WorldWideScience

Sample records for alternative diagnostic strategies

  1. Diagnostic Strategies for Postmenopausal Bleeding

    Directory of Open Access Journals (Sweden)

    M. C. Breijer

    2010-01-01

    Full Text Available Postmenopausal bleeding (PMB is a common clinical problem. Patients with PMB have 10%–15% chance of having endometrial carcinoma and therefore the diagnostic workup is aimed at excluding malignancy. Patient characteristics can alter the probability of having endometrial carcinoma in patients with PMB; in certain groups of patients the incidence has been reported to be as high as 29%. Transvaginal sonography (TVS is used as a first step in the diagnostic workup, but different authors have come to different conclusions assessing the accuracy of TVS for excluding endometrial carcinoma. Diagnostic procedures obtaining material for histological assessment (e.g., dilatation and curettage, hysteroscopy, and endometrial biopsy can be more accurate but are also more invasive. The best diagnostic strategy for diagnosing endometrial carcinoma in patients with PMB still remains controversial. Future research should be focussed on achieving a higher accuracy of different diagnostic strategies.

  2. Diagnostic Strategy in APR1400

    International Nuclear Information System (INIS)

    These features may bring out changes in operator tasks, changing the characteristics of tasks, or creating new tasks. Diagnostic strategy for identifying anomaly may be different especially in APR1400 from that in the analog control room due to the change of human-system interface, i.e. alarm system and display system. Since the first plant of APR1400 is being built at this moment, it is not known what strategies the operators will adopt in diagnosis tasks in the new operating environment. In this light, this paper aims at investigating operator's diagnostic strategies which are appropriate for APR1400. In order to collect data, several different approaches which are complementary are used to identify diagnostic strategies in the digital control room: analysis on audio/video recording of operation, observation in the simulator, and interview with the operators. The result shows that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of strategies, mostly, by getting more support from the computerized system. This paper investigated how the digitalized control room may influence operator's diagnostic strategies. Several different approaches, i. e., audio/video record, observation of training, and the interview with operators, were used to gather information about the operator's behaviors. As a conclusion, this paper figured out that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of the strategies, mostly, by getting more support from the computerized system. The operators interviewed also commented that the diagnosis in the APR1400 is quicker, more correct, and easier, compared with the analog control room

  3. Autocratic strategies for alternating games

    OpenAIRE

    McAvoy, Alex; Hauert, Christoph

    2016-01-01

    Repeated games have a long tradition in behavioral sciences and evolutionary biology. Recently, strategies were discovered that permit an unprecedented level of control over repeated interactions by enabling a player to unilaterally enforce constraints on the payoffs. Here, we extend this theory of autocratic (or zero-determinant) strategies to alternating games, which are often more biologically relevant than synchronous games. More specifically, in a strictly-alternating game with two playe...

  4. Deletion Diagnostics for Alternating Logistic Regressions

    OpenAIRE

    Preisser, John S; By, Kunthel; Perin, Jamie; Qaqish, Bahjat F.

    2012-01-01

    Deletion diagnostics are introduced for the regression analysis of clustered binary outcomes estimated with alternating logistic regressions, an implementation of generalized estimating equations (GEE) that estimates regression coefficients in a marginal mean model and in a model for the intracluster association given by the log odds ratio. The diagnostics are developed within an estimating equations framework that recasts the estimating functions for association parameters based upon conditi...

  5. ALTERNATE PRICING STRATEGIES IN CONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Krishna Mochtar

    2000-01-01

    Full Text Available Recent research findings on pricing strategies both in general and in construction are reviewed and explored. First%2C pricing strategy in general%2C mostly in the manufacturing industry%2C is reviewed. It includes the concepts of pricing strategy%2C predatory pricing%2C price wars%2C and price policy development. Second%2C pricing strategy in construction is explored. It includes various pricing models for bid price determination%2C such as the Friedman-Gates models%2C expected utility models%2C risk-pricing model%2C and the crew-day%2C multiple regression%2C and fuzzy-set pricing models. In conclusion%2C pricing strategies in construction are still predominantly based on a cost-based approach. More recent models try to close the gap between the models and the real life conditions of a bidder%5C%27s decision-making process. It appears that there are more problems in cost-based pricing as opposed to market-based pricing. Consequently%2C it is highly recommended that%2C alternative pricing approach such as that are closer to the proposed market-based pricing model need to be explored and developed for use in the construction industry. Abstract in Bahasa Indonesia : Pricing+strategy%2C+cost-based+pricing%2C+market-based+pricing.

