Cisplatin, Intensity-Modulated Radiation Therapy, and Pembrolizumab in Treating Patients With Stage III-IV Head and Neck Squamous Cell Carcinoma

Science.gov (United States)

2018-05-18

CDKN2A-p16 Negative; Stage III Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage III Laryngeal Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7

The Effect of Simvastatin on Breast Cancer Cell Growth in Women With Stage I-II Breast Cancer

Science.gov (United States)

2018-03-02

Invasive Breast Carcinoma; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

Health and Recovery Program in Increasing Physical Activity Level in Stage IA-IIIA Endometrial Cancer Survivors

Science.gov (United States)

2018-03-05

Cancer Survivor; Endometrial Carcinoma; Stage I Uterine Corpus Cancer AJCC v7; Stage IA Uterine Corpus Cancer AJCC v7; Stage IB Uterine Corpus Cancer AJCC v7; Stage II Uterine Corpus Cancer AJCC v7; Stage IIIA Uterine Corpus Cancer AJCC v7

Anti-SEMA4D Monoclonal Antibody VX15/2503 With Nivolumab or Ipilimumab in Treating Patients With Stage III or IV Melanoma

Science.gov (United States)

2018-04-26

Metastatic Melanoma; Stage III Cutaneous Melanoma AJCC v7; Stage IIIA Cutaneous Melanoma AJCC v7; Stage IIIB Cutaneous Melanoma AJCC v7; Stage IIIC Cutaneous Melanoma AJCC v7; Stage IV Cutaneous Melanoma AJCC v6 and v7

Diet and Physical Activity Change or Usual Care in Improving Progression-Free Survival in Patients With Previously Treated Stage II, III, or IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Science.gov (United States)

2018-02-14

Fallopian Tube Clear Cell Adenocarcinoma; Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Mucinous Adenocarcinoma; Fallopian Tube Serous Adenocarcinoma; Fallopian Tube Transitional Cell Carcinoma; Malignant Ovarian Brenner Tumor; Ovarian Clear Cell Adenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Adenocarcinoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Adenocarcinoma; Ovarian Transitional Cell Carcinoma; Primary Peritoneal Serous Adenocarcinoma; Stage IIA Fallopian Tube Cancer AJCC v6 and v7; Stage IIA Ovarian Cancer AJCC V6 and v7; Stage IIB Fallopian Tube Cancer AJCC v6 and v7; Stage IIB Ovarian Cancer AJCC v6 and v7; Stage IIC Fallopian Tube Cancer AJCC v6 and v7; Stage IIC Ovarian Cancer AJCC v6 and v7; Stage IIIA Fallopian Tube Cancer AJCC v7; Stage IIIA Ovarian Cancer AJCC v6 and v7; Stage IIIA Primary Peritoneal Cancer AJCC v7; Stage IIIB Fallopian Tube Cancer AJCC v7; Stage IIIB Ovarian Cancer AJCC v6 and v7; Stage IIIB Primary Peritoneal Cancer AJCC v7; Stage IIIC Fallopian Tube Cancer AJCC v7; Stage IIIC Ovarian Cancer AJCC v6 and v7; Stage IIIC Primary Peritoneal Cancer AJCC v7; Stage IV Fallopian Tube Cancer AJCC v6 and v7; Stage IV Ovarian Cancer AJCC v6 and v7; Stage IV Primary Peritoneal Cancer AJCC v7; Undifferentiated Fallopian Tube Carcinoma; Undifferentiated Ovarian Carcinoma

Recommendation for incorporation of a different lymph node scoring system in future AJCC N category for oral cancer.

Science.gov (United States)

Lee, Ching-Chih; Su, Yu-Chieh; Hung, Shih-Kai; Chen, Po-Chun; Huang, Chung-I; Huang, Wei-Lun; Lin, Yu-Wei; Yang, Ching-Chieh

2017-10-26

To compare the prognostic value of 3 different lymph node scoring systems " log odds of positive nodes (LODDS), lymph node ratio (rN), and lymph node yield " in an effort to improve the staging of oral cancer. We identified 3958 oral cancer patients from Surveillance, Epidemiology, and End Results database from 2007 to 2013. In univariate analysis, LODDS, pN, rN, and lymph node yield were prognostic factors for 5-year disease-specific survival (DSS) and overall survival (OS). Multivariate analysis indicated that patients with LODDS 4 had worst 5-year DSS and OS. Stage migration occurred in pN1 and pN2 patients with LODDS 4. In pN1 patients, those with LODDS 4 had the worst 5-year DSS (41.2%) and OS (31.6%) than patients with pN1 and LODDS 2-3. In pN2 patients, those with LODDS4 had the worst 5-year DSS (34.5%) and OS (27.4%) than patients with pN2 and LODDS 2-3. The proposed staging system, which incorporates LODDS with AJCC pN, had better discriminability and prediction accuracy for predicting survival. We also noted that patients with LODDS 4 given adjuvant radiotherapy had better 5-year DSS and OS. The LODDS should be considered as a future candidate measurement for N category in oral cancer.

Studying the Physical Function and Quality of Life Before and After Surgery in Patients With Stage I Cervical Cancer

Science.gov (United States)

2018-02-14

Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Lymphedema; Sexual Dysfunction and Infertility; Stage IA1 Cervical Cancer AJCC v6 and v7; Stage IA2 Cervical Cancer AJCC v6 and v7; Stage IB1 Cervical Cancer AJCC v6 and v7

Validation of the CPS + EG Staging System for Disease-Specific Survival in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy.

Science.gov (United States)

Abdelsattar, Jad M; Al-Hilli, Zahraa; Hoskin, Tanya L; Heins, Courtney N; Boughey, Judy C

2016-10-01

CPS + EG staging, which incorporates estrogen receptor (ER) status and tumor grade with pretreatment clinical stage (CS) and post-treatment pathologic stage (PS), has been reported to have better correlation with outcome than classic TNM staging for patients treated with neoadjuvant chemotherapy (NAC). Our goal was to evaluate the performance of CPS + EG staging system in an external cohort treated with NAC. We reviewed patients with stages I-IIIC breast cancer treated with NAC and surgery at our institution between 1988 and 2014. ER status, Nottingham grade, treatment, American Joint Committee on Cancer (AJCC) CS before NAC and PS after NAC, and follow-up data were collected. The discrimination of CPS + EG and pathologic AJCC stage were assessed using area under the curve (AUC) for survival data. A total of 769 patients were analyzed with a median follow-up of 2.6 (range 0.0-19.4) years; 103 patients died of breast cancer. Overall, the 5-year breast cancer cause-specific survival was 81.5 % [95 % confidence interval (CI) 77.6-85.5]. The 5-year, cause-specific survival by CPS + EG score was 93.8 % score 0, 89.9 % score 1, 90.7 % score 2, 84.8 % score 3, 67.7 % score 4, and 43.4 % score 5/6. CPS + EG score was significantly associated with cause-specific survival (p < 0.001) with an AUC of 0.69 (95 % CI 0.62-0.77) at 5 years. This was higher than the AUC of 0.63 (95 % CI 0.56-0.70) for AJCC PS (p = 0.10). This study validates the CPS + EG staging system using Nottingham grade in an external cohort. Addition of tumor biology and treatment response shows promise in improving survival estimates for patients treated with NAC.

Histogram analysis of diffusion kurtosis imaging of nasopharyngeal carcinoma: Correlation between quantitative parameters and clinical stage.

Science.gov (United States)

Xu, Xiao-Quan; Ma, Gao; Wang, Yan-Jun; Hu, Hao; Su, Guo-Yi; Shi, Hai-Bin; Wu, Fei-Yun

2017-07-18

To evaluate the correlation between histogram parameters derived from diffusion-kurtosis (DK) imaging and the clinical stage of nasopharyngeal carcinoma (NPC). High T-stage (T3/4) NPC showed significantly higher Kapp-mean (P = 0.018), Kapp-median (P = 0.029) and Kapp-90th (P = 0.003) than low T-stage (T1/2) NPC. High N-stage NPC (N2/3) showed significantly lower Dapp-mean (P = 0.002), Dapp-median (P = 0.002) and Dapp-10th (P Histogram parameters, including mean, median, 10th, 90th percentiles, skewness and kurtosis of Dapp and Kapp were calculated. Patients were divided into low and high T, N and clinical stage based on American Joint Committee on Cancer (AJCC) staging system. Differences of histogram parameters between low and high T, N and AJCC stages were compared using t test. Multiple receiver operating characteristic (ROC) curves were used to determine and compare the value of significant parameters in predicting high T, N and AJCC stage, respectively. DK imaging-derived parameters correlated well with clinical stage of NPC, therefore could serve as an adjunctive imaging technique for evaluating NPC.

Sapanisertib and Osimertinib in Treating Patients With Stage IV EGFR Mutation Positive Non-small Cell Lung Cancer After Progression on a Previous EGFR Tyrosine Kinase Inhibitor

Science.gov (United States)

2018-04-25

EGFR Activating Mutation; EGFR Exon 19 Deletion Mutation; EGFR NP_005219.2:p.G719X; EGFR NP_005219.2:p.L858R; EGFR NP_005219.2:p.L861Q; EGFR T790M Mutation Negative; Recurrent Non-Small Cell Lung Carcinoma; Stage III Non-Small Cell Lung Cancer AJCC v7; Stage IIIA Non-Small Cell Lung Cancer AJCC v7; Stage IIIB Non-Small Cell Lung Cancer AJCC v7; Stage IV Non-Small Cell Lung Cancer AJCC v7

A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer

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Ling Xu

2017-01-01

Conclusions: The prognostic staging system proposed in the AJCC 8th edition refines the anatomic stage group in Luminal B HER2-negative breast cancer and will lead to a more personalized approach to breast cancer treatment.

A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer.

Science.gov (United States)

Xu, Ling; Li, Jiang-Hong; Ye, Jing-Ming; Duan, Xue-Ning; Cheng, Yuan-Jia; Xin, Ling; Liu, Qian; Zhou, Bin; Liu, Yin-Hua

2017-08-20

Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual. We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analyses. This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival (DFS) of 769 Stage I-III patients was 89.7%, and the 5-year overall survival (OS) of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups. There were 372 cases (46.7%) assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS (χ2 = 11.319, P= 0.001) and 5-year OS (χ2 = 5.225, P= 0.022). In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS (χ2 = 6.510, P= 0.039) but no significant differences in 5-year OS (χ2 = 5.087, P= 0.079). However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statistically significant

A Study of 358 Cases of Locally Advanced Nasopharyngeal Carcinoma Receiving Intensity-Modulated Radiation Therapy: Improving the Seventh Edition of the American Joint Committee on Cancer T-Staging System

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Qin Zhou

2017-01-01

Full Text Available To evaluate the rationality and limitations of the seventh edition of the American Joint Committee on Cancer (the 7th AJCC edition T-staging system for locally advanced nasopharyngeal carcinoma (NPC. The prognosis of 358 patients with stage T3/T4 NPC treated with intensity-modulated radiotherapy (IMRT was analyzed with the Kaplan–Meier method or the log-rank test. The 7th AJCC staging system of NPC has some limitations in that the T category is neither the significant factor in OS/LRFS nor the independent prognostic factor in OS/LRFS/DMFS/DFS (P>0.05. After adjustment by anatomic structures, univariate analysis has shown that the adjusted-T category has statistical significance between T3 and T4 for OS (86.4% and 71.3%, P=0.002, LRFS (97% and 90.9%, P=0.048, DMFS (90.9% and 77.2%, P=0.001, and DFS (86.2% and 67.5%, P=0.000, and multivariate analysis has shown that the adjusted-T category is an independent prognostic factor for OS/DMFS/DFS (with the exception of LRFS. Then, GTV-P was taken into consideration. Multivariate analysis showed that these nT categories serve as suitable independent prognostic factors for OS/DMFS/DFS (P<0.001 and LRFS (HR = 3.131; 95% CI, 1.090–8.990; P=0.043. The 7th AJCC staging system has limitations and should be improved by including the modifications suggested, such as anatomic structures and tumor volume adjustment.

Nasopharyngeal carcinoma: comparison of diffusion and perfusion characteristics between different tumour stages using intravoxel incoherent motion MR imaging

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Lai, Vincent; Li, Xiao; Huang, Bingsheng; Khong, Pek Lan [University of Hong Kong, Queen Mary Hospital, Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, Hong Kong (China); Lee, Victor Ho Fun; Lam, Ka On [University of Hong Kong, Queen Mary Hospital, Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Hong Kong (China); Fong, Daniel Yee Tak [University of Hong Kong, School of Nursing, Li Ka Shing Faculty of Medicine, Hong Kong (China); Chan, Queenie [Philips Healthcare, Hong Kong, New Territories (China)

2014-01-15

To explore intravoxel incoherent motion (IVIM) characteristics of nasopharyngeal carcinoma (NPC) and relationships with different tumour stages. We prospectively recruited 80 patients with newly diagnosed undifferentiated NPC. Diffusion-weighted MR imaging was performed and IVIM parameters (D, pure diffusion; f, perfusion fraction; D*, pseudodiffusion coefficient) were calculated. Patients were stratified into low and high tumour stage groups based on American Joint Committee on Cancer (AJCC) and TNM staging for determination of the predictive powers of IVIM parameters using t test, multiple logistic regression and ROC curve analyses. D, f and D* were all statistically significantly lower in high-stage groups in AJCC, T and N staging. D, f and D* were all independent predictors of AJCC staging, f and D* were independent predictors of T staging, and D was an independent predictor of N staging. D was most powerful for AJCC and N staging, whereas f was most powerful for T staging. Optimal cut-off values (area under the curve, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio) were as follows: AJCC stage, D = 0.782 x 10{sup -3} mm{sup 2}/s (0.915, 93.3 %, 76.2 %, 3.92, 0.09); T staging, f = 0.133 (0.905, 80.5 %, 92.5 %, 10.73, 0.21); N staging, D = 0.761 x 10{sup -3} mm{sup 2}/s (0.848, 87.5 %, 66.7 %, 2.62, 0.19). Multivariate analysis showed no diagnostic improvement. Nasopharyngeal carcinoma has distinctive intravoxel incoherent motion characteristics parameters in different tumour staging, potentially helping pretreatment staging. (orig.)

Trametinib and TAS-102 in Treating Patients With Colon or Rectal Cancer That is Advanced, Metastatic, or Cannot Be Removed by Surgery

Science.gov (United States)

2018-04-13

RAS Family Gene Mutation; Stage III Colon Cancer AJCC v7; Stage III Colorectal Cancer AJCC v7; Stage III Rectal Cancer AJCC v7; Stage IIIA Colon Cancer AJCC v7; Stage IIIA Colorectal Cancer AJCC v7; Stage IIIA Rectal Cancer AJCC v7; Stage IIIB Colon Cancer AJCC v7; Stage IIIB Colorectal Cancer AJCC v7; Stage IIIB Rectal Cancer AJCC v7; Stage IIIC Colon Cancer AJCC v7; Stage IIIC Colorectal Cancer AJCC v7; Stage IIIC Rectal Cancer AJCC v7; Stage IV Colon Cancer AJCC v7; Stage IV Colorectal Cancer AJCC v7; Stage IV Rectal Cancer AJCC v7; Stage IVA Colon Cancer AJCC v7; Stage IVA Colorectal Cancer AJCC v7; Stage IVA Rectal Cancer AJCC v7; Stage IVB Colon Cancer AJCC v7; Stage IVB Colorectal Cancer AJCC v7; Stage IVB Rectal Cancer AJCC v7

A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer

OpenAIRE

Xu, Ling; Li, Jiang-Hong; Ye, Jing-Ming; Duan, Xue-Ning; Cheng, Yuan-Jia; Xin, Ling; Liu, Qian; Zhou, Bin; Liu, Yin-Hua

2017-01-01

Background: Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in ...

Guadecitabine and Durvalumab in Treating Patients With Advanced Liver, Pancreatic, Bile Duct, or Gallbladder Cancer

Science.gov (United States)

2018-04-27

Extrahepatic Bile Duct Adenocarcinoma, Biliary Type; Gallbladder Adenocarcinoma, Biliary Type; Metastatic Pancreatic Adenocarcinoma; Recurrent Cholangiocarcinoma; Recurrent Gallbladder Carcinoma; Recurrent Hepatocellular Carcinoma; Recurrent Intrahepatic Cholangiocarcinoma; Recurrent Pancreatic Carcinoma; Stage III Gallbladder Cancer AJCC V7; Stage III Hepatocellular Carcinoma AJCC v7; Stage III Intrahepatic Cholangiocarcinoma AJCC v7; Stage III Pancreatic Cancer AJCC v6 and v7; Stage IIIA Gallbladder Cancer AJCC v7; Stage IIIA Hepatocellular Carcinoma AJCC v7; Stage IIIB Gallbladder Cancer AJCC v7; Stage IIIB Hepatocellular Carcinoma AJCC v7; Stage IIIC Hepatocellular Carcinoma AJCC v7; Stage IV Gallbladder Cancer AJCC v7; Stage IV Hepatocellular Carcinoma AJCC v7; Stage IV Pancreatic Cancer AJCC v6 and v7; Stage IVA Gallbladder Cancer AJCC v7; Stage IVA Hepatocellular Carcinoma AJCC v7; Stage IVA Intrahepatic Cholangiocarcinoma AJCC v7; Stage IVB Gallbladder Cancer AJCC v7; Stage IVB Hepatocellular Carcinoma AJCC v7; Stage IVB Intrahepatic Cholangiocarcinoma AJCC v7; Unresectable Gallbladder Carcinoma; Unresectable Pancreatic Carcinoma

Radiofrequency Tagged Surgery in Treating Patients With Breast Cancer

Science.gov (United States)

2018-06-18

Positive Axillary Lymph Node; Stage 0 Breast Cancer AJCC v6 and v7; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7; Stage III Breast Cancer AJCC v7; Stage IIIA Breast Cancer AJCC v7; Stage IIIB Breast Cancer AJCC v7; Stage IIIC Breast Cancer AJCC v7

Phosphohistone-H3 (PHH3) is prognostic relevant in Merkel cell carcinomas but Merkel cell polyomavirus is a more powerful prognostic factor than AJCC clinical stage, PHH3, Ki-67 or mitotic indices.

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Iwasaki, Takeshi; Matsushita, Michiko; Nonaka, Daisuke; Kato, Masako; Nagata, Keiko; Murakami, Ichiro; Hayashi, Kazuhiko

2015-08-01

Merkel cell carcinomas (MCCs) associated with Merkel cell polyomavirus (MCPyV) have better prognosis than those without MCPyV. The relationship between mitotic index (MI) and MCC outcome has remained elusive because of the difficulty in differentiating mitotic cells from apoptotic ones. We evaluated the role of phosphohistone-H3 (PHH3) (Ser10), a new mitotic count biomarker, in MCPyV-positive or -negative MCC patients, and assessed its prognostic value in comparison to Ki-67 labeling index or MI using hematoxylin and eosin (HE) staining. We compared the prognostic value of PHH3 mitotic index with that of MI by HE in 19 MCPyV-positive and 9 MCPyV-negative MCC patients. PHH3-positive immunoreactivity was mostly observed in mitotic figures. Multivariate analysis significantly showed that MCPyV status (HR, 0.004; 95% CI 0.0003-0.058) and the American Joint Committee of Cancer (AJCC) stage (HR, 5.02; 95% CI 1.23-20.51) were observed as significantly independent prognostic factors for OS. PHH3-positive cell counts/10 HPF was a slightly significant independent prognostic factor for OS (HR, 4.96; 95% CI 0.93-26.55). PHH3-positive MI and MCPyV status in MCC patients are useful in prognostication, although MCPyV-infection is a more powerful prognostic factor in MCCs than the AJCC scheme on proliferation or mitotic indices. © 2015 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

Pembrolizumab, Capecitabine, and Radiation Therapy in Treating Patients With Mismatch-Repair Deficient and Epstein-Barr Virus Positive Gastric Cancer

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2017-11-15

Epstein-Barr Virus Positive; Gastric Adenocarcinoma; Mismatch Repair Protein Deficiency; Stage IB Gastric Cancer AJCC v7; Stage II Gastric Cancer AJCC v7; Stage IIA Gastric Cancer AJCC v7; Stage IIB Gastric Cancer AJCC v7; Stage III Gastric Cancer AJCC v7; Stage IIIA Gastric Cancer AJCC v7; Stage IIIB Gastric Cancer AJCC v7; Stage IIIC Gastric Cancer AJCC v7

Lower or Standard Dose Regorafenib in Treating Patients With Refractory Metastatic Colorectal Cancer

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2018-03-22

Colon Adenocarcinoma; Rectal Adenocarcinoma; Stage III Colorectal Cancer AJCC v7; Stage IIIA Colorectal Cancer AJCC v7; Stage IIIB Colorectal Cancer AJCC v7; Stage IIIC Colorectal Cancer AJCC v7; Stage IV Colorectal Cancer AJCC v7; Stage IVA Colorectal Cancer AJCC v7; Stage IVB Colorectal Cancer AJCC v7

Trametinib in Increasing Tumoral Iodine Incorporation in Patients With Recurrent or Metastatic Thyroid Cancer

Science.gov (United States)

2018-04-18

BRAF Gene Mutation; Poorly Differentiated Thyroid Gland Carcinoma; RAS Family Gene Mutation; Recurrent Thyroid Gland Carcinoma; Stage IV Thyroid Gland Follicular Carcinoma AJCC v7; Stage IV Thyroid Gland Papillary Carcinoma AJCC v7; Stage IVA Thyroid Gland Follicular Carcinoma AJCC v7; Stage IVA Thyroid Gland Papillary Carcinoma AJCC v7; Stage IVB Thyroid Gland Follicular Carcinoma AJCC v7; Stage IVB Thyroid Gland Papillary Carcinoma AJCC v7; Stage IVC Thyroid Gland Follicular Carcinoma AJCC v7; Stage IVC Thyroid Gland Papillary Carcinoma AJCC v7

Staging of nasopharyngeal carcinoma investigated by magnetic resonance imaging

International Nuclear Information System (INIS)

Lu Jincheng; Wei Baoqing; Chen Wenzhan; Qian Pudong; Zhang Yiqin; Wei Qing; Cha Wenwu; Li Feng; Ni Ming

2006-01-01

Background and purpose: To investigate the American Joint Commission on Cancer (AJCC) sixth edition staging system of nasopharyngeal carcinoma (NPC) by Magnetic Resonance Imaging (MRI). Patients and methods: One hundred and fifty-nine non-disseminated biopsy-proven NPC patients were studied with MRI before treatment. Retrieval of MRI information enabled us to restage all patients accurately according to the sixth edition of the AJCC staging system. Splitting the respective T and N stages by the significant defining factors identified, the cancer death hazard ratios were modeled by the Cox model in SPSS 10.0 for windows (SPSS Inc, Chicago, IL). Results: Single site of skull base abnormality (HR=3.91, 95% CI: 0.74-20.56) has a superior result to others involved in T3 (HR=5.83, 95% CI: 1.24-27.29). Involvement of either anterior or posterior cranial nerves solely (HR=6.02, 95% CI: 1.55-35.60) was not found to be as a poor prognostic indicator as others involved in T4 (HR=7.81, 95% CI: 1.81-33.63). Less than or equal to 3 cm of N1 (HR=4.01, 95% CI: 0.48-33.83) and N2 (HR=4.72, 95% CI: 0.62-35.78) have a better result than >3 cm of N1 (HR=8.09, 95% CI: 0.95-68.97) and N2 (HR=10.58, 95% CI: 1.32-84.62), respectively. Conclusions: Perhaps, it is better to down-stage single site of skull base abnormality from T3 to T2, and involvement of either anterior or posterior cranial nerves solely from T4 to T3, meanwhile, ≤3 cm of N2 down-stage to N1, >3 cm of N1 up-stage to N2

Fludeoxyglucose F-18-PET in Planning Lung Cancer Radiation Therapy

Science.gov (United States)

2018-04-19

Stage I Lung Cancer; Stage I Non-Small Cell Lung Cancer AJCC v7; Stage IA Non-Small Cell Lung Carcinoma AJCC v7; Stage IB Non-Small Cell Lung Carcinoma AJCC v7; Stage II Lung Cancer; Stage II Non-Small Cell Lung Cancer AJCC v7; Stage IIA Non-Small Cell Lung Carcinoma AJCC v7; Stage IIB Non-Small Cell Lung Carcinoma AJCC v7

Akt Inhibitor MK2206 and Hydroxychloroquine in Treating Patients With Advanced Solid Tumors, Melanoma, Prostate or Kidney Cancer

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2018-05-15

Adult Solid Neoplasm; Hormone-Resistant Prostate Carcinoma; Recurrent Melanoma; Recurrent Prostate Carcinoma; Recurrent Renal Cell Carcinoma; Stage IIIA Cutaneous Melanoma AJCC v7; Stage IIIB Cutaneous Melanoma AJCC v7; Stage IIIC Cutaneous Melanoma AJCC v7; Stage IV Cutaneous Melanoma AJCC v6 and v7; Stage IV Prostate Cancer AJCC v7; Stage IV Renal Cell Cancer AJCC v7

Vorinostat in Treating Patients With Locally Advanced, Recurrent, or Metastatic Adenoid Cystic Carcinoma

Science.gov (United States)

2018-03-22

Recurrent Oral Cavity Adenoid Cystic Carcinoma; Recurrent Salivary Gland Carcinoma; Salivary Gland Adenoid Cystic Carcinoma; Stage III Major Salivary Gland Cancer AJCC v7; Stage III Oral Cavity Adenoid Cystic Carcinoma AJCC v6 and v7; Stage IVA Major Salivary Gland Cancer AJCC v7; Stage IVA Oral Cavity Adenoid Cystic Carcinoma AJCC v6 and v7; Stage IVB Major Salivary Gland Cancer AJCC v7; Stage IVB Oral Cavity Adenoid Cystic Carcinoma AJCC v6 and v7; Stage IVC Major Salivary Gland Cancer AJCC v7; Stage IVC Oral Cavity Adenoid Cystic Carcinoma AJCC v6 and v7; Tongue Carcinoma

SU-E-I-85: Exploring the 18F-Fluorodeoxyglucose PET Characteristics in Staging of Esophageal Squamous Cell Carcinoma

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Ma, C; Yin, Y [Shandong Cancer Hospital, Jinan, Shandong (China)

2014-06-01

Purpose: The aim of this study was to explore the characteristics derived from 18F-fluorodeoxyglucose (18F-FDG) PET image and assess its capacity in staging of esophageal squamous cell carcinoma (ESCC). Methods: 26 patients with newly diagnosed ESCC who underwent 18F-FDG PET scan were included in this study. Different image-derived indices including the standardized uptake value (SUV), gross tumor length, texture features and shape feature were considered. Taken the histopathologic examination as the gold standard, the extracted capacities of indices in staging of ESCC were assessed by Kruskal-Wallis test and Mann-Whitney test. Specificity and sensitivity for each of the studied parameters were derived using receiver-operating characteristic curves. Results: 18F-FDG SUVmax and SUVmean showed statistically significant capability in AJCC and TNM stages. Texture features such as ENT and CORR were significant factors for N stages(p=0.040, p=0.029). Both FDG PET Longitudinal length and shape feature Eccentricity (EC) (p≤0.010) provided powerful stratification in the primary ESCC AJCC and TNM stages than SUV and texture features. Receiver-operating-characteristic curve analysis showed that tumor textural analysis can capability M stages with higher sensitivity than SUV measurement but lower in T and N stages. Conclusion: The 18F-FDG image-derived characteristics of SUV, textural features and shape feature allow for good stratification AJCC and TNM stage in ESCC patients.

Pomegranate-Extract Pill in Preventing Tumor Growth in Patients With Localized Prostate Cancer Undergoing Active Surveillance

Science.gov (United States)

2018-03-02

PSA Level Less Than or Equal to Fifteen; PSA Level Less Than Ten; Stage I Prostate Cancer AJCC v7; Stage II Prostate Cancer AJCC v7; Stage IIA Prostate Cancer AJCC v7; Stage IIB Prostate Cancer AJCC v7

Prediction of Pathological Stage in Patients with Prostate Cancer: A Neuro-Fuzzy Model.

Directory of Open Access Journals (Sweden)

Georgina Cosma

Full Text Available The prediction of cancer staging in prostate cancer is a process for estimating the likelihood that the cancer has spread before treatment is given to the patient. Although important for determining the most suitable treatment and optimal management strategy for patients, staging continues to present significant challenges to clinicians. Clinical test results such as the pre-treatment Prostate-Specific Antigen (PSA level, the biopsy most common tumor pattern (Primary Gleason pattern and the second most common tumor pattern (Secondary Gleason pattern in tissue biopsies, and the clinical T stage can be used by clinicians to predict the pathological stage of cancer. However, not every patient will return abnormal results in all tests. This significantly influences the capacity to effectively predict the stage of prostate cancer. Herein we have developed a neuro-fuzzy computational intelligence model for classifying and predicting the likelihood of a patient having Organ-Confined Disease (OCD or Extra-Prostatic Disease (ED using a prostate cancer patient dataset obtained from The Cancer Genome Atlas (TCGA Research Network. The system input consisted of the following variables: Primary and Secondary Gleason biopsy patterns, PSA levels, age at diagnosis, and clinical T stage. The performance of the neuro-fuzzy system was compared to other computational intelligence based approaches, namely the Artificial Neural Network, Fuzzy C-Means, Support Vector Machine, the Naive Bayes classifiers, and also the AJCC pTNM Staging Nomogram which is commonly used by clinicians. A comparison of the optimal Receiver Operating Characteristic (ROC points that were identified using these approaches, revealed that the neuro-fuzzy system, at its optimal point, returns the largest Area Under the ROC Curve (AUC, with a low number of false positives (FPR = 0.274, TPR = 0.789, AUC = 0.812. The proposed approach is also an improvement over the AJCC pTNM Staging Nomogram (FPR

Role of FDG-PET/CT in stage 1–4 malignant melanoma patients

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Eldon, Mai; Kjerkegaard, Ulrik Knap; Ørndrup, Mette Heisz

2017-01-01

/CT scanned in 2012 at a department of plastic surgery and to analyze the pattern of referral and outcome of PET/CT scans of these patients all back from early diagnosis of the patient in the period 2008–2012. Methods: All patients with MM stages 1–4 (AJCC stages) and melanoma of unknown primary (MUP) who...

A National-Level Validation of the New American Joint Committee on Cancer 8th Edition Subclassification of Stage IIA and B Anal Squamous Cell Cancer.

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Goffredo, Paolo; Garancini, Mattia; Robinson, Timothy J; Frakes, Jessica; Hoshi, Hisakazu; Hassan, Imran

2018-06-01

The 8th edition of the American Joint Committee on Cancer (AJCC) updated the staging system of anal squamous cell cancer (ASCC) by subdividing stage II into A (T2N0M0) and B (T3N0M0) based on a secondary analysis of the RTOG 98-11 trial. We aimed to validate this new subclassification utilizing two nationally representative databases. The National Cancer Database (NCDB) [2004-2014] and the Surveillance, Epidemiology, and End Results (SEER) database [1988-2013] were queried to identify patients with stage II ASCC. A total of 6651 and 2579 stage IIA (2-5 cm) and 1777 and 641 stage IIB (> 5 cm) patients were identified in the NCDB and SEER databases, respectively. Compared with stage IIB patients, stage IIA patients within the NCDB were more often females with fewer comorbidities. No significant differences were observed between age, race, receipt of chemotherapy and radiation, and mean radiation dose. Demographic, clinical, and pathologic characteristics were comparable between patients in both datasets. The 5-year OS was 72% and 69% for stage IIA versus 57% and 50% for stage IIB in the NCDB and SEER databases, respectively (p  5 cm) in the general ASCC population. AJCC stage IIB patients represent a higher risk category that should be targeted with more aggressive/novel therapies.

Melanoma of the vulva and vagina: principles of staging and their relevance to management based on a clinicopathologic analysis of 85 cases.

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Seifried, Susan; Haydu, Lauren E; Quinn, Michael J; Scolyer, Richard A; Stretch, Jonathan R; Thompson, John F

2015-01-01

Primary melanomas of the vulva and vagina are rare. As a result, it has been difficult to develop evidence-based guidelines for their management. By analyzing a large series of patients with vulval and vaginal melanomas, this study sought to document the most common presenting features, identify clinical and pathologic predictors of outcome, and provide management guidelines. A clinicopathologic analysis of 85 patients with primary melanomas of the vulva or vagina diagnosed and treated at Melanoma Institute Australia and associated units in Sydney, Australia, between 1960 and 2011 was performed. Predictors of disease-free and melanoma-specific survival (MSS) were determined. Patients with American Joint Committee on Cancer (AJCC) stage 0-II had a significantly better MSS (5Y MSS = 63.6 %, n = 59) compared with those with stage III disease (5Y MSS = 0 %, n = 12, p < 0.001). Tumor thickness, ulceration status, and pathologic clearance margin were significant predictors of MSS. Disease-free survival was predicted by these factors and additionally by tumor mitotic rate. The results of this study provide evidence to support the appropriateness of utilizing the AJCC (7th edition) cutaneous melanoma staging system for vulval and vaginal melanomas. Detection and removal of these melanomas at an early stage with pathologically confirmed clear margins confers the best chance of cure.

The seventh tumour-node-metastasis staging system for lung cancer: Sequel or prequel?

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van Meerbeeck, Jan P; Janssens, Annelies

2013-09-01

Anatomical cancer extent is an important predictor of prognosis and determines treatment choices. In non-small-cell lung cancer (NSCLC) the tumour-node-metastasis (TNM) classification developed by Pierre Denoix replaced in 1968 the Veterans Administration Lung cancer Group (VALG) classification, which was still in use for small-cell lung cancer (SCLC). Clifton Mountain suggested several improvements based on a database of mostly surgically treated United States (US) patients from a limited number of centres. This database was pivotal for a uniform reporting of lung cancer extent by the American Joint Committee of Cancer (AJCC) and the International Union against Cancer (IUCC), but it suffered increasingly from obsolete diagnostic and staging procedures and did not reflect new treatment modalities. Moreover, its findings were not externally validated in large Japanese and European databases, resulting in persisting controversies which could not be solved with the available database. The use of different mediastinal lymph-node maps in Japan, the (US) and Europe facilitated neither the exchange nor the comparison of treatment results. Peter Goldstraw, a United Kingdom (UK) thoracic surgeon, started the process of updating the sixth version in 1996 and brought it to a good end 10 years later. His goals were to improve the TNM system in lung cancer by addressing the ongoing controversies, to validate the modifications and additional descriptors, to validate the TNM for use in staging SCLC and carcinoid tumours, to propose a new uniform lymph-node map and to investigate the prognostic value of non-anatomical factors. A staging committee was formed within the International Association for the Study of Lung Cancer (IASLC) - which supervised the collection of the retrospective data from >100,000 patients with lung cancer - treated throughout the world between 1990 and 2000, analyse them with the help of solid statistics and validate externally with the Surveillance

Proposed Lymph Node Staging System Using the International Consensus Guidelines for Lymph Node Levels Is Predictive for Nasopharyngeal Carcinoma Patients From Endemic Areas Treated With Intensity Modulated Radiation Therapy

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Li, Wen-Fei; Sun, Ying; Mao, Yan-Ping; Chen, Lei; Chen, Yuan-Yuan; Chen, Mo [Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Liu, Li-Zhi [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Lin, Ai-Hua [Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou (China); Li, Li [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Ma, Jun, E-mail: majun2@mail.sysu.edu.cn [Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China)

2013-06-01

Purpose: To propose a lymph node (N) staging system for nasopharyngeal carcinoma (NPC) based on the International Consensus Guidelines for lymph node (LN) levels and MRI-determined nodal variables. Methods and Materials: The MRI scans and medical records of 749 NPC patients receiving intensity modulated radiation therapy with or without chemotherapy were retrospectively reviewed. The prognostic significance of nodal level, laterality, maximal axial diameter, extracapsular spread, necrosis, and Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) size criteria were analyzed. Results: Nodal level and laterality were the only independent prognostic factors for distant failure and disease failure in multivariate analysis. Compared with unilateral levels Ib, II, III, and/or Va involvement (hazard ratio [HR] 1), retropharyngeal lymph node involvement alone had a similar prognostic value (HR 0.71; 95% confidence interval [CI] 0.43-1.17; P=.17), whereas bilateral levels Ib, II, III, and/or Va involvement (HR 1.65; 95% CI 1.06-2.58; P=.03) and levels IV, Vb, and/or supraclavicular fossa involvement (HR 3.47; 95% CI 1.92-6.29; P<.01) both significantly increased the HR for distant failure. Thus we propose that the N category criteria could be revised as follows: N0, no regional LN metastasis; N1, retropharyngeal lymph node involvement, and/or unilateral levels Ib, II, III, and/or Va involvement; N2, bilateral levels Ib, II, III, and/or Va involvement; N3, levels IV, Vb, and/or supraclavicular fossa involvement. Compared with the 7th edition of the UICC/AJCC criteria, the proposed N staging system provides a more satisfactory distinction between the HRs for regional failure, distant failure, and disease failure in each N category. Conclusions: The proposed N staging system defined by the International Consensus Guidelines and laterality is predictive and practical. However, because of no measurements of the maximal nodal diameter on MRI slices

Anti-ICOS Monoclonal Antibody MEDI-570 in Treating Patients With Relapsed or Refractory Peripheral T-cell Lymphoma Follicular Variant or Angioimmunoblastic T-cell Lymphoma

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2018-05-09

Follicular T-Cell Lymphoma; Grade 1 Follicular Lymphoma; Grade 2 Follicular Lymphoma; Grade 3a Follicular Lymphoma; Recurrent Angioimmunoblastic T-Cell Lymphoma; Recurrent Follicular Lymphoma; Recurrent Mature T- and NK-Cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides; Recurrent Primary Cutaneous T-Cell Non-Hodgkin Lymphoma; Refractory Angioimmunoblastic T-Cell Lymphoma; Refractory Follicular Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Stage IB Mycosis Fungoides AJCC v7; Stage II Mycosis Fungoides AJCC v7; Stage III Cutaneous T-Cell Non-Hodgkin Lymphoma; Stage III Mycosis Fungoides AJCC v7; Stage IV Cutaneous T-Cell Non-Hodgkin Lymphoma; Stage IV Mycosis Fungoides AJCC v7

Association of Previous Clinical Breast Examination With Reduced Delays and Earlier-Stage Breast Cancer Diagnosis Among Women in Peru.

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Romanoff, Anya; Constant, Tara Hayes; Johnson, Kay M; Guadiamos, Manuel Cedano; Vega, Ana María Burga; Zunt, Joseph; Anderson, Benjamin O

2017-11-01

Mammographic screening is impractical in most of the world where breast cancers are first identified based on clinical signs and symptoms. Clinical breast examination may improve early diagnosis directly by finding breast cancers at earlier stages or indirectly by heightening women's awareness of breast health concerns. To investigate factors that influence time to presentation and stage at diagnosis among patients with breast cancer to determine whether history of previous clinical breast examination is associated with earlier presentation and/or earlier cancer stage at diagnosis. In this cross-sectional analysis of individual patient interviews using a validated Breast Cancer Delay Questionnaire, 113 (71.1%) of 159 women with breast cancer treated at a federally funded tertiary care referral cancer center in Trujillo, Peru, from February 1 through May 31, 2015, were studied. Method of breast cancer detection and factors that influence time to and stage at diagnosis. Of 113 women with diagnosed cancer (mean [SD] age, 54 [10.8] years; age range, 32-82 years), 105 (92.9%) had self-detected disease. Of the 93 women for whom stage was documented, 45 (48.4%) were diagnosed with early-stage disease (American Joint Committee on Cancer [AJCC] stage 0, I, or II), and 48 (51.6%) were diagnosed with late-stage disease (AJCC stage III or IV). Mean (SD) total delay from symptom onset to initiation of treatment was 407 (665) days because of patient (mean [SD], 198 [449] days) and health care system (mean [SD], 241 [556] days) delay. Fifty-two women (46.0%) had a history of clinical breast examination, and 23 (20.4%) had undergone previous mammography. Women who underwent a previous clinical breast examination were more likely to have shorter delays from symptom development to presentation compared with women who had never undergone a previous clinical breast examination (odds ratio, 2.92; 95% CI, 1.30-6.60; P = .01). Women diagnosed with shorter patient delay were more

Age and stage at diagnosis: a hospital series of 11 women with intellectual disability and breast carcinoma

International Nuclear Information System (INIS)

Satgé, Daniel; Sauleau, Eric-André; Jacot, William; Raffi, Fernand; Azéma, Bernard; Bouyat, Jean-Claude; El Hage Assaf, Nicolas

2014-01-01

Breast cancer has been poorly studied in women with intellectual disability (ID), which makes designing a policy for screening the nearly 70 million women with ID in the world difficult. As no data is available in the literature, we evaluated breast cancer at diagnosis in women with ID. Women with ID were searched retrospectively among all women treated for invasive breast cancer in a single hospital over 18 years. Age at diagnosis was compared among the whole group of women. Tumor size, lymph node involvement, SBR grade, TNM classification, and AJCC stage were compared to controls matched for age and period of diagnosis using conditional logistic regression. Among 484 women with invasive breast cancer, 11 had ID. The mean age at diagnosis was 55.6 years in women with ID and 62.4 years in the other women. The mean tumor size in women with ID was 3.53 cm, compared to 1.80 cm in 44 random controls from among the 473 women without ID. Lymph node involvement was observed in 9 of the 11 women with ID compared to 12 of the controls (OR = 11.53, p = 0.002), and metastases were found in 3 of the 11 women with ID compared to 1 of the 44 controls (OR = 12.00, p = 0.031). The AJCC stage was higher in women with ID compared to controls (OR = 3.19, p = 0.010). Women with ID presented at an earlier age with tumors of a higher AJCC stage than controls despite no significant differences in tumor grade and histological type. Thus, delayed diagnosis may be responsible for the differences between disabled and non-disabled women

Colorectal cancer and the 7th revision of the TNM staging system: review of changes and suggestions for uniform pathologic reporting.

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Obrocea, F L; Sajin, Maria; Marinescu, Elena Cristina; Stoica, D

2011-01-01

Colorectal cancer (CRC) is a neoplastic disease with a continuously growing incidence in Romania and throughout the world. Although the surgery remains the first line treatment for most of the cases, newly discovered targeted molecular therapies - effective for some patients, but with various side effects and significant financial burden for the national health systems - requires not only stratification of patients in prognostic groups but also evaluation of some non-anatomic factors with major impact on the prognosis and therapeutic strategy. The AJCC/UICC TNM staging system, in his 7th revision, effective for cases diagnosed on or after January 1, 2010, responds to these needs. On the other hand, the role of the pathologist is increasing in terms of workload and amount of information to be included in the pathology report in order to deliver a personalized diagnosis. There are concerns worldwide regarding relevance, validity and completeness of pathologic reporting of CRC in the absence of a uniform reporting format. Therefore, suggestions for a standardized pathology report of CRC are made, based on TNM 7 and recent, up-to-date conclusive published data.

Prognostic Impact of Erythropoietin Expression and Erythropoietin Receptor Expression on Locoregional Control and Survival of Patients Irradiated for Stage II/III Non-Small-Cell Lung Cancer

International Nuclear Information System (INIS)

Rades, Dirk; Setter, Cornelia; Dahl, Olav; Schild, Steven E.; Noack, Frank

2011-01-01

Purpose: Prognostic factors can guide the physician in selecting the optimal treatment for an individual patient. This study investigates the prognostic value of erythropoietin (EPO) and EPO receptor (EPO-R) expression of tumor cells for locoregional control and survival in non-small-cell lung cancer (NSCLC) patients. Methods and Materials: Fourteen factors were investigated in 62 patients irradiated for stage II/III NSCLC, as follows: age, gender, Karnofsky performance score (KPS), histology, grading, TNM/American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, pack years (average number of packages of cigarettes smoked per day multiplied by the number of years smoked), smoking during radiotherapy, hemoglobin levels during radiotherapy, EPO expression, and EPO-R expression. Additionally, patients with tumors expressing both EPO and EPO-R were compared to those expressing either EPO or EPO-R and to those expressing neither EPO nor EPO-R. Results: On univariate analysis, improved locoregional control was associated with AJCC stage II cancer (p 70 (p = 0.08), an N stage of 0 to 1 (p = 0.07), and no EPO-R expression (p = 0.10). On multivariate analysis, AJCC stage II and no EPO expression remained significant. No smoking during radiotherapy was almost significant. On univariate analysis, improved survival was associated with N stage 0 to 1 (p = 0.009), surgery (p = 0.039), hemoglobin levels of ≥12 g/d (p = 0.016), and no EPO expression (p = 0.001). On multivariate analysis, N stage 0 to 1 and no EPO expression maintained significance. Hemoglobin levels of ≥12 g/d were almost significant. On subgroup analyses, patients with tumors expressing both EPO and EPO-R had worse outcomes than those expressing either EPO or EPO-R and those expressing neither EPO nor RPO-R. Conclusions: EPO expression of tumor cells was an independent prognostic factor for locoregional control and survival in patients irradiated for NSCLC. EPO-R expression showed a trend

Ipilimumab in Treating Patients With Metastatic or Recurrent Human Papilloma Virus-Related Cervical Cancer

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2018-05-23

Cervical Adenocarcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Human Papillomavirus Infection; Recurrent Cervical Carcinoma; Stage IVA Cervical Cancer AJCC v6 and v7; Stage IVB Cervical Cancer AJCC v6 and v7

Refining prognostic stratification of human papillomavirus-related oropharyngeal squamous cell carcinoma: different prognosis between T1 and T2

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Lee, Su Min; Lee, Sang Wook; Park, Sun Min [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

2017-09-15

To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.

Identification of high-risk cutaneous melanoma tumors is improved when combining the online American Joint Committee on Cancer Individualized Melanoma Patient Outcome Prediction Tool with a 31-gene expression profile-based classification.

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Ferris, Laura K; Farberg, Aaron S; Middlebrook, Brooke; Johnson, Clare E; Lassen, Natalie; Oelschlager, Kristen M; Maetzold, Derek J; Cook, Robert W; Rigel, Darrell S; Gerami, Pedram

2017-05-01

A significant proportion of patients with American Joint Committee on Cancer (AJCC)-defined early-stage cutaneous melanoma have disease recurrence and die. A 31-gene expression profile (GEP) that accurately assesses metastatic risk associated with primary cutaneous melanomas has been described. We sought to compare accuracy of the GEP in combination with risk determined using the web-based AJCC Individualized Melanoma Patient Outcome Prediction Tool. GEP results from 205 stage I/II cutaneous melanomas with sufficient clinical data for prognostication using the AJCC tool were classified as low (class 1) or high (class 2) risk. Two 5-year overall survival cutoffs (AJCC 79% and 68%), reflecting survival for patients with stage IIA or IIB disease, respectively, were assigned for binary AJCC risk. Cox univariate analysis revealed significant risk classification of distant metastasis-free and overall survival (hazard ratio range 3.2-9.4, P risk by GEP but low risk by AJCC. Specimens reflect tertiary care center referrals; more effective therapies have been approved for clinical use after accrual. The GEP provides valuable prognostic information and improves identification of high-risk melanomas when used together with the AJCC online prediction tool. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Nomogram Prediction of Survival and Recurrence in Patients With Extrahepatic Bile Duct Cancer Undergoing Curative Resection Followed by Adjuvant Chemoradiation Therapy

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Song, Changhoon [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Kyubo, E-mail: kyubokim@snu.ac.kr [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Chie, Eui Kyu [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul (Korea, Republic of); Kim, Jin Ho [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jang, Jin-Young; Kim, Sun Whe [Department of Surgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Han, Sae-Won; Oh, Do-Youn; Im, Seock-Ah; Kim, Tae-You; Bang, Yung-Jue [Department of Internal Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Ha, Sung W. [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul (Korea, Republic of)

2013-11-01

Purpose: To develop nomograms for predicting the overall survival (OS) and relapse-free survival (RFS) in patients with extrahepatic bile duct cancer undergoing adjuvant chemoradiation therapy after curative resection. Methods and Materials: From January 1995 through August 2006, a total of 166 consecutive patients underwent curative resection followed by adjuvant chemoradiation therapy. Multivariate analysis using Cox proportional hazards regression was performed, and this Cox model was used as the basis for the nomograms of OS and RFS. We calculated concordance indices of the constructed nomograms and American Joint Committee on Cancer (AJCC) staging system. Results: The OS rate at 2 years and 5 years was 60.8% and 42.5%, respectively, and the RFS rate at 2 years and 5 years was 52.5% and 38.2%, respectively. The model containing age, sex, tumor location, histologic differentiation, perineural invasion, and lymph node involvement was selected for nomograms. The bootstrap-corrected concordance index of the nomogram for OS and RFS was 0.63 and 0.62, respectively, and that of AJCC staging for OS and RFS was 0.50 and 0.52, respectively. Conclusions: We developed nomograms that predicted survival and recurrence better than AJCC staging. With caution, clinicians may use these nomograms as an adjunct to or substitute for AJCC staging for predicting an individual's prognosis and offering tailored adjuvant therapy.

Cancer of the esophagus and esophagogastric junction-Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.

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Rice, Thomas W; Gress, Donna M; Patil, Deepa T; Hofstetter, Wayne L; Kelsen, David P; Blackstone, Eugene H

2017-07-08

Answer questions and earn CME/CNE New to the eighth edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual for epithelial cancers of the esophagus and esophagogastric junction are separate, temporally related cancer classifications: 1) before treatment decision (clinical); 2) after esophagectomy alone (pathologic); and 3) after preresection therapy followed by esophagectomy (postneoadjuvant pathologic). The addition of clinical and postneoadjuvant pathologic stage groupings was driven by a lack of correspondence of survival, and thus prognosis, between both clinical and postneoadjuvant pathologic cancer categories (facts about the cancer) and pathologic categories. This was revealed by a machine-learning analysis of 6-continent data from the Worldwide Esophageal Cancer Collaboration, with consensus of the AJCC Upper GI Expert Panel. Survival is markedly affected by histopathologic cell type (squamous cell carcinoma and adenocarcinoma) in clinically and pathologically staged patients, requiring separate stage grouping for each cell type. However, postneoadjuvant pathologic stage groups are identical. For the future, more refined and granular data are needed. This requires: 1) more accurate clinical staging; 2) innovative solutions to pathologic staging challenges in endoscopically resected cancers; 3) integration of genomics into staging; and 4) precision cancer care with targeted therapy. It is the responsibility of the oncology team to accurately determine and record registry data, which requires eliminating both common errors and those related to incompleteness and inconsistency. Despite the new complexity of eighth edition staging of cancers of the esophagus and esophagogastric junction, these key concepts and new directions will facilitate precision cancer care. CA Cancer J Clin 2017;67:304-317. © 2017 American Cancer Society. © 2017 American Cancer Society.

Trus and MRI should not be used to stage patients with prostate cancer: an outcome based analysis

International Nuclear Information System (INIS)

Pinover, W. H.; Hanlon, A. L.; Kaplan, E. J.; Lee, W. R.; Hanks, G. E.

1995-01-01

, upstaging by TRUS/MRI does not separate patients into groups with different prognoses. The AJCC staging system should consider eliminating the recommendation to include imaging in staging. If stage is used as a prognostic indicator in comparing results this should be restricted to palpation stage and further emphasizes the need for a biochemical PSA level based staging system. Diagnostic imaging for staging localized prostate disease is not indicated and it's elimination would result in significant savings in healthcare costs

The Prognostic Value of {sup 18}F-FDG PET/CT for Early Recurrence in Operable Breast Cancer: Comparison with TNM Stage

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O, Joo Hyun; Choi, Woo Hee; Han, Eun Ji; Choi, Eunkyoung; Chae, Byung Joo; Park, Yonggyu; Kim, Sung Hoon [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

2013-12-15

We evaluated whether the maximum standardized uptake values (SUV{sub max}) of primary tumor from the initial staging by {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) of patients with breast cancer could identify patients at risk for early recurrence within 2 years, particularly in comparison to the American Joint Committee on Cancer (AJCC) stage. We reviewed the staging {sup 18}F-FDG PET/CT images of patients with primary breast cancer and their medical records. The SUV{sub max} of the primary tumor was measured. The presence or absence of FDG uptake in the axillary lymph node (ALN) was also assessed. The patient's pathologic primary tumor stage (pT), pathologic regional lymph node stage (pN), stage grouping, age, estrogen receptor (ER) and progesterone receptor (PR) status, and neoadjuvant chemotherapy history were evaluated with the FDG uptake parameters for recurrence within 2 years following the end of first-line therapy. Recurrence within 2 years was present in 9.1%(n =40) out of the 441 patients assessed. The FDG uptake in ALN, pT, pN, stage grouping and neoadjuvant chemotherapy history were prognostic for early recurrence, while primary tumor SUV{sub max}, age, and ER or PR status were not significant on logistic regression. On multivariate analysis, only the stage grouping (odds ratio 2.79; 95 % CI 1.73, 4.48; p <0.0001) and neoadjuvant chemotherapy history (odds ratio 2.70; 95 % CI 1.22, 5.98; p =0.0141) could identify patients at increased risk for recurrence within 2 years. Primary tumor FDG uptake measured by SUV{sub max}, and visual assessment of FDG uptake in the ALN in the initial staging PET/CT of patients with breast cancer may not have additional prognostic value compared with the AJCC stage grouping for early recurrence.

