evaluated using international geological reference materials. Accurate and precise Si isotope ratios were obtained with an uncertainty typically better than 0.23‰, 2SD, δ{sup 30}Si. With both methods major element concentrations (e.g., Na, Al, Si, Mg, Ca) can be simultaneously determined. However, LASS-ICP-MS is superior over LA-MC-ICP-MS|OES, which is limited by its lower sensitivity. Moreover, LASS-ICP-MS offers trace element analysis down to the μg g{sup −1}-range for more than 28 elements due to lower limits of detection, and with typical uncertainties better than 15%. For in situ

Development of routines for simultaneous in situ chemical composition and stable Si isotope ratio analysis by femtosecond laser ablation inductively coupled plasma mass spectrometry

International Nuclear Information System (INIS)

Frick, Daniel A.; Schuessler, Jan A.; Blanckenburg, Friedhelm von

2016-01-01

Stable metal (e.g. Li, Mg, Ca, Fe, Cu, Zn, and Mo) and metalloid (B, Si, Ge) isotope ratio systems have emerged as geochemical tracers to fingerprint distinct physicochemical reactions. These systems are relevant to many Earth Science questions. The benefit of in situ microscale analysis using laser ablation (LA) over bulk sample analysis is to use the spatial context of different phases in the solid sample to disclose the processes that govern their chemical and isotopic compositions. However, there is a lack of in situ analytical routines to obtain a samples' stable isotope ratio together with its chemical composition. Here, we evaluate two novel analytical routines for the simultaneous determination of the chemical and Si stable isotope composition (δ 30 Si) on the micrometre scale in geological samples. In both routines, multicollector inductively coupled plasma mass spectrometry (MC-ICP-MS) is combined with femtosecond-LA, where stable isotope ratios are corrected for mass bias using standard-sample-bracketing with matrix-independent calibration. The first method is based on laser ablation split stream (LASS), where the laser aerosol is split and introduced simultaneously into both the MC-ICP-MS and a quadrupole ICP-MS. The second method is based on optical emission spectroscopy using direct observation of the MC-ICP-MS plasma (LA-MC-ICP-MS|OES). Both methods are evaluated using international geological reference materials. Accurate and precise Si isotope ratios were obtained with an uncertainty typically better than 0.23‰, 2SD, δ 30 Si. With both methods major element concentrations (e.g., Na, Al, Si, Mg, Ca) can be simultaneously determined. However, LASS-ICP-MS is superior over LA-MC-ICP-MS|OES, which is limited by its lower sensitivity. Moreover, LASS-ICP-MS offers trace element analysis down to the μg g −1 -range for more than 28 elements due to lower limits of detection, and with typical uncertainties better than 15%. For in situ

Microfoundations of Routines and Capabilities

DEFF Research Database (Denmark)

Felin, Tippo; Foss, Nicolai Juul; Heimericks, Koen H.

2012-01-01

This article introduces the Special Issue and discusses the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories ...

Comparison of different references for brain perfusion SPECT quantification in clinical routine

International Nuclear Information System (INIS)

Olivera J, P.; Acton, P.; Costa, D.

1997-01-01

Full text: We used 40 brain perfusion SPECT studies from the INM, UCL database to investigate the performance of several references (denominators) in the calculation of perfusion ratios with single photon emission tomography (S PET) within a routine clinical service. According to clinical diagnosis and previous SPECT findings 4 groups were identified composed of: 10 controls (C, 23 to 84 y old); 10 myalgic-encephalomyelitis / chronic fatigue syndrome (ME/CFS, 22 to 61 y old); 10 major depression (MD, 24 to 68 y old); and 10 temporal lobe epilepsy (TLE, 19 to 39 y old). Routine protocols for processing were used and the analysis was blind to group classification. Brain perfusion ratios were calculated using 7 different references: hemi cerebellum with higher counts (Cer), total counts in a 4 pixel slice through the basal ganglia slice (BG), average counts per pixel in the visual cortex (VC), average counts per pixel in the white matter (WM), total acquired counts (TAC), total reconstructed counts (TRC) and maximum counts per pixel in the entire study (MAXX). Unpaired test to compare different diagnostic groups, coefficient of variation (CV) to assess the reliability to each references followed by ANOVA were the statistical test used. The lowest mean CV's were found with VC (4.8%) and TRC (5.1%), with all the others significantly higher (p<0.0001). The range of CV's for Cer was the lowest (3.7% to 5.9%). Consistent differentiation between diagnostic groups and controls was only obtained with Cer. In conclusion, it appears that for clinical routine services Cer is the most reliable reference, exception made for all diseases affecting the cerebellum. In these cases TRC or VC should be preferred. (authors)

Acute and Time-Course Effects of Traditional and Dynamic Warm-Up Routines in Young Elite Junior Tennis Players.

Directory of Open Access Journals (Sweden)

Francisco Ayala

Full Text Available Despite the large number of studies that have examined the acute effects of different warm up modalities (WU on physical performance, none of them have documented the time course of potential performance recovery in tennis players. The aim of this study was twofold: (a to analyze and compare the acute effects of two different WU modalities (traditional WU [TWU] and dynamic WU [DWU] on physical performance (i.e., CMJ, sprint, serve speed and accuracy in elite junior players, as well as (b to monitor the time course of any WU-induced changes after 30 and 60 min of simulated match-play. Twelve junior elite players completed both WUs modalities (TWU and DWU in a counterbalanced order on separate days. In each experimental session, counter movement jump (CMJ, 20-m sprint, tennis serve speed and accuracy tests were performed before (immediately after TWU or DWU during (30 min and after 60 min of a simulated match play. Measures were compared via four factorial (WU intervention and time repeated measures ANOVAs. There were main effects of WU (TWU and DWU throughout the time for all the variables analysed. The results indicate that DWU routine led to significantly faster 20 m sprint times and higher CMJs as well as faster and more accurate tennis serves at both post warm-up and 30 min match-play testing moments in comparison with the scores reported by the TWU routine (p 75-99%. No significant intergroup differences were found at 60-min match-play testing moment in any variable (except for the 20 m sprint. Therefore, the findings of this study recommend for optimal performance in these elite tennis players, DWU routines should be performed prior to formal training and competition rather than TWU routines.

PARMELA-B A new version of PARMELA with coherent synchrotron radiation effects and a finite difference space charge routine

CERN Document Server

Koltenbah, B E C; Greegor, R B; Dowell, D H

2002-01-01

Recent interest in advanced laser light sources has stimulated development of accelerator systems of intermediate beam energy, 100-200 MeV, and high charge, 1-10 nC, for high power FEL applications and high energy, 1-2 GeV, high charge, SASE-FEL applications. The current generation of beam transport codes which were developed for high-energy, low-charge beams with low self-fields are inadequate to address this energy and charge regime, and better computational tools are required to accurately calculate self-fields. To that end, we have developed a new version of PARMELA, named PARMELA_B and written in Fortran 95, which includes a coherent synchrotron radiation (CSR) routine and an improved, generalized space charge (SC) routine. An electron bunch is simulated by a collection of macro-particles, which traverses a series of beam line elements. At each time step through the calculation, the momentum of each particle is updated due to the presence of external and self- fields. The self-fields are due to CSR and S...

A computer-controlled conformal radiotherapy system I: overview

International Nuclear Information System (INIS)

Fraass, Benedick A.; McShan, Daniel L.; Kessler, Marc L.; Matrone, Gwynne M.; Lewis, James D.; Weaver, Tamar A.

1995-01-01

Purpose: Equipment developed for use with computer-controlled conformal radiotherapy (CCRT) treatment techniques, including multileaf collimators and/or computer-control systems for treatment machines, are now available. The purpose of this work is to develop a system that will allow the safe, efficient, and accurate delivery of CCRT treatments as routine clinical treatments, and permit modifications of the system so that the delivery process can be optimized. Methods and Materials: The needs and requirements for a system that can fully support modern computer-controlled treatment machines equipped with multileaf collimators and segmental or dynamic conformal therapy capabilities have been analyzed and evaluated. This analysis has been used to design and then implement a complete approach to the delivery of CCRT treatments. Results: The computer-controlled conformal radiotherapy system (CCRS) described here consists of a process for the delivery of CCRT treatments, and a complex software system that implements the treatment process. The CCRS system described here includes systems for plan transfer, treatment delivery planning, sequencing of the actual treatment delivery process, graphical simulation and verification tools, as well as an electronic chart that is an integral part of the system. The CCRS system has been implemented for use with a number of different treatment machines. The system has been used clinically for more than 2 years to perform CCRT treatments for more than 200 patients. Conclusions: A comprehensive system for the implementation and delivery of computer-controlled conformal radiation therapy (CCRT) plans has been designed and implemented for routine clinical use with multisegment, computer-controlled, multileaf-collimated conformal therapy. The CCRS system has been successfully implemented to perform these complex treatments, and is considered quite important to the clinical use of modern computer-controlled treatment techniques

A Real-Time Accurate Model and Its Predictive Fuzzy PID Controller for Pumped Storage Unit via Error Compensation

Directory of Open Access Journals (Sweden)

Jianzhong Zhou

2017-12-01

Full Text Available Model simulation and control of pumped storage unit (PSU are essential to improve the dynamic quality of power station. Only under the premise of the PSU models reflecting the actual transient process, the novel control method can be properly applied in the engineering. The contributions of this paper are that (1 a real-time accurate equivalent circuit model (RAECM of PSU via error compensation is proposed to reconcile the conflict between real-time online simulation and accuracy under various operating conditions, and (2 an adaptive predicted fuzzy PID controller (APFPID based on RAECM is put forward to overcome the instability of conventional control under no-load conditions with low water head. Respectively, all hydraulic factors in pipeline system are fully considered based on equivalent lumped-circuits theorem. The pretreatment, which consists of improved Suter-transformation and BP neural network, and online simulation method featured by two iterative loops are synthetically proposed to improve the solving accuracy of the pump-turbine. Moreover, the modified formulas for compensating error are derived with variable-spatial discretization to improve the accuracy of the real-time simulation further. The implicit RadauIIA method is verified to be more suitable for PSUGS owing to wider stable domain. Then, APFPID controller is constructed based on the integration of fuzzy PID and the model predictive control. Rolling prediction by RAECM is proposed to replace rolling optimization with its computational speed guaranteed. Finally, the simulation and on-site measurements are compared to prove trustworthy of RAECM under various running conditions. Comparative experiments also indicate that APFPID controller outperforms other controllers in most cases, especially low water head conditions. Satisfying results of RAECM have been achieved in engineering and it provides a novel model reference for PSUGS.

Effect of the presence of support person and routine intervention for women during childbirth in Isfahan, Iran: A randomized controlled trial

Directory of Open Access Journals (Sweden)

Zahra Shahshahan

2014-01-01

Conclusions: Presence of a support person and routine intervention during labor did not effect on incidence of cervical lacerations, instrumental delivery and Apgar <7. Labor pain and women′s dissatisfaction, and number women with third and fourth degree of perineal tear among women who received routine intervention were increased compare to others. Interventions makes decreased the length of first and second stage of labor. In totally, the presence of a support person during labor in Iranian women decrease length of labor and improved labor outcomes.

Conversational routines in English convention and creativity

CERN Document Server

Aijmer, Karin

2014-01-01

It is surprising how much of everyday conversation consists of repetitive expressions such as 'thank you', 'sorry', would you mind?' and their many variants. However commonplace they may be, they do have important functions in communication.This thorough study draws upon original data from the London-Lund Corpus of Spoken English to provide a discoursal and pragmatic account of the more common expressions found in conversational routines, such as apologising, thanking, requesting and offering.The routines studied in this book range from conventionalized or idiomatized phrases t

Vascular access and infection prevention and control: a national survey of routine practices in Irish haemodialysis units.

Science.gov (United States)

McCann, Margaret; Clarke, Michael; Mellotte, George; Plant, Liam; Fitzpatrick, Fidelma

2013-04-01

National and international guidelines recommend the use of effective vascular access (VA) and infection prevention and control practices within the haemodialysis environment. Establishing an arterio-venous fistula (AVF) and preventing central venous catheter (CVC)-related infections are ongoing challenges for all dialysis settings. We surveyed VA and routine infection prevention and control practices in dialysis units, to provide national data on these practices in Ireland. A descriptive survey was emailed to nurse managers at all adult (n = 19) and children (n = 1) outpatient haemodialysis units in the Republic of Ireland. Data collected included AVF formation, CVC insertion and maintenance practices, VA use and surveillance of infection and screening protocols. Nineteen of the 20 units responded to the survey. The AVF prevalence was 49% for 1370 patients in 17 units who provided these data [mean prevalence per unit: 45.7% (SD 16.2)]; the CVC mean prevalence per unit was 52.5% (SD 16.0). Fourteen dialysis units experienced inadequate access to vascular surgical procedures either due to a lack of dedicated theatre time or hospital beds. Six units administered intravenous prophylactic antimicrobials prior to CVC insertion with only two units using a CVC insertion checklist at the time of catheter insertion. In general, dialysis units in Ireland show a strong adherence to national guidelines. Compared with the 12 countries participating in the Dialysis Outcomes Practice Patterns Study (DOPPS 4), in 2010, AVF prevalence in Irish dialysis units is the second lowest. Recommendations include establishing an AVF national prevalence target rate, discontinuing the administration of intravenous prophylactic antimicrobials prior to CVC insertion and promoting the use of CVC insertion checklists.

Accurate guitar tuning by cochlear implant musicians.

Directory of Open Access Journals (Sweden)

Thomas Lu

Full Text Available Modern cochlear implant (CI users understand speech but find difficulty in music appreciation due to poor pitch perception. Still, some deaf musicians continue to perform with their CI. Here we show unexpected results that CI musicians can reliably tune a guitar by CI alone and, under controlled conditions, match simultaneously presented tones to <0.5 Hz. One subject had normal contralateral hearing and produced more accurate tuning with CI than his normal ear. To understand these counterintuitive findings, we presented tones sequentially and found that tuning error was larger at ∼ 30 Hz for both subjects. A third subject, a non-musician CI user with normal contralateral hearing, showed similar trends in performance between CI and normal hearing ears but with less precision. This difference, along with electric analysis, showed that accurate tuning was achieved by listening to beats rather than discriminating pitch, effectively turning a spectral task into a temporal discrimination task.

Changing of the Guard: How Different School Leaders Change Organizational Routines

Science.gov (United States)

Enomoto, Ernestine K.; Conley, Sharon

2008-01-01

While providing stability and uniformity, organizational routines can foster continuous change. Using Feldman's (2000) performative model of routinized action theory, coupled with leadership succession research, we examined how three successive administrations in a California high school revised a student attendance (tardy-monitoring) routine over…

Endocarditis : Effects of routine echocardiography during Gram-positive bacteraemia

NARCIS (Netherlands)

Vos, F J; Bleeker-Rovers, C P; Sturm, P D; Krabbe, P F M; van Dijk, A P J; Oyen, W J G; Kullberg, B J

2011-01-01

BACKGROUND: Despite firm recommendations to perform echocardiography in high-risk patients with Gram-positive bacteraemia, routine echocardiography is not embedded in daily practice in many settings. The aim of this study was to evaluate whether a regime including routine echocardiography results in

Do detour tasks provide accurate assays of inhibitory control?

Science.gov (United States)

Whiteside, Mark A.; Laker, Philippa R.; Beardsworth, Christine E.

2018-01-01

Transparent Cylinder and Barrier tasks are used to purportedly assess inhibitory control in a variety of animals. However, we suspect that performances on these detour tasks are influenced by non-cognitive traits, which may result in inaccurate assays of inhibitory control. We therefore reared pheasants under standardized conditions and presented each bird with two sets of similar tasks commonly used to measure inhibitory control. We recorded the number of times subjects incorrectly attempted to access a reward through transparent barriers, and their latencies to solve each task. Such measures are commonly used to infer the differential expression of inhibitory control. We found little evidence that their performances were consistent across the two different Putative Inhibitory Control Tasks (PICTs). Improvements in performance across trials showed that pheasants learned the affordances of each specific task. Critically, prior experience of transparent tasks, either Barrier or Cylinder, also improved subsequent inhibitory control performance on a novel task, suggesting that they also learned the general properties of transparent obstacles. Individual measures of persistence, assayed in a third task, were positively related to their frequency of incorrect attempts to solve the transparent inhibitory control tasks. Neophobia, Sex and Body Condition had no influence on individual performance. Contrary to previous studies of primates, pheasants with poor performance on PICTs had a wider dietary breadth assayed using a free-choice task. Our results demonstrate that in systems or taxa where prior experience and differences in development cannot be accounted for, individual differences in performance on commonly used detour-dependent PICTS may reveal more about an individual's prior experience of transparent objects, or their motivation to acquire food, than providing a reliable measure of their inhibitory control. PMID:29593115

Controller Design for Accurate Antenna Pointing Onboard a Spacecraft

National Research Council Canada - National Science Library

Barba, Victor M

2007-01-01

.... Simulations are conducted to show that the integration of feedforward control action and feedback compensation produces better responses than the implementation of either individual control system...

A problem-solving routine for improving hospital operations.

Science.gov (United States)

Ghosh, Manimay; Sobek Ii, Durward K

2015-01-01

The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

[The usage of protective gloves for routine disinfection of patient contact areas : An anonymous survey of work doctors and hygienists (infection control nurses, link nurses and physicians)].

Science.gov (United States)

Dittmann, Kathleen; Morch-Röder, Alexandra; Kramer, Axel; Kagel, Verena; Hübner, Nils-Olaf

2017-10-01

Disinfection, routinely carried out in healthcare facilities and known as "ongoing disinfection" or "untargeted disinfection", covers areas that are suspected of being contaminated with pathogen-containing material without being recognizable or visible in individual cases. The use of chemical resistant protective gloves is indispensable for surface disinfection. However, it is unclear if healthcare facilities set specific requirements regarding the selection and application of gloves. The usage of protective gloves for routine disinfection of patient contact areas was assessed in an anonymous cross-sectional study. Work doctors and hygienists (infection control nurses, link nurses and physicians) were queried by questionnaire. Disposable gloves were predominantly used, in most cases largely in accordance with EN 374. The most common glove material was nitrile. Glove change was mostly reported between rooms. Reprocessing of reusable gloves is inconsistent. Several professions are responsible for selecting protective gloves. Procedures for glove selection and application for disinfection of contact surfaces vary between the surveyed institutions. Therefore, more attention has to be paid to these three aspects in the future and these must be included in the hygiene plans.

Analysis of positive control STR experiments reveals that results obtained for FGA, D3S1358, and D13S317 condition the success rate of the analysis of routine reference samples.

Science.gov (United States)

Murigneux, Valentine; Dufour, Anne-Béatrice; Lobry, Jean R; Pène, Laurent

2014-07-01

About 120,000 reference samples are analyzed each year in the Forensic Laboratory of Lyon. A total of 1640 positive control experiments used to validate and optimize the analytical method in the routine process were submitted to a multivariate exploratory data analysis approach with the aim of better understanding the underlying sources of variability. The peak heights of the 16 genetic markers targeted by the AmpFℓSTR(®) Identifiler(®) STR kit were used as variables of interest. Six different 3130xl genetic analyzers located in the same controlled environment were involved. Two major sources of variability were found: (i) the DNA load of the sample modulates all peak heights in a similar way so that the 16 markers are highly correlated, (ii) the genetic analyzer used with a locus-specific response for peak height and a better sensitivity for the most recently acquired. Three markers (FGA, D3S1358, and D13S317) were found to be of special interest to predict the success rate observed in the routine process. © 2014 American Academy of Forensic Sciences.

Literature Review Lifestyles and routine activities of South African ...

African Journals Online (AJOL)

Journal of Child and Adolescent Mental Health ... Lifestyles and routine activities of South African teenagers at risk of being trafficked for involuntary prostitution. Thozama ... Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are ...

Routine maintenance prolongs ESP time between failures

International Nuclear Information System (INIS)

Hurst, T.; Lannom, R.W.; Divine, D.L.

1992-01-01

This paper reports that routine maintenance of electric submersible motors (ESPs) significantly lengthened the mean time between motor failures (MTBF), decreased operating costs, and extended motor run life in the Sacroc Unit of the Kelly-Snyder field in West Texas. After the oil price boom of the early 1980s. rapidly eroding profit margins from producing properties caused a much stronger focus on reducing operating costs. In Sacroc, ESP operating life and repair costs became a major target of cost reduction efforts. The routine ESP maintenance program has been in place for over 3 years

Localized single voxel 1H MR spectroscopy toward routine clinical use

International Nuclear Information System (INIS)

Lee, Jung Hee; Choi, Choong Gon; Kim, Sang Tae; Kim, Jin Suh; Mun, Chi Woong; Suh, Dae Chul; Lim, Tae Hwan; Auh, Young Ho

1996-01-01

To evaluate the automated 1 H magnetic resonance spectroscopy ( 1 H-MRS) method for a routine clinical use, various regions of the normal human brain were examined for regional variations, the reproducibility, and the quality control of the spectral data. Localized 1 H-MRS was performed in a GE 1.5T SIGNA MRI/MRS system using the automated method (PROton Brain Exam:PROBE). Six regions of the human brain from normal volunteers (N=25, age=23-65) were examined: Occipital gray matter, parietal white matter, frontal white matter, pons, cerebellum, and basal ganglia region. STEAM was used as the localization method with the following parameters : TE=30 msec, TR=3.0 sec, AVG=48 AVG, NEX=2, Spectral Width (SW)=2500 Hz, Size (SI)=2048 points (2K), and the size of voxel=7-9 ml. The reproducibility and the quality control of the spectral data were evaluated. For the 6 regions, the regional variation by the spectral patterns and the metabolites ratios relative to creatine was well demonstrated. Rates of the auto prescan success and the percentages of obtaining the acceptable quality spectral were high in the parietal white matter, occipital gray matter, and basal ganglia regions, and low in the frontal white matter and pons regions. PROBE is a highly practical as well as reliable method to produce reproducible quality spectra that represent the regional metabolic exam or as an additional series to a routine brain MRI exam, which takes less than 10 minutes for acquisition of one spectrum. In order to obtain good quality spectra, a good quality control scheme of the MR instrument is mandatory

User's Manual: Routines for Radiative Heat Transfer and Thermometry

Science.gov (United States)

Risch, Timothy K.

2016-01-01

Determining the intensity and spectral distribution of radiation emanating from a heated surface has applications in many areas of science and engineering. Areas of research in which the quantification of spectral radiation is used routinely include thermal radiation heat transfer, infrared signature analysis, and radiation thermometry. In the analysis of radiation, it is helpful to be able to predict the radiative intensity and the spectral distribution of the emitted energy. Presented in this report is a set of routines written in Microsoft Visual Basic for Applications (VBA) (Microsoft Corporation, Redmond, Washington) and incorporating functions specific to Microsoft Excel (Microsoft Corporation, Redmond, Washington) that are useful for predicting the radiative behavior of heated surfaces. These routines include functions for calculating quantities of primary importance to engineers and scientists. In addition, the routines also provide the capability to use such information to determine surface temperatures from spectral intensities and for calculating the sensitivity of the surface temperature measurements to unknowns in the input parameters.

Learning fast accurate movements requires intact frontostriatal circuits

Directory of Open Access Journals (Sweden)

Britne eShabbott

2013-11-01

Full Text Available The basal ganglia are known to play a crucial role in movement execution, but their importance for motor skill learning remains unclear. Obstacles to our understanding include the lack of a universally accepted definition of motor skill learning (definition confound, and difficulties in distinguishing learning deficits from execution impairments (performance confound. We studied how healthy subjects and subjects with a basal ganglia disorder learn fast accurate reaching movements, and we addressed the definition and performance confounds by: 1 focusing on an operationally defined core element of motor skill learning (speed-accuracy learning, and 2 using normal variation in initial performance to separate movement execution impairment from motor learning abnormalities. We measured motor skill learning learning as performance improvement in a reaching task with a speed-accuracy trade-off. We compared the performance of subjects with Huntington’s disease (HD, a neurodegenerative basal ganglia disorder, to that of premanifest carriers of the HD mutation and of control subjects. The initial movements of HD subjects were less skilled (slower and/or less accurate than those of control subjects. To factor out these differences in initial execution, we modeled the relationship between learning and baseline performance in control subjects. Subjects with HD exhibited a clear learning impairment that was not explained by differences in initial performance. These results support a role for the basal ganglia in both movement execution and motor skill learning.

Understanding teachers’ routines to inform classroom technology design

OpenAIRE

An, P.; Bakker, S.; Eggen, J.H.

2017-01-01

Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction to take place both in the center and periphery of users’ attention and naturally shift between the two. We believe that classroom technologies emplo...

How to Analyze Routines in Teachers' Thinking Processes during Lesson Planning.

Science.gov (United States)

Bromme, Rainer

A justification for the study of teachers' routines, as they affect the preparation of lesson plans, prefaces this paper on teachers' thought processes during lesson planning. In focusing on the importance of research into teachers' routines, it is pointed out that lesson preparation and classroom routines permit teachers to direct attention to…

Rapid and accurate control rod calibration measurement and analysis

International Nuclear Information System (INIS)

Nelson, George W.; Doane, Harry J.

1990-01-01

In order to reduce the time needed to perform control rod calibrations and improve the accuracy of the results, a technique for a measurement, analysis, and tabulation of integral rod worths has been developed. A single series of critical rod positions are determined at constant low power to reduce the waiting time between positive period measurements and still assure true stable reactor period data. Reactivity values from positive period measurements and control rod drop measurements are used as input data for a non-linear fit to the expected control rod integral worth shape. With this method, two control rods can be calibrated in about two hours, and integral and differential calibration tables for operator use are printed almost immediately. Listings of the BASIC computer programs for the non-linear fitting and calibration table preparation are provided. (author)

PARMELA sub B a new version of PARMELA with coherent synchrotron radiation effects and a finite difference space charge routine

CERN Document Server

Koltenbah, B E C; Greegor, R B; Dowell, D H

2002-01-01

Recent interest in advanced laser light sources has stimulated development of accelerator systems of intermediate beam energy, 100-200 MeV, and high charge, 1-10 nC, for high power FEL applications and high energy, 1-2 GeV, high charge, SASE-FEL applications. The current generation of beam transport codes which were developed for high-energy, low-charge beams with low self-fields are inadequate to address this energy and charge regime, and better computational tools are required to accurately calculate self-fields. To that end, we have developed a new version of PARMELA, named PARMELA sub B and written in Fortran 95, which includes a coherent synchrotron radiation (CSR) routine and an improved, generalized space charge (SC) routine. An electron bunch is simulated by a collection of macro-particles, which traverses a series of beam line elements. At each time step through the calculation, the momentum of each particle is updated due to the presence of external and self-fields. The self-fields are due to CSR an...

Improving Automation Routines for Automatic Heating Load Detection in Buildings

Directory of Open Access Journals (Sweden)

Stephen Timlin

2012-11-01

Full Text Available Energy managers use weather compensation data and heating system cut off routines to reduce heating energy consumption in buildings and improve user comfort. These routines are traditionally based on the calculation of an estimated building load that is inferred from the external dry bulb temperature at any point in time. While this method does reduce heating energy consumption and accidental overheating, it can be inaccurate under some weather conditions and therefore has limited effectiveness. There remains considerable scope to improve on the accuracy and relevance of the traditional method by expanding the calculations used to include a larger range of environmental metrics. It is proposed that weather compensation and automatic shut off routines that are commonly used could be improved notably with little additional cost by the inclusion of additional weather metrics. This paper examines the theoretical relationship between various external metrics and building heating loads. Results of the application of an advanced routine to a recently constructed building are examined, and estimates are made of the potential savings that can be achieved through the use of the routines proposed.

Family routines and rituals following separation: continuity and change

NARCIS (Netherlands)

Bakker, W.; Karsten, L.; Mulder, C.H.

2015-01-01

Separation always changes family life. The aim of this study is to gain insight into the everyday practices of ‘doing family’ after separation. We focus on two central elements of family life: routines and rituals. While in most families both parents are involved in family routines and rituals, this

Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review

Directory of Open Access Journals (Sweden)

Kaian Amorim Teles

Full Text Available Abstract Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

Impact of measles supplementary immunization activities on reaching children missed by routine programs.

Science.gov (United States)

Portnoy, Allison; Jit, Mark; Helleringer, Stéphane; Verguet, Stéphane

2018-01-02

Measles supplementary immunization activities (SIAs) are vaccination campaigns that supplement routine vaccination programs with a recommended second dose opportunity to children of different ages regardless of their previous history of measles vaccination. They are conducted every 2-4 years and over a few weeks in many low- and middle-income countries. While SIAs have high vaccination coverage, it is unclear whether they reach the children who miss their routine measles vaccine dose. Determining who is reached by SIAs is vital to understanding their effectiveness, as well as measure progress towards measles control. We examined SIAs in low- and middle-income countries from 2000 to 2014 using data from the Demographic and Health Surveys. Conditional on a child's routine measles vaccination status, we examined whether children participated in the most recent measles SIA. The average proportion of zero-dose children (no previous routine measles vaccination defined as no vaccination date before the SIA) reached by SIAs across 14 countries was 66%, ranging from 28% in São Tomé and Príncipe to 91% in Nigeria. However, when also including all children with routine measles vaccination data, this proportion decreased to 12% and to 58% when imputing data for children with vaccination reported by the mother and vaccination marks on the vaccination card across countries. Overall, the proportions of zero-dose children reached by SIAs declined with increasing household wealth. Some countries appeared to reach a higher proportion of zero-dose children using SIAs than others, with proportions reached varying according to the definition of measles vaccination (e.g., vaccination dates on the vaccination card, vaccination marks on the vaccination card, and/or self-reported data). This suggests that some countries could improve their targeting of SIAs to children who miss other measles vaccine opportunities. Across all countries, SIAs played an important role in reaching

Intelligent navigation and accurate positioning of an assist robot in indoor environments

Science.gov (United States)

Hua, Bin; Rama, Endri; Capi, Genci; Jindai, Mitsuru; Tsuri, Yosuke

2017-12-01

Intact robot's navigation and accurate positioning in indoor environments are still challenging tasks. Especially in robot applications, assisting disabled and/or elderly people in museums/art gallery environments. In this paper, we present a human-like navigation method, where the neural networks control the wheelchair robot to reach the goal location safely, by imitating the supervisor's motions, and positioning in the intended location. In a museum similar environment, the mobile robot starts navigation from various positions, and uses a low-cost camera to track the target picture, and a laser range finder to make a safe navigation. Results show that the neural controller with the Conjugate Gradient Backpropagation training algorithm gives a robust response to guide the mobile robot accurately to the goal position.