  6. Diagnostic strategies in nasal congestion

    Directory of Open Access Journals (Sweden)

    John Krouse

    2010-02-01

    Full Text Available John Krouse1, Valerie Lund2, Wytske Fokkens3, Eli O Meltzer41Temple University School of Medicine, Philadelphia, PA, USA; 2Ear Institute, University College London, UK; 3Department of Otorhinolaryngology, Amsterdam Medical Centre, Netherlands; 4Allergy and Asthma Medical Group and Research Center, San Diego, CA and Department of Pediatrics, University of California, San Diego, USAAbstract: Nasal congestion is a major symptom of upper respiratory tract disorders, and its characterization an important part of the diagnosis of these illnesses. Patient history and assessment of nasal symptoms are essential components of diagnosis, providing an initial evaluation that may be adequate to rule out serious conditions. However, current congestion medications are not always fully effective. Thus, if symptoms do not respond adequately to therapy, or symptoms suggestive of more serious conditions are present, specialized assessments may be needed. Various techniques are available for diagnosing patients, including those used chiefly by primary care clinicians and those requiring the expertise of otolaryngologists, allergists, and other specialists. Endoscopy remains a mainstay for evaluating nasal blockage and its causes, while modalities such as peak nasal inspiratory flow and acoustic rhinometry are evolving to provide easy-to-use, noninvasive procedures that are sensitive enough to measure small but clinically important abnormalities and therapeutic changes. Several imaging modalities are available to the specialist for severe or unusual cases, as are specialized diagnostic procedures that measure adjunctive features of congestion, such as impaired mucociliary function.Keywords: allergic rhinitis, congestion, diagnosis, obstruction, rhinosinusitis

  7. Evolving imaging techniques in diagnostic strategies of pulmonary embolism.

    Science.gov (United States)

    Robert-Ebadi, Helia; Le Gal, Grégoire; Righini, Marc

    2016-04-01

    Modern non invasive diagnostic strategies for pulmonary embolism (PE) rely on the sequential use of clinical probability assessment, D-dimer measurement and thoracic imaging tests. Planar ventilation/perfusion (V/Q) scintigraphy was the cornerstone for more than two decades and has now been replaced by computed tomography pulmonary angiography (CTPA). Diagnostic strategies using CTPA are very safe to rule out PE and have been well validated in large prospective management outcome studies. With the widespread use of CTPA, concerns regarding radiation and overdiagnosis of PE have paved the way for investigating new diagnostic modalities. V/Q single photon emission tomography has arisen as a highly accurate test and a potential alternative to CTPA. However, prospective management outcome studies are still lacking and are warranted before implementation in everyday clinical practice. PMID:26691634

  8. ALTERNATE PRICING STRATEGIES IN CONSTRUCTION

    OpenAIRE

    Krishna Mochtar; David Arditi

    2000-01-01

    Recent research findings on pricing strategies both in general and in construction are reviewed and explored. First%2C pricing strategy in general%2C mostly in the manufacturing industry%2C is reviewed. It includes the concepts of pricing strategy%2C predatory pricing%2C price wars%2C and price policy development. Second%2C pricing strategy in construction is explored. It includes various pricing models for bid price determination%2C such as the Friedman-Gates models%2C expected utility model...

  9. An Alternative Triangle Area Strategy

    Science.gov (United States)

    Shockey, T. L.; Zhang, P.; Brosnan, P.