Role of PET in the initial staging of cutaneous malignant melanoma: systematic review.

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Krug, Bruno; Crott, Ralph; Lonneux, Max; Baurain, Jean-François; Pirson, Anne-Sophie; Vander Borght, Thierry

2008-12-01

To calculate summary estimates of the diagnostic performance of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomographic (PET) imaging in the initial staging of cutaneous malignant melanoma (CMM), following the new American Joint Committee on Cancer (AJCC) staging classification on per-patient and per-lesion bases. MEDLINE, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews databases, and reference lists of reviews and included papers were searched, without any language restrictions, for relevant articles published before March 2007. Two reviewers independently assessed study eligibility and methodologic quality by using the quality assessment of diagnostic accuracy studies checklist. A pooled random effect was estimated and a fixed coefficient regression model was used to explore the existing heterogeneity. Twenty-eight studies involving 2905 patients met the inclusion criteria. The pooled estimates of FDG PET for the detection of metastasis in the initial staging of CMM were sensitivity, 83% (95% confidence interval [CI]: 81%, 84%); specificity, 85% (95% CI: 83%, 87%); positive likelihood ratio (LR), 4.56 (95% CI: 3.12, 6.64); negative LR, 0.27 (95% CI: 0.18, 0.40); and diagnostic odds ratio, 19.8 (95% CI: 10.8, 36.4). Results from eight studies suggested that FDG PET was associated with 33% disease management changes (range, 15%-64%). There is good preliminary evidence that FDG PET is useful for the initial staging of patients with CMM, especially as adjunctive role in AJCC stages III and IV, to help detect deep soft-tissue, lymph node, and visceral metastases. FDG PET-computed tomographic imaging seemed to be more precise than PET alone, as suggested by four eligible studies. Further evaluation by using a well-designed prospective study, with clinical outcome-focused measures and cost effectiveness analysis, is needed to clarify the appropriate role of FDG PET in CMM staging. http://radiology.rsnajnls.org/cgi/content/full/249/3/836/DC

Lung-MAP: Talazoparib in Treating Patients With HRRD Positive Recurrent Stage IV Squamous Cell Lung Cancer

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2018-05-31

ATM Gene Mutation; ATR Gene Mutation; BARD1 Gene Mutation; BRCA1 Gene Mutation; BRCA2 Gene Mutation; BRIP1 Gene Mutation; CHEK1 Gene Mutation; CHEK2 Gene Mutation; FANCA Gene Mutation; FANCC Gene Mutation; FANCD2 Gene Mutation; FANCF Gene Mutation; FANCM Gene Mutation; NBN Gene Mutation; PALB2 Gene Mutation; RAD51 Gene Mutation; RAD51B Gene Mutation; RAD54L Gene Mutation; Recurrent Squamous Cell Lung Carcinoma; RPA1 Gene Mutation; Stage IV Squamous Cell Lung Carcinoma AJCC v7

A stage is a stage is a stage: a direct comparison of two scoring systems.

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Dawson, Theo L

2003-09-01

L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.

CT staging of renal cell carcinoma using the revised 1997 TNM staging criteria: in comparison with the previous one

International Nuclear Information System (INIS)

Sung, Deuk Jae; Kim, Yun Hwan; Chung, Hwan Hoon; Chung, Kyoo Byung; Suh, Won Hyuck

2001-01-01

To assess the accuracy of preoperative CT staging of RCC and to compare the relationship between T stage and the incidence of metastasis on the basis of the old (1992) and the new (1997) UICC and AJCC tumor classification system. In 112 cases of surgically resected RCC, the stagings of preoperative CT scans were determined retrospectively by two radiologists and were compared with the results of pathologic examinations. In 70 cases which had been followed up over three years after surgery, the incidence of metastasis at initial diagnosis and during the follow-up period was assessed. All cases were reconsidered, and using the old and the new TNM classification, the incidence of metastasis was compared. According to the old TNM classification, 5 cases (4%) were staged at T1, 73(65%) at T2, 21(19%) at T3a, 9(8%) at T3b, 0 at T3c, and 4(4%) at T4. Using the new TNM classification, we also staged 54 cases (48%) at T1 and 24(21%) at T2. Overall, using this new classification, CT correctly staged 79% of patients (88/112) overstaged 15%(17/112) and understaged 6%(7/112). CT had a sensitivity of 84% and specificity of 91% in new T1 tumors, 71% and 95%, respectively, in new T2 tumors, 69% and 88% in T3a tumors, 78% and 98% in T3b tumors, and 75% and 99% in T4 tumors. CT had a sensitivity of 44% and a specificity of 99% in old T1 tumors, and 82% and 71%, respectively, in old T2 tumors. The incidence of metastasis in CT-staged (cT) tumors was 0% (0/4) in old cT1, 8% (3/39) in new cT1, 29% (4/14) in new cT2, 67% (6/9) in cT3a, and 75% (6/8) in cT3b. In the staging of T1 tumors, CT is more sensitive when the new TNM classification is used. Even though the cut off point between T1 and T2 tumors had been in creased from 2.5 to 7.0 cm, T1 tumors staged according to the new system did not show a significantly higher incidence of metastasis than those staged according to the old

Osimertinib and Necitumumab in Treating Patients With EGFR-Mutant Stage IV or Recurrent Non-small Cell Lung Cancer Who Have Progressed on a Previous EGFR Tyrosine Kinase Inhibitor

Science.gov (United States)

2018-03-07

EGFR Exon 19 Deletion Mutation; EGFR Exon 20 Insertion Mutation; EGFR NP_005219.2:p.G719X; EGFR NP_005219.2:p.L858R; EGFR NP_005219.2:p.L861Q; EGFR NP_005219.2:p.T790M; EGFR T790M Mutation Negative; Recurrent Non-Small Cell Lung Carcinoma; Stage IV Non-Small Cell Lung Cancer AJCC v7

Operation of staged membrane oxidation reactor systems

Science.gov (United States)

Repasky, John Michael

2012-10-16

A method of operating a multi-stage ion transport membrane oxidation system. The method comprises providing a multi-stage ion transport membrane oxidation system with at least a first membrane oxidation stage and a second membrane oxidation stage, operating the ion transport membrane oxidation system at operating conditions including a characteristic temperature of the first membrane oxidation stage and a characteristic temperature of the second membrane oxidation stage; and controlling the production capacity and/or the product quality by changing the characteristic temperature of the first membrane oxidation stage and/or changing the characteristic temperature of the second membrane oxidation stage.

A prognostic analysis of 895 cases of stage III colon cancer in different colon subsites.

Science.gov (United States)

Zhang, Yan; Ma, Junli; Zhang, Sai; Deng, Ganlu; Wu, Xiaoling; He, Jingxuan; Pei, Haiping; Shen, Hong; Zeng, Shan

2015-09-01

Stage III colon cancer is currently treated as an entity with a unified therapeutic principle. The aim of the retrospective study is to explore the clinicopathological characteristics and outcomes of site-specific stage III colon cancers and the influences of tumor location on prognosis. Eight hundred ninety-five patients with stage III colon cancer treated with radical operation and subsequent adjuvant chemotherapy (5-fluorouracil/oxaliplatin) were divided into seven groups according to colon segment (cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, and sigmoid colon). Expression of excision repair cross-complementing group 1 (ERCC1) and thymidylate synthase (TS) was examined by immunohistochemistry. We assessed if differences exist in patient characteristics and clinic outcomes between the seven groups. There were significant differences in tumor differentiation (P Cancer (AJCC) tumor-node-metastasis (TNM) stage (P colon. Cox regression analyses identified that tumor location was an independent prognostic factor for RFS and OS. Stage III colon cancer located proximally carried a poorer survival than that located distally. Different efficacies of FOLFOX adjuvant chemotherapy may be an important factor affecting survival of site-specific stage III colon cancers.

Risk stratification of patients with locally aggressive differentiated thyroid cancer. Results of the MSDS trial

International Nuclear Information System (INIS)

Riemann, B.; Kraemer, J.A.; Schober, O.; Schmid, K.W.; Dralle, H.; Dietlein, M.; Schicha, H.; Sauerland, C.; Frankewitsch, T.

2010-01-01

The Multicentre Study Differentiated Thyroid Cancer (MSDS) collective represents a well defined group of patients with locally aggressive thyroid carcinomas (pT4; AJCC/UICC 1997). The aim of the present study was to compare the survival of patients with minimum and extensive extrathyroidal growth according to the new AJCC/UICC TNM staging system 2009. Patients, methods: The follow-up data of 347 patients were analysed. Patients were reclassified according to the current AJCC/UICC 2009 classification. The event-free and overall survival was evaluated using Kaplan-Meier analysis. In addition, postoperative complications and status of disease were documented. Results: 327 patients were assigned to stage pT3 and 20 patients to stage pT4a, respectively. Median follow-up was 6.1 years (range 0.04-9.8 years). 92.5% of patients reached complete remission. There were 7.8% recurrences in the thyroid bed, in locoregional lymph nodes and/or in distant sites. The overall survival was >98% both in pT3 and pT4a patients (p = n. s.). In contrast, the event-free survival was significantly less favourable in pT4a patients (p < 0.001). Using multivariate analysis the following parameters were significant predictors of event-free survival: histological tumour type, degree of extrathyroidal extension and nodal metastasis (p < 0.05). Conclusions: The MSDS patients with locally aggressive differentiated thyroid cancer showed an excellent overall survival during a median follow-up of 6.1 years. According to the current AJCC/UICC 2009 classification, pT3 patients with minimal extrathyroidal extension revealed a significantly better event-free survival than pT4a patients with extensive extrathyroidal growth. (orig.)

COOLING STAGES OF CRYOGENIC SYSTEMS

OpenAIRE

Троценко, А. В.

2011-01-01

The formalized definition for cooling stage of low temperature system is done. Based on existing information about the known cryogenic unit cycles the possible types of cooling stages are single out. From analyses of these stages their classification by various characteristics is suggested. The results of thermodynamic optimization of final throttle stage of cooling, which are used as working fluids helium, hydrogen and nitrogen, are shown.

[A comparison between 3.0 T MRI and histopathology for preoperative T staging of potentially resectable esophageal cancer].

Science.gov (United States)

Wang, Z Q; Zhang, F G; Guo, J; Zhang, H K; Qin, J J; Zhao, Y; Ding, Z D; Zhang, Z X; Zhang, J B; Yuan, J H; Li, H L; Qu, J R

2017-03-21

Objective: To explore the value of 3.0 T MRI using multiple sequences (star VIBE+ BLADE) in evaluating the preoperative T staging for potentially resectable esophageal cancer (EC). Methods: Between April 2015 and March 2016, a total of 66 consecutive patients with endoscopically proven resectable EC underwent 3.0T MRI in the Affiliated Cancer Hospital of Zhengzhou University.Two independent readers were assigned a T staging on MRI according to the 7th edition of UICC-AJCC TNM Classification, the results of preoperative T staging were compared and analyzed with post-operative pathologic confirmation. Results: The MRI T staging of two readers were highly consistent with histopathological findings, and the sensitivity, specificity and accuracy of preoperative T staging MR imaging were also very high. Conclusion: 3.0 T MRI using multiple sequences is with high accuracy for patients of potentially resectable EC in T staging. The staging accuracy of T1, T2 and T3 is better than that of T4a. 3.0T MRI using multiple sequences could be used as a noninvasive imaging method for pre-operative T staging of EC.

CEA in activated macrophages. New diagnostic possibilities for tumor markers in early colorectal cancer.

Science.gov (United States)

Japink, Dennis; Leers, Mathie P G; Sosef, Meindert N; Nap, Marius

2009-08-01

Serum tumor markers show low sensitivity, making them unsuitable for early detection of cancer. Activated macrophages (AM) from peripheral blood can accumulate tumor marker substances and facilitate early detection in prostate cancer. Here it was investigated whether carcinoembryonic antigen (CEA)-containing macrophages (CEACM) can be used to detect colorectal cancer (CRC) at earlier stages than can serum CEA. Peripheral blood was collected from patients with CRC (n=48), inflammatory colorectal disease (n=5) and from healthy controls (n=18). After separating and labeling AM with CD14-APC/CD16-FITC, AM were intracellularly labeled with anti-CEA antibody and flow cytometrically analyzed. Serum CEA and C-reactive protein (CRP) were measured. The fraction-size of CEACM discriminated between controls and CRC patients, irrespective of AJCC stage (AJCC stage I-IV, pCEA values were significantly elevated in AJCC stage II, III and IV (p=0.02, 0.006 and <0.0001, respectively). Combining CEACM with CRP levels separated CRC from inflammatory colorectal disease. CEACM combined with CRP appears to have diagnostic potential in early CRC.

Impact of tumour volume on prediction of progression-free survival in sinonasal cancer

International Nuclear Information System (INIS)

Hennersdorf, Florian; Mauz, Paul-Stefan; Adam, Patrick; Welz, Stefan; Sievert, Anne; Ernemann, Ulrike; Bisdas, Sotirios

2015-01-01

The present study aimed to analyse potential prognostic factors, with emphasis on tumour volume, in determining progression free survival (PFS) for malignancies of the nasal cavity and the paranasal sinuses. Retrospective analysis of 106 patients with primary sinonasal malignancies treated and followed-up between March 2006 and October 2012. Possible predictive parameters for PFS were entered into univariate and multivariate Cox regression analysis. Kaplan-Meier curve analysis included age, sex, baseline tumour volume (based on MR imaging), histology type, TNM stage and prognostic groups according to the American Joint Committee on Cancer (AJCC) classification. Receiver operating characteristic (ROC) curve analysis concerning the predictive value of tumour volume for recurrence was also conducted. The main histological subgroup consisted of epithelial tumours (77%). The majority of the patients (68%) showed advanced tumour burden (AJCC stage III–IV). Lymph node involvement was present in 18 cases. The mean tumour volume was 26.6 ± 21.2 cm 3 . The median PFS for all patients was 24.9 months (range: 2.5–84.5 months). The ROC curve analysis for the tumour volume showed 58.1% sensitivity and 75.4% specificity for predicting recurrence. Tumour volume, AJCC staging, T- and N- stage were significant predictors in the univariate analysis. Positive lymph node status and tumour volume remained significant and independent predictors in the multivariate analysis. Radiological tumour volume proofed to be a statistically reliable predictor of PFS. In the multivariate analysis, T-, N- and overall AJCC staging did not show significant prognostic value

Prognostic Factors Affecting Locally Recurrent Rectal Cancer and Clinical Significance of Hemoglobin

International Nuclear Information System (INIS)

Rades, Dirk; Kuhn, Hildegard; Schultze, Juergen; Homann, Nils; Brandenburg, Bernd; Schulte, Rainer; Krull, Andreas; Schild, Steven E.; Dunst, Juergen

2008-01-01

Purpose: To investigate potential prognostic factors, including hemoglobin levels before and during radiotherapy, for associations with survival and local control in patients with unirradiated locally recurrent rectal cancer. Patients and Methods: Ten potential prognostic factors were investigated in 94 patients receiving radiotherapy for recurrent rectal cancer: age (≤68 vs. ≥69 years), gender, Eastern Cooperative Oncology Group performance status (0-1 vs. 2-3), American Joint Committee on Cancer (AJCC) stage (≤II vs. III vs. IV), grading (G1-2 vs. G3), surgery, administration of chemotherapy, radiation dose (equivalent dose in 2-Gy fractions: ≤50 vs. >50 Gy), and hemoglobin levels before (<12 vs. ≥12 g/dL) and during (majority of levels: <12 vs. ≥12 g/dL) radiotherapy. Multivariate analyses were performed, including hemoglobin levels, either before or during radiotherapy (not both) because these are confounding variables. Results: Improved survival was associated with better performance status (p < 0.001), lower AJCC stage (p = 0.023), surgery (p = 0.011), chemotherapy (p = 0.003), and hemoglobin levels ≥12 g/dL both before (p = 0.031) and during (p < 0.001) radiotherapy. On multivariate analyses, performance status, AJCC stage, and hemoglobin levels during radiotherapy maintained significance. Improved local control was associated with better performance status (p = 0.040), lower AJCC stage (p = 0.010), lower grading (p = 0.012), surgery (p < 0.001), chemotherapy (p < 0.001), and hemoglobin levels ≥12 g/dL before (p < 0.001) and during (p < 0.001) radiotherapy. On multivariate analyses, chemotherapy, grading, and hemoglobin levels before and during radiotherapy remained significant. Subgroup analyses of the patients having surgery demonstrated the extent of resection to be significantly associated with local control (p = 0.011) but not with survival (p = 0.45). Conclusion: Predictors for outcome in patients who received radiotherapy for locally

Staged membrane oxidation reactor system

Science.gov (United States)

Repasky, John Michael; Carolan, Michael Francis; Stein, VanEric Edward; Chen, Christopher Ming-Poh

2012-09-11

Ion transport membrane oxidation system comprising (a) two or more membrane oxidation stages, each stage comprising a reactant zone, an oxidant zone, one or more ion transport membranes separating the reactant zone from the oxidant zone, a reactant gas inlet region, a reactant gas outlet region, an oxidant gas inlet region, and an oxidant gas outlet region; (b) an interstage reactant gas flow path disposed between each pair of membrane oxidation stages and adapted to place the reactant gas outlet region of a first stage of the pair in flow communication with the reactant gas inlet region of a second stage of the pair; and (c) one or more reactant interstage feed gas lines, each line being in flow communication with any interstage reactant gas flow path or with the reactant zone of any membrane oxidation stage receiving interstage reactant gas.

FDG-PET in the initial staging of squamous cell oesophageal carcinoma

International Nuclear Information System (INIS)

Buchmann, I.; Schreckenberger, M.; Bartenstein, P.; Hansen, T.; Brochhausen, C.; Kneist, W.; Junginger, T.; Oberholzer, K.

2006-01-01

Squamous cell oesophageal carcinoma is the most common carcinoma of the oesophagus worldwide. The tumour stage as most important prognostic factor determines the clinical management. Aim of this study was to evaluate the value of FDG-PET 1. in imaging the primary tumour and 2. in N- and M-staging of squamous cell oesophogeal carcinoma. Patients, methods: in 20 patients with histological proven squamous cell carcinoma of the upper and middle oesophagus, FDG-PET was performed in standard technique prior to therapy. FDG uptake in the primary was determined by calculation of the SUVmax. NM-staging due to PET findings was performed as designated by the AJCC/UICC group classification and was compared with pathological and clinically based staging. Sensitivities, specificities and accuracies were calculated. Results: in 19 of 20 patients, primary squamous cell oesopohageal carcinoma was detected by FDG-PET findings with a maximum SUV of 12.5 (mean) ± 5.1 (median 11.5; range 4.8-23.8). One carcinoma in situ was missed. The sensitivity of FDG-PET in imaging the primary tumour was 96%. The sensitivities, specificities and accuracies were 20%, 100%, 58% for N-staging, and 60%, 86% and 93% for M-staging. PET findings caused changes of therapy in 5% (1 patient). Conclusions: FDG-PET was excellent in imaging the primary of squamous cell oesophageal carcinoma in stage T1-T4 and was efficient in M-staging. The low sensitivity in N-staging is of inferior clinical importance. The efficacy of FDG-PET seems to be not significantly be influenced by the histological subtype of oesophageal carcinoma. (orig.)

Two-stage implant systems.

Science.gov (United States)

Fritz, M E

1999-06-01

Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of

Multi-Stage System for Automatic Target Recognition

Science.gov (United States)

Chao, Tien-Hsin; Lu, Thomas T.; Ye, David; Edens, Weston; Johnson, Oliver

2010-01-01

A multi-stage automated target recognition (ATR) system has been designed to perform computer vision tasks with adequate proficiency in mimicking human vision. The system is able to detect, identify, and track targets of interest. Potential regions of interest (ROIs) are first identified by the detection stage using an Optimum Trade-off Maximum Average Correlation Height (OT-MACH) filter combined with a wavelet transform. False positives are then eliminated by the verification stage using feature extraction methods in conjunction with neural networks. Feature extraction transforms the ROIs using filtering and binning algorithms to create feature vectors. A feedforward back-propagation neural network (NN) is then trained to classify each feature vector and to remove false positives. The system parameter optimizations process has been developed to adapt to various targets and datasets. The objective was to design an efficient computer vision system that can learn to detect multiple targets in large images with unknown backgrounds. Because the target size is small relative to the image size in this problem, there are many regions of the image that could potentially contain the target. A cursory analysis of every region can be computationally efficient, but may yield too many false positives. On the other hand, a detailed analysis of every region can yield better results, but may be computationally inefficient. The multi-stage ATR system was designed to achieve an optimal balance between accuracy and computational efficiency by incorporating both models. The detection stage first identifies potential ROIs where the target may be present by performing a fast Fourier domain OT-MACH filter-based correlation. Because threshold for this stage is chosen with the goal of detecting all true positives, a number of false positives are also detected as ROIs. The verification stage then transforms the regions of interest into feature space, and eliminates false positives using an

Assessment of Serosal Invasion and Criteria for the Classification of Pathological (p) T4 Staging in Colorectal Carcinoma: Confusions, Controversies and Criticisms

Energy Technology Data Exchange (ETDEWEB)

Stewart, Colin J. R., E-mail: colin.stewart@health.wa.gov.au; Hillery, Simon [Department of Histopathology, SJOG Hospital, Perth, Western Australia (Australia); Platell, Cameron [Colorectal Surgery Unit, SJOG Hospital, Perth, Western Australia and University of Western (Australia); Puppa, Giacomo [Division of Pathology, ‘G. Fracastoro’ City Hospital, Verona (Italy)

2011-01-04

Transmural spread by colorectal carcinoma can result in tumor invasion of the serosal surface and, hence, more likely dissemination within the peritoneal cavity and potentially to additional metastatic sites. The adverse prognostic significance of serosal invasion is widely accepted and its presence may be considered an indication for chemotherapy in patients with node negative disease. However, controversy persists regarding the most appropriate criteria for diagnosis and there are also practical difficulties associated with histological assessment in some cases. Therefore, serosal invasion may be under-diagnosed in a significant proportion of tumors, potentially leading to sub-optimal treatment of high-risk patients. The examination of multiple microscopic sections combined with ancillary studies such as cytology preparations, elastin stains, and immunohistochemistry may prove beneficial in selected problematic cases, but these are not used routinely. The relative prognostic significance of serosal invasion and of direct tumor spread to other organs, both of which are incorporated within the pT4 category of the AJCC/UICC TNM staging system, remains unclear. Further studies are required to demonstrate whether recent adjustments to the TNM staging of pT4 tumors are appropriate.

Pathological stage after neoadjuvant chemoradiation and esophagectomy superiorly predicts survival in patients with esophageal squamous cell carcinoma

International Nuclear Information System (INIS)

Wang, Chia-Chun; Cheng, Jason Chia-Hsien; Tsai, Chiao-Ling; Lee, Jang-Ming; Huang, Pei-Ming; Lin, Chia-Chi; Hsu, Chih-Hung; Hsieh, Min-Shu; Chang, Yih-Leong; Hsu, Feng-Ming

2015-01-01

Background and purpose: To assess the usefulness of pathological stage according to the 7th edition of the Union for International Cancer Control–American Joint Committee on Cancer (UICC–AJCC) as a prognostic tool in patients undergoing neoadjuvant chemoradiation followed by esophagectomy (trimodality therapy, TMT) for locally advanced esophageal squamous cell carcinoma. Material and methods: One hundred twenty-five eligible patients completing TMT were enrolled for analysis. The clinical (cTNM7) and pathological (ypTNM7) stage groups of their tumors were prospectively classified, and re-grouped by the 6th edition (ypTNM6). Survival was analyzed using the Kaplan–Meier method. The Cox proportional hazard model and the Akaike information criterion (AIC) were used to compare the performance of staging systems. Results: With a median follow-up of 24.6 months, 54 patients (43.2%) died. Forty patients (32%) achieved pathological complete remission (pCR). The median survival was 31.8 months. On multivariate analysis, ypTNM7 (but not pCR or pN) was the only independent factor affecting overall survival (p < 0.001). The ypTNM7 was superior to cTNM7 or ypTNM6 in predicting both overall and recurrence-free survival after TMT based on AIC values and Cox proportional hazard model analysis. Conclusions: In patients with locally advanced esophageal squamous cell carcinoma undergoing TMT, ypTNM7 is the best predictor of survival

Different patterns in the prognostic value of age for bladder cancer-specific survival depending on tumor stages.

Science.gov (United States)

Feng, Huan; Zhang, Wei; Li, Jiajun; Lu, Xiaozhe

2015-01-01

To compare the pathological features and long-term survival of bladder cancer (BCa) in young patients with elderly counterparts. Using the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) population-based data, we identified 93115 patients with non-metastatic bladder cancer diagnosed between 1988 and 2003. Patients were categorized into young (50 years and under) and elderly groups (over 50 years of age). The overall and five-year bladder cancer specific survival (BCSS) data were obtained using Kaplan-Meier plots. Multivariable Cox regression models were built for the analysis of long-term survival outcomes and risk factors. There were significant differences between the two groups in primary site, pathologic grading, histologic type, AJCC stage (pstage patients. The study findings show different patterns in the prognostic value of age for determining BCSS, depending on the tumor stages. Compared with elderly patients, young patients with bladder cancer surgery appear to have unique characteristics and a higher overall and cancer specific survival rate.

The role of magnetic resonance imaging (MRI) and MRI-guided surgery in the evaluation of patients with early stage breast cancer for breast conserving therapy

International Nuclear Information System (INIS)

Tan, Jacqueline E.; Orel, Susan G.; Schnall, Mitchell D.; Solin, Lawrence J.

1997-01-01

Purpose: Mammography is the primary imaging modality for the detection of breast cancer and the evaluation of patients with early stage breast cancer for breast conserving therapy (BCT). MRI may be more sensitive than mammography for detecting breast cancer and may have an adjunctive role in assessing patients with early stage disease for BCT. Our experience with 83 patients undergoing breast MRI during consideration for breast conserving therapy is analyzed. Materials and Methods: We reviewed 83 consecutive cases of patients undergoing breast MRI during standard work-up and evaluation for BCT from 1993 to 1996. Analysis of cases was limited to women who were AJCC clinical Stage 0, I, or II and who received definitive therapy at our institution. All patients signed informed consent. MRI of the breast was performed at 1.5 Tesla. Sagittal T1 and T2 and 3-D gradient pre- and post-contrast images were obtained. All MRI studies were reviewed by two radiologists. All patients were evaluated by one radiation oncologist. The records of these 83 patients were reviewed for patient age, tumor size, AJCC stage, histology, physical examination findings, mammographic findings, ultrasound findings, MRI findings, timing of first MRI study with respect to excisional surgery, findings from MRI-guided surgery (when done), and whether the patient underwent BCT. Results: The median age at the time of presentation was 51.5 years (range 26-77 years). Of the 83 patients, 16% were AJCC clinical stage 0, 65% were stage I, and 19% were stage II. No patient presented with synchronous bilateral carcinoma. Two patients had a history of prior contralateral breast carcinoma; both received BCT for their initial disease. Sixteen percent of patients had intraductal carcinoma, 39% had intraductal and infiltrating carcinoma, 28% had infiltrating ductal carcinoma, 7% had infiltrating lobular carcinoma, 4% had tubular carcinoma, 2% had adenoid cystic carcinoma, 2% had medullary carcinoma, 1% had colloid

Wide-bandwidth bilateral control using two-stage actuator system

International Nuclear Information System (INIS)

Kokuryu, Saori; Izutsu, Masaki; Kamamichi, Norihiro; Ishikawa, Jun

2015-01-01

This paper proposes a two-stage actuator system that consists of a coarse actuator driven by a ball screw with an AC motor (the first stage) and a fine actuator driven by a voice coil motor (the second stage). The proposed two-stage actuator system is applied to make a wide-bandwidth bilateral control system without needing expensive high-performance actuators. In the proposed system, the first stage has a wide moving range with a narrow control bandwidth, and the second stage has a narrow moving range with a wide control bandwidth. By consolidating these two inexpensive actuators with different control bandwidths in a complementary manner, a wide bandwidth bilateral control system can be constructed based on a mechanical impedance control. To show the validity of the proposed method, a prototype of the two-stage actuator system has been developed and basic performance was evaluated by experiment. The experimental results showed that a light mechanical impedance with a mass of 10 g and a damping coefficient of 2.5 N/(m/s) that is an important factor to establish good transparency in bilateral control has been successfully achieved and also showed that a better force and position responses between a master and slave is achieved by using the proposed two-stage actuator system compared with a narrow bandwidth case using a single ball screw system. (author)

Association between traditional clinical high-risk features and gene expression profile classification in uveal melanoma.

Science.gov (United States)

Nguyen, Brandon T; Kim, Ryan S; Bretana, Maria E; Kegley, Eric; Schefler, Amy C

2018-02-01

To evaluate the association between traditional clinical high-risk features of uveal melanoma patients and gene expression profile (GEP). This was a retrospective, single-center, case series of patients with uveal melanoma. Eighty-three patients met inclusion criteria for the study. Patients were examined for the following clinical risk factors: drusen/retinal pigment epithelium (RPE) changes, vascularity on B-scan, internal reflectivity on A-scan, subretinal fluid (SRF), orange pigment, apical tumor height/thickness, and largest basal dimensions (LBD). A novel point system was created to grade the high-risk clinical features of each tumor. Further analyses were performed to assess the degree of association between GEP and each individual risk factor, total clinical risk score, vascularity, internal reflectivity, American Joint Committee on Cancer (AJCC) tumor stage classification, apical tumor height/thickness, and LBD. Of the 83 total patients, 41 were classified as GEP class 1A, 17 as class 1B, and 25 as class 2. The presence of orange pigment, SRF, low internal reflectivity and vascularity on ultrasound, and apical tumor height/thickness ≥ 2 mm were not statistically significantly associated with GEP class. Lack of drusen/RPE changes demonstrated a trend toward statistical association with GEP class 2 compared to class 1A/1B. LBD and advancing AJCC stage was statistically associated with higher GEP class. In this cohort, AJCC stage classification and LBD were the only clinical features statistically associated with GEP class. Clinicians should use caution when inferring the growth potential of melanocytic lesions solely from traditional funduscopic and ultrasonographic risk factors without GEP data.

Two-Stage Variable Sample-Rate Conversion System

Science.gov (United States)

Tkacenko, Andre

2009-01-01

A two-stage variable sample-rate conversion (SRC) system has been pro posed as part of a digital signal-processing system in a digital com munication radio receiver that utilizes a variety of data rates. The proposed system would be used as an interface between (1) an analog- todigital converter used in the front end of the receiver to sample an intermediatefrequency signal at a fixed input rate and (2) digita lly implemented tracking loops in subsequent stages that operate at v arious sample rates that are generally lower than the input sample r ate. This Two-Stage System would be capable of converting from an input sample rate to a desired lower output sample rate that could be var iable and not necessarily a rational fraction of the input rate.

Staged fluidized-bed combustion and filter system

International Nuclear Information System (INIS)

Mei, J.S.; Halow, J.S.

1994-01-01

A staged fluidized-bed combustion and filter system are described for substantially reducing the quantity of waste through the complete combustion into ash-type solids and gaseous products. The device has two fluidized-bed portions, the first primarily as a combustor/pyrolyzer bed, and the second as a combustor/filter bed. The two portions each have internal baffles to define stages so that material moving therein as fluidized beds travel in an extended route through those stages. Fluidization and movement is achieved by the introduction of gases into each stage through a directional nozzle. Gases produced in the combustor/pyrolyzer bed are permitted to travel into corresponding stages of the combustor/filter bed through screen filters that permit gas flow but inhibit solids flow. Any catalyst used in the combustor/filter bed is recycled. The two beds share a common wall to minimize total volume of the system. A slightly modified embodiment can be used for hot gas desulfurization and sorbent regeneration. Either side-by-side rectangular beds or concentric beds can be used. The system is particularly suited to the processing of radioactive and chemically hazardous waste. 10 figures

Staging of intestinal- and diffuse-type gastric cancers with the OLGA and OLGIM staging systems.

Science.gov (United States)

Cho, S-J; Choi, I J; Kook, M-C; Nam, B-H; Kim, C G; Lee, J Y; Ryu, K W; Kim, Y-W

2013-11-01

Operative link on gastritis assessment (OLGA) and Operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems have been proposed for gastric cancer (GC) risk estimation. To validate the OLGA and OLGIM staging systems in a region with high risk of GC. This retrospective study included 474 GC patients and age- and sex-matched health screening control persons in a cancer centre hospital. We classified gastritis patterns according to the OLGA and OLGIM systems using the histological database that a pathologist prospectively evaluated using the updated Sydney system. GC risk according to the OLGA and OLGIM stages was evaluated using logistic regression analysis. More GC patients had OLGA stages III-IV (46.2%) than controls (26.6%, P diffuse-type GCs (30.9%). OLGA stages III and IV were significantly associated with increased risk of GC [odds ratios (ORs), 2.09; P = 0.008 and 2.04; P = 0.014 respectively] in multivariate analysis. The association was more significant for intestinal-type (ORs, 4.76; P = 0.001 and 4.19; P = 0.002 respectively), but not diffuse-type GC. OLGIM stages from I to IV were significantly associated with increased risk of both intestinal-type (ORs, 3.64, 5.15, 7.89 and 13.20 respectively) and diffuse-type GC (ORs, 1.84, 2.59, 5.08 and 6.32 respectively) with a significantly increasing trend. As high OLGA and OLGIM stages are independent risk factors for gastric cancer, the staging systems may be useful for risk assessment in high-risk regions, especially for intestinal-type gastric cancer. © 2013 John Wiley & Sons Ltd.

The prognostic value of metabolic tumor volume in FDG PET/CT evaluation of post-operative survival in patients with esophageal squamous cell cancer

International Nuclear Information System (INIS)

Zhu Wanqi; Yu Jinming; Sun Xiaorong; Xing Ligang; Xie Peng; Sun Xindong; Guo Hongbo; Yang Guoren; Kong Li

2011-01-01

Objective: To evaluate the prognostic value of MTV on 18 F-FDG PET/CT in patients with esophageal cancer. Methods: Forty-nine patients with esophageal cancer underwent 18 F-FDG PET/CT scan before surgery. The median follow-up time for the patients was 29 months (range, 8-57 months). The prognostic significance of MTV, age, sex, histologic grade, SUV max of the primary tumor, tumor size measured on PET/CT, T stage, N stage, M stage, American Joint Committee on Cancer (AJCC) stage, number and location of lymph nodes metastases were assessed by Kaplan-Meier analysis and multivariate Cox model. Results: In the univariate analysis, AJCC stage (χ 2 =16.206, hazard ratio (HR)=1.177, P<0.001), N stage (χ 2 =9.536, HR=10.833, P=0.002), T stage (χ 2 =5.810, HR=2.397, P=0.016), number of lymph nodes metastases (χ 2 =11.423, HR=1.567, P=0.001), and MTV (χ 2 =3.872, HR=2.433, P=0.049) were significant predictors of survival.Multivariate analysis showed that MTV and AJCC stage were independent predictors of survival (χ 2 =4.525, HR 1.170, P=0.033; χ 2 =4.875, HR=3.071, P=0.027). Kaplan-Meier survival curves revealed longer survival time of low-MTV group as compared to high-MTV group (Log-rank, χ 2 =4.186, P=0.041). Conclusion: MTV on 18 F-FDG PET/CT may be an independent prognostic factor in patients with esophageal cancer. (authors)

[Helicobacter pylori gastritis: assessment of OLGA and OLGIM staging systems].

Science.gov (United States)

Ben Slama, Sana; Ben Ghachem, Dorra; Dhaoui, Amen; Jomni, Mohamed Taieb; Dougui, Mohamed Hédi; Bellil, Khadija

2016-01-01

Helicobacter pylori (H pylori) gastritis presents a risk of cancer related to atrophy and intestinal metaplasia. Two recent classifications OLGA (Operative Link on Gastritis Assessment) and OLGIM (Operative Link on Gastritic Intestinal Metaplasia assessment) have been proposed to identify high-risk forms (stages III and IV). The aim of this study is to evaluate the OLGA and OLGIM staging systems in H pylori gastritis. A descriptive study of 100 cases of chronic H pylori gastritis was performed. The revaluation of Sydney System parameters of atrophy and intestinal metaplasia, of gastric antrum and corpus, allowed identifying respectively the stages of OLGA and OLGIM systems. The progressive risk of our H pylori gastritis was 6% according to OLGA staging and 7% according to OLGIM staging. Significant correlation was revealed between age and OLGA staging. High-risk gastritis according to OLGIM staging was significantly associated with moderate to severe atrophy. High-risk forms according to OLGA staging were associated in 80% of the cases to intestinal metaplasia. OLGA and OLGIM systems showed a highly significant positive correlation between them with a mismatch at 5% for H pylori gastritis. The OLGA and OLGIM staging systems in addition to Sydney System, allow selection of high risk forms of chronic gastritis requiring accurate observation.

A simplified staging system based on the radiological findings in different stages of ochronotic spondyloarthropathy

International Nuclear Information System (INIS)

Jebaraj, Isaac; Chacko, Binita Riya; Chiramel, George Koshy; Matthai, Thomas; Parameswaran, Apurve

2013-01-01

This study describes a group of 26 patients with ochronotic spondyloarthropathy who were on regular treatment and follow-up at a tertiary level hospital and proposes a simplified staging system for ochronotic spondyloarthropathy based on radiographic findings seen in the thoracolumbar spine. This proposed classification makes it easy to identify the stage of the disease and start the appropriate management at an early stage. Four progressive stages are described: an inflammatory stage (stage 1), the stage of early discal calcification (stage 2), the stage of fibrous ankylosis (stage 3), and the stage of bony ankylosis (stage 4). To our knowledge, this is the largest reported series of radiological description of spinal ochronosis, and emphasizes the contribution of the spine radiograph in the diagnosis and staging of the disease

A simplified staging system based on the radiological findings in different stages of ochronotic spondyloarthropathy

Directory of Open Access Journals (Sweden)

Isaac Jebaraj

2013-01-01

Full Text Available This study describes a group of 26 patients with ochronotic spondyloarthropathy who were on regular treatment and follow-up at a tertiary level hospital and proposes a simplified staging system for ochronotic spondyloarthropathy based on radiographic findings seen in the thoracolumbar spine. This proposed classification makes it easy to identify the stage of the disease and start the appropriate management at an early stage. Four progressive stages are described: an inflammatory stage (stage 1, the stage of early discal calcification (stage 2, the stage of fibrous ankylosis (stage 3, and the stage of bony ankylosis (stage 4. To our knowledge, this is the largest reported series of radiological description of spinal ochronosis, and emphasizes the contribution of the spine radiograph in the diagnosis and staging of the disease.

Accuracy of preoperative CT T staging of renal cell carcinoma: which features predict advanced stage?

International Nuclear Information System (INIS)

Bradley, A.J.; MacDonald, L.; Whiteside, S.; Johnson, R.J.; Ramani, V.A.C.

2015-01-01

Aims: To characterise CT findings in renal cell carcinoma (RCC), and establish which features are associated with higher clinical T stage disease, and to evaluate patterns of discrepancy between radiological and pathological staging of RCC. Materials and methods: Preoperative CT studies of 92 patients with 94 pathologically proven RCCs were retrospectively reviewed. CT stage was compared with pathological stage using the American Joint Committee on Cancer (AJCC), 7 th edition (2010). The presence or absence of tumour necrosis, perinephric fat standing, thickening of Gerota's fascia, collateral vessels were noted, and correlated with pT stage. The sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) for predicting pT stage ≥pT3a were derived separately for different predictors using cross-tabulations. Results: Twenty-four lesions were pathological stage T1a, 21 were T1b, seven were T2a, 25 were T3a, 11 were T3b, four were T3c, and two were T4. There were no stage T2b. Sixty-three (67%) patients had necrosis, 27 (29%) thickening of Gerota's fascia (1 T1a), 25 had collateral vessels (0 T1a), 28 (30%) had fat stranding of <2 mm, 20 (21%) of 2–5mm and one (1%) of >5 mm. For pT stage ≥pT3a, the presence of perinephric fat stranding had a sensitivity, specificity, PPV and NPV of 74%, 65%, 63%, and 76%, respectively. Presence of tumour necrosis had a sensitivity, specificity, PPV, and NPV of 81%, 44%, 54%, and 72%, respectively. Thickening of Gerota's fascia had a sensitivity, specificity, PPV, and NPV of 52%, 90%, 81% and 70%, respectively; and enlarged collateral vessels had a sensitivity, specificity, PPV, and NPV value of 52%, 94%, 88%, and 71% respectively. Conclusion: The presence of perinephric stranding and tumour necrosis were not reliable signs for pT stage >T3a. Thickening of Gerota's fascia and the presence of collateral vessels in the peri- or paranephric fat had 90% and 94% specificity, with 82% and 88

The influence of quantitative tumor volume measurements on local control in advanced head and neck cancer using concomitant boost accelerated superfractionated irradiation

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Johnson, Christopher R; Khandelwal, Shiv R; Schmidt-Ullrich, Rupert K; Ravalese, Joseph; Wazer, David E

1995-06-15

Purpose: Current methods to clinically define head and neck tumor bulk are qualitative and imprecise. Although the American Joint Committee on Cancer (AJCC) staging system is important for this purpose, limitations exist. This study will investigate the prognostic value of computed tomography (CT) derived tumor volume measurements in comparison to AJCC stage and other significant variables. Materials and Methods: Seventy-six patients with advanced head and neck squamous cell carcinoma were treated with concomitant boost accelerated superfractionated irradiation. Doses ranged from 68.4-73.8 Gy (median 70.2 Gy). Good quality pretherapy CT scans were available in 51 patients. Total tumor volume (TTV) estimates were derived from these scans using digital integration of primary tumor and metastatic lymphadenopathy. Actuarial and multivariate statistical techniques were applied to analyze local control. Results: Thirty-six-month local control was 63%. TTV ranged from 5-196 cm{sup 3} (median 35 cm{sup 3}) for all cases, 5-142 cm{sup 3} (median 17 cm{sup 3}) for those controlled, and 16-196 cm{sup 3} (median 47 cm{sup 3}) for local failures. There was a significant increase in failures above 35 cm{sup 3}. Univariate analysis found that TTV, T-stage, N-stage, and primary site were each significant prognostic variables. Local control for TTV {<=}35 cm{sup 3} was 92% at 36 months vs. 34% for TTV >35 cm{sup 3} (p = 0.0001). Multivariate analysis, however, found that TTV, primary site, and sex were important as independent variables; T and N stage were not independently significant unless TTV was removed from the model. Conclusions: This study demonstrates the prognostic significance of TTV in advanced carcinoma of the head and neck. This variable appears to be a more predictive than AJCC clinical stage. Quantitative tumor volume measurements may prove to be a useful parameter in future analyses of head and neck cancer.

Prognostic Value of Volume-Based {sup 18}F-Fluorodeoxyglucose PET/CT Parameters in Patients with Clinically Node-Negative Oral Tongue Squamous Cell Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Lee, Su Jin [Dept. of Nuclear Medicine, Ajou University School of Medicine, Suwon (Korea, Republic of); Choi, Joon Young; Lee, Hwan Joo; Hyun, Seung Hyup; Moon, Seung Hwan; Kim, Byung Tae [Dept. of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Baek, Chung Hwan; Son, Young Ik [Dept. of Otorhinolaryngology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2012-11-15

To evaluate the prognostic value of volume-based metabolic parameters measured with {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors. In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, ({sup 18}F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with ({sup 18}F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis. In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUVmax, SUVavg, MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV {>=} 7.78 cm{sup 3} showed a worse prognosis than those with MTV < 7.78 cm{sup 3} (p = 0.037). The MTV of primary tumor as a volumetric parameter of ({sup 18}F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC.

Disparities in the survivorship experience among Latina survivors of breast cancer.

Science.gov (United States)

Olagunju, Tinuke O; Liu, Yihang; Liang, Li-Jung; Stomber, James M; Griggs, Jennifer J; Ganz, Patricia A; Thind, Amardeep; Maly, Rose C

2018-04-06

The authors investigated disparities in the survivorship experience among Latinas with breast cancer (BC) in comparison with non-Latinas. A cross-sectional bilingual telephone survey was conducted among 212 Latina and non-Latina women within 10 to 24 months after a diagnosis of BC (AJCC TNM staging system stage 0-III) at 2 Los Angeles County public hospitals. Data were collected using the Preparing for Life as a (New) Survivor (PLANS) scale, Perceived Efficacy in Patient-Physician Interactions Questionnaire (PEPPI), Breast Cancer Prevention Trial (BCPT) Symptom Checklist, Satisfaction with Care and Information Scale, Consumer Assessment of Healthcare Providers and Systems (CAHPS) tool, Charlson Comorbidity Index adapted for patient self-report, and the 12-item Short Form Health Survey. Controlling variables included age, stage as determined by the American Joint Committee on Cancer (AJCC) TNM staging system, educational level, and study site in multivariate analyses. The mean ages of Latinas and non-Latinas were 51.5 years and 56.6 years, respectively. Compared with non-Latinas, Latinas reported less BC survivorship knowledge (27.3 vs 30.7; Psatisfaction with BC survivorship care (9.6 vs 8.8; P = .298), or their discussion with physicians (9.6 vs 8.1; P = .07). These ethnic group differences persisted in multivariate analyses, with the exception of PEPPI. Latina survivors of BC experienced disparities in BC knowledge and satisfaction with information received, but believed themselves to be prepared for survivorship and were as satisfied with providers, care received, and discussions with physicians as non-Latinas. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Attainability and minimum energy of multiple-stage cascade membrane Systems

KAUST Repository

Alshehri, Ali

2015-08-12

Process design and simulation of multi-stage membrane systems have been widely studied in many gas separation systems. However, general guidelines have not been developed yet for the attainability and the minimum energy consumption of a multi-stage membrane system. Such information is important for conceptual process design and thus it is the topic of this work. Using a well-mixed membrane model, it was determined that the attainability curve of multi-stage systems is defined by the pressure ratio and membrane selectivity. Using the constant recycle ratio scheme, the recycle ratio can shift the attainability behavior between single-stage and multi-stage membrane systems. When the recycle ratio is zero, all of the multi-stage membrane processes will decay to a single-stage membrane process. When the recycle ratio approaches infinity, the required selectivity and pressure ratio reach their absolute minimum values, which have a simple relationship with that of a single-stage membrane process, as follows: View the MathML sourceSn=S1, View the MathML sourceγn=γ1, where n is the number of stages. The minimum energy consumption of a multi-stage membrane process is primarily determined by the membrane selectivity and recycle ratio. A low recycle ratio can significantly reduce the required membrane selectivity without substantial energy penalty. The energy envelope curve can provide a guideline from an energy perspective to determine the minimum required membrane selectivity in membrane process designs to compete with conventional separation processes, such as distillation.

Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System.

Science.gov (United States)

Edsberg, Laura E; Black, Joyce M; Goldberg, Margaret; McNichol, Laurie; Moore, Lynn; Sieggreen, Mary

Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An NPUAP-appointed Task Force reviewed the literature and created drafts of definitions, which were then reviewed by stakeholders and the public, including clinicians, educators, and researchers around the world. Using a consensus-building methodology, these revised definitions were the focus of a multidisciplinary consensus conference held in April 2016. As a result of stakeholder and public input, along with the consensus conference, important changes were made and incorporated into the new staging definitions. The revised staging system uses the term injury instead of ulcer and denotes stages using Arabic numerals rather than Roman numerals. The revised definition of a pressure injury now describes the injuries as usually occurring over a bony prominence or under a medical or other device. The revised definition of a Stage 2 pressure injury seeks to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear. The term suspected has been removed from the Deep Tissue Pressure Injury diagnostic label. Each definition now describes the extent of tissue loss present and the anatomical features that may or may not be present in the stage of injury. These important revisions reflect the methodical and collaborative approach used to examine the available evidence and incorporate current interdisciplinary clinical expertise into better defining the important phenomenon of pressure injury etiology and development.

The relationships between memory systems and sleep stages.

Science.gov (United States)

Rauchs, Géraldine; Desgranges, Béatrice; Foret, Jean; Eustache, Francis

2005-06-01

Sleep function remains elusive despite our rapidly increasing comprehension of the processes generating and maintaining the different sleep stages. Several lines of evidence support the hypothesis that sleep is involved in the off-line reprocessing of recently-acquired memories. In this review, we summarize the main results obtained in the field of sleep and memory consolidation in both animals and humans, and try to connect sleep stages with the different memory systems. To this end, we have collated data obtained using several methodological approaches, including electrophysiological recordings of neuronal ensembles, post-training modifications of sleep architecture, sleep deprivation and functional neuroimaging studies. Broadly speaking, all the various studies emphasize the fact that the four long-term memory systems (procedural memory, perceptual representation system, semantic and episodic memory, according to Tulving's SPI model; Tulving, 1995) benefit either from non-rapid eye movement (NREM) (not just SWS) or rapid eye movement (REM) sleep, or from both sleep stages. Tulving's classification of memory systems appears more pertinent than the declarative/non-declarative dichotomy when it comes to understanding the role of sleep in memory. Indeed, this model allows us to resolve several contradictions, notably the fact that episodic and semantic memory (the two memory systems encompassed in declarative memory) appear to rely on different sleep stages. Likewise, this model provides an explanation for why the acquisition of various types of skills (perceptual-motor, sensory-perceptual and cognitive skills) and priming effects, subserved by different brain structures but all designated by the generic term of implicit or non-declarative memory, may not benefit from the same sleep stages.

Stage III nasopharyngeal angiofibroma: Improving results with endoscopic-assisted midfacial degloving and modification to the Fisch staging system.

Science.gov (United States)

Shah, Saurin R; Keshri, Amit; Patadia, Simple; Sahu, Rabi Narayan; Srivastava, Arun Kumar; Behari, Sanjay

2015-10-01

To study outcomes with endoscopic-assisted midfacial degloving for Fisch stage III nasopharyngeal angiofibroma and propose a new staging system. Retrospective study of patients with Fisch stage III juvenile nasopharyngeal angiofibroma (JNA) including preoperative angiography, intraoperative blood loss and residue/recurrence following surgery. Tertiary care superspecialty referral center. Fifteen consecutive patients with Fisch stage III JNA undergoing operations over a period of 18 months. Preoperative angiography details, intraoperative blood loss, residue/recurrence, complications of surgery. Transarterial embolization with particulate agents followed by endoscopic-assisted midfacial degloving provides excellent outcomes with Fisch stage III JNAs. The modified Fisch staging system proposed would allow better preoperative evaluation and comparison of outcomes with different treatment options for stage III JNAs. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Observer variation in FDG PET-CT for staging of non-small-cell lung carcinoma

International Nuclear Information System (INIS)

Hofman, Michael S.; Smeeton, Nigel C.; Rankin, Sheila C.; Nunan, Tom; O'Doherty, Michael J.