An Element of Practical Knowledge in Education: Professional Routines

Science.gov (United States)

Lacourse, France

2011-01-01

The question of practical knowledge and its teaching has arisen more perceptibly since the appearance of the aim to professionalize teachers. How can imperceptible knowledge such as professional routines be taught? To establish a social fabric and effective class management, it is essential to call on creative and adaptive professional routines.…

32 CFR 701.121 - Processing “routine use” disclosures.

Science.gov (United States)

2010-07-01

... DEPARTMENT OF THE NAVY DOCUMENTS AFFECTING THE PUBLIC DON Privacy Program § 701.121 Processing “routine use... be in writing and state that it is being made under a “routine use” established by a specific PA... and maintain a disclosure accounting of the information released. (See § 701.111.) (b) Failure to cite...

Predictors of routine episiotomy in primigravida women in Oman.

Science.gov (United States)

Al-Ghammari, Khadija; Al-Riyami, Zainab; Al-Moqbali, Moza; Al-Marjabi, Fatma; Al-Mahrouqi, Basma; Al-Khatri, Amal; Al-Khasawneh, Esra M

2016-02-01

Episiotomy is still the most common surgical procedure performed on women, despite the evidence against its routine use. This cross-sectional study was conducted to determine the practice and predictors of routine episiotomy on primigravidae in Oman. Demographic data, reasons for and rate of performing routine episiotomies, and perceptions of 269 obstetricians, midwives and nurses from 11 hospitals in Oman regarding the procedure were recorded and analyzed. The rate of episiotomies was 66%. In terms of performing routine episiotomies (p<0.05): non-Omanis were 4.49 times more likely than Omanis; bachelor's degree-holders were 2.26 more likely than diploma-holders; and regional hospitals were 2.36 times more likely than tertiary hospitals. The majority perceived episiotomies "reduce spontaneous perineal tearing risk", "reduce shoulder dystocia complications", and allow for "easier suturing". The rate of episiotomies was higher than other similar contexts. An urgent intervention is necessary to curb this excessive practice, and create a culture of evidence-based practice to deal with misleading perceptions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

PROCEDURES FOR ACCURATE PRODUCTION OF COLOR IMAGES FROM SATELLITE OR AIRCRAFT MULTISPECTRAL DIGITAL DATA.

Science.gov (United States)

Duval, Joseph S.

1985-01-01

Because the display and interpretation of satellite and aircraft remote-sensing data make extensive use of color film products, accurate reproduction of the color images is important. To achieve accurate color reproduction, the exposure and chemical processing of the film must be monitored and controlled. By using a combination of sensitometry, densitometry, and transfer functions that control film response curves, all of the different steps in the making of film images can be monitored and controlled. Because a sensitometer produces a calibrated exposure, the resulting step wedge can be used to monitor the chemical processing of the film. Step wedges put on film by image recording machines provide a means of monitoring the film exposure and color balance of the machines.

Barcoding T Cell Calcium Response Diversity with Methods for Automated and Accurate Analysis of Cell Signals (MAAACS)

Science.gov (United States)

Sergé, Arnauld; Bernard, Anne-Marie; Phélipot, Marie-Claire; Bertaux, Nicolas; Fallet, Mathieu; Grenot, Pierre; Marguet, Didier; He, Hai-Tao; Hamon, Yannick

2013-01-01

We introduce a series of experimental procedures enabling sensitive calcium monitoring in T cell populations by confocal video-microscopy. Tracking and post-acquisition analysis was performed using Methods for Automated and Accurate Analysis of Cell Signals (MAAACS), a fully customized program that associates a high throughput tracking algorithm, an intuitive reconnection routine and a statistical platform to provide, at a glance, the calcium barcode of a population of individual T-cells. Combined with a sensitive calcium probe, this method allowed us to unravel the heterogeneity in shape and intensity of the calcium response in T cell populations and especially in naive T cells, which display intracellular calcium oscillations upon stimulation by antigen presenting cells. PMID:24086124

[Routine fluoroscopic investigations after primary bariatric surgery].

Science.gov (United States)

Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

2016-03-01

Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

Building Micro-Foundations for the Routines, Capabilities, and Performance Links

DEFF Research Database (Denmark)

Abell, Peter; Felin, Teppo; Foss, Nicolai Juul

2007-01-01

a neglect of micro-foundations - is incomplete. There are no mechanisms that work solely on the macro-level, directly connecting routines and capabilities to firm-level outcomes. While routines and capabilities are useful shorthand for complicated patterns of individual action and interaction, ultimately...... they are best understood at the micro-level. Second, we provide a formal model that shows precisely why macro explanation is incomplete and which exemplifies how explicit micro-foundations may be built for notions of routines and capabilities and for how these impact firm performance....

STELLAR LOCUS REGRESSION: ACCURATE COLOR CALIBRATION AND THE REAL-TIME DETERMINATION OF GALAXY CLUSTER PHOTOMETRIC REDSHIFTS

International Nuclear Information System (INIS)

High, F. William; Stubbs, Christopher W.; Rest, Armin; Stalder, Brian; Challis, Peter

2009-01-01

We present stellar locus regression (SLR), a method of directly adjusting the instrumental broadband optical colors of stars to bring them into accord with a universal stellar color-color locus, producing accurately calibrated colors for both stars and galaxies. This is achieved without first establishing individual zero points for each passband, and can be performed in real-time at the telescope. We demonstrate how SLR naturally makes one wholesale correction for differences in instrumental response, for atmospheric transparency, for atmospheric extinction, and for Galactic extinction. We perform an example SLR treatment of Sloan Digital Sky Survey data over a wide range of Galactic dust values and independently recover the direction and magnitude of the canonical Galactic reddening vector with 14-18 mmag rms uncertainties. We then isolate the effect of atmospheric extinction, showing that SLR accounts for this and returns precise colors over a wide range of air mass, with 5-14 mmag rms residuals. We demonstrate that SLR-corrected colors are sufficiently accurate to allow photometric redshift estimates for galaxy clusters (using red sequence galaxies) with an uncertainty σ(z)/(1 + z) = 0.6% per cluster for redshifts 0.09 < z < 0.25. Finally, we identify our objects in the 2MASS all-sky catalog, and produce i-band zero points typically accurate to 18 mmag using only SLR. We offer open-source access to our IDL routines, validated and verified for the implementation of this technique, at http://stellar-locus-regression.googlecode.com.

Accurate and computationally efficient prediction of thermochemical properties of biomolecules using the generalized connectivity-based hierarchy.

Science.gov (United States)

Sengupta, Arkajyoti; Ramabhadran, Raghunath O; Raghavachari, Krishnan

2014-08-14

In this study we have used the connectivity-based hierarchy (CBH) method to derive accurate heats of formation of a range of biomolecules, 18 amino acids and 10 barbituric acid/uracil derivatives. The hierarchy is based on the connectivity of the different atoms in a large molecule. It results in error-cancellation reaction schemes that are automated, general, and can be readily used for a broad range of organic molecules and biomolecules. Herein, we first locate stable conformational and tautomeric forms of these biomolecules using an accurate level of theory (viz. CCSD(T)/6-311++G(3df,2p)). Subsequently, the heats of formation of the amino acids are evaluated using the CBH-1 and CBH-2 schemes and routinely employed density functionals or wave function-based methods. The calculated heats of formation obtained herein using modest levels of theory and are in very good agreement with those obtained using more expensive W1-F12 and W2-F12 methods on amino acids and G3 results on barbituric acid derivatives. Overall, the present study (a) highlights the small effect of including multiple conformers in determining the heats of formation of biomolecules and (b) in concurrence with previous CBH studies, proves that use of the more effective error-cancelling isoatomic scheme (CBH-2) results in more accurate heats of formation with modestly sized basis sets along with common density functionals or wave function-based methods.

Community-driven demand creation for the use of routine viral load testing: a model to scale up routine viral load testing.

Science.gov (United States)

Killingo, Bactrin M; Taro, Trisa B; Mosime, Wame N

2017-11-01

HIV treatment outcomes are dependent on the use of viral load measurement. Despite global and national guidelines recommending the use of routine viral load testing, these policies alone have not translated into widespread implementation or sufficiently increased access for people living with HIV (PLHIV). Civil society and communities of PLHIV recognize the need to close this gap and to enable the scale up of routine viral load testing. The International Treatment Preparedness Coalition (ITPC) developed an approach to community-led demand creation for the use of routine viral load testing. Using this Community Demand Creation Model, implementers follow a step-wise process to capacitate and empower communities to address their most pressing needs. This includes utlizing a specific toolkit that includes conducting a baseline assessment, developing a treatment education toolkit, organizing mobilization workshops for knowledge building, provision of small grants to support advocacy work and conducting benchmark evaluations. The Community Demand Creation Model to increase demand for routine viral load testing services by PLHIV has been delivered in diverse contexts including in the sub-Saharan African, Asian, Latin American and the Caribbean regions. Between December 2015 and December 2016, ITPC trained more than 240 PLHIV activists, and disbursed US$90,000 to network partners in support of their national advocacy work. The latter efforts informed a regional, community-driven campaign calling for domestic investment in the expeditious implementation of national viral load testing guidelines. HIV treatment education and community mobilization are critical components of demand creation for access to optimal HIV treatment, especially for the use of routine viral load testing. ITPC's Community Demand Creation Model offers a novel approach to achieving this goal. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of

Master schedule for CY-1978. Hanford Environmental Surveillance Routine Program

International Nuclear Information System (INIS)

Blumer, P.J.; Myers, D.A.; Fix, J.J.

1977-12-01

This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. No results are presented in this report. The data collected are available in routine reports issued by the Environmental Evaluations staff

Routine versus on demand removal of the syndesmotic screw; A protocol for an international randomised controlled trial (RODEO-trial)

NARCIS (Netherlands)

S.A. Dingemans (Siem); Birnie, M.F.N. (M. F.N.); Sanders, F.R.K. (F. R.K.); M.P.J. van den Bekerom (Michel); Backes, M. (M.); E.F. van Beeck (Ed); F.W. Bloemers (Frank); B.A. van Dijkman (Bart); E.R. Flikweert (Elvira); D.J. Haverkamp; H.R. Holtslag (Herman); Hoogendoorn, J.M. (J. M.); P. Joosse (Pieter); Parkkinen, M. (M.); G.R. Roukema (Gert); N.L. Sosef (Nico L.); B. Twigt (Bas); R.N. van Veen (Ruben); Van Der Veen, A.H. (A. H.); Vermeulen, J. (J.); Winkelhagen, J. (J.); Van Der Zwaard, B.C. (B. C.); S. Van Dieren (Susan); J.C. Goslings (Carel); T. Schepers (Tim)

2018-01-01

textabstractBackground: Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally

A new model with an anatomically accurate human renal collecting system for training in fluoroscopy-guided percutaneous nephrolithotomy access.

Science.gov (United States)

Turney, Benjamin W

2014-03-01

Obtaining renal access is one of the most important and complex steps in learning percutaneous nephrolithotomy (PCNL). Ideally, this skill should be practiced outside the operating room. There is a need for anatomically accurate and cheap models for simulated training. The objective was to develop a cost-effective, anatomically accurate, nonbiologic training model for simulated PCNL access under fluoroscopic guidance. Collecting systems from routine computed tomography urograms were extracted and reformatted using specialized software. These images were printed in a water-soluble plastic on a three-dimensional (3D) printer to create biomodels. These models were embedded in silicone and then the models were dissolved in water to leave a hollow collecting system within a silicone model. These PCNL models were filled with contrast medium and sealed. A layer of dense foam acted as a spacer to replicate the tissues between skin and kidney. 3D printed models of human collecting systems are a useful adjunct in planning PCNL access. The PCNL access training model is relatively low cost and reproduces the anatomy of the renal collecting system faithfully. A range of models reflecting the variety and complexity of human collecting systems can be reproduced. The fluoroscopic triangulation process needed to target the calix of choice can be practiced successfully in this model. This silicone PCNL training model accurately replicates the anatomic architecture and orientation of the human renal collecting system. It provides a safe, clean, and effective model for training in accurate fluoroscopy-guided PCNL access.

Colocalization analysis in fluorescence micrographs: verification of a more accurate calculation of pearson's correlation coefficient.

Science.gov (United States)

Barlow, Andrew L; Macleod, Alasdair; Noppen, Samuel; Sanderson, Jeremy; Guérin, Christopher J

2010-12-01

One of the most routine uses of fluorescence microscopy is colocalization, i.e., the demonstration of a relationship between pairs of biological molecules. Frequently this is presented simplistically by the use of overlays of red and green images, with areas of yellow indicating colocalization of the molecules. Colocalization data are rarely quantified and can be misleading. Our results from both synthetic and biological datasets demonstrate that the generation of Pearson's correlation coefficient between pairs of images can overestimate positive correlation and fail to demonstrate negative correlation. We have demonstrated that the calculation of a thresholded Pearson's correlation coefficient using only intensity values over a determined threshold in both channels produces numerical values that more accurately describe both synthetic datasets and biological examples. Its use will bring clarity and accuracy to colocalization studies using fluorescent microscopy.

Learning Together and Working Apart: Routines for Organizational Learning in Virtual Teams

Science.gov (United States)

Dixon, Nancy

2017-01-01

Purpose: Research suggests that teaming routines facilitate learning in teams. This paper identifies and details how specific teaming routines, implemented in a virtual team, support its continual learning. The study's focus was to generate authentic and descriptive accounts of the interviewees' experiences with virtual teaming routines.…

Using Routine Data for Quality Assessment in NeuroNet Telestroke Care

DEFF Research Database (Denmark)

Theiss, Stephan; Günzel, Franziska; Storm, Anna

2013-01-01

: Routine clinical data from the HELIOS hospital information system were compared before and after implementation of the NeuroNet concept, including neurologic acute stroke teleconsultations, standard operating procedures, and peer review quality management in 3 hospital cohorts: 5 comprehensive stroke...... centers, 5 NeuroNet hospitals, and 5 matched control hospitals. RESULTS: During the study period, the rate of thrombolytic therapy increased by 4.8% in NeuroNet hospitals, while ischemic stroke in-hospital mortality decreased (relative risk reduction ∼29% in NeuroNet and control hospitals). The odds ratio...... for thrombolytic therapy in comprehensive stroke centers compared to NeuroNet hospitals was reduced from 3.7 to 1.3 between 2006 and 2009. Comprehensive stroke care coding according to German Diagnosis Related Groups definitions increased by 45% in NeuroNet (P

Using the volumetric effect of a finite-sized detector for routine quality assurance of multileaf collimator leaf positioning

International Nuclear Information System (INIS)

Yang Yong; Xing Lei

2003-01-01

Intensity modulated radiation therapy (IMRT) is an advanced form of radiation therapy and promises to improve dose conformation while reducing the irradiation to the sensitive structures. The modality is, however, more complicated than conventional treatment and requires much more stringent quality assurance (QA) to ensure what has been planned can be achieved accurately. One of the main QA tasks is the assurance of positioning accuracy of multileaf collimator (MLC) leaves during IMRT delivery. Currently, the routine quality assurance of MLC in most clinics is being done using radiographic films with specially designed MLC leaf sequences. Besides being time consuming, the results of film measurements are difficult to quantify and interpret. In this work, we propose a new and effective technique for routine MLC leaf positioning QA. The technique utilizes the fact that, when a finite-sized detector is placed under a leaf, the relative output of the detector will depend on the relative fractional volume irradiated. A small error in leaf positioning would change the fractional volume irradiated and lead to a deviation of the relative output from the normal reading. For a given MLC and detector system, the relation between the relative output and the leaf displacement can be easily established through experimental measurements and used subsequently as a quantitative means for detecting possible leaf positional errors. The method was tested using a linear accelerator with an 80-leaf MLC. Three different locations, including two locations on central plane (X1=X2=0) and one point on an off-central plane location (X1=-7.5, X=7.5), were studied. Our results indicated that the method could accurately detect a leaf positional change of ∼0.1 mm. The method was also used to monitor the stability of MLC leaf positioning for five consecutive weeks. In this test, we intentionally introduced two positional errors in the testing MLC leaf sequences: -0.2 mm and 1.2 mm. The technique

Older adults' personal routine at time of hospitalization.

Science.gov (United States)

Zisberg, Anna; Gur-Yaish, Nurit

This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014

Directory of Open Access Journals (Sweden)

Adam Haji

2016-02-01

Full Text Available Abstract Background Globally, vaccine preventable diseases are responsible for nearly 20 % of deaths annually among children 5 km from health facility (OR 1.6, CI 1.0–2.7 were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04–0.8. There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5–1.6. Conclusion Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of text message reminders in routine vaccination services.

Design, analysis, and interpretation of field quality-control data for water-sampling projects

Science.gov (United States)

Mueller, David K.; Schertz, Terry L.; Martin, Jeffrey D.; Sandstrom, Mark W.

2015-01-01

The process of obtaining and analyzing water samples from the environment includes a number of steps that can affect the reported result. The equipment used to collect and filter samples, the bottles used for specific subsamples, any added preservatives, sample storage in the field, and shipment to the laboratory have the potential to affect how accurately samples represent the environment from which they were collected. During the early 1990s, the U.S. Geological Survey implemented policies to include the routine collection of quality-control samples in order to evaluate these effects and to ensure that water-quality data were adequately representing environmental conditions. Since that time, the U.S. Geological Survey Office of Water Quality has provided training in how to design effective field quality-control sampling programs and how to evaluate the resultant quality-control data. This report documents that training material and provides a reference for methods used to analyze quality-control data.

Routine versus on demand removal of the syndesmotic screw; a protocol for an international randomised controlled trial (RODEO-trial)

NARCIS (Netherlands)

Dingemans, S. A.; Birnie, M. F. N.; Sanders, F. R. K.; van den Bekerom, M. P. J.; Backes, M.; van Beeck, E.; Bloemers, F. W.; van Dijkman, B.; Flikweert, E.; Haverkamp, D.; Holtslag, H. R.; Hoogendoorn, J. M.; Joosse, P.; Parkkinen, M.; Roukema, G.; Sosef, N.; Twigt, B. A.; van Veen, R. N.; van der Veen, A. H.; Vermeulen, J.; Winkelhagen, J.; van der Zwaard, B. C.; van Dieren, S.; Goslings, J. C.; Schepers, T.

2018-01-01

Background: Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally the screw is

Colonoscopy and computerised tomography scan are not sufficient to localise right sided colonic lesions accurately.

LENUS (Irish Health Repository)

Solon, Jacqueline Gemma

2009-11-23

: Aim: accurate pre-operative localisation of colonic lesions is critical especially in laparoscopic colectomy where tactile localisation is absent particularly in screen-detected tumours. The study aimed to evaluate the accuracy of colonoscopy and double-contrast computerised tomography (CT) to localise lesions treated by right hemicolectomy. Method: a retrospective chart review was performed of patients treated by right hemicolectomy under the colorectal service between July 2003 and October 2006. Pre-operative tumour location determined by CT scan and colonoscopy were compared with the intra-operative and histopathologic findings. Results: of 101 patients, 73 (73%) were for adenoma or cancer, with a final diagnosis of adenocarcinoma in 59 (59%). Pre-operative localisation was inaccurate in 29% of lesions using both CT and colonoscopy. In the transverse colon colonoscopy alone was only 37.5% accurate, increasing to 62.5% when information from the CT scan was added. Conclusion: pre-operative localisation of right-sided colon cancers using colonoscopy and CT scanning is unreliable in at least 29% of cases. Inaccurate localisation of transverse colon tumours risks inadequate lymphadenectomy with an adverse cancer outcome. Pre-operative abdominal CT scan improves accuracy but endoscopic tattoo localisation should be employed routinely especially in patients undergoing laparoscopic resection.

IONEOS: a fast, analytic, ion equation-of-state routine

International Nuclear Information System (INIS)

Cranfill, C.W.; More, R.

1978-10-01

A routine IONEOS has been developed to compute ion pressure and specific energy along with their derivatives. The theoretical model used is due to R.D. Cowan and includes non-ideal-gas behavior. The routine is designed for use in large hydrodynamics codes as an improved procedure for splitting the total pressure and specific energy (which are usually tabulated) into ion and electron components

42 CFR 493.941 - Hematology (including routine hematology and coagulation).

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Hematology (including routine hematology and....941 Hematology (including routine hematology and coagulation). (a) Program content and frequency of challenge. To be approved for proficiency testing for hematology, a program must provide a minimum of five...

Continuity of care by a midwife team versus routine care during pregnancy and birth: a randomised trial.

Science.gov (United States)

Rowley, M J; Hensley, M J; Brinsmead, M W; Wlodarczyk, J H

1995-09-18

To compare continuity of care from a midwife team with routine care from a variety of doctors and midwives. A stratified, randomised controlled trial. 814 women attending the antenatal clinic of a tertiary referral, university hospital. Women were randomly allocated to team care from a team of six midwives, or routine care from a variety of doctors and midwives. Antenatal, intrapartum and neonatal events; maternal satisfaction; and cost of treatment. 405 women were randomly allocated to team care and 409 to routine care; they delivered 385 and 386 babies, respectively. Team care women were more likely to attend antenatal classes (OR, 1.73; 95% CI, 1.23-2.42); less likely to use pethidine during labour (OR, 0.32; 95% CI, 0.22-0.46); and more likely to labour and deliver without intervention (OR, 1.73; 95% CI, 1.28-2.34). Babies of team care mothers received less neonatal resuscitation (OR, 0.59; 95% CI, 0.41-0.86), although there was no difference in Apgar scores at five minutes (OR, 0.86; 95% CI, 0.29-2.57). The stillbirth and neonatal death rate was the same for both groups of mothers with a singleton pregnancy (three deaths), but there were three deaths (birthweights of 600 g, 660 g, 1340 g) in twin pregnancies in the group receiving team care. Team care was rated better than routine care for all measures of maternal satisfaction. Team care meant a cost reduction of 4.5%. Continuity of care provided by a small team of midwives resulted in a more satisfying birth experience at less cost than routine care and fewer adverse maternal and neonatal outcomes. Although a much larger study would be required to provide adequate power to detect rare outcomes, our study found that continuity of care by a midwife team was as safe as routine care.

Marshalling embedded routines in support of firm creation

DEFF Research Database (Denmark)

Houman Andersen, Poul; Norus, Jesper

2003-01-01

The paper has a dual purpose. First, we suggest that entrepreneurs in their establishment of new businesses draw on a range of pre-existing socially embedded routines for creating acceptance by their environment. Also they draw upon external resources that are used in patterning specific practices....... This ability is treated as entrepreneurial assets. Secondly, we argue that the existence and patterning of these socially embedded routines used in new business development are contingent on the institutional context. We see the institutional context as complex and fragmented, composed and shaped by different...

Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

DEFF Research Database (Denmark)

Husted, Gitte; Thorsteinsson, Birger; Esbensen, Bente Appel

2011-01-01

visits will reduce haemoglobin A1c (HbA1c) concentrations and improve adolescents' life skills compared with a control group. METHODS: Using a mixed methods design comprising a randomised controlled trial and a nested qualitative evaluation, we will recruit 68 adolescents age 13 - 18 years with type 1......ABSTRACT: BACKGROUND: Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus...... are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y)) for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic...

Novel high accurate sensorless dual-axis solar tracking system controlled by maximum power point tracking unit of photovoltaic systems

International Nuclear Information System (INIS)

Fathabadi, Hassan

2016-01-01

Highlights: • Novel high accurate sensorless dual-axis solar tracker. • It has the advantages of both sensor based and sensorless solar trackers. • It does not have the disadvantages of sensor based and sensorless solar trackers. • Tracking error of only 0.11° that is less than the tracking errors of others. • An increase of 28.8–43.6% depending on the seasons in the energy efficiency. - Abstract: In this study, a novel high accurate sensorless dual-axis solar tracker controlled by the maximum power point tracking unit available in almost all photovoltaic systems is proposed. The maximum power point tracking controller continuously calculates the maximum output power of the photovoltaic module/panel/array, and uses the altitude and azimuth angles deviations to track the sun direction where the greatest value of the maximum output power is extracted. Unlike all other sensorless solar trackers, the proposed solar tracking system is a closed loop system which means it uses the actual direction of the sun at any time to track the sun direction, and this is the contribution of this work. The proposed solar tracker has the advantages of both sensor based and sensorless dual-axis solar trackers, but it does not have their disadvantages. Other sensorless solar trackers all are open loop, i.e., they use offline estimated data about the sun path in the sky obtained from solar map equations, so low exactness, cloudy sky, and requiring new data for new location are their problems. A photovoltaic system has been built, and it is experimentally verified that the proposed solar tracking system tracks the sun direction with the tracking error of 0.11° which is less than the tracking errors of other both sensor based and sensorless solar trackers. An increase of 28.8–43.6% depending on the seasons in the energy efficiency is the main advantage of utilizing the proposed solar tracking system.

Design of common software for quality control of SPECT

International Nuclear Information System (INIS)

Li Xiaohua; Gao Ruzhen; Chen Shengzu

1993-01-01

The goal of this study is to design a common testing system for SPECT quality control according to NEMA standard. Using the system, the performances of different types of SPECT can be tested, so that the acceptance testing, performance comparing and routine quality control for SPECT can be normalized. The system was based on IBM PC series of microcomputer. Testing data are acquired from various types of SPECT, then transferred into IBM PC through interface and tested with an unique testing program. Two parts were included: interface and SPECT testing program. It emphatically studied the managing program of RS232 interface, designing skills and the mathematic patterns of SPECT testing program. The system which was composed of 11 subroutines can be used to measure the performances for both gamma camera and SPECT. The system was tested on OMEGA 500/MCS 560 SPECT and the results showed that it is effective, accurate and easy to use

Developing Routines in Large Inter-organisational Projects: A Case Study of an Infrastructure Megaproject

Directory of Open Access Journals (Sweden)

Therese Eriksson

2015-08-01

Full Text Available General management research has increasingly recognised the significance of routines in organisational performance. Among organisational tasks, megaprojects depend more on routines selected and created within the project than standard, small-scale projects do, owing largely to their size, duration, and uniqueness. Within this context, the present paper investigates how project routines were established and developed during the early design phase of an inter-organisational megaproject. A case study of a large public infrastructure project was conducted, in which data were collected during observations, semi-structured interviews, and project document studies over the course of three years. Results of analysis revealed that the client exerted the greatest impact on choice of routines and that the temporary nature of tasks limited efforts to fine-tune routines. Changes in routines were primarily reactive to new knowledge concerning project needs. The findings suggest that meta-routines to consciously review routines should be used to a greater extent and designed to capture supplier experiences as well.

Routine systemic antibiotic prophylaxis for burn injuries in developing countries: A best evidence topic (BET)

Science.gov (United States)

Stewart, Barclay T; Gyedu, Adam; Agbenorku, Pius; Amankwa, Richcane; Kushner, Adam L; Gibran, Nicole

2015-01-01

Background Burns are common in low- and middle-income countries (LMICs) and complicated by unhygienic conditions, malnutrition, use of high-risk homemade dressings and delayed presentation. Resultantly, use of routine systemic antibiotic prophylaxis (SAP) to prevent wound infection is common practice despite this intervention being abandoned in high-income countries due to increased antimicrobial resistance and non-bacterial suprainfection, Methods A best evidence topic (BET) was constructed using a structured protocol. The question addressed was: In LMICs, does routine use of SAP reduce burn wound infection, morbidity or mortality? Results From 704 retrieved records, 48 reports met criteria to be examined. Of those, 3 studies represented the best available evidence. Together, two randomized clinical trials (RCTs) and a retrospective cohort study reported no difference in the proportion of wound infection, any infection or length of hospital stay between SAP groups and controls. One RCT described a greater proportion of wounds infected with P. aeruginosa among SAP arms compared to controls. The studies had few participants and significant methodological weaknesses. Conclusion On the basis of limited, currently available evidence, the use of SAP cannot be recommended for patients in LMICs that present soon after burn injury. PMID:26260622

Factors for Radical Creativity, Incremental Creativity, and Routine, Noncreative Performance

Science.gov (United States)

Madjar, Nora; Greenberg, Ellen; Chen, Zheng

2011-01-01

This study extends theory and research by differentiating between routine, noncreative performance and 2 distinct types of creativity: radical and incremental. We also use a sensemaking perspective to examine the interplay of social and personal factors that may influence a person's engagement in a certain level of creative action versus routine,…

See, Say, Write: A Writing Routine for the Preschool Classroom

Science.gov (United States)

Copp, Stefanie B.; Cabell, Sonia Q.; Tortorelli, Laura S.

2016-01-01

See, Say, Write is an adaptable classroom writing routine that teachers can use across a range of activities in the preschool classroom. This preschool writing routine offers an opportunity for teachers to build on a shared experience through engagement in rich conversation and writing. After a shared experience, teachers will provide a visual…

Probability and statistics with integrated software routines

CERN Document Server

Deep, Ronald

2005-01-01

Probability & Statistics with Integrated Software Routines is a calculus-based treatment of probability concurrent with and integrated with statistics through interactive, tailored software applications designed to enhance the phenomena of probability and statistics. The software programs make the book unique.The book comes with a CD containing the interactive software leading to the Statistical Genie. The student can issue commands repeatedly while making parameter changes to observe the effects. Computer programming is an excellent skill for problem solvers, involving design, prototyping, data gathering, testing, redesign, validating, etc, all wrapped up in the scientific method.See also: CD to accompany Probability and Stats with Integrated Software Routines (0123694698)* Incorporates more than 1,000 engaging problems with answers* Includes more than 300 solved examples* Uses varied problem solving methods

Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014.

Science.gov (United States)

Haji, Adam; Lowther, S; Ngan'ga, Z; Gura, Z; Tabu, C; Sandhu, H; Arvelo, Wences

2016-02-16

Globally, vaccine preventable diseases are responsible for nearly 20% of deaths annually among children education [Odds Ratio (OR) 1.8, 95% Confidence Interval (CI) 1.1-3.2], and residing >5 km from health facility (OR 1.6, CI 1.0-2.7) were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04-0.8). There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5-1.6). Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of text message reminders in routine vaccination services.

Efficient linear algebra routines for symmetric matrices stored in packed form.

Science.gov (United States)

Ahlrichs, Reinhart; Tsereteli, Kakha

2002-01-30

Quantum chemistry methods require various linear algebra routines for symmetric matrices, for example, diagonalization or Cholesky decomposition for positive matrices. We present a small set of these basic routines that are efficient and minimize memory requirements.

Dosimetric systems developed in Brazil for the radiation processes quality control

International Nuclear Information System (INIS)

Galante, Ana Maria Sisti; Campos, Leticia Lucente

2011-01-01

In order to apply new technologies to the industrial processing of materials aiming economy, efficiency, speed and high quality, ionizing radiation has been used in medicine, archaeology, chemistry, food preservation and other areas. For this reason, the dosimetry area looks for improve current dosimeters and develop new materials for application on quality control of these processes. In Brazil, the research in the dosimetry area occurs with great speed providing many different dosimetric systems. The chemical dosimetry is the most used technique in routine dosimetry, which requires fast and accurate responses. This technique involves determination of absorbed dose by measuring chemical changes radiation induced in the materials. Different dosimetric systems were developed at IPEN for application on radiation process quality and all of them present excellent results; the low cost of these materials allows a more effective dose control, therefore, a larger area or volume can be monitored. (author).