    2016-01-01

    We explore the mathematics engagement of a group of mathematics coaches, working in k-12 mathematics education. The incenter of a triangle is used to derive an alternative formula for the area of a triangle inspired by Usiskin, Peressini, Marhisotto, and Stanley (2002).

  10. ANTARES alternative event reconstruction strategies

    CERN Document Server

    Becherini, Y

    2007-01-01

    The ANTARES Collaboration is building a high-energy neutrino telescope at 2500 m depth in the Mediterranean Sea. The experiment aims to search for high-energy cosmic neutrinos through the detection of Cerenkov light induced by muons and showers resulting from neutrino interactions with the surrounding medium. The detector will consist of a three-dimensional array of 900 optical modules housing photomultipliers. It will be composed of 12 strings, 5 of them being already in operation since January 2007. The muon track is reconstructed from the arrival time and the charge of the signals obtained from the photomultipliers, whose positions are known by means of an acoustic positioning system. The reconstruction strategies include several steps among which there are: optical background filtering, algorithms for first estimations of the track parameters, and a final fit aiming to reach an angular resolution better than 0.3 degree above 10 TeV in the full detector. Different reconstruction strategies will be presente...

  11. Summary: analysis of alternative FBR development strategies

    International Nuclear Information System (INIS)

    This report summarizes the comparative evaluation of alternative strategies for the development of the commercial fast breeder reactor (FBR) in the United States. For planning purposes, a range of possible FBR development paths called strategies were selected for evaluation. These strategies, designed to be technically and economically feasible, were expressed in terms of the timing and nature of facilities/research and development programs required to reach full power operation of the first commercial FBR. Four of the seven strategies resulted in a large (1457 MWe) FBR as an end point, the other three in a 1000-MWe plant. Probability distributions were calculated for total strategy costs and time to completion. For the seven strategies analyzed, the costs (discounted 1980 dollars) ranged from $1.8 billion to $4.9 billion; the completion times ranged from 24 to 55 years

  12. MR imaging of the kidneys: new diagnostic strategies

    International Nuclear Information System (INIS)

    Aim: New diagnostic strategies for evaluation of the kidney by fast MR imaging of renal morphology, multiphase 3D gadolinium MR angiography, MR urography and MR flow measurements. A signal MR examination is designed to grade renovascular disease and assess the hemodynamic and functional significance, detect and characterize renal lesions and evaluate the urinary tract. Results: The combined analysis of morphologic and functional data allows reliable assessment of renal artery stenosis, benign and malignant renal masses and diseases of the renal collecting system and ureters, as well as congenital abnormalities in good agreement to the results of conventional imaging modalities. The improved tissue contrast and additional functional information compensates for the disadvantage of a lower spatial resolution. Conclusion: Combined morphologic and functional MR examination represents a reliable, non-invasive and cost-effective alternative imaging modality for comprehensive diagnostic evaluation of renal disease. (orig.)

  13. An alternative strategy for Kyoto protocol

    International Nuclear Information System (INIS)

    Europe will unlikely meet its Kyoto target of reducing greenhouse gas emission by 8 percent below 1990 levels. The economic impact of reductions might be dramatic, especially given Europe's slow economic growth. An alternative strategy should then be considered, in order to gain a global participation to the process and find a long-term solution

  14. Research requirements for alternative reactor development strategies

    International Nuclear Information System (INIS)

    The purpose of this paper is to estimate and compare resource requirements and other fuel cycle quantities for alternative reactor deployment strategies. The paper examines from global and national perspectives the interaction of various fuel cycle alternatives described in the previous U.S. submissions to Working Groups 4, 5, 8 and Subgroup 1A/2A. Nuclear energy forecasts of Subgroup 1A/2A are used in the calculation of uranium demand for each strategy. These uranium demands are then compared to U.S. estimates of annual uranium producibility. Annual rather than cumulative producibility was selected because it does not assume preplanned stockpiling, and is therefore more conservative. The strategies attempt to span a range of nuclear power mixes which could evolve if appropriate commercial and governmental climates develop