2009-01-01

Error and variation in reporting remains one of the weakest features of clinical imaging despite enormous technological advances in nuclear medicine and radiology. The aim of this study was to evaluate agreement amongst experienced readers in staging non-small-cell lung cancer (NSCLC) with PET-CT. A series of 18 F-FDG PET-CT scans from 100 consecutive patients were reviewed independently by three experienced readers, with two readers reviewing each scan series a second time. Individual mediastinal lymph node stations were assessed as benign/inflammatory, equivocal or malignant, and AJCC N and M stage were also assigned. Kappa (κ) was used to compare ratings from two categories and weighted kappa (κ w ) for three or more categories, and kappa values were interpreted according to the Landis-Koch benchmarks. Both intra- and interobserver agreement for N and M staging were high. For M staging there was almost perfect intra- and interobserver agreement (κ = 0.90-0.93). For N staging, agreement was either almost perfect or substantial (intraobserver κ w = 0.79, 0.91; interobserver κ w = 0.75-0.81). Importantly, there was almost perfect agreement for N0/1 vs N2/3 disease (κ = 0.80-0.97). Agreement for inferior and superior mediastinal nodes (stations 1, 2, 3, 7, 8, 9) was either almost perfect or substantial (κ w = 0.71-0.88), but lower for hilar nodes (10; κ w = 0.56-0.71). Interreporter variability was greatest for aortopulmonary nodes (5, 6; κ w = 0.48-0.55). Amongst experienced reporters in a single centre, there was a very high level of agreement for both mediastinal nodal stage and detection of distant metastases with PET-CT. This supports the use of PET-CT as a robust imaging modality for staging NSCLC. (orig.)

Observer variation in FDG PET-CT for staging of non-small-cell lung carcinoma

Energy Technology Data Exchange (ETDEWEB)

Hofman, Michael S. [St Thomas' Hospital, PET Imaging Centre, London (United Kingdom)]|[Southern Health, Nuclear Medicine, Melbourne (Australia); Smeeton, Nigel C. [King' s College London, Division of Health and Social Care Research, London (United Kingdom); Rankin, Sheila C.; Nunan, Tom; O' Doherty, Michael J. [St Thomas' Hospital, PET Imaging Centre, London (United Kingdom)

2009-02-15

Error and variation in reporting remains one of the weakest features of clinical imaging despite enormous technological advances in nuclear medicine and radiology. The aim of this study was to evaluate agreement amongst experienced readers in staging non-small-cell lung cancer (NSCLC) with PET-CT. A series of {sup 18}F-FDG PET-CT scans from 100 consecutive patients were reviewed independently by three experienced readers, with two readers reviewing each scan series a second time. Individual mediastinal lymph node stations were assessed as benign/inflammatory, equivocal or malignant, and AJCC N and M stage were also assigned. Kappa ({kappa}) was used to compare ratings from two categories and weighted kappa ({kappa}{sub w}) for three or more categories, and kappa values were interpreted according to the Landis-Koch benchmarks. Both intra- and interobserver agreement for N and M staging were high. For M staging there was almost perfect intra- and interobserver agreement ({kappa} = 0.90-0.93). For N staging, agreement was either almost perfect or substantial (intraobserver {kappa}{sub w} = 0.79, 0.91; interobserver {kappa}{sub w} = 0.75-0.81). Importantly, there was almost perfect agreement for N0/1 vs N2/3 disease ({kappa} = 0.80-0.97). Agreement for inferior and superior mediastinal nodes (stations 1, 2, 3, 7, 8, 9) was either almost perfect or substantial ({kappa}{sub w} = 0.71-0.88), but lower for hilar nodes (10; {kappa}{sub w} = 0.56-0.71). Interreporter variability was greatest for aortopulmonary nodes (5, 6; {kappa}{sub w} = 0.48-0.55). Amongst experienced reporters in a single centre, there was a very high level of agreement for both mediastinal nodal stage and detection of distant metastases with PET-CT. This supports the use of PET-CT as a robust imaging modality for staging NSCLC. (orig.)

Use of Image-Guided Stereotactic Body Radiation Therapy in Lieu of Intracavitary Brachytherapy for the Treatment of Inoperable Endometrial Neoplasia

Energy Technology Data Exchange (ETDEWEB)

Kemmerer, Eric [Department of Radiation Oncology, Temple University Hospital, Philadelphia, Pennsylvania (United States); Hernandez, Enrique; Ferriss, James S. [Department of Obstetrics and Gynecology, Temple University Hospital, Philadelphia, Pennsylvania (United States); Valakh, Vladimir; Miyamoto, Curtis; Li, Shidong [Department of Radiation Oncology, Temple University Hospital, Philadelphia, Pennsylvania (United States); Micaily, Bizhan, E-mail: bizhan.micaily@tuhs.temple.edu [Department of Radiation Oncology, Temple University Hospital, Philadelphia, Pennsylvania (United States)

2013-01-01

Purpose: Retrospective analysis of patients with invasive endometrial neoplasia who were treated with external beam radiation therapy followed by stereotactic body radiation therapy (SBRT) boost because of the inability to undergo surgery or brachytherapy. Methods and Materials: We identified 11 women with stage I-III endometrial cancer with a median age of 78 years that were not candidates for hysterectomy or intracavitary brachytherapy secondary to comorbidities (91%) or refusal (9%). Eight patients were American Joint Committee on Cancer (AJCC) stage I (3 stage IA, 5 stage IB), and 3 patients were AJCC stage III. Patients were treated to a median of 4500 cGy at 180 cGy per fraction followed by SBRT boost (600 cGy per fraction Multiplication-Sign 5). Results: The most common side effect was acute grade 1 gastrointestinal toxicity in 73% of patients, with no late toxicities observed. With a median follow-up of 10 months since SBRT, 5 patients (45%) experienced locoregional disease progression, with 3 patients (27%) succumbing to their malignancy. At 12 and 18 months from SBRT, the overall freedom from progression was 68% and 41%, respectively. Overall freedom from progression (FFP) was 100% for all patients with AJCC stage IA endometrial carcinoma, whereas it was 33% for stage IB at 18 months. The overall FFP was 100% for International Federation of Obstetrics and Gynecology grade 1 disease. The estimated overall survival was 57% at 18 months from diagnosis. Conclusion: In this study, SBRT boost to the intact uterus was feasible, with encouragingly low rates of acute and late toxicity, and favorable disease control in patients with early-stage disease. Additional studies are needed to provide better insight into the best management of these clinically challenging cases.

Treatment deintensification in human papillomavirus-positive oropharynx cancer: Outcomes from the National Cancer Data Base.

Science.gov (United States)

Cheraghlou, Shayan; Yu, Phoebe K; Otremba, Michael D; Park, Henry S; Bhatia, Aarti; Zogg, Cheryl K; Mehra, Saral; Yarbrough, Wendell G; Judson, Benjamin L

2018-02-15

The growing epidemic of human papillomavirus-positive (HPV+) oropharyngeal cancer and the favorable prognosis of this disease etiology have led to a call for deintensified treatment for some patients with HPV+ cancers. One of the proposed methods of treatment deintensification is the avoidance of chemotherapy concurrent with definitive/adjuvant radiotherapy. To the authors' knowledge, the safety of this form of treatment de-escalation is unknown and the current literature in this area is sparse. The authors investigated outcomes after various treatment combinations stratified by American Joint Committee on Cancer (AJCC) eighth edition disease stage using patients from the National Cancer Data Base. A retrospective study of 4443 patients with HPV+ oropharyngeal cancer in the National Cancer Data Base was conducted. Patients were stratified into AJCC eighth edition disease stage groups. Multivariate Cox regressions as well as univariate Kaplan-Meier analyses were conducted. For patients with stage I disease, treatment with definitive radiotherapy was associated with diminished survival compared with chemoradiotherapy (hazard ratio [HR], 1.798; P = .029), surgery with adjuvant radiotherapy (HR, 2.563; P = .002), or surgery with adjuvant chemoradiotherapy (HR, 2.427; P = .001). For patients with stage II disease, compared with treatment with chemoradiotherapy, patients treated with a single-modality (either surgery [HR, 2.539; P = .009] or radiotherapy [HR, 2.200; P = .030]) were found to have poorer survival. Among patients with stage III disease, triple-modality therapy was associated with improved survival (HR, 0.518; P = .024) compared with treatment with chemoradiotherapy. Deintensification of treatment from chemoradiotherapy to radiotherapy or surgery alone in cases of HPV+ AJCC eighth edition stage I or stage II disease may compromise patient safety. Treatment intensification to triple-modality therapy for patients with stage III disease may improve survival in

Non-Small-Cell Lung Cancer Clinico pathologic Features and Survival Outcomes in Asian Pacific Islanders Residing in the United States: A SEER Analysis

International Nuclear Information System (INIS)

Hamid, M. S.; Shameem, R.; Gafoor, K.; George, J.; Mina, B.; Sullivan, K.

2015-01-01

The objective of our study was to ascertain racial/ethnic disparities in Asian/Pacific Islanders (API) for non-small-cell lung cancer (NSCLC) clinico pathologic features and survival outcomes based on various tumor characteristics and treatment modalities. Method. SEER database identified invasive NSCLC cases from 2004 to 2010. Variables included American Joint Committee on Cancer (AJCC) stage 7, tumor grade, tumor size, histology, age, marital status, radiation, surgery, and reason for no surgery. The Kruskall-Wallis test and the Z test were used to examine differences between races/ethnicities and the referent, non-Hispanic white (NHW). Multivariate Cox proportional analyses were used to establish the weight of the prognostic significance contributing to disease-specific survival (DSS) in each AJCC stage. Result. Improved DSS was seen in API across stage I (HR: 0.78), stage II (HR: 0.79), and stage IV (HR: 0.86), respectively, compared to the referent NHW (P<0.01). being female gender, AIS histology, and birth outside the US (P<0.01). Conclusion. We have demonstrated improved survival among API in early stage and stage IV NSCLC. Further research is necessary to clarify the role of lifestyle and tumor biology for these differences.

Comparison of five systems for staging lymph node metastasis in gastric cancer.

Science.gov (United States)

Yu, W; Choi, G S; Whang, I; Suh, I S

1997-09-01

There are several systems for staging lymph node metastasis in gastric cancer. Their relative merits are not clear. In this retrospective analysis, the nodal status was classified according to the Union Internacional Contra la Cancrum (UICC) and Japanese staging systems, the number and frequency of lymph node metastasis, and the level of involved nodes. Each staging system was scored as good (+1), fair (0) or poor (-1) with respect to prognostic value, theoretical value, convenience, reproducibility and surgical applicability. There were no differences between the five staging systems in predicting survival. The Japanese staging system was most arbitrary owing to the complexity of the system, although it had an advantage in surgical application. The same disadvantage was found in the UICC system and the level system. Determination of the number and frequency of involved nodes was convenient and reproducible, but the number of lymph nodes dissected must be considered when the number of positive nodes is used for staging. The classification of metastasis to the regional lymph nodes as N0 (no nodal metastasis), N1 (metastasis in 1-25 per cent of dissected nodes) and N2 (metastasis in more than 25 per cent of dissected nodes) would be a simple, convenient, reproducible staging system with an ability to predict surgical results.

Olaparib in Treating Patients With Metastatic or Advanced Urothelial Cancer With DNA-Repair Defects

Science.gov (United States)

2018-06-14

Abnormal DNA Repair; ATM Gene Mutation; ATR Gene Mutation; BAP1 Gene Mutation; BARD1 Gene Mutation; BLM Gene Mutation; BRCA1 Gene Mutation; BRCA2 Gene Mutation; BRIP1 Gene Mutation; CHEK1 Gene Mutation; CHEK2 Gene Mutation; FANCC Gene Mutation; FANCD2 Gene Mutation; FANCE Gene Mutation; FANCF Gene Mutation; MEN1 Gene Mutation; Metastatic Urothelial Carcinoma; MLH1 Gene Mutation; MSH2 Gene Mutation; MSH6 Gene Mutation; MUTYH Gene Mutation; NPM1 Gene Mutation; PALB2 Gene Mutation; PMS2 Gene Mutation; POLD1 Gene Mutation; POLE Gene Mutation; PRKDC Gene Mutation; RAD50 Gene Mutation; RAD51 Gene Mutation; SMARCB1 Gene Mutation; Stage III Bladder Urothelial Carcinoma AJCC v6 and v7; Stage IV Bladder Urothelial Carcinoma AJCC v7; STK11 Gene Mutation; Urothelial Carcinoma

Cell-free DNA levels and correlation to stage and outcome following treatment of locally advanced rectal cancer.

Science.gov (United States)

Boysen, Anders Kindberg; Wettergren, Yvonne; Sorensen, Boe Sandahl; Taflin, Helena; Gustavson, Bengt; Spindler, Karen-Lise Garm

2017-11-01

Accurate staging of rectal cancer remains essential for optimal patient selection for combined modality treatment, including radiotherapy, chemotherapy and surgery. We aimed at examining the correlation of cell free DNA with the pathologic stage and subsequent risk of recurrence for patients with locally advanced rectal cancer undergoing preoperative chemoradiation. We examined 75 patients with locally advanced rectal cancer receiving preoperative chemoradiation. Blood samples for translational use were drawn prior to rectal surgery. The level of cell free DNA was quantified by digital droplet PCR and expressed as copy number of beta 2 microglobulin. We found a median level of cell free DNA in the AJCC stages I-III of 3100, 8300, and 10,700 copies/mL respectively. For patients with 12 sampled lymph nodes or above, the median level of cell free DNA were 2400 copies/mL and 4400 copies/mL (p = 0.04) for node negative and node positive disease respectively. The median follow-up was 39 months and 11 recurrences were detected (15%). The median level for patients with recurrent disease was 13,000 copies/mL compared to 5200 copies/mL for non-recurrent patients (p = 0.08). We have demonstrated a correlation between the level of total cell free DNA and the pathologic stage and nodal involvement. Furthermore, we have found a trend towards a correlation with the risk of recurrence following resection of localized rectal cancer.

The stages of the international drug control system.

Science.gov (United States)

Carstairs, Catherine

2005-01-01

This paper argues that the history of the international drug control system of the League of Nations/United Nations can be divided into three cumulative stages. The first stage, the supply stage, dates back to early part of the 20th century, and aimed to reduce the supply of drugs through careful monitoring and trade regulations. This has remained the dominant control strategy. In the middle of the century, demand control, in the form of treatment and criminalization of the individual user, began to appear. This was the least successful stage. Finally, in the 1980s, the dangers of the drug traffic assumed an important place on the international agenda and measures to reduce drug-related organized crime were enacted. To date, this has been a process of proliferation of regulatory strategies. Recently, new challenges to the international drug control system have emerged, including well-funded non-governmental organizations critical of the war on drugs, and the adoption of harm reduction measures in national policies around the world.

Intestinal diffuse large B-cell lymphoma: an evaluation of different staging systems.

Science.gov (United States)

Hwang, Hee Sang; Yoon, Dok Hyun; Suh, Cheolwon; Park, Chan-Sik; Huh, Jooryung

2014-01-01

The gastrointestinal tract is the most common primary extranodal site for diffuse large B-cell lymphoma (DLBCL). However, there is no consensus on the most appropriate staging system for intestinal DLBCL. We evaluated the utility of the modified Ann Arbor system, the Lugano system, and the Paris staging system (a modification of the Tumor, Node, Metastases [TNM] staging for epithelial tumors) in 66 cases of resected intestinal DLBCL. The cases were treated with surgery, plus either cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy alone (n=26) or with the addition of rituximab immunotherapy (n=40). Median follow-up time was 40.4 months (range, 2.1-171.6 months). Fifty-six patients (84.8%) achieved complete remission. The overall 5-yr survival rate was 86.4% (57/66). Of the stage categories defined for each staging system, only the T stage of the Paris classification showed prognostic significance for overall survival by univariate analysis. However, none of the stage parameters was significantly correlated with patient survival on multivariate analysis. In conclusion, the results suggest that the T stage of the Paris classification system may be a prognostic indicator in intestinal DLBCL. The results also imply that in surgically resected intestinal DLBCL, the addition of rituximab to the CHOP regimen does not confer significant survival advantage.

The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report.

Science.gov (United States)

Monclair, Tom; Brodeur, Garrett M; Ambros, Peter F; Brisse, Hervé J; Cecchetto, Giovanni; Holmes, Keith; Kaneko, Michio; London, Wendy B; Matthay, Katherine K; Nuchtern, Jed G; von Schweinitz, Dietrich; Simon, Thorsten; Cohn, Susan L; Pearson, Andrew D J

2009-01-10

The International Neuroblastoma Risk Group (INRG) classification system was developed to establish a consensus approach for pretreatment risk stratification. Because the International Neuroblastoma Staging System (INSS) is a postsurgical staging system, a new clinical staging system was required for the INRG pretreatment risk classification system. To stage patients before any treatment, the INRG Task Force, consisting of neuroblastoma experts from Australia/New Zealand, China, Europe, Japan, and North America, developed a new INRG staging system (INRGSS) based on clinical criteria and image-defined risk factors (IDRFs). To investigate the impact of IDRFs on outcome, survival analyses were performed on 661 European patients with INSS stages 1, 2, or 3 disease for whom IDRFs were known. In the INGRSS, locoregional tumors are staged L1 or L2 based on the absence or presence of one or more of 20 IDRFs, respectively. Metastatic tumors are defined as stage M, except for stage MS, in which metastases are confined to the skin, liver, and/or bone marrow in children younger than 18 months of age. Within the 661-patient cohort, IDRFs were present (ie, stage L2) in 21% of patients with stage 1, 45% of patients with stage 2, and 94% of patients with stage 3 disease. Patients with INRGSS stage L2 disease had significantly lower 5-year event-free survival than those with INRGSS stage L1 disease (78% +/- 4% v 90% +/- 3%; P = .0010). Use of the new staging (INRGSS) and risk classification (INRG) of neuroblastoma will greatly facilitate the comparison of risk-based clinical trials conducted in different regions of the world.

End-Stage Renal Disease Prospective Payment System

Data.gov (United States)

U.S. Department of Health & Human Services — This final rule implements a case-mix adjusted bundled prospective payment system (PPS) for Medicare outpatient end-stage renal disease (ESRD) dialysis facilities...

Analysis of multi-stage open shop processing systems

NARCIS (Netherlands)

Eggermont, C.E.J.; Schrijver, A.; Woeginger, G.J.; Schwentick, T.; Dürr, C.

2011-01-01

We study algorithmic problems in multi-stage open shop processing systems that are centered around reachability and deadlock detection questions. We characterize safe and unsafe system states. We show that it is easy to recognize system states that can be reached from the initial state (where the

The global stability of a delayed predator-prey system with two stage-structure

International Nuclear Information System (INIS)

Wang Fengyan; Pang Guoping

2009-01-01

Based on the classical delayed stage-structured model and Lotka-Volterra predator-prey model, we introduce and study a delayed predator-prey system, where prey and predator have two stages, an immature stage and a mature stage. The time delays are the time lengths between the immature's birth and maturity of prey and predator species. Results on global asymptotic stability of nonnegative equilibria of the delay system are given, which generalize and suggest that good continuity exists between the predator-prey system and its corresponding stage-structured system.

[Comparison of differentiated thyroid carcinoma staging systems in a Spanish population].

Science.gov (United States)

Andía Melero, Víctor Manuel; Martín de Santa-Olalla Llanes, María; Sambo Salas, Marcel; Percovich Hualpa, Juan Carlos; Motilla de la Cámara, Marta; Collado Yurrita, Luis

2015-04-01

Differentiated thyroid carcinoma staging is increasingly important due to the current trends to a less intensive therapy in low-risk patients. The TNM system is most widely used, but other systems based on follow-up of several patient cohorts have been developed. When these systems have been applied to other populations, results have been discordant. Our study evaluates the suitability of several differentiated thyroid carcinoma staging systems in a Spanish population. 729 patients with differentiated thyroid carcinoma and staging data available were enrolled. Mean follow-up time was 10.8 years. The TNM, EORTC, AMES, Clinical class, MACIS, Ohio, NTCTCS, and Spanish systems were applied to all histological types. The Kaplan-Meier survival curves for each system were analyzed, and compared using the proportion of explained variation (PEV). The demographic and clinical characteristics of our population were similar to those of other Spanish and international cohorts reported. The best systems were NTCTCS, with 74.7% PEV, and TNM (68.3%), followed by the Ohio, MACIS, EORTC, and AMES systems with minimal differences between them, while the least adequate were the Spanish (55.2%) and Clinical class (47.1%) systems. The NTCTCS staging system was found to be better than TNM in our population but, because of its simplicity and greater dissemination, the TNM appears to be recommended for staging of patients with differentiated thyroid carcinoma. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Thoracic staging with {sup 18}F-FDG PET/MR in non-small cell lung cancer - does it change therapeutic decisions in comparison to {sup 18}F-FDG PET/CT?

Energy Technology Data Exchange (ETDEWEB)

Schaarschmidt, Benedikt M. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany); University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Grueneisen, Johannes; Umutlu, Lale [University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Metzenmacher, Martin [University Duisburg-Essen, Medical Faculty, Department of Medical Oncology, Essen (Germany); Gomez, Benedikt; Ruhlmann, Verena [University Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Gauler, Thomas [University Duisburg-Essen, Medical Faculty, Radiation and Tumour Clinic, Essen (Germany); Roesel, Christian [University Duisburg-Essen, Ruhrlandklinik, Thoracic Surgery and Endoscopy, Essen (Germany); Heusch, Philipp; Antoch, Gerald; Buchbender, Christian [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany)

2017-02-15

To investigate whether differences in thoracic tumour staging between {sup 18}F-FDG PET/CT and PET/MR imaging lead to different therapeutic decisions in Non-Small Cell Lung Cancer (NSCLC). Seventy-seven NSCLC patients that underwent whole-body {sup 18}F-FDG PET/CT from the base of skull to the upper thighs and thoracic PET/MR were enrolled in this retrospective study. Thoracic PET/CT and PET/MR images were staged according to the 7th edition of the AJCC staging manual. Staging results of both modalities were discussed separately in a simulated interdisciplinary tumour board and therapeutic decisions based on both imaging modalities were recorded. Descriptive statistics were used to compare the results and reasons for changes in the therapeutic decision were investigated. Staging results differed in 35 % of patients (27 patients) between thoracic PET/CT and PET/MR. Differences were detected when assessing the T-stage in 18 % (n = 14), the N-stage in 23 % (n = 18), and the M-stage in 1 % (n = 1). However, patient therapy management was changed in only six patients (8 %). Despite the variability of thoracic {sup 18}F-FDG PET/CT and PET/MR in TNM-staging, both modalities lead to comparable therapeutic decisions in patients suffering from NSCLC. Hence, {sup 18}F-FDG PET/MR can be considered an possible alternative to {sup 18}F-FDG PET/CT for clinical NSCLC staging. (orig.)

Bladder cancer staging in CT urography: effect of stage labels on statistical modeling of a decision support system

Science.gov (United States)

Gandikota, Dhanuj; Hadjiiski, Lubomir; Cha, Kenny H.; Chan, Heang-Ping; Caoili, Elaine M.; Cohan, Richard H.; Weizer, Alon; Alva, Ajjai; Paramagul, Chintana; Wei, Jun; Zhou, Chuan

2018-02-01

In bladder cancer, stage T2 is an important threshold in the decision of administering neoadjuvant chemotherapy. Our long-term goal is to develop a quantitative computerized decision support system (CDSS-S) to aid clinicians in accurate staging. In this study, we examined the effect of stage labels of the training samples on modeling such a system. We used a data set of 84 bladder cancers imaged with CT Urography (CTU). At clinical staging prior to treatment, 43 lesions were staged as below stage T2 and 41 were stage T2 or above. After cystectomy and pathological staging that is considered the gold standard, 10 of the lesions were upstaged to stage T2 or above. After correcting the stage labels, 33 lesions were below stage T2, and 51 were stage T2 or above. For the CDSS-S, the lesions were segmented using our AI-CALS method and radiomic features were extracted. We trained a linear discriminant analysis (LDA) classifier with leave-one-case-out cross validation to distinguish between bladder lesions of stage T2 or above and those below stage T2. The CDSS-S was trained and tested with the corrected post-cystectomy labels, and as a comparison, CDSS-S was also trained with understaged pre-treatment labels and tested on lesions with corrected labels. The test AUC for the CDSS-S trained with corrected labels was 0.89 +/- 0.04. For the CDSS-S trained with understaged pre-treatment labels and tested on the lesions with corrected labels, the test AUC was 0.86 +/- 0.04. The likelihood of stage T2 or above for 9 out of the 10 understaged lesions was correctly increased for the CDSS-S trained with corrected labels. The CDSS-S is sensitive to the accuracy of stage labeling. The CDSS-S trained with correct labels shows promise in prediction of the bladder cancer stage.

Proposal for a new staging system for osteoradionecrosis of the mandible

NARCIS (Netherlands)

Karagozoglu, K.H.; Dekker, H.; Rietveld, D.H.F.; de Bree, R.; Schulten, E.A.J.M.; Kantola, S.; Forouzanfar, T.; van der Waal, I.

2014-01-01

The presented staging system seems well reproducible, facilitating the comparison of study groups dealing with the various issues of osteoradionecrosis of the mandible. It is yet to be evaluated whether the presently proposed staging system is useful for management purposes.

SLS Block 1-B and Exploration Upper Stage Navigation System Design

Science.gov (United States)

Oliver, T. Emerson; Park, Thomas B.; Smith, Austin; Anzalone, Evan; Bernard, Bill; Strickland, Dennis; Geohagan, Kevin; Green, Melissa; Leggett, Jarred

2018-01-01

The SLS Block 1B vehicle is planned to extend NASA's heavy lift capability beyond the initial SLS Block 1 vehicle. The most noticeable change for this vehicle from SLS Block 1 is the swapping of the upper stage from the Interim Cryogenic Propulsion stage (ICPS), a modified Delta IV upper stage, to the more capable Exploration Upper Stage (EUS). As the vehicle evolves to provide greater lift capability and execute more demanding missions so must the SLS Integrated Navigation System to support those missions. The SLS Block 1 vehicle carries two independent navigation systems. The responsibility of the two systems is delineated between ascent and upper stage flight. The Block 1 navigation system is responsible for the phase of flight between the launch pad and insertion into Low-Earth Orbit (LEO). The upper stage system assumes the mission from LEO to payload separation. For the Block 1B vehicle, the two functions are combined into a single system intended to navigate from ground to payload insertion. Both are responsible for self-disposal once payload delivery is achieved. The evolution of the navigation hardware and algorithms from an inertial-only navigation system for Block 1 ascent flight to a tightly coupled GPS-aided inertial navigation system for Block 1-B is described. The Block 1 GN&C system has been designed to meet a LEO insertion target with a specified accuracy. The Block 1-B vehicle navigation system is designed to support the Block 1 LEO target accuracy as well as trans-lunar or trans-planetary injection accuracy. This is measured in terms of payload impact and stage disposal requirements. Additionally, the Block 1-B vehicle is designed to support human exploration and thus is designed to minimize the probability of Loss of Crew (LOC) through high-quality inertial instruments and Fault Detection, Isolation, and Recovery (FDIR) logic. The preliminary Block 1B integrated navigation system design is presented along with the challenges associated with

A Lymph Node Staging System for Gastric Cancer: A Hybrid Type Based on Topographic and Numeric Systems.

Directory of Open Access Journals (Sweden)

Yoon Young Choi

Full Text Available Although changing a lymph node staging system from an anatomically based system to a numerically based system in gastric cancer offers better prognostic performance, several problems can arise: it does not offer information on the anatomical extent of disease and cannot represent the extent of lymph node dissection. The purpose of this study was to discover an alternative lymph node staging system for gastric cancer. Data from 6025 patients who underwent gastrectomy for primary gastric cancer between January 2000 and December 2010 were reviewed. The lymph node groups were reclassified into lesser-curvature, greater-curvature, and extra-perigastric groups. Presence of any metastatic lymph node in one group was considered positive. Lymph node groups were further stratified into four (new N0-new N3 according to the number of positive lymph node groups. Survival outcomes with this new N staging were compared with those of the current TNM system. For validation, two centers in Japan (large center, n = 3443; medium center, n = 560 were invited. Even among the same pN stages, the more advanced new N stage showed worse prognosis, indicating that the anatomical extent of metastatic lymph nodes is important. The prognostic performance of the new staging system was as good as that of the current TNM system for overall advanced gastric cancer as well as lymph node-positive gastric cancer (Harrell C-index was 0.799, 0.726, and 0.703 in current TNM and 0.799, 0.727, and 0.703 in new TNM stage. Validation sets supported these outcomes. The new N staging system demonstrated prognostic performance equal to that of the current TNM system and could thus be used as an alternative.

Self-tuning in master-slave synchronization of high-precision stage systems

NARCIS (Netherlands)

Heertjes, M.F.; Temizer, B.; Schneiders, M.G.E.

2013-01-01

For synchronization of high-precision stage systems, in particular the synchronization between a wafer and a reticle stage system of a wafer scanner, a master–slave controller design is presented. The design consists of a synchronization controller based on FIR filters and a data-driven self-tuning

Parachute systems for the atmospheric reentry of launcher upper stages

Directory of Open Access Journals (Sweden)

Bogdan DOBRESCU

2017-03-01

Full Text Available Parachute systems can be used to control the reentry trajectory of launcher upper stages, in order to lower the risks to the population or facilitate the retrieval of the stage. Several types of parachutes deployed at subsonic, supersonic and hypersonic speeds are analyzed, modeled as single and multistage systems. The performance of deceleration parachutes depends on their drag area and deployment conditions, while gliding parachutes are configured to achieve stable flight with a high glide ratio. Gliding parachutes can be autonomously guided to a low risk landing area. Sizing the canopy is shown to be an effective method to reduce parachute sensitivity to wind. The reentry trajectory of a launcher upper stage is simulated for each parachute system configuration and the results are compared to the nominal reentry case.

The NxStage System One.

Science.gov (United States)

Clark, William R; Turk, Joseph E

2004-01-01

Given the results of recent randomized controlled trials as well as staffing and budget challenges that today face many institutions across North America, a novel therapeutic approach is likely necessary to enable improvements in clinical outcomes for renal failure patients. The NxStage System One was developed to address these challenges. The system is an innovative, flexible device that delivers hemodialysis, hemofiltration, and/or ultrafiltration therapies to patients with renal failure or fluid overload. The unique characteristics of this system include a highly automated system design with a drop-in cartridge to facilitate training and simple operation; portable size and independence from dedicated infrastructure to minimize practical barriers to where therapy may be administered; use of high-quality premixed treatment fluids to enable capture of the potential clinical benefits of fluid purity without the hassles of local water treatment; and wide operating ranges to allow clinician flexibility in patient therapy prescriptions. In both the chronic and acute care environments, the System One presents clinicians with a new platform for delivering patient therapy improvements within real-world constraints.

Wind Solar Hybrid System Rectifier Stage Topology Simulation

OpenAIRE

Anup M. Gakare; Subhash Kamdi

2014-01-01

This paper presents power-control strategies of a grid-connected hybrid generation system with versatile power transfer. The hybrid system allows maximum utilization of freely available renewable sources like wind and photovoltaic energies. This paper presents a new system configuration of the multi input rectifier stage for a hybrid wind and photovoltaic energy system. This configuration allows the two sources to supply the load simultaneously depending on the availability of...

A Thermoelectric Generation System and Its Power Electronics Stage

DEFF Research Database (Denmark)

Gao, Junling; Sun, Kai; Ni, Longxian

2012-01-01

stage and signal-conditioning circuits of the load, including DC–DC conversion, the maximum power point tracking (MPPT) controller, and other power management controllers. In this paper, a survey of existing power electronics designs for TEG systems is presented first. Second, a flat, wall-like TEG...... system consisting of 32 modules is experimentally optimized, and the improved power parameters are tested. Power-conditioning circuitry based on an interleaved boost DC–DC converter is then developed for the TEG system in terms of the tested power specification. The power electronics design features...... a combined control scheme with an MPPT and a constant output voltage as well as the low-voltage and high-current output characteristics of the TEG system. The experimental results of the TEG system with the power electronics stage and with purely resistive loads are compared. The comparisons verify...

Liver-inherent immune system: its role in blood-stage malaria.

Science.gov (United States)

Wunderlich, Frank; Al-Quraishy, Saleh; Dkhil, Mohamed A

2014-01-01

The liver is well known as that organ which is obligately required for the intrahepatocyte development of the pre-erythrocytic stages of the malaria-causative agent Plasmodium. However, largely neglected is the fact that the liver is also a central player of the host defense against the morbidity- and mortality-causing blood stages of the malaria parasites. Indeed, the liver is equipped with a unique immune system that acts locally, however, with systemic impact. Its main "antipodal" functions are to recognize and to generate effective immunoreactivity against pathogens on the one hand, and to generate tolerance to avoid immunoreactivity with "self" and harmless substances as dietary compounds on the other hand. This review provides an introductory survey of the liver-inherent immune system: its pathogen recognition receptors including Toll-like receptors (TLRs) and its major cell constituents with their different facilities to fight and eliminate pathogens. Then, evidence is presented that the liver is also an essential organ to overcome blood-stage malaria. Finally, we discuss effector responses of the liver-inherent immune system directed against blood-stage malaria: activation of TLRs, acute phase response, phagocytic activity, cytokine-mediated pro- and anti-inflammatory responses, generation of "protective" autoimmunity by extrathymic T cells and B-1 cells, and T cell-mediated repair of liver injuries mainly produced by malaria-induced overreactions of the liver-inherent immune system.

Effectiveness of interim stage filter in the exhaust system of glove boxes

International Nuclear Information System (INIS)

Patre, D.K.; Vangara, H.; Thanamani, S.; Gopalakrishnan, R.K.; Mhatre, Amol M.

2018-01-01

All operations in radiochemical laboratories are carried out in containment systems like Glove boxes and Fume hoods. For controlling air contamination two separate air cleaning systems are incorporated. Laboratory has general ventilation system and glove boxes are provided with a negative pressure system (NPS). Glove box exhaust air is passed through three stage filtration systems: in situ, interim and final before discharging to the atmosphere. In addition to the individual HEPA filters of each glove box, there is an interim HEPA filter bank introduced at the laboratory end. This was introduced to reduce a load on main exhaust filter system. Finally the exhaust air is discharged through the final stage HEPA filter located in the filter house through the Stack. The interim HEPA filter bank provides additional protection for the release of particulate activity and reduces load on the final stage filters. In the present work efforts have been put to validate the interim stage filter, which has been introduced, to limit the environmental release

Macrophage markers in serum and tumor have prognostic impact in American Joint Committee on Cancer stage I/II melanoma

DEFF Research Database (Denmark)

Jensen, Trine O.; Schmidt, Henrik; Møller, Holger John

2009-01-01

PURPOSE: To evaluate the prognostic role of soluble CD163 (sCD163) in serum and macrophage infiltration in primary melanomas from patients with American Joint Committee on Cancer (AJCC) stage I/II melanoma. The scavenger receptor CD163 is associated with anti-inflammatory macrophages...... melanomas from 190 patients were available for immunohistochemical analyzes of CD163(+) and CD68(+) macrophage infiltration. They were estimated semiquantitatively in three different tumor compartments: tumor nests, tumor stroma, and at the invasive front of the tumor. RESULTS: Serum sCD163 treated......, HR = 1.4; 95% CI, 1.1 to 1.8; P = .003). Melanomas with dense CD163(+) macrophage infiltration in tumor stroma and CD68(+) macrophage infiltration at the invasive front were associated with poor overall survival (CD163, HR = 2.7; 95% CI, 0.8 to 9.3; P = .11; and CD68, HR = 2.8; 95% CI, 1.2 to 6.8; P...

Circulating Tyrosinase and MART-1 mRNA does not Independently Predict Relapse or Survival in Patients with AJCC Stage I–II Melanoma

DEFF Research Database (Denmark)

Schmidt, Henrik; Sørensen, Boe S; Sjoegren, Pia

2006-01-01

The detection of melanoma cells in peripheral blood has been proposed to select patients with a high risk of relapse. In this study, tyrosinase and melanoma antigen recognized by T cells 1 (MART-1) mRNA expression was evaluated in serial samples obtained before definitive surgery and during follow......-up in patients with American Joint Committee on Cancer stage I-II melanoma. Serial samples (n=2,262) were collected from 236 patients from 1997 to 2002. Analyses of the RNA samples were performed with a calibrated reverse transcriptase-PCR assay. Gender, age, primary tumor site, ulceration, thickness, Clark...

Alternatives generation and analysis for phase I intermediate waste feed staging system design requirements

Energy Technology Data Exchange (ETDEWEB)

Britton, M.D.

1996-10-02

This document provides; a decision analysis summary; problem statement; constraints, requirements, and assumptions; decision criteria; intermediate waste feed staging system options and alternatives generation and screening; intermediate waste feed staging system design concepts; intermediate waste feed staging system alternative evaluation and analysis; and open issues and actions.

A Gas-Spring-Loaded X-Y-Z Stage System for X-ray Microdiffraction Sample Manipulation

International Nuclear Information System (INIS)

Shu Deming; Cai Zhonghou; Lai, Barry

2007-01-01

We have designed and constructed a gas-spring-loaded x-y-z stage system for x-ray microdiffraction sample manipulation at the Advanced Photon Source XOR 2-ID-D station. The stage system includes three DC-motor-driven linear stages and a gas-spring-based heavy preloading structure, which provides antigravity forces to ensure that the stage system keeps high-positioning performance under variable goniometer orientation. Microdiffraction experiments with this new stage system showed significant sample manipulation performance improvement

A Three-Stage Optimal Approach for Power System Economic Dispatch Considering Microgrids

Directory of Open Access Journals (Sweden)

Wei-Tzer Huang

2016-11-01

Full Text Available The inclusion of microgrids (MGs in power systems, especially distribution-substation-level MGs, significantly affects power systems because of the large volumes of import and export power flows. Consequently, power dispatch has become complicated, and finding an optimal solution is difficult. In this study, a three-stage optimal power dispatch model is proposed to solve such dispatch problems. In the proposed model, the entire power system is divided into two parts, namely, the main power grid and MGs. The optimal power dispatch problem is resolved on the basis of multi-area concepts. In stage I, the main power system economic dispatch (ED problem is solved by sensitive factors. In stage II, the optimal power dispatches of the local MGs are addressed via an improved direct search method. In stage III, the incremental linear models for the entire power system can be established on the basis of the solutions of the previous two stages and can be subjected to linear programming to determine the optimal reschedules from the original dispatch solutions. The proposed method is coded using Matlab and tested by utilizing an IEEE 14-bus test system to verify its feasibility and accuracy. Results demonstrated that the proposed approach can be used for the ED of power systems with MGs as virtual power plants.

Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis.

Science.gov (United States)

McLeod, Donald S A; Jonklaas, Jacqueline; Brierley, James D; Ain, Kenneth B; Cooper, David S; Fein, Henry G; Haugen, Bryan R; Ladenson, Paul W; Magner, James; Ross, Douglas S; Skarulis, Monica C; Steward, David L; Xing, Mingzhao; Litofsky, Danielle R; Maxon, Harry R; Sherman, Steven I

2015-10-01

Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R(2)). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. The best five alternate papillary cancer systems had age cut-points of 45-50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50-55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003-0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation.

Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis

Science.gov (United States)

McLeod, Donald S.A.; Jonklaas, Jacqueline; Brierley, James D.; Ain, Kenneth B.; Cooper, David S.; Fein, Henry G.; Haugen, Bryan R.; Ladenson, Paul W.; Magner, James; Ross, Douglas S.; Skarulis, Monica C.; Steward, David L.; Xing, Mingzhao; Litofsky, Danielle R.; Maxon, Harry R.

2015-01-01

Background: Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. Objective: This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. Methods: A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R2). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. Results: The best five alternate papillary cancer systems had age cut-points of 45–50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50–55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003–0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). Conclusions: No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation. PMID:26203804

Docetaxel, Carboplatin, and Rucaparib Camsylate in Treating Patients With Metastatic Castration Resistant Prostate Cancer With Homologous Recombination DNA Repair Deficiency

Science.gov (United States)

2018-02-20

ATM Gene Mutation; BRCA1 Gene Mutation; BRCA2 Gene Mutation; Castration Levels of Testosterone; Castration-Resistant Prostate Carcinoma; Homologous Recombination Deficiency; Prostate Carcinoma Metastatic in the Bone; PSA Level Greater Than or Equal to Two; PSA Progression; Stage IV Prostate Adenocarcinoma AJCC v7

Comparative study of nasopharyngeal carcinoma staging system between the chinese 2008 and '92 Fuzhou

International Nuclear Information System (INIS)

Zong Jingfeng; Lin Shaojun; Zhang Yu; Chen Yunbin; Guo Qiaojuan; Pan Jianji

2010-01-01

Objective: To carry out a comparative study between the Chinese 2008 and '92 staging system of nasopharyngeal carcinoma (NPC). Methods: A total of 777 patients presented with untreated non disseminated NPC who had received MRI scan of nasopharynx and neck were studied retrospectively. The clinical materials and information of imaging were collected. All patients were restaged according to the Chinese 2008 and 92 staging system of nasopharyngeal carcinoma. Distribution of T, N stage, survival and prognostic value were compared. 513 patients of the 777 cases were treated with conventional radiotherapy, 264 cases with intensity modulated radiation therapy. Results: The 3-year follow-up rate was 97.6%. The consistency of T stages was 95.0%. T, N and clinical stage distributions in two systems were similar ( Kappa = 0.93, P = 0.000; Kappa = 0.58, P = 0.000; Kappa = 0.74, P = 0.000). Local failure-free survival and disease specific survival were also similar. There was no difference of distant metastasis between N 0 and N 1 (χ 2 = 1.94, P=0. 164), and a marginal difference between N 1 and N 2 (χ 2 =3.83, P=0.051) in the Chinese '92 staging system. However, although there was also no difference of distant metastasis-free survival between N 0 and N 1a (χ 2 =0.07, P =0.797), ) the difference of overall survival among N 1b , N 2 , and N 3 were significant (χ 2 = 4.95, P = 0.026; χ 2 = 6.74, P = 0.009) in the Chinese 2008 staging system. Conventional radiotherapy or intensity modulated radiation therapy was not a prognostic factor for survival (χ 2 = 3.60, P =0.058). It is reasonable for the Chinese 2008 staging system integrated lymph node characteristics such as laterality, level and extra nodal neoplastic spread into the N staging criteria (χ 2 = 6.59, P = 0.010; χ 2 =4.78, P=0. 029; χ 2 =9.32, P=0.002). Conclusions: For the Chinese 2008 staging system, it was reasonable to simplify the previous T stage. The N stage showed a better predictive role of distant

Configuration of management accounting information system for multi-stage manufacturing

Science.gov (United States)

Mkrtychev, S. V.; Ochepovsky, A. V.; Enik, O. A.

2018-05-01

The article presents an approach to configuration of a management accounting information system (MAIS) that provides automated calculations and the registration of normative production losses in multi-stage manufacturing. The use of MAIS with the proposed configuration at the enterprises of textile and woodworking industries made it possible to increase the accuracy of calculations for normative production losses and to organize accounting thereof with the reference to individual stages of the technological process. Thus, high efficiency of multi-stage manufacturing control is achieved.

Two-stage model of development of heterogeneous uranium-lead systems in zircon

International Nuclear Information System (INIS)

Mel'nikov, N.N.; Zevchenkov, O.A.

1985-01-01

Behaviour of isotope systems of multiphase zircons at their two-stage distortion is considered. The results of calculations testify to the fact that linear correlations on the diagram with concordance can be explained including two-stage discovery of U-Pb systems of cogenetic zircons if zircon is considered physically heterogeneous and losing in its different part different ratios of accumulated radiogenic lead. ''Metamorphism ages'' obtained by these two-stage opening zircons are intermediate, and they not have geochronological significance while ''crystallization ages'' remain rather close to real ones. Two-stage opening zircons in some cases can be diagnosed by discordance of their crystal component

[Retrospective analysis of 47 cases with hilar cholangiocarcinoma using T-staging system].

Science.gov (United States)

Peng, Cheng-hong; Zhao, Zhi-ming; Peng, Shu-you; Liu, Ying-bin; Wu, Yü-lian; Fang, He-qing; Jiang, Xian-chuan

2005-01-01

To evaluate the clinical value of T-staging system for hilar cholangiocarcinoma which was adopted in memorial Sloan-Kettering cancer center of New York. The image data of these 47 patients were analyzed retrospectively from December 1997 to December 2002 whose data were according with our demand, and they were staged into three-stage according to the criteria of the T-staging system. The difference of respectability, ratio of tumor-free resection margin and actuarial survival rate were analyzed for different T-staging. And the coincident ratio of three different kinds of imaging methods was also analyzed. Twenty patients had T(1) tumors, twenty three had T(2) tumors and four had T(3) tumors. The resectability of the three stage was 60%, 39% and 0% respectively, and the difference was significant (P = 0.013). The likelihood of achieving tumor-free margin decreased progressively with increasing T stage (P = 0.018). The cumulative 1-year survival rates of T(1), T(2) and T(3) patients were 60%, 39% and 0% respectively, and the cumulative 3-year survival rate was 35%, 9% and 0% respectively, the survival of different stage patients differed markedly (P = 0.0103). The coincident ratio of combined using MRCP and color Doppler-ultrasonography was higher than that of combined using MRCP and B-ultrasonography or combined using CT/SCT and color Doppler-ultrasonography (P = 0.007). The T-staging system has a better value for preoperative assessment, and can be used to judge resectability and survival of hilar cholangiocarcinoma. It will be helpful to use MRCP and color Doppler-Ultrasonography combined to verdict the coverage of the tumor and the T-staging preoperatively.

Changes of endocrine and ultrasound markers as ovarian aging in modifying the Stages of Reproductive Aging Workshop (STRAW) staging system with subclassification of mid reproductive age stage.

Science.gov (United States)

Ding, Ting; Luo, Aiyue; Jiang, Jingjing; Du, Xiaofang; Yang, Shuhong; Lai, Zhiwen; Shen, Wei; Lu, Yunping; Ma, Ding; Wang, Shixuan

2013-01-01

To demonstrate the changes of ovarian aging markers across the Stages of Reproductive Aging Workshop (STRAW) stages and modify it with subclassification of mid reproductive age stage (MR). Healthy females were classified according to the STRAW system. Serum basal FSH, LH, E2, and anti-Müllerian hormone (AMH) were detected, FSH/LH ratio calculated, and antral follicle counts (AFCs) determined in follicular phase. Progression through the whole STRAW stages under MR stage subdivided is associated with elevations in FSH, LH, FSH/LH ratio and decreases in E2, AMH and AFCs (p age in MR stage. 0.982 ng/ml AMH and 3 antral follicles (low level of MR 25-30 years) were set as cutoffs to distinguish MR stage into early mid reproductive age (EMR) and late mid reproductive age (LMR) stages. The women in EMR stage compared with LMR could retrieve more oocytes in IVF treatment (p stage, demonstrating disparate reproductive aging period with reduced ovarian reserve in young age across the STRAW stages.

Comparison of four staging systems of lymph node metastasis in gastric cancer.

Science.gov (United States)

Zhang, Ming; Zhu, Guanyu; Ma, Yan; Xue, Yingwei

2009-11-01

The classification of lymph node metastasis in patients with gastric cancer is still controversial. Our aim was to evaluate the relative merits of four staging systems of lymph node metastasis. In our study, the nodal status was classified according to the 5th edition of the tumor node metastasis (TNM) system, the Japanese Classification of Gastric Carcinoma (JCGC), the ratio of metastatic lymph nodes, and the size of the largest metastatic lymph node. Each staging system was scored as good (+2), fair (+1), or poor (0) with respect to the theoretical value (extent of the anatomical lymphatic tumor spread), convenience (simplicity), surgical applicability (extent of lymph node dissection), and prognostic value (ability to predict survival rate). In the multivariate analysis including the four staging systems and other potential prognostic factors, stepwise Cox regression revealed that the ratio of metastatic lymph nodes was the most independent prognostic factor. The TNM, ratio, and size systems were convenient because they had no consideration for the location of the tumor and lymph node. Although the JCGC system had advantages in theoretical value and surgical application, it was most optional due to the complexity of the system. Although all different staging systems are comparable, the metastatic lymph node ratio system is convenient, reproducible, and has the highest ability to predict survival.

Stages in the energetics of baroclinic systems

Science.gov (United States)

Orlanski, Isidoro; Sheldon, John P.

1995-10-01

The results from several idealized and case studies are drawn together to form a comprehensive picture of "downstream baroclinic evolution" using local energetics. This new viewpoint offers a complementary alternative to the more conventional descriptions of cyclone development. These additional insights are made possible largely because the local energetics approach permits one to define an energy flux vector which accurately describes the direction of energy dispersion and quantifies the role of neighboring systems in local development. In this view, the development of a system's energetics is divided into three stages. In Stage 1, a pre-existing disturbance well upstream of an incipient trough loses energy via ageostrophic geopotential fluxes directed downstream through the intervening ridge, generating a new energy center there. In Stage 2, this new energy center grows vigorously, at first due to the convergence of these fluxes, and later by baroclinic conversion as well. As the center matures, it begins to export energy via geopotential fluxes to the eastern side of the trough, initiating yet another energy center. In Stage 3, this new energy center continues to grow while that on the western side of the trough decays due to a dwinding supply of energy via fluxes from the older upstream system and also as a consequence of its own export of energy downstream. As the eastern energy center matures, it exports energy further downstream, and the sequence begins anew. The USA "Blizzard of'93" is used as a new case study to test the limits to which this conceptual sequence might apply, as well as to augment the current limited set of case studies. It is shown that, despite the extraordinary magnitude of the event, the evolution of the trough associated with the Blizzard fits the conceptual picture of downstream baroclinic evolution quite well, with geopotential fluxes playing a critical rôle in three respects. First, fluxes from an old, decaying system in the

Adherence to treatment guidelines and survival for older patients with stage II or III colon cancer in Texas from 2001 through 2011.

Science.gov (United States)

Zhao, Hui; Zhang, Ning; Ho, Vivian; Ding, Minming; He, Weiguo; Niu, Jiangong; Yang, Ming; Du, Xianglin L; Zorzi, Daria; Chavez-MacGregor, Mariana; Giordano, Sharon H

2018-02-15

Treatment guidelines for colon cancer recommend colectomy with lymphadenectomy of at least 12 lymph nodes for patients with stage I to stage III disease as surgery adherence (SA) and adjuvant chemotherapy for individuals with stage III disease. Herein, the authors evaluated adherence to these guidelines among older patients in Texas with colon cancer and the associated survival outcomes. Using Texas Cancer Registry data linked with Medicare data, the authors included patients with AJCC stage II and III colon cancer who were aged ≥66 years and diagnosed between 2001 and 2011. SA and adjuvant chemotherapy adherence rates to treatment guidelines were estimated. The chi-square test, general linear regression, survival probability, and Cox regression were used to identify factors associated with adherence and survival. The rate of SA increased from 47.2% to 84% among 6029 patients with stage II or stage III disease from 2001 to 2011, and the rate of adjuvant chemotherapy increased from 48.9% to 53.1% for patients with stage III disease during the same time period. SA was associated with marital status, tumor size, surgeon specialty, and year of diagnosis. Patient age, sex, marital status, Medicare state buy-in status, comorbidity status, and year of diagnosis were found to be associated with adjuvant chemotherapy. The 5-year survival probability for patients receiving guideline-concordant treatment was the highest at 87% for patients with stage II disease and was 73% for those with stage III disease. After adjusting for demographic and tumor characteristics, improved cancer cause-specific survival was associated with the receipt of stage-specific, guideline-concordant treatment for patients with stage II or stage III disease. The adherence to guideline-concordant treatment among older patients with colon cancer residing in Texas improved over time, and was associated with better survival outcomes. Future studies should be focused on identifying interventions to

Influence of dispatching rules on average production lead time for multi-stage production systems.

Science.gov (United States)

Hübl, Alexander; Jodlbauer, Herbert; Altendorfer, Klaus

2013-08-01

In this paper the influence of different dispatching rules on the average production lead time is investigated. Two theorems based on covariance between processing time and production lead time are formulated and proved theoretically. Theorem 1 links the average production lead time to the "processing time weighted production lead time" for the multi-stage production systems analytically. The influence of different dispatching rules on average lead time, which is well known from simulation and empirical studies, can be proved theoretically in Theorem 2 for a single stage production system. A simulation study is conducted to gain more insight into the influence of dispatching rules on average production lead time in a multi-stage production system. We find that the "processing time weighted average production lead time" for a multi-stage production system is not invariant of the applied dispatching rule and can be used as a dispatching rule independent indicator for single-stage production systems.

LOX/LH2 propulsion system for launch vehicle upper stage, test results

Science.gov (United States)

Ikeda, T.; Imachi, U.; Yuzawa, Y.; Kondo, Y.; Miyoshi, K.; Higashino, K.