Accelerated spike resampling for accurate multiple testing controls.

Science.gov (United States)

Harrison, Matthew T

2013-02-01

Controlling for multiple hypothesis tests using standard spike resampling techniques often requires prohibitive amounts of computation. Importance sampling techniques can be used to accelerate the computation. The general theory is presented, along with specific examples for testing differences across conditions using permutation tests and for testing pairwise synchrony and precise lagged-correlation between many simultaneously recorded spike trains using interval jitter.

Impact assessment of malaria vector control using routine surveillance data in Zambia: implications for monitoring and evaluation

Directory of Open Access Journals (Sweden)

Chanda Emmanuel

2012-12-01

Full Text Available Abstract Background Malaria vector control using long-lasting insecticidal nets (LLINs and indoor residual spraying (IRS, with pyrethroids and DDT, to reduce malaria transmission has been expansively implemented in Zambia. The impact of these interventions on malaria morbidity and mortality has not previously been formally assessed at the population level in Zambia. Methods The impact of IRS (15 urban districts and LLINs (15 rural districts implementation on severe malaria cases, deaths and case fatality rates in children below the age of five years were compared. Zambian national Health Management Information System data from 2007 to 2008 were retrospectively analysed to assess the epidemiological impact of the two interventions using odds ratios to compare the pre-scaling up year 2007 with the scaling-up year 2008. Results Overall there were marked reductions in morbidity and mortality, with cases, deaths and case fatality rates (CFR of severe malaria decreasing by 31%, 63% and 62%, respectively between 2007 and 2008. In urban districts with IRS introduction there was a significant reduction in mortality (Odds Ratio [OR] = 0.37, 95% CI = 0.31-0.43, P = 0.015, while the reduction in mortality in rural districts with LLINs implementation was not significant (OR = 0.83, 95% CI = 0.67-1.04, P = 0.666. A similar pattern was observed for case fatality rates with a significant reduction in urban districts implementing IRS (OR = 0.34, 95% CI = 0.33-0.36, P = 0.005, but not in rural districts implementing LLINs (OR = 0.96, 95% CI = 0.91-1.00, P = 0.913. No substantial difference was detected in overall reduction of malaria cases between districts implementing IRS and LLINs (P = 0.933. Conclusion Routine surveillance data proved valuable for determining the temporal effects of malaria control with two strategies, IRS and LLINs on severe malaria disease in different types of Zambian districts. However, this analysis did not take into account the effect

Is Routine Preoperative Chest X-ray Indicated in Elderly Patients ...

African Journals Online (AJOL)

Background: In our hospital pre-operative chest x-ray (CXR) are routinely requested without prior establishment of any medical indication for patients of 70 or more years of age who are undergoing elective surgery. The aim of this study was to determine if routine preoperative chest x-rays are justifiably indicated for elderly ...

Direct Calculation of Permeability by High-Accurate Finite Difference and Numerical Integration Methods

KAUST Repository

Wang, Yi

2016-07-21

Velocity of fluid flow in underground porous media is 6~12 orders of magnitudes lower than that in pipelines. If numerical errors are not carefully controlled in this kind of simulations, high distortion of the final results may occur [1-4]. To fit the high accuracy demands of fluid flow simulations in porous media, traditional finite difference methods and numerical integration methods are discussed and corresponding high-accurate methods are developed. When applied to the direct calculation of full-tensor permeability for underground flow, the high-accurate finite difference method is confirmed to have numerical error as low as 10-5% while the high-accurate numerical integration method has numerical error around 0%. Thus, the approach combining the high-accurate finite difference and numerical integration methods is a reliable way to efficiently determine the characteristics of general full-tensor permeability such as maximum and minimum permeability components, principal direction and anisotropic ratio. Copyright © Global-Science Press 2016.

Linking child travel routes and routine health data

Directory of Open Access Journals (Sweden)

Amy Mizen

2017-04-01

Depending on modelled accuracy, a GIS and data linkage approach may allow the investigation of natural experiments and intervention evaluation at the scale of the total population. This is the first step towards anonymously modelling part of the daily exposure environment using routine data. A limitation is the lack of routinely collected BMI data for older children and teenagers an age when they are more likely to have the option to choose to buy food on the school route. This work will have many potential applications, including the delivery and evaluation of multiple school and workplace commuting interventions.

Manualized cognitive therapy versus cognitive-behavioral treatment-as-usual for social anxiety disorder in routine practice: A cluster-randomized controlled trial.

Science.gov (United States)

Hoyer, Jürgen; Čolić, Jasmin; Pittig, Andre; Crawcour, Stephen; Moeser, Manuela; Ginzburg, Denise; Lin, Jihong; Wiltink, Joerg; Leibing, Eric; Stangier, Ulrich

2017-08-01

This study examined the effectiveness of manualized cognitive therapy (mCT) following the Clark-Wells approach versus non-manualized cognitive-behavioral treatment-as-usual (CBTAU) for social anxiety disorder (SAD) in routine practice. Forty-eight private practitioners were recruited within a multi-center trial and either received training in manualized CT for SAD or no such training. Practitioners treated 162 patients with SAD in routine practice (N = 107 completers, n = 57 for mCT, n = 50 for CBTAU). Social anxiety symptoms (Liebowitz Social Anxiety Scale; LSAS) and secondary measures were assessed before treatment, at treatment-hour 8, 15, and 25, at end of treatment, as well as 6 and 12 months after treatment. Patients in both groups showed significant reductions of SAD severity after treatment (d = 1.91 [mCT] and d = 1.80 [CBTAU], within-group effect sizes, intent-to-treat analyses, LSAS observer ratings), which remained stable at follow-up. There were no differences between groups in terms of symptom reduction and treatment duration. The present trial confirms the high effectiveness of CBTAU and mCT for SAD when practitioners conduct the treatments in routine practice. Additional training in the CT manual did not result in significant between-group effects on therapy outcome. Explanations for this unexpected result are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Accurate, model-based tuning of synthetic gene expression using introns in S. cerevisiae.

Directory of Open Access Journals (Sweden)

Ido Yofe

2014-06-01

Full Text Available Introns are key regulators of eukaryotic gene expression and present a potentially powerful tool for the design of synthetic eukaryotic gene expression systems. However, intronic control over gene expression is governed by a multitude of complex, incompletely understood, regulatory mechanisms. Despite this lack of detailed mechanistic understanding, here we show how a relatively simple model enables accurate and predictable tuning of synthetic gene expression system in yeast using several predictive intron features such as transcript folding and sequence motifs. Using only natural Saccharomyces cerevisiae introns as regulators, we demonstrate fine and accurate control over gene expression spanning a 100 fold expression range. These results broaden the engineering toolbox of synthetic gene expression systems and provide a framework in which precise and robust tuning of gene expression is accomplished.

Clinical Neuropathology practice news 1-2014: Pyrosequencing meets clinical and analytical performance criteria for routine testing of MGMT promoter methylation status in glioblastoma

Science.gov (United States)

Preusser, Matthias; Berghoff, Anna S.; Manzl, Claudia; Filipits, Martin; Weinhäusel, Andreas; Pulverer, Walter; Dieckmann, Karin; Widhalm, Georg; Wöhrer, Adelheid; Knosp, Engelbert; Marosi, Christine; Hainfellner, Johannes A.

2014-01-01

Testing of the MGMT promoter methylation status in glioblastoma is relevant for clinical decision making and research applications. Two recent and independent phase III therapy trials confirmed a prognostic and predictive value of the MGMT promoter methylation status in elderly glioblastoma patients. Several methods for MGMT promoter methylation testing have been proposed, but seem to be of limited test reliability. Therefore, and also due to feasibility reasons, translation of MGMT methylation testing into routine use has been protracted so far. Pyrosequencing after prior DNA bisulfite modification has emerged as a reliable, accurate, fast and easy-to-use method for MGMT promoter methylation testing in tumor tissues (including formalin-fixed and paraffin-embedded samples). We performed an intra- and inter-laboratory ring trial which demonstrates a high analytical performance of this technique. Thus, pyrosequencing-based assessment of MGMT promoter methylation status in glioblastoma meets the criteria of high analytical test performance and can be recommended for clinical application, provided that strict quality control is performed. Our article summarizes clinical indications, practical instructions and open issues for MGMT promoter methylation testing in glioblastoma using pyrosequencing. PMID:24359605

GRALIB, DISSPLA Plot Routines Emulator

International Nuclear Information System (INIS)

Dunford, L.

1999-01-01

1 - Description of program or function: GRALIB is a library of graphics subroutines used by PLOTEF. 2 - Method of solution: The PLOTEF library contains routines to generate and manipulate data which are independent of the output graphics device. In order to produce output for a given graphics device - which interact with GRALIB using the DISSPLA conventions - a device driver must be written by the user for this device

Pulse processing routines for neutron time-of-flight data

CERN Document Server

Žugec, P; Guerrero, C; Gunsing, F; Vlachoudis, V; Sabate-Gilarte, M; Stamatopoulos, A; Wright, T; Lerendegui-Marco, J; Mingrone, F; Ryan, J A; Warren, S G; Tsinganis, A; Barbagallo, M

2016-01-01

A pulse shape analysis framework is described, which was developed for n_TOF-Phase3, the third phase in the operation of the n_TOF facility at CERN. The most notable feature of this new framework is the adoption of generic pulse shape analysis routines, characterized by a minimal number of explicit assumptions about the nature of pulses. The aim of these routines is to be applicable to a wide variety of detectors, thus facilitating the introduction of the new detectors or types of detectors into the analysis framework. The operational details of the routines are suited to the specific requirements of particular detectors by adjusting the set of external input parameters. Pulse recognition, baseline calculation and the pulse shape fitting procedure are described. Special emphasis is put on their computational efficiency, since the most basic implementations of these conceptually simple methods are often computationally inefficient.

Methods to improve routine bioassay monitoring for freshly separated, poorly transported plutonium

International Nuclear Information System (INIS)

Bihl, D.E.; Lynch, T.P.; Carbaugh, E.H.; Sula, M.J.

1988-09-01

Several human cases involving inhalation of plutonium oxide at Hanford have shown clearance half-times from the lung that are much longer than the 500-day half-time recommended for class Y plutonium in Publication 30 of the International Commission on Radiological Protection(ICRP). The more tenaciously retained material is referred to as super class Y plutonium. The ability to detect super class Y plutonium by current routine bioassay measurements is shown to be poor. Pacific Northwest Laboratory staff involved in the Hanford Internal Dosimetry Program investigated four methods to se if improvements in routine monitoring of workers for fresh super class Y plutonium are feasible. The methods were lung counting, urine sampling, fecal sampling, and use of diethylenetriaminepentaacetate (DTPA) to enhance urinary excretion. Use of DTPA was determined to be not feasible. Routine fecal sampling was found to be feasible but not recommended. Recommendations were made to improve the detection level for routine annual urinalysis and routine annual lung counting. 12 refs., 9 figs., 7 tabs

HistoStitcher© : An Interactive Program for Accurate and Rapid Reconstruction of Digitized Whole Histological Sections from Tissue Fragments

Science.gov (United States)

Chappelow, Jonathan; Tomaszewski, John E.; Feldman, Michael; Shih, Natalie; Madabhushi, Anant

2011-01-01

We present an interactive program called HistoStitcher© for accurate and rapid reassembly of histology fragments into a pseudo-whole digitized histological section. HistoStitcher© provides both an intuitive graphical interface to assist the operator in performing the stitch of adjacent histology fragments by selecting pairs of anatomical landmarks, and a set of computational routines for determining and applying an optimal linear transformation to generate the stitched image. Reconstruction of whole histological sections from images of slides containing smaller fragments is required in applications where preparation of whole sections of large tissue specimens is not feasible or efficient, and such whole mounts are required to facilitate (a) disease annotation and (b) image registration with radiological images. Unlike manual reassembly of image fragments in a general purpose image editing program (such as Photoshop), HistoStitcher© provides memory efficient operation on high resolution digitized histology images and a highly flexible stitching process capable of producing more accurate results in less time. Further, by parameterizing the series of transformations determined by the stitching process, the stitching parameters can be saved, loaded at a later time, refined, or reapplied to multi-resolution scans, or quickly transmitted to another site. In this paper, we describe in detail the design of HistoStitcher© and the mathematical routines used for calculating the optimal image transformation, and demonstrate its operation for stitching high resolution histology quadrants of a prostate specimen to form a digitally reassembled whole histology section, for 8 different patient studies. To evaluate stitching quality, a 6 point scoring scheme, which assesses the alignment and continuity of anatomical structures important for disease annotation, is employed by three independent expert pathologists. For 6 studies compared with this scheme, reconstructed sections

Master schedule for CY-1983 Hanford environmental surveillance routine sampling program

International Nuclear Information System (INIS)

Blumer, P.J.; Sula, M.J.; Eddy, P.A.; Dirkes, R.L.

1982-12-01

The current schedule of data collection for the routine Hanford environmental surveillance and ground-water monitoring programs at the Hanford Site is presented. The purpose of the programs is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. Radiological monitoring data are reported for air (particulate filter and gases/vapor), Columbia River water, sanitary water, onsite pond water, foodstuffs (whole milk, leafy vegetables, fruit, wheat/alfalfa, beef, poultry/eggs), wildlife, soil and vegetation, and direct radiation. Information is also given for on site radiation control audit surveys (roadway, railway, aerial, and waste disposal sites, and the Hanford ground-water monitoring program

Taking medicine at home - create a routine

Science.gov (United States)

... page: //medlineplus.gov/ency/patientinstructions/000613.htm Taking medicine at home - create a routine To use the ... teeth. Find Ways to Help You Remember Your Medicines You can: Set the alarm on your clock, ...

Individual Differences in Accurately Judging Personality From Text.

Science.gov (United States)

Hall, Judith A; Goh, Jin X; Mast, Marianne Schmid; Hagedorn, Christian

2016-08-01

This research examines correlates of accuracy in judging Big Five traits from first-person text excerpts. Participants in six studies were recruited from psychology courses or online. In each study, participants performed a task of judging personality from text and performed other ability tasks and/or filled out questionnaires. Participants who were more accurate in judging personality from text were more likely to be female; had personalities that were more agreeable, conscientious, and feminine, and less neurotic and dominant (all controlling for participant gender); scored higher on empathic concern; self-reported more interest in, and attentiveness to, people's personalities in their daily lives; and reported reading more for pleasure, especially fiction. Accuracy was not associated with SAT scores but had a significant relation to vocabulary knowledge. Accuracy did not correlate with tests of judging personality and emotion based on audiovisual cues. This research is the first to address individual differences in accurate judgment of personality from text, thus adding to the literature on correlates of the good judge of personality. © 2015 Wiley Periodicals, Inc.

Fundamentals for routined utilization of tomography in beam diagnostic

International Nuclear Information System (INIS)

Reichau, Hermine

2012-01-01

A general and systematic approach to implement tomography for beam diagnostics has been invented and exemplarily shown for the invention of beam tomography for the Frankfurt Neutron Source. Following the diagnostic pipeline the first step was to prepare the data basis for the tomography reconstruction. For the monitoring, standard parameters have to be obtained with sufficient accuracy. In the context of this work, tomography has been kept as flexible as possible. Firstly, it will be used for the analysis of beam dynamics but also for the further development of beam tomography for routined utilization. Later on it will have to serve as a monitoring system at the end of the LEBT of FRANZ. The data preparation for tomography was demonstrated step by step. The iterated backprojection (FBP) algorithm was derived to show the basic idea of tomography which is contained in all forms of tomography algorithms. In connection with data exhibiting a high signal to noise ratio the FBP obtains the result with the highest accuracy, beyond that the accuracy can be controlled by the number of projections. The algebraic reconstruction and maximum entropy approach were outlined in a nutshell. By the introduction of the diagnostic pipeline in combination with the decision systematics the basis for a routined utilization of tomography in ion beam diagnostics have been established and exemplarily demonstrated on the introduction of beam tomography for FRANZ. A rotatable vacuum chamber has been developed to close a gap between the availability of projections to use the FBP and the small physical space on which they have to be determined. (orig.)

Spectrally accurate contour dynamics

International Nuclear Information System (INIS)

Van Buskirk, R.D.; Marcus, P.S.

1994-01-01

We present an exponentially accurate boundary integral method for calculation the equilibria and dynamics of piece-wise constant distributions of potential vorticity. The method represents contours of potential vorticity as a spectral sum and solves the Biot-Savart equation for the velocity by spectrally evaluating a desingularized contour integral. We use the technique in both an initial-value code and a newton continuation method. Our methods are tested by comparing the numerical solutions with known analytic results, and it is shown that for the same amount of computational work our spectral methods are more accurate than other contour dynamics methods currently in use

Heterotopic pregnancy after in vitro fertilization and embryo transfer: the role of routine transvaginal ultrasonography

International Nuclear Information System (INIS)

Lee, Eun Ju

1994-01-01

Spontaneous heterotopic pregnancy (HP) is a rare condition, however, the rising incidence after in-vitro fertilization and embryo transfer (IVF-ET) may present serious problems as the diagnosis of this potentially fatal condition is often missed. The purposes of this study were to investigate the frequency of HP after IVF-ET, to analyze the clinical presentation and the outcome of coincidental intrauterine pregnancy, and to evaluate the value of routine transvaginal ultrasonography in early diagnosis and treatment of HP. There were 11 cases of HP among 484 pregnancies after IVF-ET (The incidence was 2.3%) in recent 2 years. We evaluated the clinical findings and the findings of transvaginal sonography in those 11 patients. The combined extrauterine pregnancies were tubal (n = 9), cornual (n = 1), and both the tubal and cornual (n = 1). Vaginal bleeding was absent in 4 cases and one of them was asymptomatic. HP may be suspected if there was an elevated serum hCG in the absence of intrauterine multiple gestations. In all cases, the condition was diagnosed by transvaginal sonography performed prior to surgical intervention. The coincidental intrauterine pregnancies were ended in successful full-term delivery in 7 cases, while one pregnancy was ongoing at that time. The incidence of HP was evidently higher in IVF-ET than in spontaneous pregnancies. Transvaginal sonography was useful in accurate diagnosis in clinically suspected cases and even in asymptomatic cases. Routine transvaginal sonography played an important role in early diagnosis and prompt management of HP

The Emergence of Routines: Entrepreneurship, Organization, and Business History

DEFF Research Database (Denmark)

Lubinski, Christina

2018-01-01

Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1.......Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1....

Is bioelectrical impedance accurate for use in large epidemiological studies?

Directory of Open Access Journals (Sweden)

Merchant Anwar T

2008-09-01

Full Text Available Abstract Percentage of body fat is strongly associated with the risk of several chronic diseases but its accurate measurement is difficult. Bioelectrical impedance analysis (BIA is a relatively simple, quick and non-invasive technique, to measure body composition. It measures body fat accurately in controlled clinical conditions but its performance in the field is inconsistent. In large epidemiologic studies simpler surrogate techniques such as body mass index (BMI, waist circumference, and waist-hip ratio are frequently used instead of BIA to measure body fatness. We reviewed the rationale, theory, and technique of recently developed systems such as foot (or hand-to-foot BIA measurement, and the elements that could influence its results in large epidemiologic studies. BIA results are influenced by factors such as the environment, ethnicity, phase of menstrual cycle, and underlying medical conditions. We concluded that BIA measurements validated for specific ethnic groups, populations and conditions can accurately measure body fat in those populations, but not others and suggest that for large epdiemiological studies with diverse populations BIA may not be the appropriate choice for body composition measurement unless specific calibration equations are developed for different groups participating in the study.

Sequencing-based breast cancer diagnostics as an alternative to routine biomarkers.

Science.gov (United States)

Rantalainen, Mattias; Klevebring, Daniel; Lindberg, Johan; Ivansson, Emma; Rosin, Gustaf; Kis, Lorand; Celebioglu, Fuat; Fredriksson, Irma; Czene, Kamila; Frisell, Jan; Hartman, Johan; Bergh, Jonas; Grönberg, Henrik

2016-11-30

Sequencing-based breast cancer diagnostics have the potential to replace routine biomarkers and provide molecular characterization that enable personalized precision medicine. Here we investigate the concordance between sequencing-based and routine diagnostic biomarkers and to what extent tumor sequencing contributes clinically actionable information. We applied DNA- and RNA-sequencing to characterize tumors from 307 breast cancer patients with replication in up to 739 patients. We developed models to predict status of routine biomarkers (ER, HER2,Ki-67, histological grade) from sequencing data. Non-routine biomarkers, including mutations in BRCA1, BRCA2 and ERBB2(HER2), and additional clinically actionable somatic alterations were also investigated. Concordance with routine diagnostic biomarkers was high for ER status (AUC = 0.95;AUC(replication) = 0.97) and HER2 status (AUC = 0.97;AUC(replication) = 0.92). The transcriptomic grade model enabled classification of histological grade 1 and histological grade 3 tumors with high accuracy (AUC = 0.98;AUC(replication) = 0.94). Clinically actionable mutations in BRCA1, BRCA2 and ERBB2(HER2) were detected in 5.5% of patients, while 53% had genomic alterations matching ongoing or concluded breast cancer studies. Sequencing-based molecular profiling can be applied as an alternative to histopathology to determine ER and HER2 status, in addition to providing improved tumor grading and clinically actionable mutations and molecular subtypes. Our results suggest that sequencing-based breast cancer diagnostics in a near future can replace routine biomarkers.

Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

Science.gov (United States)

McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

2017-06-01

Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de

[Routine oral examinations and specific after-care for removable partial dentures

NARCIS (Netherlands)

Baat, C. de; Witter, D.J.; Keltjens, H.M.A.M.; Creugers, N.H.J.

2011-01-01

Following treatment with a removable partial denture, routine oral examinations are required to stabilize the existing condition in a sustainable way and to make possible the timely treatment of anomalies which have appeared. In cases of problems assessed during a routine oral examination in

Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading

Directory of Open Access Journals (Sweden)

Thomas G. Di Virgilio

2016-11-01

Discussion: Sub-concussive head impacts routine in soccer heading are associated with immediate, measurable electrophysiological and cognitive impairments. Although these changes in brain function were transient, these effects may signal direct consequences of routine soccer heading on (long-term brain health which requires further study.

Computer program for storage of historical and routine safety data related to radiologically controlled facilities

International Nuclear Information System (INIS)

Marsh, D.A.; Hall, C.J.

1984-01-01

A method for tracking and quick retrieval of radiological status of radiation and industrial safety systems in an active or inactive facility has been developed. The system uses a mini computer, a graphics plotter, and mass storage devices. Software has been developed which allows input and storage of architectural details, radiological conditions such as exposure rates, current location of safety systems, and routine and historical information on exposure and contamination levels. A blue print size digitizer is used for input. The computer program retains facility floor plans in three dimensional arrays. The software accesses an eight pen color plotter for output. The plotter generates color plots of the floor plans and safety systems on 8 1/2 x 11 or 20 x 30 paper or on overhead transparencies for reports and presentations

Clinician’s Attitudes to the Introduction of Routine Weighing in Pregnancy

Directory of Open Access Journals (Sweden)

Tim Hasted

2016-01-01

Full Text Available Background. Excessive gestational weight gain poses significant short- and long-term health risks to both mother and baby. Professional bodies and health services increasingly recommend greater attention be paid to weight gain in pregnancy. A large Australian tertiary maternity hospital plans to facilitate the (reintroduction of routine weighing of all women at every antenatal visit. Objective. To identify clinicians’ perspectives of barriers and enablers to routinely weighing pregnant women and variations in current practice, knowledge, and attitudes between different staff groups. Method. Forty-four maternity staff from three professional groups were interviewed in four focus groups. Staff included midwives; medical staff; and dietitians. Transcripts underwent qualitative content analysis to identify and examine barriers and enablers to the routine weighing of women throughout pregnancy. Results. While most staff supported routine weighing, various concerns were raised. Issues included access to resources and staff; the ability to provide appropriate counselling and evidence-based interventions; and the impact of weighing on patients and the therapeutic relationship. Conclusion. Many clinicians supported the practice of routine weighing in pregnancy, but barriers were also identified. Implementation strategies will be tailored to the discrete professional groups and will address identified gaps in knowledge, resources, and clinician skills and confidence.

COPD management: role of symptom assessment in routine clinical practice

Directory of Open Access Journals (Sweden)

van der Molen T

2013-10-01

Full Text Available Thys van der Molen,1,2 Marc Miravitlles,3 Janwillem WH Kocks1,21Department of General Practice, 2GRIAC (Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 3Pneumology Department, Hospital Universitari Vall d'Hebron, Biomedical Research Networking Centre in Respiratory Diseases (CIBERES, Barcelona, SpainAbstract: Patients with chronic obstructive pulmonary disease (COPD present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients' everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed.Keywords: chronic obstructive pulmonary disease, symptoms, questionnaires

Routine human-competitive machine intelligence by means of genetic programming

Science.gov (United States)

Koza, John R.; Streeter, Matthew J.; Keane, Martin

2004-01-01

Genetic programming is a systematic method for getting computers to automatically solve a problem. Genetic programming starts from a high-level statement of what needs to be done and automatically creates a computer program to solve the problem. The paper demonstrates that genetic programming (1) now routinely delivers high-return human-competitive machine intelligence; (2) is an automated invention machine; (3) can automatically create a general solution to a problem in the form of a parameterized topology; and (4) has delivered a progression of qualitatively more substantial results in synchrony with five approximately order-of-magnitude increases in the expenditure of computer time. Recent results involving the automatic synthesis of the topology and sizing of analog electrical circuits and controllers demonstrate these points.

Unmeasured improvement work: the lack of routinely collected, service-related data in NHS endoscopy units in England involved in "modernisation"

Directory of Open Access Journals (Sweden)

Hutchings Hayley A

2008-01-01

Full Text Available Abstract Background The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. Methods This retrospective observational study asked 19 endoscopy units to submit copies of all in-house, service-related endoscopy data that had been routinely collected by the unit – Referral numbers, Activity, Number of patients waiting and Number of lost slots. Nine of the endoscopy units had previously participated in the Modernising Endoscopy Services (MES project during 2003 to redesign their endoscopy services. These MES sites had access to additional funding and data collection software. The other ten (Control sites had modernised independently. All data was requested in two phases and corresponded to eight specific time points between January 2003 and April 2006. Results Only eight of 19 endoscopy units submitted routinely collected, service-related data. Another site's data was collected specifically for the study. A further two units claimed to routinely collect service-related data but did not submit any to the study. The remaining eight did not collect any service-related endoscopy data routinely and liaised with their Trust for data. Of the eight sites submitting service-related data, only three were MES project sites. Of these three, the data variables collected were limited and none collected the complete set of endoscopy data variables requested. Of the other five sites, two collected all four endoscopy data types. Data for the three MES project sites went back as far as January 2003, whilst the five Control sites were only able to submit data from December 2003 onwards. Conclusion There was a lack of service-related endoscopy data routinely collected by the study sites, especially those who had participated in the MES project. Without this data, NHS endoscopy services cannot have a true understanding of their services, cannot identify problems and cannot measure the impact of any

Benchmarking routine psychological services: a discussion of challenges and methods.

Science.gov (United States)

Delgadillo, Jaime; McMillan, Dean; Leach, Chris; Lucock, Mike; Gilbody, Simon; Wood, Nick

2014-01-01

Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

1995-06-15

Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

International Nuclear Information System (INIS)

Lee, Kang Wook; Lee, Heon Young

1995-01-01

Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

Eigenvalue routines in NASTRAN: A comparison with the Block Lanczos method

Science.gov (United States)

Tischler, V. A.; Venkayya, Vipperla B.

1993-01-01

The NASA STRuctural ANalysis (NASTRAN) program is one of the most extensively used engineering applications software in the world. It contains a wealth of matrix operations and numerical solution techniques, and they were used to construct efficient eigenvalue routines. The purpose of this paper is to examine the current eigenvalue routines in NASTRAN and to make efficiency comparisons with a more recent implementation of the Block Lanczos algorithm by Boeing Computer Services (BCS). This eigenvalue routine is now available in the BCS mathematics library as well as in several commercial versions of NASTRAN. In addition, CRAY maintains a modified version of this routine on their network. Several example problems, with a varying number of degrees of freedom, were selected primarily for efficiency bench-marking. Accuracy is not an issue, because they all gave comparable results. The Block Lanczos algorithm was found to be extremely efficient, in particular, for very large size problems.

Development and Validation of the Pediatric Diabetes Routines Questionnaire for Adolescents.

Science.gov (United States)

Pierce, Jessica S; Jordan, Sara S; Arnau, Randolph C

2018-04-06

This study describes the development and psychometric evaluation of an adolescent self-report version of the Pediatric Diabetes Routines Questionnaire (PDRQ:A), a measure of diabetes-specific routines for youth with type 1 diabetes, and further validation of the parent-version (PDRQ:P) in an adolescent sample. Participants included 120 parent-adolescent dyads (ages 12-17) and an additional 24 parents who completed measures of diabetes-specific adolescent routines, general adolescent routines, diabetes self-care, and family support of youth diabetes care. The PDRQ:P/A demonstrated good internal consistency, test-retest reliability, and parent-child agreement, and adequate validity coefficients. Confirmatory factor analysis supported a one-factor model. Promising results were obtained. The PDRQ:P/A is a clinically feasible parent- and self-report measure that can provide valuable information regarding how frequently adolescents engage in their diabetes management tasks in a consistent manner. Addition of an adolescent report format will enhance the utility of the measure for clinical and research use.

Equipment recommendations for uniform work places for routine stomatological radiodiagnosis

Energy Technology Data Exchange (ETDEWEB)

Rother, U [Rostock Univ. (German Democratic Republic). Radiologische Klinik; Taschner, P [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic); Wiltschke, F; Tonne, E; Kuehling, U; Nenning, K

1977-03-01

Corresponding to the different objectives, the Working Group on Radiology of the Stomatological Society has designed 6 standardized work places for routine radiodiagnosis in stomatology. Apart from the objectives, the problems related to the division of rooms, equipment, radioprotection and film processing are dealt with separately and specifically. The work places for routine stomatological radiodiagnosis are intended for achieving an improvement in a sector of stomatological care.

Control of muscle relaxation during anesthesia: a novel approach for clinical routine.