  15. Alternative evacuation strategies for nuclear power accidents

    International Nuclear Information System (INIS)

    In the U.S., current protective-action strategies to safeguard the public following a nuclear power accident have remained largely unchanged since their implementation in the early 1980s. In the past thirty years, new technologies have been introduced, allowing faster computations, better modeling of predicted radiological consequences, and improved accident mapping using geographic information systems (GIS). Utilizing these new technologies, we evaluate the efficacy of alternative strategies, called adaptive protective action zones (APAZs), that use site-specific and event-specific data to dynamically determine evacuation boundaries with simple heuristics in order to better inform protective action decisions (rather than relying on pre-event regulatory bright lines). Several candidate APAZs were developed and then compared to the Nuclear Regulatory Commission’s keyhole evacuation strategy (and full evacuation of the emergency planning zone). Two of the APAZs were better on average than existing NRC strategies at reducing either the radiological exposure, the population evacuated, or both. These APAZs are especially effective for larger radioactive plumes and at high population sites; one of them is better at reducing radiation exposure, while the other is better at reducing the size of the population evacuated. - Highlights: • Developed framework to compare nuclear power accident evacuation strategies. • Evacuation strategies were compared on basis of radiological and evacuation risk. • Current strategies are adequate for smaller scale nuclear power accidents. • New strategies reduced radiation exposure and evacuation size for larger accidents

  16. Measurement and evaluation of alternative planning strategies

    OpenAIRE

    Jwala, Vidya Ranya

    1995-01-01

    Strategic Planning is a function practiced by most public and private sector organizations. Most managers are familiar with the concept of strategic planning and associated processes. There has been some research in the field of management focusing on the alternatives to strategic planning approach. "Management by groping along" is one such approach. The "Management by groping along" strategy attempts to make an organization capable of adapting, responding and, allocating resou...

  17. Trypanosoma evansi in Northern Ethiopia: epidemiology, diversity and alternative diagnostics

    OpenAIRE

    Abera, Birhanu Hadush

    2016-01-01

    Trypanosoma evansi in Northern Ethiopia: epidemiology, diversity and alternative diagnostics Animal African trypanosomosis (AAT) is a complex of parasitic diseases of various domestic and wild animal species caused by different species of trypanosomes. Trypanosoma (T.) brucei, T. congolense and T. vivax are transmitted by tsetse flies. Trypanosoma evansi, but also T. vivax, is mechanically transmitted by other biting flies and T. equiperdum is sexually transmitted in Equidae. All these ...

  18. In-service diagnostics of 1000 MW turbo-alternator

    International Nuclear Information System (INIS)

    The tests are described of a 1000 MW turbo-alternator involving stator and rotor windings cooling, diagnostics of hydrogen coolers and the fan circuit coolers, hydrogen leak detection, recording the size and changes of current and voltage, monitoring the level of stator face vibrations, the indication of short-circuits of rotor winding turns, and monitoring the size of the electromagnetic moment across the stator and the rotor. (J.B.)

  19. Colorectal cancer: diagnostic and therapeutic strategies

    International Nuclear Information System (INIS)

    Technical advances that has been achieved during the past two decades have not dramatically improved the 35 % five-year rate observed in patients with colorectal cancer. These tumours remain one of the most challenging problems in public health policies in western countries. Screening applies to some subgroups of high-risk individuals and the general population aged over 50. In order to improve their efficacy, such screening programs imply large-scale information campaigns and a strong cooperation with the general physicians. The diagnosis is strongly suggested by any recent modification of bowel habits ad by rectal bleeding. It has to be confirmed by rectal examination and by colonoscopy which allows sampling to the tumour. Loco-regional and distant metastatic tumour spread must be assessed precisely before any therapeutic strategy is decided. Surgery, which resects the tumour en bloc with the corresponding lymphatic territories, is the only treatment that can achieve long term cure. In localized tumours, surgery alone can provide patients with 5-years survival rates close to 95 %. On the other hand, surgery alone is not sufficient to cure patients with advances cancers. In recent years, several adjuvant therapeutic modalities have been shown to improve the results of surgery in these cases (rectal cancer: pre-operative radiotherapy or post-operative radio-chemotherapy, colon cancer with nodal metastases: post-operative chemotherapy). There is a hope that a better use of our diagnostic and therapeutic armementarium would be able to avoid or to cure up to 75 % of the colorectal cancers we are dealing with. (author)