1984-01-01

The test results of small LOX/LH2 engines for two propulsion systems, a pump fed system and a pressure fed system are reported. The pump fed system has the advantages of higher performances and higher mass fraction. The pressure fed system has the advantages of higher reliability and relative simplicity. Adoption of these cryogenic propulsion systems for upper stage of launch vehicle increases the payload capability with low cost. The 1,000 kg thrust class engine was selected for this cryogenic stage. A thrust chamber assembly for the pressure fed propulsion system was tested. It is indicated that it has good performance to meet system requirements.

Measuring colorectal cancer care quality for the publicly insured in New York State

International Nuclear Information System (INIS)

Sinclair, Amber H; Schymura, Maria J; Boscoe, Francis P; Yung, Rachel L; Chen, Kun; Roohan, Patrick; Tai, Eric; Schrag, Deborah

2012-01-01

The extent to which concordance with colorectal cancer treatment quality metrics varies by patient characteristics in the publicly insured is not well understood. Our objective was to evaluate the quality of colorectal cancer care for publicly insured residents of New York State (NYS). NYS cancer registry data were linked to Medicaid and Medicare claims and hospital discharge data. We identified colorectal cancer cases diagnosed from 2004 through 2006 and evaluated three treatment quality measures: adjuvant chemotherapy within 4 months of diagnosis for American Joint Cancer Committee (AJCC) stage III colon cancer, adjuvant radiation within 6 months of diagnosis for AJCC stage IIB or III rectal cancer, and adjuvant chemotherapy within 9 months of diagnosis for AJCC stage II–III rectal cancer. Concordance with guidelines was evaluated separately for Medicaid-enrollees under age 65 years and Medicare-enrollees aged 65–79 years. For adjuvant chemotherapy for colon cancer, 79.4% (274/345) of the Medicaid cohort and 71.8% (585/815) of the Medicare cohort were guideline concordant. For adjuvant radiation for rectal cancer, 72.3% (125/173) of the Medicaid cohort and 66.9% (206/308) of the Medicare cohort were concordant. For adjuvant chemotherapy for rectal cancer, 89.5% (238/266) of the Medicaid cohort and 76.0% (392/516) of the Medicare cohort were concordant. Younger age was associated with higher adjusted odds of concordance for all three measures in the Medicare cohort. Racial differences were not evident in either cohort. There is room for improvement in concordance with accepted metrics of cancer care quality. Feedback about performance may assist in targeting efforts to improve care

NxStage dialysis system-associated thrombocytopenia: a report of two cases.

Science.gov (United States)

Sekkarie, Mohamed; Waldron, Michelle; Reynolds, Texas

2016-01-01

Thrombocytopenia in hemodialysis patients has recently been reported to be commonly caused by electron-beam sterilization of dialysis filters. We report the occurrence of thrombocytopenia in the first two patients of a newly established home hemodialysis program. The 2 patients switched from conventional hemodialysis using polysulfone electron-beam sterilized dialyzers to a NxStage system, which uses gamma sterilized polyehersulfone dialyzers incorporated into a drop-in cartridge. The thrombocytopenia resolved after return to conventional dialysis in both patients and recurred upon rechallenge in the patient who opted to retry NxStage. This is the first report of thrombocytopenia with the NxStage system according to the authors’ knowledge. Dialysis-associated thrombocytopenia pathophysiology and clinical significance are not well understood and warrant additional investigations.

MR staging accuracy for endometrial cancer based on the new FIGO stage

International Nuclear Information System (INIS)

Shin, Kyung Eun; Park, Byung Kwan; Kim, Chan Kyo; Bae, Duk Soo; Song, Sang Yong; Kim, Bohyun

2011-01-01

Background: Magnetic resonance imaging (MRI) has been frequently used to determine a preoperative treatment plan for gynecologic cancers. However, the MR accuracy for staging an endometrial cancer is not satisfactory based on the old FIGO staging system. Purpose: To evaluate MR accuracy for staging endometrial cancer using the new FIGO staging system. Material and Methods: Between January 2005 and May 2009, 199 women underwent surgery due to endometrial cancer. In each patient, an endometrial cancer was staged using MR findings based on the old FIGO staging system and then repeated according to the new FIGO staging system for comparison. Histopathologic findings were used as a standard of reference. Results: The accuracy of MRI in the staging of endometrial carcinoma stage I, II, III, and IV using the old FIGO staging system were 80% (159/199), 89% (178/199), 90% (179/199), and 99% (198/199), respectively, compared to 87% (174/199), 97% (193/199), 90% (179/199), and 99% (198/199), respectively, when using the new FIGO staging criteria. The overall MR accuracy of the old and new staging systems were 51% (101/199) and 81% (161/199), respectively. Conclusion: MRI has become a more useful tool in the preoperative staging of endometrial cancers using the new FIGO staging system compared to the old one with increased accuracy

Vibration isolation and dual-stage actuation pointing system for space precision payloads

Science.gov (United States)

Kong, Yongfang; Huang, Hai

2018-02-01

Pointing and stability requirements for future space missions are becoming more and more stringent. This work follows the pointing control method which consists of a traditional spacecraft attitude control system and a payload active pointing loop, further proposing a vibration isolation and dual-stage actuation pointing system for space precision payloads based on a soft Stewart platform. Central to the concept is using the dual-stage actuator instead of the traditional voice coil motor single-stage actuator to improve the payload active pointing capability. Based on a specified payload, the corresponding platform was designed to be installed between the spacecraft bus and the payload. The performance of the proposed system is demonstrated by preliminary closed-loop control investigations in simulations. With the ordinary spacecraft bus, the line-of-sight pointing accuracy can be controlled to below a few milliarcseconds in tip and tilt. Meanwhile, utilizing the voice coil motor with the softening spring in parallel, which is a portion of the dual-stage actuator, the system effectively achieves low-frequency motion transmission and high-frequency vibration isolation along the other four degree-of-freedom directions.

Information and Analysis System Stages of Family Welfare in District Balong

Directory of Open Access Journals (Sweden)

Eka Arynda Ayu

2017-05-01

Full Text Available Badan Kependudukan dan Keluarga Berencana Nasional (BKKBN is a family that formed due to legal marriage, is able to meet the needs of the spiritual and the material that is decent, devoted to God Almighty, have a relationship that is harmonious and balanced between members and between families with the community and the environment. Every year the government to collect data on the status of a prosperous family stage where the purpose of the data collection is in the framework of development and poverty alleviation programs. Data collection process in the District Balong is still done manually so that the risk of error in determining the status of a family stage could happen. Information and analysis system of status stages of family welfare is designed to make web-based officers in the input data and determine the status of a prosperous family stages based on selected indicators of the sheet R/1/KS. Sample of data from Bulukidul village and sub-district village of Balong Ngraket 2014. Results of the system in the form of data reports the results of process steps and the results can be viewed in graphical form. Comparison chart to show the status of the highest percentage of poor welfare families stages. Instead lowest percentage shows the stages of a prosperous family able or rich. 

Influence of capacity- and time-constrained intermediate storage in two-stage food production systems

DEFF Research Database (Denmark)

Akkerman, Renzo; van Donk, Dirk Pieter; Gaalman, Gerard

2007-01-01

In food processing, two-stage production systems with a batch processor in the first stage and packaging lines in the second stage are common and mostly separated by capacity- and time-constrained intermediate storage. This combination of constraints is common in practice, but the literature hardly...... of systems like this. Contrary to the common sense in operations management, the LPT rule is able to maximize the total production volume per day. Furthermore, we show that adding one tank has considerable effects. Finally, we conclude that the optimal setup frequency for batches in the first stage...... pays any attention to this. In this paper, we show how various capacity and time constraints influence the performance of a specific two-stage system. We study the effects of several basic scheduling and sequencing rules in the presence of these constraints in order to learn the characteristics...

Value of five-stage prognostic system in predicting short-term outcome of patients with liver cirrhosis

Directory of Open Access Journals (Sweden)

TIAN Yan

2015-03-01

Full Text Available ObjectiveTo evaluate the clinical value of five-stage prognostic system in predicting the short-term outcome of patients with liver cirrhosis, and to compare it with the Child-Turcotte-Pugh (CTP and Model of End-Stage Liver Disease (MELD scores. MethodsTwo hundred and one hospitalized patients with liver cirrhosis in the Department of Gastroenterology in the First Affiliated Hospital of Anhui Medical University from January 2011 to January 2014 were enrolled in the study and followed up for at least six months. Patients were classified accorded to the five-stage prognostic system, and the mortality rate in each stage was measured. The receiver operating characteristic (ROC curve and the area under the ROC curve (AUC were used to assess the accuracy of the five-stage prognostic system in predicting the short-term death risk of cirrhotic patients, which was then compared with the CTP and MELD scores. Categorical data were analyzed by chi-square test. Comparison of AUC was made by normal distribution Z test. Spearman′s correlation analysis was used to investigate the correlation of the five-stage prognostic system with the CTP and MELD scores. ResultsThe study used the admission time as the starting point and the death of patients or study termination time as the endpoint. Among the 201 patients, 50 (24.9% died within six months. Based on the five-stage prognostic system, the mortality rates for stages 1 to 5 were 0(0/11, 0（0/18, 4.2%（2/48, 16.3% (7/43, and 50.6%（41/81, respectively. In patients with decompensated cirrhosis (stages 3, 4, and 5, the mortality increased with stage, and the differences in mortality between patients in stages 3 and 4, 3 and 5, and 4 and 5 were all significant (χ2=3.89, 35.33, and 13.96, respectively; P=0.049, 0.000, and 0.049, respectively. The AUC for the five-stage prognostic system, five-stage prognostic system combined with CTP and MELD score, and CTP score were 0820, 0.915, 0.888, and 0

Optimization of a Two Stage Pulse Tube Refrigerator for the Integrated Current Lead System

Science.gov (United States)

Maekawa, R.; Matsubara, Y.; Okada, A.; Takami, S.; Konno, M.; Tomioka, A.; Imayoshi, T.; Hayashi, H.; Mito, T.

2008-03-01

Implementation of a conventional current lead with a pulse tube refrigerator has been validated to be working as an Integrated Current Lead (ICL) system for the Superconducting Magnetic Energy Storage (SMES). Realization of the system is primarily accounted for the flexibility of a pulse tube refrigerator, which does not posses any mechanical piston and/or displacer. As for an ultimate version of the ICL system, a High Temperature Superconducting (HTS) lead links a superconducting coil with a conventional copper lead. To ensure the minimization of heat loads to the superconducting coil, a pulse tube refrigerator has been upgraded to have a second cooling stage. This arrangement reduces not only the heat loads to the superconducting coil but also the operating cost for a SMES system. A prototype two-stage pulse tube refrigerator, series connected arrangement, was designed and fabricated to satisfy the requirements for the ICL system. Operation of the first stage refrigerator is a four-valve mode, while the second stage utilizes a double inlet configuration to ensure its confined geometry. The paper discusses the optimization of second stage cooling to validate the conceptual design

Multi-stage fuzzy PID power system automatic generation controller in deregulated environments

International Nuclear Information System (INIS)

Shayeghi, H.; Shayanfar, H.A.; Jalili, A.

2006-01-01

In this paper, a multi-stage fuzzy proportional integral derivative (PID) type controller is proposed to solve the automatic generation control (AGC) problem in a deregulated power system that operates under deregulation based on the bilateral policy scheme. In each control area, the effects of the possible contracts are treated as a set of new input signals in a modified traditional dynamical model. The multi-stage controller uses the fuzzy switch to blend a proportional derivative (PD) fuzzy logic controller with an integral fuzzy logic input. The proposed controller operates on fuzzy values passing the consequence of a prior stage on to the next stage as fact. The salient advantage of this strategy is its high insensitivity to large load changes and disturbances in the presence of plant parameter variations and system nonlinearities. This newly developed strategy leads to a flexible controller with simple structure that is easy to implement, and therefore, it can be useful for the real world power systems. The proposed method is tested on a three area power system with different contracted scenarios under various operating conditions. The results of the proposed controller are compared with those of the classical fuzzy PID type controller and classical PID controller through some performance indices to illustrate its robust performance

Computer simulation of a staging system for a theta-pinch reactor (RTPR)

International Nuclear Information System (INIS)

Crnkovich, P.G.

1976-02-01

To reduce excessive energy requirements for the implosion heating system of a theta-pinch reactor, two staging methods, the brute force and bucking field options, were proposed. A Marshall coil and a segmented coil were also considered. Calculations involved in coding these coil designs and staging options into a PL/I subprogram are described. A marked savings in the energy required for the IH system is realized with the bucking option and others

Development and validation of a surgical-pathologic staging and scoring system for cervical cancer.

Science.gov (United States)

Li, Shuang; Li, Xiong; Zhang, Yuan; Zhou, Hang; Tang, Fangxu; Jia, Yao; Hu, Ting; Sun, Haiying; Yang, Ru; Chen, Yile; Cheng, Xiaodong; Lv, Weiguo; Wu, Li; Zhou, Jin; Wang, Shaoshuai; Huang, Kecheng; Wang, Lin; Yao, Yuan; Yang, Qifeng; Yang, Xingsheng; Zhang, Qinghua; Han, Xiaobing; Lin, Zhongqiu; Xing, Hui; Qu, Pengpeng; Cai, Hongbing; Song, Xiaojie; Tian, Xiaoyu; Shen, Jian; Xi, Ling; Li, Kezhen; Deng, Dongrui; Wang, Hui; Wang, Changyu; Wu, Mingfu; Zhu, Tao; Chen, Gang; Gao, Qinglei; Wang, Shixuan; Hu, Junbo; Kong, Beihua; Xie, Xing; Ma, Ding

2016-04-12

Most cervical cancer patients worldwide receive surgical treatments, and yet the current International Federation of Gynecology and Obstetrics (FIGO) staging system do not consider surgical-pathologic data. We propose a more comprehensive and prognostically valuable surgical-pathologic staging and scoring system (SPSs). Records from 4,220 eligible cervical cancer cases (Cohort 1) were screened for surgical-pathologic risk factors. We constructed a surgical-pathologic staging and SPSs, which was subsequently validated in a prospective study of 1,104 cervical cancer patients (Cohort 2). In Cohort 1, seven independent risk factors were associated with patient outcome: lymph node metastasis (LNM), parametrial involvement, histological type, grade, tumor size, stromal invasion, and lymph-vascular space invasion (LVSI). The FIGO staging system was revised and expanded into a surgical-pathologic staging system by including additional criteria of LNM, stromal invasion, and LVSI. LNM was subdivided into three categories based on number and location of metastases. Inclusion of all seven prognostic risk factors improves practical applicability. Patients were stratified into three SPSs risk categories: zero-, low-, and high-score with scores of 0, 1 to 3, and ≥4 (P=1.08E-45; P=6.15E-55). In Cohort 2, 5-year overall survival (OS) and disease-free survival (DFS) outcomes decreased with increased SPSs scores (P=9.04E-15; P=3.23E-16), validating the approach. Surgical-pathologic staging and SPSs show greater homogeneity and discriminatory utility than FIGO staging. Surgical-pathologic staging and SPSs improve characterization of tumor severity and disease invasion, which may more accurately predict outcome and guide postoperative therapy.

Fill Rates of Single-Stage and Multistage Supply Systems

OpenAIRE

Matthew J. Sobel

2004-01-01

A supply system's fill rate is the fraction of demand that is met from on-hand inventory. This paper presents formulas for the fill rate of periodic review supply systems that use base-stock-level policies. The first part of the paper contains fill-rate formulas for a single-stage system and general distributions of demand. When demand is normally distributed, an exact expression uses only the standard normal distribution and density functions, and a good approximation uses only the standard ...

Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis).

Science.gov (United States)

Tekola, Fasil; Ayele, Zewdu; Mariam, Dereje Haile; Fuller, Claire; Davey, Gail

2008-10-01

To develop and test a robust clinical staging system for podoconiosis, a geochemical disease in individuals exposed to red clay soil. We adapted the Dreyer system for staging filarial lymphoedema and tested it in four re-iterative field tests conducted in an area of high-podoconiosis prevalence in Southern Ethiopia. The system has five stages according to proximal spread of disease and presence of dermal nodules, ridges and bands. We measured the 1-week repeatability and the inter-observer agreement of the final staging system. The five-stage system is readily understood by community workers with little health training. Kappa for 1-week repeatability was 0.88 (95% CI 0.80-0.96), for agreement between health professionals was 0.71 (95% CI 0.60-0.82), while that between health professionals and community podoconiosis agents without formal health training averaged 0.64 (95% CI 0.52-0.78). This simple staging system with good inter-observer agreement and repeatability can assist in the management and further study of podoconiosis.

A two-stage stochastic programming approach for operating multi-energy systems

DEFF Research Database (Denmark)

Zeng, Qing; Fang, Jiakun; Chen, Zhe

2017-01-01

This paper provides a two-stage stochastic programming approach for joint operating multi-energy systems under uncertainty. Simulation is carried out in a test system to demonstrate the feasibility and efficiency of the proposed approach. The test energy system includes a gas subsystem with a gas...

The experimental study of a two-stage photovoltaic thermal system based on solar trough concentration

International Nuclear Information System (INIS)

Tan, Lijun; Ji, Xu; Li, Ming; Leng, Congbin; Luo, Xi; Li, Haili

2014-01-01

Highlights: • A two-stage photovoltaic thermal system based on solar trough concentration. • Maximum cell efficiency of 5.21% with the mirror opening width of 57 cm. • With single cycle, maximum temperatures rise in the heating stage is 12.06 °C. • With 30 min multiple cycles, working medium temperature 62.8 °C, increased 28.7 °C. - Abstract: A two-stage photovoltaic thermal system based on solar trough concentration is proposed, in which the metal cavity heating stage is added on the basis of the PV/T stage, and thermal energy with higher temperature is output while electric energy is output. With the 1.8 m 2 mirror PV/T system, the characteristic parameters of the space solar cell under non-concentrating solar radiation and concentrating solar radiation are respectively tested experimentally, and the solar cell output characteristics at different opening widths of concentrating mirror of the PV/T stage under condensation are also tested experimentally. When the mirror opening width was 57 cm, the solar cell efficiency reached maximum value of 5.21%. The experimental platform of the two-stage photovoltaic thermal system was established, with a 1.8 m 2 mirror PV/T stage and a 15 m 2 mirror heating stage, or a 1.8 m 2 mirror PV/T stage and a 30 m 2 mirror heating stage. The results showed that with single cycle, the long metal cavity heating stage would bring lower thermal efficiency, but temperature rise of the working medium is higher, up to 12.06 °C with only single cycle. With 30 min closed multiple cycles, the temperature of the working medium in the water tank was 62.8 °C, with an increase of 28.7 °C, and thermal energy with higher temperature could be output

Performance assessment and transient optimization of air precooling in multi-stage solid desiccant air conditioning systems

International Nuclear Information System (INIS)

Gadalla, Mohamed; Saghafifar, Mohammad

2016-01-01

Highlights: • Studying three two-stage solid desiccant cooling systems using Maisotsenko cooler. • Proposing precooling to improve two-stage desiccant systems’ COP for humid climates. • Performing transient analysis for a two-stage solid desiccant cooler in UAE. • Optimizing daily performance of a two-stage solid desiccant cooler for UAE. - Abstract: Renewable energy is one of the most promising solutions to both energy and global warming crisis. Energy consumption can be minimized considerably by utilizing solar energy in air conditioning systems operation. One of the popular solar air conditioning technologies is desiccant air conditioning. Nonetheless, conventional desiccant air conditioning systems have a relatively low coefficient of performance (COP). In consequence, two-stage desiccant air-conditioning systems are proposed to improve desiccant air conditioning systems’ COP. Moreover, a recently commercialized cooling method named Maisotsenko cooling cycle which is capable of cooling air near to its dew point temperature is considered to be integrated within the proposed multi-stage desiccant cooling systems. In this paper, three new two-stage desiccant air conditioning systems incorporating Maisotsenko cooling cycle are proposed and investigated in details for hot and humid climates such as UAE. Furthermore, air precooling is considered to improve two stage desiccant air conditioning systems’ COP. Moreover, full transient analysis and optimization are carried out in UAE within June–October. The proposed system can minimize the required solar heating during noon time as the ambient air dry bulb temperature rises. Average COP of the system during electricity load peak hours (10:00–14:00) for all five considered and combined months is 1.77. Average rate of heat input required to operate the system and average building cooling load are determined to be 100.3 kW and 46.2 kW, respectively. Therefore, system average COP is computed to be 0.46.

A two-stage stochastic programming model for the optimal design of distributed energy systems

International Nuclear Information System (INIS)

Zhou, Zhe; Zhang, Jianyun; Liu, Pei; Li, Zheng; Georgiadis, Michael C.; Pistikopoulos, Efstratios N.

2013-01-01

Highlights: ► The optimal design of distributed energy systems under uncertainty is studied. ► A stochastic model is developed using genetic algorithm and Monte Carlo method. ► The proposed system possesses inherent robustness under uncertainty. ► The inherent robustness is due to energy storage facilities and grid connection. -- Abstract: A distributed energy system is a multi-input and multi-output energy system with substantial energy, economic and environmental benefits. The optimal design of such a complex system under energy demand and supply uncertainty poses significant challenges in terms of both modelling and corresponding solution strategies. This paper proposes a two-stage stochastic programming model for the optimal design of distributed energy systems. A two-stage decomposition based solution strategy is used to solve the optimization problem with genetic algorithm performing the search on the first stage variables and a Monte Carlo method dealing with uncertainty in the second stage. The model is applied to the planning of a distributed energy system in a hotel. Detailed computational results are presented and compared with those generated by a deterministic model. The impacts of demand and supply uncertainty on the optimal design of distributed energy systems are systematically investigated using proposed modelling framework and solution approach.

Comparison of single-stage and temperature-phased two-stage anaerobic digestion of oily food waste

International Nuclear Information System (INIS)

Wu, Li-Jie; Kobayashi, Takuro; Li, Yu-You; Xu, Kai-Qin

2015-01-01

Highlights: • A single-stage and two two-stage anaerobic systems were synchronously operated. • Similar methane production 0.44 L/g VS_a_d_d_e_d from oily food waste was achieved. • The first stage of the two-stage process became inefficient due to serious pH drop. • Recycle favored the hythan production in the two-stage digestion. • The conversion of unsaturated fatty acids was enhanced by recycle introduction. - Abstract: Anaerobic digestion is an effective technology to recover energy from oily food waste. A single-stage system and temperature-phased two-stage systems with and without recycle for anaerobic digestion of oily food waste were constructed to compare the operation performances. The synchronous operation indicated the similar ability to produce methane in the three systems, with a methane yield of 0.44 L/g VS_a_d_d_e_d. The pH drop to less than 4.0 in the first stage of two-stage system without recycle resulted in poor hydrolysis, and methane or hydrogen was not produced in this stage. Alkalinity supplement from the second stage of two-stage system with recycle improved pH in the first stage to 5.4. Consequently, 35.3% of the particulate COD in the influent was reduced in the first stage of two-stage system with recycle according to a COD mass balance, and hydrogen was produced with a percentage of 31.7%, accordingly. Similar solids and organic matter were removed in the single-stage system and two-stage system without recycle. More lipid degradation and the conversion of long-chain fatty acids were achieved in the single-stage system. Recycling was proved to be effective in promoting the conversion of unsaturated long-chain fatty acids into saturated fatty acids in the two-stage system.

A Two-stage DC-DC Converter for the Fuel Cell-Supercapacitor Hybrid System

DEFF Research Database (Denmark)

Zhang, Zhe; Thomsen, Ole Cornelius; Andersen, Michael A. E.

2009-01-01

A wide input range multi-stage converter is proposed with the fuel cells and supercapacitors as a hybrid system. The front-end two-phase boost converter is used to optimize the output power and to reduce the current ripple of fuel cells. The supercapacitor power module is connected by push...... and designed. A 1kW prototype controlled by TMS320F2808 DSP is built in the lab. Simulation and experimental results confirm the feasibility of the proposed two stage dc-dc converter system.......-pull-forward half bridge (PPFHB) converter with coupled inductors in the second stage to handle the slow transient response of the fuel cells and realize the bidirectional power flow control. Moreover, this cascaded structure simplifies the power management. The control strategy for the whole system is analyzed...

Two-stage energy storage equalization system for lithium-ion battery pack

Science.gov (United States)

Chen, W.; Yang, Z. X.; Dong, G. Q.; Li, Y. B.; He, Q. Y.

2017-11-01

How to raise the efficiency of energy storage and maximize storage capacity is a core problem in current energy storage management. For that, two-stage energy storage equalization system which contains two-stage equalization topology and control strategy based on a symmetric multi-winding transformer and DC-DC (direct current-direct current) converter is proposed with bidirectional active equalization theory, in order to realize the objectives of consistent lithium-ion battery packs voltages and cells voltages inside packs by using a method of the Range. Modeling analysis demonstrates that the voltage dispersion of lithium-ion battery packs and cells inside packs can be kept within 2 percent during charging and discharging. Equalization time was 0.5 ms, which shortened equalization time of 33.3 percent compared with DC-DC converter. Therefore, the proposed two-stage lithium-ion battery equalization system can achieve maximum storage capacity between lithium-ion battery packs and cells inside packs, meanwhile efficiency of energy storage is significantly improved.

Target tracking system based on preliminary and precise two-stage compound cameras

Science.gov (United States)

Shen, Yiyan; Hu, Ruolan; She, Jun; Luo, Yiming; Zhou, Jie

2018-02-01

Early detection of goals and high-precision of target tracking is two important performance indicators which need to be balanced in actual target search tracking system. This paper proposed a target tracking system with preliminary and precise two - stage compound. This system using a large field of view to achieve the target search. After the target was searched and confirmed, switch into a small field of view for two field of view target tracking. In this system, an appropriate filed switching strategy is the key to achieve tracking. At the same time, two groups PID parameters are add into the system to reduce tracking error. This combination way with preliminary and precise two-stage compound can extend the scope of the target and improve the target tracking accuracy and this method has practical value.

Human papillomavirus genotyping and p16 expression as prognostic factors for patients with American Joint Committee on Cancer stages I to III carcinoma of the anal canal

DEFF Research Database (Denmark)

Serup-Hansen, Eva; Linnemann, Dorte; Skovrider-Ruminski, Wojciech

2014-01-01

-specific survival (DSS) in patients diagnosed with American Joint Committee on Cancer (AJCC) stages I to III carcinoma of the anal canal. PATIENTS AND METHODS: HPV genotyping polymerase chain reaction (high-risk subtypes 16, 18, 31, 33, 45, 52, and 58) and immunohistochemical expression of p16 were analyzed......PURPOSE: Carcinomas of the anal canal are strongly associated with the human papillomavirus (HPV). Expression of p16 is used as a surrogate marker of HPV infection. In a retrospective study, we evaluated HPV genotyping and p16 expression as prognostic markers of overall survival (OS) and disease...... by using paraffin-embedded tumor biopsies from 143 anal carcinomas. The patients were treated with combined chemoradiotherapy or radiotherapy alone. RESULTS: HPV16 was detected in 81.0% of the tumors, followed by HPV33 (5.1%), HPV18 (2.2%), and HPV58 (0.7%). p16 positivity was found in 92.9% of the tumors...

Coupling effect and control strategies of the maglev dual-stage inertially stabilization system based on frequency-domain analysis.

Science.gov (United States)

Lin, Zhuchong; Liu, Kun; Zhang, Li; Zeng, Delin

2016-09-01

Maglev dual-stage inertially stabilization (MDIS) system is a newly proposed system which combines a conventional two-axis gimbal assembly and a 5-DOF (degree of freedom) magnetic bearing with vernier tilting capacity to perform dual-stage stabilization for the LOS of the suspended optical instrument. Compared with traditional dual-stage system, maglev dual-stage system exhibits different characteristics due to the negative position stiffness of the magnetic forces, which introduces additional coupling in the dual stage control system. In this paper, the coupling effect on the system performance is addressed based on frequency-domain analysis, including disturbance rejection, fine stage saturation and coarse stage structural resonance suppression. The difference between various control strategies is also discussed, including pile-up(PU), stabilize-follow (SF) and stabilize-compensate (SC). A number of principles for the design of a maglev dual stage system are proposed. A general process is also suggested, which leads to a cost-effective design striking a balance between high performance and complexity. At last, a simulation example is presented to illustrate the arguments in the paper. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Production system and harvesting stage influence on nitrate content and quality of butterhead lettuce

Directory of Open Access Journals (Sweden)

Siti Fairuz Yosoff

2015-01-01

Full Text Available Leafy vegetables such as lettuce grown under different production systems may accumulate different concentrations of nitrate which may reach to the levels potentially toxic to humans. Moreover, nitrate accumulation varies in various plant parts and physiological age of the plant. Therefore, to determine the effect of production system and harvesting stage on nitrate accumulation and quality of butterhead lettuce, a study was conducted considering two lettuce production systems namely hydroponic and organic, and four different harvesting stages such as 35, 38, 41 and 44 days after transplanting (DAT. The experimental design was complete randomized design (CRD with four replications. Hydroponic and organic systems performed similar in terms of yield, quality and nitrate content of butterhead lettuce. Delaying harvesting can not only increase yield but also can minimize nitrate accumulation and health hazard risk as well. Delay in harvesting stage may result in quality deterioration of lettuce and increased production cost. Thus, a compromise is necessary to consider 41 DAT as the optimum stage to harvest butterhead lettuce with significantly higher reduction of nitrate content in both outer adult leaf blades and young leaves of hydroponic lettuce. Fresh weight, firmness and color of butterhead lettuce at this stage were still acceptable.

Proposal for a new staging system for osteoradionecrosis of the mandible

NARCIS (Netherlands)

Karagozoglu, K.H.; Dekker, H.A.; Rietveld, D.; de Bree, R.; Schulten, E.A.J.M.; Kantola, S.; Forouzanfar, T.; van der Waal, I.

2014-01-01

A new staging system for osteoradionecrosis of the mandible has been retrospectively applied to a group of 31 patients. In this system clinicoradiographic signs and symptoms are incorporated in a simplified manner. For imaging purposes the use of plain radiographs such as periapical films and

Embryonic staging using a 3D virtual reality system

NARCIS (Netherlands)

C.M. Verwoerd-Dikkeboom (Christine); A.H.J. Koning (Anton); P.J. van der Spek (Peter); N. Exalto (Niek); R.P.M. Steegers-Theunissen (Régine)

2008-01-01

textabstractBACKGROUND: The aim of this study was to demonstrate that Carnegie Stages could be assigned to embryos visualized with a 3D virtual reality system. METHODS: We analysed 48 3D ultrasound scans of 19 IVF/ICSI pregnancies at 7-10 weeks' gestation. These datasets were visualized as 3D

Two-stage commercial evaluation of engineering systems production projects for high-rise buildings

Science.gov (United States)

Bril, Aleksander; Kalinina, Olga; Levina, Anastasia

2018-03-01

The paper is devoted to the current and debatable problem of methodology of choosing the effective innovative enterprises for venture financing. A two-stage system of commercial innovation evaluation based on the UNIDO methodology is proposed. Engineering systems account for 25 to 40% of the cost of high-rise residential buildings. This proportion increases with the use of new construction technologies. Analysis of the construction market in Russia showed that the production of internal engineering systems elements based on innovative technologies has a growth trend. The production of simple elements is organized in small enterprises on the basis of new technologies. The most attractive for development is the use of venture financing of small innovative business. To improve the efficiency of these operations, the paper proposes a methodology for a two-stage evaluation of small business development projects. A two-stage system of commercial evaluation of innovative projects allows creating an information base for informed and coordinated decision-making on venture financing of enterprises that produce engineering systems elements for the construction business.

Two-stage commercial evaluation of engineering systems production projects for high-rise buildings

Directory of Open Access Journals (Sweden)

Bril Aleksander

2018-01-01

Full Text Available The paper is devoted to the current and debatable problem of methodology of choosing the effective innovative enterprises for venture financing. A two-stage system of commercial innovation evaluation based on the UNIDO methodology is proposed. Engineering systems account for 25 to 40% of the cost of high-rise residential buildings. This proportion increases with the use of new construction technologies. Analysis of the construction market in Russia showed that the production of internal engineering systems elements based on innovative technologies has a growth trend. The production of simple elements is organized in small enterprises on the basis of new technologies. The most attractive for development is the use of venture financing of small innovative business. To improve the efficiency of these operations, the paper proposes a methodology for a two-stage evaluation of small business development projects. A two-stage system of commercial evaluation of innovative projects allows creating an information base for informed and coordinated decision-making on venture financing of enterprises that produce engineering systems elements for the construction business.

Validation of the Mayo Clinic Staging System in Determining Prognoses of Patients With Perihilar Cholangiocarcinoma

NARCIS (Netherlands)

Coelen, Robert J. S.; Gaspersz, Marcia P.; Labeur, Tim A.; van Vugt, Jeroen L. A.; van Dieren, Susan; Willemssen, François E. J. A.; Nio, Chung Y.; Ijzermans, Jan N. M.; Klümpen, Heinz-Josef; Groot Koerkamp, Bas; van Gulik, Thomas M.

2017-01-01

BACKGROUND & AIMS: Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiologic variables, but has not yet been validated. We

Staging for vulvar cancer.

Science.gov (United States)

Hacker, Neville F; Barlow, Ellen L

2015-08-01

Vulvar cancer has been staged by the International Federation of Gynaecology and Obstetrics (FIGO) since 1969, and the original staging system was based on clinical findings only. This system provided a very good spread of prognostic groupings. Because vulvar cancer is virtually always treated surgically, the status of the lymph nodes is the most important prognostic factor and this can only be determined with certainty by histological examination of resected lymph nodes, FIGO introduced a surgical staging system in 1988. This was modified in 1994 to include a category of microinvasive vulvar cancer (stage IA), because such patients have virtually no risk of lymph node metastases. This system did not give a reasonably even spread of prognostic groupings. In addition, patients with stage III disease were shown to be a heterogeneous group prognostically, and the number of positive nodes and the morphology of those nodes were not taken into account. A new surgical staging system for vulvar cancer was introduced by FIGO in 2009. Initial retrospective analyses have suggested that this new staging system has overcome the major deficiencies in the 1994 system. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Development and applications of a two-dimensional tip-tilting stage system with nanoradian-level positioning resolution

Energy Technology Data Exchange (ETDEWEB)

Shu Deming, E-mail: shu@aps.anl.gov [Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439 (United States); Lee, Wah-Keat; Liu, Wenjun [Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439 (United States); Ice, Gene E. [MST Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831-6132 (United States); Shvyd' ko, Yuri; Kim, Kwang-Je [Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439 (United States)

2011-09-01

In this paper, designs of a novel rotary weak-link stage for a vertical rotation axis and a two-dimensional tip-tilting system are presented. Applications of these new stage systems include: an advanced X-ray stereo imaging instrument for particle tracking velocimetry, an alignment stage system for hard X-ray nano-focusing Montel mirror optics, and an ultra-precision crystal manipulator for cryo-cooling optical cavities of an X-ray free-electron-laser oscillator (XFELO).

Application of two-stage biofilter system for the removal of odorous compounds.

Science.gov (United States)

Jeong, Gwi-Taek; Park, Don-Hee; Lee, Gwang-Yeon; Cha, Jin-Myeong

2006-01-01

Biofiltration is a biological process which is considered to be one of the more successful examples of biotechnological applications to environmental engineering, and is most commonly used in the removal of odoriferous compounds. In this study, we have attempted to assess the efficiency with which both single and complex odoriferous compounds could be removed, using one- or two-stage biofiltration systems. The tested single odor gases, limonene, alpha-pinene, and iso-butyl alcohol, were separately evaluated in the biofilters. Both limonene and alpha-pinene were removed by 90% or more EC (elimination capacity), 364 g/m3/h and 321 g/m3/h, respectively, at an input concentration of 50 ppm and a retention time of 30 s. The iso-butyl alcohol was maintained with an effective removal yield of more than 90% (EC 375 g/m3/h) at an input concentration of 100 ppm. The complex gas removal scheme was applied with a 200 ppm inlet concentration of ethanol, 70 ppm of acetaldehyde, and 70 ppm of toluene with residence time of 45 s in a one- or two-stage biofiltration system. The removal yield of toluene was determined to be lower than that of the other gases in the one-stage biofilter. Otherwise, the complex gases were sufficiently eliminated by the two-stage biofiltration system.

{sup 18}F-FDG-PET/CT for systemic staging of newly diagnosed triple-negative breast cancer

Energy Technology Data Exchange (ETDEWEB)

Ulaner, Gary A.; Castillo, Raychel; Riedl, Christopher C.; Jochelson, Maxine S. [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Weill Cornell Medical College, Department of Radiology, New York, NY (United States); Goldman, Debra A.; Goenen, Mithat [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Wills, Jonathan [Memorial Sloan Kettering Cancer Center, Department of Information Systems, New York, NY (United States); Pinker-Domenig, Katja [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States)

2016-10-15

National Comprehensive Cancer Network guidelines recommend {sup 18}F-FDG-PET/CT, in addition to standard staging procedures, for systemic staging of newly diagnosed stage III breast cancer patients. However, factors in addition to stage may influence PET/CT utility. As breast cancers that are negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor (triple-negative breast cancer, or TNBC) are more aggressive and metastasize earlier than other breast cancers, we hypothesized that receptor expression may be one such factor. This study assesses {sup 18}F-FDG-PET/CT for systemic staging of newly diagnosed TNBC. In this Institutional Review Board-approved retrospective study, our Healthcare Information System was screened for patients with TNBC who underwent {sup 18}F-FDG-PET/CT in 2007-2013 prior to systemic or radiation therapy. Initial stage was determined from mammography, ultrasound, magnetic resonance imaging, and/or surgery, if performed prior to {sup 18}F-FDG-PET/CT. {sup 18}F-FDG-PET/CT was evaluated to identify unsuspected extra-axillary regional nodal and distant metastases, as well as unsuspected synchronous malignancies. Kaplan Meier survival estimates were calculated for initial stage IIB patients stratified by whether or not stage 4 disease was detected by {sup 18}F-FDG-PET/CT. A total of 232 patients with TNBC met inclusion criteria. {sup 18}F-FDG-PET/CT revealed unsuspected distant metastases in 30 (13 %): 0/23 initial stage I, 4/82 (5 %) stage IIA, 13/87 (15 %) stage IIB, 4/23 (17 %) stage IIIA, 8/14 (57 %) stage IIIB, and 1/3 (33 %) stage IIIC. Twenty-six of 30 patients upstaged to IV by {sup 18}F-FDG-PET/CT were confirmed by pathology, with the remaining four patients confirmed by follow-up imaging. In addition, seven unsuspected synchronous malignancies were identified in six patients. Initial stage 2B patients who were upstaged to 4 by {sup 18}F-FDG-PET/CT had significantly shorter survival compared to

Method and system for dual resolution translation stage

Science.gov (United States)

Halpin, John Michael

2014-04-22

A dual resolution translation stage includes a stage assembly operable to receive an optical element and a low resolution adjustment device mechanically coupled to the stage assembly. The dual resolution stage also includes an adjustable pivot block mechanically coupled to the stage assembly. The adjustable pivot block includes a pivot shaft. The dual resolution stage further includes a lever arm mechanically coupled to the adjustable pivot block. The lever arm is operable to pivot about the pivot shaft. The dual resolution stage additionally includes a high resolution adjustment device mechanically coupled to the lever arm and the stage assembly.

Performance study of a heat pump driven and hollow fiber membrane-based two-stage liquid desiccant air dehumidification system

International Nuclear Information System (INIS)

Zhang, Ning; Yin, Shao-You; Zhang, Li-Zhi

2016-01-01

Graphical abstract: A heat pump driven, hollow fiber membrane-based two-stage liquid desiccant air dehumidification system. - Highlights: • A two-stage hollow fiber membrane based air dehumidification is proposed. • It is heat pump driven liquid desiccant system. • Performance is improved 20% upon single stage system. • The optimal first to second stage dehumidification area ratio is 1.4. - Abstract: A novel compression heat pump driven and hollow fiber membrane-based two-stage liquid desiccant air dehumidification system is presented. The liquid desiccant droplets are prevented from crossing over into the process air by the semi-permeable membranes. The isoenthalpic processes are changed to quasi-isothermal processes by the two-stage dehumidification processes. The system is set up and a model is proposed for simulation. Heat and mass capacities in the system, including the membrane modules, the condenser, the evaporator and the heat exchangers are modeled in detail. The model is also validated experimentally. Compared with a single-stage dehumidification system, the two-stage system has a lower solution concentration exiting from the dehumidifier and a lower condensing temperature. Thus, a better thermodynamic system performance is realized and the COP can be increased by about 20% under the typical hot and humid conditions in Southern China. The allocations of heat and mass transfer areas in the system are also investigated. It is found that the optimal regeneration to dehumidification area ratio is 1.33. The optimal first to second stage dehumidification area ratio is 1.4; and the optimal first to second stage regeneration area ratio is 1.286.

Nitrogen removal and microbial communities in a three-stage system simulating a riparian environment.

Science.gov (United States)

Wang, Ziyuan; Wang, Zhixin; Pei, Yuansheng

2014-06-01

The riparian zone is an active interface for nitrogen removal, in which nitrogen transformations by microorganisms have not been valued. In this study, a three-stage system was constructed to simulate the riparian zone environments, and nitrogen removal as well as the microbial community was investigated in this 'engineered riparian system'. The results demonstrated that stage 1 of this system accounted for 41-51 % of total nitrogen removal. Initial ammonium loading and redox potential significantly impacted the nitrogen removal performances. Stages 1 and 2 were both composed of an anoxic/oxic (A/O) zone and an anaerobic column. The A/O zone removed most of the ammonium load (6.8 g/m(2)/day), while the anaerobic column showed a significant nitrate removal rate (11.1 g/m(2)/day). Molecular biological analysis demonstrated that bacterial diversity was high in the A/O zones, where ammonium-oxidizing bacteria and nitrite-oxidizing bacteria accounted for 8.42 and 3.32 % of the bacterial population, respectively. The denitrifying bacteria Acidovorax sp. and the nitrifying bacteria Nitrosospira/Nitrosomonas were the predominant microorganisms in this engineered riparian system. This three-stage system was established to achieve favorable nitrogen removal and the microbial community in the system was also retained. This investigation should deepen our understanding of biological nitrogen removal in engineered riparian zones.

STAGES : a system for generating strategic alternatives for forest management

NARCIS (Netherlands)

Bos, J.

1994-01-01

Strategic planning is important in forest management. However, it has never been described clearly in literature. In this study a framework for strategic planning was developed and based on this a STrategic Alternatives Generating System (STAGES) to support decision making in strategic

Scout fourth stage attitude and velocity control (AVC) system feasibility study

Science.gov (United States)

Byars, L. B.

1975-01-01

The feasibility of incorporating a guidance system in the Scout fourth stage to achieve a significant improvement in expected payload delivery accuracy is studied. The technical investigations included the determination of the AVC equipment performance requirements, establishment of qualification and acceptance test levels, generation of layouts illustrating design approaches for the upper D and payload transition sections to incorporate the hardware, and the preparation of a vendor bid package. Correction concepts, utilizing inertial velocity and attitude, were identified and evaluated. Fourth stage attitude adjustments as determined from inertial velocity variation through the first three stages and a final velocity correction based upon the measured in-plane component errors at injection were employed. Results show radical reductions in apogee-perigee deviations.

Influence of conformal radiotherapy technique on survival after chemoradiotherapy for patients with stage III non-small cell lung cancer in the National Cancer Data Base.

Science.gov (United States)

Sher, David J; Koshy, Matthew; Liptay, Michael J; Fidler, Mary Jo

2014-07-01

Definitive chemoradiotherapy is a core treatment modality for patients with stage III non-small cell lung cancer (NSCLC). Although radiotherapy (RT) technologies have advanced dramatically, to the authors' knowledge relatively little is known regarding the importance of irradiation technique on outcome, particularly given the competing risk of distant metastasis. The National Cancer Data Base was used to determine predictors of overall survival (OS) in patients with AJCC stage III NSCLC who were treated with chemoradiotherapy, focusing on the importance of conformal RT (CRT). Patients with stage III NSCLC who were treated with chemoradiotherapy between 2003 and 2005 in the National Cancer Data Base were included. RT technique was defined as conventional, 3-dimensional-conformal, or intensity-modulated RT (IMRT), the latter 2 combined as CRT. Cox proportional hazards regression was performed for univariable and multivariable analyses of OS. The median, 3-year, and 5-year survival outcomes for the 13,292 patients were 12.9 months, 19%, and 11%, respectively. The 3-year and 5-year survival probabilities of patients receiving CRT versus no CRT were 22% versus 19% and 14% versus 11%, respectively (P < .0001). On multivariable analysis, CRT was found to be significantly associated with improved OS (hazards ratio, 0.89). This effect was confirmed on sensitivity analyses, including restricting the cohort to minimum 6-month survivors, young patients with stage IIIA disease, and propensity score-matching. Institutional academic status and patient volume were not found to be associated with OS. CRT was found to be independently associated with a survival advantage. These results reflect the importance of optimal locoregional therapy in patients with stage III NSCLC and provide motivation for further study of advanced RT technologies in patients with NSCLC. © 2014 American Cancer Society.

Pre-defined and optional staging for the deployment of enterprise systems: a case study and a framework

Science.gov (United States)

Lichtenstein, Yossi; Cucuy, Shy; Fink, Lior

2017-03-01

The effective deployment of enterprise systems has been a major challenge for many organisations. Customising the new system, changing business processes, and integrating multiple information sources are all difficult tasks. As such, they are typically done in carefully planned stages in a process known as phased implementation. Using ideas from Option Theory, this article critiques aspects of phased implementation. One customer relationship management (CRM) project and its phased implementation are described in detail and ten other enterprise system deployments are summarised as a basis for the observation that almost all deployment stages are pre-defined operational steps rather than decision points. However, Option Theory suggests that optional stages, to be used only when risk materialises, should be integral parts of project plans. Although such optional stages are often more valuable than pre-defined stages, the evidence presented in this article shows that they are only rarely utilised. Therefore, a simple framework is presented; it first identifies risks related to the deployment of enterprise systems, then identifies optional stages that can mitigate these risks, and finally compares the costs and benefits of both pre-defined and optional stages.

Comparison of {sup 18}F-FDG PET/MRI and MRI for pre-therapeutic tumor staging of patients with primary cancer of the uterine cervix

Energy Technology Data Exchange (ETDEWEB)

Sarabhai, Theresia; Wetter, Axel; Forsting, Michael; Umutlu, Lale; Grueneisen, Johannes [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schaarschmidt, Benedikt M.; Kirchner, Julian [University Dusseldorf, Department of Diagnostic and Interventional Radiology, Medical Faculty, Dusseldorf (Germany); Aktas, Bahriye [University Hospital Essen, University of Duisburg-Essen, Department of Obstetrics and Gynecology, Essen (Germany); Ruhlmann, Verena; Herrmann, Ken [University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

2018-01-15

The aim of the present study was to assess and compare the diagnostic performance of integrated PET/MRI and MRI alone for local tumor evaluation and whole-body tumor staging of primary cervical cancers. In addition, the corresponding impact on further patient management of the two imaging modalities was assessed. A total of 53 consecutive patients with histopathological verification of a primary cervical cancer were prospectively enrolled for a whole-body 18F-FDG PET/MRI examination. Two experienced physicians analyzed the MRI data, in consensus, followed by a second reading session of the PET/MRI datasets. The readers were asked to perform a dedicated TNM staging in accordance with the 7th edition of the AJCC staging manual. Subsequently, the results of MRI and PET/MRI were discussed in a simulated interdisciplinary tumor board and therapeutic decisions based on both imaging modalities were recorded. Results from histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI allowed for a correct determination of the T stage in 45/53 (85%) cases, while MRI alone enabled a correct identification of the tumor stage in 46/53 (87%) cases. In 24 of the 53 patients, lymph node metastases were present. For the detection of nodal-positive patients, sensitivity, specificity and accuracy of PET/MRI were 83%, 90% and 87%, respectively. The respective values for MRI alone were 71%, 83% and 77%. In addition, PET/MRI showed higher values for the detection of distant metastases than MRI alone (sensitivity: 87% vs. 67%, specificity: 92% vs. 90%, diagnostic accuracy: 91% vs. 83%). Among the patients with discrepant staging results in the two imaging modalities, PET/MRI enabled correct treatment recommendations for a higher number (n = 9) of patients than MRI alone (n = 3). The present results demonstrate the successful application of integrated PET/MRI imaging for whole-body tumor staging of cervical cancer patients, enabling improved treatment

Evolution of International Space Station GN&C System Across ISS Assembly Stages

Science.gov (United States)

Lee, Roscoe; Frank, K. D. (Technical Monitor)

1999-01-01

The Guidance Navigation and Control (GN&C) system for the International Space Station is initially implemented by the Functional Cargo Block (FGB) which was built by the Khrunichev Space Center under direct contract to Boeing. This element (Stage 1A/R) was launched on 20 November 1998 and is currently operating on-orbit. The components and capabilities of the FGB Motion Control System (MCS) are described. The next ISS element, which has GN&C functionality will be the Service Module (SM) built by Rocket Space Corporation-Energia. This module is scheduled for launch (Stage 1R) in early 2000. Following activation of the SM GN&C system, the FGB MCS is deactivated and no longer used. The components and capabilities of the SM GN&C system are described. When a Progress vehicle is attached to the ISS it can be used for reboost operations, based on commands provided by the Mission Control Center-Moscow. When a data connection is implemented between the SM and the Progress, the SM can command the Progress thrusters for attitude control and reboosts. On Stage 5A, the U.S. GN&C system will become activated when the U.S. Laboratory is de loyed and installed (launch schedule is currently TBD). The U.S. GN&C system provides non-propulsive control capabilities to support micro-gravity operations and minimize the use of propellant for attitude control, and an independent capability for determining the ISS state vector, attitude, attitude rate. and time.. The components and capabilities of the U.S. GN&C system are described and the interactions between the U.S. and Russian Segment GN&C systems are also described.

System-level Reliability Assessment of Power Stage in Fuel Cell Application

DEFF Research Database (Denmark)

Zhou, Dao; Wang, Huai; Blaabjerg, Frede

2016-01-01

reliability. In a case study of a 5 kW fuel cell power stage, the parameter variations of the lifetime model prove that the exponential factor of the junction temperature fluctuation is the most sensitive parameter. Besides, if a 5-out-of-6 redundancy is used, it is concluded both the B10 and the B1 system......High efficient and less pollutant fuel cell stacks are emerging and strong candidates of the power solution used for mobile base stations. In the application of the backup power, the availability and reliability hold the highest priority. This paper considers the reliability metrics from...... the component-level to the system-level for the power stage used in a fuel cell application. It starts with an estimation of the annual accumulated damage for the key power electronic components according to the real mission profile of the fuel cell system. Then, considering the parameter variations in both...

Dynamic multi-stage dispatch of isolated wind–diesel power systems

DEFF Research Database (Denmark)

Hu, Yu; Morales González, Juan Miguel; Pineda, Salvador

2015-01-01

-stage decision-making model is proposed to determine the diesel power output that minimizes the cost of running and maintaining the wind–diesel power system. Optimized operational decisions for each time period are generated dynamically considering the path-dependent nature of the optimal dispatch policy, given......An optimal dispatch strategy is crucial for an isolated wind–diesel power system to save diesel fuel and maintain the system stability. The uncertainty associated with the stochastic character of the wind is, though, a challenging problem for this optimization. In this paper, a dynamic multi...

New J-STAGE system accelerates digitization and distribution of academic journals from Japan

Science.gov (United States)

Sato, Ryuichi; Kubota, Soichi; Aoyama, Kota; Tsuchiya, Eri; Miyagawa, Yoshiyuki

13 years have passed since J-STAGE was launched. At present no one could deny that its user interface and functions were already out of date comparing to foreign established e-journals. So JST has developed a new system called “J-STAGE3” in order to offer better usability and give powerful dissemination of academic papers from Japan. As the result of it, they will be able to enjoy the following things: 1) integration of two databases, Journal@rchive and J-STAGE, 2) new design/interface, 3) introduction of international standard XML format, 4) advanced subscription management, 5) saving cost of publishers, and 6) improving J-STAGE online submission and review system. At the end of March 2011, we conducted a market research on current status of digitization on Japanese society journals. The report told us that digitization ratio of those was 62% in total but it was 34% in humanities/social sciences. Or it was 92% in English journals and 55% in Japanese ones. It means that we need further promotion of digitization. In this paper, we discuss functions and direction of J-STAGE3 as well as our role in promotion of digitization of Japanese society journals.