Science.gov (United States)

Stadler, Konrad S; Schumacher, Peter M; Hirter, Sibylle; Leibundgut, Daniel; Bouillon, Thomas W; Glattfelder, Adolf H; Zbinden, Alex M

2006-03-01

During general anesthesia drugs are administered to provide hypnosis, ensure analgesia, and skeletal muscle relaxation. In this paper, the main components of a newly developed controller for skeletal muscle relaxation are described. Muscle relaxation is controlled by administration of neuromuscular blocking agents. The degree of relaxation is assessed by supramaximal train-of-four stimulation of the ulnar nerve and measuring the electromyogram response of the adductor pollicis muscle. For closed-loop control purposes, a physiologically based pharmacokinetic and pharmacodynamic model of the neuromuscular blocking agent mivacurium is derived. The model is used to design an observer-based state feedback controller. Contrary to similar automatic systems described in the literature this controller makes use of two different measures obtained in the train-of-four measurement to maintain the desired level of relaxation. The controller is validated in a clinical study comparing the performance of the controller to the performance of the anesthesiologist. As presented, the controller was able to maintain a preselected degree of muscle relaxation with excellent precision while minimizing drug administration. The controller performed at least equally well as the anesthesiologist.

Routine Design for Mechanical Engineering

OpenAIRE

Brinkop, Axel; Laudwein, Norbert; Maasen, Rudiger

1995-01-01

COMIX (configuration of mixing machines) is a system that assists members of the EKATO Sales Department in designing a mixing machine that fulfills the requirements of a customer. It is used to help the engineer design the requested machine and prepare an offer that's to be submitted to the customer. comix integrates more traditional software techniques with explicit knowledge representation and constraint propagation. During the process of routine design, some design decisions have to be mad...

Instrumental neutron activation analysis - a routine method

International Nuclear Information System (INIS)

Bruin, M. de.

1983-01-01

This thesis describes the way in which at IRI instrumental neutron activation analysis (INAA) has been developed into an automated system for routine analysis. The basis of this work are 20 publications describing the development of INAA since 1968. (Auth.)

The effectiveness of online cognitive behavioral treatment in routine clinical practice.

Directory of Open Access Journals (Sweden)

Jeroen Ruwaard

Full Text Available Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders.To assess the effectiveness of online CBT for different mental disorders in routine clinical practice.An uncontrolled before-after study, with measurements at baseline, posttest, 6-week follow-up, and 1-year follow-up.1500 adult patients (female: 67%; mean age: 40 years with a GP referral for psychotherapy were treated at a Dutch online mental health clinic for symptoms of depression (n = 413, panic disorder (n = 139, posttraumatic stress (n = 478, or burnout (n = 470.Manualized, web-based, therapist-assisted CBT, of which the efficacy was previously demonstrated in a series of controlled trials. Standardized duration of treatment varied from 5 weeks (online CBT for Posttraumatic stress to 16 weeks (online CBT for Depression.Validated self-report questionnaires of specific and general psychopathology, including the Beck Depression Inventory, the Impact of Event Scale, the Panic Disorder Severity Scale-Self Report, the Oldenburg Burnout Inventory, and the Depression Anxiety Stress Scales.Treatment adherence was 71% (n = 1071. Study attrition was 21% at posttest, 33% at 6-week FU and 65% at 1-year FU. Mixed-model repeated measures regression identified large short-term reductions in all measures of primary symptoms (d = 1.9±0.2 to d = 1.2±0.2; P<.001, which sustained up to one year after treatment. At posttest, rates of reliable improvement and recovery were 71% and 52% in the completer sample (full sample: 55%/40%. Patient satisfaction was high.Results suggest that online therapist-assisted CBT may be as effective in routine practice as it is in clinical trials. Although pre-treatment withdrawal and long-term outcomes require further study, results warrant continued implementation of online CBT.

Should we reconsider the routine use of placebo controls in clinical research?

Directory of Open Access Journals (Sweden)

Avins Andrew L

2012-04-01

Full Text Available Abstract Background Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. Methods We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. Results We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. Conclusions Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.

Should we reconsider the routine use of placebo controls in clinical research?

Science.gov (United States)

Avins, Andrew L; Cherkin, Daniel C; Sherman, Karen J; Goldberg, Harley; Pressman, Alice

2012-04-27

Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.

Cultural Responsiveness and Routines: When Center and Home Don't Match

Science.gov (United States)

Gonzalez-Mena, Janet

2010-01-01

This article discusses cultural responsiveness and routines of child care centers that do not match what families are accustomed to at home. It can be difficult to discuss cultural differences in some routine caregiving activities because of the standards, rules, regulations, best practices, and health concerns that those trained in early…

Examining the cost of delivering routine immunization in Honduras.

Science.gov (United States)

Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

2015-05-07

Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

Sterilization of health care products - Ethylene oxide - Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices

International Nuclear Information System (INIS)

2007-01-01

This part of ISO 11135 describes requirements that, if met, will provide an ethylene oxide sterilization process intended to sterilize medical devices, which has appropriate microbicidal activity. Furthermore, compliance with the requirements ensures that this activity is both reliable and reproducible so that it can be predicted, with reasonable confidence, that there is a low level of probability of there being a viable microorganism present on product after sterilization. Specification of this probability is a matter for regulatory authorities and may vary from country to country. The paper provides information on scope, normative references, terms and definitions, quality management systems, sterilizing agent characterization, process and equipment characterization, product definition, process definition, validation, routine monitoring and control, product release from sterilization and maintaining process effectiveness followed by Annex A (Determination of lethal rate of the sterilization process - Biological indicator/bioburden approach), Annex B (Conservative determination of lethal rate of the sterilization process - Overkill approach, annex C (General guidance) and a bibliography.

Should the lateral chest radiograph be routinely performed?

International Nuclear Information System (INIS)

Osman, Fatuma; Williams, Imelda

2014-01-01

Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms.

Science.gov (United States)

Lanza, H Isabella; Drabick, Deborah A G

2011-01-01

Although child impulsivity is associated with oppositional defiant disorder (ODD) symptoms, few studies have examined whether family processes moderate this association. To address this gap, we tested whether child-reported family routine moderated the relation between child hyperactivity/impulsivity (HI) and ODD symptoms among a sample of low-income, urban, ethnic-minority children (N = 87, 51% male). Child HI and ODD symptoms were assessed using parent and teacher reports. HI also was indexed by a laboratory task. Family routine was assessed using child self-report. Hierarchical regression analyses indicated that family routine moderated child HI. Among children with higher levels of teacher-reported HI symptoms, lower levels of family routine were associated with higher levels of teacher-reported ODD symptoms compared to children with lower levels of teacher-reported HI symptoms. Children who self-reported higher levels of family routine were rated as low on teacher-reported ODD symptoms, regardless of teacher-reported HI levels. Parent report and laboratory measures of child HI did not produce significant interactions. Lower levels of family routine may confer risk for ODD symptoms among low-income, urban, ethnic-minority children experiencing higher levels of HI.

Routine administration of standardized questionnaires that assess aspects of patients quality of life in medical oncology clinics: A systematic review

International Nuclear Information System (INIS)

Alsaleh, Kh.

2013-01-01

Purpose: Increasing interest in the Quality of Life outcomes in cancer patients led to increase implementation of their use in routine clinical practice. The aim of this systemic review is to review the scientific evidence behind recommending the use of quality of life (QoL) scales routinely in outpatient evaluation. Methods: Systematic review for all published randomized controlled trials in English language between January 1, 1990 till December 31, 2012. Out of 487 articles (476 identified by electronic search + 11 articles identified by manual search), six trials satisfied the eligibility criteria: (1) the study was a randomized controlled trial (RCT) with randomization of patients or health care providers; (2) the findings of the administered questionnaire or scale (the intervention) were given to health care provider, and compared to standard care with no questionnaire administered (the control); (3) study was conducted in outpatient oncology clinics; and (4) an outcome was measured that related to (i) QoL improvement, (ii) reduction in morbidity, (iii) reduction in stress for the patients, (iv) improvement in communication between patients and health care provider, or (v) improved patient satisfaction. Assessment for the quality of the study was done using the GRADE methodology. Results: Serious methodological issues were affecting most of the trials. Overall the evaluation of the quality of the evidence from these identified trials suggests that there is a weak recommendation to use QoL scales in routine oncology practice to improve communication between physicians and patients. Conclusion: The routine use of such tools in the outpatient settings at improving the patient outcome or satisfaction cannot be recommended based on the available evidence. The potential harm with the excess use of resources needed to implement, collect, store, analyse, and present such data to health care providers should be also considered. Further research and better designed

Expert system driven fuzzy control application to power reactors

International Nuclear Information System (INIS)

Tsoukalas, L.H.; Berkan, R.C.; Upadhyaya, B.R.; Uhrig, R.E.

1990-01-01

For the purpose of nonlinear control and uncertainty/imprecision handling, fuzzy controllers have recently reached acclaim and increasing commercial application. The fuzzy control algorithms often require a ''supervisory'' routine that provides necessary heuristics for interface, adaptation, mode selection and other implementation issues. Performance characteristics of an on-line fuzzy controller depend strictly on the ability of such supervisory routines to manipulate the fuzzy control algorithm and enhance its control capabilities. This paper describes an expert system driven fuzzy control design application to nuclear reactor control, for the automated start-up control of the Experimental Breeder Reactor-II. The methodology is verified through computer simulations using a valid nonlinear model. The necessary heuristic decisions are identified that are vitally important for the implemention of fuzzy control in the actual plant. An expert system structure incorporating the necessary supervisory routines is discussed. The discussion also includes the possibility of synthesizing the fuzzy, exact and combined reasoning to include both inexact concepts, uncertainty and fuzziness, within the same environment

Accurate Evaluation of Quantum Integrals

Science.gov (United States)

Galant, D. C.; Goorvitch, D.; Witteborn, Fred C. (Technical Monitor)

1995-01-01

Combining an appropriate finite difference method with Richardson's extrapolation results in a simple, highly accurate numerical method for solving a Schrodinger's equation. Important results are that error estimates are provided, and that one can extrapolate expectation values rather than the wavefunctions to obtain highly accurate expectation values. We discuss the eigenvalues, the error growth in repeated Richardson's extrapolation, and show that the expectation values calculated on a crude mesh can be extrapolated to obtain expectation values of high accuracy.

A Novel Device for Accurate Chest Tube Insertion

DEFF Research Database (Denmark)

Katballe, Niels; Moeller, Lars B; Olesen, Winnie H

2016-01-01

BACKGROUND: Optimal positioning of a large-bore chest tube is in the part of the pleural cavity that needs drainage. It is recommended that the chest tube be positioned apically in pneumothorax and basally for fluids. However, targeted chest tube positioning to a specific part of the pleural cavity...... can be a challenge. METHODS: A new medical device, the KatGuide, was developed for accurate guiding of a chest tube (28F) to an intended part of the pleural cavity. The primary end point of this randomized, controlled trial was optimal position of the chest tube. The optimal position in pneumothorax...

Factors Associated with Routine Dental Attendance among Aboriginal Australians.

Science.gov (United States)

Amarasena, Najith; Kapellas, Kostas; Skilton, Michael R; Maple-Brown, Louise J; Brown, Alex; Bartold, Mark; O'Dea, Kerin; Celermajer, David; Jamieson, Lisa M

2016-01-01

To determine factors associated with routine dental attendance in Aboriginal Australians. Data of 271 Aboriginal adults residing in Australia's Northern Territory were used. Routine dental attendance was defined as last visiting a dentist less than one year ago or visiting a dentist for a check-up. Both bivariate and multivariable analytical techniques were used. While 27% visited a dentist in the past year, 29% of these visited for a check-up. In bivariate analysis, being female, low psychological distress, and low clinical attachment loss (CAL) were associated with visiting a dentist within last year. Being aged younger than 39 years, male, no oral health impairment, being caries-free, low CAL, and low apolipoprotein B were associated with visiting for a check-up. Clinical attachment loss remained associated with visiting a dentist less than one year ago while being younger than 39 years and having no oral health impairment remained associated with usually visiting for a check-up in multivariable analysis. Younger age, no oral health impairment, and low CAL were associated with routine dental attendance among Indigenous Australians.

Epidural analgesia during labour, routinely or on request: a cost-effectiveness analysis.

Science.gov (United States)

Bonouvrié, Kimberley; van den Bosch, Anouk; Roumen, Frans J M E; van Kuijk, Sander M; Nijhuis, Jan G; Evers, Silvia M A A; Wassen, Martine M L H

2016-12-01

To assess the cost-effectiveness of routine labour epidural analgesia (EA), from a societal perspective, as compared with labour analgesia on request. Women delivering of a singleton in cephalic presentation beyond 36+0 weeks' gestation were randomly allocated to routine labour EA or analgesia on request in one university and one non-university teaching hospital in the Netherlands. Costs included all medical, non-medical and indirect costs from randomisation to 6 weeks postpartum. Effectiveness was defined as a non-operative, spontaneous vaginal delivery without EA-related maternal adverse effects. Incremental cost-effectiveness ratio (ICER) was defined as the ratio of the difference in costs and the difference in effectiveness between both groups. Data were analysed according to intention to treat and divided into a base case analysis and a sensitivity analysis. Total delivery costs in the routine EA group (n=233) were higher than in the labour on request group (n=255) (difference -€ 322, 95% CI -€ 60 to € 355) due to more medication costs (including EA), a longer stay in the labour ward, and more operations including caesarean sections. Total postpartum hospital costs in the routine EA group were lower (difference -€ 344, 95% CI -€ 1338 to € 621) mainly due to less neonatal admissions (difference -€ 472, 95% CI -€ 1297 to € 331), whereas total postpartum home and others costs were comparable (difference -€ 20, 95% CI -€ 267 to € 248, and -€ 1, 95% CI -€ 67 to € 284, respectively). As a result, the overall mean costs per woman were comparable between the routine EA group and the analgesia on request group (€ 8.708 and € 8.710, respectively, mean difference -€ 2, 95% CI -€ 1.012 to € 916). Routine labour EA resulted in more deliveries with maternal adverse effects, nevertheless the ICER remained low (€ 8; bootstrap 95% CI -€ 6.120 to € 8.659). The cost-effectiveness acceptability curve indicated a low probability that

Novel structuring routines of titania films for application in photovoltaics

OpenAIRE

Niedermeier, Martin A.

2014-01-01

Novel routines to structure titania thin films on various length scales are investigated regarding photovoltaic applications. The main focus of the investigations lies on the custom-tailoring of the morphologies of the titania films using sol-gel chemistry in combination with block copolymer templating. Additionally, a low-temperature routine for functional hybrid films as well as the growth of gold as electrode material on top of an organic hole-conductor are investigated. Im Hinblick auf...

Radioprotective shield - an adequate radioprotective device for routine stomatological radiodiagnosis

Energy Technology Data Exchange (ETDEWEB)

Wiltschke, F [Ernst-Moritz-Arndt-Univ., Greifswald (German Democratic Republic); Taschner, P; Koenig, W; Menzel, B [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic)

1975-01-01

Starting from the shortcomings of the radioprotective devices at present used in routine stomatological radiodiagnosis, the authors describe the advantages of a radioprotective shield which has been produced in the Greifswald University Stomatological Clinic. On the basis of dosimetric studies, the National Board for Nuclear Safety and Radiological Protection of the GDR (Staatliches Amt fuer Atomsicherheit und Strahlenschutz der DDR) could demonstrate the suitability of this shield as a radioprotective device for routine stomatological radiodiagnosis.

Acceptability of routine offer of HIV testing (opt-out approach) among ...

African Journals Online (AJOL)

Background: With the introduction of the opt out HIV testing policy in Ghana, the HIV test is offered routinely to all pregnant women unless they decline testing. Objective: To assess acceptability of the routine offer of HIV testing antenatal clinic (ANC) clients in the Wa municipality, Ghana. Design: Cross-sectional study of 270 ...

The Surgical Teams' Perception of the Effects of a Routine Intraoperative Pause.

Science.gov (United States)

Erestam, Sofia; Angenete, Eva; Derwinger, Kristoffer

2016-12-01

A pause routine may reduce stress and errors during surgery. The aim of this study was to explore how the team, divided into the different professional groups, perceived the implementation of a pause routine and its possible impact on safety. A pause routine was introduced at a University hospital operating theatre in Sweden in 2013. Questionnaires were distributed about 1 year later to all members of the operating theatre team. The questions included different perspectives of possible effects of the pause routine. A majority were positive to scheduled pauses. The surgeons often felt refreshed and at times changed their view on both anatomy and their surgical strategy. They were also perceived by other team members as improved regarding communication. All groups felt that patient safety was promoted. There were differences by profession in perception of team communication. The pause routine was well perceived by the surgical team. A majority believed that scheduled and regular pauses contribute to improved patient safety and better team communication. There were also findings of differences in communication and experience of team coherence between personnel categories that could benefit from further acknowledgement and exploration.

Accurate Multisteps Traffic Flow Prediction Based on SVM

Directory of Open Access Journals (Sweden)

Zhang Mingheng

2013-01-01

Full Text Available Accurate traffic flow prediction is prerequisite and important for realizing intelligent traffic control and guidance, and it is also the objective requirement for intelligent traffic management. Due to the strong nonlinear, stochastic, time-varying characteristics of urban transport system, artificial intelligence methods such as support vector machine (SVM are now receiving more and more attentions in this research field. Compared with the traditional single-step prediction method, the multisteps prediction has the ability that can predict the traffic state trends over a certain period in the future. From the perspective of dynamic decision, it is far important than the current traffic condition obtained. Thus, in this paper, an accurate multi-steps traffic flow prediction model based on SVM was proposed. In which, the input vectors were comprised of actual traffic volume and four different types of input vectors were compared to verify their prediction performance with each other. Finally, the model was verified with actual data in the empirical analysis phase and the test results showed that the proposed SVM model had a good ability for traffic flow prediction and the SVM-HPT model outperformed the other three models for prediction.

Patient decision aids in routine maternity care: Benefits, barriers, and new opportunities.

Science.gov (United States)

Stevens, Gabrielle; Thompson, Rachel; Watson, Bernadette; Miller, Yvette D

2016-02-01

Participation in decision-making, supported by comprehensive and quality information provision, is increasingly emphasised as a priority for women in maternity care. Patient decision aids are tools that can offer women greater access to information and guidance to participate in maternity care decision-making. Relative to their evaluation in controlled settings, the implementation of patient decision aids in routine maternity care has received little attention and our understanding of which approaches may be effective is limited. This paper critically discusses the application of patient decision aids in routine maternity care and explores viable solutions for promoting their successful uptake. A range of patient decision aids have been developed for use within maternity care, and controlled trials have highlighted their positive impact on the decision-making process for women. Nevertheless, evidence of successful patient decision aid implementation in real world health care settings is lacking due to practical and ideological barriers that exist. Patient-directed social marketing campaigns are a relatively novel approach to patient decision aid delivery that may facilitate their adoption in maternity care, at least in the short-term, by overcoming common implementation barriers. Social marketing may also be particularly well suited to maternity care, given the unique characteristics of this health context. The potential of social marketing campaigns to facilitate patient decision aid adoption in maternity care highlights the need for pragmatic trials to evaluate their effectiveness. Identifying which sub-groups of women are more or less likely to respond to these strategies will further direct implementation. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Nanomanufacturing of titania interfaces with controlled structural and functional properties by supersonic cluster beam deposition

International Nuclear Information System (INIS)

Podestà, Alessandro; Borghi, Francesca; Indrieri, Marco; Bovio, Simone; Piazzoni, Claudio; Milani, Paolo

2015-01-01

Great emphasis is placed on the development of integrated approaches for the synthesis and the characterization of ad hoc nanostructured platforms, to be used as templates with controlled morphology and chemical properties for the investigation of specific phenomena of great relevance in interdisciplinary fields such as biotechnology, medicine, and advanced materials. Here, we discuss the crucial role and the advantages of thin film deposition strategies based on cluster-assembling from supersonic cluster beams. We select cluster-assembled nanostructured titania (ns-TiO 2 ) as a case study to demonstrate that accurate control over morphological parameters can be routinely achieved, and consequently, over several relevant interfacial properties and phenomena, like surface charging in a liquid electrolyte, and proteins and nanoparticles adsorption. In particular, we show that the very good control of nanoscale morphology is obtained by taking advantage of simple scaling laws governing the ballistic deposition regime of low-energy, mass-dispersed clusters with reduced surface mobility

Nanomanufacturing of titania interfaces with controlled structural and functional properties by supersonic cluster beam deposition

Energy Technology Data Exchange (ETDEWEB)

Podestà, Alessandro, E-mail: alessandro.podesta@mi.infn.it, E-mail: pmilani@mi.infn.it; Borghi, Francesca; Indrieri, Marco; Bovio, Simone; Piazzoni, Claudio; Milani, Paolo, E-mail: alessandro.podesta@mi.infn.it, E-mail: pmilani@mi.infn.it [Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (C.I.Ma.I.Na.), Dipartimento di Fisica, Università degli Studi di Milano, via Celoria 16, 20133 Milano (Italy)

2015-12-21

Great emphasis is placed on the development of integrated approaches for the synthesis and the characterization of ad hoc nanostructured platforms, to be used as templates with controlled morphology and chemical properties for the investigation of specific phenomena of great relevance in interdisciplinary fields such as biotechnology, medicine, and advanced materials. Here, we discuss the crucial role and the advantages of thin film deposition strategies based on cluster-assembling from supersonic cluster beams. We select cluster-assembled nanostructured titania (ns-TiO{sub 2}) as a case study to demonstrate that accurate control over morphological parameters can be routinely achieved, and consequently, over several relevant interfacial properties and phenomena, like surface charging in a liquid electrolyte, and proteins and nanoparticles adsorption. In particular, we show that the very good control of nanoscale morphology is obtained by taking advantage of simple scaling laws governing the ballistic deposition regime of low-energy, mass-dispersed clusters with reduced surface mobility.

Nanomanufacturing of titania interfaces with controlled structural and functional properties by supersonic cluster beam deposition

Science.gov (United States)

Podestà, Alessandro; Borghi, Francesca; Indrieri, Marco; Bovio, Simone; Piazzoni, Claudio; Milani, Paolo

2015-12-01

Great emphasis is placed on the development of integrated approaches for the synthesis and the characterization of ad hoc nanostructured platforms, to be used as templates with controlled morphology and chemical properties for the investigation of specific phenomena of great relevance in interdisciplinary fields such as biotechnology, medicine, and advanced materials. Here, we discuss the crucial role and the advantages of thin film deposition strategies based on cluster-assembling from supersonic cluster beams. We select cluster-assembled nanostructured titania (ns-TiO2) as a case study to demonstrate that accurate control over morphological parameters can be routinely achieved, and consequently, over several relevant interfacial properties and phenomena, like surface charging in a liquid electrolyte, and proteins and nanoparticles adsorption. In particular, we show that the very good control of nanoscale morphology is obtained by taking advantage of simple scaling laws governing the ballistic deposition regime of low-energy, mass-dispersed clusters with reduced surface mobility.

Invasive meningococcal disease epidemiology and control measures: a framework for evaluation

Directory of Open Access Journals (Sweden)

Coudeville L

2007-06-01

Full Text Available Abstract Background Meningococcal disease can have devastating consequences. As new vaccines emerge, it is necessary to assess their impact on public health. In the absence of long-term real world data, modeling the effects of different vaccination strategies is required. Discrete event simulation provides a flexible platform with which to conduct such evaluations. Methods A discrete event simulation of the epidemiology of invasive meningococcal disease was developed to quantify the potential impact of implementing routine vaccination of adolescents in the United States with a quadrivalent conjugate vaccine protecting against serogroups A, C, Y, and W-135. The impact of vaccination is assessed including both the direct effects on individuals vaccinated and the indirect effects resulting from herd immunity. The simulation integrates a variety of epidemiologic and demographic data, with core information on the incidence of invasive meningococcal disease and outbreak frequency derived from data available through the Centers for Disease Control and Prevention. Simulation of the potential indirect benefits of vaccination resulting from herd immunity draw on data from the United Kingdom, where routine vaccination with a conjugate vaccine has been in place for a number of years. Cases of disease are modeled along with their health consequences, as are the occurrence of disease outbreaks. Results When run without a strategy of routine immunization, the simulation accurately predicts the age-specific incidence of invasive meningococcal disease and the site-specific frequency of outbreaks in the Unite States. 2,807 cases are predicted annually, resulting in over 14,000 potential life years lost due to invasive disease. In base case analyses of routine vaccination, life years lost due to infection are reduced by over 45% (to 7,600 when routinely vaccinating adolescents 12 years of age at 70% coverage. Sensitivity analyses indicate that herd immunity plays

performance routines followed by free throw shooting accuracy in secondary basketball players

Directory of Open Access Journals (Sweden)

Phelps Ashley

2015-12-01

Full Text Available Study aim: The purpose of the current study was to determine whether existing pre-performance routines had an effect on free throw shooting accuracy in high school pupils as compared to shooting without a pre-performance routine.

Approaching system equilibrium with accurate or not accurate feedback information in a two-route system

Science.gov (United States)

Zhao, Xiao-mei; Xie, Dong-fan; Li, Qi

2015-02-01

With the development of intelligent transport system, advanced information feedback strategies have been developed to reduce traffic congestion and enhance the capacity. However, previous strategies provide accurate information to travelers and our simulation results show that accurate information brings negative effects, especially in delay case. Because travelers prefer to the best condition route with accurate information, and delayed information cannot reflect current traffic condition but past. Then travelers make wrong routing decisions, causing the decrease of the capacity and the increase of oscillations and the system deviating from the equilibrium. To avoid the negative effect, bounded rationality is taken into account by introducing a boundedly rational threshold BR. When difference between two routes is less than the BR, routes have equal probability to be chosen. The bounded rationality is helpful to improve the efficiency in terms of capacity, oscillation and the gap deviating from the system equilibrium.

Capturing the True Value of Assistive Technologies to Consumers in Routine Outcome Measurement

Directory of Open Access Journals (Sweden)

Desleigh de Jonge

2016-10-01

Full Text Available (1 Background: Recent reforms in Australia, providing people with disability and older people with choice and control over allocated funding, have altered consumer expectations and transformed the landscape of assistive technology (AT service provision. The purpose of this study is to report on the routine AT outcomes of people who accessed an AT consultation service and examine how well these capture the impact of AT on their lives; (2 Methods: This study, which uses mixed methods for concurrent triangulation of the data, reports on the outcomes for 127 people who acquired a range of assistive technology in 2015 and examines the adequacy of an existing service outcome framework in capturing the true value of these technologies to AT users. Outcome data was routinely collected by a community service 2–4 months following an AT consultation. A telephone or face-to-face interview gathered demographic information as well as AT outcomes, using two standardized tools, the Individualized Prioritised Problem Assessment (IPPA and the EATS 6D. Qualitative comments relating to the impact of the AT on the person’s life were also documented; (3 Results: The acquired AT generally met or exceeded expectations of the person using the AT and the attending health professional. Overall, people experienced decreased difficulty and increased feelings of autonomy, with most of the reported improvements identified in mobility and usual activities; (4 Conclusion: Routine outcome data provide some evidence of the value of AT in addressing concerns as identified by clients. Qualitative data, which captured the impact of AT on people’s lives, suggest that the empowering and transformative aspects of AT are not currently being captured by existing measures.

Cyclotrons, radionuclides, precursors, and demands for routine versus research compounds

International Nuclear Information System (INIS)

Wolf, A.P.

1984-01-01

Accelerators for producing commonly used short-lived positron emitters for positron emission tomography are addressed in the context of their use for the preparation of labeled compounds for research and routine biomedical applications. Progress and direction in the preparation and use of radiotracers for studies of the brain are discussed. Advancement to complete automation is stressed as an important factor for the eventual use of positron emission tomography as a routine clinical tool in universities and major medical centers

Age at BCG administration during routine immunization.

African Journals Online (AJOL)

Age at BCG administration during routine immunization. R.D. Wammanda , M.J. Gambo and I. Abdulkadir. Department of Paediatrics,. Ahmadu Bello University Teaching Hospital,. Zaria. Correspondence to: Dr.R.D. Wammanda. Email: wammanda@yahoo.com. Summary. In Nigeria, as part of the National Programme on ...

Community Pharmacies As Possible Centres For Routine ...

African Journals Online (AJOL)

Method: Sixty (60) pre-tested questionnaires were randomly administered to community pharmacists. Forty-three (43) questionnaires were retrieved for analysis. Results: The study revealed that the use of community pharmacies as places where routine immunization services can be provided is feasible as shown by 95.3% ...

Individual Values, Learning Routines and Academic Procrastination

Science.gov (United States)

Dietz, Franziska; Hofer, Manfred; Fries, Stefan

2007-01-01

Background: Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. Aims: The…

A routine PET/CT protocol with simple calculations for assessing cardiac amyloid using 18F-Florbetapir

Directory of Open Access Journals (Sweden)

Dustin Ryan Osborne

2015-05-01

Full Text Available Introduction: Cardiac amyloidosis is a rare condition characterized by the deposition of well-structured protein fibrils, proteoglycans, and serum proteins as amyloid. Recent work has shown that it may be possible to use 18F-Florbetapir to image cardiac amyloidosis. Current methods for assessment include invasive biopsy techniques. This work enhances foundational work by Dorbala et al. by developing a routine imaging and analysis protocol using 18F-Florbetapir for cardiac amyloid assessment.Methods: Ten patients, 3 healthy controls and 7 amyloid positive patients, were imaged using 18F-Florbetapir to assess cardiac amyloid burden. Four of the patients also were imaged using 82Rb-Chloride to evaluate possible 18F-Florbetapir retention because of reduced myocardial blood flow. Quantitative methods using modeling, SUVs and SUV ratios were used to define a new streamlined clinical imaging protocol that could be used routinely and provide patient stratification.Results: Quantitative analysis of 18F-Florbetapir cardiac amyloid data were compiled from a 20 minute listmode protocol with data histogrammed into two static images at 0-5 minutes and, 10-15 min or 15-20 min. Data analysis indicated the use of SUVs or ratios of SUVs calculated from regions draw in the septal wall were adequate in identification of all healthy controls from amyloid positive patients in this small cohort. Additionally, we found that it may be possible to use this method to differentiate patients suffering from AL vs. TTR amyloid.Conclusions: This work builds on the seminal work by Dorbala et Al. by describing a short 18F-Florbetapir imaging protocol that is suitable for routine clinical use and uses a simple method for quantitative analysis of cardiac amyloid disease.

A New Cluster Analysis-Marker-Controlled Watershed Method for Separating Particles of Granular Soils.

Science.gov (United States)

Alam, Md Ferdous; Haque, Asadul

2017-10-18

An accurate determination of particle-level fabric of granular soils from tomography data requires a maximum correct separation of particles. The popular marker-controlled watershed separation method is widely used to separate particles. However, the watershed method alone is not capable of producing the maximum separation of particles when subjected to boundary stresses leading to crushing of particles. In this paper, a new separation method, named as Monash Particle Separation Method (MPSM), has been introduced. The new method automatically determines the optimal contrast coefficient based on cluster evaluation framework to produce the maximum accurate separation outcomes. Finally, the particles which could not be separated by the optimal contrast coefficient were separated by integrating cuboid markers generated from the clustering by Gaussian mixture models into the routine watershed method. The MPSM was validated on a uniformly graded sand volume subjected to one-dimensional compression loading up to 32 MPa. It was demonstrated that the MPSM is capable of producing the best possible separation of particles required for the fabric analysis.

Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial.

Science.gov (United States)

Aung, Myo Nyein; Yuasa, Motoyuki; Lorga, Thaworn; Moolphate, Saiyud; Fukuda, Hiroshi; Kitajima, Tsutomu; Yokokawa, Hirohide; Minematsu, Kazuo; Tanimura, Susumu; Hiratsuka, Yoshimune; Ono, Koichi; Naunboonruang, Prissana; Thinuan, Payom; Kawai, Sachio; Suya, Yaoyanee; Chumvicharana, Somboon; Marui, Eiji

2013-12-05

Smoking cessation is a high-priority intervention to prevent CVD events and deaths in developing countries. While several interventions to stop smoking have been proved successful, the question of how to increase their effectiveness and practicality in developing countries remains. In this study, a newly devised evidence-based smoking cessation service package will be compared with the existing service in a randomized controlled trial within the community setting of Thailand. This randomized control trial will recruit 440 current smokers at CVD risk because of being diabetic and/or hypertensive. Informed, consented participants will be randomly allocated into the new service-package arm and the routine service arm. The study will take place in the non-communicable disease clinics of the Maetha District Hospital, Lampang, northern Thailand. The new smoking-cessation service-package comprises (1) regular patient motivation and coaching from the same primary care nurse over a 3-month period; (2) monthly application of piCO + smokerlyzer to sustain motivation of smoker's quitting attempt and provide positive feedback over a 3-month period; (3) assistance by an assigned family member; (4) nicotine replacement chewing gum to relieve withdrawal symptoms. This new service will be compared with the traditional routine service comprising the 5A approach in a 1-year follow-up. Participants who consent to participate in the study but refuse to attempt quitting smoking will be allocated to the non-randomized arm, where they will be just followed up and monitored. Primary outcome of the study is smoking cessation rate at 1-year follow-up proven by breath analysis measuring carbomonoxide in parts per million in expired air. Secondary outcomes are smoking cessation rate at the 6-month follow-up, blood pressure and heart rate, CVD risk according to the Framingham general cardiovascular risk score, CVD events and deaths at the 12-month follow-up, and the cost-effectiveness of the

Shared Decision Making in mental health care using Routine Outcome Monitoring as a source of information: a cluster randomised controlled trial

NARCIS (Netherlands)

Metz, M.J.; Franx, G.C.; Verbeek, M.A.; de Beurs, E.; van der Feltz-Cornelis, C.M.; Beekman, A.T.

2015-01-01

Background Shared Decision Making (SDM) is a way to empower patients when decisions are made about treatment. In order to be effective agents in this process, patients need access to information of good quality. Routine Outcome Monitoring (ROM) may provide such information and therefore may be a key

Interval of Routine Maintenance and Maintenance Performance: A Literature Review

Directory of Open Access Journals (Sweden)

Au-Yong Cheong Peng

2016-01-01

Full Text Available In high-rise residential buildings, the quality of facilities management services is significant to the normal operation of the facilities. Unfortunately, lack of concern towards building maintenance, especially preventive maintenance, happens in domestic housing industry in Malaysia. Majority of the maintenance operations of condominiums suffer from lack of planning, lack of proactive maintenance plan, and lack of proper implementation. Thus, this paper reviews the implementation of preventive maintenance strategy, routine maintenance in specific. An extensive review of literature published in 1987 to 2014 is performed for the purpose of this research. The publications are sourced from journal articles, conference proceedings and books. The literature analysis confirms that the routine maintenance of facilities and building services is vital and it can be influential towards the maintenance performance. Subsequently, a theoretical framework is developed, which shows the relationship between routine maintenance of building facilities & services and maintenance performance. The building facilities & services are divided into two categories. They are essential facilities & services that ensure the safety, health, habitability, and operability of buildings; while value-added facilities & services deal with property value, return on investment, and quality living of buildings. Based on the findings, a future research is proposed, which aims to identify the appropriate routine of maintenance for the facilities and services in high-rise residential buildings to improve the maintenance performance.

Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway

Science.gov (United States)

2010-01-15

information. 2.0 DESCRIPTION Naval Submarine Medical Research Laboratory (NSMRL) is seeking information from the eyewear industry that will provide...Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway by Alison America, MA Wayne G. Horn, MD...Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway 50818 Alison America, MA Wayne G. Horn, MD Naval Submarine Medical Research

Cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Buell, U.; Winkler, U.

1983-09-01

Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases.

A Machine Learned Classifier That Uses Gene Expression Data to Accurately Predict Estrogen Receptor Status

Science.gov (United States)

Bastani, Meysam; Vos, Larissa; Asgarian, Nasimeh; Deschenes, Jean; Graham, Kathryn; Mackey, John; Greiner, Russell

2013-01-01

Background Selecting the appropriate treatment for breast cancer requires accurately determining the estrogen receptor (ER) status of the tumor. However, the standard for determining this status, immunohistochemical analysis of formalin-fixed paraffin embedded samples, suffers from numerous technical and reproducibility issues. Assessment of ER-status based on RNA expression can provide more objective, quantitative and reproducible test results. Methods To learn a parsimonious RNA-based classifier of hormone receptor status, we applied a machine learning tool to a training dataset of gene expression microarray data obtained from 176 frozen breast tumors, whose ER-status was determined by applying ASCO-CAP guidelines to standardized immunohistochemical testing of formalin fixed tumor. Results This produced a three-gene classifier that can predict the ER-status of a novel tumor, with a cross-validation accuracy of 93.17±2.44%. When applied to an independent validation set and to four other public databases, some on different platforms, this classifier obtained over 90% accuracy in each. In addition, we found that this prediction rule separated the patients' recurrence-free survival curves with a hazard ratio lower than the one based on the IHC analysis of ER-status. Conclusions Our efficient and parsimonious classifier lends itself to high throughput, highly accurate and low-cost RNA-based assessments of ER-status, suitable for routine high-throughput clinical use. This analytic method provides a proof-of-principle that may be applicable to developing effective RNA-based tests for other biomarkers and conditions. PMID:24312637

Determination of accurate metal silicide layer thickness by RBS

International Nuclear Information System (INIS)

Kirchhoff, J.F.; Baumann, S.M.; Evans, C.; Ward, I.; Coveney, P.

1995-01-01

Rutherford Backscattering Spectrometry (RBS) is a proven useful analytical tool for determining compositional information of a wide variety of materials. One of the most widely utilized applications of RBS is the study of the composition of metal silicides (MSi x ), also referred to as polycides. A key quantity obtained from an analysis of a metal silicide is the ratio of silicon to metal (Si/M). Although compositional information is very reliable in these applications, determination of metal silicide layer thickness by RBS techniques can differ from true layer thicknesses by more than 40%. The cause of these differences lies in how the densities utilized in the RBS analysis are calculated. The standard RBS analysis software packages calculate layer densities by assuming each element's bulk densities weighted by the fractional atomic presence. This calculation causes large thickness discrepancies in metal silicide thicknesses because most films form into crystal structures with distinct densities. Assuming a constant layer density for a full spectrum of Si/M values for metal silicide samples improves layer thickness determination but ignores the underlying physics of the films. We will present results of RBS determination of the thickness various metal silicide films with a range of Si/M values using a physically accurate model for the calculation of layer densities. The thicknesses are compared to scanning electron microscopy (SEM) cross-section micrographs. We have also developed supporting software that incorporates these calculations into routine analyses. (orig.)

Routine chest X-ray in the allergy clinic

International Nuclear Information System (INIS)

Garcia-Barredo, M.R.; Usamentiaga, E.; Fidalgo, I.

1997-01-01

To determine whether routine chest X-ray is indicated in allergy patients when there is no evidence of cardiopulmonary involvement. A retrospective study to analyze the indications and radiologic findings in 515 consecutive patients who underwent chest X-ray: Positive findings were considered to be any radiological sing that led to the performance of additional diagnostic measures or a change in the therapeutic management of the patient. Positive radiologic findings were observed in 39 cases (7.59%). Only two patients (0.38%) were diagnosed as having diseases that were susceptible to proper treatment. In one of them (0.19%), the failure to perform chest X-ray would have impeded the introduction of proper treatment. We do not recommend carrying out routine chest X-ray in this patient population. (Author) 7 refs

SVM detection of epileptiform activity in routine EEG.

LENUS (Irish Health Repository)

Kelleher, Daniel

2010-01-01

Routine electroencephalogram (EEG) is an important test in aiding the diagnosis of patients with suspected epilepsy. These recordings typically last 20-40 minutes, during which signs of abnormal activity (spikes, sharp waves) are looked for in the EEG trace. It is essential that events of short duration are detected during the routine EEG test. The work presented in this paper examines the effect of changing a range of input values to the detection system on its ability to distinguish between normal and abnormal EEG activity. It is shown that the length of analysis window in the range of 0.5s to 1s are well suited to the task. Additionally, it is reported that patient specific systems should be used where possible due to their better performance.

Ordinary and partial differential equation routines in C, C++, Fortran, Java, Maple, and Matlab

CERN Document Server

Lee, HJ

2003-01-01

This book provides a set of ODE/PDE integration routines in the six most widely used computer languages, enabling scientists and engineers to apply ODE/PDE analysis toward solving complex problems. This text concisely reviews integration algorithms and then analyzes the widely used Runge-Kutta method. It first presents a complete code before discussing its components in detail, focusing on integration concepts such as error monitoring and control. The format allows readers to understand the basics of ODE/PDE integration, and then calculate sample numerical solutions within the targeted program

Children′s behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial

Directory of Open Access Journals (Sweden)

Ali Bagherian

2016-01-01

Conclusion: It may be concluded that the cotton-roll vibration method can be more helpful than the routine topical anesthesia in reducing behavioral pain reactions in children during local anesthesia administration.

Calculation of accurate small angle X-ray scattering curves from coarse-grained protein models

Directory of Open Access Journals (Sweden)

Stovgaard Kasper

2010-08-01

Full Text Available Abstract Background Genome sequencing projects have expanded the gap between the amount of known protein sequences and structures. The limitations of current high resolution structure determination methods make it unlikely that this gap will disappear in the near future. Small angle X-ray scattering (SAXS is an established low resolution method for routinely determining the structure of proteins in solution. The purpose of this study is to develop a method for the efficient calculation of accurate SAXS curves from coarse-grained protein models. Such a method can for example be used to construct a likelihood function, which is paramount for structure determination based on statistical inference. Results We present a method for the efficient calculation of accurate SAXS curves based on the Debye formula and a set of scattering form factors for dummy atom representations of amino acids. Such a method avoids the computationally costly iteration over all atoms. We estimated the form factors using generated data from a set of high quality protein structures. No ad hoc scaling or correction factors are applied in the calculation of the curves. Two coarse-grained representations of protein structure were investigated; two scattering bodies per amino acid led to significantly better results than a single scattering body. Conclusion We show that the obtained point estimates allow the calculation of accurate SAXS curves from coarse-grained protein models. The resulting curves are on par with the current state-of-the-art program CRYSOL, which requires full atomic detail. Our method was also comparable to CRYSOL in recognizing native structures among native-like decoys. As a proof-of-concept, we combined the coarse-grained Debye calculation with a previously described probabilistic model of protein structure, TorusDBN. This resulted in a significant improvement in the decoy recognition performance. In conclusion, the presented method shows great promise for

Routine hemoglobin electrophoresis for pediatric surgery day case ...

African Journals Online (AJOL)

2015-09-25

Sep 25, 2015 ... 2016 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer - Medknow ... surgery day case in at-risk populations: Suggested algorithm for screening .... HBE is a routine preoperative investigation before a surgical ...

Pink-Beam, Highly-Accurate Compact Water Cooled Slits

International Nuclear Information System (INIS)

Lyndaker, Aaron; Deyhim, Alex; Jayne, Richard; Waterman, Dave; Caletka, Dave; Steadman, Paul; Dhesi, Sarnjeet

2007-01-01

Advanced Design Consulting, Inc. (ADC) has designed accurate compact slits for applications where high precision is required. The system consists of vertical and horizontal slit mechanisms, a vacuum vessel which houses them, water cooling lines with vacuum guards connected to the individual blades, stepper motors with linear encoders, limit (home position) switches and electrical connections including internal wiring for a drain current measurement system. The total slit size is adjustable from 0 to 15 mm both vertically and horizontally. Each of the four blades are individually controlled and motorized. In this paper, a summary of the design and Finite Element Analysis of the system are presented

A control study of TACE using high-dosed and routine-dosed iodized oil as a treatment of large hepatocellular carcinoma

International Nuclear Information System (INIS)

Zhou Junmin; Zhan Jincheng; Zhang Zhenming

2005-01-01

Objective: To investigate the side effects and curative effect in high-dosed lipiodol-transcatheter arterial chemoembolization as a treatment of large hepatocellular carcinoma. Methods: 79 patients with unresectable hepatocellular carcinoma were treated by TACE, and divided into 2 groups. In group A, 39 patients with the tumor sized 7-18cm in diameter, routine-dosed, 10-20ml lipiodol was given in TACE. 40 patients were enrolled in the high-dosed group B, who were given more than 20ml iodized oil in TACE. Results: The First to third year survival rate of group A was 66.7%, 33.3%, 0% respectively,while in group B it was 75%, 45%, 7.5% respectively. The effective rate was 71.7% in Group A and 87.5% in Group B. There was a significant difference between both groups. There was no significant difference of critical side effects and liver function damage between group A and B. Conclusion: High-dosed lipiodol chemoembolization as a treatment of unresectable hepatocellular carcinoma is superior to the routine TACE, especially when the tumor is large and the liver function reserve is good. (authors)

Widely applicable MATLAB routines for automated analysis of saccadic reaction times.

Science.gov (United States)

Leppänen, Jukka M; Forssman, Linda; Kaatiala, Jussi; Yrttiaho, Santeri; Wass, Sam

2015-06-01

Saccadic reaction time (SRT) is a widely used dependent variable in eye-tracking studies of human cognition and its disorders. SRTs are also frequently measured in studies with special populations, such as infants and young children, who are limited in their ability to follow verbal instructions and remain in a stable position over time. In this article, we describe a library of MATLAB routines (Mathworks, Natick, MA) that are designed to (1) enable completely automated implementation of SRT analysis for multiple data sets and (2) cope with the unique challenges of analyzing SRTs from eye-tracking data collected from poorly cooperating participants. The library includes preprocessing and SRT analysis routines. The preprocessing routines (i.e., moving median filter and interpolation) are designed to remove technical artifacts and missing samples from raw eye-tracking data. The SRTs are detected by a simple algorithm that identifies the last point of gaze in the area of interest, but, critically, the extracted SRTs are further subjected to a number of postanalysis verification checks to exclude values contaminated by artifacts. Example analyses of data from 5- to 11-month-old infants demonstrated that SRTs extracted with the proposed routines were in high agreement with SRTs obtained manually from video records, robust against potential sources of artifact, and exhibited moderate to high test-retest stability. We propose that the present library has wide utility in standardizing and automating SRT-based cognitive testing in various populations. The MATLAB routines are open source and can be downloaded from http://www.uta.fi/med/icl/methods.html .

Peri-colonic haematoma following routine colonoscopy

OpenAIRE

Felicity Page; Olfunso Adedeji

2016-01-01

Introduction: We present a case of an extra-luminal haematoma following routine colonoscopy. This case highlights an uncommon but potentially life threatening complication in which there is little published literature to date. Presentation of case: A 73 year old male presented with abdominal pain and a reduction in haemoglobin following an uneventful colonoscopy. The imaging had been required as part of colorectal cancer follow up. Initial differential diagnosis included colonic perforatio...

The Yield from Routine Chest X-Rays in Stage 3 Breast Cancer ...

African Journals Online (AJOL)

Context: Cancer of the breast is a common malignancy in Nigerian women and various imaging examinations, including the chest radiograph are routinely requested in all patients with this disease. Objective: The objective of this study was to determine the positive yield from routine chest radiographs in Nigerian patients ...

Predicament in detection and reporting of extended spectrum beta lactamase production in routine antibiotic susceptibility testing

International Nuclear Information System (INIS)

Butt, T.; Butt, E.; Raza, S.

2017-01-01

This descriptive and cross-sectional study was planned to determine the dilemma of inadvertent detection of extended spectrum beta lactamase (ESBL) production in Enterobacteriaceaewhen using inhibition zone size of antibiotic disks of Cefotaxime or Aztreonam in routine antibiotic susceptibility testing as recommended by Clinical Laboratory Standards Institute (CLSI). Screening and double disk tests were adopted as per CLSI. Escherichia coli ATCC 25922 was used as control strain. Among total specimens of 5346, there were 348 isolates of Escherichia coli(n=235), Klebsiella pneumonia (n=92), Klebsiella oxytoca(n=3) or Proteus mirabilus(n=18). The screening method recommended by CLSI significantly falsely detected ESBL production in 79 (32.3%) isolates (p<0.0001). ESBL detection is important as its frequency is high and treatment of the infection varies with the presence and absence of ESBL. To avoid false reporting, proper phenotypic detection of ESBL confirmatory method-like double-disk synergy test, should be used routinely. (author)

Analytical method development and validation for quantification of uranium by Fourier Transform Infrared Spectroscopy (FTIR) for routine quality control analysis

International Nuclear Information System (INIS)

Pereira, Elaine; Silva, Ieda de S.; Gomide, Ricardo G.; Pires, Maria Aparecida F.

2015-01-01

This work presents a low cost, simple and new methodology for direct determination uranium in different matrices uranium: organic phase (UO 2 (NO 3 ) 2 .2TBP - uranyl nitrate complex) and aqueous phase (UO 2 (NO 3 ) 2 - NTU - uranyl nitrate), based on Fourier Transform Infrared spectroscopy (FTIR) using KBr pellets technique. The analytical validation is essential to define if a developed methodology is completely adjusted to the objectives that it is destined and is considered one of the main instruments of quality control. The parameters used in the validation process were: selectivity, linearity, limits of detection (LD) and quantitation (LQ), precision (repeatability and intermediate precision), accuracy and robustness. The method for uranium in organic phase (UO 2 (NO 3 ) 2 .2TBP in hexane/embedded in KBr) was linear (r=0.9989) over the range of 1.0 g L -1 a 14.3 g L -1 , LD were 92.1 mg L -1 and LQ 113.1 mg L -1 , precision (RSD < 1.6% and p-value < 0.05), accurate (recovery of 100.1% - 102.9%). The method for uranium aqueous phase (UO 2 (NO 3 )2/embedded in KBr) was linear (r=0.9964) over the range of 5.4 g L -1 a 51.2 g L -1 , LD were 835 mg L -1 and LQ 958 mg L -1 , precision (RSD < 1.0% and p-value < 0.05), accurate (recovery of 99.1% - 102.0%). The FTIR method is robust regarding most of the variables analyzed, as the difference between results obtained under nominal and modified conditions were lower than the critical value for all analytical parameters studied. Some process samples were analyzed in FTIR and compared with gravimetric and x ray fluorescence (XRF) analyses showing similar results in all three methods. The statistical tests (Student-t and Fischer) showed that the techniques are equivalent. (author)

Toward Accurate On-Ground Attitude Determination for the Gaia Spacecraft

Science.gov (United States)

Samaan, Malak A.

2010-03-01

The work presented in this paper concerns the accurate On-Ground Attitude (OGA) reconstruction for the astrometry spacecraft Gaia in the presence of disturbance and of control torques acting on the spacecraft. The reconstruction of the expected environmental torques which influence the spacecraft dynamics will be also investigated. The telemetry data from the spacecraft will include the on-board real-time attitude, which is of order of several arcsec. This raw attitude is the starting point for the further attitude reconstruction. The OGA will use the inputs from the field coordinates of known stars (attitude stars) and also the field coordinate differences of objects on the Sky Mapper (SM) and Astrometric Field (AF) payload instruments to improve this raw attitude. The on-board attitude determination uses a Kalman Filter (KF) to minimize the attitude errors and produce a more accurate attitude estimation than the pure star tracker measurement. Therefore the first approach for the OGA will be an adapted version of KF. Furthermore, we will design a batch least squares algorithm to investigate how to obtain a more accurate OGA estimation. Finally, a comparison between these different attitude determination techniques in terms of accuracy, robustness, speed and memory required will be evaluated in order to choose the best attitude algorithm for the OGA. The expected resulting accuracy for the OGA determination will be on the order of milli-arcsec.

32 CFR 318.14 - Blanket routine uses.

Science.gov (United States)

2010-07-01

... interest of simplicity, economy and to avoid redundancy. (b) Routine Use—Law Enforcement. If a system of... to the OMB in connection with the review of private relief legislation as set forth in OMB Circular A-19 at any stage of the legislative coordination and clearance process as set forth in that Circular...

Taking a new biomarker into routine use – A perspective from the routine clinical biochemistry laboratory

Science.gov (United States)

Sturgeon, Catharine; Hill, Robert; Hortin, Glen L; Thompson, Douglas

2010-01-01

There is increasing pressure to provide cost-effective healthcare based on “best practice.” Consequently, new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence base and if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test, ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefit studies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway. From the laboratory perspective, pre-analytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker in relevant physiological matrices is essential to avoid the need for special processing. Absence of specific timing requirements for sampling and knowledge of the effect of medications that might be used to treat the patients in whom the biomarker will be measured is also highly desirable. Analytically, automation is essential in modern high-throughput clinical laboratories. Assays must therefore be robust, fulfilling standard requirements for linearity on dilution, precision and reproducibility, both within- and between-run. Provision of measurements by a limited number of specialized reference laboratories may be most appropriate, especially when a new biomarker is first introduced into routine practice. PMID:21137030

Automatic and accurate reconstruction of distal humerus contours through B-Spline fitting based on control polygon deformation.

Science.gov (United States)

Mostafavi, Kamal; Tutunea-Fatan, O Remus; Bordatchev, Evgueni V; Johnson, James A

2014-12-01

The strong advent of computer-assisted technologies experienced by the modern orthopedic surgery prompts for the expansion of computationally efficient techniques to be built on the broad base of computer-aided engineering tools that are readily available. However, one of the common challenges faced during the current developmental phase continues to remain the lack of reliable frameworks to allow a fast and precise conversion of the anatomical information acquired through computer tomography to a format that is acceptable to computer-aided engineering software. To address this, this study proposes an integrated and automatic framework capable to extract and then postprocess the original imaging data to a common planar and closed B-Spline representation. The core of the developed platform relies on the approximation of the discrete computer tomography data by means of an original two-step B-Spline fitting technique based on successive deformations of the control polygon. In addition to its rapidity and robustness, the developed fitting technique was validated to produce accurate representations that do not deviate by more than 0.2 mm with respect to alternate representations of the bone geometry that were obtained through different-contact-based-data acquisition or data processing methods. © IMechE 2014.

The role of routine preoperative EUS when performed after contrast enhanced CT in the diagnostic work-up in patients suspected of pancreatic or periampullary cancer.

Science.gov (United States)

Cieslak, Kasia P; van Santvoort, Hjalmar C; Vleggaar, Frank P; van Leeuwen, Maarten S; ten Kate, Fibo J; Besselink, Marc G; Molenaar, I Quintus

2014-01-01

In patients suspected of pancreatic or periampullary cancer, abdominal contrast-enhanced computed tomography (CT) is the standard diagnostic modality. A supplementary endoscopic ultrasonography (EUS) is often performed, although there is only limited evidence of its additional diagnostic value. The aim of the study is to evaluate the additional diagnostic value of EUS over CT in deciding on exploratory laparotomy in patients suspected of pancreatic or periampullary cancer. We retrospectively analyzed 86 consecutive patients who routinely underwent CT and EUS before exploratory laparotomy with or without pancreatoduodenectomy for suspected pancreatic or periampullary carcinoma between 2007 and 2010. Primary outcomes were visibility of a mass, resectability on CT/EUS and resection with curative intent. A mass was visible on CT in 72/86 (84%) patients. In these 72 patients, EUS demonstrated a mass in 64/72 (89%) patients. Resectability was accurately predicted by CT in 65/72 (90%) and by EUS in 58/72 (81%) patients. In 14/86 (16%) patients no mass was seen on CT. EUS showed a mass in 12/14 (86%) of these patients. A malignant lesion was histological proven in 11/12 (92%) of these patients. Overall, resectability was accurately predicted by CT and EUS in 90% (77/86) and 84% (72/86), respectively. In patients with a visible mass on CT, suspected for pancreatic or periampullary cancer, EUS has no additional diagnostic value, does not influence the decision to perform laparotomy and should therefore not be performed routinely. In patients without a visible mass on CT, EUS is useful to confirm the presence of a tumor. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Interpolation Routines Assessment in ALS-Derived Digital Elevation Models for Forestry Applications

Directory of Open Access Journals (Sweden)

Antonio Luis Montealegre

2015-07-01

Full Text Available Airborne Laser Scanning (ALS is capable of estimating a variety of forest parameters using different metrics extracted from the normalized heights of the point cloud using a Digital Elevation Model (DEM. In this study, six interpolation routines were tested over a range of land cover and terrain roughness in order to generate a collection of DEMs with spatial resolution of 1 and 2 m. The accuracy of the DEMs was assessed twice, first using a test sample extracted from the ALS point cloud, second using a set of 55 ground control points collected with a high precision Global Positioning System (GPS. The effects of terrain slope, land cover, ground point density and pulse penetration on the interpolation error were examined stratifying the study area with these variables. In addition, a Classification and Regression Tree (CART analysis allowed the development of a prediction uncertainty map to identify in which areas DEMs and Airborne Light Detection and Ranging (LiDAR derived products may be of low quality. The Triangulated Irregular Network (TIN to raster interpolation method produced the best result in the validation process with the training data set while the Inverse Distance Weighted (IDW routine was the best in the validation with GPS (RMSE of 2.68 cm and RMSE of 37.10 cm, respectively.

Routine cine-CMR for prosthesis-associated mitral regurgitation: a multicenter comparison to echocardiography.

Science.gov (United States)

Simprini, Lauren A; Afroz, Anika; Cooper, Mitchell A; Klem, Igor; Jensen, Christoph; Kim, Raymond J; Srichai, Monvadi B; Heitner, John F; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J; Lopez-Mattei, Juan; Biederman, Robert W; Grizzard, John D; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

2014-09-01

Mitral regurgitation (MR) is an important complication after prosthetic mitral valve (PMV) implantation. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-cardiac magnetic resonance (CMR) holds the potential for the non-invasive assessment of regurgitant severity based on MR-induced inter-voxel dephasing. The study aim was to evaluate routine cine-CMR for the visual assessment of PMV-associated MR. Routine cine-CMR was performed at nine sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild 2/3). MR was graded in each long-axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PVSFR). Visual interpretation was compared to quantitative analysis in a single-center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. The population comprised 85 PMV patients (59% mechanical valves, 41% bioprostheses). Among the derivation cohort (n = 25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p = 0.001). Patients with severe MR had an almost three-fold increase in quantitative jet area (p = 0.002), and a two-fold increase in density (p = 0.04) than did other patients. Among the multicenter cohort, cine-CMR and TEE (Δ =. 2 ± 3 days) demonstrated moderate agreement (κ = 0.44); 64% of discordances differed by ≤ 1 grade (Δ = 1.2 ± 0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value = 100%). Patients with visually graded severe MR also had more frequent PVSFR (p cine-CMR. Cine-CMR is useful for the assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter-voxel dephasing. Visual MR

Early rehabilitation exercise program for inpatients during an acute exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial.

Science.gov (United States)

Tang, Clarice Y; Blackstock, Felicity C; Clarence, Michael; Taylor, Nicholas F

2012-01-01

To determine whether an early rehabilitation program was safe and feasible for patients during an acute exacerbation of chronic obstructive pulmonary disease (COPD). In this phase 1 randomized controlled trial, patients with an acute exacerbation of COPD admitted to the hospital were randomly allocated to a low-intensity exercise group, a moderate- to high-intensity exercise group, or a control group, who received routine physical therapy. In addition to routine physical therapy, patients in the exercise group had to participate in an exercise program. The program consisted of twice-daily aerobic and resistance exercise sessions. Primary outcomes were the number and classification of adverse events and program adherence. In 174 exercise sessions, there was 1 serious adverse event of arrhythmia in the low-intensity exercise group that resolved within 1 hour. There were 12 other minor adverse events involving 5 patients with no significant differences between groups. Patients completed an average of 80% of their scheduled sessions with no significant between-group differences. The exercise groups improved significantly in walking distance; however, no significant between-group differences were observed. There was preliminary evidence that it was safe and feasible to implement an exercise program for patients during an acute exacerbation of COPD. Additional studies with larger sample sizes are required to accurately evaluate program effectiveness.

Factors related to pain during routine photodynamic therapy

DEFF Research Database (Denmark)

Miller, I M; Nielsen, J S; Lophaven, S

2011-01-01

between pain-reducing intervention and diagnosis, pre-treatment, gender or age was found. CONCLUSIONS: Pain-reducing intervention was required in 44% of the PDT treatments. Intervention was particularly required when treating lesions in areas suited for PDT therapy for cosmetic reasons such as the scalp......BACKGROUND: Pain may be a limiting factor in the use of photodynamic therapy (PDT). The consequences of the pain i.e. the resources spent on pain-intervention during routine PDT therapy are poorly described. OBJECTIVES: To describe the consequences of pain during PDT by describing the use of pain......-reducing interventions in routine use. We studied the frequency as well as level of pain-reducing intervention. METHODS: Descriptive data from PDT treated patients. The level of pain-reducing intervention was graded 0, no intervention; +, cold water spray and ++, pause or nerve block. RESULTS: Data from 983 PDT...

"How Was Your Weekend?": Developing the Interactional Competence in Managing Routine Inquiries

Science.gov (United States)

Waring, Hansun Zhang

2013-01-01

Given the cross-cultural differences underlying interactional routines such as "How are you?" or "How was your weekend?", managing such routine inquiries can be problematic for second language learners. Based on data from an adult ESL (English as a second language) class, this conversation analytic study shows how learners develop their competence…

Socioeconomic Segregation of Activity Spaces in Urban Neighborhoods: Does Shared Residence Mean Shared Routines?

Directory of Open Access Journals (Sweden)

Christopher R. Browning

2017-02-01

Full Text Available Residential segregation by income and education is increasing alongside slowly declining black-white segregation. Segregation in urban neighborhood residents’ nonhome activity spaces has not been explored. How integrated are the daily routines of people who live in the same neighborhood? Are people with different socioeconomic backgrounds that live near one another less likely to share routine activity locations than those of similar education or income? Do these patterns vary across the socioeconomic continuum or by neighborhood structure? The analyses draw on unique data from the Los Angeles Family and Neighborhood Survey that identify the location where residents engage in routine activities. Using multilevel p2 (network models, we analyze pairs of households in the same neighborhood and examine whether the dyad combinations across three levels of SES conduct routine activities in the same location, and whether neighbor socioeconomic similarity in the co-location of routine activities is dependent on the level of neighborhood socioeconomic inequality and trust. Results indicate that, on average, increasing SES diminishes the likelihood of sharing activity locations with any SES group. This pattern is most pronounced in neighborhoods characterized by high levels of socioeconomic inequality. Neighborhood trust explains a nontrivial proportion of the inequality effect on the extent of routine activity sorting by SES. Thus stark, visible neighborhood-level inequality by SES may lead to enhanced effects of distrust on the willingness to share routines across class.