  20. Autoimmune diagnostics: the technology, the strategy and the clinical governance.

    Science.gov (United States)

    Bizzaro, Nicola; Tozzoli, Renato; Villalta, Danilo

    2015-02-01

    In recent years, there has been a profound change in autoimmune diagnostics. From long, tiring and inaccurate manual methods, the art of diagnostics has turned to modern, rapid and automated technology. New antibody tests have been developed, and almost all autoimmune diseases now have some specific diagnostic markers. The current need to make the most of available economic and human resources has led to the production of diagnostic algorithms and guidelines designated for optimal strategic use of the tests and to increase the diagnostic appropriateness. An important role in this scenario was assumed by the laboratory autoimmunologist, whose task is not only to govern the analytical phase, but also to help clinicians in correctly choosing the most suitable test for each clinical situation and provide consultancy support. In this review, we summarize recent advances in technology, describe the diagnostic strategies and highlight the current role of the laboratory autoimmunologist in the clinical governance of autoimmune diagnostics. PMID:25398640

  1. 24 CFR 248.223 - Alternative State strategy.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Alternative State strategy. 248.223... Preservation Act of 1987 § 248.223 Alternative State strategy. (a) The Commissioner may approve a State strategy providing for State approval of plans of action that involve termination of low...

  2. Pivot and cluster strategy: a preventive measure against diagnostic errors

    Directory of Open Access Journals (Sweden)

    Shimizu T

    2012-11-01

    Full Text Available Taro Shimizu,1 Yasuharu Tokuda21Rollins School of Public Health, Emory University, Atlanta, GA, USA; 2Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, JapanAbstract: Diagnostic errors constitute a substantial portion of preventable medical errors. The accumulation of evidence shows that most errors result from one or more cognitive biases and a variety of debiasing strategies have been introduced. In this article, we introduce a new diagnostic strategy, the pivot and cluster strategy (PCS, encompassing both of the two mental processes in making diagnosis referred to as the intuitive process (System 1 and analytical process (System 2 in one strategy. With PCS, physicians can recall a set of most likely differential diagnoses (System 2 of an initial diagnosis made by the physicians’ intuitive process (System 1, thereby enabling physicians to double check their diagnosis with two consecutive diagnostic processes. PCS is expected to reduce cognitive errors and enhance their diagnostic accuracy and validity, thereby realizing better patient outcomes and cost- and time-effective health care management.Keywords: diagnosis, diagnostic errors, debiasing

  3. Molecular diagnostics: future probe-based strategies.

    Science.gov (United States)

    Marsh, Peter; Cardy, Donald L N

    2004-01-01

    Nucleic acid amplification technologies (NAATs) represent powerful tools in clinical microbiology, particularly in areas where traditional culture-based methods alone prove insufficient. A notable advantage is in reducing the time from taking samples to reporting results. This, and the specificity and sensitivity imparted by NAATs, can help to improve patient care. Both thermal and isothermal NAATs have been adapted to aid diagnosis in clinical laboratories. Current molecular diagnostic assays are generally high-tech, and are expensive to buy and perform. Easy-to-use NAATs are beginning to appear, not only facilitating acceptable throughput in clinical laboratories, but also allowing tests to move out of the laboratory, closer to the point of care. Demand for simpler, miniaturized equipment and assays, and the trend toward personalized medicine, is leading towards the development of fully integrated automation and home-use kits. The integration of diverse disciplines, such as genomics, molecular biology, microelectromechanical systems, microfluidics, microfabrication, and organic chemistry, is behind the emerging DNA microarray technology. Development of DNA microchips allows the simultaneous detection of potentially thousands of target sequences, not only favoring high throughput, but also the potential for genotyping patient subsets with respect to their response to particular drug types (pharmakogenomics). It is envisaged that the future of probe-based technologies will see the development of fully integrated assays and devices suitable for nonskilled users. PMID:15148419