Adaptive kanban control mechanism for a single-stage hybrid system

Science.gov (United States)

Korugan, Aybek; Gupta, Surendra M.

2002-02-01

In this paper, we consider a hybrid manufacturing system with two discrete production lines. Here the output of either production line can satisfy the demand for the same type of product without any penalties. The interarrival times for demand occurrences and service completions are exponentially distributed i.i.d. variables. In order to control this type of manufacturing system we suggest a single stage pull type control mechanism with adaptive kanbans and state independent routing of the production information.

A Sensorless Power Reserve Control Strategy for Two-Stage Grid-Connected PV Systems

DEFF Research Database (Denmark)

Sangwongwanich, Ariya; Yang, Yongheng; Blaabjerg, Frede

2017-01-01

Due to the still increasing penetration of grid-connected Photovoltaic (PV) systems, advanced active power control functionalities have been introduced in grid regulations. A power reserve control, where namely the active power from the PV panels is reserved during operation, is required for grid...... support. In this paper, a cost-effective solution to realize the power reserve for two-stage grid-connected PV systems is proposed. The proposed solution routinely employs a Maximum Power Point Tracking (MPPT) control to estimate the available PV power and a Constant Power Generation (CPG) control...... performed on a 3-kW two-stage single-phase grid-connected PV system, where the power reserve control is achieved upon demands....

New current control based MPPT technique for single stage grid connected PV systems

International Nuclear Information System (INIS)

Jain, Sachin; Agarwal, Vivek

2007-01-01

This paper presents a new maximum power point tracking algorithm based on current control for a single stage grid connected photovoltaic system. The main advantage of this algorithm comes from its ability to predict the approximate amplitude of the reference current waveform or power that can be derived from the PV array with the help of an intermediate variable β. A variable step size for the change in reference amplitude during initial tracking helps in fast tracking. It is observed that if the reference current amplitude is greater than the array capacity, the system gets unstable (i.e. moves into the positive slope region of the p-v characteristics of the array). The proposed algorithm prevents the PV system from entering the positive slope region of the p-v characteristics. It is also capable of restoring stability if the system goes unstable due to a sudden environmental change. The proposed algorithm has been tested on a new single stage grid connected PV configuration recently developed by the authors to feed sinusoidal current into the grid. The system is operated in a continuous conduction mode to realize advantages such as low device current stress, high efficiency and low EMI. A fast MPPT tracker with single stage inverter topology operating in CCM makes the overall system highly efficient. Specific cases of the system, operating in just discontinuous current mode and discontinuous current mode and their relative merits and demerits are also discussed

Optimisation of Refrigeration System with Two-Stage and Intercooler Using Fuzzy Logic and Genetic Algorithm

Directory of Open Access Journals (Sweden)

Bayram Kılıç

2017-04-01

Full Text Available Two-stage compression operation prevents excessive compressor outlet pressure and temperature and this operation provides more efficient working condition in low-temperature refrigeration applications. Vapor compression refrigeration system with two-stage and intercooler is very good solution for low-temperature refrigeration applications. In this study, refrigeration system with two-stage and intercooler were optimized using fuzzy logic and genetic algorithm. The necessary thermodynamic characteristics for optimization were estimated with Fuzzy Logic and liquid phase enthalpy, vapour phase enthalpy, liquid phase entropy, vapour phase entropy values were compared with actual values. As a result, optimum working condition of system was estimated by the Genetic Algorithm as -6.0449 oC for evaporator temperature, 25.0115 oC for condenser temperature and 5.9666 for COP. Morever, irreversibility values of the refrigeration system are calculated.

The effect of marital status on breast cancer-related outcomes in women under 65: A SEER database analysis.

Science.gov (United States)

Hinyard, Leslie; Wirth, Lorinette Saphire; Clancy, Jennifer M; Schwartz, Theresa

2017-04-01

Marital status is strongly associated with improved health and longevity. Being married has been shown to be positively associated with survival in patients with multiple different types of malignancy; however, little is known about the relationship between marital status and breast cancer in younger women. The purpose of this study is to investigate the effect of marital status on diagnosis, and survival of women under the age of 65 with breast cancer. The SEER 18 regions database was used to identify women between the ages of 25-64 diagnosed with invasive breast cancer in the years 2004-2009. Logistic regression was used to predict later stage diagnosis by marital status and Cox proportional hazards models were used to compare breast cancer-related and all-cause survival by marital status classification. Models were stratified by AJCC stage. After adjusting for age, race, and ER status, unmarried women were 1.18 times more likely to be diagnosed at a later stage than married women (95% CI 1.15, 1.20). In adjusted analysis unmarried women were more likely to die of breast cancer and more likely to die of all causes than married women across all AJCC stages. Younger unmarried women with breast cancer may benefit from additional counseling, psychosocial support and case management at the time of diagnosis to ensure their overall outcomes are optimized. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intraoperative extracorporeal autogenous irradiated tendon grafts for functional limb salvage surgery of soft tissue sarcomas of the wrist and hand.

Science.gov (United States)

Omori, Shinsuke; Hamada, Kenichiro; Outani, Hidetatsu; Oshima, Kazuya; Joyama, Susumu; Tomita, Yasuhiko; Naka, Norifumi; Araki, Nobuhito; Yoshikawa, Hideki

2015-05-12

In patients with soft tissue sarcoma of the wrist and hand, limb salvage operation is extremely challenging for surgeons in attempting a complete tumor resection with negative surgical margins. In this study, we report four patients with soft tissue sarcoma of the wrist and hand treated by limb salvage operation with intraoperative extracorporeal autogenous irradiated tendon grafts. The patients were all male, and the mean age at the time of surgery was 45 years. Histological diagnoses included clear cell sarcoma in two patients, synovial sarcoma in one, and angiosarcoma in one. All four patients had high grade tumors, wherein three had American Joint Committee on Cancer (AJCC) stage III disease and one with AJCC stage IV disease. The tumors were resected en bloc with involved tendons. The tendons were isolated from the resected tissues, irradiated ex vivo, and re-implanted into the host tendons. In one patient, the bone was resected additionally because of tumor invasion to the bone. Hand function was evaluated using Musculoskeletal Tumor Society (MSTS) rating system. Of the four patients, three died of distant metastatic disease. The remaining patient lives and remains disease-free. The mean follow-up period was 33 months. One patient had local recurrence outside the irradiated graft at 20 months after surgery. The functional rating was 22. Lower scores were seen in patients with reconstruction of flexor tendons than extensor tendons. Limb salvage operation with intraoperative extracorporeal autogenous irradiated tendon grafts is an acceptable method in selected patients with soft tissue sarcoma of the wrist and hand.

Preoperative carcinoembryonic antigen and prognosis of colorectal cancer. An independent prognostic factor still reliable.

Science.gov (United States)

Li Destri, Giovanni; Rubino, Antonio Salvatore; Latino, Rosalia; Giannone, Fabio; Lanteri, Raffaele; Scilletta, Beniamino; Di Cataldo, Antonio

2015-04-01

To evaluate whether, in a sample of patients radically treated for colorectal carcinoma, the preoperative determination of the carcinoembryonic antigen (p-CEA) may have a prognostic value and constitute an independent risk factor in relation to disease-free survival. The preoperative CEA seems to be related both to the staging of colorectal neoplasia and to the patient's prognosis, although this-to date-has not been conclusively demonstrated and is still a matter of intense debate in the scientific community. This is a retrospective analysis of prospectively collected data. A total of 395 patients were radically treated for colorectal carcinoma. The preoperative CEA was statistically compared with the 2010 American Joint Committee on Cancer (AJCC) staging, the T and N parameters, and grading. All parameters recorded in our database were tested for an association with disease-free survival (DFS). Only factors significantly associated (P < 0.05) with the DFS were used to build multivariate stepwise forward logistic regression models to establish their independent predictors. A statistically significant relationship was found between p-CEA and tumor staging (P < 0.001), T (P < 0.001) and N parameters (P = 0.006). In a multivariate analysis, the independent prognostic factors found were: p-CEA, stages N1 and N2 according to AJCC, and G3 grading (grade). A statistically significant difference (P < 0.001) was evident between the DFS of patients with normal and high p-CEA levels. Preoperative CEA makes a pre-operative selection possible of those patients for whom it is likely to be able to predict a more advanced staging.

Mechanisms important to later stages of streamer system development

Science.gov (United States)

Lehtinen, N. G.; Carlson, B.; Kochkin, P.; Østgaard, N.

2017-12-01

Typical streamer modeling focuses on the propagation of the streamer head and thus neglects processes such as electron detachment, electron energy relaxation, and thermalization of the electron energy distribution. These mechanisms, however, may become important at later stages of streamer system development, in particular following streamer collisions. We present a model of a later-stage streamer system development which includes these processes. A linear analysis suggests that these processes under some conditions can lead to new effects, such as excitation of waves similar to striations in the positive column of a glow discharge. Such instabilities do not occur if these mechanisms are neglected under the same conditions, although previous modeling suggested existence of wave-like phenomena during the streamer propagation [Luque et al, 2016, doi:10.1002/2015JA022234]. In the sea-level pressure air, the obtained striation-like waves may manifest as very high frequency range (>10 MHz) oscillations in plasma parameters and may have been detected in the electrode current and electromagnetic radiation measurements during laboratory spark experiments. We discuss whether the longitudinal electric field in such waves can efficiently transfer energy to charged particles, because such a process may play a role in production of x-rays.

Performance assessment and microbial diversity of two pilot scale multi-stage sub-surface flow constructed wetland systems.

Science.gov (United States)

Babatunde, A O; Miranda-CasoLuengo, Raul; Imtiaz, Mehreen; Zhao, Y Q; Meijer, Wim G

2016-08-01

This study assessed the performance and diversity of microbial communities in multi-stage sub-surface flow constructed wetland systems (CWs). Our aim was to assess the impact of configuration on treatment performance and microbial diversity in the systems. Results indicate that at loading rates up to 100gBOD5/(m(2)·day), similar treatment performances can be achieved using either a 3 or 4 stage configuration. In the case of phosphorus (P), the impact of configuration was less obvious and a minimum of 80% P removal can be expected for loadings up to 10gP/(m(2)·day) based on the performance results obtained within the first 16months of operation. Microbial analysis showed an increased bacterial diversity in stage four compared to the first stage. These results indicate that the design and configuration of multi-stage constructed wetland systems may have an impact on the treatment performance and the composition of the microbial community in the systems, and such knowledge can be used to improve their design and performance. Copyright © 2016. Published by Elsevier B.V.

Prognosis of patients with hepatocellular carcinoma. Validation and ranking of established staging-systems in a large western HCC-cohort.

Directory of Open Access Journals (Sweden)

Mark op den Winkel

Full Text Available HCC is diagnosed in approximately half a million people per year, worldwide. Staging is a more complex issue than in most other cancer entities and, mainly due to unique geographic characteristics of the disease, no universally accepted staging system exists to date. Focusing on survival rates we analyzed demographic, etiological, clinical, laboratory and tumor characteristics of HCC-patients in our institution and applied the common staging systems. Furthermore we aimed at identifying the most suitable of the current staging systems for predicting survival.Overall, 405 patients with HCC were identified from an electronic medical record database. The following seven staging systems were applied and ranked according to their ability to predict survival by using the Akaike information criterion (AIC and the concordance-index (c-index: BCLC, CLIP, GETCH, JIS, Okuda, TNM and Child-Pugh. Separately, every single variable of each staging system was tested for prognostic meaning in uni- and multivariate analysis. Alcoholic cirrhosis (44.4% was the leading etiological factor followed by viral hepatitis C (18.8%. Median survival was 18.1 months (95%-CI: 15.2-22.2. Ascites, bilirubin, alkaline phosphatase, AFP, number of tumor nodes and the BCLC tumor extension remained independent prognostic factors in multivariate analysis. Overall, all of the tested staging systems showed a reasonable discriminatory ability. CLIP (closely followed by JIS was the top-ranked score in terms of prognostic capability with the best values of the AIC and c-index (AIC 2286, c-index 0.71, surpassing other established staging systems like BCLC (AIC 2343, c-index 0.66. The unidimensional scores TNM (AIC 2342, c-index 0.64 and Child-Pugh (AIC 2369, c-index 0.63 performed in an inferior fashion.Compared with six other staging systems, the CLIP-score was identified as the most suitable staging system for predicting prognosis in a large German cohort of predominantly non-surgical HCC-patients.

Design of a Scalable Modular Production System for a Two-stage Food Service Franchise System

OpenAIRE

Matt,; T., D.; Rauch,; E.,

2012-01-01

The geographically distributed production of fresh food poses unique challenges to the production system design because of their stringent industry and logistics requirements. The purpose of this research is to examine the case of a European fresh food manufacturer’s approach to introduce a scalable modular production concept for an international two‐stage gastronomy franchise system in order to identify best practice guidelines and to derive a framework for the design of distributed producti...

Role of [18F]FDG PET in prediction of KRAS and EGFR mutation status in patients with advanced non-small-cell lung cancer

International Nuclear Information System (INIS)

Caicedo, Carlos; Garcia-Velloso, Maria Jose; Vigil Diaz, Carmen; Richter Echevarria, Jose Angel; Lozano, Maria Dolores; Labiano, Tania; Lopez-Picazo, Jose Maria; Gurpide, Alfonso; Perez Gracia, Jose Luis; Zulueta, Javier

2014-01-01

The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [ 18 F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC. Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [ 18 F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [ 18 F]FDG PET/CT for predicting KRAS mutation. From 102 patients staged using [ 18 F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [ 18 F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p 18 F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p 18 F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC. (orig.)

Multi-Stage Admission Control for Load Balancing in Next Generation Systems

DEFF Research Database (Denmark)

Mihovska, Albena D.; Anggorojati, Bayu; Luo, Jijun

2008-01-01

This paper describes a load-dependent multi-stage admission control suitable for next generation systems. The concept uses decision polling in entities located at different levels of the architecture hierarchy and based on the load to activate a sequence of actions related to the admission...

Three-stage enzymatic digestive system for a gut-on-a-chip

NARCIS (Netherlands)

de Haan, Pim; Ianovska, Margaryta A.; Mathwig, Klaus; Bouwmeester, Hans; Verpoorte, Elisabeth

2017-01-01

In this work, we present the development of a three-stage microfluidic system as a cell-free model for digestion in the human gastrointestinal (GI) tract. Larger-scale digestion models are currently being used for pharmacological, toxicological and nutritional studies to determine the possible

A clinical staging system and treatment guidelines for maxillary osteoradionecrosis in irradiated nasopharyngeal carcinoma patients

International Nuclear Information System (INIS)

Cheng, S.-J.; Lee, J.-J.; Ting, L.-L.; Tseng, I.-Y.; Chang, H.-H.; Chen, H.-M.; Kuo, Y.-S.; Hahn, L.-J.; Kok, S.-H.

2006-01-01

Purpose: To develop a clinical staging system for maxillary osteoradionecrosis (ORN) in irradiated nasopharyngeal carcinoma (NPC) patients. Methods and Materials: The data of maxillary ORN cases among 1,758 irradiated NPC patients were analyzed. A staging system based on the degrees of bone exposure (E), infection (I), and bleeding (B) was developed. Correlations between various clinical parameters and stages of maxillary ORN and relationships between treatment modalities and outcomes at each stage were evaluated. Cumulative success of treatment and risk factors that affect treatment outcomes were analyzed. Results: The incidence of maxillary ORN was 2.7% (48/1,758). TNM stage of NPC (p < 0.001), radiation dose (p = 0.029), and tooth extraction (p < 0.001) appeared to have significant influences on disease severity. Success rates between conservative therapy and surgical treatment were not significantly different for Stage I ORN but differed significantly for Stage II (p = 0.013) and Stage III (p = 0.008) lesions. Grade 3 infection and bleeding significantly jeopardized treatment success (p = 0.043 and 0.015, respectively). The risk ratios of treatment failure for Grade 3 infection and bleeding were 2.523 (p = 0.034) and 3.141 (p = 0.027), respectively. Conclusions: More serious maxillary ORN tended to occur in cases with more advanced NPC, higher radiation dose, and history of tooth extraction. Surgical treatment was usually required in Stage II and III ORN. The grades of infection and bleeding are important factors in guidance of treatment and prediction of outcomes

Waterhammer modeling for the Ares I Upper Stage Reaction Control System cold flow development test article

Science.gov (United States)

Williams, Jonathan Hunter

The Upper Stage Reaction Control System provides in-flight three-axis attitude control for the Ares I Upper Stage. The system design must accommodate rapid thruster firing to maintain proper launch trajectory and thus allow for the possibility to pulse multiple thrusters simultaneously. Rapid thruster valve closure creates an increase in static pressure, known as waterhammer, which propagates throughout the propellant system at pressures exceeding nominal design values. A series of development tests conducted at Marshall Space Flight Center in 2009 were performed using a water-flow test article to better understand fluid characteristics of the Upper Stage Reaction Control System. A subset of the tests examined the waterhammer pressure and frequency response in the flight-representative system and provided data to anchor numerical models. This thesis presents a comparison of waterhammer test results with numerical model and analytical results. An overview of the flight system, test article, modeling and analysis are also provided.

Waterhammer Modeling for the Ares I Upper Stage Reaction Control System Cold Flow Development Test Article

Science.gov (United States)

Williams, Jonathan H.

2010-01-01

The Upper Stage Reaction Control System provides three-axis attitude control for the Ares I launch vehicle during active Upper Stage flight. The system design must accommodate rapid thruster firing to maintain the proper launch trajectory and thus allow for the possibility to pulse multiple thrusters simultaneously. Rapid thruster valve closure creates an increase in static pressure, known as waterhammer, which propagates throughout the propellant system at pressures exceeding nominal design values. A series of development tests conducted in the fall of 2009 at Marshall Space Flight Center were performed using a water-flow test article to better understand fluid performance characteristics of the Upper Stage Reaction Control System. A subset of the tests examined waterhammer along with the subsequent pressure and frequency response in the flight-representative system and provided data to anchor numerical models. This thesis presents a comparison of waterhammer test results with numerical model and analytical results. An overview of the flight system, test article, modeling and analysis are also provided.

Performance evaluation of a once-through multi-stage flash distillation system: Impact of brine heater fouling

International Nuclear Information System (INIS)

Baig, Hasan; Antar, Mohamed A.; Zubair, Syed M.

2011-01-01

Multi-stage flash distillation (MSF) system modeling involves a number of process variables. An estimation of all these process variables requires both analytical solutions and experimental/field analysis. However, the accurate estimate of variables related to the brine heater operation in a MSF system is very important for a reliable operation of the system. For example, steam operating conditions as well as the brine properties including fouling of the brine heater tubes have a significant effect on the heat transfer characteristics of the brine heater, which in turn influence the distillate output from the system. In this study, the effect of various design as well as operating conditions on the performance ratio (PR), brine temperature and salinity as it leaves the last flash stage are investigated in a once-through system. Increasing the number of stages from 24 to 32 has a significant effect on the PR, it ranges between 79% (for ΔT = 1.5) and 327% (for ΔT = 2.3) for a top-brine temperature of 106 o C. This value increase as the top-brine temperature increases. Increasing the stage-to-stage temperature difference increases the water salinity as it leaves the final stage and reduces its temperature that would imply better energy utilization within the plant. Results show that brine side heat exchanger fouling has a significant effect in decreasing the overall heat transfer coefficient, which reduces the production rate as the fouling increases with time. A sensitivity analysis to identify the key parameters, which can have a significant influence on the desalination plant performance, is carried out in an attempt to contribute a better understanding and operation of MSF desalination processes.

[Home Daily Hemodialysis with NxStage System One: monocentric italian casistic results].

Science.gov (United States)

Brunati, Chiara; Cassaro, Franca; Cretti, Laura; Izzo, Michela; Pegoraro, Marisa; Negri, Daniela; Gervasi, Francesca; Colussi, Giacomo

2017-09-28

NxStage System One is a new dialytic technology based on easy setup, simplicity of use and reduced dimensions, which is increasingly in use worldwide for home hemodialysis treatments. The system utilizes a low amount of dialysate, usually 15-30 liters according to anthropometric patients' values. The dialysate is supplied at very low flux, generally about 1/3 of blood flow, in order to obtain an elevated saturation of dialysate for solutes. In these conditions the clearance of urea will be almost equal to dialysate flow rate. In order to achieve an obptimal weekly clearance evaluated by Std Kt/V the dialysis sessions are repeated six times a week. In this way a good control of blood voleme can be reached. In this paper we report our experience of treatment with NxStage System One in 12 patients from May 2011 to Dicember 2016. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

A two-stage optimal planning and design method for combined cooling, heat and power microgrid system

International Nuclear Information System (INIS)

Guo, Li; Liu, Wenjian; Cai, Jiejin; Hong, Bowen; Wang, Chengshan

2013-01-01

Highlights: • A two-stage optimal method is presented for CCHP microgrid system. • Economic and environmental performance are considered as assessment indicators. • Application case demonstrates its good economic and environmental performance. - Abstract: In this paper, a two-stage optimal planning and design method for combined cooling, heat and power (CCHP) microgrid system was presented. The optimal objective was to simultaneously minimize the total net present cost and carbon dioxide emission in life circle. On the first stage, multi-objective genetic algorithm based on non-dominated sorting genetic algorithm-II (NSGA-II) was applied to solve the optimal design problem including the optimization of equipment type and capacity. On the second stage, mixed-integer linear programming (MILP) algorithm was used to solve the optimal dispatch problem. The approach was applied to a typical CCHP microgrid system in a hospital as a case study, and the effectiveness of the proposed method was verified

Single stage three level grid interactive MPPT inverter for PV systems

International Nuclear Information System (INIS)

Ozdemir, Saban; Altin, Necmi; Sefa, Ibrahim

2014-01-01

Highlights: • A three phase three-level NPC inverter for grid interactive PV systems is proposed. • A novel MPPT algorithm is introduced for single stage systems. • The proposed algorithm is robust with respect to parameter variations of PV system. • THD level is measured as 3.45% and it meets the international standards (<5%). • Total system efficiency is measured as 93.08%. - Abstract: In this study, three-phase, single stage neutral point clamped grid interactive inverter is designed and implemented. The reference current of the voltage source inverter is determined by maximum power point tracking sub-program in order to obtain maximum power from photovoltaic modules instantaneously. Proposed control is realized via TMS320F28335 32-bit floating point processor. The modified incremental conductance method is applied for maximum power point tracking; the PI regulator is used to control the inverter output current shape and level. Galvanic isolation is provided by a line frequency transformer that matches inverter output voltage to the grid voltage level and prevents DC current injection into the grid. Experimental results show that the designed inverter imports energy to the grid with unity power factor, total harmonic distortion level is 3.45% and this value is in the limits of the international standards. In addition, the total efficiency of the system is measured as 93.08%. The proposed system gets the maximum power from photovoltaic module and dispatches into the grid without using additional DC/DC converter

Structural integration of separation and reaction systems: I. Integration of stage-wise processes

Directory of Open Access Journals (Sweden)

Mitrović Milan

2002-01-01

Full Text Available The structural integration of separation processes, using multifunctional equipment, has been studied on four stage-wise liquid-liquid separations extraction, absorption, distillation, adsorption and on some combinations of these processes. It was shown for stage - wise processes that the ultimate aim of equipment integration is 3-way integration (by components by steps and by stages and that membrane multiphase contactors present concerning the equipment optimal solutions in many cases. First, by using partially integrated equipment and, later by developing fully integrated systems it was experimentally confirmed that structural 3-way integration produces much higher degrees of component separations and component enrichments in compact and safe equipment.

Dilemmas in Lung Cancer Staging.

Science.gov (United States)

Vlahos, Ioannis

2018-05-01

The advent of the 8th edition of the lung cancer staging system reflects a further meticulous evidence-based advance in the stratification of the survival of patients with lung cancer. Although addressing many limitations of earlier staging systems, several limitations in staging remain. This article reviews from a radiological perspective the limitations of the current staging system, highlighting the process of TNM restructuring, the residual issues with regards to the assignment of T, N, M descriptors, and their associated stage groupings and how these dilemmas impact guidance of multidisciplinary teams taking care of patients with lung cancer. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Nitrogen and phosphorus removed from a subsurface flow multi-stage filtration system purifying agricultural runoff.

Science.gov (United States)

Zhao, Yaqi; Huang, Lei; Chen, Yucheng

2018-07-01

Agricultural nonpoint source pollution has been increasingly serious in China since the 1990s. The main causes were excessive inputs of nitrogen fertilizer and pesticides. A multi-stage filtration system was built to test the purification efficiencies and removal characteristics of nitrogen and phosphorus when treating agricultural runoff. Simulated runoff pollution was prepared by using river water as source water based on the monitoring of local agricultural runoff. Experimental study had been performed from September to November 2013, adopting 12 h for flooding and 12 h for drying. The results showed that the system was made adaptive to variation of inflow quality and quantity, and had good removal for dissolved total nitrogen, total nitrogen, dissolved total phosphorus (DTP), and total phosphorus, and the average removal rate was 27%, 36%, 32%, and 48%, respectively. Except nitrate ([Formula: see text]), other forms of nitrogen and phosphorus all decreased with the increase of stages. Nitrogen was removed mainly in particle form the first stage, and mostly removed in dissolved form the second and third stage. Phosphorus was removed mainly in particulate during the first two stages, but the removal of particulate phosphorus and DTP were almost the same in the last stage. An approximate logarithmic relationship between removal loading and influent loading to nitrogen and phosphorus was noted in the experimental system, and the correlation coefficient was 0.78-0.94. [Formula: see text]: ammonium; [Formula: see text]: nitrite; [Formula: see text]: nitrate; DTN: dissolved total nitrogen; TN: total nitrogen; DTP: dissolved total phosphorus; TP: total phosphorus; PN: particulate nitrogen; PP: particulate phosphorus.

Evaluation of high step-up power electronics stages in thermoelectric generator systems

DEFF Research Database (Denmark)

Sun, Kai; Ni, Longxian; Chen, Min

2013-01-01

To develop practical thermoelectric generator (TEG) systems, especially radioisotope thermoelectric power supplies for deep-space exploration, a power conditioning stage with high step-up gain is indispensable. This stage is used to step up the low output voltage of thermoelectric generators...... to the required high level. Furthermore, maximum power point tracking control for TEG modules needs to be implemented into the power electronics stages. In this paper, the temperature-dependent electrical characteristics of a thermoelectric generator are analyzed in depth. Three typical high step-up power...... converters suitable for TEG applications are discussed: an interleaved boost converter, a boost converter with a coupled inductor and an interleaved boost converter with an auxiliary transformer. A general comparison of the three high step-up converters is conducted to study the step-up gain, conversion...

Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2007 and 2011 staging systems

DEFF Research Database (Denmark)

Soriano, Joan B; Lamprecht, Bernd; Ramírez, Ana S

2015-01-01

BACKGROUND: There is no universal consensus on the best staging system for chronic obstructive pulmonary disease (COPD). Although documents (eg, the Global Initiative for Chronic Obstructive Lung Disease [GOLD] 2007) have traditionally used forced expiratory volume in 1 s (FEV1) for staging, clin...

∑∆ Modulator System-Level Considerations for Hearing-Aid Audio Class-D Output Stage Application

DEFF Research Database (Denmark)

Pracný, Peter; Bruun, Erik

2012-01-01

This paper deals with a system-level design of a digital sigma-delta (∑∆) modulator for hearing-aid audio Class D output stage application. The aim of this paper is to provide a thorough discussion on various possibilities and tradeoffs of ∑∆ modulator system-level design parameter combinations...... - order, oversampling ratio (OSR) and number of bits in the quantizer - including their impact on interpolation filter design as well. The system is kept in digital domain up to the input of the Class D power stage including the digital pulse width modulation (DPWM) block. Notes on the impact of the DPWM...

Juvenile nasopharyngeal angiofibroma staging: An overview.

Science.gov (United States)

Alshaikh, Nada Ali; Eleftheriadou, Anna

2015-06-01

Staging of tumors is very important in treatment and surgical decision making, as well as in predicting disease recurrence and prognosis. This review focuses on the different available classifications of juvenile nasopharyngeal angiofibroma (JNA) and their impact on the evaluation, management, and prognosis of JNA. The literature was reviewed, and publications on JNA staging were examined. Our MEDLINE search of the entire English-language literature found no review article on the current available staging systems for JNA. In this article, we review the common JNA classification systems that have been published, and we discuss some of their advantages and disadvantages. The most commonly used staging systems for JNA are the Radkowski and the Andrews-Fisch staging systems. However, some newer staging systems that are based on advances in technology and surgical approaches-the Onerci, INCan, and UPMC systems-have shown promising utility, and they will probably gain popularity in the future.

System and method for single-phase, single-stage grid-interactive inverter

Science.gov (United States)

Liu, Liming; Li, Hui

2015-09-01

The present invention provides for the integration of distributed renewable energy sources/storages utilizing a cascaded DC-AC inverter, thereby eliminating the need for a DC-DC converter. The ability to segment the energy sources and energy storages improves the maintenance capability and system reliability of the distributed generation system, as well as achieve wide range reactive power compensation. In the absence of a DC-DC converter, single stage energy conversion can be achieved to enhance energy conversion efficiency.

Experimental study on an innovative multifunction heat pipe type heat recovery two-stage sorption refrigeration system

International Nuclear Information System (INIS)

Li, T.X.; Wang, R.Z.; Wang, L.W.; Lu, Z.S.

2008-01-01

An innovative multifunction heat pipe type sorption refrigeration system is designed, in which a two-stage sorption thermodynamic cycle based on two heat recovery processes was employed to reduce the driving heat source temperature, and the composite sorbent of CaCl 2 and activated carbon was used to improve the mass and heat transfer performances. For this test unit, the heating, cooling and heat recovery processes between two reactive beds are performed by multifunction heat pipes. The aim of this paper is to investigate the cycled characteristics of two-stage sorption refrigeration system with heat recovery processes. The two sub-cycles of a two-stage cycle have different sorption platforms though the adsorption and desorption temperatures are equivalent. The experimental results showed that the pressure evolutions of two beds are nearly equivalent during the first stage, and desorption pressure during the second stage is large higher than that in the first stage while the desorption temperatures are same during the two operation stages. In comparison with conventional two-stage cycle, the two-stage cycle with heat recovery processes can reduce the heating load for desorber and cooling load for adsorber, the coefficient of performance (COP) has been improved more than 23% when both cycles have the same regeneration temperature of 103 deg. C and the cooling water temperature of 30 deg. C. The advanced two-stage cycle provides an effective method for application of sorption refrigeration technology under the condition of low-grade temperature heat source or utilization of renewable energy

Novel clinical staging for patients with end-stage gastrointestinal carcinoma.

Science.gov (United States)

Yasuda, Naokuni; Nakashima, Osamu; Ohnaka, Toru; Kamisaka, Koji; Tsunoda, Akira; Kusano, Mitsuo

2006-01-01

We created a new clinical staging system for end-stage gastrointestinal (GI) carcinoma to clarify the therapeutic goals for these patients. Data were obtained from a retrospective review of medical charts. Based on daily clinical observation of 144 patients with end-stage GI carcinoma, we classified the terminal stages as A, B, C, and D. The mean durations of terminal stages A, B, C, and D were 19, 16.6, 6.6, and 1.8 days, respectively, in patients with end-stage gastric cancer and 28.5, 9.1, 5.4, and 1.9 days, respectively, in patients with colorectal cancer. Moreover, 88.0% of patients with gastric carcinoma and 82.6% of patients with colorectal carcinoma passed through terminal stages A, B, C, and D sequentially. The patients in terminal stage B experienced temporary relief of symptoms, but those in terminal stage C did not (P terminal stages can easily be judged by clinical observation and may be an effective new tool with which to manage patients with end-stage GI carcinoma and their families.

Stage separation study of Nike-Black Brant V Sounding Rocket System

Science.gov (United States)

Ferragut, N. J.

1976-01-01

A new Sounding Rocket System has been developed. It consists of a Nike Booster and a Black Brant V Sustainer with slanted fins which extend beyond its nozzle exit plane. A cursory look was taken at different factors which must be considered when studying a passive separation system. That is, one separation system without mechanical constraints in the axial direction and which will allow separation due to drag differential accelerations between the Booster and the Sustainer. The equations of motion were derived for rigid body motions and exact solutions were obtained. The analysis developed could be applied to any other staging problem of a Sounding Rocket System.

Effect of ammoniacal nitrogen on one-stage and two-stage anaerobic digestion of food waste

International Nuclear Information System (INIS)

Ariunbaatar, Javkhlan; Scotto Di Perta, Ester; Panico, Antonio; Frunzo, Luigi; Esposito, Giovanni; Lens, Piet N.L.; Pirozzi, Francesco

2015-01-01

Highlights: • Almost 100% of the biomethane potential of food waste was recovered during AD in a two-stage CSTR. • Recirculation of the liquid fraction of the digestate provided the necessary buffer in the AD reactors. • A higher OLR (0.9 gVS/L·d) led to higher accumulation of TAN, which caused more toxicity. • A two-stage reactor is more sensitive to elevated concentrations of ammonia. • The IC 50 of TAN for the AD of food waste amounts to 3.8 g/L. - Abstract: This research compares the operation of one-stage and two-stage anaerobic continuously stirred tank reactor (CSTR) systems fed semi-continuously with food waste. The main purpose was to investigate the effects of ammoniacal nitrogen on the anaerobic digestion process. The two-stage system gave more reliable operation compared to one-stage due to: (i) a better pH self-adjusting capacity; (ii) a higher resistance to organic loading shocks; and (iii) a higher conversion rate of organic substrate to biomethane. Also a small amount of biohydrogen was detected from the first stage of the two-stage reactor making this system attractive for biohythane production. As the digestate contains ammoniacal nitrogen, re-circulating it provided the necessary alkalinity in the systems, thus preventing an eventual failure by volatile fatty acids (VFA) accumulation. However, re-circulation also resulted in an ammonium accumulation, yielding a lower biomethane production. Based on the batch experimental results the 50% inhibitory concentration of total ammoniacal nitrogen on the methanogenic activities was calculated as 3.8 g/L, corresponding to 146 mg/L free ammonia for the inoculum used for this research. The two-stage system was affected by the inhibition more than the one-stage system, as it requires less alkalinity and the physically separated methanogens are more sensitive to inhibitory factors, such as ammonium and propionic acid

Treatment of natural rubber processing wastewater using a combination system of a two-stage up-flow anaerobic sludge blanket and down-flow hanging sponge system.

Science.gov (United States)

Tanikawa, D; Syutsubo, K; Hatamoto, M; Fukuda, M; Takahashi, M; Choeisai, P K; Yamaguchi, T

2016-01-01

A pilot-scale experiment of natural rubber processing wastewater treatment was conducted using a combination system consisting of a two-stage up-flow anaerobic sludge blanket (UASB) and a down-flow hanging sponge (DHS) reactor for more than 10 months. The system achieved a chemical oxygen demand (COD) removal efficiency of 95.7% ± 1.3% at an organic loading rate of 0.8 kg COD/(m(3).d). Bacterial activity measurement of retained sludge from the UASB showed that sulfate-reducing bacteria (SRB), especially hydrogen-utilizing SRB, possessed high activity compared with methane-producing bacteria (MPB). Conversely, the acetate-utilizing activity of MPB was superior to SRB in the second stage of the reactor. The two-stage UASB-DHS system can reduce power consumption by 95% and excess sludge by 98%. In addition, it is possible to prevent emissions of greenhouse gases (GHG), such as methane, using this system. Furthermore, recovered methane from the two-stage UASB can completely cover the electricity needs for the operation of the two-stage UASB-DHS system, accounting for approximately 15% of the electricity used in the natural rubber manufacturing process.

Grid Integration of Single Stage Solar PV System using Three-level Voltage Source Converter

Science.gov (United States)

Hussain, Ikhlaq; Kandpal, Maulik; Singh, Bhim

2016-08-01

This paper presents a single stage solar PV (photovoltaic) grid integrated power generating system using a three level voltage source converter (VSC) operating at low switching frequency of 900 Hz with robust synchronizing phase locked loop (RS-PLL) based control algorithm. To track the maximum power from solar PV array, an incremental conductance algorithm is used and this maximum power is fed to the grid via three-level VSC. The use of single stage system with three level VSC offers the advantage of low switching losses and the operation at high voltages and high power which results in enhancement of power quality in the proposed system. Simulated results validate the design and control algorithm under steady state and dynamic conditions.

Adjuvant therapy in the treatment of gallbladder cancer: a meta-analysis

International Nuclear Information System (INIS)

Ma, Ning; Cheng, Hui; Qin, Baodong; Zhong, Renqian; Wang, Bin

2015-01-01

The benefit of adjuvant therapy (AT) for gallbladder cancer (GBC) is unclear as evidenced by conflicting results from nonrandomized studies. Here we aimed to perform a meta-analysis to determine the impact of AT on overall survival (OS). We used data from MEDLINE, EMBASE and the Cochrane Collaboration Library and published between October 1967 and October 2014. Studies that evaluated AT compared with curative-intent surgery alone for resected GBC were included. Subgroup analyses of benefit based on node status, margins status, and American Joint Committee on Cancer (AJCC) staging were prespecified. Data were weighted and pooled using random-effect modeling. Ten retrospective studies involving 3,191 patients were analyzed. There was a nonsignificant improvement in OS with AT compared with surgery alone (hazard ratio [HR], 0.76; 95 % confidence interval [CI], 0.56–1.03). A significant improvement was observed in OS with chemotherapy (CT) compared with surgery alone (HR, 0.42; 95 % CI, 0.22–0.80) by sensitivity analysis. The greatest benefit for AT was also observed in those with R1 disease (HR, 0.33; 95 % CI, 0.19–0.59), LN-positive disease (HR, 0.71; 95 % CI, 0.63–0.81), and AJCC staging meeting or exceeding tumor Stage II (HR, 0.45; 95 % CI, 0.26–0.79), but not in those with LN-negative or R0 disease. Our results strongly support the use of CT as an AT in GBC. Moreover, patients with node positivity, margin positivity, or non-stage I disease are more likely to benefit from AT

Low cryogen inventory, forced flow Ne cooling system with room temperature compression stage and heat recuperation

CERN Document Server

Shornikov, A; Wolf, A

2014-01-01

We present design and commissioning results of a forced flow cooling system utilizing neon at 30 K. The cryogen is pumped through the system by a room-temperature compression stage. To decouple the cold zone from the compression stage a recuperating counterflow tube-in-tube heat exchanger is used. Commissioning demonstrated successful condensation of neon and transfer of up to 30 W cooling power to the load at 30 K using only 30 g of the cryogen circulating in the system at pressures below 170 kPa.

Clinicopathologic Characteristics and Treatment Outcomes of Penile Cancer

Science.gov (United States)

Nam, Jong Kil; Lee, Dong Hoon; Park, Sung Woo; Kam, Sung Chul; Lee, Ki Soo; Kim, Tae Hyo; Kim, Taek Sang; Oh, Cheol Kyu; Park, Hyun Jun

2017-01-01

Purpose The aim of this study was to assess the clinicopathologic characteristics of penile cancer, including patterns of therapy, oncologic results, and survival. Materials and Methods Between January 2005 and July 2015, 71 patients at 6 institutions who had undergone penectomy or penile biopsy were enrolled. Their medical records were reviewed to identify the mode of therapy, pathology reports, and cancer-specific survival (CSS) rate. Results Clinicopathologic and outcome information was available for 52 male patients (mean age, 64.3 years; mean follow-up, 61.4 months). At presentation, 17 patients were node-positive, and 4 had metastatic disease. Management was partial penectomy in 34 patients, total penectomy in 12 patients, and chemotherapy or radiotherapy in 6 patients. The pathology reports were squamous cell carcinoma in 50 patients and other types of carcinoma in the remaining 2 patients. Kaplan-Meier survival analysis showed a 5-year CSS rate of 84.0%. In univariate and multivariate analyses, the American Joint Committee on Cancer (AJCC) stage and pathologic grade were associated with survival. Conclusions Partial penectomy was the most common treatment of penile lesions. The oncologic outcomes were good, with a 5-year CSS of 84.0%. The AJCC stage and pathologic grade were independent prognostic factors for survival. PMID:28459145

Two-stage simplified swarm optimization for the redundancy allocation problem in a multi-state bridge system

International Nuclear Information System (INIS)

Lai, Chyh-Ming; Yeh, Wei-Chang

2016-01-01

The redundancy allocation problem involves configuring an optimal system structure with high reliability and low cost, either by alternating the elements with more reliable elements and/or by forming them redundantly. The multi-state bridge system is a special redundancy allocation problem and is commonly used in various engineering systems for load balancing and control. Traditional methods for redundancy allocation problem cannot solve multi-state bridge systems efficiently because it is impossible to transfer and reduce a multi-state bridge system to series and parallel combinations. Hence, a swarm-based approach called two-stage simplified swarm optimization is proposed in this work to effectively and efficiently solve the redundancy allocation problem in a multi-state bridge system. For validating the proposed method, two experiments are implemented. The computational results indicate the advantages of the proposed method in terms of solution quality and computational efficiency. - Highlights: • Propose two-stage SSO (SSO_T_S) to deal with RAP in multi-state bridge system. • Dynamic upper bound enhances the efficiency of searching near-optimal solution. • Vector-update stages reduces the problem dimensions. • Statistical results indicate SSO_T_S is robust both in solution quality and runtime.

Magnetic Resonance Imaging Features of the Nigrostriatal System: Biomarkers of Parkinson’s Disease Stages?

Science.gov (United States)

Hopes, Lucie; Grolez, Guillaume; Moreau, Caroline; Lopes, Renaud; Ryckewaert, Gilles; Carrière, Nicolas; Auger, Florent; Laloux, Charlotte; Petrault, Maud; Devedjian, Jean-Christophe; Bordet, Regis; Defebvre, Luc; Jissendi, Patrice; Delmaire, Christine; Devos, David

2016-01-01

Introduction Magnetic resonance imaging (MRI) can be used to identify biomarkers in Parkinson’s disease (PD); R2* values reflect iron content related to high levels of oxidative stress, whereas volume and/or shape changes reflect neuronal death. We sought to assess iron overload in the nigrostriatal system and characterize its relationship with focal and overall atrophy of the striatum in the pivotal stages of PD. Methods Twenty controls and 70 PD patients at different disease stages (untreated de novo patients, treated early-stage patients and advanced-stage patients with L-dopa-related motor complications) were included in the study. We determined the R2* values in the substantia nigra, putamen and caudate nucleus, together with striatal volume and shape analysis. We also measured R2* in an acute MPTP mouse model and in a longitudinal follow-up two years later in the early-stage PD patients. Results The R2* values in the substantia nigra, putamen and caudate nucleus were significantly higher in de novo PD patients than in controls. Early-stage patients displayed significantly higher R2* values in the substantia nigra (with changes in striatal shape), relative to de novo patients. Measurements after a two-year follow-up in early-stage patients and characterization of the acute MPTP mouse model confirmed that R2* changed rapidly with disease progression. Advanced-stage patients displayed significant atrophy of striatum, relative to earlier disease stages. Conclusion Each pivotal stage in PD appears to be characterized by putative nigrostriatal MRI biomarkers: iron overload at the de novo stage, striatal shape changes at early-stage disease and generalized striatal atrophy at advanced disease. PMID:27035571

Space Launch System, Core Stage, Structural Test Design and Implementation

Science.gov (United States)

Shaughnessy, Ray

2017-01-01

As part of the National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, engineers at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama are working to design, develop and implement the SLS Core Stage structural testing. The SLS will have the capability to return humans to the Moon and beyond and its first launch is scheduled for December of 2017. The SLS Core Stage consist of five major elements; Forward Skirt, Liquid Oxygen (LOX) tank, Intertank (IT), Liquid Hydrogen (LH2) tank and the Engine Section (ES). Structural Test Articles (STA) for each of these elements are being designed and produced by Boeing at Michoud Assembly Facility located in New Orleans, La. The structural test for the Core Stage STAs (LH2, LOX, IT and ES) are to be conducted by the MSFC Test Laboratory. Additionally, the MSFC Test Laboratory manages the Structural Test Equipment (STE) design and development to support the STAs. It was decided early (April 2012) in the project life that the LH2 and LOX tank STAs would require new test stands and the Engine Section and Intertank would be tested in existing facilities. This decision impacted schedules immediately because the new facilities would require Construction of Facilities (C of F) funds that require congressional approval and long lead times. The Engine Section and Intertank structural test are to be conducted in existing facilities which will limit lead times required to support the first launch of SLS. With a SLS launch date of December, 2017 Boeing had a need date for testing to be complete by September of 2017 to support flight certification requirements. The test facilities were required to be ready by October of 2016 to support test article delivery. The race was on to get the stands ready before Test Article delivery and meet the test complete date of September 2017. This paper documents the past and current design and development phases and the supporting processes, tools, and

In situ immune response after neoadjuvant chemotherapy for breast cancer predicts survival.

Science.gov (United States)

Ladoire, Sylvain; Mignot, Grégoire; Dabakuyo, Sandrine; Arnould, Laurent; Apetoh, Lionel; Rébé, Cedric; Coudert, Bruno; Martin, Francois; Bizollon, Marie Hélène; Vanoli, André; Coutant, Charles; Fumoleau, Pierre; Bonnetain, Franck; Ghiringhelli, François

2011-07-01

Accumulating preclinical evidence suggests that anticancer immune responses contribute to the success of chemotherapy. However, the predictive value of tumour-infiltrating lymphocytes after neoadjuvant chemotherapy for breast cancer remains unknown. We hypothesized that the nature of the immune infiltrate following neoadjuvant chemotherapy would predict patient survival. In a series of 111 consecutive HER2- and a series of 51 non-HER2-overexpressing breast cancer patients treated by neoadjuvant chemotherapy, we studied by immunohistochemistry tumour infiltration by FOXP3 and CD8 T lymphocytes before and after chemotherapy. Kaplan-Meier analysis and Cox modelling were used to assess relapse-free survival (RFS) and overall survival (OS). A predictive scoring system using American Joint Committee on Cancer (AJCC) pathological staging and immunological markers was created. Association of high CD8 and low FOXP3 cell infiltrates after chemotherapy was significantly associated with improved RFS (p = 0.02) and OS (p = 0.002), and outperformed classical predictive factors in multivariate analysis. A combined score associating CD8/FOXP3 ratio and pathological AJCC staging isolated a subgroup of patients with a long-term overall survival of 100%. Importantly, this score also identified patients with a favourable prognosis in an independent cohort of HER2-negative breast cancer patients. These results suggest that immunological CD8 and FOXP3 cell infiltrate after treatment is an independent predictive factor of survival in breast cancer patients treated with neoadjuvant chemotherapy and provides new insights into the role of the immune milieu and cancer. Copyright © 2011 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Validation of the Hong Kong Liver Cancer Staging System in Determining Prognosis of the North American Patients Following Intra-arterial Therapy

Science.gov (United States)

Sohn, Jae Ho; Duran, Rafael; Zhao, Yan; Fleckenstein, Florian; Chapiro, Julius; Sahu, Sonia P.; Schernthaner, Rüdiger E.; Qian, Tianchen; Lee, Howard; Zhao, Li; Hamilton, James; Frangakis, Constantine; Lin, MingDe; Salem, Riad; Geschwind, Jean-Francois

2018-01-01

Background & Aims There is debate over the best way to stage hepatocellular carcinoma (HCC). We attempted to validate the prognostic and clinical utility of the recently developed Hong Kong Liver Cancer (HKLC) staging system, a hepatitis B-based model, and compared data with that from the Barcelona Clinic Liver Cancer (BCLC) staging system in a North American population who underwent intra-arterial therapy (IAT). Methods We performed a retrospective analysis of data from 1009 patients with HCC who underwent intra-arterial therapy from 2000 through 2014. Most patients had hepatitis C or unresectable tumors; all patients underwent IAT, with or without resection, transplantation, and/or systemic chemotherapy. We calculated HCC stage for each patient using 5-stage HKLC (HKLC-5) and 9-stage HKLC (HKLC-9) system classifications, as well as the BCLC system. Survival information was collected up until end of 2014 at which point living or unconfirmed patients were censored. We compared performance of the BCLC, HKLC-5, and HKLC-9 systems in predicting patient outcomes using Kaplan-Meier estimates, calibration plots, c-statistic, Akaike information criterion, and the likelihood ratio test. Results Median overall survival time, calculated from first IAT until date of death or censorship, for the entire cohort (all stages) was 9.8 months. The BCLC and HKLC staging systems predicted patient survival times with significance (P<.001). HKLC-5 and HKLC-9 each demonstrated good calibration. The HKLC-5 system outperformed the BCLC system in predicting patient survival times (HKLC c=0.71, Akaike information criterion=6242; BCLC c=0.64, Akaike information criterion=6320), reducing error in predicting survival time (HKLC reduced error by 14%, BCLC reduced error by 12%), and homogeneity (HKLC χ2=201; P<.001; BCLC χ2=119; P<.001) and monotonicity (HKLC linear trend χ2=193; P<.001; BCLC linear trend χ2=111; P<.001). Small proportions of patients with HCC of stages IV or V, according to

Application of preference selection index method for decision making over the design stage of production system life cycle

Directory of Open Access Journals (Sweden)

Rajesh Attri

2015-07-01

Full Text Available The life cycle of production system shows the progress of production system from the inception to the termination of the system. During each stage, mainly in the design stage, certain strategic decisions have to be taken. These decisions are more complex as the decision makers have to assess a wide range of alternatives based on a set of conflicting criteria. As the decision making process is found to be unstructured, characterized by domain dependent knowledge, there is a need to apply an efficient multi-criteria decision making (MCDM tool to help the decision makers in making correct decisions. This paper explores the application of a novel MCDM method i.e. Preference selection index (PSI method to solve various decision-making problems that are generally encountered in the design stage of production system life cycle. To prove the potentiality, applicability and accuracy of PSI method in solving decision making problem during the design stage of production system life cycle, five examples are cited from the literature and are compared with the results obtained by the past researchers.

An adaptive three-stage extended Kalman filter for nonlinear discrete-time system in presence of unknown inputs.

Science.gov (United States)

Xiao, Mengli; Zhang, Yongbo; Wang, Zhihua; Fu, Huimin

2018-04-01

Considering the performances of conventional Kalman filter may seriously degrade when it suffers stochastic faults and unknown input, which is very common in engineering problems, a new type of adaptive three-stage extended Kalman filter (AThSEKF) is proposed to solve state and fault estimation in nonlinear discrete-time system under these conditions. The three-stage UV transformation and adaptive forgetting factor are introduced for derivation, and by comparing with the adaptive augmented state extended Kalman filter, it is proven to be uniformly asymptotically stable. Furthermore, the adaptive three-stage extended Kalman filter is applied to a two-dimensional radar tracking scenario to illustrate the effect, and the performance is compared with that of conventional three stage extended Kalman filter (ThSEKF) and the adaptive two-stage extended Kalman filter (ATEKF). The results show that the adaptive three-stage extended Kalman filter is more effective than these two filters when facing the nonlinear discrete-time systems with information of unknown inputs not perfectly known. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Health system delay and its effect on clinical stage of breast cancer: Multicenter study.

Science.gov (United States)

Unger-Saldaña, Karla; Miranda, Alfonso; Zarco-Espinosa, Gelasio; Mainero-Ratchelous, Fernando; Bargalló-Rocha, Enrique; Miguel Lázaro-León, Jesús

2015-07-01

The objective of this study was to determine the correlation between health system delay and clinical disease stage in patients with breast cancer. This was a cross-sectional study of 886 patients who were referred to 4 of the largest public cancer hospitals in Mexico City for the evaluation of a probable breast cancer. Data on time intervals, sociodemographic factors, and clinical stage at diagnosis were retrieved. A logistic regression model was used to estimate the average marginal effects of delay on the probability of being diagnosed with advanced breast cancer (stages III and IV). The median time between problem identification and the beginning of treatment was 7 months. The subinterval with the largest delay was that between the first medical consultation and diagnosis (median, 4 months). Only 15% of the patients who had cancer were diagnosed with stage 0 and I disease, and 48% were diagnosed with stage III and IV disease. Multivariate analyses confirmed independent correlations for the means of problem identification, patient delay, health system delay, and age with a higher probability that patients would begin cancer treatment in an advanced stage. In the sample studied, the majority of patients with breast cancer began treatment after a delay. Both patient delays and provider delays were associated with advanced disease. Research aimed at identifying specific access barriers to medical services is much needed to guide the design of tailored health policies that go beyond the promotion of breast care awareness and screening participation to include improvements in health services that facilitate access to timely diagnosis and treatment. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Two-Stage orders sequencing system for mixed-model assembly

Science.gov (United States)

Zemczak, M.; Skolud, B.; Krenczyk, D.