[Use of routine data from statutory health insurances for federal health monitoring purposes].

Science.gov (United States)

Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E

2014-04-01

Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes.

Routine recovery: an ethical plan for greatly increasing the supply of transplantable organs.

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Spital, Aaron; Taylor, James S

2008-04-01

All current organ procurement policies require some form of consent. Many families refuse to permit organ recovery from a recently deceased relative; therefore, the major cost of requiring consent is the loss of some lives that could have been saved through transplantation. Here, we argue for a much more efficient approach to organ procurement from brain dead individuals - routine recovery of all transplantable organs without consent. Careful analysis of the relevant literature shows that, compared with its competitors, routine recovery has the greatest potential to increase cadaveric organ procurement and save lives while causing very little harm. Furthermore, a recent survey suggests that 30% of the US public would already accept routine recovery even though the respondents were not educated regarding the value of this approach. Patients on the transplant waiting list are dying while organs that could have saved them are being buried or burned because of family refusal to allow posthumous organ procurement. Routine recovery would eliminate this tragic loss of life-saving organs without violating ethical principles. Indeed, we argue that of all the proposals designed to increase the supply of transplantable cadaveric organs, routine recovery is the best.

A new software routine that automates the fitting of protein X-ray crystallographic electron-density maps.

Science.gov (United States)

Levitt, D G

2001-07-01

The classical approach to building the amino-acid residues into the initial electron-density map requires days to weeks of a skilled investigator's time. Automating this procedure should not only save time, but has the potential to provide a more accurate starting model for input to refinement programs. The new software routine MAID builds the protein structure into the electron-density map in a series of sequential steps. The first step is the fitting of the secondary alpha-helix and beta-sheet structures. These 'fits' are then used to determine the local amino-acid sequence assignment. These assigned fits are then extended through the loop regions and fused with the neighboring sheet or helix. The program was tested on the unaveraged 2.5 A selenomethionine multiple-wavelength anomalous dispersion (SMAD) electron-density map that was originally used to solve the structure of the 291-residue protein human heart short-chain L-3-hydroxyacyl-CoA dehydrogenase (SHAD). Inputting just the map density and the amino-acid sequence, MAID fitted 80% of the residues with an r.m.s.d. error of 0.43 A for the main-chain atoms and 1.0 A for all atoms without any user intervention. When tested on a higher quality 1.9 A SMAD map, MAID correctly fitted 100% (418) of the residues. A major advantage of the MAID fitting procedure is that it maintains ideal bond lengths and angles and constrains phi/psi angles to the appropriate Ramachandran regions. Recycling the output of this new routine through a partial structure-refinement program may have the potential to completely automate the fitting of electron-density maps.

Routine cognitive errors: a trait-like predictor of individual differences in anxiety and distress.

Science.gov (United States)

Fetterman, Adam K; Robinson, Michael D

2011-02-01

Five studies (N=361) sought to model a class of errors--namely, those in routine tasks--that several literatures have suggested may predispose individuals to higher levels of emotional distress. Individual differences in error frequency were assessed in choice reaction-time tasks of a routine cognitive type. In Study 1, it was found that tendencies toward error in such tasks exhibit trait-like stability over time. In Study 3, it was found that tendencies toward error exhibit trait-like consistency across different tasks. Higher error frequency, in turn, predicted higher levels of negative affect, general distress symptoms, displayed levels of negative emotion during an interview, and momentary experiences of negative emotion in daily life (Studies 2-5). In all cases, such predictive relations remained significant with individual differences in neuroticism controlled. The results thus converge on the idea that error frequency in simple cognitive tasks is a significant and consequential predictor of emotional distress in everyday life. The results are novel, but discussed within the context of the wider literatures that informed them. © 2010 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

MR diffusion weighted imaging of gastric cancer: b-value determination and comparison with routine sequences

International Nuclear Information System (INIS)

Zhao Xiaopeng; Tang Lei; Sun Yingshi; Li Jie; Cao Kun

2007-01-01

Objective: To choose the optimal b-values for the DWI of gastric cancer (GC), and investigate the value of DWI in the diagnosis of GCs. Methods: MRI examinations (T 1 WI, T 2 WI, and DWI) were performed on 31 patients with gastric cancer. Three diffusion-weighted sequences were designed with different b values, including 300 s/mm 2 (low), 600 s/mm 2 (intermediate), and 1000 s/mm 2 (high). Free water grade was used to evaluate the suppression of content in gastric lumen. Background contrast grade was used to evaluate the discriminating ability of different sequences between GC and nearby tissues. The ADCs of GCs, nearby gastric wall region, and free water in gastric lumen were measured. SNR Ca , CNR Ca-GW and SIR CaGW of high b-value DWI and routine MRI sequences were evaluated and compared. Results: The signal intensity of free water in gastric lumen decreased as b-value increased, and the SIR were 8.11± 0.77 (b=300 s/mm 2 ), 2.70±0.35 (b=600 s/mm 2 ), and 1.13±0.22 (b=1000 s/mm 2 ) (F55.368, P 2 =16.692, P 2 =9.923, P -3 mm 2 /s, (1.43±0.41) x 10 -3 mm 2 /s, and (1.18±0.25) x 10 -3 mm 2 /s; (F=12.066, P 1 WI (CNR: 12.46 vs. 2.35, Z=-3.746, P 2 WI (CNR: 12.46 vs. 3.92, Z=-3.518, P 2 ) is reasonable for DWI of GCs, which can reflect diffusion condition of water molecules more accurately, suppress signal of content in gastric lumen, and possess higher contrast. DWI can be a supplementary method of routine MRI examination for better demonstration of gastric cancers. (authors)

Accuracy and Quality of Routine Immunisation Data Monitoring ...

African Journals Online (AJOL)

TNHJOURNALPH

Accuracy and Quality of Routine Immunisation Data Monitoring. System in two South-Eastern Districts of Nigeria. AkinolaAyoola Fatiregun, CeciliaAwogu. Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of. Medicine, University ofibadan, Ibadan, Nigeria. ABSTRACT. BACKGROUND.

Measuring anteversion in the femoral neck from routine radiographs

International Nuclear Information System (INIS)

Hermann, K.L.; Egund, N.

1998-01-01

Purpose: To describe a new method for measuring femoral neck anteversion (FNA) that requires only one lateral radiograph of the knee in addition to routine radiographs of the hip for evaluation of total hip replacement; and to compare the proposed method with FNA measurement by means of 3D CT. Material and Methods: In 18 femoral specimens, radiographic examinations of the hip and knee, in three different rotational positions, and one CT examination were made, and the measurements of FNA were compared. Similarly, in 38 patients with 40 total hip replacements, measurements form routine radiographic examinations of the hip and knee and from CT examinations were compared. The accuracy and reproducibility of the FNA measurements produced by this proposed method were calculated. Results: Accuracy and reproducibility were 2 and 2 for the proposed method in the femoral specimen study, and accuracy was 4 in the hip patient study. The proposed method had a minor flaw that was caused almost solely by differences in knee size at inward rotation of the femur. Conclusion: FNA measurement can be made from a routine radiographic examination of the hip and a lateral view of the knee. This method achieves an acceptable level of accuracy and reproducibility. (orig.)

The 9 to 5 routine: advancing the understanding of occupational transition for new immigrants.

Science.gov (United States)

Movsessian, Yeraz

2013-01-01

This paper offers a reflection on temporal routines that underscore daily work life and work transitions. This reflection includes views of a Canadian student who examines work transitions through lived experiences and observation of the Chilean work/home routine. A narrative reflection on lived experience is used to examine 9 to 5 work transitions. There is a blending of work and daily life routines that provide a balance for workers in Chile and there are differences across countries in the valuing of work and daily life routines. Narrative reflections about work and work transitions can highlight differences at the macro level that can yield personal insights into challenges in transitioning into work for new immigrants.

System for remote routine monitoring of power equipment at TPP and NPP

International Nuclear Information System (INIS)

Kantsedalov, V.G.; Samojlenko, V.P.; Doroshenko, V.A.

1988-01-01

A system for remote routine monitoring of TPP and NPP pipeline metals is described. The principal functional unit of the system is the unit of remote routine methods and techniques for studying and monitoring the metal and properties. The system is equipped with 5 types of routine monitoring equipment: robots, remote aggregated complexes, periodical diagnostic monitors, other means of metal diagnostics (endoscopes, introscopes). All current information enters the unit for estimating and forecasting the service life of power unit, where it is compared with the standard indices of reliability, duravility and efficiency. The system considered permits to reduce significantly or minimize the scope of works on metal monitoring during overhauls, increase intermonitoring and interrepairing compaigns to 8 years

Clinical relevance of routinely measured vital signs in hospitalized patients: a systematic review

NARCIS (Netherlands)

Storm-Versloot, Marja N.; Verweij, Lotte; Lucas, Cees; Ludikhuize, Jeroen; Goslings, J. Carel; Legemate, Dink A.; Vermeulen, Hester

2014-01-01

Conflicting evidence exists on the effectiveness of routinely measured vital signs on the early detection of increased probability of adverse events. To assess the clinical relevance of routinely measured vital signs in medically and surgically hospitalized patients through a systematic review.

Assessing the Structure of Non-Routine Decision Processes in Airline Operations Control

NARCIS (Netherlands)

Richters, Floor; Schraagen, Johannes Martinus Cornelis; Heerkens, Johannes M.G.

2015-01-01

Unfamiliar severe disruptions challenge airline operations control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of airline operations control professionals’ decision process during unfamiliar disruptions by mapping three macrocognitive

Assessing the structure of non-routine decision processes in Airline Operations Control

NARCIS (Netherlands)

Richters, F.; Schraagen, J.M.C.; Heerkens, H.

2015-01-01

Unfamiliar severe disruptions challenge Airline Operations Control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of Airline Operations Control professionals’ decision process during unfamiliar disruptions by mapping three macrocognitive

Are routine visits to oncology clinics the most appropriate way to follow-up breast cancer patients?

International Nuclear Information System (INIS)

Kirkbride, Peter; Vallis, Katherine

1997-01-01

Purpose The routine follow-up at oncology clinics, of patients treated for breast cancer is believed to serve two purposes: to facilitate early detection of loco-regional recurrences and new primary tumors, and to provide psychological support for patients. Since it does not translate into improved survival, early detection of distant metastatic disease is not a priority. The purpose of this study was to determine the efficacy of routine clinic review in detecting loco-regional relapse following treatment for breast cancer. Materials and Methods The charts of all 579 patients with stage I, II and III breast cancer seen for the first time at our institution in 1982 were reviewed. Treatment consisted of mastectomy (367 cases), lumpectomy alone (53), or lumpectomy plus radiotherapy (159). Follow-up policy stipulated that patients were seen every 3 months for the first 2 years after primary treatment, every 6 months for the next 3 years and annually thereafter. Annual mammograms were performed. Results Thirteen patients were lost to follow-up during the 14 year study period. Loco-regional recurrence was diagnosed in 184 patients. Recurrent disease were detected by the patient (79 cases, 45%), at routine mammography (13 cases, 7%), at visits to physicians other than oncologists(40 cases, 22%). In 18 cases, the method of detection was unknown and only 34 (18%) loco-regional recurrences were detected at routine visits to oncology clinics. It is calculated that this group of patients attended approximately 11,000 follow-up clinic appointments over the period in question. Even if we assume that the 18 cases in which the method of detection was unknown were in fact detected at a visit to an oncology clinic, then the rate of detection is only 1 local recurrence per 212 visits. Conclusion Given the apparent limitations of routine follow-up, other methods of surveillance such as open access to a Breast Cancer Resource Centre merit investigation. It is imperative that non

The Balancing Act: Student Classroom Placement Routines and the Uses of Data in Elementary Schools

Science.gov (United States)

Park, Vicki; St. John, Elise; Datnow, Amanda; Choi, Bailey

2017-01-01

Purpose: The purpose of this paper is to examine how data are used in classroom placement routines. The authors explore educators' assumptions about the purposes of the classroom placement routine, detailing the ostensive (i.e. structure and template) and performative aspects of the routine itself, and the implications of data use for equity and…

Effect of routine assessment of specific psychosocial problems on personalized communication, counselors’ awareness, and distress levels in cancer genetic counseling practice: a randomized controlled trial.

Science.gov (United States)

Eijzenga, Willem; Aaronson, Neil K; Hahn, Daniela E E; Sidharta, Grace N; van der Kolk, Lizet E; Velthuizen, Mary E; Ausems, Margreet G E M; Bleiker, Eveline M A

2014-09-20

This study evaluated the efficacy of a cancer genetics–specific questionnaire in facilitating communication about, awareness of, and management of psychosocial problems, as well as in lowering distress levels. Individuals referred to genetic counseling for cancer at two family cancer clinics in The Netherlands were randomly assigned to an intervention or a control group. All participants completed the psychosocial questionnaire before counseling. In the intervention group, the counselors received the results of this questionnaire before the counseling session. All sessions were audiotaped for content analysis. Primary outcomes were the frequency with which psychosocial problems were discussed, the genetic counselors’ awareness of these problems, and their management. Secondary outcomes included cancer worries and psychological distress, duration and dynamics of the counseling, and satisfaction. The frequency with which psychosocial problems were discussed with 246 participating counselees was significantly higher in the intervention group (n = 127) than in the control group (n =119; P = .004), as was the counselors’ awareness of psychosocial problems regarding hereditary predisposition (P cancer (P = .01), and general emotions (P cancer worries (p = .005) and distress (p = .02) after counseling. The routine assessment of psychosocial problems by questionnaire facilitates genetic counselors’ recognition and discussion of their clients’ psychosocial problems and reduces clients’ distress levels.

Routine Activities and Sexual Harassment in the Workplace.

Science.gov (United States)

De Coster, Stacy; Estes, Sarah Beth; Mueller, Charles W.

1999-01-01

In criminology, routine activities of potential victims can be used to predict victimization. Application to organizational sexual harassment data shows that organizational features (proximity in job location, supervisor or work group guardianship) and individual characteristics (target attractiveness) can predict sexual harassment victimization,…

Accurate Typing of Human Leukocyte Antigen Class I Genes by Oxford Nanopore Sequencing.

Science.gov (United States)

Liu, Chang; Xiao, Fangzhou; Hoisington-Lopez, Jessica; Lang, Kathrin; Quenzel, Philipp; Duffy, Brian; Mitra, Robi David

2018-04-03

Oxford Nanopore Technologies' MinION has expanded the current DNA sequencing toolkit by delivering long read lengths and extreme portability. The MinION has the potential to enable expedited point-of-care human leukocyte antigen (HLA) typing, an assay routinely used to assess the immunologic compatibility between organ donors and recipients, but the platform's high error rate makes it challenging to type alleles with accuracy. We developed and validated accurate typing of HLA by Oxford nanopore (Athlon), a bioinformatic pipeline that i) maps nanopore reads to a database of known HLA alleles, ii) identifies candidate alleles with the highest read coverage at different resolution levels that are represented as branching nodes and leaves of a tree structure, iii) generates consensus sequences by remapping the reads to the candidate alleles, and iv) calls the final diploid genotype by blasting consensus sequences against the reference database. Using two independent data sets generated on the R9.4 flow cell chemistry, Athlon achieved a 100% accuracy in class I HLA typing at the two-field resolution. Copyright © 2018 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

BeerOz, a set of Matlab routines for the quantitative interpretation of spectrophotometric measurements of metal speciation in solution

Science.gov (United States)

Brugger, Joël

2007-02-01

The modelling of the speciation and mobility of metals under surface and hydrothermal conditions relies on the availability of accurate thermodynamic properties for all relevant minerals, aqueous species, gases and surface species. Spectroscopic techniques obeying the Beer-Lambert law can be used to obtain thermodynamic properties for reactions among aqueous species (e.g., ligand substitution; protonation). BeerOz is a set of Matlab routines designed to perform both qualitative and quantitative analysis of spectroscopic data following the Beer-Lambert law. BeerOz is modular and can be customised for particular experimental strategies or for simultaneous refinement of several datasets obtained using different techniques. Distribution of species calculations are performed using an implementation of the EQBRM code, which allows for customised activity coefficient calculations. BeerOz also contains routines to study the n-dimensional solution space, in order to provide realistic estimates of errors and test for the existence of multiple local minima and correlation between the different refined variables. The paper reviews the physical principles underlying the qualitative and quantitative analysis of spectroscopic data collected on aqueous speciation, in particular for studying successive ligand replacement reactions, and presents the non-linear least-squares algorithm implemented in BeerOz. The discussion is illustrated using UV-Vis spectra collected on acidic Fe(III) solutions containing varying LiCl concentrations, and showing the change from the hexaaquo Fe(H 2O) 63+ complex to the tetrahedral FeCl 4- complex.

Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: a cluster preference randomized controlled trial.

Science.gov (United States)

Rogers, Simon N; Lowe, Derek; Lowies, Cher; Yeo, Seow Tien; Allmark, Christine; Mcavery, Dominic; Humphris, Gerald M; Flavel, Robert; Semple, Cherith; Thomas, Steven J; Kanatas, Anastasios

2018-04-18

The consequences of treatment for Head and Neck cancer (HNC) patients has profound detrimental impacts such as impaired QOL, emotional distress, delayed recovery and frequent use of healthcare. The aim of this trial is to determine if the routine use of the Patients Concerns Inventory (PCI) package in review clinics during the first year following treatment can improve overall quality of life, reduce the social-emotional impact of cancer and reduce levels of distress. Furthermore, we aim to describe the economic costs and benefits of using the PCI. This will be a cluster preference randomised control trial with consultants either 'using' or 'not using' the PCI package at clinic. It will involve two centres Leeds and Liverpool. 416 eligible patients from at least 10 consultant clusters are required to show a clinically meaningful difference in the primary outcome. The primary outcome is the percentage of participants with less than good overall quality of life at the final one-year clinic as measured by the University of Washington QOL questionnaire version 4 (UWQOLv4). Secondary outcomes at one-year are the mean social-emotional subscale (UWQOLv4) score, Distress Thermometer (DT) score ≥ 4, and key health economic measures (QALY-EQ-5D-5 L; CSRI). This trial will provide knowledge on the effectiveness of a consultation intervention package based around the PCI used at routine follow-up clinics following treatment of head and neck cancer with curative intent. If this intervention is (cost) effective for patients, the next step will be to promote wider use of this approach as standard care in clinical practice. 32,382. Clinical Trials Identifier, NCT03086629 . Version 3.0, 1st July 2017.

Biomarkers in routine diagnosis of pleural effusions

Directory of Open Access Journals (Sweden)

Tiva Nemanič

2018-03-01

Full Text Available Background: Pleural fluid biochemical analysis is the first step in pleural effusion (PE diagnostics. Our purpose was to analyse the utility of the biomarkers used at our clinic in the routine diagnosis of PE. Methods: We retrospectively reviewed the PE levels of proteins, lactate dehydrogenase (LDH, alpha amylase (AA, pH and glucose in 433 patients who were treated at the University Clinic Golnik in a one-year period and compared these values with the final identified aetiology of the effusions. Results: The majority of the effusions were determined to be a consequence of malignancy (n = 154 or infection (n = 108. In 94 cases the aetiology of the effusions was heart failure and in 54 cases other diseases, while 23 effusions remained aetiologically undetermined. Considering Light’s criteria, the vast majority of the effusions were correctly classified as exudates or transudates (97.1 %. Comparing paramalignant and malignant effusions, we detected significantly lower values of pleural fluid LDH (p < 0.0005 and proteins (p < 0.0005, and higher pH (p < 0.0005 values in the paramalignant effusions. Conclusion: We have found that pleural LDH and proteins are the most helpful biochemical parameters in our routine diagnosis of pleural effusions and helped us to correctly narrow the aetiological spectrum. Furthermore, significantly higher pleural LDH and protein values and a pH below 7.32 additionally facilitated distinguishing between malignant and paramalignant effusions. Parameters such as glucose and AA are useful in selected cases and have a limited role in routine diagnostics.

Intraoperative bone and bone marrow sampling: a simple method for accurate measurement of uptake of radiopharmaceuticals in bone and bone marrow

International Nuclear Information System (INIS)

Oyen, W.J.G.; Buijs, W.C.A.M.; Kampen, A. van; Koenders, E.B.; Claessens, R.A.M.J.; Corstens, F.H.M.

1993-01-01

Accurate estimation of bone marrow uptake of radiopharmaceuticals is of crucial importance for accurate whole body dosimetry. In this study, a method for obtaining normal bone marrow and bone during routine surgery without inconvenience to volunteers is suggested and compared to an indirect method. In five volunteers (group 1), 4 MBq 111 In-labelled human polyclonal IgG ( 111 In-IgG) was administered 48h before placement of a total hip prosthesis. After resection of the femoral head and neck, bone marrow was aspirated from the medullary space with a biopsy needle. In five patients, suspected of having infectious disease (group 2), bone marrow uptake was calculated according to a well-accepted method using regions of interest over the lumbar spine, 48h after injection of 75 MBq 111 In-IgG. Bone marrow uptake in group 1 (4.5 ±1.3%D kg -1 ) was significantly lower than that in group 2 (8.5 ± 2.1%D kg -1 ) (P<0.01). Blood and plasma activity did not differ significantly for both groups. This method provides a system for directly and accurately measuring uptake and retention in normal bone marrow and bone of all radiopharmaceuticals at various time points. It is a safe and simple procedure without any discomfort to the patient. Since small amounts of activity are sufficient, the radiation dose to the patient is low. (author)

Accurate control of oxygen level in cells during culture on silicone rubber membranes with application to stem cell differentiation.

Science.gov (United States)

Powers, Daryl E; Millman, Jeffrey R; Bonner-Weir, Susan; Rappel, Michael J; Colton, Clark K

2010-01-01

Oxygen level in mammalian cell culture is often controlled by placing culture vessels in humidified incubators with a defined gas phase partial pressure of oxygen (pO(2gas)). Because the cells are consuming oxygen supplied by diffusion, a difference between pO(2gas) and that experienced by the cells (pO(2cell)) arises, which is maximal when cells are cultured in vessels with little or no oxygen permeability. Here, we demonstrate theoretically that highly oxygen-permeable silicone rubber membranes can be used to control pO(2cell) during culture of cells in monolayers and aggregates much more accurately and can achieve more rapid transient response following a disturbance than on polystyrene and fluorinated ethylene-propylene copolymer membranes. Cell attachment on silicone rubber was achieved by physical adsorption of fibronectin or Matrigel. We use these membranes for the differentiation of mouse embryonic stem cells to cardiomyocytes and compare the results with culture on polystyrene or on silicone rubber on top of polystyrene. The fraction of cells that are cardiomyocyte-like increases with decreasing pO(2) only when using oxygen-permeable silicone membrane-based dishs, which contract on silicone rubber but not polystyrene. The high permeability of silicone rubber results in pO(2cell) being equal to pO(2gas) at the tissue-membrane interface. This, together with geometric information from histological sections, facilitates development of a model from which the pO(2) distribution within the resulting aggregates is computed. Silicone rubber membranes have significant advantages over polystyrene in controlling pO(2cell), and these results suggest they are a valuable tool for investigating pO(2) effects in many applications, such as stem cell differentiation. Copyright 2009 American Institute of Chemical Engineers

ESTIMATION OF ROUTINE DISCHARGE OF RADIONUCLIDES ON POWER REACTOR EXPERIMENTAL RDE

Directory of Open Access Journals (Sweden)

P.M. Udiyani

2017-02-01

Full Text Available Experimental power reactor (RDE which is planned to be constructed by BATAN is a kind of High Temperature Gas Cooled Reactor (HTGR with 10 MWth power. HTGR is a helium gas-cooled reactor with TRISO-coated fuel that is able to confine fission products remained in the core. Although the fission products released into the environment are very small, in order to comply the regulations the study about environmental radiation on normal or routine operation condition need to be performed. Estimation of radiology in the environment involves the source term released into the environment under routine operation condition. The purpose of this study is to estimate the source term released into the environment based on postulation of normal or routine operations of RDE. The research approach starts with an assumption that there are defects and impurities in the TRISO fuel because of limitation during the fabrication. Mechanism of fission products release from the fuel to the environment was created based on the safety features design of RDE. Radionuclides inventories in the reactor were calculated using ORIGEN-2 whose library has been modified for HTGR type, and the assumptions of defects of the TRISO fuel and release fraction for each compartment of RDE safety system used a reference parameter. The results showed that the important source terms of RDE are group of noble gases (Kr and Xe, halogen (I, Sr, Cs, H-3, and Ag. Activities of RDE source terms for routine operations have no significant difference with the HTGR source terms with the same power. Keywords: routine discharge, radionuclide, source term, RDE, HTGR

Should we routinely remove the dose delivered by the images of control?

International Nuclear Information System (INIS)

Goasduff, G.; Pene Baverez, D.; Pradier, O.; Bouchekoua, M.

2009-01-01

The constraints of doses fixed by the international commission on radiation units and measurements (ICRU) for the target volume (95-107% of the prescribed dose) are respected. for the hypo fractionated treatments, it is necessary to control the impact of the dose delivered by the control images for every patient. The dose delivered at the isocenter is estimated between 1 and 3 Gy by control image: this dose depends on the beams size and on the distance-source-skin. Protocols of the patient positioning checking must be implemented on optimizing their frequency to limit the dose received by the patient. (N.C.)

Implementing shared decision-making in routine practice: barriers and opportunities.

Science.gov (United States)

Holmes-Rovner, Margaret; Valade, Diane; Orlowski, Catherine; Draus, Catherine; Nabozny-Valerio, Barbara; Keiser, Susan

2000-09-01

OBJECTIVE: Determine feasibility of shared decision-making programmes in fee-for-service hospital systems including physicians' offices and in-patient facilities. DESIGN: Survey and participant observation. Data obtained during Phase 1 of a patient outcome study. SETTINGS AND PARTICIPANTS: Three hospitals in Michigan: one 299-bed rural regional hospital, one 650-bed urban community hospital, one 459-bed urban and suburban teaching hospital. All nurses and physicians who agreed to use the programmes participated in the evaluation (n = 34). INTERVENTION: Two shared decision-making(R) (SDP) multimedia programmes: surgical treatment choice for breast cancer and ischaemic heart disease treatment choice. MAIN OUTCOME MEASURES: (1) clinicians' evaluations of programme quality; (2) challenges in hospital settings; and (3) patient referral rates. RESULTS: SDP programmes were judged to be clear, accurate and about the right length and amount of information. Programmes were judged to be informative and appropriate for patients to see before making a decision. Clinicians were neutral about patients' desire to participate in treatment decision-making. Referral volume to SDPs was lower than expected: 24 patients in 7 months across three hospitals. Implementation challenges centred on time pressures in patient care. CONCLUSIONS: Productivity and time pressure in US health care severely constrain shared decision-making programme implementation. Physician referral may not be a reliable mechanism for patient access. Possible innovations include: (1) incorporation into the informed consent process; (2) provider or payer negotiated requirement in the routine hospital procedure to use the SDP as a quality indicator; and (3) payer reimbursement to professional providers who make SDP programmes available to patients.

A machine learned classifier that uses gene expression data to accurately predict estrogen receptor status.

Directory of Open Access Journals (Sweden)

Meysam Bastani

Full Text Available BACKGROUND: Selecting the appropriate treatment for breast cancer requires accurately determining the estrogen receptor (ER status of the tumor. However, the standard for determining this status, immunohistochemical analysis of formalin-fixed paraffin embedded samples, suffers from numerous technical and reproducibility issues. Assessment of ER-status based on RNA expression can provide more objective, quantitative and reproducible test results. METHODS: To learn a parsimonious RNA-based classifier of hormone receptor status, we applied a machine learning tool to a training dataset of gene expression microarray data obtained from 176 frozen breast tumors, whose ER-status was determined by applying ASCO-CAP guidelines to standardized immunohistochemical testing of formalin fixed tumor. RESULTS: This produced a three-gene classifier that can predict the ER-status of a novel tumor, with a cross-validation accuracy of 93.17±2.44%. When applied to an independent validation set and to four other public databases, some on different platforms, this classifier obtained over 90% accuracy in each. In addition, we found that this prediction rule separated the patients' recurrence-free survival curves with a hazard ratio lower than the one based on the IHC analysis of ER-status. CONCLUSIONS: Our efficient and parsimonious classifier lends itself to high throughput, highly accurate and low-cost RNA-based assessments of ER-status, suitable for routine high-throughput clinical use. This analytic method provides a proof-of-principle that may be applicable to developing effective RNA-based tests for other biomarkers and conditions.

Investigations of CR39 dosimeters for neutron routine dosimetry

International Nuclear Information System (INIS)

Weinstein, M.; Abraham, A.; Tshuva, A.; German, U.

2004-01-01

CR-39 is a polymeric nuclear track detector which is widely used for neutron dosimetry. CR-39 detector development was conducted at a number of laboratories throughout the world(1,2) , and was accepted also for routine dosimetry. However, there are shortcomings which must be taken into consideration the lack of a dosimetry grade material which causes batch variations, significant angular dependence and a moderate sensitivity. CR-39 also under-responds for certain classes of neutron spectra (lower energy neutrons from reactors or high energy accelerator-produced neutrons).In order to introduce CR-39 as a routine dosimeter at NRCN, a series of checks were performed. The present work describes the results of some of our checks, to characterize the main properties of CR-39 dosimeters

What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials.

Science.gov (United States)

Kotronoulas, Grigorios; Kearney, Nora; Maguire, Roma; Harrow, Alison; Di Domenico, David; Croy, Suzanne; MacGillivray, Stephen

2014-05-10

The systematic use of patient-reported outcome measures (PROMs) has been advocated as an effective way to standardize cancer practice. Yet, the question of whether PROMs can lead to actual improvements in the quality of patient care remains under debate. This review examined whether inclusion of PROM in routine clinical practice is associated with improvements in patient outcomes, processes of care, and health service outcomes during active anticancer treatment. A systematic review of five electronic databases (Medline, EMBASE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], PsycINFO, and Psychology and Behavioral Sciences Collection [PBSC]) was conducted from database inception to May 2012 to locate randomized and nonrandomized controlled trials of patients receiving active anticancer treatment or supportive care irrespective of type of cancer. Based on prespecified eligibility criteria, we included 26 articles that reported on 24 unique controlled trials. Wide variability in the design and use of interventions delivered, outcomes evaluated, and cancer- and modality-specific context was apparent. Health service outcomes were only scarcely included as end points. Overall, the number of statistically significant findings were limited and PROMs' intervention effect sizes were predominantly small-to-moderate. The routine use of PROMs increases the frequency of discussion of patient outcomes during consultations. In some studies, PROMs are associated with improved symptom control, increased supportive care measures, and patient satisfaction. Additional effort is required to ensure patient adherence, as well as additional support to clinicians who will respond to patient concerns and issues, with clear system guidelines in place to guide their responses. More research is required to support PROM cost-benefit in terms of patient safety, clinician burden, and health services usage.