2015-11-01

In the paper, the authors focus on the NP-hard problem of orders sequencing, formulated similarly to Car Sequencing Problem (CSP). The object of the research is the assembly line in an automotive industry company, on which few different models of products, each in a certain number of versions, are assembled on the shared resources, set in a line. Such production type is usually determined as a mixed-model production, and arose from the necessity of manufacturing customized products on the basis of very specific orders from single clients. The producers are nowadays obliged to provide each client the possibility to determine a huge amount of the features of the product they are willing to buy, as the competition in the automotive market is large. Due to the previously mentioned nature of the problem (NP-hard), in the given time period only satisfactory solutions are sought, as the optimal solution method has not yet been found. Most of the researchers that implemented inaccurate methods (e.g. evolutionary algorithms) to solving sequencing problems dropped the research after testing phase, as they were not able to obtain reproducible results, and met problems while determining the quality of the received solutions. Therefore a new approach to solving the problem, presented in this paper as a sequencing system is being developed. The sequencing system consists of a set of determined rules, implemented into computer environment. The system itself works in two stages. First of them is connected with the determination of a place in the storage buffer to which certain production orders should be sent. In the second stage of functioning, precise sets of sequences are determined and evaluated for certain parts of the storage buffer under certain criteria.

Optics of two-stage photovoltaic concentrators with dielectric second stages

Science.gov (United States)

Ning, Xiaohui; O'Gallagher, Joseph; Winston, Roland

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Optics of two-stage photovoltaic concentrators with dielectric second stages.

Science.gov (United States)

Ning, X; O'Gallagher, J; Winston, R

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Effect of ammoniacal nitrogen on one-stage and two-stage anaerobic digestion of food waste

Energy Technology Data Exchange (ETDEWEB)

Ariunbaatar, Javkhlan, E-mail: jaka@unicas.it [Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Via Di Biasio 43, 03043 Cassino, FR (Italy); UNESCO-IHE Institute for Water Education, Westvest 7, 2611 AX Delft (Netherlands); Scotto Di Perta, Ester [Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125 Naples (Italy); Panico, Antonio [Telematic University PEGASO, Piazza Trieste e Trento, 48, 80132 Naples (Italy); Frunzo, Luigi [Department of Mathematics and Applications Renato Caccioppoli, University of Naples Federico II, Via Claudio, 21, 80125 Naples (Italy); Esposito, Giovanni [Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Via Di Biasio 43, 03043 Cassino, FR (Italy); Lens, Piet N.L. [UNESCO-IHE Institute for Water Education, Westvest 7, 2611 AX Delft (Netherlands); Pirozzi, Francesco [Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125 Naples (Italy)

2015-04-15

Highlights: • Almost 100% of the biomethane potential of food waste was recovered during AD in a two-stage CSTR. • Recirculation of the liquid fraction of the digestate provided the necessary buffer in the AD reactors. • A higher OLR (0.9 gVS/L·d) led to higher accumulation of TAN, which caused more toxicity. • A two-stage reactor is more sensitive to elevated concentrations of ammonia. • The IC{sub 50} of TAN for the AD of food waste amounts to 3.8 g/L. - Abstract: This research compares the operation of one-stage and two-stage anaerobic continuously stirred tank reactor (CSTR) systems fed semi-continuously with food waste. The main purpose was to investigate the effects of ammoniacal nitrogen on the anaerobic digestion process. The two-stage system gave more reliable operation compared to one-stage due to: (i) a better pH self-adjusting capacity; (ii) a higher resistance to organic loading shocks; and (iii) a higher conversion rate of organic substrate to biomethane. Also a small amount of biohydrogen was detected from the first stage of the two-stage reactor making this system attractive for biohythane production. As the digestate contains ammoniacal nitrogen, re-circulating it provided the necessary alkalinity in the systems, thus preventing an eventual failure by volatile fatty acids (VFA) accumulation. However, re-circulation also resulted in an ammonium accumulation, yielding a lower biomethane production. Based on the batch experimental results the 50% inhibitory concentration of total ammoniacal nitrogen on the methanogenic activities was calculated as 3.8 g/L, corresponding to 146 mg/L free ammonia for the inoculum used for this research. The two-stage system was affected by the inhibition more than the one-stage system, as it requires less alkalinity and the physically separated methanogens are more sensitive to inhibitory factors, such as ammonium and propionic acid.

Organic semiconductor wastewater treatment using a four-stage Bardenpho with membrane system.

Science.gov (United States)

Chung, Jinwook; Fleege, Daniel; Ong, Say Kee; Lee, Yong-Woo

2014-01-01

Electronic wastewater from a semiconductor plant was treated with a pilot-scale four-stage Bardenpho process with membrane system. The system was operated over a 14-month period with an overall hydraulic retention time (HRT) ranging from 9.5 to 30 h. With a few exceptions, the pilot plant consistently treated the electronic wastewater with an average removal efficiency of chemical oxygen demand (COD) and total nitrogen of 97% and 93%, respectively, and achieving effluent quality of COD<15 mg/L, turbidity<1, and silt density index<1. Based on removal efficiencies of the pilot plant, it is possible to lower the HRT to less than 9.5 h to achieve comparable removal efficiencies. An energy-saving configuration where an internal recycle line was omitted and the biomass recycle was rerouted to the pre-anoxic tank, can reduce energy consumption by 8.6% and gave removal efficiencies that were similar to the Bardenpho process. The system achieved pre-anoxic and post-anoxic specific denitrification rate values with a 95% confidence interval of 0.091 ± 0.011 g NO₃-N/g MLVSS d and 0.087 ± 0.016 g NO₃-N/g MLVSS d, respectively. The effluent from the four-stage Bardenpho with membrane system can be paired with a reverse osmosis system to provide further treatment for reuse purposes.

Two-stage open-loop velocity compensating method applied to multi-mass elastic transmission system

Directory of Open Access Journals (Sweden)

Zhang Deli

2014-02-01

Full Text Available In this paper, a novel vibration-suppression open-loop control method for multi-mass system is proposed, which uses two-stage velocity compensating algorithm and fuzzy I + P controller. This compensating method is based on model-based control theory in order to provide a damping effect on the system mechanical part. The mathematical model of multi-mass system is built and reduced to estimate the velocities of masses. The velocity difference between adjacent masses is calculated dynamically. A 3-mass system is regarded as the composition of two 2-mass systems in order to realize the two-stage compensating algorithm. Instead of using a typical PI controller in the velocity compensating loop, a fuzzy I + P controller is designed and its input variables are decided according to their impact on the system, which is different from the conventional fuzzy PID controller designing rules. Simulations and experimental results show that the proposed velocity compensating method is effective in suppressing vibration on a 3-mass system and it has a better performance when the designed fuzzy I + P controller is utilized in the control system.

Two-stage dental implants inserted in a one-stage procedure : a prospective comparative clinical study

NARCIS (Netherlands)

Heijdenrijk, Kees

2002-01-01

The results of this study indicate that dental implants designed for a submerged implantation procedure can be used in a single-stage procedure and may be as predictable as one-stage implants. Although one-stage implant systems and two-stage.

Computerized breast cancer analysis system using three stage semi-supervised learning method.

Science.gov (United States)

Sun, Wenqing; Tseng, Tzu-Liang Bill; Zhang, Jianying; Qian, Wei

2016-10-01

A large number of labeled medical image data is usually a requirement to train a well-performed computer-aided detection (CAD) system. But the process of data labeling is time consuming, and potential ethical and logistical problems may also present complications. As a result, incorporating unlabeled data into CAD system can be a feasible way to combat these obstacles. In this study we developed a three stage semi-supervised learning (SSL) scheme that combines a small amount of labeled data and larger amount of unlabeled data. The scheme was modified on our existing CAD system using the following three stages: data weighing, feature selection, and newly proposed dividing co-training data labeling algorithm. Global density asymmetry features were incorporated to the feature pool to reduce the false positive rate. Area under the curve (AUC) and accuracy were computed using 10 fold cross validation method to evaluate the performance of our CAD system. The image dataset includes mammograms from 400 women who underwent routine screening examinations, and each pair contains either two cranio-caudal (CC) or two mediolateral-oblique (MLO) view mammograms from the right and the left breasts. From these mammograms 512 regions were extracted and used in this study, and among them 90 regions were treated as labeled while the rest were treated as unlabeled. Using our proposed scheme, the highest AUC observed in our research was 0.841, which included the 90 labeled data and all the unlabeled data. It was 7.4% higher than using labeled data only. With the increasing amount of labeled data, AUC difference between using mixed data and using labeled data only reached its peak when the amount of labeled data was around 60. This study demonstrated that our proposed three stage semi-supervised learning can improve the CAD performance by incorporating unlabeled data. Using unlabeled data is promising in computerized cancer research and may have a significant impact for future CAD system

Strengthening power generation efficiency utilizing liquefied natural gas cold energy by a novel two-stage condensation Rankine cycle (TCRC) system

International Nuclear Information System (INIS)

Bao, Junjiang; Lin, Yan; Zhang, Ruixiang; Zhang, Ning; He, Gaohong

2017-01-01

Highlights: • A two-stage condensation Rankine cycle (TCRC) system is proposed. • Net power output and thermal efficiency increases by 45.27% and 42.91%. • The effects of the condensation temperatures are analyzed. • 14 working fluids (such as propane, butane etc.) are compared. - Abstract: For the low efficiency of the traditional power generation system with liquefied natural gas (LNG) cold energy utilization, by improving the heat transfer characteristic between the working fluid and LNG, this paper has proposed a two-stage condensation Rankine cycle (TCRC) system. Using propane as working fluid, compared with the combined cycle in the conventional LNG cold energy power generation method, the net power output, thermal efficiency and exergy efficiency of the TCRC system are respectively increased by 45.27%, 42.91% and 52.31%. Meanwhile, the effects of the first-stage and second-stage condensation temperature and LNG vaporization pressure on the performance and cost index of the TCRC system (net power output, thermal efficiency, exergy efficiency and UA) are analyzed. Finally, using the net power output as the objective function, with 14 organic fluids (such as propane, butane etc.) as working fluids, the first-stage and second-stage condensation temperature at different LNG vaporization pressures are optimized. The results show that there exists a first-stage and second-stage condensation temperature making the performance of the TCRC system optimal. When LNG vaporization pressure is supercritical pressure, R116 has the best economy among all the investigated working fluids, and while R150 and R23 are better when the vaporization pressure of LNG is subcritical.

Performance evaluation of a piezoactuator-based single-stage valve system subjected to high temperature

Science.gov (United States)

Jeon, Juncheol; Han, Chulhee; Chung, Jye Ung; Choi, Seung-Bok

2015-01-01

In this paper, a novel single-stage valve system activated by a piezostack actuator is proposed and experimentally evaluated at both room temperature (20 °C) and high temperature (100 °C) conditions. A hinge-lever displacement amplifier is adopted in the valve system to magnify the displacement generated from the piezostack actuator. After explaining the operating principle of the proposed piezostack-driven single-stage valve system, the geometric dimensions and mechanical properties of the valve components are discussed in details. An experimental apparatus is then manufactured to evaluate the performances of the valve system such as flow rate. The experimental apparatus consists of a heat chamber, which can regulate the temperature of the valve system and oil, pneumatic-hydraulic cylinders, a hydraulic circuit, a pneumatic circuit, electronic devices, an interface card, and a high voltage amplifier. The pneumatic-hydraulic cylinder transforms the pneumatic pressure into hydraulic pressure. The performances of the valve system regarding spool response, pressure drop, and flow rate are evaluated and presented. In addition, the performance of the valve system under high temperature condition is compared with that under room temperature condition. The experimental results are plotted in both frequency and time domains.

Performance evaluation of a piezoactuator-based single-stage valve system subjected to high temperature

International Nuclear Information System (INIS)

Jeon, Juncheol; Han, Chulhee; Ung Chung, Jye; Choi, Seung-Bok

2015-01-01

In this paper, a novel single-stage valve system activated by a piezostack actuator is proposed and experimentally evaluated at both room temperature (20 °C) and high temperature (100 °C) conditions. A hinge-lever displacement amplifier is adopted in the valve system to magnify the displacement generated from the piezostack actuator. After explaining the operating principle of the proposed piezostack-driven single-stage valve system, the geometric dimensions and mechanical properties of the valve components are discussed in details. An experimental apparatus is then manufactured to evaluate the performances of the valve system such as flow rate. The experimental apparatus consists of a heat chamber, which can regulate the temperature of the valve system and oil, pneumatic-hydraulic cylinders, a hydraulic circuit, a pneumatic circuit, electronic devices, an interface card, and a high voltage amplifier. The pneumatic-hydraulic cylinder transforms the pneumatic pressure into hydraulic pressure. The performances of the valve system regarding spool response, pressure drop, and flow rate are evaluated and presented. In addition, the performance of the valve system under high temperature condition is compared with that under room temperature condition. The experimental results are plotted in both frequency and time domains. (paper)

Two-Stage Battery Energy Storage System (BESS in AC Microgrids with Balanced State-of-Charge and Guaranteed Small-Signal Stability

Directory of Open Access Journals (Sweden)

Bing Xie

2018-02-01

Full Text Available In this paper, a two-stage battery energy storage system (BESS is implemented to enhance the operation condition of conventional battery storage systems in a microgrid. Particularly, the designed BESS is composed of two stages, i.e., Stage I: integration of dispersed energy storage units (ESUs using parallel DC/DC converters, and Stage II: aggregated ESUs in grid-connected operation. Different from a conventional BESS consisting of a battery management system (BMS and power conditioning system (PCS, the developed two-stage architecture enables additional operation and control flexibility in balancing the state-of-charge (SoC of each ESU and ensures the guaranteed small-signal stability, especially in extremely weak grid conditions. The above benefits are achieved by separating the control functions between the two stages. In Stage I, a localized power sharing scheme based on the SoC of each particular ESU is developed to manage the SoC and avoid over-charge or over-discharge issues; on the other hand, in Stage II, an additional virtual impedance loop is implemented in the grid-interactive DC/AC inverters to enhance the stability margin with multiple parallel-connected inverters integrating at the point of common coupling (PCC simultaneously. A simulation model based on MATLAB/Simulink is established, and simulation results verify the effectiveness of the proposed BESS architecture and the corresponding control diagram.

Dynamic solar-powered multi-stage direct contact membrane distillation system: Concept design, modeling and simulation

KAUST Repository

Lee, Jung Gil; Kim, Woo-Seung; Choi, June-Seok; Ghaffour, NorEddine; Kim, Young-Deuk

2017-01-01

This paper presents a theoretical analysis of the monthly average daily and hourly performances of a solar-powered multi-stage direct contact membrane distillation (SMDCMD) system with an energy recovery scheme and dynamic operating system. Mid

Seasonal thermal energy storage in shallow geothermal systems: thermal equilibrium stage

Directory of Open Access Journals (Sweden)

Nowamooz Hossein

2016-01-01

Full Text Available This paper is dedicated to the study of seasonal heat storage in shallow geothermal installations in unsaturated soils for which hydrothermal properties such as degree of saturation and thermal conductivity vary with time throughout the profile. In the model, a semi-analytical model which estimates time-spatial thermal conductivity is coupled with a 2D cylindrical heat transfer modeling using finite difference method. The variation of temperature was obtained after 3 heating and cooling cycles for the different types of loads with maximum thermal load of qmax = 15 W.m−1 with variable angular frequency (8 months of heating and 4 months of cooling.and constant angular frequency (6 months of heating and 6 months of cooling to estimate the necessary number of cycles to reach the thermal equilibrium stage. The results show that we approach a thermal equilibrium stage where the same variation of temperature can be observed in soils after several heating and cooling cycles. Based on these simulations, the necessary number of cycles can be related to the total applied energy on the system and the minimum number of cycles is for a system with the total applied energy of 1.9qmax.

New Safety Margins for Melanoma Surgery: Nice Possibility for Drinking of "Just That Cup of Coffee"?

Science.gov (United States)

Tchernev, Georgi; Chokoeva, Anastasiya Atanasova

2017-06-15

The American Joint Committee on Cancer (AJCC's) skin melanoma surgical treatment recommendations from 2011 are characterised by a prima facie "freedom of choice" regarding how extensive should be the excisions for melanomas with tumour thickness up to 2 mm and melanoma in situ. It is unclear why the recommended surgical security margins vary between 0.5 and 1 cm for melanoma in situ, whereas for melanomas with a tumour thickness of up to 1.99 mm, the range of variation is also between 1 and 2 cm, without specifying when the surgical field should be broader and, narrower, accordingly. This "uncertainty or lack of intent" of the guilders often leads to the same surgical approach to melanomas at different stages, or to a different approach in cases of melanomas at the same stage, in contrast. Therefore, this should be defined as wrong, logically. We present 3 patients with cutaneous melanomas, treated with similar fields of surgical security. Current issues, generated within the framework of melanoma's surgery guided by the recommendations of the AJCC are also discussed. A new surgical approach in patients with melanoma is recommended, discussed for the first time in world literature. We hypothesize that the introduction of a certain recommendations for a 2 cm surgical field in all directions during the initial excision, combined with the parallel performance of a sentinel lymph node biopsy, will lead in fact to several important advantages: 1) avoiding of the secondary excision in at least 70% - 90% of the patients (depending on the tumor thickness), 2) minimizing the risk of lymphatic effusion change and misinterpretation of the sentinel lymph node biopsy's results in patients with secondary excision; 3) optimization of the surgical team's work; 4) minimizing the possibility of unprepared/uninformed personnel to take part in decisions for treating a specific disease such as skin melanoma, 4) facilitating the appropriate patients' group selection at the appropriate

ABC transporters and xenobiotic defense systems in early life stages of rainbow trout (Oncorhynchus mykiss).

Science.gov (United States)

Kropf, Christian; Segner, Helmut; Fent, Karl

2016-01-01

Embryos of oviparous fish, in contrast to (ovo) viviparous species, develop in the aquatic environment, and therefore need solute transport systems at their body surfaces for maintaining internal homeostasis and defending against potentially harmful substances. We hypothesized that solute transporters undergo changes in tissue distribution from the embryo to the larval stage. We therefore studied the mRNA profiles of eight ABC transporters (abcb1a, abcb1b, abcc1, abcc2, abcc3, abcc4, abcc5, abcg2) and three solute carriers (oatp1d, putative oatp2 putative, mate1) in different body regions (head, yolk sac epithelium, abdominal viscera, skin/muscles) of developing rainbow trout. Additionally, we investigated mRNA levels of phase I (cyp1a, cyp3a) and phase II (gstp, putative ugt1, putative ugt2) biotransformation enzymes. The study covered the developmental period from the eleuthero-embryo stage to the first-feeding larval stage (1-20days post-hatch, dph). At 1dph, transcripts of abcc2, abcc4, abcg2, cyp3a, gstp, putative mate1, and putative oatp2 occurred primarily in the yolk sac epithelium, whereas at later stages expression of these genes was predominantly observed in the abdominal viscera. The functional activity of ABC transporters in fish early life stages was assessed by rhodamine B accumulation assays. Finally, we investigated the potential impact of xenobiotics (clotrimazole, clofibric acid) on the ABC and biotransformation systems of trout early life stages. While clofibric acid had no effect, clotrimazole lead to an increased rhodamine B accumulation. The results provide evidence that the transition from the eleuthero-embryo to the larval stage is accompanied by a major alteration in tissue expression of ABC transporters. Copyright © 2016 Elsevier Inc. All rights reserved.

Adaptive fuzzy trajectory control for biaxial motion stage system

Directory of Open Access Journals (Sweden)

Wei-Lung Mao

2016-04-01

Full Text Available Motion control is an essential part of industrial machinery and manufacturing systems. In this article, the adaptive fuzzy controller is proposed for precision trajectory tracking control in biaxial X-Y motion stage system. The theoretical analyses of direct fuzzy control which is insensitive to parameter uncertainties and external load disturbances are derived to demonstrate the feasibility to track the reference trajectories. The Lyapunov stability theorem has been used to testify the asymptotic stability of the whole system, and all the signals are bounded in the closed-loop system. The intelligent position controller combines the merits of the adaptive fuzzy control with robust characteristics and learning ability for periodic command tracking of a servo drive mechanism. The simulation and experimental results on square, triangle, star, and circle reference contours are presented to show that the proposed controller indeed accomplishes the better tracking performances with regard to model uncertainties. It is observed that the convergence of parameters and tracking errors can be faster and smaller compared with the conventional adaptive fuzzy control in terms of average tracking error and tracking error standard deviation.

Plasma gasification of refuse derived fuel in a single-stage system using different gasifying agents.

Science.gov (United States)

Agon, N; Hrabovský, M; Chumak, O; Hlína, M; Kopecký, V; Masláni, A; Bosmans, A; Helsen, L; Skoblja, S; Van Oost, G; Vierendeels, J

2016-01-01

The renewable evolution in the energy industry and the depletion of natural resources are putting pressure on the waste industry to shift towards flexible treatment technologies with efficient materials and/or energy recovery. In this context, a thermochemical conversion method of recent interest is plasma gasification, which is capable of producing syngas from a wide variety of waste streams. The produced syngas can be valorized for both energetic (heat and/or electricity) and chemical (ammonia, hydrogen or liquid hydrocarbons) end-purposes. This paper evaluates the performance of experiments on a single-stage plasma gasification system for the treatment of refuse-derived fuel (RDF) from excavated waste. A comparative analysis of the syngas characteristics and process yields was done for seven cases with different types of gasifying agents (CO2+O2, H2O, CO2+H2O and O2+H2O). The syngas compositions were compared to the thermodynamic equilibrium compositions and the performance of the single-stage plasma gasification of RDF was compared to that of similar experiments with biomass and to the performance of a two-stage plasma gasification process with RDF. The temperature range of the experiment was from 1400 to 1600 K and for all cases, a medium calorific value syngas was produced with lower heating values up to 10.9 MJ/Nm(3), low levels of tar, high levels of CO and H2 and which composition was in good agreement to the equilibrium composition. The carbon conversion efficiency ranged from 80% to 100% and maximum cold gas efficiency and mechanical gasification efficiency of respectively 56% and 95%, were registered. Overall, the treatment of RDF proved to be less performant than that of biomass in the same system. Compared to a two-stage plasma gasification system, the produced syngas from the single-stage reactor showed more favourable characteristics, while the recovery of the solid residue as a vitrified slag is an advantage of the two-stage set-up. Copyright �

System-Level Optimization of a DAC for Hearing-Aid Audio Class D Output Stage

DEFF Research Database (Denmark)

Pracný, Peter; Jørgensen, Ivan Harald Holger; Bruun, Erik

2013-01-01

This paper deals with system-level optimization of a digital-to-analog converter (DAC) for hearing-aid audio Class D output stage. We discuss the ΣΔ modulator system-level design parameters – the order, the oversampling ratio (OSR) and the number of bits in the quantizer. We show that combining...... by comparing two ΣΔ modulator designs. The proposed optimization has impact on the whole hearing-aid audio back-end system including less hardware in the interpolation filter and half the switching rate in the digital-pulse-width-modulation (DPWM) block and Class D output stage...... a reduction of the OSR with an increase of the order results in considerable power savings while the audio quality is kept. For further savings in the ΣΔ modulator, overdesign and subsequent coarse coefficient quantization are used. A figure of merit (FOM) is introduced to confirm this optimization approach...

Dynamic multi-stage dispatch of isolated wind–diesel power systems

International Nuclear Information System (INIS)

Hu, Yu; Morales, Juan M.; Pineda, Salvador; Sánchez, María Jesús; Solana, Pablo

2015-01-01

Highlights: • Optimal decision-making model for isolated hybrid wind–diesel power system is proposed. • Wind power uncertainty and conditional operating cost are considered. • Battery wear cost of the energy storage system is included in the model. • The results are compared with deterministic dispatch strategies. - Abstract: An optimal dispatch strategy is crucial for an isolated wind–diesel power system to save diesel fuel and maintain the system stability. The uncertainty associated with the stochastic character of the wind is, though, a challenging problem for this optimization. In this paper, a dynamic multi-stage decision-making model is proposed to determine the diesel power output that minimizes the cost of running and maintaining the wind–diesel power system. Optimized operational decisions for each time period are generated dynamically considering the path-dependent nature of the optimal dispatch policy, given the plausible future realizations of the wind power production. A numerical case study is analyzed and it is demonstrated that the proposed stochastic dynamic optimization model significantly outperforms the traditional deterministic dispatch strategies

Peritumoral eosinophils predict recurrence in colorectal cancer.

Science.gov (United States)

Harbaum, Lars; Pollheimer, Marion J; Kornprat, Peter; Lindtner, Richard A; Bokemeyer, Carsten; Langner, Cord

2015-03-01

In colorectal cancer, the presence and extent of eosinophil granulocyte infiltration may render important prognostic information. However, it remains unclear whether an increasing number of eosinophils might simply be linked to the overall inflammatory cell reaction or represent a self-contained, antitumoral mechanism that needs to be documented and promoted therapeutically. Peri- and intratumoral eosinophil counts were retrospectively assessed in 381 primary colorectal cancers from randomly selected patients. Tumors were diagnosed in American Joint Committee on Cancer (AJCC)/Union Internationale Contre le Cancer (UICC) stage I in 21%, stage II in 32%, stage III in 33%, and stage IV in 14%. Presence and extent of eosinophils was related to various histopathological parameters as well as patients' outcome. Overall, peri- and intratumoral eosinophils were observed in 86 and 75% cancer specimens. The peritumoral eosinophil count correlated strongly with the intratumoral eosinophil count (R=0.69; Peosinophil counts were significantly associated with lower T and N classification, better tumor differentiation, absence of vascular invasion, as well as improved progression-free and cancer-specific survival. However, only peritumoral eosinophils, but not intratumoral, were an independent prognosticator of favorable progression-free (hazard ratio 0.75; 95% confidence interval 0.58-0.98; P=0.04) and cancer-specific survival (hazard ratio 0.7; 95% confidence interval 0.52-0.93; P=0.01)-independent of the intensity of overall inflammatory cell reaction. This was also found for patients with AJCC/UICC stage II disease, wherein the presence of peritumoral eosinophils was significantly associated with favorable outcome. In conclusion, the number of peritumoral eosinophils had a significant favorable impact on prognosis of colorectal cancer patients independent of the overall tumor-associated inflammatory response. Evaluation of peritumoral eosinophils represents a promising

A translating stage system for µ-PIV measurements surrounding the tip of a migrating semi-infinite bubble.

Science.gov (United States)

Smith, B J; Yamaguchi, E; Gaver, D P

2010-01-01

We have designed, fabricated and evaluated a novel translating stage system (TSS) that augments a conventional micro particle image velocimetry (µ-PIV) system. The TSS has been used to enhance the ability to measure flow fields surrounding the tip of a migrating semi-infinite bubble in a glass capillary tube under both steady and pulsatile reopening conditions. With conventional µ-PIV systems, observations near the bubble tip are challenging because the forward progress of the bubble rapidly sweeps the air-liquid interface across the microscopic field of view. The translating stage mechanically cancels the mean bubble tip velocity, keeping the interface within the microscope field of view and providing a tenfold increase in data collection efficiency compared to fixed-stage techniques. This dramatic improvement allows nearly continuous observation of the flow field over long propagation distances. A large (136-frame) ensemble-averaged velocity field recorded with the TSS near the tip of a steadily migrating bubble is shown to compare well with fixed-stage results under identical flow conditions. Use of the TSS allows the ensemble-averaged measurement of pulsatile bubble propagation flow fields, which would be practically impossible using conventional fixed-stage techniques. We demonstrate our ability to analyze these time-dependent two-phase flows using the ensemble-averaged flow field at four points in the oscillatory cycle.

Quantitative Resilience Assessment under a Tri-Stage Framework for Power Systems

Directory of Open Access Journals (Sweden)

Han Zhang

2018-06-01

Full Text Available The frequent occurrence of natural disasters and malicious attacks has exerted unprecedented disturbances on power systems, accounting for the extensive attention paid to power system resilience. Combined with the evolving nature of general disasters, this paper proposes resilience assessment approaches for power systems under a tri-stage framework. The pre-disaster toughness is proposed to quantify the robustness of power systems against potential disasters, where the thinking of area division and partitioned multi-objective risk method (PMRM is introduced. In the case of information deficiency caused by disasters, the during-disaster resistance to disturbance is calculated to reflect the real-time system running state by state estimation (SE. The post-disaster restoration ability consists of response ability, restoration efficiency and restoration economy, which is evaluated by Sequential Monte-Carlo Simulation to simulate the system restoration process. Further, a synthetic metric system is presented to quantify the resilience performance of power systems from the above three aspects. The proposed approaches and framework are validated on the IEEE RTS 79 system, and helpful conclusions are drawn from extensive case studies.

Prognosis and therapy for ruptured hepatocellular carcinoma: Problems with staging and treatment strategy

Energy Technology Data Exchange (ETDEWEB)

Hiraoka, Atsushi, E-mail: hirage@m.ehime-u.ac.jp [Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime 790-0024 (Japan); Kawamura, Tomoe; Aibiki, Toshihiko; Okudaira, Tomonari; Toshimori, Akiko; Yamago, Hiroka; Nakahara, Hiromasa; Suga, Yoshifumi; Azemoto, Nobuaki; Miyata, Hideki; Miyamoto, Yasunao; Ninomiya, Tomoyuki [Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime 790-0024 (Japan); Murakami, Tadashi; Ishimaru, Yoshihiro [Department of Radiology, Ehime Prefectural Central Hospital (Japan); Kawasaki, Hideki [Department of Surgery, Ehime Prefectural Central Hospital (Japan); Hirooka, Masashi; Abe, Masanori; Matsuura, Bunzo; Hiasa, Yoichi [Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime (Japan); Michitaka, Kojiro [Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime 790-0024 (Japan)

2015-03-15

Highlights: •Although a patient with a ruptured HCC is generally considered to have a poor prognosis and treated as T4 in the 7th edition of the AJCC/UICC, some ruptured cases show a good clinical course. •There are no clear criteria established for treating a ruptured hepatocellular carcinoma (HCC) which is classified as T4 in TNM stage of UICC 7th. •This article describes that better prognosis can be expected with curative treatment in patients with a ruptured HCC, especially those with a single tumor, and without decompensated liver cirrhosis and PVTT/extrahepatic metastasis. T4 classification should not include all types of ruptured HCC. -- Abstract: Background: There are no clear criteria established for treating a ruptured hepatocellular carcinoma (HCC). To elucidate the clinical features of affected patients, we examined prognosis and therapy choices. Materials/methods: We enrolled 67 patients treated for a ruptured HCC (HCV 44, HBV 5, HBV + HCV 1, alcohol 2, others 15; naïve HCC 34, recurrent 33) from 2000 to 2013, and investigated their clinical background and prognosis. Results: Median survival time (MST) for all cases was 4 months. For patients who survived for more than 1 year after rupture, the percentages of Child-Pugh C and positive for portal vein tumor thrombosis (PVTT)/extrahepatic metastasis were less than for those who died within 1 year. Child-Pugh classification (A:B:C = 14:15:5 vs. 4:9:20, P < 0.001) was better, while the percentage of patients with multiple tumors was lower [19/34 (55.9%) vs. 29/33 (87.9%), respectively; P < 0.001] in the naïve group. The 1- and 3-year survival rates were better in the naïve as compared to the recurrent group (60.6% and 33.3% vs. 12.6% and 0%, respectively; P < 0.01). MST according to modified TNM stage (UICC 7th) calculated after exclusion of T4 factor of rupture, stage I was better than others (22.7 vs. (II) 2.2, (III) 1.2, and (IV) 0.7 months) (P = 0.010). Conclusion: In patients with a ruptured

76 FR 18930 - Medicare Programs: Changes to the End-Stage Renal Disease Prospective Payment System Transition...

Science.gov (United States)

2011-04-06

... Payment System Transition Budget-Neutrality Adjustment AGENCY: Centers for Medicare & Medicaid Services... in the CY 2011 ESRD Prospective Payment System (PPS) final rule for renal dialysis services provided...-Stage Renal Disease Prospective Payment System'', hereinafter, referred to as the CY 2011 ESRD PPS final...

The use of adjuvant radiotherapy in elderly patients with early-stage breast cancer: changes in practice patterns after publication of Cancer and Leukemia Group B 9343.

Science.gov (United States)

Palta, Manisha; Palta, Priya; Bhavsar, Nrupen A; Horton, Janet K; Blitzblau, Rachel C

2015-01-15

The Cancer and Leukemia Group B (CALGB) 9343 randomized phase 3 trial established lumpectomy and adjuvant therapy with tamoxifen alone, rather than both radiotherapy and tamoxifen, as a reasonable treatment course for women aged >70 years with clinical stage I (AJCC 7th edition), estrogen receptor-positive breast cancer. An analysis of the Surveillance, Epidemiology, and End Results (SEER) registry was undertaken to assess practice patterns before and after the publication of this landmark study. The SEER database from 2000 to 2009 was used to identify 40,583 women aged ≥70 years who were treated with breast-conserving surgery for clinical stage I, estrogen receptor-positive and/or progesterone receptor-positive breast cancer. The percentage of patients receiving radiotherapy and the type of radiotherapy delivered was assessed over time. Administration of radiotherapy was further assessed across age groups; SEER cohort; and tumor size, grade, and laterality. Approximately 68.6% of patients treated between 2000 and 2004 compared with 61.7% of patients who were treated between 2005 and 2009 received some form of adjuvant radiotherapy (P < .001). Coinciding with a decline in the use of external beam radiotherapy, there was an increase in the use of implant radiotherapy from 1.4% between 2000 and 2004 to 6.2% between 2005 to 2009 (P < .001). There were significant reductions in the frequency of radiotherapy delivery over time across age groups, tumor size, and tumor grade and regardless of laterality (P < .001 for all). Randomized phase 3 data support the omission of adjuvant radiotherapy in elderly women with early-stage breast cancer. Analysis of practice patterns before and after the publication of these data indicates a significant decline in radiotherapy use; however, nearly two-thirds of women continue to receive adjuvant radiotherapy. © 2014 American Cancer Society.

Risk Stratification in Differentiated Thyroid Cancer: An Ongoing Process

Directory of Open Access Journals (Sweden)

Gal Omry-Orbach

2016-01-01

Full Text Available Thyroid cancer is an increasingly common malignancy, with a rapidly rising prevalence worldwide. The social and economic ramifications of the increase in thyroid cancer are multiple. Though mortality from thyroid cancer is low, and most patients will do well, the risk of recurrence is not insignificant, up to 30%. Therefore, it is important to accurately identify those patients who are more or less likely to be burdened by their disease over years and tailor their treatment plan accordingly. The goal of risk stratification is to do just that. The risk stratification process generally starts postoperatively with histopathologic staging, based on the AJCC/UICC staging system as well as others designed to predict mortality. These do not, however, accurately assess the risk of recurrence/persistence. Patients initially considered to be at high risk may ultimately do very well yet be burdened by frequent unnecessary monitoring. Conversely, patients initially thought to be low risk, may not respond to their initial treatment as expected and, if left unmonitored, may have higher morbidity. The concept of risk-adaptive management has been adopted, with an understanding that risk stratification for differentiated thyroid cancer is dynamic and ongoing. A multitude of variables not included in AJCC/UICC staging are used initially to classify patients as low, intermediate, or high risk for recurrence. Over the course of time, a response-to-therapy variable is incorporated, and patients essentially undergo continuous risk stratification. Additional tools such as biochemical markers, genetic mutations, and molecular markers have been added to this complex risk stratification process such that this is essentially a continuum of risk. In recent years, additional considerations have been discussed with a suggestion of pre-operative risk stratification based on certain clinical and/or biologic characteristics. With the increasing prevalence of thyroid cancer but

Validation of the CPS+EG and Neo-Bioscore staging systems after preoperative systemic therapy for breast cancer in a single center in China.

Science.gov (United States)

Xu, Ling; Duan, Xuening; Zhou, Bin; Liu, Yinhua; Ye, Jingming; Liu, Zhaorui; Ma, Chao; Zhang, Hong; Zhang, Shuang; Zhang, Lanbo; Zhao, Jianxin; Cheng, Yuanjia

2018-04-17

Prognostic assessment after preoperative systemic therapy (PST) plays a vital role in determining treatment in breast cancer patients. Many researchers have sought to develop a system to quantitate residual tumor and its correlation with prognosis after PST. This retrospective study validated the CPS + EG staging system and Neo-Bioscore in a single center in China. Data from patients with non-metastatic primary breast cancer who were treated with PST and surgery from Jan. 2008 to Dec. 2014 at the Breast Disease Center of Peking University First Hospital, China, were reviewed. DFS, DSS and OS were calculated using the K-M curve and AUC. Multivariate analysis was used for a Cox proportional hazards model. All calculations were performed with SAS 9.4. A total of 403 patients were enrolled in this study. The median follow-up period was 45 (range 11-107) months. The five-year DFS, DSS and OS rates were 86.4%, 91.2% and 90.5%, respectively. The CS, PS, CPS + EG staging system and Neo-Bioscore stratified patients according to DFS, DSS, and OS after PST, with all P values < 0.0001. The CPS + EG staging system and Neo-Bioscore stratified prognosis after PST better than CS. HER2-positive patients without trastuzumab treatment had obviously worse DFS and OS than other subgroups with different HER2 statuses that scored a 3 in the Neo-Bioscore system. The CPS + EG staging system and Neo-Bioscore can improve prognostic prediction in non-pCR breast cancer patients after PST and, provided unfavorable prognostic factors such as insufficient treatment are incorporated, will have broader clinical applicability. Copyright © 2018 Elsevier Ltd. All rights reserved.

Edmonton obesity staging system among pediatric patients: a validation and obesogenic risk factor analysis.

Science.gov (United States)

Grammatikopoulou, M G; Chourdakis, M; Gkiouras, K; Roumeli, P; Poulimeneas, D; Apostolidou, E; Chountalas, I; Tirodimos, I; Filippou, O; Papadakou-Lagogianni, S; Dardavessis, T

2018-01-08

The Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a useful tool, delineating different obesity severity tiers associated with distinct treatment barriers. The aim of the study was to apply the EOSS-P on a Greek pediatric cohort and assess risk factors associated with each stage, compared to normal weight controls. A total of 361 children (2-14 years old), outpatients of an Athenian hospital, participated in this case-control study by forming two groups: the obese (n = 203) and the normoweight controls (n = 158). Anthropometry, blood pressure, blood and biochemical markers, comorbidities and obesogenic lifestyle parameters were recorded and the EOSS-P was applied. Validation of EOSS-P stages was conducted by juxtaposing them with IOTF-defined weight status. Obesogenic risk factors' analysis was conducted by constructing gender-and-age-adjusted (GA) and multivariate logistic models. The majority of obese children were stratified at stage 1 (46.0%), 17.0% were on stage 0, and 37.0% on stage 2. The validation analysis revealed that EOSS-P stages greater than 0 were associated with diastolic blood pressure and levels of glucose, cholesterol, LDL and ALT. Reduced obesity odds were observed among children playing outdoors and increased odds for every screen time hour, both in the GA and in the multivariate analyses (all P  2 times/week was associated with reduced obesity odds in the GA analysis (OR = 0.57, 95% CI = 0.33-0.98, P linear = 0.047), it lost its significance in the multivariate analysis (P linear = 0.145). Analogous results were recorded in the analyses of the abovementioned physical activity risk factors for the EOSS-P stages. Linear relationships were observed for fast-food consumption and IOTF-defined obesity and higher than 0 EOSS-P stages. Parental obesity status was associated with all EOSS-P stages and IOTF-defined obesity status. Few outpatients were healthy obese (stage 0), while the majority exhibited several comorbidities

Grating exchange system of independent mirror supported by floating rotary stage

Science.gov (United States)

Zhang, Jianhuan; Tao, Jin; Liu, Yan; Nan, Yan

2015-10-01

The performance of The Grating Exchange System can satisfy the Thirty Meter Telescope - TMT for astronomical observation WFOS index requirements and satisfy the requirement of accuracy in the grating exchange. It is used to install in the MOBIE and a key device of MOBIE. The Wide Field Optical Spectrograph (WFOS) is one of the three first-light observing capabilities selected by the TMT Science Advisory Committee. The Multi-Object Broadband Imaging Echellette (MOBIE) instrument design concept has been developed to address the WFOS requirements as described in the TMT Science-Based Requirements Document (SRD). The Grating Exchange System uses a new type of separate movement way of three grating devices and a mirror device. Three grating devices with a mirror are able to achieve independence movement. This kind of grating exchange system can effectively solve the problem that the volume of the grating change system is too large and that the installed space of MOBIE instruments is too limit. This system adopts the good stability, high precision of rotary stage - a kind of using air bearing (Air bearing is famous for its ultra-high precision, and can meet the optical accuracy requirement) and rotation positioning feedback gauge turntable to support grating device. And with a kind of device which can carry greater weight bracket fixed on the MOBIE instrument, with two sets of servo motor control rotary stage and the mirror device respectively. And we use the control program to realize the need of exercising of the grating device and the mirror device. Using the stress strain analysis software--SolidWorks for stress and strain analysis of this structure. And then checking the structure of the rationality and feasibility. And prove that this system can realize the positioning precision under different working conditions can meet the requirements of imaging optical grating diffraction efficiency and error by the calculation and optical performance analysis.

Design of decoupled dual servo stage with voice coil motor and linear motor for XY long stroke ultra-precision scanning system

Science.gov (United States)

Kim, Ki-Hyun; Choi, Young-Man; Gweon, Dae-Gab; Hong, Dong-Pyo; Kim, Koung-Suk; Lee, Suk-Won; Lee, Moon-Gu

2005-12-01

A decoupled dual servo (DDS) stage for ultra-precision scanning system is introduced in this paper. The proposed DDS consists of a 3 axis fine stage for handling and carrying workpieces and a XY coarse stage. Especially, the DDS uses three voice coil motors (VCM) as a planar actuation system of the fine stage to reduce the disturbances due to any mechanical connections with its coarse stage. VCMs are governed by Lorentz law. According to the law and its structure, there are no mechanical connections between coils and magnetic circuits. Moreover, the VCM doesn't have force ripples due to imperfections of commutation components of linear motor systems - currents and flux densities. However, due to the VCM's mechanical constraints the working range of the fine is about 5mm2. To break that hurdle, the coarse stage with linear motors is used for the fine stage to move about 200mm2. Because of the above reasons, the proposed DDS can achieve higher precision scanning than other stages with only one servo. Using MATLAB's Sequential Quadratic Programming (SQP), the VCMs are optimally designed for the highest force under conditions and constraints such as thermal dissipations due to its coil, its size, and so on. For linear motors, Halbach magnet linear motor is proposed and optimally designed in this paper. In addition, for their smooth movements without any frictions, guide systems of the DDS are composed of air bearings. And then, precisely to get their positions, linear scales with 0.1um resolution are used for the coarse's XY motions and plane mirror laser interferometers with 20nm for the fine's XYθz. On scanning, the two stages have same trajectories and are controlled. The control algorithm is Parallel method. The embodied ultra-precision scanning system has about 100nm tracking error and in-positioning stability.

A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages.

Science.gov (United States)

Hegde, Gautham; Hegde, Nanditha; Kumar, Anil; Keshavaraj

2014-07-01

Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.

Stage measurement at gaging stations

Science.gov (United States)

Sauer, Vernon B.; Turnipseed, D. Phil

2010-01-01

Stream and reservoir stage are critical parameters in the computation of stream discharge and reservoir volume, respectively. In addition, a record of stream stage is useful in the design of structures that may be affected by stream elevation, as well as for the planning for various uses of flood plains. This report describes equipment and methodology for the observation, sensing, and recording of stage in streams and reservoirs. Although the U.S. Geological Survey (USGS) still uses the traditional, basic stilling-well float system as a predominant gaging station, modern electronic stage sensors and water-level recorders are now commonly used. Bubble gages coupled with nonsubmersible pressure transducers eliminate the need for stilling wells. Submersible pressure transducers have become common in use for the measurement of stage in both rivers and lakes. Furthermore, noncontact methods, such as radar, acoustic, and laser methods of sensing water levels, are being developed and tested, and in the case of radar, are commonly used for the measurement of stage. This report describes commonly used gaging-station structures, as well as the design and operation of gaging stations. Almost all of the equipment and instruments described in this report will meet the accuracy standard set by the USGS Office of Surface Water (OSW) for the measurement of stage for most applications, which is ±0.01 foot (ft) or 0.2 percent of the effective stage. Several telemetry systems are used to transmit stage data from the gaging station to the office, although satellite telemetry has become the standard. These telemetry systems provide near real-time stage data, as well as other information that alerts the hydrographer to extreme or abnormal events, and instrument malfunctions.

Vibration characteristics of two-stage planetary transmission system with thin-walled ring gear on elastic supports

Science.gov (United States)

Li, JianYing; Hu, QingChun; Zong, ChangFu; Zhu, TianJun; Zhang, ZeXing

2018-03-01

A dual-clutch and dual-speed planetary gears mechanism of a hybrid car coupled-system is taken as research subject, in which the ring gear of planet set II is a thin-walled structure and the clutch friction plates of planet set II are used as its elastic supports. Based on the lumped parameter-rigid elastic coupled dynamic model of two-stage planetary transmission system with thin-walled ring gear on elastic supports, the motion differential equations are established and the dynamic responses are solved by the Runge-Kutta method considering each stage internal and external time-varying mesh stiffness. The vibration displacements of each stage ring gear have been affected differently in time-domain, the translational vibration displacement of the ring gear of planet set I are obviously more than the torsional vibration displacement, but it is opposite for the ring gear of planet set II; The translational and torsional vibration responses of each stage ring gear arrive the peak in low-frequency. The analysis results of this paper can enrich the theoretical research of multistage planetary transmission and provide guidance for dynamic design.

A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages

Directory of Open Access Journals (Sweden)

Gautham Hegde

2014-01-01

Full Text Available Objective: Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Materials and Methods: A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian′s stages of dental calcification and the modified MP3 stages. Results and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.

A two-stage approach for multi-objective decision making with applications to system reliability optimization

International Nuclear Information System (INIS)

Li Zhaojun; Liao Haitao; Coit, David W.

2009-01-01

This paper proposes a two-stage approach for solving multi-objective system reliability optimization problems. In this approach, a Pareto optimal solution set is initially identified at the first stage by applying a multiple objective evolutionary algorithm (MOEA). Quite often there are a large number of Pareto optimal solutions, and it is difficult, if not impossible, to effectively choose the representative solutions for the overall problem. To overcome this challenge, an integrated multiple objective selection optimization (MOSO) method is utilized at the second stage. Specifically, a self-organizing map (SOM), with the capability of preserving the topology of the data, is applied first to classify those Pareto optimal solutions into several clusters with similar properties. Then, within each cluster, the data envelopment analysis (DEA) is performed, by comparing the relative efficiency of those solutions, to determine the final representative solutions for the overall problem. Through this sequential solution identification and pruning process, the final recommended solutions to the multi-objective system reliability optimization problem can be easily determined in a more systematic and meaningful way.

Design and modelling of an innovative three-stage thermal storage system for direct steam generation CSP plants

Science.gov (United States)

Garcia, Pierre; Vuillerme, Valéry; Olcese, Marco; El Mourchid, Nadim

2016-05-01

Thermal Energy Storage systems (TES) for a Direct Steam Generation (DSG) solar plant feature preferably three stages in series including a latent heat storage module so that steam can be recovered with a limited temperature loss. The storage system designed within the Alsolen Sup project is characterized by an innovative combination of sensible and latent modules. A dynamic model of this three-stage storage has been developed and applied to size the storage system of the Alsolen Sup® plant demonstrator at CEA Cadarache. Results of this simulation show that this promising concept is an efficient way to store heat in DSG solar plants.

DNA repair systems and the pathogenesis of Mycobacterium tuberculosis: varying activities at different stages of infection.

Science.gov (United States)

Gorna, Alina E; Bowater, Richard P; Dziadek, Jaroslaw

2010-05-25

Mycobacteria, including most of all MTB (Mycobacterium tuberculosis), cause pathogenic infections in humans and, during the infectious process, are exposed to a range of environmental insults, including the host's immune response. From the moment MTB is exhaled by infected individuals, through an active and latent phase in the body of the new host, until the time they reach the reactivation stage, MTB is exposed to many types of DNA-damaging agents. Like all cellular organisms, MTB has efficient DNA repair systems, and these are believed to play essential roles in mycobacterial pathogenesis. As different stages of infection have great variation in the conditions in which mycobacteria reside, it is possible that different repair systems are essential for progression to specific phases of infection. MTB possesses homologues of DNA repair systems that are found widely in other species of bacteria, such as nucleotide excision repair, base excision repair and repair by homologous recombination. MTB also possesses a system for non-homologous end-joining of DNA breaks, which appears to be widespread in prokaryotes, although its presence is sporadic within different species within a genus. However, MTB does not possess homologues of the typical mismatch repair system that is found in most bacteria. Recent studies have demonstrated that DNA repair genes are expressed differentially at each stage of infection. In the present review, we focus on different DNA repair systems from mycobacteria and identify questions that remain in our understanding of how these systems have an impact upon the infection processes of these important pathogens.

Two-Stage Series-Resonant Inverter

Science.gov (United States)

Stuart, Thomas A.

1994-01-01

Two-stage inverter includes variable-frequency, voltage-regulating first stage and fixed-frequency second stage. Lightweight circuit provides regulated power and is invulnerable to output short circuits. Does not require large capacitor across ac bus, like parallel resonant designs. Particularly suitable for use in ac-power-distribution system of aircraft.

A Sensorless Power Reserve Control Strategy for Two-Stage Grid-Connected PV Systems

OpenAIRE

Sangwongwanich, Ariya; Yang, Yongheng; Blaabjerg, Frede

2017-01-01

Due to the still increasing penetration of grid-connected Photovoltaic (PV) systems, advanced active power control functionalities have been introduced in grid regulations. A power reserve control, where namely the active power from the PV panels is reserved during operation, is required for grid support. In this paper, a cost-effective solution to realize the power reserve for two-stage grid-connected PV systems is proposed. The proposed solution routinely employs a Maximum Power Point Track...

Morphogenesis of the rhea (Rhea americana respiratory system in different embryonic and foetal stages

Directory of Open Access Journals (Sweden)

Renata P. Sousa

Full Text Available ABSTRACT: The rhea (Rhea americana is an important wild species that has been highlighted in national and international livestock. This research aims to analyse embryo-foetal development in different phases of the respiratory system of rheas. Twenty-three embryos and foetuses were euthanized, fixed and dissected. Fragments of the respiratory system, including the nasal cavity, larynx, trachea, syrinx, bronchi and lungs, were collected and processed for studies using light and scanning electron microscopy. The nasal cavity presented cubic epithelium in the early stages of development. The larynx exhibited typical respiratory epithelium between 27 and 31 days. The trachea showed early formation of hyaline cartilage after 15 days. Syrinx in the mucous membrane of 18-day foetuses consisted of ciliated epithelium in the bronchial region. The main bronchi had ciliated epithelium with goblet cells in the syringeal region. In the lung, the parabronchial stage presented numerous parabronchi between 15 and 21 days. This study allowed the identification of normal events that occur during the development of the rhea respiratory system, an important model that has not previously been described. The information generated here will be useful for the diagnosis of pathologies that affect this organic system, aimed at improving captive production systems.

THE EVALUATION SYSTEM OF DESIGN SOLUTIONS FOR RESIDENTIAL PROPERTY ON THE PRE-INVESTMENT STAGE THROUGH NEURAL NETWORK TECHNOLOGY

Directory of Open Access Journals (Sweden)

G. D. Kostsikava

2016-01-01

Full Text Available Ever since the Soviet Union design solutions were evaluated according to different criteria and indicators. At the present stage of evaluation systems of design solutions stands systemengineering doctrine is allocated. It is complemented by the theory of efficiency and financial sustainability investment project in view of the general market concept. Also great attention is paid to the virtual object modeling. It is urgent to include the behavior prediction of an investment construction project model at each stage of its life cycle. The high cost of all phases of this life cycle makes it necessary to calculate the feasibility of the investment. Very urgent to do it as accurately as possible and before we start of design works on the stage of the investment plan evaluation. Belarus has legislated pre-investment stage of construction project development. To evaluate the design solution at this stage is necessary to develop an investment justification, a project management plan and a business plan. They will evaluate and will compare several options for future objects by the complex. This requires not only time, but considerable financial costs. In order to optimize the process to develop an evaluation system design solutions based on existing projects. It allows the customer (investor choose design solutions to build the object without developing of pre-design documentations for several options. This system it is advisable to try out the example of apartment house building with the assistance of the national fund of project documentation and objects-analogues data bank. The developed evaluation system of design solutions for residential real estate objects in the pre-investment stage is supposed to use the theory of neural networks and neyroprogramming. This system bases on the input parameters projects. The hidden layer neurons are trained to choose suitable projects of apartment houses with their classification. The projects will be classified

Frequent hemodialysis with NxStage system in pediatric patients receiving maintenance hemodialysis.

Science.gov (United States)

Goldstein, Stuart L; Silverstein, Douglas M; Leung, Jocelyn C; Feig, Daniel I; Soletsky, Beth; Knight, Cathy; Warady, Bradley A

2008-01-01

Recent evidence from adult hemodialysis (HD) patient studies reveal improved biochemical control and reported health-related quality of life after transition from conventional thrice weekly to daily home maintenance HD treatment. Published pediatric frequent dialysis experiences demonstrate similar improvement but all used conventional HD machines, which employ a treated municipal water supply, thereby frequently exposing patients to proinflammatory components. We report our pediatric experience with six-times-weekly HD using the NxStage system, which uses sterile dialysis fluid to provide dialysis in the home or center setting. Four patients (weight range 38-61.4 kg) completed the 16-week study. Patients exhibited progressive reductions in casual pretreatment systolic and diastolic blood pressures, discontinuation of antihypertensive medications, and decreased blood pressure load by ambulatory blood pressure monitoring. Mean serum phosphorus improved without change in phosphorus binder medication, and all three patients with a normalized protein catabolic rate 1.1 g/kg per day. Patients reported no adverse effects. Variable changes in proinflammatory cytokine levels were observed. We suggest that frequent HD with the NxStage system be considered for children who would benefit from home-based maintenance dialysis.

Lot-sizing for a single-stage single-product production system with rework of perishable production defectives

NARCIS (Netherlands)

Teunter, R.; Flapper, S.D.P.

2003-01-01

We consider a single-stage single-product production system. Produced units may be non-defective, reworkable defective, or non-reworkable defective. The system switches between production and rework. After producing a fixed number (N) of units, all reworkable defective units are reworked. Reworkable

Influence of Shaft Torsional Stiffness on Dynamic Response of Four-Stage Main Transmission System

Directory of Open Access Journals (Sweden)

Yuan Chen

2018-01-01

Full Text Available Dynamic response analysis has potential for increasing fatigue life of the components in the transmission of a multistage main transmission system. The calculated data can demonstrate the influence of shaft torsional stiffness on dynamic characteristics of the system. Detecting key shafts of the system and analyzing their sensitivity are important for the design of four-stage helicopter gear box. Lumped mass method is applied for dynamic modeling and Fourier method is used to solve differential equation of the system. Results of the analysis indicate that key shafts can be designed carefully to improve the performance of the transmission system.

Two-stage single-phase grid-connected photovoltaic system with reduced complexity

Science.gov (United States)

da Silva, Cintia S.; Motta, Filipe R.; Tofoli, Fernando L.

2011-06-01

This article presents a grid-connected photovoltaic (PV) system using the classical DC-DC buck converter, which is responsible for stepping down the resulting voltage from several series-connected panels. Besides, the structure provides high power factor operation by injecting a quasi-sinusoidal current into the grid, with near no displacement in relation to the line voltage at the point of common coupling among the PV system and the loads. A CSI employing thyristors is cascaded with the DC-DC stage so that AC voltage results. The inverter output voltage level is adjusted by using a low-frequency transformer, which also provides galvanic isolation. The proposed system is described as mathematical approach and design guidelines are presented, providing an overview of the topology. An experimental prototype is also implemented, and relevant results to validate the proposal are discussed.

Method for simulating predictive control of building systems operation in the early stages of building design

DEFF Research Database (Denmark)

Petersen, Steffen; Svendsen, Svend

2011-01-01

A method for simulating predictive control of building systems operation in the early stages of building design is presented. The method uses building simulation based on weather forecasts to predict whether there is a future heating or cooling requirement. This information enables the thermal...... control systems of the building to respond proactively to keep the operational temperature within the thermal comfort range with the minimum use of energy. The method is implemented in an existing building simulation tool designed to inform decisions in the early stages of building design through...... parametric analysis. This enables building designers to predict the performance of the method and include it as a part of the solution space. The method furthermore facilitates the task of configuring appropriate building systems control schemes in the tool, and it eliminates time consuming manual...

Predicting prognosis in hepatocellular carcinoma; comparison of staging system in pakistani cohort

International Nuclear Information System (INIS)

Sarwar, S.; Khan, A.A.

2015-01-01

To determine the clinical, biochemical and radiological prognostic indicators and to compare the performance of six staging systems in patients of hepatocellular carcinoma (HCC). Study Design:Descriptive study. Place and Duration of Study: Department of Gastroenterology, Doctors Hospital, Lahore, from October 2007 to December 2013. Methodology:Patients with HCC were included. Baseline clinical, hematological and radiological variables were noted. Patients were followed for 5 years or till death. Survival predictors were identified using Cox proportional hazard analysis and 6 prognostic staging systems were evaluated by determining homogeneity, discriminatory ability and monotonicity. Results: Of the 228 patients included, male to female ratio was 2.6/1 (165/63) and mean age was 56.5 ± 10.4 years. Majority of patients 189 (82.9%) were anti-HCV positive. Solitary HCC lesion was seen in 121 (53.1%) patients, 16 (7%) had 2 lesions while 73 (32%) had 3 or more lesions. Only 36 (15.8%) patients had palliative therapy for HCC. Survival rate was 45.2%, 25%, 12.3%, 7%, 2.2% and 1% for 6 months, 1, 2, 3, 4 and 5 years respectively. Male gender, portal vein thrombosis, serum albumin < 3.5 g/dl, tumor size =6 cm and alpha fetoprotein (AFP) =147 U/ml were bad prognostic indicators. OKUDA, GRETCH and early stages of CLIP had better homogeneity while CLIP showed superior discriminatory ability and monotonicity for predicting survival. Conclusion: Male gender, presence of portal vein thrombosis, low serum albumin, large tumor size and high AFP level are poor prognostic indicators in patients of HCC. CLIP has better performance in predicting mortality. (author)

Experimental investigation of two-stage thermoelectric generator system integrated with phase change materials

DEFF Research Database (Denmark)

Ahmadi Atouei, Saeed; Ranjbar, Ali Akbar; Rezaniakolaei, Alireza

2017-01-01

this amount of voltage just for 2100 s. Therefore, the proposed design makes TEG systems more suitable for wireless sensor applications when the heat source does not provide steady thermal energy. In this study, four different patterns of thermal power applied to the TTEG system are considered. These patterns...... experimentally. In the first stage, a TEG module installed between a phase change material (PCM) heat sink, as cooling system, and an electrical heater, as the heat source. Because of the inherent characteristics of PCMs to save the thermal energy as latent heat, the PCM heat sink is used as the heat source...

Stage-by-Stage and Parallel Flow Path Compressor Modeling for a Variable Cycle Engine

Science.gov (United States)

Kopasakis, George; Connolly, Joseph W.; Cheng, Larry

2015-01-01

This paper covers the development of stage-by-stage and parallel flow path compressor modeling approaches for a Variable Cycle Engine. The stage-by-stage compressor modeling approach is an extension of a technique for lumped volume dynamics and performance characteristic modeling. It was developed to improve the accuracy of axial compressor dynamics over lumped volume dynamics modeling. The stage-by-stage compressor model presented here is formulated into a parallel flow path model that includes both axial and rotational dynamics. This is done to enable the study of compressor and propulsion system dynamic performance under flow distortion conditions. The approaches utilized here are generic and should be applicable for the modeling of any axial flow compressor design.

A Two-Stage Queue Model to Optimize Layout of Urban Drainage System considering Extreme Rainstorms

OpenAIRE

He, Xinhua; Hu, Wenfa

2017-01-01

Extreme rainstorm is a main factor to cause urban floods when urban drainage system cannot discharge stormwater successfully. This paper investigates distribution feature of rainstorms and draining process of urban drainage systems and uses a two-stage single-counter queue method M/M/1→M/D/1 to model urban drainage system. The model emphasizes randomness of extreme rainstorms, fuzziness of draining process, and construction and operation cost of drainage system. Its two objectives are total c...

Bioremediation of storage tank bottom sludge by using a two-stage composting system: Effect of mixing ratio and nutrients addition.

Science.gov (United States)

Koolivand, Ali; Rajaei, Mohammad Sadegh; Ghanadzadeh, Mohammad Javad; Saeedi, Reza; Abtahi, Hamid; Godini, Kazem

2017-07-01

The effect of mixing ratio and nutrients addition on the efficiency of a two-stage composting system in removal of total petroleum hydrocarbons (TPH) from storage tank bottom sludge (STBS) was investigated. The system consisted of ten windrow piles as primary composting (PC) followed by four in-vessel reactors as secondary composting (SC). Various initial C/N/P and mixing ratios of STBS to immature compost (IC) were examined in the PC and SC for 12 and 6weeks, respectively. The removal rates of TPH in the two-stage system (93.72-95.24%) were higher than those in the single-stage one. Depending on the experiments, TPH biodegradation fitted to the first- and second-order kinetics with the rate constants of 0.051-0.334d -1 and 0.002-0.165gkg -1 d -1 , respectively. The bacteria identified were Pseudomonas sp., Bacillus sp., Klebsiella sp., Staphylococcus sp., and Proteus sp. The study verified that a two-stage composting system is effective in treating the STBS. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comorbidity, age, race and stage at diagnosis in colorectal cancer: a retrospective, parallel analysis of two health systems

Directory of Open Access Journals (Sweden)

Rowe Krista L

2008-11-01

earlier stage of CRC diagnosis. Multiple factors, perhaps including increased interactions with the healthcare system due to comorbidity, might contribute to this finding. Such increased interactions are seen among patients within a healthcare system like the VA system in the US versus sporadic interactions which may be seen with FFS healthcare.

Design of nonimaging concentrators as second stages in tandem with image-forming first-stage concentrators

Science.gov (United States)

Winston, R.; Welford, W. T.

1980-02-01

The paper discusses the paraboloidal mirror as a tracking solar concentrator, fitting a nonimaging second stage to the paraboloidal mirror, other image-forming systems as first stages, and tracking systems in two-dimensional geometry. Because of inherent aberrations, the paraboloidal mirror cannot achieve the thermodynamic limit. It is shown how paraboloidal mirrors of short focal ratio and similar systems can have their flux concentration enhanced to near the thermodynamic limit by the addition of nonimaging compound elliptical concentrators.

Design of nonimaging concentrators as second stages in tandem with image-forming first-stage concentrators

Science.gov (United States)

Winston, R.; Welford, W. T.

1980-01-01

The paper discusses the paraboloidal mirror as a tracking solar concentrator, fitting a nonimaging second stage to the paraboloidal mirror, other image-forming systems as first stages, and tracking systems in two-dimensional geometry. Because of inherent aberrations, the paraboloidal mirror cannot achieve the thermodynamic limit. It is shown how paraboloidal mirrors of short focal ratio and similar systems can have their flux concentration enhanced to near the thermodynamic limit by the addition of nonimaging compound elliptical concentrators.

America's Next Great Ship: Space Launch System Core Stage Transitioning from Design to Manufacturing

Science.gov (United States)

Birkenstock, Benjamin; Kauer, Roy

2014-01-01

The Space Launch System (SLS) Program is essential to achieving the Nation's and NASA's goal of human exploration and scientific investigation of the solar system. As a multi-element program with emphasis on safety, affordability, and sustainability, SLS is becoming America's next great ship of exploration. The SLS Core Stage includes avionics, main propulsion system, pressure vessels, thrust vector control, and structures. Boeing manufactures and assembles the SLS core stage at the Michoud Assembly Facility (MAF) in New Orleans, LA, a historical production center for Saturn V and Space Shuttle programs. As the transition from design to manufacturing progresses, the importance of a well-executed manufacturing, assembly, and operation (MA&O) plan is crucial to meeting performance objectives. Boeing employs classic techniques such as critical path analysis and facility requirements definition as well as innovative approaches such as Constraint Based Scheduling (CBS) and Cirtical Chain Project Management (CCPM) theory to provide a comprehensive suite of project management tools to manage the health of the baseline plan on both a macro (overall project) and micro level (factory areas). These tools coordinate data from multiple business systems and provide a robust network to support Material & Capacity Requirements Planning (MRP/CRP) and priorities. Coupled with these tools and a highly skilled workforce, Boeing is orchestrating the parallel buildup of five major sub assemblies throughout the factory. Boeing and NASA are transforming MAF to host state of the art processes, equipment and tooling, the most prominent of which is the Vertical Assembly Center (VAC), the largest weld tool in the world. In concert, a global supply chain is delivering a range of structural elements and component parts necessary to enable an on-time delivery of the integrated Core Stage. SLS is on plan to launch humanity into the next phase of space exploration.

Multifunctional Solar Systems Based On Two-Stage Regeneration Absorbent Solution

Directory of Open Access Journals (Sweden)

Doroshenko A.V.

2015-04-01

Full Text Available The concepts of multifunctional dehumidification solar systems, heat supply, cooling, and air conditioning based on the open absorption cycle with direct absorbent regeneration developed. The solar systems based on preliminary drainage of current of air and subsequent evaporated cooling. The solar system using evaporative coolers both types (direct and indirect. The principle of two-stage regeneration of absorbent used in the solar systems, it used as the basis of liquid and gas-liquid solar collectors. The main principle solutions are designed for the new generation of gas-liquid solar collectors. Analysis of the heat losses in the gas-liquid solar collectors, due to the mechanism of convection and radiation is made. Optimal cost of gas and liquid, as well as the basic dimensions and configuration of the working channel of the solar collector identified. Heat and mass transfer devices, belonging to the evaporative cooling system based on the interaction between the film and the gas stream and the liquid therein. Multichannel structure of the polymeric materials used to create the tip. Evaporative coolers of water and air both types (direct and indirect are used in the cooling of the solar systems. Preliminary analysis of the possibilities of multifunctional solar absorption systems made reference to problems of cooling media and air conditioning on the basis of experimental data the authors. Designed solar systems feature low power consumption and environmental friendliness.

A predator-prey system with stage-structure for predator and nonlocal delay

DEFF Research Database (Denmark)

Lin, Z.G.; Pedersen, Michael; Zhang, Lai

2010-01-01

This paper deals with the behavior of solutions to the reaction-diffusion system under homogeneous Neumann boundary condition, which describes a prey-predator model with nonlocal delay. Sufficient conditions for the global stability of each equilibrium are derived by the Lyapunov functional...... and the results show that the introduction of stage-structure into predator positively affects the coexistence of prey and predator. Numerical simulations are performed to illustrate the results....

Setting safety stocks in multi-stage inventory systems under rolling horizon mathematical programming models

NARCIS (Netherlands)

Boulaksil, Y.; Fransoo, J.C.; van Halm, E.N.G.

2009-01-01

This paper considers the problem of determining safety stocks in multi-item multi-stage inventory systems that face demand uncertainties. Safety stocks are necessary to make the supply chain, which is driven by forecasts of customer orders, responsive to (demand) uncertainties and to achieve

Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy

International Nuclear Information System (INIS)

Min, Sun Young; Lee, Seung Ju; Shin, Kyung Hwan; Park, In Hae; Jung, So-Youn; Lee, Keun Seok; Ro, Jungsil; Lee, Seeyoun; Kim, Seok Won; Kim, Tae Hyun; Kang, Han-Sung; Cho, Kwan Ho

2011-01-01

Purpose: Breast conservation surgery (BCS) and radiotherapy (RT) following neoadjuvant chemotherapy (NCT) have been linked with high locoregional recurrence (LRR) rates and ipsilateral breast tumor recurrence (IBTR) rates. The purpose of this study was to analyze clinical outcomes in patients who exhibited LRR and IBTR after being treated by BCS and RT following NCT. Methods and Materials: In total, 251 breast cancer patients treated with BCS and RT following NCT between 2001 and 2006 were included. All patients had been shown to be clinically node-positive. Clinical stage at diagnosis (2003 AJCC) was II in 68% of patients and III in 32% of patients. Of those, 50%, 35%, and 15% of patients received anthracycline-based, taxane-based, and combined anthracycline-taxane NCT, respectively. All patients received RT. Results: During follow-up (median, 55 months), 26 (10%) patients had LRR, 19 of these patients had IBTR. Five-year actuarial rates of IBTR-free and LRR-free survival were 91% and 89%, respectively. In multivariate analyses, lack of hormone suppression therapy was found to increase both LRR and IBTR rates. Hazard ratios were 7.99 (p < 0.0001) and 4.22 (p = 0.004), respectively. Additionally, pathology stage N2 to N3 increased LRR rate (hazard ratio, 4.22; p = 0.004), and clinical AJCC stage III IBTR rate (hazard ratio, 9.05; p = 0.034). Achievement of pathological complete response and presence of multifocal tumors did not affect LRR or IBTR. Conclusions: In patients with locally advanced disease, who were clinically node-positive at presentation, BCS after NCT resulted in acceptably low rates of IBTR and LRR. Mastectomy should be considered as an option in patients who present with clinical stage III tumors or who are not treated with adjuvant hormone suppression therapy, because they exhibit high IBTR rates after NCT and BCS.

Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Min, Sun Young [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Surgery, Kyung Hee University, Seoul (Korea, Republic of); Lee, Seung Ju [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Park, In Hae; Jung, So-Youn; Lee, Keun Seok; Ro, Jungsil; Lee, Seeyoun; Kim, Seok Won [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kim, Tae Hyun [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kang, Han-Sung [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Cho, Kwan Ho [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

2011-12-01

Purpose: Breast conservation surgery (BCS) and radiotherapy (RT) following neoadjuvant chemotherapy (NCT) have been linked with high locoregional recurrence (LRR) rates and ipsilateral breast tumor recurrence (IBTR) rates. The purpose of this study was to analyze clinical outcomes in patients who exhibited LRR and IBTR after being treated by BCS and RT following NCT. Methods and Materials: In total, 251 breast cancer patients treated with BCS and RT following NCT between 2001 and 2006 were included. All patients had been shown to be clinically node-positive. Clinical stage at diagnosis (2003 AJCC) was II in 68% of patients and III in 32% of patients. Of those, 50%, 35%, and 15% of patients received anthracycline-based, taxane-based, and combined anthracycline-taxane NCT, respectively. All patients received RT. Results: During follow-up (median, 55 months), 26 (10%) patients had LRR, 19 of these patients had IBTR. Five-year actuarial rates of IBTR-free and LRR-free survival were 91% and 89%, respectively. In multivariate analyses, lack of hormone suppression therapy was found to increase both LRR and IBTR rates. Hazard ratios were 7.99 (p < 0.0001) and 4.22 (p = 0.004), respectively. Additionally, pathology stage N2 to N3 increased LRR rate (hazard ratio, 4.22; p = 0.004), and clinical AJCC stage III IBTR rate (hazard ratio, 9.05; p = 0.034). Achievement of pathological complete response and presence of multifocal tumors did not affect LRR or IBTR. Conclusions: In patients with locally advanced disease, who were clinically node-positive at presentation, BCS after NCT resulted in acceptably low rates of IBTR and LRR. Mastectomy should be considered as an option in patients who present with clinical stage III tumors or who are not treated with adjuvant hormone suppression therapy, because they exhibit high IBTR rates after NCT and BCS.

Role of [{sup 18}F]FDG PET in prediction of KRAS and EGFR mutation status in patients with advanced non-small-cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Caicedo, Carlos; Garcia-Velloso, Maria Jose; Vigil Diaz, Carmen; Richter Echevarria, Jose Angel [University of Navarra, Nuclear Medicine Department, University Clinic of Navarra, Pamplona (Spain); Lozano, Maria Dolores; Labiano, Tania [University of Navarra, Pathology Department, University Clinic of Navarra, Pamplona (Spain); Lopez-Picazo, Jose Maria; Gurpide, Alfonso; Perez Gracia, Jose Luis [University of Navarra, Oncology Department, University Clinic of Navarra, Pamplona (Spain); Zulueta, Javier [University of Navarra, Pulmonology Department, University Clinic of Navarra, Pamplona (Spain)

2014-11-15

The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [{sup 18}F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC. Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [{sup 18}F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [{sup 18}F]FDG PET/CT for predicting KRAS mutation. From 102 patients staged using [{sup 18}F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [{sup 18}F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p < 0.001). No significant differences were observed in [{sup 18}F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p < 0.001). The multivariate analysis showed a sensitivity and specificity of 78.6 % and 62.2 %, respectively, and the AUC was 0.773. NSCLC patients with tumours harbouring KRAS mutations showed significantly higher [{sup 18}F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC. (orig.)

Identification and Fibrosis Staging of Hepatitis C Patients Using the Electronic Medical Record System.

Science.gov (United States)

Anand, Vijay; Hyun, Christian; Khan, Qasim M; Hall, Curtis; Hessefort, Norbert; Sonnenberg, Amnon; Fimmel, Claus J

2016-09-01

The aim of this study was to noninvasively assess the severity of chronic hepatitis C virus (HCV) in large patient populations. It would be helpful if fibrosis scores could be calculated solely on the basis of data contained in the patients' electronic medical records (EMR). We performed a pilot study to identify all HCV-infected patients in a large health care system, and predict their fibrosis stage on the basis of demographic and laboratory data using common data from their EMR. HCV-infected patients were identified using the EMR. The liver biopsies of 191 HCV patients were graded using the Ishak and Metavir scoring systems. Demographic and laboratory data were extracted from the EMR and used to calculate the aminotransferase to platelet ratio index, Fib-4, Fibrosis Index, Forns, Göteborg University Cirrhosis Index, Lok Index, and Vira-HepC. In total, 869 HCV-infected patients were identified from a population of over 1 million. In the subgroup of patients with liver biopsies, all 7 algorithms were significantly correlated with the fibrosis stage. The degree of correlation was moderate, with correlation coefficients ranging from 0.22 to 0.60. For the detection of advanced fibrosis (Metavir 3 or 4), the areas under the receiver operating characteristic curve ranged from 0.71 to 0.84, with no significant differences between the individual scores. Sensitivities, specificities, and positive and negative predictive values were within the previously reported range. All scores tended to perform better for higher fibrosis stages. Our study demonstrates that HCV-infected patients can be identified and their fibrosis staged using commonly available EMR-based algorithms.

Illumination uniformity issue explored via two-stage solar concentrator system based on Fresnel lens and compound flat concentrator

International Nuclear Information System (INIS)

Yeh, Naichia

2016-01-01

This paper illustrates details about the solar radiation distribution on the target of a two-stage solar concentrator that combines the Fresnel lens (FL) and the compound flat concentrator (CFC). The paper starts with a review of some FL development milestones such as the two-stage systems and the comparisons of flat vs. curved lenses in addition to the most noteworthy FL-based solar energy application, concentration photovoltaic (CPV). Through the review of the FL based CPV and two-stage concentrators, this study leads to the development of an algorithm to explore the spectrum distribution insight on the receiver of a two-stage (FL plus CFC) solar concentration system. It established the potential for using a correctly positioned 2nd stage reflector of right dimension to selectively redirect the desired spectrum on the target area so as to enhance the concentration flux intensity and uniformity at the same time. The study also helped to chart out the approximate locations of certain spectrum segments on the FL's target area, which is useful for exploring the spectrum control mechanism via the Fresnel lenses. - Highlights: • Map out the approximate locations of spectrum segments on FL's focal area. • Use the 2nd stage reflector to selectively reflect the desired spectrum on target. • Explore the spectrum distribution insight on FL solar concentrators' target area.

Optimal design of distributed energy resource systems based on two-stage stochastic programming

International Nuclear Information System (INIS)

Yang, Yun; Zhang, Shijie; Xiao, Yunhan

2017-01-01

Highlights: • A two-stage stochastic programming model is built to design DER systems under uncertainties. • Uncertain energy demands have a significant effect on the optimal design. • Uncertain energy prices and renewable energy intensity have little effect on the optimal design. • The economy is overestimated if the system is designed without considering the uncertainties. • The uncertainty in energy prices has the significant and greatest effect on the economy. - Abstract: Multiple uncertainties exist in the optimal design of distributed energy resource (DER) systems. The expected energy, economic, and environmental benefits may not be achieved and a deficit in energy supply may occur if the uncertainties are not handled properly. This study focuses on the optimal design of DER systems with consideration of the uncertainties. A two-stage stochastic programming model is built in consideration of the discreteness of equipment capacities, equipment partial load operation and output bounds as well as of the influence of ambient temperature on gas turbine performance. The stochastic model is then transformed into its deterministic equivalent and solved. For an illustrative example, the model is applied to a hospital in Lianyungang, China. Comparative studies are performed to evaluate the effect of the uncertainties in load demands, energy prices, and renewable energy intensity separately and simultaneously on the system’s economy and optimal design. Results show that the uncertainties in load demands have a significant effect on the optimal system design, whereas the uncertainties in energy prices and renewable energy intensity have almost no effect. Results regarding economy show that it is obviously overestimated if the system is designed without considering the uncertainties.

A theoretical analysis of price elasticity of energy demand in multi-stage energy conversion systems

International Nuclear Information System (INIS)

Lowe, Robert

2003-01-01

The objective of this paper is an analytical exploration of the problem of price elasticity of energy demand in multi-stage energy conversion systems. The paper describes in some detail an analytical model of energy demand in such systems. Under a clearly stated set of assumptions, the model makes it possible to explore both the impacts of the number of sub-systems, and of varying sub-system elasticities on overall system elasticity. The analysis suggests that overall price elasticity of energy demand for such systems will tend asymptotically to unity as the number of sub-systems increases

A four stage approach for ontology-based health information system design.

Science.gov (United States)

Kuziemsky, Craig E; Lau, Francis

2010-11-01

To describe and illustrate a four stage methodological approach to capture user knowledge in a biomedical domain area, use that knowledge to design an ontology, and then implement and evaluate the ontology as a health information system (HIS). A hybrid participatory design-grounded theory (GT-PD) method was used to obtain data and code them for ontology development. Prototyping was used to implement the ontology as a computer-based tool. Usability testing evaluated the computer-based tool. An empirically derived domain ontology and set of three problem-solving approaches were developed as a formalized model of the concepts and categories from the GT coding. The ontology and problem-solving approaches were used to design and implement a HIS that tested favorably in usability testing. The four stage approach illustrated in this paper is useful for designing and implementing an ontology as the basis for a HIS. The approach extends existing ontology development methodologies by providing an empirical basis for theory incorporated into ontology design. Copyright © 2010 Elsevier B.V. All rights reserved.

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Science.gov (United States)

2010-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... § 413.210 Conditions for payment under the end-stage renal disease (ESRD) prospective payment system... prospective payment system described in § 413.215 through § 413.235 of this part. (a) Qualifications for...

Experimental study on two-stage compression refrigeration/heat pump system with dual-cylinder rolling piston compressor

International Nuclear Information System (INIS)

Shuxue, Xu; Guoyuan, Ma

2014-01-01

A thermodynamically analytical model on the two-stage compression refrigeration/heat pump system with vapor injection was derived. The optimal volume ratio of the high-pressure cylinder to the low-pressure one has been discussed under both cooling and heating conditions. Based on the above research, the prototype was developed and its experimental setup established. A comprehensive experiments for the prototype have been conducted, and the results show that, compared with the single-stage compression heat pump system, the cooling capacity and cooling COP can increase 5%–15% and 10–12%, respectively. Also, the heating capacity with the evaporating temperature ranging from 0.3 to 3 °C is 92–95% of that under the rate condition with the evaporating temperature of 7 °C, and 58% when the evaporation temperature is between −28 °C and −24 °C. -- Highlights: • The volume ratio of the compressor is between 0.65 and 0.78 and the relative vapor injection mass ranges from 15% to 20%. • The cooling capacity and COP of the two-stage compression system can improve 5%–15% and 10%–12%. • The heating capacity can also be improved under low temperature condition

Integrated Circuit Design of 3 Electrode Sensing System Using Two-Stage Operational Amplifier

Science.gov (United States)

Rani, S.; Abdullah, W. F. H.; Zain, Z. M.; N, Aqmar N. Z.

2018-03-01

This paper presents the design of a two-stage operational amplifier(op amp) for 3-electrode sensing system readout circuits. The designs have been simulated using 0.13μm CMOS technology from Silterra (Malaysia) with Mentor graphics tools. The purpose of this projects is mainly to design a miniature interfacing circuit to detect the redox reaction in the form of current using standard analog modules. The potentiostat consists of several op amps combined together in order to analyse the signal coming from the 3-electrode sensing system. This op amp design will be used in potentiostat circuit device and to analyse the functionality for each module of the system.

Many-Objective Particle Swarm Optimization Using Two-Stage Strategy and Parallel Cell Coordinate System.

Science.gov (United States)

Hu, Wang; Yen, Gary G; Luo, Guangchun

2017-06-01

It is a daunting challenge to balance the convergence and diversity of an approximate Pareto front in a many-objective optimization evolutionary algorithm. A novel algorithm, named many-objective particle swarm optimization with the two-stage strategy and parallel cell coordinate system (PCCS), is proposed in this paper to improve the comprehensive performance in terms of the convergence and diversity. In the proposed two-stage strategy, the convergence and diversity are separately emphasized at different stages by a single-objective optimizer and a many-objective optimizer, respectively. A PCCS is exploited to manage the diversity, such as maintaining a diverse archive, identifying the dominance resistant solutions, and selecting the diversified solutions. In addition, a leader group is used for selecting the global best solutions to balance the exploitation and exploration of a population. The experimental results illustrate that the proposed algorithm outperforms six chosen state-of-the-art designs in terms of the inverted generational distance and hypervolume over the DTLZ test suite.

The interrater and intrarater reliability of the Philpott-Javer staging system based on level of training.

Science.gov (United States)

Parhar, Harman S; Thamboo, Andrew; Habib, Al-Rahim; Chang, Brent; Gan, Eng Cern; Javer, Amin R

2014-04-01

The Philpott-Javer postoperative endoscopic mucosal staging system for allergic fungal rhinosinusitis has previously demonstrated acceptable interrater reliability among rhinologists. There are, however, numerous learners involved in patient care at tertiary centers. This study aims to analyze the interrater and intrarater reliability of this system among learners in otolaryngology at different stages in training. A prospective analysis of retrospectively collected endoscopic photographs. A tertiary care teaching hospital (January 2013). Fifty patients undergoing routine follow-up. Three photographs from each of 50 patients undergoing routine postsurgical nasoendoscopy were reviewed. Images were played twice, 1 week apart, in 2 differently randomized cycles and scored according to Philpott-Javer criteria by a rhinologist, a rhinology fellow, a senior otolaryngology resident, a junior otolaryngology resident, and a medical student. Interobserver reliability was assessed using the intraclass correlation coefficient, while intrarater reliability was assessed by Shrout-Fleiss κ values. Agreement between each learner and the rhinologist was also assessed using κ values. The interclass correlation among the 5 raters was 0.7600 (95% confidence interval, 0.6917-0.8161) for the Philpott-Javer scoring system, suggesting substantial reliability. Intrarater data showed substantial to almost-perfect reliability (κ values between 0.668 and 0.815) among all raters using this system. There was also moderate to substantial agreement between the learners and the rhinologist (κ values between 0.534 and 0.710). Results suggest that the Philpott-Javer staging system has acceptable intrarater and interrater reliability among learners of differing levels of clinical experience and is suitable for evaluating progress following surgery.

Treatment Trends for Stage I Testicular Seminoma in an Equal-Access Medical System.

Science.gov (United States)

Wingate, Jonathan T; Etzioni, Ruth; Macdonald, Dusten M; Brand, Timothy C

2016-10-01

The practice patterns for adjuvant therapies for stage I seminoma are rapidly evolving, and surveillance is currently preferred. How these recommendations have affected contemporary practice in an equal-access US population is unknown. A total of 436 men diagnosed with clinical stage IA-IB seminoma from 2001 to 2011 were identified in the Automated Central Tumor Registry (ACTUR). The ACTUR is the cancer registry system for the Department of Defense. Logistic regression models analyzed the association between patient characteristics and adjuvant therapy. Overall and recurrence-free survival were determined from Kaplan-Meier analysis. The use of adjuvant radiotherapy in this population decreased significantly from 2001 to 2011. In 2001, 83.9% of patients received radiotherapy compared with only 24.0% in 2011. During that period, a concomitant increase occurred in the use of chemotherapy from 0% to 38.0%. A later year of diagnosis was significantly associated with a greater rate of receiving chemotherapy relative to radiotherapy (P associated with the receipt of surveillance (P = .412 for 2006-2011 vs. 2001-2005; odds ratio, 0.83; 95% CI, 0.54-1.29). Black race or age was not significantly associated with adjuvant therapy. With a median follow-up period of 4.7 years, the 5-year overall and recurrence-free survival rates were 98.0% and 77.0%, respectively. The use of adjuvant radiotherapy has been replaced by chemotherapy for clinical stage I testicular seminoma in an equal-access system. The lack of an increase in active surveillance in our cohort might represent overtreatment of the population. Published by Elsevier Inc.

A two-stage predictive model to simultaneous control of trihalomethanes in water treatment plants and distribution systems: adaptability to treatment processes.

Science.gov (United States)

Domínguez-Tello, Antonio; Arias-Borrego, Ana; García-Barrera, Tamara; Gómez-Ariza, José Luis

2017-10-01

The trihalomethanes (TTHMs) and others disinfection by-products (DBPs) are formed in drinking water by the reaction of chlorine with organic precursors contained in the source water, in two consecutive and linked stages, that starts at the treatment plant and continues in second stage along the distribution system (DS) by reaction of residual chlorine with organic precursors not removed. Following this approach, this study aimed at developing a two-stage empirical model for predicting the formation of TTHMs in the water treatment plant and subsequently their evolution along the water distribution system (WDS). The aim of the two-stage model was to improve the predictive capability for a wide range of scenarios of water treatments and distribution systems. The two-stage model was developed using multiple regression analysis from a database (January 2007 to July 2012) using three different treatment processes (conventional and advanced) in the water supply system of Aljaraque area (southwest of Spain). Then, the new model was validated using a recent database from the same water supply system (January 2011 to May 2015). The validation results indicated no significant difference in the predictive and observed values of TTHM (R 2 0.874, analytical variance distribution systems studied, proving the adaptability of the new model to the boundary conditions. Finally the predictive capability of the new model was compared with 17 other models selected from the literature, showing satisfactory results prediction and excellent adaptability to treatment processes.

The role of adjuvant chemotherapy in nasopharyngeal carcinoma with bulky neck lymph nodes in the era of IMRT.

Science.gov (United States)

Xu, Tingting; Shen, Chunying; Ou, Xiaomin; He, Xiayun; Ying, Hongmei; Hu, Chaosu

2016-04-12

Nasopharyngeal carcinoma (NPC) patients with N2-3 diseases are prone to develop distant metastasis even treated with standard concurrent chemoradiotherapy (CCRT). Our study is aim to determine the optimal treatment strategy of these patients. Patients with histologically proven NPC were retrospectively analyzed according to the AJCC 2002 stage classification system. A total of 547 patients who had N2-3 diseases were enrolled. They were all treated with Intensity-modulated radiation therapy (IMRT) combined with systemic treatments, including radiotherapy alone (RT alone), neoadjuvant chemotherapy followed by radiotherapy (NACT+RT), CCRT, NACT+CCRT, NACT followed by radiotherapy and adjuvant chemotherapy (NACT+RT+AC), CCRT+AC and NACT+CCRT+AC. A subgroup analysis was also conducted. With a median follow-up time of 53.8 months, adjuvant chemotherapy significantly decreased the risk of distant metastasis (HR 0.413, 95% CI 0.194-0.881, p = 0.022) as well as significantly increased the OS (HR 0.398, 95% CI 0.187-0.848, p = 0.017) in patients with N3 disease. The addition of adjuvant chemotherapy seemed to provide benefits to patients with N3 stage NPC and the current study may indicate the need for further randomized investigation.

Evaluation of the prognostic value of Okuda, Cancer of the Liver Italian Program, and Japan Integrated Staging systems for hepatocellular carcinoma patients undergoing radiotherapy

International Nuclear Information System (INIS)

Seong, Jinsil; Shim, Su Jung; Lee, Ik Jae; Han, Kwang Hyub; Chon, Chae Yoon; Ahn, Sang Hoon

2007-01-01

Purpose: The purpose of this study was to compare the validity of staging systems, as well as to identify the staging system with the best prognostic value, in hepatocellular carcinoma (HCC) patients treated with radiotherapy. Methods and Materials: From 1992 to 2003, a total of 305 patients undergoing radiotherapy for HCC were evaluated retrospectively. All patients were classified before radiation therapy by the following systems: tumor-node-metastasis (TNM), Okuda, Cancer of the Liver Italian Program (CLIP), and Japan Integrated Staging (JIS) score. Cumulative survival rates were obtained using the Kaplan-Meier method, and were statistically compared using the log-rank test. Results: Median survival time was 11 months. The 1-, 2-, 3-, 4-, and 5-year survival rates were 45.1%, 24.5%, 14.7%, 10.3%, and 6.4%, respectively. Significant differences in survival were observed between all TNM stages, between CLIP scores 2, 3 and 5, 6, as well as between JIS scores 1, 2, and 2, 3. Conclusions: Among the systems studied, the TNM staging approach appeared to be the best predictor of prognosis. Staging systems that reflect liver disease status (Okuda stage, CLIP, and JIS score) showed limitations in stratifying patients undergoing radiotherapy into different prognostic groups

Optimal dynamic performance for high-precision actuators/stages

International Nuclear Information System (INIS)

Preissner, C.; Lee, S.-H.; Royston, T. J.; Shu, D.

2002-01-01

System dynamic performance of actuator/stage groups, such as those found in optical instrument positioning systems and other high-precision applications, is dependent upon both individual component behavior and the system configuration. Experimental modal analysis techniques were implemented to determine the six degree of freedom stiffnesses and damping for individual actuator components. These experimental data were then used in a multibody dynamic computer model to investigate the effect of stage group configuration. Running the computer model through the possible stage configurations and observing the predicted vibratory response determined the optimal stage group configuration. Configuration optimization can be performed for any group of stages, provided there is stiffness and damping data available for the constituent pieces

Preventive measures of water hammer in the design stage of mine drainage system

International Nuclear Information System (INIS)

Wu Dongyan

2012-01-01

The mechanisms and types of water hammer accident in mine drainage system are introduced. Through calculating water hammer pressure head of pump-failure water hammer, the extent of the harm caused by water hammer can be displayed visually, therefore,the preventive measures to be taken in the design stage are put forward in order to reduce water hammer accident. (author)

Silicon concentrator cells in a two-stage photovoltaic system with a concentration factor of 300x

Energy Technology Data Exchange (ETDEWEB)

Mohr, A.

2005-06-15

In this work a rear contacted silicon concentrator cell was developed for an application in a two stage concentrator photovoltaic system. This system was developed at Fraunhofer ISE some years ago. The innovation of this one-axis tracked system is that it enables a high geometrical concentration of 300x in combination with a high optical efficiency (around 78%) and a large acceptance angle of {+-}23.5 all year through. For this, the system uses a parabolic mirror (40.4x) and a three dimensional second stage consisting of compound parabolic concentrators (CPCs, 7.7x). For the concentrator concept and particularly for an easy cell integration, the rear line contacted concentrator (RLCC) cells with a maximum efficiency of 25% were developed and a hybrid mounting concept for the RLCC cells is presented. The optical performance of different CPC materials was tested and analysed in this work. Finally, small modules consisting of six series interconnected RLCC cells and six CPCs were integrated into the concentrator system and tested outdoor. A system efficiency of 16.2% was reached at around 800 W/m2 direct irradiance under realistic outdoor conditions. (orig.)

Disturbance estimation and compensation for planar motors on the long-stroke stage of a wafer stage

Directory of Open Access Journals (Sweden)

Bizhong Xia

2015-04-01

Full Text Available This article presents a data-based method to estimate and compensate low-frequency disturbance in planar motors on the long-stroke stage of a wafer stage, which is a typical multiple-input multiple-output system. First, a data-based method is introduced to decouple the multiple-input multiple-output system into multi-single-input single-output system, which is crucial for the design of controller and the correction of disturbance estimation in the scanning direction. Second, dominant low-frequency disturbances in the long-stroke stage are analyzed. Third, estimation and compensation method under moving condition is proposed. The compensation method is based on three feedforward tables, and the tables are indexed by trajectory parameters, including velocity and position instead of time in the iterative learning control method. Finally, experiments are performed on the long-stroke stage of a wafer stage to verify the proposed method. Experimental results show that the proposed method can effectively improve the servo performance by reducing the tracking errors by nearly 1/2 in the forward direction and 1/3 in the backward direction and lowering error difference between the forward and backward directions from 5.1 to 1.2 µm.

Assessment of capabilities in persons with advanced stage of dementia: Validation of The Montessori Assessment System (MAS).

Science.gov (United States)

Erkes, Jérôme; Camp, Cameron J; Raffard, Stéphane; Gély-Nargeot And, Marie-Christine; Bayard, Sophie

2017-01-01

This study evaluated the validity and reliability of the Montessori Assessment System. The Montessori Assessment System assesses preserved abilities in persons with moderate to severe dementia. In this respect, this instrument provides crucial information for the development of effective person-centered care plans. A total of 196 persons with a diagnosis of dementia in the moderate to severe stages of dementia were recruited in 10 long-term care facilities in France. All participants completed the Montessori Assessment System, the Clinical Dementia Rating Scale and/or the Mini Mental State Examination and the Severe Impairment Battery-short form. The internal consistency and temporal stability of the Montessori Assessment System were high. Additionally, good construct and divergent validity were demonstrated. Factor analysis showed a one-factor structure. The Montessori Assessment System demonstrated satisfactory psychometric properties while being a useful instrument to assess capabilities in persons with advanced stages of dementia and hence to develop person-centered plans of care.

Proposal for the construction of the staged Scyllac prototype

International Nuclear Information System (INIS)

Nunnally, W.C.; McDonald, T.E.

1975-07-01

After the completion of the present feedback experiment on Scyllac, the machine will be reconfigured into a toroidal staged theta pinch. A 0.9-m prototype of the Staged Scyllac experiment is proposed which will be used to test the components required for the implosion-heating and staging circuits in a system environment. In addition, various systems of the Staged Scyllac, such as the trigger system and the gap-monitoring system, can be developed on the prototype before installation on the full experiment. (auth)

Evaluation on prognosis of esophageal squamous cell carcinoma patients after three-dimensional conformal radiotherapy with different clinical stage system

International Nuclear Information System (INIS)

Wang Yuxiang; Zhu Shuchai; Qiu Rong; Liu Zhikun; Shen Wenbin

2011-01-01

Objective: To evaluate the prognostic significance of 3 clinical stage system in 3-dimensional conformal radiotherapy (3DCRT) for esophageal squamous cell carcinoma. Methods: From January 2004 to August 2007, 179 cases of esophageal squamous cell carcinoma were treated with 3DCRT. Before radiation, each patient was staged with UICC 2003 TNM stage, stage of Chinese esophageal cancer cooperation group (cooperation group' stage), and Zhu's clinical stage respectively. Concordance of each clinical stage and prognosis was analyzed with SPSS 11.5. Results In 179 cases of esophageal cancer, Concordance was better in T stage (Kappa = 0.271) than in TNM stage (Kappa = 0.167) between cooperation group' stage and Zhu's stage. Among them, 98 cases was staged with UICC stage, concordance of T stage was better between UICC-T and cooperation group' T stage (Kappa =0.261) than between UICCT and Zhu's T stage (Kappa = 0.045) ;concordance of TNM stage was better between UICC-TNM and Zhu's TNM stage (Kappa = 0.597) than between UICC-TNM and cooperation group' TNM stage (Kappa =0.299). With multivariate analysis, T (χ 2 value is 11.58, 26.00 and 51.05, all P 2 value is 15.28, 16.10 and 16.10, all P 2 value is 5.59, 27.78 and 27.78, all P 2 value is 15.77, 34, 35 and 51.10, all P 1 - T 3 was difficult to definite and the prognosis was not significantly different in T 1 - T 3 stage. Conclusions: In this study, 3 kinds of clinical stage could evaluate prognosis of esophageal cancer after radiotherapy; cooperation group' stage and Zhu's stage need further application, with further accuracy needed. (authors)

Solar Thermal Upper Stage Cryogen System Engineering Checkout Test

Science.gov (United States)

Olsen, A. D; Cady, E. C.; Jenkins, D. S.

1999-01-01

The Solar Thermal Upper Stage technology (STUSTD) program is a solar thermal propulsion technology program cooperatively sponsored by a Boeing led team and by NASA MSFC. A key element of its technology program is development of a liquid hydrogen (LH2) storage and supply system which employs multi-layer insulation, liquid acquisition devices, active and passive thermodynamic vent systems, and variable 40W tank heaters to reliably provide near constant pressure H2 to a solar thermal engine in the low-gravity of space operation. The LH2 storage and supply system is designed to operate as a passive, pressure fed supply system at a constant pressure of about 45 psia. During operation of the solar thermal engine over a small portion of the orbit the LH2 storage and supply system propulsively vents through the enjoy at a controlled flowrate. During the long coast portion of the orbit, the LH2 tank is locked up (unvented). Thus, all of the vented H2 flow is used in the engine for thrust and none is wastefully vented overboard. The key to managing the tank pressure and therefore the H2 flow to the engine is to manage and balance the energy flow into the LH2 tank with the MLI and tank heaters with the energy flow out of the LH2 tank through the vented H2 flow. A moderate scale (71 cu ft) LH2 storage and supply system was installed and insulated at the NASA MSFC Test Area 300. The operation of the system is described in this paper. The test program for the LH2 system consisted of two parts: 1) a series of engineering tests to characterize the performance of the various components in the system: and 2) a 30-day simulation of a complete LEO and GEO transfer mission. This paper describes the results of the engineering tests, and correlates these results with analytical models used to design future advanced Solar Orbit Transfer Vehicles.

Droop Control with Improved Disturbance Adaption for PV System with Two Power Conversion Stages

DEFF Research Database (Denmark)

Liu, Hongpeng; Loh, Poh Chiang; Wang, Xiongfei

2016-01-01

with no or insufficient storage for cushioning climatic changes. In addition, most droop-controlled literatures have assumed a single dc-ac inverter with its input dc source fixed. Front-end dc-dc converter added to a two-stage photovoltaic (PV) system has therefore usually been ignored. To address these unresolved...

MR imaging for staging of cervical carcinoma: Update

Energy Technology Data Exchange (ETDEWEB)

Yoon, Seong Kuk; Kim, Dong Won [Dong A University Hospital, Busan(Korea, Republic of)

2017-08-15

Uterine cervical cancer is globally the third most common cancer among women, and shows high mortality with invasive cervical carcinoma. Early detection of the disease, its correct staging, and treatment are therefore of great importance. The staging system updated in 2009 by the International Federation of Gynecology and Obstetrics (FIGO), is commonly used for planning the treatment. However, there are significant inaccuracies in the FIGO staging system. Accurate tumor staging is very important to decide the treatment strategy. Although not included in the staging system, magnetic resonance (MR) imaging is a valuable tool for local staging of the disease, and is useful in assessing the spread of the tumor and metastatic lymph nodes, thereby becoming a more accurate substitute for clinical staging of cervical carcinoma. In addition, it is capable of assessing the disease response to surgery or chemoradiation. This review briefly describes the role of MR imaging and the basic MR scanning protocol in evaluating cervical carcinoma. The MR findings with staging, and MR evaluation of treatment response, are further addressed.

Squamous Cell Carcinoma: Clinical and Pathological Features and Associated Risk Factors in an Observational Study of 118 Patients.

Science.gov (United States)

Díaz-Corpas, T; Morales-Suárez-Varela, M; Rausell Fontestad, N; Fuertes Prósper, A; Marquina-Vila, A; Jordá-Cuevas, E

2015-12-01

In the latest edition of its cancer staging manual, the American Joint Committee on Cancer (AJCC) revised the criteria for staging squamous cell carcinoma (SCC) by introducing high-risk tumor features to define tumor stage (T) and help to identify tumors with a higher risk of metastasis. The aim of this study was to investigate the characteristics associated with SCC meeting the high-risk criteria defined by the AJCC for T2 lesions. We performed a case-case observational study in which patients with SCC were included over a period of 18 months. We collected clinical, anthropometric, and tumor data, and analyzed these using PASW Statistics (SPSS) version 18. One-hundred eighteen patients, the majority of whom were men, were included. Mean age was 77 years. Over 70% of the tumors were located in the head region and a majority of tumors measured 2 cm or less. The prevalence of SCC T2 was 61.9%. The risk factors significantly associated with SCC T2 were an age of over 85 years (odds ratio [OR], 4.48), location in the head and neck region (OR, 3.38), presence of solar elastosis in the peritumoral tissue (OR, 2.08), a higher tumor growth rate (>1.5 mm·wk(-1); OR, 5.73), and higher cumulative exposure to smoking (>20 pack-years, OR, 3.63). Advanced age, location in the head and neck region, presence of solar elastosis, high tumor growth rate, and high cumulative smoking exposure were all significantly associated with the presence of SCC T2. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

Elevated serum creatinine and low albumin are associated with poor outcomes in patients with liposarcoma.

Science.gov (United States)

Panotopoulos, Joannis; Posch, Florian; Funovics, Philipp T; Willegger, Madeleine; Scharrer, Anke; Lamm, Wolfgang; Brodowicz, Thomas; Windhager, Reinhard; Ay, Cihan

2016-03-01

Low serum albumin levels and impaired kidney function have been associated with decreased survival in patients with a variety of cancer types. In a retrospective cohort study, we analyzed 84 patients with liposarcoma treated at from May 1994 to October 2011. Uni- and multivariable Cox proportional hazard models and competing risk analyses were performed to evaluate the association between putative biomarkers with disease-specific and overall survival. The median age of the study population was 51.7 (range 19.6-83.8) years. In multivariable analysis adjusted for AJCC tumor stage, serum creatinine was highly associated with disease-specific survival (Subdistribution Hazard ratio (SHR) per 1 mg/dl increase = 2.94; 95%CI 1.39-6.23; p = 0.005). High albumin was associated with improved overall and disease-specific survival (Hazard Ratio (HR) per 10 units increase = 0.50; 95%CI 0.26-0.95; p = 0.033 and SHR = 0.64; 95%CI 0.42-1.00; p = 0.049). The serum albumin-creatinine-ratio emerged to be associated with both overall and disease-specific survival after adjusting for AJCC tumor stage (HR = 0.95; 95%CI 0.92-0.99; p = 0.011 and SHR = 0.96; 95%CI 0.93-0.99; p = 0.08). Our study provides evidence for a tumor-stage-independent association between higher creatinine and lower albumin with worse disease-specific survival. Low albumin and a high albumin-creatinine-ratio independently predict poor overall survival. Our work identified novel prognostic biomarkers for prognosis of patients with liposarcoma. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Prognostic value of {sup 18}F-FDG uptake by regional lymph nodes on pretreatment PET/CT in patients with resectable colorectal cancer

Energy Technology Data Exchange (ETDEWEB)

Byun, Byung Hyun; Lim, Ilhan; Kim, Byung Il; Choi, Chang Woon; Lim, Sang Moo [Korea Institute of Radiological and Medical Sciences, Department of Nuclear Medicine, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Moon, Sun Mi; Shin, Ui Sup [Korea Institute of Radiological and Medical Sciences (KIRAMS), Surgery, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

2014-12-15

We evaluated the ability of pretreatment {sup 18}F-FDG uptake by regional lymph nodes to predict the survival of patients with resectable colorectal cancer. The records of 78 patients with AJCC stage III colorectal cancer (pathologically confirmed node-positive disease without evidence of distant metastasis) treated with surgery and adjuvant chemotherapy were retrospectively reviewed. The maximum standardized uptake values of the primary tumor (SUVp) and regional lymph nodes (SUVn) were measured by pretreatment {sup 18}F-FDG PET/CT. The ROC curve analyses and the Cox proportional hazard model were used to analyze whether SUVp, SUVn, and clinicopathologic parameters could predict disease-free survival. Although there were no significant differences between the median SUVp in the event group and that in the non-event group, the median SUVn was significantly higher in the event group (1.7) than in the non-event group (0.8, p = 0.023). Based on the ROC curve analysis, SUVn predicted the event for disease-free survival (AUC = 0.668, p = 0.02) with the optimal criterion, sensitivity, specificity, and accuracy of > 1.2, 71 %, 63 %, and 65 %, respectively. However, SUVp did not predict disease-free survival (AUC = 0.570, p = 0.349). Univariate analysis revealed that SUVn (p = 0.011) and venous invasion (p = 0.016) were associated with disease-free survival, but pathologic N stage was not (p = 0.09). By multivariate analysis, only SUVn > 1.2 independently shortened the disease-free survival (relative risk, 2.97; 95 % CI, 1.14-7.74, p = 0.026). SUVn before surgery may be a useful prognostic marker in patients with AJCC stage III colorectal cancer. (orig.)