Diagnostic accuracy of routine postoperative body temperature measurements

NARCIS (Netherlands)

Vermeulen, Hester; Storm-Versloot, Marja N.; Goossens, Astrid; Speelman, Peter; Legemate, Dink A.

2005-01-01

BACKGROUND: On surgical wards, body temperature is routinely measured, but there is no proof that this is useful for detecting postoperative infection. The aim of this study was to compare temperature measurements (the test) with the confirmed absence or presence of a postoperative infection (the

ORIGINAL ARTICLES Acceptability, feasibility and impact of routine ...

African Journals Online (AJOL)

programme, leading to the identification of children with previously undiagnosed HIV ... We explored the acceptability and feasibility of routine HIV screening in ... proportion of previously undiagnosed HIV-positive children aged ..... primary healthcare facilities in South Africa: Attitudes of nurses and child caregivers. Soc Sci ...

Routine hemoglobin electrophoresis for pediatric surgery day case ...

African Journals Online (AJOL)

Background: Hemoglobin electrophoresis (HBE) is a part of the preoperative routine requested by anesthetists. However, the prevalence of hemoglobinopathy in the population is low. This study aims to determine the clinical risk factors for hemoglobinopathies and propose clinical guidelines for preoperative screening of ...

Accurate Sliding-Mode Control System Modeling for Buck Converters

DEFF Research Database (Denmark)

Høyerby, Mikkel Christian Wendelboe; Andersen, Michael Andreas E.

2007-01-01

This paper shows that classical sliding mode theory fails to correctly predict the output impedance of the highly useful sliding mode PID compensated buck converter. The reason for this is identified as the assumption of the sliding variable being held at zero during sliding mode, effectively...... approach also predicts the self-oscillating switching action of the sliding-mode control system correctly. Analytical findings are verified by simulation as well as experimentally in a 10-30V/3A buck converter....

Accurate location estimation of moving object In Wireless Sensor network

Directory of Open Access Journals (Sweden)

Vinay Bhaskar Semwal

2011-12-01

Full Text Available One of the central issues in wirless sensor networks is track the location, of moving object which have overhead of saving data, an accurate estimation of the target location of object with energy constraint .We do not have any mechanism which control and maintain data .The wireless communication bandwidth is also very limited. Some field which is using this technique are flood and typhoon detection, forest fire detection, temperature and humidity and ones we have these information use these information back to a central air conditioning and ventilation.In this research paper, we propose protocol based on the prediction and adaptive based algorithm which is using less sensor node reduced by an accurate estimation of the target location. We had shown that our tracking method performs well in terms of energy saving regardless of mobility pattern of the mobile target. We extends the life time of network with less sensor node. Once a new object is detected, a mobile agent will be initiated to track the roaming path of the object.

Development of iodimetric redox method for routine estimation of ascorbic acid from fresh fruit and vegetables

International Nuclear Information System (INIS)

Munir, M.; Baloch, A. K.; Khan, W. A.; Ahmad, F.; Jamil, M.

2013-01-01

The iodimetric method (Im) is developed for rapid estimation of ascorbic acid from fresh fruit and vegetables. The efficiency of Im was compared with standard with standard dye method (Dm) utilizing a variety of model solutions and aqueous extracts from fresh fruit and vegetables of different colors. The Im presented consistently accurate and precise results from colorless to colored model solutions and from fruit/vegetable extracts with standard deviation (Stdev) in the range of +-0.013 - +-0.405 and +-0.019 - +-0.428 respectively with no significant difference between the replicates. The Dm worked also satisfactorily for colorless model solutions and extracts (Stdev range +-0.235 - +-0.309) while producing unsatisfactory results (+-0.464 - +-3.281) for colored counterparts. Severe discrepancies/ overestimates continued to pileup (52% to 197%) estimating the nutrient from high (3.0 mg/10mL) to low (0.5 mg/10mL) concentration levels, respectively. On the basis of precision and reliability, the Im technique is suggested for adoption in general laboratories for routine estimation of ascorbic acid from fruit and vegetables possessing any shade. (author)

A new generation of cancer genome diagnostics for routine clinical use: overcoming the roadblocks to personalized cancer medicine.

Science.gov (United States)

Heuckmann, J M; Thomas, R K

2015-09-01

The identification of 'druggable' kinase gene alterations has revolutionized cancer treatment in the last decade by providing new and successfully targetable drug targets. Thus, genotyping tumors for matching the right patients with the right drugs have become a clinical routine. Today, advances in sequencing technology and computational genome analyses enable the discovery of a constantly growing number of genome alterations relevant for clinical decision making. As a consequence, several technological approaches have emerged in order to deal with these rapidly increasing demands for clinical cancer genome analyses. Here, we describe challenges on the path to the broad introduction of diagnostic cancer genome analyses and the technologies that can be applied to overcome them. We define three generations of molecular diagnostics that are in clinical use. The latest generation of these approaches involves deep and thus, highly sensitive sequencing of all therapeutically relevant types of genome alterations-mutations, copy number alterations and rearrangements/fusions-in a single assay. Such approaches therefore have substantial advantages (less time and less tissue required) over PCR-based methods that typically have to be combined with fluorescence in situ hybridization for detection of gene amplifications and fusions. Since these new technologies work reliably on routine diagnostic formalin-fixed, paraffin-embedded specimens, they can help expedite the broad introduction of personalized cancer therapy into the clinic by providing comprehensive, sensitive and accurate cancer genome diagnoses in 'real-time'. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Investigation of quality assurance routines of DAP-meters in Swedish hospitals; Kartlaeggning av kvalitetssaekringsrutiner foer DAP-maetare i svensk sjukvaard

Energy Technology Data Exchange (ETDEWEB)

Almen, Anja; Grindborg, Jan-Erik; Leitz, Wolfram

2005-11-01

The Swedish Radiation Protection Authority has investigated quality control of dose area product meters (DAP meters) used in x-ray diagnostics. A questionnaire was sent out to medical physics experts who are working with diagnostic radiology in Swedish hospitals. This report presents information about the routines practised and gives examples of measures to improve the quality of these practices.

Diagnosing somatisation disorder (P75) in routine general practice using the International Classification of Primary Care.

Science.gov (United States)

Schaefert, Rainer; Laux, Gunter; Kaufmann, Claudia; Schellberg, Dieter; Bölter, Regine; Szecsenyi, Joachim; Sauer, Nina; Herzog, Wolfgang; Kuehlein, Thomas

2010-09-01

(i) To analyze general practitioners' diagnosis of somatisation disorder (P75) using the International Classification of Primary Care (ICPC)-2-E in routine general practice. (ii) To validate the distinctiveness of the ICD-10 to ICPC-2 conversion rule which maps ICD-10 dissociative/conversion disorder (F44) as well as half of the somatoform categories (F45.0-2) to P75 and codes the other half of these disorders (F45.3-9), including autonomic organ dysfunctions and pain syndromes, as symptom diagnoses plus a psychosocial code in a multiaxial manner. Cross-sectional analysis of routine data from a German research database comprising the electronic patient records of 32 general practitioners from 22 practices. For each P75 patient, control subjects matched for age, gender, and practice were selected from the 2007 yearly contact group (YCG) without a P75 diagnosis using a propensity-score algorithm that resulted in eight controls per P75 patient. Of the 49,423 patients in the YCG, P75 was diagnosed in 0.6% (302) and F45.3-9 in 1.8% (883) of cases; overall, somatisation syndromes were diagnosed in 2.4% of patients. The P75 coding pattern coincided with typical characteristics of severe, persistent medically unexplained symptoms (MUS). F45.3-9 was found to indicate moderate MUS that otherwise showed little clinical difference from P75. Pain syndromes exhibited an unspecific coding pattern. Mild and moderate MUS were predominantly recorded as symptom diagnoses. Psychosocial codes were rarely documented. ICPC-2 P75 was mainly diagnosed in cases of severe MUS. Multiaxial coding appears to be too complicated for routine primary care. Instead of splitting P75 and F45.3-9 diagnoses, it is proposed that the whole MUS spectrum should be conceptualized as a continuum model comprising categorizations of uncomplicated (mild) and complicated (moderate and severe) courses. Psychosocial factors require more attention. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Validating soil phosphorus routines in the SWAT model

Science.gov (United States)

Phosphorus transfer from agricultural soils to surface waters is an important environmental issue. Commonly used models like SWAT have not always been updated to reflect improved understanding of soil P transformations and transfer to runoff. Our objective was to validate the ability of the P routin...

The SOS pilot study: a RCT of routine oxygen supplementation early after acute stroke--effect on recovery of neurological function at one week.

Directory of Open Access Journals (Sweden)

Christine Roffe

Full Text Available Mild hypoxia is common after stroke and associated with poor long-term outcome. Oxygen supplementation could prevent hypoxia and improve recovery. A previous study of routine oxygen supplementation showed no significant benefit at 7 and 12 months. This pilot study reports the effects of routine oxygen supplementation for 72 hours on oxygen saturation and neurological outcomes at 1 week after a stroke.Patients with a clinical diagnosis of acute stroke were recruited within 24 h of hospital admission between October 2004 and April 2008. Participants were randomized to oxygen via nasal cannulae (72 h or control (room air, oxygen given only if clinically indicated. Clinical outcomes were assessed by research team members at 1 week. Baseline data for oxygen (n = 148 and control (n = 141 did not differ between groups.The median (interquartile range National Institutes of Health Stroke Scale (NIHSS score for the groups at baseline was 6 (7 and 5 (7 respectively. The median Nocturnal Oxygen Saturation during treatment was 1.4% (0.3 higher in the oxygen than in the control group (p<0.001 during the intervention. At 1 week, the median NIHSS score had reduced by 2 (3 in the oxygen and by 1 (2 in the control group. 31% of participants in the oxygen group and 14% in the control group had an improvement of ≥4 NIHSS points at 1 week doubling the odds of improvement in the oxygen group (OR: 2.9.Our data show that routine oxygen supplementation started within 24 hours of hospital admission with acute stroke led to a small, but statistically significant, improvement in neurological recovery at 1 week. However, the difference in NIHSS improvement may be due to baseline imbalance in stroke severity between the two groups and needs to be confirmed in a larger study and linked to longer-term clinical outcome.Controlled-Trials.com ISRCTN12362720; European Clinical Trials Database 2004-001866-41.

INDUSTRIAL MEASUREMENT AND CONTROL OF SLURRIES USING RADIOISOTOPE GAGES

Energy Technology Data Exchange (ETDEWEB)

Cook, Jr., H. L.

1963-09-15

Radioactivity gages are available in a variety of configurations to suit the problem of process measurement. The placement of any gage configuration must be selected carefully so that the process material flowing past the gage is representative of actual process conditions. The initial calibration of a gage is relatively simple but when the gage reading is compared with the existing manual sample measurement, confusion can result if the manual measurement is not basically accurate or subject to human error. Routine mechanical and electrical maintenance of the gage is relatively simple, because modern gages use solidstate circuitry with modular plug-in construction. Thus, routine maintenance of the gage is usually limited to restandardization to compensate for source decay. Two types of zero suppression are available, via. fixed and reductionwith-time. If reduction-with-time suppression is used the re-standardization period is about ten times longer than that required for fixed-zero suppression. Routine maintenance of the process piping and machinery is necessary to assure that a representative process material sample continues to flow through the gage. (auth)

Routine clinical use of radiopharmaceuticals in Latin American developing countries

International Nuclear Information System (INIS)

Mitta, A.E.

1985-01-01

The paper describes the routine clinical use of radiopharmaceuticals in the developing countries of Latin America made possible by: (1) the International Atomic Energy Agency (IAEA), which sent experts and equipment to many countries and made a substantial bibliographic contribution on the subject; (2) the Latin American Association of Societies of Nuclear Biology and Medicine (ALASBIMN), which fostered the exchange of data on techniques of radiopharmaceutical preparation and quality control by providing materials for tests, etc., and by publishing quality control manuals in some countries, finally in 1982 producing the Manual of Radiopharmaceutical Quality Control, in collaboration with the Inter-American Nuclear Energy Commission (CIEN) and published by the Organization of American States (OAS); (3) the countries themselves under agreements between their atomic energy commissions; (4) radiopharmacy courses organized by universities, either alone or in collaboration with the IAEA, WHO, etc.; (5) professional workers who established radiopharmaceutical services at private centres. Finally, the societies of nuclear medicine and biology in each country, the World Federation of Nuclear Medicine and Biology, the ALASBIMN, the IAEA, etc. organized symposia and meetings which afforded opportunities to professionals of these countries to receive and exchange information, since in Latin America, given its language and human characteristics, the problems are similar. The countries referred to are Argentina, Brazil, Mexico, Uruguay, Bolivia, Paraguay, Chile, Peru, Ecuador, Colombia, Venezuela, Costa Rica, Guatemala, Puerto Rico, El Salvador and Panama; little is known about Honduras, Nicaragua, the Dominican Republic and Cuba. (author)

Daily medication routine of adolescents with HIV/AIDS

Directory of Open Access Journals (Sweden)

Cristiane Cardoso de Paula

2013-12-01

Full Text Available The objective of this study was to describe the sociodemographic, clinical, and behavioral characteristics of the daily medication routine of adolescents with HIV/AIDS of ages 13 to 19 years, followed at a reference service. This descriptive cross-sectional study was performed with 23 adolescents, using a quantitative approach. Data were collected using a form during appointments at the outpatient clinic. Univariate analysis revealed: females, in the initial phase of adolescence, and vertical transmission. The highlights were: lack of assiduity to appointments; unprotected sex; and consumption of alcohol. Regarding the daily medication routine, subjects depend on their parents or guardians, use strategies to remember to take the medications, and are unaware about the laboratory test for disease management and treatment. There is a need for educative intervention using information and communication technology, such as the Internet, to promote health and autonomy among adolescents. Descriptors: Acquired Immunodeficiency Syndrome; Adolescent Health; Antiretroviral Therapy, Highly Active; Nursing.

Routine one-stage exchange for chronic infection after total hip replacement.

Science.gov (United States)

Jenny, Jean-Yves; Lengert, Régis; Diesinger, Yann; Gaudias, Jeannot; Boeri, Cyril; Kempf, Jean-François

2014-12-01

We hypothesized that a routine one-stage exchange for treatment of chronically infected total hip replacement (THR) will lead to (1) a higher rate of infection recurrence and (2) a poorer hip outcome than the published rates after two-stage exchange. Sixty-five cases have been treated consecutively with one-stage exchange. All patients have been followed for a period of three to six years or until death or infection recurrence. The five-year rate for infection recurrence was 16%. The five-year survival rate for recurrence of the index infection was 8%. Forty-two percent of the hips had a good or excellent PMA score, and 46% a good or excellent OH score. Routine one-stage exchange was not associated with a higher recurrence rate and a poorer hip function than previously published series of two-stage exchange. Therefore, there is little support to choose two-stage exchange as the routine treatment for management of chronically infected THR.

Design and construction of stepper motor controller for brachy-therapy equipment

International Nuclear Information System (INIS)

Ahmad Rifai; Usep Setia Gunawan; Indarzah Masbatin Putra

2011-01-01

Based on a microcontroller, a stepper motor controller for brachy-therapy equipment has been designed and prototyped. The embedded control program routine and its other associated routines enable the microcontroller to generate required pulses via external commands for stepper motor based position control. The controller receives ASCII text command via a serial port. The constructed algorithm implements the widely used method that allows motor to rotate in three phases, i.e: acceleration, constant speed, and deceleration. (author)

Generic environmental statement on the routine use of plutonium-powered cardiac pacemakers

International Nuclear Information System (INIS)

Shoup, R.L.; Robinson, T.W.; O'Donnell, F.R.

1976-01-01

The purpose of a continuing program at ORNL is to provide technical assistance to the NRC on writing and editing of the final environmental statement on the routine use of nuclear-powered (primarily 238 Pu) cardiac pacemakers. This environmental statement defines the safety and reliability standards that nuclear-powered pacemakers are required to meet. All aspects of the risks to the patients, the public, and the environment are evaluated both for the routine use of plutonium-powered pacemakers and for postulated accidents involving pacemaker patients. Benefits derived from the use of plutonium-powered units are discussed and weighed against the risks in order to determine whether routine use is justified. Available alternative pacemakers with various performance characteristics are compared with respect to costs and to the needs of pacemaker patients

Implementing components of the routines-based model

OpenAIRE

McWilliam, Robin; Fernández Valero, Rosa

2015-01-01

The MBR is comprised of 17 components that can generally be grouped into practices related to (a) functional assessment and intervention planning (for example, Routines-Based Interview), (b) organization of services (including location and staffing), (c) service delivery to children and families (using a consultative approach with families and teachers, integrated therapy), (d) classroom organization (for example, classroom zones), and (e) supervision and training through ch...

Patient's needs and preferences in routine follow-up after treatment for breast cancer

NARCIS (Netherlands)

de Bock, GH; Bonnema, J; Zwaan, RE; de Velde, CJH; Kievit, J; Stiggelbout, AM

2004-01-01

The purpose of the study was to analyse the needs of women who participated in a routine follow-up programme after treatment for primary breast cancer. A cross-sectional survey was conducted using a postal questionnaire among women without any sign of relapse during the routine follow-up period. The

Reduced order modeling and parameter identification of a building energy system model through an optimization routine

International Nuclear Information System (INIS)

Harish, V.S.K.V.; Kumar, Arun

2016-01-01

Highlights: • A BES model based on 1st principles is developed and solved numerically. • Parameters of lumped capacitance model are fitted using the proposed optimization routine. • Validations are showed for different types of building construction elements. • Step response excitations for outdoor air temperature and relative humidity are analyzed. - Abstract: Different control techniques together with intelligent building technology (Building Automation Systems) are used to improve energy efficiency of buildings. In almost all control projects, it is crucial to have building energy models with high computational efficiency in order to design and tune the controllers and simulate their performance. In this paper, a set of partial differential equations are formulated accounting for energy flow within the building space. These equations are then solved as conventional finite difference equations using Crank–Nicholson scheme. Such a model of a higher order is regarded as a benchmark model. An optimization algorithm has been developed, depicted through a flowchart, which minimizes the sum squared error between the step responses of the numerical and the optimal model. Optimal model of the construction element is nothing but a RC-network model with the values of Rs and Cs estimated using the non-linear time invariant constrained optimization routine. The model is validated with comparing the step responses with other two RC-network models whose parameter values are selected based on a certain criteria. Validations are showed for different types of building construction elements viz., low, medium and heavy thermal capacity elements. Simulation results show that the optimal model closely follow the step responses of the numerical model as compared to the responses of other two models.

The Controlled-Air Incinerator at Los Alamos

Energy Technology Data Exchange (ETDEWEB)

Newmyer, J.N.

1994-04-01

The Controlled-Air Incinerator (CAI) at Los Alamos is being modified and upgraded to begin routine operations treating low-level mixed waste (LLMW), radioactively contaminated polychlorinated biphenyl (PCB) wastes, low-level liquid wastes, and possibly transuranic (TRU) wastes. This paper describes those modifications. Routine waste operations should begin in late FY95.

Antibody response to routine measles vaccination among a ...

African Journals Online (AJOL)

owner

2013-02-08

Feb 8, 2013 ... Abstract Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vacci- nation in Nigerian children and evaluate vaccine potency.

Clinical Outcome of Degenerative Mitral Regurgitation: Critical Importance of Echocardiographic Quantitative Assessment in Routine Practice.

Science.gov (United States)

Antoine, Clemence; Benfari, Giovanni; Michelena, Hector I; Malouf, Joseph F; Nkomo, Vuyisile T; Thapa, Prabin; Enriquez-Sarano, Maurice

2018-05-31

Background -Echocardiographic quantitation of degenerative mitral regurgitation (DMR) is recommended whenever possible in clinical guidelines but is criticized and its scalability to routine clinical practice doubted. We hypothesized that echocardiographic DMR quantitation, performed in routine clinical practice by multiple practitioners predicts independently long-term survival, and thus is essential to DMR management. Methods -We included patients diagnosed with isolated mitral-valve-prolapse 2003-2011 and any degree of MR quantified by any physician/sonographer in routine clinical practice. Clinical/echocardiographic data acquired at diagnosis were retrieved electronically. Endpoint was mortality under medical treatment analyzed by Kaplan-Meir method and Proportional-Hazard models. Results -The cohort included 3914 patients (55% male) aged 62±17 years, with left ventricular ejection fraction (LVEF) 63±8% and routinely measured effective regurgitant orifice area (EROA) 19[0-40] mm 2 During follow-up (6.7±3.1 years) 696 patients died under medical management and 1263 underwent mitral surgery. In multivariate analysis, routinely measured EROA was associated with mortality (adjusted-hazard-ratio 1.19[1.13-1.24] p 40 mm 2 threshold. Conclusions -Echocardiographic DMR quantitation is scalable to routine practice and is independently associated with clinical outcome. Routinely measured EROA is strongly associated with long-term survival under medical treatment. Excess mortality vs. the general population appears in the "moderate" DMR range and steadily increases with higher EROA. Hence, individual EROA values should be integrated into therapeutic considerations, additionally to categorical DMR grading.

Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation – A Multicenter Comparison to Echocardiography

Science.gov (United States)

Simprini, Lauren A.; Afroz, Anika; Cooper, Mitchell A.; Klem, Igor; Jensen, Christoph; Kim, Raymond J.; Srichai, Monvadi B.; Heitner, John F.; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J.; Lopez-Mattei, Juan; Biederman, Robert W.; Grizzard, John D.; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

2016-01-01

Background/Aim MR is an important complication after PMV. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-CMR holds potential to non-invasively assess regurgitant severity based on MR-induced inter-voxel dephasing. This study evaluated routine cine-CMR for visual assessment of prosthetic mitral valve (PMV) associated mitral regurgitation (MR). Methods Routine cine-CMR was performed at 9 sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild 2/3): MR was graded in each long axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PSFR). Visual interpretation was compared to quantitative analysis in a single center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. Results The population comprised 85 PMV patients (59% mechanical, 41% bioprosthetic). Among the derivation cohort (n=25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p=0.001): Patients with severe MR had nearly a 3-fold increase in quantitative jet area (p=0.002), and 2-fold increase in density (p=0.04) than did others. Among the multicenter cohort, cine-CMR and TEE (Δ=2±3 days) demonstrated moderate agreement (κ=0.44); 64% of discordances differed by ≤ 1 grade (Δ=1.2±0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value=100%). Patients with visually graded severe MR also had more frequent PVSFR (pcine-CMR. Conclusions Cine-CMR is useful for assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter-voxel dephasing. Visual MR assessment based on jet size provides an accurate non-invasive means of screening for

Cost-effectiveness of routine imaging of suspected appendicitis.

Science.gov (United States)

D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

2018-01-01

Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

Immune Infertility Should Be Positively Diagnosed Using an Accurate Method by Monitoring the Level of Anti-ACTL7a Antibody

Science.gov (United States)

Fu, Jun; Yao, Rongyan; Luo, Yanyun; Yang, Dantong; Cao, Yang; Qiu, Yi; Song, Wei; Miao, Shiying; Gu, Yiqun; Wang, Linfang

2016-01-01

Infertility is currently a major public health problem. Anti-sperm antibodies (ASAs) markedly reduce sperm quality, which can subsequently lead to male and/or female infertility. The accurate detection of ASAs derived from specific spermatozoa is, therefore, clinically useful. We have focused on the spermatozoa-specific expression protein ACTL7a for many years and have developed an enzyme-linked immunosorbent assay (ELISA) to detect the concentration of anti-ACTL7a antibodies in fertile sera (n = 267) and infertile sera (n = 193). Infertile sera were collected from the positive sera of tray agglutination tests (TAT), which is a routine ASA screening methodology. We found that the concentration of anti-ACTL7a antibodies was significantly higher in the infertile sera (than in the fertile sera, P infertile sera. The ELISA was much better for male sera detection (AUC = 0.9899). If we set the standard at a strongly positive value (calculated by ROC curve), the positive predictive value of the antibody detection reached 100 percent, with a false positive rate of zero. The developed ELISA method for anti-ACTL7a antibody detection is therefore sensitive, accurate, and easy to perform, making it an excellent potential tool for future clinical use. PMID:26957350

Artificial neural networks to predict presence of significant pathology in patients presenting to routine colorectal clinics.

Science.gov (United States)

Maslekar, S; Gardiner, A B; Monson, J R T; Duthie, G S

2010-12-01

Artificial neural networks (ANNs) are computer programs used to identify complex relations within data. Routine predictions of presence of colorectal pathology based on population statistics have little meaning for individual patient. This results in large number of unnecessary lower gastrointestinal endoscopies (LGEs - colonoscopies and flexible sigmoidoscopies). We aimed to develop a neural network algorithm that can accurately predict presence of significant pathology in patients attending routine outpatient clinics for gastrointestinal symptoms. Ethics approval was obtained and the study was monitored according to International Committee on Harmonisation - Good Clinical Practice (ICH-GCP) standards. Three-hundred patients undergoing LGE prospectively completed a specifically developed questionnaire, which included 40 variables based on clinical symptoms, signs, past- and family history. Complete data sets of 100 patients were used to train the ANN; the remaining data was used for internal validation. The primary output used was positive finding on LGE, including polyps, cancer, diverticular disease or colitis. For external validation, the ANN was applied to data from 50 patients in primary care and also compared with the predictions of four clinicians. Clear correlation between actual data value and ANN predictions were found (r = 0.931; P = 0.0001). The predictive accuracy of ANN was 95% in training group and 90% (95% CI 84-96) in the internal validation set and this was significantly higher than the clinical accuracy (75%). ANN also showed high accuracy in the external validation group (89%). Artificial neural networks offer the possibility of personal prediction of outcome for individual patients presenting in clinics with colorectal symptoms, making it possible to make more appropriate requests for lower gastrointestinal endoscopy. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

Families experiencing housing instability: the effects of housing programs on family routines and rituals.

Science.gov (United States)

Mayberry, Lindsay Satterwhite; Shinn, Marybeth; Benton, Jessica Gibbons; Wise, Jasmine

2014-01-01

Maintenance of family processes can protect parents, children, and families from the detrimental effects of extreme stressors, such as homelessness. When families cannot maintain routines and rituals, the stressors of poverty and homelessness can be compounded for both caregivers and children. However, characteristics of living situations common among families experiencing homelessness present barriers to the maintenance of family routines and rituals. We analyzed 80 in-depth interviews with parents who were experiencing or had recently experienced an instance of homelessness. We compared their assessments of challenges to family schedules, routines, and rituals across various living situations, including shelter, transitional housing programs, doubled-up (i.e., living temporarily with family or friends), and independent housing. Rules common across shelters and transitional housing programs impeded family processes, and parents felt surveilled and threatened with child protective service involvement in these settings. In doubled-up living situations, parents reported adapting their routines to those of the household and having parenting interrupted by opinions of friends and family members. Families used several strategies to maintain family routines and rituals in these living situations and ensure consistency and stability for their children during an otherwise unstable time. (c) 2014 APA, all rights reserved.

FeetForward: On Blending New Classroom Technologies into Secondary School Teachers’ Routines

OpenAIRE

An , Pengcheng; Bakker , Saskia; Eggen , Berry

2017-01-01

Part 5: Interaction at the Workplace; International audience; Secondary school teachers have complex, intensive and dynamic routines in their classrooms, which makes their attentional resources limited for human-computer interaction. Leveraging principles of peripheral interaction can reduce attention demanded by technologies and interactions could blend more seamlessly into the everyday routine. We present the design and deployment of FeetForward - an open-ended, and foot-based peripheral in...

Disturbance observer based model predictive control for accurate atmospheric entry of spacecraft

Science.gov (United States)

Wu, Chao; Yang, Jun; Li, Shihua; Li, Qi; Guo, Lei

2018-05-01

Facing the complex aerodynamic environment of Mars atmosphere, a composite atmospheric entry trajectory tracking strategy is investigated in this paper. External disturbances, initial states uncertainties and aerodynamic parameters uncertainties are the main problems. The composite strategy is designed to solve these problems and improve the accuracy of Mars atmospheric entry. This strategy includes a model predictive control for optimized trajectory tracking performance, as well as a disturbance observer based feedforward compensation for external disturbances and uncertainties attenuation. 500-run Monte Carlo simulations show that the proposed composite control scheme achieves more precise Mars atmospheric entry (3.8 km parachute deployment point distribution error) than the baseline control scheme (8.4 km) and integral control scheme (5.8 km).

Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations

Energy Technology Data Exchange (ETDEWEB)

Creeden, Sean G.; Rao, Anil G.; Eklund, Meryle J.; Hill, Jeanne G.; Thacker, Paul G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

2017-03-15

Although practice patterns vary, scout radiographs are often routinely performed with pediatric fluoroscopic studies. However few studies have evaluated their utility in routine pediatric fluoroscopy. To evaluate the value of scout abdomen radiographs in routine barium or water-soluble enema, upper gastrointestinal (GI) series, and voiding cystourethrogram pediatric fluoroscopic procedures. We retrospectively evaluated 723 barium or water-soluble enema, upper GI series, and voiding cystourethrogram fluoroscopic procedures performed at our institution. We assessed patient history and demographics, clinical indication for the examination, prior imaging findings and impressions, scout radiograph findings, additional findings provided by the scout radiograph that were previously unknown, and whether the scout radiograph contributed any findings that significantly changed management. We retrospectively evaluated 723 fluoroscopic studies (368 males and 355 females) in pediatric patients. Of these, 700 (96.8%) had a preliminary scout radiograph. Twenty-three (3.2%) had a same-day radiograph substituted as a scout radiograph. Preliminary scout abdomen radiographs/same-day radiographs showed no new significant findings in 719 (99.4%) studies. New but clinically insignificant findings were seen in 4 (0.6%) studies and included umbilical hernia, inguinal hernia and hip dysplasia. No findings were found on the scout radiographs that would either alter the examination performed or change management with regard to the exam. Pre-procedural scout abdomen radiographs are unnecessary in routine barium and water-soluble enema, upper GI series, and voiding cystourethrogram pediatric fluoroscopic procedures and can be substituted with a spot fluoroscopic last-image hold. (orig.)

The Utrecht Health Project: Optimization of routine healthcare data for research

International Nuclear Information System (INIS)

Grobbee, Diederick E.; Hoes, Arno W.; Verheij, Theo J. M.; Schrijvers, Augustinus J. P.; Ameijden, Erik J. C. van; Numans, Mattijs E.

2005-01-01

Background. Research on the impact of changes in healthcare policy, developments in community and public health and determinants of health and disease during lifetime may effectively make use of routine healthcare data. These data, however, need to meet minimal criteria for quality and completeness. Research opportunities are further improved when routine data are supplemented with a standardized 'baseline' assessment of the full population. This formed the basis for a new study initiated in a newly developed large residential area in Leidsche Rijn, part of the city of Utrecht, the Netherlands.Methods. All new inhabitants are invited by their general practitioner to participate in the Utrecht Health Project (UHP). Informed consent is obtained and an individual health profile (IHP) is made by dedicated research nurses. The IHP is the starting point for the UHP research database as well as for the primary care electronic medical records. Follow-up data are collected through continuous linkage with the computerized medical files recorded by the general practitioners. UHP staff in each practice takes care of quality management of registration as well as data handling.Results. Currently, over 60 of invited new residents in the area have given informed consent with participation steadily increasing. Discussion. The Utrecht Health Project combines key elements of traditional epidemiologic cohort studies with the current power of routine electronic medical record keeping in primary care. The research approach optimizes routine health care data for use in scientific research

Ethnographic study of ICT-supported collaborative work routines in general practice.

Science.gov (United States)

Swinglehurst, Deborah; Greenhalgh, Trisha; Myall, Michelle; Russell, Jill

2010-12-29

Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice.

Guidance to Achieve Accurate Aggregate Quantitation in Biopharmaceuticals by SV-AUC.

Science.gov (United States)

Arthur, Kelly K; Kendrick, Brent S; Gabrielson, John P

2015-01-01

The levels and types of aggregates present in protein biopharmaceuticals must be assessed during all stages of product development, manufacturing, and storage of the finished product. Routine monitoring of aggregate levels in biopharmaceuticals is typically achieved by size exclusion chromatography (SEC) due to its high precision, speed, robustness, and simplicity to operate. However, SEC is error prone and requires careful method development to ensure accuracy of reported aggregate levels. Sedimentation velocity analytical ultracentrifugation (SV-AUC) is an orthogonal technique that can be used to measure protein aggregation without many of the potential inaccuracies of SEC. In this chapter, we discuss applications of SV-AUC during biopharmaceutical development and how characteristics of the technique make it better suited for some applications than others. We then discuss the elements of a comprehensive analytical control strategy for SV-AUC. Successful implementation of these analytical control elements ensures that SV-AUC provides continued value over the long time frames necessary to bring biopharmaceuticals to market. © 2015 Elsevier Inc. All rights reserved.

Quality Assessment of Urinary Stone Analysis

DEFF Research Database (Denmark)

Siener, Roswitha; Buchholz, Noor; Daudon, Michel

2016-01-01

After stone removal, accurate analysis of urinary stone composition is the most crucial laboratory diagnostic procedure for the treatment and recurrence prevention in the stone-forming patient. The most common techniques for routine analysis of stones are infrared spectroscopy, X-ray diffraction......, fulfilled the quality requirements. According to the current standard, chemical analysis is considered to be insufficient for stone analysis, whereas infrared spectroscopy or X-ray diffraction is mandatory. However, the poor results of infrared spectroscopy highlight the importance of equipment, reference...... spectra and qualification of the staff for an accurate analysis of stone composition. Regular quality control is essential in carrying out routine stone analysis....

PELLET: a computer routine for modeling pellet fueling in tokamak plasmas

International Nuclear Information System (INIS)

Houlberg, W.A.; Iskra, M.A.; Howe, H.C.; Attenberger, S.E.

1979-01-01

Recent experimental results of frozen hydrogenic pellet injection into hot tokamak plasmas and substantial agreement with theoretical predictions have led to a much greater interest in pellets as a means of refueling plasmas. The computer routine PELLET has been developed and used as an aid in assessing pellet ablation models and the effects of pellets on plasma behavior. PELLET provides particle source profiles under various options for the ablation model and can be coupled either to a fluid transport code or to a brief routine which supplies the required input parameters

Changing in Convergence: The Impact of TV News Routines on the Usage of Online UGC Sources

Directory of Open Access Journals (Sweden)

Huei-Ling Liu

2014-10-01

Full Text Available Online videos, or so called user-generated content, have been used in TV news frequently because of recent media convergence. This study examined whether this phenomenon influences news routines, and whether new characteristics of news routines have emerged because of the dependency on UGC sources. A qualitative research method was adopted, and 15 Taiwanese TV journalists were interviewed. The results show that the high dependence on the Internet for obtaining news has encouraged journalists producing news without having to leave newsroom. New routines have been formed in new production. At organizational levels, the search for online materials has been routinized, Journalist’ newsgathering and reporting are no longer original and initial but follow the hit topics on the Internet, Moreover, and news coverage currently focuses on format instead of meaning. At interorganizational level, TV news organizations monitor and imitate each other to adjust their routines. This paper shows that some unprofessional behaviors of journalists have become reasonable because of news routines changed. Consequently, the ethical and professional controversies have been ignored in newsroom.

The (Proper) Microfoundations of Routines and Capabilities

DEFF Research Database (Denmark)

Felin, Teppo; Foss, Nicolai Juul

2012-01-01

Sidney Winter (2011), Brian Pentland (2011), and Geoffrey Hodgson and Thorbjørn Knudsen (2011) take issue with the arguments in Teppo Felin and Nicolai J. Foss (2011), along with more generally critiquing the ‘microfoundations project’ related to routines and capabilities. In this rejoinder we ar...... chauvinism; (3) models of mind and man; (4) levels of analysis; (5) agency and uncaused causes; and then further discuss (6) a rationalist alternative....

Are tidal volume measurements in neonatal pressure-controlled ventilation accurate?

Science.gov (United States)

Chow, Lily C; Vanderhal, Andre; Raber, Jorge; Sola, Augusto

2002-09-01

Bedside pulmonary mechanics monitors (PMM) have become useful in ventilatory management in neonates. These monitors are used more frequently due to recent improvements in data-processing capabilities. PMM devices are often part of the ventilator or are separate units. The accuracy and reliability of these systems have not been carefully evaluated. We compared a single ventilatory parameter, tidal volume (V(t)), as measured by several systems. We looked at two freestanding PMMs: the Ventrak Respiratory Monitoring System (Novametrix, Wallingford, CT) and the Bicore CP-100 Neonatal Pulmonary Monitor (Allied Health Care Products, Riverside, CA), and three ventilators with built-in PMM: the VIP Bird Ventilator (Bird Products Corp., Palm Springs, CA), Siemens Servo 300A (Siemens-Elema AB, Solna, Sweden), and Drager Babylog 8000 (Drager, Inc., Chantilly, VA). A calibrated syringe (Hans Rudolph, Inc., Kansas City, MO) was used to deliver tidal volumes of 4, 10, and 20 mL to each ventilator system coupled with a freestanding PMM. After achieving steady state, six consecutive V(t) readings were taken simultaneously from the freestanding PMM and each ventilator. In a second portion of the bench study, we used pressure-control ventilation and measured exhaled tidal volume (V(te)) while ventilating a Bear Test Lung with the same three ventilators. We adjusted peak inspiratory pressure (PIP) under controlled conditions to achieve the three different targeted tidal volumes on the paired freestanding PMM. Again, six V(te) measurements were recorded for each tidal volume. Means and standard deviations were calculated.The percentage difference in measurement of V(t) delivered by calibrated syringe varied greatly, with the greatest discrepancy seen in the smallest tidal volumes, by up to 28%. In pressure control mode, V(te) as measured by the Siemens was significantly overestimated by 20-95%, with the biggest discrepancy at the smallest V(te), particularly when paired with the Bicore

ARTIFICIAL NEURAL NETWORK AND FUZZY LOGIC CONTROLLER FOR GTAW MODELING AND CONTROL

Institute of Scientific and Technical Information of China (English)

无

2002-01-01

An artificial neural network(ANN) and a self-adjusting fuzzy logic controller(FLC) for modeling and control of gas tungsten arc welding(GTAW) process are presented. The discussion is mainly focused on the modeling and control of the weld pool depth with ANN and the intelligent control for weld seam tracking with FLC. The proposed neural network can produce highly complex nonlinear multi-variable model of the GTAW process that offers the accurate prediction of welding penetration depth. A self-adjusting fuzzy controller used for seam tracking adjusts the control parameters on-line automatically according to the tracking errors so that the torch position can be controlled accurately.

Laser Acupuncture at Large Intestine 4 Compared with Oral Glucose Administration for Pain Prevention in Healthy Term Neonates Undergoing Routine Heel Lance: Study Protocol for an Observer-Blinded, Randomised Controlled Clinical Trial

Directory of Open Access Journals (Sweden)

Jasmin Stadler

2018-01-01

Full Text Available Background. Nonpharmacological strategies have actually become more important in neonatal pain management during routinely applied minor painful procedures. However, commonly used nonpharmacological strategies are inferior to orally administered sweet solutions. Therefore, we will compare laser acupuncture, as a recent nonpharmacological method, with the standard care of oral glucose solution for pain prevention. Methods. Ninety-five healthy term neonates will be allocated into one of two groups. Before routine heel lance for metabolic screening, one group will receive laser acupuncture at acupuncture point Large Intestine 4 (LI 4 bilaterally for 60 seconds per point (acupuncture group and the other will receive the standard care with orally administered glucose solution (glucose group. The complete procedure of blood sampling will be recorded on video, excluding the intervention before heel lance. A paediatric nurse, blinded with respect to the allocation, will evaluate these video recordings and determine the Premature Infant Pain Profile (PIPP for each neonate. Primary outcome will be the mean difference in PIPP scores between groups. Discussion. This observer-blinded randomised controlled trial has been designed to explore potential advantages of laser acupuncture in the management of neonatal pain because more data are required to provide information about its efficacy and safety. Trial Registration. This trial is registered with DRKS00010122.

Laser Acupuncture at Large Intestine 4 Compared with Oral Glucose Administration for Pain Prevention in Healthy Term Neonates Undergoing Routine Heel Lance: Study Protocol for an Observer-Blinded, Randomised Controlled Clinical Trial.

Science.gov (United States)

Stadler, Jasmin; Avian, Alexander; Posch, Katrin; Urlesberger, Berndt; Raith, Wolfgang

2018-01-01

Nonpharmacological strategies have actually become more important in neonatal pain management during routinely applied minor painful procedures. However, commonly used nonpharmacological strategies are inferior to orally administered sweet solutions. Therefore, we will compare laser acupuncture, as a recent nonpharmacological method, with the standard care of oral glucose solution for pain prevention. Ninety-five healthy term neonates will be allocated into one of two groups. Before routine heel lance for metabolic screening, one group will receive laser acupuncture at acupuncture point Large Intestine 4 (LI 4) bilaterally for 60 seconds per point (acupuncture group) and the other will receive the standard care with orally administered glucose solution (glucose group). The complete procedure of blood sampling will be recorded on video, excluding the intervention before heel lance. A paediatric nurse, blinded with respect to the allocation, will evaluate these video recordings and determine the Premature Infant Pain Profile (PIPP) for each neonate. Primary outcome will be the mean difference in PIPP scores between groups. This observer-blinded randomised controlled trial has been designed to explore potential advantages of laser acupuncture in the management of neonatal pain because more data are required to provide information about its efficacy and safety. This trial is registered with DRKS00010122.

Utility of routine postoperative chest radiography in pediatric tracheostomy.

Science.gov (United States)

Genther, Dane J; Thorne, Marc C

2010-12-01

Routine chest radiography following pediatric tracheostomy is commonly performed in order to evaluate for air-tracking complications. Routine chest radiography affords disadvantages of radiation exposure and cost. The primary objective of this study was to determine the utility of routine postoperative chest radiography following tracheostomy in pediatric patients. Secondary objectives were to compare the rates of postoperative complications by various patient and surgeon characteristics. All infants and children 18 years of age or less (n=421) who underwent tracheostomy at a single tertiary-care medical center from January 2000 to April 2009 were included in the study. A combination of data obtained from billing and administrative systems and review of electronic medical records were recorded and compiled in a database for statistical analysis. Three air-tracking complications (2 pneumothoraces and 1 pneumomediastinum) were identified in our population of 421 pediatric patients, for an incidence of 0.71% (95% CI: 0.1-2.0%). No significant relationships were found between the incidence of air-tracking complication and surgical specialty, patient age, or type of procedure (elective, urgent/emergent). Our study identified a low rate of pneumothorax and pneumomediastinum following pediatric tracheostomy. In all three cases, the pneumothorax was suspected clinically. This finding suggests that postoperative chest radiography should be reserved for cases where there is suspicion of a complication on the basis of intraoperative findings or clinical parameters. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Examining daily activity routines of older adults using workflow.

Science.gov (United States)

Chung, Jane; Ozkaynak, Mustafa; Demiris, George

2017-07-01

We evaluated the value of workflow analysis supported by a novel visualization technique to better understand the daily routines of older adults and highlight their patterns of daily activities and normal variability in physical functions. We used a self-reported activity diary to obtain data from six community-dwelling older adults for 14 consecutive days. Workflow for daily routine was analyzed using the EventFlow tool, which aggregates workflow information to highlight patterns and variabilities. A total of 1453 events were included in the data analysis. To demonstrate the patterns and variability of each individual's daily activities, participant activity workflows were visualized and compared. The workflow analysis revealed great variability in activity types, regularity, frequency, duration, and timing of performing certain activities across individuals. Also, when workflow approach was applied to spatial information of activities, the analysis revealed the ability to provide meaningful data on individuals' mobility in different levels of life spaces from home to community. Results suggest that using workflows to characterize the daily activities of older adults will be helpful for clinicians and researchers in understanding their daily routines and preparing education and prevention strategies tailored to each individual's activity level. This tool also has the potential to be integrated into consumer informatics technologies, such as patient portals or personal health records, so that consumers may be encouraged to become actively involved in monitoring and managing their health. Copyright © 2017 Elsevier Inc. All rights reserved.

Perspex in the verification routines for accelerator beam

International Nuclear Information System (INIS)

Paredes G, L.; Genis S, R.

1998-01-01

It is analyzed the use of a perspex solid phantom, adequately referred to a water phantom, as an auxiliary alternative for the daily stability verification routines or constance of radiation beam, as an option in the case of radiotherapy installations with high charge of accelerator working and with basic dosimetry equipment. (Author)

Interpreted consultations as 'business as usual'? An analysis of organisational routines in general practices.

Science.gov (United States)

Greenhalgh, Trisha; Voisey, Christopher; Robb, Nadia

2007-09-01

UK general practices operate in an environment of high linguistic diversity, because of recent large-scale immigration and of the NHS's commitment to provide a professional interpreter to any patient if needed. Much activity in general practice is co-ordinated and patterned into organisational routines (defined as repeated patterns of interdependent actions, involving multiple actors, bound by rules and customs) that tend to be stable and to persist. If we want to understand how general practices are responding to pressures to develop new routines, such as interpreted consultations, we need to understand how existing organisational routines change. This will then help us to address a second question, which is how the interpreted consultation itself is being enacted and changing as it becomes routinised (or not) in everyday general practice. In seeking answers to these two questions, we undertook a qualitative study of narratives of interpreted primary care consultations in three London boroughs with large minority ethnic populations. In 69 individual interviews and two focus groups, we sought accounts of interpreted consultations from service users, professional interpreters, family member interpreters, general practitioners, practice nurses, receptionists, and practice managers. We asked participants to tell us both positive and negative stories of their experiences. We analysed these data by searching for instances of concepts relating to the organisational routine, the meaning of the interpreted consultation to the practice, and the sociology of medical work. Our findings identified a number of general properties of the interpreted consultation as an organisational routine, including the wide variation in the form of adoption, the stability of the routine, the adaptability of the routine, and the strength of the routine. Our second key finding was that this variation could be partly explained by characteristics of the practice as an organisation, especially

The nexus between organizational routines and projects\\ud A goal-based perspective

OpenAIRE

Olufemi, Moses; Hope, Alex; Osborne, Allan

2015-01-01

It has long been established that routines can be sources of stability and change within organizations. It has been suggested however that an understanding of routines alone is not enough for explaining how new actions emerge in organizations. In arguing that traditional forms of organizational structure are not flexible enough to adapt to new actions (Ansoff, 1980), some theorists have proposed projects as management methods for adapting to fast changes occurring in the business environment....

Dual-Routine HCV/HIV Testing: Seroprevalence and Linkage to Care in Four Community Health Centers in Philadelphia, Pennsylvania.

Science.gov (United States)

Coyle, Catelyn; Kwakwa, Helena

2016-01-01

Despite common risk factors, screening for hepatitis C virus (HCV) and HIV at the same time as part of routine medical care (dual-routine HCV/HIV testing) is not commonly implemented in the United States. This study examined improvements in feasibility of implementation, screening increase, and linkage to care when a dual-routine HCV/HIV testing model was integrated into routine primary care. National Nursing Centers Consortium implemented a dual-routine HCV/HIV testing model at four community health centers in Philadelphia, Pennsylvania, on September 1, 2013. Routine HCV and opt-out HIV testing replaced the routine HCV and opt-in HIV testing model through medical assistant-led, laboratory-based testing and electronic medical record modification to prompt, track, report, and facilitate reimbursement for tests performed on uninsured individuals. This study examined testing, seropositivity, and linkage-to-care comparison data for the nine months before (December 1, 2012-August 31, 2013) and after (September 1, 2013-May 31, 2014) implementation of the dual-routine HCV/HIV testing model. A total of 1,526 HCV and 1,731 HIV tests were performed before, and 1,888 HCV and 3,890 HIV tests were performed after dual-routine testing implementation, resulting in a 23.7% increase in HCV tests and a 124.7% increase in HIV tests. A total of 70 currently HCV-infected and four new HIV-seropositive patients vs. 101 HCV-infected and 13 new HIV-seropositive patients were identified during these two periods, representing increases of 44.3% for HCV antibody-positive and RNA-positive tests and 225.0% for HIV-positive tests. Linkage to care increased from 27 currently infected HCV--positive and one HIV-positive patient pre-dual-routine testing to 39 HCV--positive and nine HIV-positive patients post-dual-routine testing. The dual-routine HCV/HIV testing model shows that integrating dual-routine testing in a primary care setting is possible and leads to increased HCV and HIV screening

Development of accurate techniques for controlling polarization of a long wavelength neutron beam in very low magnetic fields. I

International Nuclear Information System (INIS)

Kawai, Takeshi; Ebisawa, Toru; Tasaki, Seiji; Akiyoshi, Tsunekazu; Eguchi, Yoshiaki; Hino, Masahiro; Achiwa, Norio.

1995-01-01

The purpose of our study is to develop accurate techniques for controlling polarization of a long wavelength neutron beam and to make a thin-film dynamical spin-flip device operated in magnetizing fields less than 100 gauss and in a shorter switching time up to 20 kHz. The device would work as a chopper for a polarized neutron beam and as a magnetic switching device for a multilayer neutron interferometer. We have started to develop multilayer polarizing mirrors functioning under magnetizing fields less than 100 gauss. The multilayers of Permalloy-Ge and Fe-Ge have been produced using the evaporation method under magnetizing fields of about 100 gauss parallel to the Si-wafer substrate surface. The hysteresis loop for in-plane magnetization of the multilayers were measured to discuss their feasibilities for the polarizing device functioning under very low magnetizing fields. The polarizing efficiencies of Fe-Ge and Permalloy-Ge multilayers were 95 % and 91 % with reflectivities of 50 % and 66 % respectively under magnetizing fields of 80 gauss. The report also discusses problems in applying these multilayer polarizing mirrors to ultracold neutrons. (author)

Setting the standard for routine asthma consultations: a discussion of the aims, process and outcomes of reviewing people with asthma in primary care.

Science.gov (United States)

Pinnock, Hilary; Fletcher, Monica; Holmes, Steve; Keeley, Duncan; Leyshon, Jane; Price, David; Russell, Richard; Versnel, Jenny; Wagstaff, Bronwen

2010-03-01

Globally, asthma morbidity remains unacceptably high. If outcomes are to be improved, it is crucial that routine review consultations in primary care are performed to a high standard. Key components of a review include: * Assessment of control using specific morbidity questions to elucidate the presence of symptoms, in conjunction with the frequency of use of short-acting bronchodilators and any recent history of acute attacks * After consideration of the diagnosis, and an assessment of compliance, inhaler technique, smoking status, triggers, and rhinitis, identification of poor control should result in a step-up of treatment in accordance with evidence-based guideline recommendations * Discussion should address understanding of the condition, patient-centred management goals and attitudes to regular treatment, and should include personalised self-management education Regular review of people with asthma coupled with provision of self-management education improves outcomes. Underpinned by a theoretical framework integrating professional reviews and patient self-care we discuss the practical barriers to implementing guided selfmanagement in routine clinical practice.

Comparison between the triglycerides standardization of routine methods used in Japan and the chromotropic acid reference measurement procedure used by the CDC Lipid Standardization Programme.

Science.gov (United States)

Nakamura, Masakazu; Iso, Hiroyasu; Kitamura, Akihiko; Imano, Hironori; Noda, Hiroyuki; Kiyama, Masahiko; Sato, Shinichi; Yamagishi, Kazumasa; Nishimura, Kunihiro; Nakai, Michikazu; Vesper, Hubert W; Teramoto, Tamio; Miyamoto, Yoshihiro

2016-11-01

Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) -1.292 ( n = 495, R 2  = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was -0.71%, -0.42% and -0.13%, respectively. For the combined precision, the equation y (CV) = -0.398 × (triglycerides value) + 1.797 ( n = 495, R 2  = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time.

On the cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

International Nuclear Information System (INIS)

Buell, U.; Winkler, U.

1983-01-01

Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases. (orig.) [de

Measuring and improving the quality of postoperative epidural analgesia for major abdominal surgery using statistical process control charts.

Science.gov (United States)

Duncan, Fiona; Haigh, Carol

2013-10-01

To explore and improve the quality of continuous epidural analgesia for pain relief using Statistical Process Control tools. Measuring the quality of pain management interventions is complex. Intermittent audits do not accurately capture the results of quality improvement initiatives. The failure rate for one intervention, epidural analgesia, is approximately 30% in everyday practice, so it is an important area for improvement. Continuous measurement and analysis are required to understand the multiple factors involved in providing effective pain relief. Process control and quality improvement Routine prospectively acquired data collection started in 2006. Patients were asked about their pain and side effects of treatment. Statistical Process Control methods were applied for continuous data analysis. A multidisciplinary group worked together to identify reasons for variation in the data and instigated ideas for improvement. The key measure for improvement was a reduction in the percentage of patients with an epidural in severe pain. The baseline control charts illustrated the recorded variation in the rate of several processes and outcomes for 293 surgical patients. The mean visual analogue pain score (VNRS) was four. There was no special cause variation when data were stratified by surgeons, clinical area or patients who had experienced pain before surgery. Fifty-seven per cent of patients were hypotensive on the first day after surgery. We were able to demonstrate a significant improvement in the failure rate of epidurals as the project continued with quality improvement interventions. Statistical Process Control is a useful tool for measuring and improving the quality of pain management. The applications of Statistical Process Control methods offer the potential to learn more about the process of change and outcomes in an Acute Pain Service both locally and nationally. We have been able to develop measures for improvement and benchmarking in routine care that

Automated lung volumetry from routine thoracic CT scans: how reliable is the result?

Science.gov (United States)

Haas, Matthias; Hamm, Bernd; Niehues, Stefan M

2014-05-01

Today, lung volumes can be easily calculated from chest computed tomography (CT) scans. Modern postprocessing workstations allow automated volume measurement of data sets acquired. However, there are challenges in the use of lung volume as an indicator of pulmonary disease when it is obtained from routine CT. Intra-individual variation and methodologic aspects have to be considered. Our goal was to assess the reliability of volumetric measurements in routine CT lung scans. Forty adult cancer patients whose lungs were unaffected by the disease underwent routine chest CT scans in 3-month intervals, resulting in a total number of 302 chest CT scans. Lung volume was calculated by automatic volumetry software. On average of 7.2 CT scans were successfully evaluable per patient (range 2-15). Intra-individual changes were assessed. In the set of patients investigated, lung volume was approximately normally distributed, with a mean of 5283 cm(3) (standard deviation = 947 cm(3), skewness = -0.34, and curtosis = 0.16). Between different scans in one and the same patient the median intra-individual standard deviation in lung volume was 853 cm(3) (16% of the mean lung volume). Automatic lung segmentation of routine chest CT scans allows a technically stable estimation of lung volume. However, substantial intra-individual variations have to be considered. A median intra-individual deviation of 16% in lung volume between different routine scans was found. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Routine antibiotic cover for newborns intubated for aspirating meconium: is it necessary?

Science.gov (United States)

Krishnan, L; Nasruddin; Prabhakar, P; Bhaskaranand, N

1995-05-01

A retrospective analysis was performed on 215 babies to evaluate the incidence of septicemia in babies intubated at birth for aspirating meconium from the trachea. Only term, appropriate for gestational age babies were included. Babies with any known perinatal risk factor for infection were excluded from the study and none of the babies had been put on "prophylactic antibiotics." There were 88 babies in the intubated group in a one year period from January 1991 to December 1991. One hundred and twenty seven babies were taken as controls. There was no significant difference in the incidence of early septicemia in the two groups. There were no deaths in either group. It is concluded that well term babies who are intubated for aspirating meconium need not be put on routine antibiotic cover.

Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines

Directory of Open Access Journals (Sweden)

Annette Kluge

2018-02-01

Full Text Available To cope with the already large, and ever increasing, amount of information stored in organizational memory, “forgetting,” as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management, forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the literature on the need for organizational forgetting and particularly on accidental vs. intentional forgetting. We discuss the current state of the art of theory and empirical evidence on forgetting from cognitive psychology in order to infer mechanisms applicable to the organizational context. In this respect, we emphasize retrieval theories and the relevance of retrieval cues important for forgetting. Subsequently, we transfer the empirical evidence that the elimination of retrieval cues leads to faster forgetting to the forgetting of organizational routines, as routines are part of organizational memory. We then propose a classification of cues (context, sensory, business process-related cues that are relevant in the forgetting of routines, and discuss a meta-cue called the “situational strength” cue, which is relevant if cues of an old and a new routine are present simultaneously. Based on the classification as business process-related cues (information, team, task, object cues, we propose mechanisms to accelerate forgetting by eliminating specific cues based on the empirical and theoretical state of the art. We conclude that in intentional organizational change processes, the elimination of cues to accelerate forgetting should be used in change management practices.

Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines.

Science.gov (United States)

Kluge, Annette; Gronau, Norbert

2018-01-01

To cope with the already large, and ever increasing, amount of information stored in organizational memory, "forgetting," as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management), forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the literature on the need for organizational forgetting and particularly on accidental vs. intentional forgetting. We discuss the current state of the art of theory and empirical evidence on forgetting from cognitive psychology in order to infer mechanisms applicable to the organizational context. In this respect, we emphasize retrieval theories and the relevance of retrieval cues important for forgetting. Subsequently, we transfer the empirical evidence that the elimination of retrieval cues leads to faster forgetting to the forgetting of organizational routines, as routines are part of organizational memory. We then propose a classification of cues (context, sensory, business process-related cues) that are relevant in the forgetting of routines, and discuss a meta-cue called the "situational strength" cue, which is relevant if cues of an old and a new routine are present simultaneously. Based on the classification as business process-related cues (information, team, task, object cues), we propose mechanisms to accelerate forgetting by eliminating specific cues based on the empirical and theoretical state of the art. We conclude that in intentional organizational change processes, the elimination of cues to accelerate forgetting should be used in change management practices.

Programmable Digital Controller

Science.gov (United States)

Wassick, Gregory J.

2012-01-01

An existing three-channel analog servo loop controller has been redesigned for piezoelectric-transducer-based (PZT-based) etalon control applications to a digital servo loop controller. This change offers several improvements over the previous analog controller, including software control over proportional-integral-derivative (PID) parameters, inclusion of other data of interest such as temperature and pressure in the control laws, improved ability to compensate for PZT hysteresis and mechanical mount fluctuations, ability to provide pre-programmed scanning and stepping routines, improved user interface, expanded data acquisition, and reduced size, weight, and power.

Experience with a routine fecal sampling program for plutonium workers

International Nuclear Information System (INIS)

Bihl, D.E.; Buschbom, R.L.; Sula, M.J.

1993-01-01

A quarterly fecal sampling program was conducted at the U. S. Department of Energy's Hanford site for congruent to 100 workers at risk for an intake of plutonium oxide and other forms of plutonium. To our surprise, we discovered that essentially all of the workers were excreting detectable activities of plutonium. Further investigation showed that the source was frequent, intermittent intakes at levels below detectability by normal workplace monitoring, indicating the extraordinary sensitivity of fecal sampling. However, the experience of this study also indicated that the increased sensitivity of routine fecal sampling relative to more common bioassay methods is offset by many problems. These include poor worker cooperation; difficulty in distinguishing low-level chronic intakes from a more significant, acute intake; difficulty in eliminating interference from ingested plutonium; and difficulty in interpreting what a single void means in terms of 24-h excretion. Recommendations for a routine fecal program include providing good communication to workers and management about reasons and logistics of fecal sampling prior to starting, using annual (instead of quarterly) fecal sampling for class Y plutonium, collecting samples after workers have been away from plutonium exposure for a least 3 d, and giving serious consideration to improving urinalysis sensitivity rather than going to routine fecal sampling

Development of a setup to enable stable and accurate flow conditions for membrane biofouling studies

KAUST Repository

Bucs, Szilard

2015-07-10

Systematic laboratory studies on membrane biofouling require experimental conditions that are well defined and representative for practice. Hydrodynamics and flow rate variations affect biofilm formation, morphology, and detachment and impacts on membrane performance parameters such as feed channel pressure drop. There is a suite of available monitors to study biofouling, but systems to operate monitors have not been well designed to achieve an accurate, constant water flow required for a reliable determination of biomass accumulation and feed channel pressure drop increase. Studies were done with membrane fouling simulators operated in parallel with manual and automated flow control, with and without dosage of a biodegradable substrate to the feedwater to enhance biofouling rate. High flow rate variations were observed for the manual water flow system (up to ≈9%) compared to the automatic flow control system (<1%). The flow rate variation in the manual system was strongly increased by biofilm accumulation, while the automatic system maintained an accurate and constant water flow in the monitor. The flow rate influences the biofilm accumulation and the impact of accumulated biofilm on membrane performance. The effect of the same amount of accumulated biomass on the pressure drop increase was related to the linear flow velocity. Stable and accurate feedwater flow rates are essential for biofouling studies in well-defined conditions in membrane systems. © 2015 Balaban Desalination Publications. All rights reserved.

Shared Decision Making in mental health care using Routine Outcome Monitoring as a source of information: a cluster randomised controlled trial.