Neck keloids: evaluation of risk factors and recommendation for keloid staging system.

Science.gov (United States)

Tirgan, Michael H

2016-01-01

Importance : Health care providers have long struggled with recurrent and hard to treat keloids. Advancing our understanding of natural history and risk factors for development of large, very large and massive neck keloids can lead to improved treatment outcomes. Clinical staging system for the categorization of keloid lesions, as well as grouping of keloid patients according to the extent of skin involvement is both fundamental for design and delivery of proper plan of care and an absolute necessity for methodical trial design and interpretation of the results thereof. Objective : To review clinical presentation and natural history of neck keloids; to explore risk factors for development of large, very large and massive neck keloids; and to propose a clinical staging system that allows for categorization of keloid lesions by their size and grouping of keloid patients by the extent of their skin involvement.  Setting:  This is a retrospective analysis of 82 consecutive patients with neck keloids who were seen by the author in his keloid specialty medical practice.    Intervention : Non-surgical treatment was offered to all patients.  Results : Neck-area keloids were found to have several unique characteristics. All 65 African Americans in this study had keloidal lesions elsewhere on their skin. Very large and massive neck keloids appear to be race-specific and almost exclusively seen among African Americans. Submandibular and submental skin was the most commonly involved area of the neck. Keloid removal surgery was found to be the main risk factor for development of very large and massive neck keloids.  Conclusions and relevance : Surgical removal of neck keloids results in wounding of the skin and triggering a pathological wound-healing response that often leads to formation of a much larger keloid.  Given the potential for greater harm from surgery, the author proposes non-surgical approach for treatment of all primary neck keloids. Author's attempts to

Multi-stage crypto ransomware attacks: A new emerging cyber threat to critical infrastructure and industrial control systems

OpenAIRE

Aaron Zimba; Zhaoshun Wang; Hongsong Chen

2018-01-01

The inevitable integration of critical infrastructure to public networks has exposed the underlying industrial control systems to various attack vectors. In this paper, we model multi-stage crypto ransomware attacks, which are today an emerging cyber threat to critical infrastructure. We evaluate our modeling approach using multi-stage attacks by the infamous WannaCry ransomware. The static malware analysis results uncover the techniques employed by the ransomware to discover vulnerable nodes...

Development of flying spot illumination system for stage lighting

Science.gov (United States)

Asakawa, Hisashi; Ishii, Katsunori; Koshiro, Hikari; Baba, Junko; Wakaki, Moriaki

2014-02-01

The system to control the area of illumination is important for the luminaires used for stages and TV studios. Presently the methods to change the distance between a lamp and lenses, or to use a zooming projection of the aperture illuminated by the lamp are used to control the area. However, these methods require many optical components or mechanical components. Moreover, the energy of the light source is partially consumed by the absorption of the shutter on adjusting the illumination area. On the other hand, the control of the illuminance over the illuminated area is not possible by the methods. In this study, we developed the lighting system which enables to control both the illuminated area and the illuminance distribution within the area by scanning the beam from a LED array light source. The area of illumination was expanded along one dimension by scanning the LED beam using a rotating polygon mirror. The selection of the illuminated width and the control of the illuminance distribution were achieved by synchronizing the pulse width modulation (PWM) control of the LED with the rotation of the mirror using a time sharing control. As a result, various illuminance distributions can be realized at real time by using software control for the luminaire. The developed system has the merits of compact and high efficiency.

Does tumour location influence postoperative long-term survival in patients with oesophageal squamous cell carcinoma?

Science.gov (United States)

Shi, Hui; Zhang, Kun; Niu, Zhong-Xi; Wang, Wen-Ping; Gao, Qiang; Chen, Long-Qi

2015-08-01

The seventh edition of the American Joint Committee on Cancer (AJCC) staging system introduced tumour location for the first time as an determinant of stage grouping in pathological T2N0M0 and T3N0M0 (pT2-3N0M0) oesophageal squamous cell carcinoma (OSCC). However, the new modification remains controversial. The objective of this study was to investigate the correlation between tumour location and postoperative long-term survival in patients with OSCC in China. The clinicopathological data and over 10 years of follow-up results from a large cohort of 988 patients with OSCC undergoing radical-intent oesophagectomy from 1984 to 1995 without preoperative and postoperative chemoradiotherapy were reviewed, in which 632 patients were staged as pT2-3N0M0. Tumour location was redefined according to the seventh edition of the AJCC staging system. Survival was calculated by the Kaplan-Meier method; univariate log-rank and multivariate Cox proportional hazard models were used to further determine the impact of tumour location on long-term survival. Univariate analysis showed that OSCC tumour location was closely associated with long-term survival for the entire cohort of 988 patients (odds ratio [OR]: 0.82; 95% confidence interval [95% CI]: 0.67-0.99; P = 0.049), and for pT2-3N0M0 patients (OR: 0.63; 95% CI: 0.48-0.84; P = 0.001). The median survival times for patients with pT2-3N0M0 OSCC in the upper, middle and lower third of the oesophagus were 38.1, 46.6 and 66.0 months, respectively, with corresponding 5-year survival rates of 40.0, 51.8 and 66.2%, respectively. Overall survival rates among three categories of patients according to tumour location in the pT2-3N0M0 patients were statistically different (P = 0.004). Multivariate analysis demonstrated that tumour location was a significant independent predictor of long-term survival for pT2-3N0M0 patients (OR: 0.53; 95% CI: 0.42-0.67; P = 0.0001), but not for the entire cohort of 988 patients (OR: 0.99; 95% CI: 0.79-1.23; P

Robust lag synchronization between two different chaotic systems via dual-stage impulsive control

International Nuclear Information System (INIS)

Hua-Guang, Zhang; Tie-Dong, Ma; Jie, Fu; Shao-Cheng, Tong

2009-01-01

In this paper, an improved impulsive lag synchronization scheme for different chaotic systems with parametric uncertainties is proposed. Based on the new definition of synchronization with error bound and a novel impulsive control scheme (the so-called dual-stage impulsive control), some new and less conservative sufficient conditions are established to guarantee that the error dynamics can converge to a predetermined level, which is more reasonable and rigorous than the existing results. In particular, some simpler and more convenient conditions are derived by taking the same impulsive distances and control gains. Finally, some numerical simulations for the Lorenz system and the Chen system are given to demonstrate the effectiveness and feasibility of the proposed method

Investigation on a two-stage solar liquid-desiccant (LiBr) dehumidification system assisted by CaCl2 solution

International Nuclear Information System (INIS)

Xiong, Z.Q.; Dai, Y.J.; Wang, R.Z.

2009-01-01

A two-stage solar powered liquid-desiccant dehumidification system, for which two kinds of desiccant solution (lithium chloride and calcium bromide) are fed to the two dehumidification stages separately, has been studied. In the studied system air moisture (latent) load is separately removed by a pre-dehumidifier using cheap calcium chloride (CaCl 2 ) and a main dehumidifier using stable lithium bromide (LiBr). Side-effect of mixing heat rejected during dehumidification process is considerably alleviated by an indirect evaporative cooling unit added between the two dehumidification stages. The feasibility of high-desiccant concentration difference achieved by reusing desiccant solution to dehumidify air and regenerating desiccant repeatedly is analyzed. By increasing desiccant concentration difference, desiccant storage capacity is effectively explored. It is found that the pre-dehumidification effect of CaCl 2 solution is significant in high ambient humidity condition. Also seen is that the desiccant investment can be decreased by 53%, though the cost of equipments is somewhat increased, and the Tcop and COP of the proposed system can reach 0.97 and 2.13, respectively

Numerical analysis of flow interaction of turbine system in two-stage turbocharger of internal combustion engine

Science.gov (United States)

Liu, Y. B.; Zhuge, W. L.; Zhang, Y. J.; Zhang, S. Y.

2016-05-01

To reach the goal of energy conservation and emission reduction, high intake pressure is needed to meet the demand of high power density and high EGR rate for internal combustion engine. Present power density of diesel engine has reached 90KW/L and intake pressure ratio needed is over 5. Two-stage turbocharging system is an effective way to realize high compression ratio. Because turbocharging system compression work derives from exhaust gas energy. Efficiency of exhaust gas energy influenced by design and matching of turbine system is important to performance of high supercharging engine. Conventional turbine system is assembled by single-stage turbocharger turbines and turbine matching is based on turbine MAP measured on test rig. Flow between turbine system is assumed uniform and value of outlet physical quantities of turbine are regarded as the same as ambient value. However, there are three-dimension flow field distortion and outlet physical quantities value change which will influence performance of turbine system as were demonstrated by some studies. For engine equipped with two-stage turbocharging system, optimization of turbine system design will increase efficiency of exhaust gas energy and thereby increase engine power density. However flow interaction of turbine system will change flow in turbine and influence turbine performance. To recognize the interaction characteristics between high pressure turbine and low pressure turbine, flow in turbine system is modeled and simulated numerically. The calculation results suggested that static pressure field at inlet to low pressure turbine increases back pressure of high pressure turbine, however efficiency of high pressure turbine changes little; distorted velocity field at outlet to high pressure turbine results in swirl at inlet to low pressure turbine. Clockwise swirl results in large negative angle of attack at inlet to rotor which causes flow loss in turbine impeller passages and decreases turbine

Evaluating Managerial Styles for System Development Life Cycle Stages to Ensure Software Project Success

Science.gov (United States)

Kocherla, Showry

2012-01-01

Information technology (IT) projects are considered successful if they are completed on time, within budget, and within scope. Even though, the required tools and methodologies are in place, IT projects continue to fail at a higher rate. Current literature lacks explanation for success within the stages of system development life-cycle (SDLC) such…

Experimental evaluation of desuperheating and oil cooling process through liquid injection in two-staged ammonia refrigeration systems with screw compressors

International Nuclear Information System (INIS)

Zlatanović, Ivan; Rudonja, Nedžad

2012-01-01

This paper examines the problem of achieving desuperheating through liquid injection in two-staged refrigeration systems based on screw compressors. The oil cooling process by refrigerant injection is also included. The basic thermodynamic principles of desuperheating and compressor cooling as well as short comparison with traditional method with a thermosyphon system have also been presented. Finally, the collected data referring to a big refrigeration plant are analyzed in the paper. Specific ammonia system concept applied in this refrigeration plant has demonstrated its advantages and disadvantages. - Highlights: ► An experiment was setup during a frozen food factory refrigeration system reconstruction and adaptation. ► Desuperheating and low-stage compressors oil cooling process were investigated. ► Efficiency of compression process and high-stage compressors functioning were examined. ► Evaporation temperature reduction has great influence on the need for injected liquid refrigerant. ► Several cases in which desuperheating and oil cooling process application are justified were determined.

The New Stage of the Turkish Counseling System: Explosive Growth (2000 to the Present)

Science.gov (United States)

Arslan, Ümüt; Sommers-Flanagan, John

2018-01-01

The Turkish counseling system has been developing since the 1950s. Over the past 15 years, rapid and substantial changes have started to affect counseling and counselor education in Turkey. These changes have both positive and negative ramifications. Overall, the changes appear to represent a new stage of counseling that the authors refer to as…

Multi-stage crypto ransomware attacks: A new emerging cyber threat to critical infrastructure and industrial control systems

Directory of Open Access Journals (Sweden)

Aaron Zimba

2018-03-01

Full Text Available The inevitable integration of critical infrastructure to public networks has exposed the underlying industrial control systems to various attack vectors. In this paper, we model multi-stage crypto ransomware attacks, which are today an emerging cyber threat to critical infrastructure. We evaluate our modeling approach using multi-stage attacks by the infamous WannaCry ransomware. The static malware analysis results uncover the techniques employed by the ransomware to discover vulnerable nodes in different SCADA and production subnets, and for the subsequent network propagation. Based on the uncovered artifacts, we recommend a cascaded network segmentation approach, which prioritizes the security of production network devices. Keywords: Critical infrastructure, Cyber-attack, Industrial control system, Crypto ransomware, Vulnerability

Life cycle analysis in preliminary design stages

OpenAIRE

Agudelo , Lina-Maria; Mejía-Gutiérrez , Ricardo; Nadeau , Jean-Pierre; PAILHES , Jérôme

2014-01-01

International audience; In a design process the product is decomposed into systems along the disciplinary lines. Each stage has its own goals and constraints that must be satisfied and has control over a subset of design variables that describe the overall system. When using different tools to initiate a product life cycle, including the environment and impacts, its noticeable that there is a gap in tools that linked the stages of preliminary design and the stages of materialization. Differen...

Prediction of Curve Progression in Idiopathic Scoliosis: Validation of the Sanders Skeletal Maturity Staging System.

Science.gov (United States)

Sitoula, Prakash; Verma, Kushagra; Holmes, Laurens; Gabos, Peter G; Sanders, James O; Yorgova, Petya; Neiss, Geraldine; Rogers, Kenneth; Shah, Suken A

2015-07-01

Retrospective case series. This study aimed to validate the Sanders Skeletal Maturity Staging System and to assess its correlation to curve progression in idiopathic scoliosis. The Sanders Skeletal Maturity Staging System has been used to predict curve progression in idiopathic scoliosis. This study intended to validate that initial study with a larger sample size. We retrospectively reviewed 1100 consecutive patients with idiopathic scoliosis between 2005 and 2011. Girls aged 8 to 14 years (skeletal age and scoliosis curve magnitude were followed to skeletal maturity (Risser stage 5 or fully capped Risser stage 4), curve progression to 50° or greater, or spinal fusion. Patients with nonidiopathic curves were excluded. There were 161 patients: 131 girls (12.3 ± 1.2 yr) and 30 boys (13.9 ± 1.1 yr). The distribution of patients within Sanders stage (SS) 1 through 7 was 7, 28, 41, 45, 7, 31, and 2 patients, respectively; modified Lenke curve types 1 to 6 were 26, 12, 63, 5, 38, and 17 patients, respectively. All patients in SS2 with initial Cobb angles of 25° or greater progressed, and patients in SS1 and SS3 with initial Cobb angles of 35° or greater progressed. Similarly, all patients with initial Cobb angles of 40° or greater progressed except those in SS7. Conversely, none of the patients with initial Cobb angles of 15° or less or those in SS5, SS6, and SS7 with initial Cobb angles of 30° or less progressed. Predictive progression of 67%, 50%, 43%, 27%, and 60% was observed for subgroups SS1/30°, SS2/20°, SS3/30°, SS4/30°, and SS6/35° respectively. This larger cohort shows a strong predictive correlation between SS and initial Cobb angle for probability of curve progression in idiopathic scoliosis. 3.

[An analysis of 68 invasive lobular breast cancer cases in clinicopathological characteristics and the prognostic determinants].

Science.gov (United States)

Liu, Q; Xiang, H Y; Ye, J M; Xu, L; Zhang, H; Zhang, S; Duan, X N; Liu, Y H

2018-02-01

Objective: To study the clinicopathological characteristics and the prognostic determinants of the invasive lobular carcinoma breast cancer. Methods: This was a retrospective single-center study of invasive lobular breast cancer cases diagnosed from January 2008 to December 2014 at Peking University First Hospital Breast Disease Center. The study enrolled 68 invasive lobular breast cancer patients, which represented 3.64% (68/1 870) of total invasive breast cancer. The median age of all selected patients was 46 years ranging from 36 to 83 years. All patients were restaged based on the 8(th) edition of AJCC cancer staging system and follow-up data including disease-free survival (DFS) and overall survival (OS) were analyzed to explore the prognostic determinants. The 5-year OS and DFS were calculated using Kaplan-Meier method; the significance of correlations between clinicopathological features and prognostic factors was estimated using log-rank test. Results: There were significant differences in OS between patients with different anatomic stage, prognostic stage, lymph node metastasis, progesterone receptor (PR) expression, lymphvascular invasion and perineural invasion (χ(2:) 4.318 to 32.394, all P invasion (χ(2:) 4.347 to 27.369, all P invasion are the prognostic factors of invasive lobular breast cancer. Regard to invasive lobular breast cancer patients, clinicians should pay close attention to the differences between prognostic stage and anatomic stage.

Dynamic solar-powered multi-stage direct contact membrane distillation system: Concept design, modeling and simulation

KAUST Repository

Lee, Jung Gil

2017-04-26

This paper presents a theoretical analysis of the monthly average daily and hourly performances of a solar-powered multi-stage direct contact membrane distillation (SMDCMD) system with an energy recovery scheme and dynamic operating system. Mid-latitude meteorological data from Busan, Korea is employed, featuring large climate variation over the course of one year. The number of module stages used by the dynamic operating scheme changes dynamically based on the inlet feed temperature of the successive modules, which results in an improvement of the water production and thermal efficiency. The simulations of the SMDCMD system are carried out to investigate the spatial and temporal variations in the feed and permeate temperatures and permeate flux. The monthly average daily water production increases from 0.37m3/day to 0.4m3/day and thermal efficiency increases from 31% to 45% when comparing systems both without and with dynamic operation in December. The water production with respect to collector area ranged from 350m2 to 550m2 and the seawater storage tank volume ranged from 16m3 to 28.8m3, and the solar fraction at various desired feed temperatures from 50°C to 80°C have been investigated in October and December.

Evaluation of Revised International Staging System (R-ISS) for transplant-eligible multiple myeloma patients.

Science.gov (United States)

González-Calle, Verónica; Slack, Abigail; Keane, Niamh; Luft, Susan; Pearce, Kathryn E; Ketterling, Rhett P; Jain, Tania; Chirackal, Sintosebastian; Reeder, Craig; Mikhael, Joseph; Noel, Pierre; Mayo, Angela; Adams, Roberta H; Ahmann, Gregory; Braggio, Esteban; Stewart, A Keith; Bergsagel, P Leif; Van Wier, Scott A; Fonseca, Rafael

2018-04-06

The International Myeloma Working Group has proposed the Revised International Staging System (R-ISS) for risk stratification of multiple myeloma (MM) patients. There are a limited number of studies that have validated this risk model in the autologous stem cell transplant (ASCT) setting. In this retrospective study, we evaluated the applicability and value for predicting survival of the R-ISS model in 134 MM patients treated with new agents and ASCT at the Mayo Clinic in Arizona and the University Hospital of Salamanca in Spain. The patients were reclassified at diagnosis according to the R-ISS: 44 patients (33%) had stage I, 75 (56%) had stage II, and 15 (11%) had stage III. After a median follow-up of 60 months, R-ISS assessed at diagnosis was an independent predictor for overall survival (OS) after ASCT, with median OS not reached, 111 and 37 months for R-ISS I, II and III, respectively (P R-ISS II and having high-risk chromosomal abnormalities (CA) had a significant shorter median OS than those with R-ISS II without CA: 70 vs. 111 months, respectively. Therefore, this study lends further support for the R-ISS as a reliable prognostic tool for estimating survival in transplant myeloma patients and suggests the importance of high-risk CA in the R-ISS II group.

{sup 18}F-FDG-PET/CT for systemic staging of patients with newly diagnosed ER-positive and HER2-positive breast cancer

Energy Technology Data Exchange (ETDEWEB)

Ulaner, Gary A.; Castillo, Raychel [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Weill Cornell Medical College, Department of Radiology, New York, NY (United States); Wills, Jonathan [Memorial Sloan Kettering Cancer Center, Department of Information Systems, New York, NY (United States); Goenen, Mithat; Goldman, Debra A. [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States)

2017-08-15

This study assesses {sup 18}F-FDG-PET/CT for patients with newly diagnosed estrogen receptor-positive/human epidermal growth factor receptor-negative (ER+/HER2-) and human epidermal growth factor receptor-positive (HER2+) breast cancer. In this Institutional Review Board-approved retrospective study, our Healthcare Information System was screened for patients with ER+/HER2- and HER2+ breast cancer who underwent {sup 18}F-FDG-PET/CT prior to systemic or radiation therapy. The initial stage was determined from mammography, ultrasound, magnetic resonance imaging, and/or surgery.{sup 18}F-FDG-PET/CT was evaluated to identify unsuspected extra-axillary regional nodal and distant metastases. The proportion of patients upstaged overall and stratified by stage and receptor phenotypes was calculated along with confidence intervals (CI). A total of 238 patients with ER+/HER2- and 245 patients with HER2+ who met inclusion criteria were evaluated. For patients with ER+/HER2-breast cancer, {sup 18}F-FDG-PET/CT revealed unsuspected distant metastases in 3/71 (4%) initial stage IIA, 13/95 (14%) stage IIB, and 15/57 (26%) stage III. For patients with HER2+ breast cancer, {sup 18}F-FDG-PET/CT revealed unsuspected distant metastases in 3/72 (4%) initial stage IIA, 13/93 (14%) stage IIB, and 13/59 (22%) stage III. The overall upstaging rate for IIB was 14% (95% confidence interval (CI): 9-20%). {sup 18}F-FDG-PET/CT revealed distant metastases in 14% (95% CI: 9-20%) of patients with stage IIB ER+/HER2- and HER2+ breast cancer, which is similar to upstaging rates previously seen in patients with stage IIB triple-negative breast cancer (15%, 95% CI: 9-24%). The detection of unsuspected distant metastases in these patients alters treatment and prognosis. NCCN guidelines should consider adding patients with stage IIB breast cancer for consideration of systemic staging with {sup 18}F-FDG-PET/CT at the time of initial diagnosis. (orig.)

Staged Optimization Design for Updating Urban Drainage Systems in a City of China

Directory of Open Access Journals (Sweden)

Kui Xu

2018-01-01

Full Text Available Flooding has been reported more often than in the past in most cities of China in recent years. In response, China’s State Council has urged the 36 largest cities to update the preparedness to handle the 50-year rainfall, which would be a massive project with large investments. We propose a staged optimization design for updating urban drainage that is not only a flexible option against environmental changes, but also an effective way to reduce the cost of the project. The staged cost optimization model involving the hydraulic model was developed in Fuzhou City, China. This model was established to minimize the total present costs, including intervention costs and flooding costs, with full consideration of the constraints of specific local conditions. The results show that considerable financial savings could be achieved by a staged design rather than the implement-once scheme. The model’s sensitivities to four data parameters were analyzed, including rainfall increase rate, flood unit cost, storage unit cost, and discount rate. The results confirm the applicability and robustness of the model for updating drainage systems to meet the requirements. The findings of this study may have important implications on urban flood management in the cities of developing countries with limited construction investments.

Water erosion and soil water infiltration in different stages of corn development and tillage systems

Directory of Open Access Journals (Sweden)

Daniel F. de Carvalho

2015-11-01

Full Text Available ABSTRACTThis study evaluated soil and water losses, soil water infiltration and infiltration rate models in soil tillage systems and corn (Zea mays, L. development stages under simulated rainfall. The treatments were: cultivation along contour lines, cultivation down the slope and exposed soil. Soil losses and infiltration in each treatment were quantified for rains applied using a portable simulator, at 0, 30, 60 and 75 days after planting. Infiltration rates were estimated using the models of Kostiakov-Lewis, Horton and Philip. Based on the obtained results, the combination of effects between soil tillage system and corn development stages reduces soil and water losses. The contour tillage system promoted improvements in soil physical properties, favoring the reduction of erosion in 59.7% (water loss and 86.6% (soil loss at 75 days after planting, and the increase in the stable infiltration rate in 223.3%, compared with the exposed soil. Associated to soil cover, contour cultivation reduces soil and water losses, and the former is more influenced by management. Horton model is the most adequate to represent soil water infiltration rate under the evaluated conditions.

Two-Stage n-PSK Partitioning Carrier Phase Recovery Scheme for Circular mQAM Coherent Optical Systems

Directory of Open Access Journals (Sweden)

Jaime Rodrigo Navarro

2016-06-01

Full Text Available A novel two-stage n-PSK partitioning carrier phase recovery (CPR scheme for circular multilevel quadrature amplitude modulation (C-mQAM constellations is presented. The first stage of the algorithm provides an initial rough estimation of the received constellation, which is utilized in the second stage for CPR. The performance of the proposed algorithm is studied through extensive simulations at the forward error correction bit error rate targets of 3.8 × 10−3 and 1 × 10−2 and is compared with different CPR algorithms. A significant improvement in the combined linewidth symbol duration product (ΔνTs tolerance is achieved compared to the single-stage n-PSK partitioning scheme. Superior performance in the ΔνTs tolerance compared to the blind phase search algorithm is also reported. The relative improvements with respect to other CPR schemes are also validated experimentally for a 28-Gbaud C-16QAM back-to-back transmission system. The computational complexity of the proposed CPR scheme is studied, and reduction factors of 24.5 | 30.1 and 59.1 | 63.3 are achieved for C-16QAM and C-64QAM, respectively, compared to single-stage BPS in the form of multipliers | adders.

A portable high-power diode laser-based single-stage ceramic tile grout sealing system

Science.gov (United States)

Lawrence, J.; Schmidt, M. J. J.; Li, L.; Edwards, R. E.; Gale, A. W.

2002-02-01

By means of a 60 W high-power diode laser (HPDL) and a specially developed grout material the void between adjoining ceramic tiles has been successfully sealed. A single-stage process has been developed which uses a crushed ceramic tile mix to act as a tough, inexpensive bulk substrate and a glazed enamel surface to provide an impervious surface glaze. The single-stage ceramic tile grout sealing process yielded seals produced in normal atmospheric conditions that displayed no discernible cracks and porosities. The single-stage grout is simple to formulate and easy to apply. Tiles were successfully sealed with power densities as low as 200 kW/ mm2 and at rates of up to 600 mm/ min. Bonding of the enamel to the crushed ceramic tile mix was identified as being primarily due to van der Waals forces and, on a very small scale, some of the crushed ceramic tile mix material dissolving into the glaze. In terms of mechanical, physical and chemical characteristics, the single-stage ceramic tile grout was found to be far superior to the conventional epoxy tile grout and, in many instances, matched and occasionally surpassed that of the ceramic tiles themselves. What is more, the development of a hand-held HPDL beam delivery unit and the related procedures necessary to lead to the commercialisation of the single-stage ceramic tile grout sealing process are presented. Further, an appraisal of the potential hazards associated with the use of the HPDL in an industrial environment and the solutions implemented to ensure that the system complies with the relevant safety standards are given.

Design of an Image-Servo Mask Alignment System Using Dual CCDs with an XXY Stage

Directory of Open Access Journals (Sweden)

Chih-Jer Lin

2016-02-01

Full Text Available Mask alignment of photolithography technology is used in many applications, such as micro electro mechanical systems’ semiconductor process, printed circuits board, and flat panel display. As the dimensions of the product are getting smaller and smaller, the automatic mask alignment of photolithography is becoming more and more important. The traditional stacked XY-Θz stage is heavy and it has cumulative flatness errors due to its stacked assembly mechanism. The XXY stage has smaller cumulative error due to its coplanar design and it can move faster than the traditional XY-Θz stage. However, the relationship between the XXY stage’s movement and the commands of the three motors is difficult to compute, because the movements of the three motors on the same plane are coupling. Therefore, an artificial neural network is studied to establish a nonlinear mapping from the desired position and orientation of the stage to three motors’ commands. Further, this paper proposes an image-servo automatic mask alignment system, which consists of a coplanar XXY stage, dual GIGA-E CCDs with lens and a programmable automatic controller (PAC. Before preforming the compensation, a self-developed visual-servo provides the positioning information which is obtained from the image processing and pattern recognition according to the specified fiducial marks. To obtain better precision, two methods including the center of gravity method and the generalize Hough Transformation are studied to correct the shift positioning error.

Attainability and minimum energy of multiple-stage cascade membrane Systems

KAUST Repository

Alshehri, Ali; Lai, Zhiping

2015-01-01

: View the MathML sourceSn=S1, View the MathML sourceγn=γ1, where n is the number of stages. The minimum energy consumption of a multi-stage membrane process is primarily determined by the membrane selectivity and recycle ratio. A low recycle ratio can

Anaerobic sewage treatment in a one-stage UASB reactor and a combined UASB Digester system

NARCIS (Netherlands)

Mahmoud, N.A.; Zeeman, G.; Gijzen, H.J.; Lettinga, G.

2004-01-01

The treatment of sewage at 15°C was investigated in a one-stage upflow anaerobic sludge blanket (UASB) reactor and a UASB-Digester system. The latter consists of a UASB reactor complemented with a digester for mutual sewage treatment and sludge stabilisation. The UASB reactor was operated at a

Detection of Integrase Gene in E. coli Isolated from Pigs at Different Stages of Production System

Directory of Open Access Journals (Sweden)

Eulalia de la Torre

2014-01-01

Full Text Available Integrons are one of the genetic elements involved in the acquisition of antibiotic resistance. The aim of the present research is to investigate the presence of integrons in commensal Escherichia coli (E. coli strains, isolated from pigs at different stages of production system and from the environment in an Argentinian farm. Five sows postpartum and five randomly chosen piglets from each litter were sampled by rectal swabs. They were sampled again at day 21 and at day 70. Environmental samples from the farm were also obtained. E. coli containing any integron class or combination of both integrons was detected by polymerase chain reaction in 100% of sows and in piglets at different stages of production: farrowing pen stage 68.1%;, weaning 60%, and growing/finishing 85.8%, showing an increase along the production system. From environmental samples 78.4% of E. coli containing any integron class was detected. We conclude that animals and farm environment can act as reservoirs for potential spread of resistant bacteria by means of mobile genetic elements as integrons, which has a major impact on production of food animals and that can reach man through the food chain, constituting a problem for public health.

High performance work systems and employee well-being: a two stage study of a rural Australian hospital.

Science.gov (United States)

Young, Suzanne; Bartram, Timothy; Stanton, Pauline; Leggat, Sandra G

2010-01-01

This paper aims to explore the attitudes of managers and employees to high performance work practices (HPWS) in a medium sized rural Australian hospital. The study consists of two stages. Stage one involved a qualitative investigation consisting of interviews and focus group sessions with senior, middle and line management at the hospital. Bowen and Ostroffs framework was used to examine how strategic HRM was understood, interpreted and operationalised across the management hierarchy. Stage one investigates the views of managers concerning the implementation of strategic HRM/HPWS. Stage two consisted of a questionnaire administered to all hospital employees. The mediation effects of social identification on the relationship between high performance work systems and affective commitment and job satisfaction are examined. The purpose of stage two was to investigate the views and effects of SHRM/HPWS on employees. It should be noted that HPWS and strategic HRM are used inter-changeably in this paper. At the management level the importance of distinctiveness, consistency and consensus in the interpretation of strategic HRM/HPWS practices across the organization was discovered. Findings indicate that social identification mediates the relationship between HPWS and affective commitment and also mediates the relationship between HPWS and job satisfaction. High performance work systems may play a crucial role facilitating social identification at the unit level. Such practices and management support is likely to provide benefits in terms of high performing committed employees. The paper argues that team leaders and managers play a key role in building social identification within the team and that organizations need to understand this role and provide recognition, reward, education and support to their middle and lower managers.

Evaluation of Pachymetric Measurements with Scheimpflug Photography-Based System and Optical Coherence Tomography Pachymetry at Different Stages of Keratoconus

Directory of Open Access Journals (Sweden)

Betül İlkay Sezgin Akçay

2014-01-01

Full Text Available The aim of this study was to compare the central and peripheral pachymetric measurements determined with Sirius system and Visante OCT and evaluate the agreement between them at different stages of keratoconus. Measurements were not significantly different in all patients and subgroups and showed high correlation for the corneal thicknesses of the entire cornea in different stages of keratoconus.

Wind turbines and transmission systems for offshore wind projects in planning stage

Energy Technology Data Exchange (ETDEWEB)

Madariaga, Ander; Martin, Jose Luis; Martinez de Alegria, Inigo; Zamora, Inmaculada [University of the Basque Country (UPV/EHU), Bilbao (Spain). Engineering Faculty; Ceballos, Salvador [Parque Tecnologico de Bizkaia, Derio (Spain). Tecnalia Research and Innovation

2012-07-01

This paper reviews the current situation of the offshore wind turbines (OWTs) and the transmission systems (TSs) for offshore wind projects in the planning stage. Bearing in mind that offshore wind projects can last between seven and ten years from the first environmental studies to the commissioning, research engineers from companies and academia consider the solutions already available, but also to the new proposals expected to be ready in time for the project under consideration. Regarding the wind energy conversion systems (WECSs) installed in the OWTs, their main characteristics are reviewed considering turbines in the 4.1 to 10.0 MW range. Regarding the TSs, the current situation of point-to-point HVAC and HVDC links is presented, as well as some ideas related to future DC grids currently under study. (orig.)

A Two Stage Solution Procedure for Production Planning System with Advance Demand Information

Science.gov (United States)

Ueno, Nobuyuki; Kadomoto, Kiyotaka; Hasuike, Takashi; Okuhara, Koji

We model for ‘Naiji System’ which is a unique corporation technique between a manufacturer and suppliers in Japan. We propose a two stage solution procedure for a production planning problem with advance demand information, which is called ‘Naiji’. Under demand uncertainty, this model is formulated as a nonlinear stochastic programming problem which minimizes the sum of production cost and inventory holding cost subject to a probabilistic constraint and some linear production constraints. By the convexity and the special structure of correlation matrix in the problem where inventory for different periods is not independent, we propose a solution procedure with two stages which are named Mass Customization Production Planning & Management System (MCPS) and Variable Mesh Neighborhood Search (VMNS) based on meta-heuristics. It is shown that the proposed solution procedure is available to get a near optimal solution efficiently and practical for making a good master production schedule in the suppliers.

Two-stage SQUID systems and transducers development for MiniGRAIL

International Nuclear Information System (INIS)

Gottardi, L; Podt, M; Bassan, M; Flokstra, J; Karbalai-Sadegh, A; Minenkov, Y; Reinke, W; Shumack, A; Srinivas, S; Waard, A de; Frossati, G

2004-01-01

We present measurements on a two-stage SQUID system based on a dc-SQUID as a sensor and a DROS as an amplifier. We measured the intrinsic noise of the dc-SQUID at 4.2 K. A new dc-SQUID has been fabricated. It was specially designed to be used with MiniGRAIL transducers. Cooling fins have been added in order to improve the cooling of the SQUID and the design is optimized to achieve the quantum limit of the sensor SQUID at temperatures above 100 mK. In this paper we also report the effect of the deposition of a Nb film on the quality factor of a small mass Al5056 resonator. Finally, the results of Q-factor measurements on a capacitive transducer for the current MiniGRAIL run are presented

A two-stage planning and control model toward Economically Adapted Power Distribution Systems using analytical hierarchy processes and fuzzy optimization

Energy Technology Data Exchange (ETDEWEB)

Schweickardt, Gustavo [Instituto de Economia Energetica, Fundacion Bariloche, Centro Atomico Bariloche - Pabellon 7, Av. Bustillo km 9500, 8400 Bariloche (Argentina); Miranda, Vladimiro [INESC Porto, Instituto de Engenharia de Sistemas e Computadores do Porto and FEUP, Faculdade de Engenharia da Universidade do Porto, R. Dr. Roberto Frias, 378, 4200-465 Porto (Portugal)

2009-07-15

This work presents a model to evaluate the Distribution System Dynamic De-adaptation respecting its planning for a given period of Tariff Control. The starting point for modeling is brought about by the results from a multi-criteria method based on Fuzzy Dynamic Programming and on Analytic Hierarchy Processes applied in a mid/short-term horizon (stage 1). Then, the decision-making activities using the Hierarchy Analytical Processes will allow defining, for a Control of System De-adaptation (stage 2), a Vector to evaluate the System Dynamic Adaptation. It is directly associated to an eventual series of inbalances that take place during its evolution. (author)

Preoperative magnetic resonance imaging assessment of circumferential resection margin predicts disease-free survival and local recurrence: 5-year follow-up results of the MERCURY study.

Science.gov (United States)

Taylor, Fiona G M; Quirke, Philip; Heald, Richard J; Moran, Brendan J; Blomqvist, Lennart; Swift, Ian R; Sebag-Montefiore, David; Tekkis, Paris; Brown, Gina

2014-01-01

The prognostic relevance of preoperative high-resolution magnetic resonance imaging (MRI) assessment of circumferential resection margin (CRM) involvement is unknown. This follow-up study of 374 patients with rectal cancer reports the relationship between preoperative MRI assessment of CRM staging, American Joint Committee on Cancer (AJCC) TNM stage, and clinical variables with overall survival (OS), disease-free survival (DFS), and time to local recurrence (LR). Patients underwent protocol high-resolution pelvic MRI. Tumor distance to the mesorectal fascia of ≤ 1 mm was recorded as an MRI-involved CRM. A Cox proportional hazards model was used in multivariate analysis to determine the relationship of MRI assessment of CRM to survivorship after adjusting for preoperative covariates. Surviving patients were followed for a median of 62 months. The 5-year OS was 62.2% in patients with MRI-clear CRM compared with 42.2% in patients with MRI-involved CRM with a hazard ratio (HR) of 1.97 (95% CI, 1.27 to 3.04; P < .01). The 5-year DFS was 67.2% (95% CI, 61.4% to 73%) for MRI-clear CRM compared with 47.3% (95% CI, 33.7% to 60.9%) for MRI-involved CRM with an HR of 1.65 (95% CI, 1.01 to 2.69; P < .05). Local recurrence HR for MRI-involved CRM was 3.50 (95% CI, 1.53 to 8.00; P < .05). MRI-involved CRM was the only preoperative staging parameter that remained significant for OS, DFS, and LR on multivariate analysis. High-resolution MRI preoperative assessment of CRM status is superior to AJCC TNM-based criteria for assessing risk of LR, DFS, and OS. Furthermore, MRI CRM involvement is significantly associated with distant metastatic disease; therefore, colorectal cancer teams could intensify treatment and follow-up accordingly to improve survival outcomes.

Staging with spatial filters

International Nuclear Information System (INIS)

Glaze, J.

1974-01-01

It is known that small scale beam instabilities limit the focusable energy that can be achieved from a terawatt laser chain. Spatial filters are currently being used on CYCLOPS to ameliorate this problem. Realizing the full advantage of such a filter, however, may require certain staging modifications. A staging methodology is discussed that should be applicable to the CYCLOPS, 381, and SHIVA systems. Experiments are in progress on CYCLOPS that will address directly the utility of the proposed approach

Advantages of preoperative ultrasound in conjunction with lymphoscintigraphy in detecting malignant melanoma metastases in sentinel lymph nodes: a retrospective analysis in 221 patients with malignant melanoma AJCC Stages I and II.

Science.gov (United States)

Stoffels, I; Dissemond, J; Poeppel, T; Klötgen, K; Hillen, U; Körber, A; Schadendorf, D; Klode, J

2012-01-01

Sentinel lymph node excision (SLNE) for the detection of regional nodal metastases and staging of malignant melanoma has resulted in some controversies in international discussions as it is a surgical intervention with potential morbidity. The present retrospective study seeks to clarify the reliability of preoperative ultrasonography (US) in direct comparison to the result of SLNE and seeks to identify potential advantages of preoperative ultrasound if performed in conjunction with lymphoscintigraphy in detecting malignant melanoma metastases in sentinel lymph node (SLN). We retrospectively analysed data from 221 patients with primary malignant melanoma with a Breslow index of ≥ 1.0 mm. Of the 221 patients, 77.4% (n = 171) had a negative SLN. In 50 patients (22.6%), the histopathological investigation of 71 excised lymph nodes resulted in a positive SLN. The US examination demonstrated a sensitivity of 13.6%, a specificity of 96.9%, a positive predictive value of 97.2% and a negative predictive value of 12.6%. SLNE alone shows a sensitivity of 94%, a specificity of 98.6%, a positive predictive value of 100% and a negative predictive value of 98.3%. Preoperative US in conjunction with dynamic lymphoscintigraphy, followed by SLNE, demonstrated a detecting ratio of 100% (n = 28) for micrometastases and 98.6% (n = 42/43) for macrometastases. In conclusion, this study confirms that preoperative US alone cannot replace the vital information obtained during dynamic lymphoscintigraphy. But preoperative US is an important component of the staging procedure in melanoma patients and has clear advantages when performed in conjunction with dynamic lymphoscintigraphy. Therefore, we recommend preoperative US before every SLNE. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

The development of giftedness within the three-level system of music education in Poland and Serbia: Outcomes at different stages

Directory of Open Access Journals (Sweden)

Nogaj Anna Antonina

2015-01-01

Full Text Available The character of this article is theoretical and practice oriented, therefore offering educational implications for music educators and music psychologists. Its main objective is to give an overview of the most important musical and developmental changes of musically talented children and youth, at different stages of the three-level specialized music education. The theoretical background of the article refers to stage theories of development of gifted with the intention to point out correspondence between stages of development and the specificity of music education stages. Theoretical conceptions are used as a framework to synthesize and to interpret empirical data and practice-related professional experiences of psychologists in music schools in Poland and Serbia. Both countries, though culturally distinct in nature and in the character of traditional music, are characterized by a very similar system of specialized/professional music education. Further on, the article presents a review of the wide range of benefits/outcomes experienced by music school students, as a result of the highly simulative, systematic and supportive environment of music learning. The article begins with an introduction to the context of the specialized music education system in Poland and Serbia and then presents how a particular system of education for the gifted contributes to the development in the field of acquiring musical knowledge and skills, as well as to benefits/outcomes of the education system for the personal, social and professional development of the musically gifted, indicating a wide range of positive experiences.

Novel design and sensitivity analysis of displacement measurement system utilizing knife edge diffraction for nanopositioning stages.

Science.gov (United States)

Lee, ChaBum; Lee, Sun-Kyu; Tarbutton, Joshua A

2014-09-01

This paper presents a novel design and sensitivity analysis of a knife edge-based optical displacement sensor that can be embedded with nanopositioning stages. The measurement system consists of a laser, two knife edge locations, two photodetectors, and axillary optics components in a simple configuration. The knife edge is installed on the stage parallel to its moving direction and two separated laser beams are incident on knife edges. While the stage is in motion, the direct transverse and diffracted light at each knife edge is superposed producing interference at the detector. The interference is measured with two photodetectors in a differential amplification configuration. The performance of the proposed sensor was mathematically modeled, and the effect of the optical and mechanical parameters, wavelength, beam diameter, distances from laser to knife edge to photodetector, and knife edge topography, on sensor outputs was investigated to obtain a novel analytical method to predict linearity and sensitivity. From the model, all parameters except for the beam diameter have a significant influence on measurement range and sensitivity of the proposed sensing system. To validate the model, two types of knife edges with different edge topography were used for the experiment. By utilizing a shorter wavelength, smaller sensor distance and higher edge quality increased measurement sensitivity can be obtained. The model was experimentally validated and the results showed a good agreement with the theoretically estimated results. This sensor is expected to be easily implemented into nanopositioning stage applications at a low cost and mathematical model introduced here can be used for design and performance estimation of the knife edge-based sensor as a tool.

Linac project - actual stage

International Nuclear Information System (INIS)

Carlin Filho, N.

1990-01-01

The actual development stage of Pelletron accelerator to study heavy ion reactions, nuclear structures and applied nuclear physics is presented. The construction of acceleration systems able to provide beams of several mass and energies up to 20 MeV/A, is discussed, describing acceleration structures and implemented systems. (M.C.K.)

Cancer classification using the Immunoscore: a worldwide task force.

Science.gov (United States)

Galon, Jérôme; Pagès, Franck; Marincola, Francesco M; Angell, Helen K; Thurin, Magdalena; Lugli, Alessandro; Zlobec, Inti; Berger, Anne; Bifulco, Carlo; Botti, Gerardo; Tatangelo, Fabiana; Britten, Cedrik M; Kreiter, Sebastian; Chouchane, Lotfi; Delrio, Paolo; Arndt, Hartmann; Asslaber, Martin; Maio, Michele; Masucci, Giuseppe V; Mihm, Martin; Vidal-Vanaclocha, Fernando; Allison, James P; Gnjatic, Sacha; Hakansson, Leif; Huber, Christoph; Singh-Jasuja, Harpreet; Ottensmeier, Christian; Zwierzina, Heinz; Laghi, Luigi; Grizzi, Fabio; Ohashi, Pamela S; Shaw, Patricia A; Clarke, Blaise A; Wouters, Bradly G; Kawakami, Yutaka; Hazama, Shoichi; Okuno, Kiyotaka; Wang, Ena; O'Donnell-Tormey, Jill; Lagorce, Christine; Pawelec, Graham; Nishimura, Michael I; Hawkins, Robert; Lapointe, Réjean; Lundqvist, Andreas; Khleif, Samir N; Ogino, Shuji; Gibbs, Peter; Waring, Paul; Sato, Noriyuki; Torigoe, Toshihiko; Itoh, Kyogo; Patel, Prabhu S; Shukla, Shilin N; Palmqvist, Richard; Nagtegaal, Iris D; Wang, Yili; D'Arrigo, Corrado; Kopetz, Scott; Sinicrope, Frank A; Trinchieri, Giorgio; Gajewski, Thomas F; Ascierto, Paolo A; Fox, Bernard A

2012-10-03

Prediction of clinical outcome in cancer is usually achieved by histopathological evaluation of tissue samples obtained during surgical resection of the primary tumor. Traditional tumor staging (AJCC/UICC-TNM classification) summarizes data on tumor burden (T), presence of cancer cells in draining and regional lymph nodes (N) and evidence for metastases (M). However, it is now recognized that clinical outcome can significantly vary among patients within the same stage. The current classification provides limited prognostic information, and does not predict response to therapy. Recent literature has alluded to the importance of the host immune system in controlling tumor progression. Thus, evidence supports the notion to include immunological biomarkers, implemented as a tool for the prediction of prognosis and response to therapy. Accumulating data, collected from large cohorts of human cancers, has demonstrated the impact of immune-classification, which has a prognostic value that may add to the significance of the AJCC/UICC TNM-classification. It is therefore imperative to begin to incorporate the 'Immunoscore' into traditional classification, thus providing an essential prognostic and potentially predictive tool. Introduction of this parameter as a biomarker to classify cancers, as part of routine diagnostic and prognostic assessment of tumors, will facilitate clinical decision-making including rational stratification of patient treatment. Equally, the inherent complexity of quantitative immunohistochemistry, in conjunction with protocol variation across laboratories, analysis of different immune cell types, inconsistent region selection criteria, and variable ways to quantify immune infiltration, all underline the urgent requirement to reach assay harmonization. In an effort to promote the Immunoscore in routine clinical settings, an international task force was initiated. This review represents a follow-up of the announcement of this initiative, and of the J

Cancer classification using the Immunoscore: a worldwide task force

Directory of Open Access Journals (Sweden)

Galon Jérôme

2012-10-01

Full Text Available Abstract Prediction of clinical outcome in cancer is usually achieved by histopathological evaluation of tissue samples obtained during surgical resection of the primary tumor. Traditional tumor staging (AJCC/UICC-TNM classification summarizes data on tumor burden (T, presence of cancer cells in draining and regional lymph nodes (N and evidence for metastases (M. However, it is now recognized that clinical outcome can significantly vary among patients within the same stage. The current classification provides limited prognostic information, and does not predict response to therapy. Recent literature has alluded to the importance of the host immune system in controlling tumor progression. Thus, evidence supports the notion to include immunological biomarkers, implemented as a tool for the prediction of prognosis and response to therapy. Accumulating data, collected from large cohorts of human cancers, has demonstrated the impact of immune-classification, which has a prognostic value that may add to the significance of the AJCC/UICC TNM-classification. It is therefore imperative to begin to incorporate the ‘Immunoscore’ into traditional classification, thus providing an essential prognostic and potentially predictive tool. Introduction of this parameter as a biomarker to classify cancers, as part of routine diagnostic and prognostic assessment of tumors, will facilitate clinical decision-making including rational stratification of patient treatment. Equally, the inherent complexity of quantitative immunohistochemistry, in conjunction with protocol variation across laboratories, analysis of different immune cell types, inconsistent region selection criteria, and variable ways to quantify immune infiltration, all underline the urgent requirement to reach assay harmonization. In an effort to promote the Immunoscore in routine clinical settings, an international task force was initiated. This review represents a follow-up of the announcement of

Optimal analysis of gas cooler and intercooler for two-stage CO2 trans-critical refrigeration system

International Nuclear Information System (INIS)

Li, Wenhua

2013-01-01

Highlights: • Simplified model for tube-fin gas cooler for CO 2 refrigeration system was presented and validated. • Several parameters were investigated using 1st law and 2nd law in component and system level. • Practical guidelines of optimum for tube-fin gas cooler and intercooler were proposed. - Abstract: Energy-based 1st law and exergy-based 2nd law are both employed in the paper to assess the optimal design of gas cooler and intercooler for two-stage CO 2 refrigeration system. A simplified mathematical model of the air-cooled coil is presented and validated against experimental data with good accuracy. The optimum circuit length under the influence of frontal air velocity and deep rows is investigated first. Thereafter, designed coil with optimum circuit length is further evaluated within the two-stage refrigeration system. It is found out the optimum point using 1st law does not coincide with the point using 2nd law in isolated component and the simulation results from isolated component by 2nd law are closer to system analysis. Results show optimum circuit length is much bigger for gas cooler than intercooler and the influence on the length from variation of frontal air velocity and deep rows may be neglected. There does exist optimum frontal air velocity which will decrease with more number of deep rows

Staged cost optimization of urban storm drainage systems based on hydraulic performance in a changing environment

Directory of Open Access Journals (Sweden)

M. Maharjan

2009-04-01

Full Text Available Urban flooding causes large economic losses, property damage and loss of lives. The impact of environmental changes, mainly urbanization and climatic change, leads to increased runoff and peak flows which the drainage system must be able to cope with to reduce potential damage and inconvenience. Allowing for detention storage to compliment the conveyance capacity of the drainage system network is one of the approaches to reduce urban floods. Contemporary practice is to design systems against stationary environmental forcings – including design rainfall, landuse, etc. Due to the rapid change in the climate- and the urban environment, this approach is no longer appropriate, and explicit consideration of gradual changes during the life-time of the drainage system is warranted. In this paper, a staged cost optimization tool based on the hydraulic performance of the drainage system is presented. A one dimensional hydraulic model is used for hydraulic evaluation of the network together with a genetic algorithm based optimization tool to determine optimal intervention timings and responses over the analysis period. The model was applied in a case study area in the city of Porto Alegre, Brazil. It was concluded that considerable financial savings and/or additional level of flood-safety can be achieved by approaching the design problem as a staged plan rather than one-off scheme.

Research on Multiple-Split Load Sharing Characteristics of 2-Stage External Meshing Star Gear System in Consideration of Displacement Compatibility

Directory of Open Access Journals (Sweden)

Shuai Mo

2017-01-01

Full Text Available This paper studies the multiple-split load sharing mechanism of gears in two-stage external meshing planetary transmission system of aeroengine. According to the eccentric error, gear tooth thickness error, pitch error, installation error, and bearing manufacturing error, we performed the meshing error analysis of equivalent angles, respectively, and we also considered the floating meshing error caused by the variation of the meshing backlash, which is from the floating of all gears at the same time. Finally, we obtained the comprehensive angle meshing error of the two-stage meshing line, established a refined mathematical computational model of 2-stage external 3-split loading sharing coefficient in consideration of displacement compatibility, got the regular curves of the load sharing coefficient and load sharing characteristic curve of full floating multiple-split and multiple-stage system, and took the variation law of the floating track and the floating quantity of the center wheel. These provide a scientific theory to determine the load sharing coefficient, reasonable load distribution, and control tolerances in aviation design and manufacturing.

Comparison of abdominoperineal resection and low anterior resection in lower and middle rectal cancer.

Science.gov (United States)