  4. Diagnostic Imaging Strategies of the Midface

    Directory of Open Access Journals (Sweden)

    Florian Dammann

    2011-05-01

    Full Text Available Review of the actual recommendations and clinical key"nissues of imaging midface disease High resolution spiral"nCT is accepted as the standard modality for imaging"nof midface disorders. The main indications include"nchronic sinusitis, tumor diagnosis and midfacial trauma."nThe diagnostic key issues of these different indications"nand the derivational implications for CT technique are"nexplained. CT is the most precise and comprehensive"nimaging modality for diagnosis of midfacial trauma."nMultiplanar reformations of spiral CT including"ncoronal and sagitally angulated views along the orbital"nfloor as well as three-dimensional renderings are"ncrucial for a detailed pre-operative diagnosis, but some"ntechnical issues have to be regarded. Paranasal sinus"ninflammatory disease is the most frequent indication"nfor a midface CT. Low dose technique should be applied"nas state of the art in these examinations. The lecture"nwill elucidate relevant technical details of paranasal"nsinus CT, as well as anatomical key structures and the"nspecific patho-anatomical nomenclature that should"nbe refered to in the radiological report. The use of MRI"nin the midface is yet mostly limited to complications"nof inflammatory disease or malignant tumors of the"nmidface. The lecture will show case typical clinical"nsettings, but also future aspects of MRI diagnosis of the"nmidface.

  5. CHOLANGIOCARCINOMA: STRATEGY OF DIAGNOSTIC AND TREATMENT

    Directory of Open Access Journals (Sweden)

    C. Gouillat

    2005-10-01

    Full Text Available Cancers of the biliary tree located within the hilum of the liver, are classified according to the pattern of right and left hepatic ductal involvement (Bismuth classification. For this kind of cancers (Klatskin tumors the treatment is controversy. The diagnosis and tumor stage are established by some explorations: ultrasound exam, computed tomography (CT, helical CT, MRI (magnetic resonance imagery, ERCP (endoscopic retrograde cholangiopancreatography. The laparoscopic assessment is useful (with intraoperative ultrasonography and had an accuracy of 53% in some papers. There are two therapeutic strategies: the "aggressive" attitude (surgical resection and palliative treatment. Surgical resections are indicated in elective patients; these techniques include hepatectomies, resection of the main biliary duct, cholecystectomy and sometimes, hepato-duodeno-pancreatectomy. The most optimistic statistics show a postoperative mortality of 10%, a morbidity of 60% and a R0 resection rate of 60%. The mean survival rate was 30-40 month. Palliative treatment includes: the trans-tumoral endo-prothesis (inserted by surgery or, better, by minimally invasive techniques - ERCP, interventional radiology and percutaneous external biliary drainage. Conclusions: A correct assessment of the Klatskin tumors is necessary for therapeutic strategy. The aggressive surgical treatment is indicated only in elective patients and with a multidisciplinary team. Surgeons are playing a key role in the management of cholangiocarcinoma.

  6. Diagnostic strategies for C-reactive protein

    Directory of Open Access Journals (Sweden)

    Kluft Cees

    2002-05-01

    Full Text Available Abstract Background Serum C-reactive protein (CRP has been identified in prospective epidemiological research as an independent risk marker for cardiovascular disease. In this paper, short-term biological variation of CRP is documented and a strategy to test the reliability of a single CRP sample is proposed. Methods Data were obtained from three groups of healthy volunteers: men, no oral contraceptives (OC-using women and OC-using women. Blood samples were obtained 3 times in men and twice in women during a workweek. Results and discussion CRP values were highest in the OC-using women, followed by the men, and lowest in the no OC-using women. Averaged over the three groups the within-subject coefficients of variation (CVi was 49.24% for CRP, and 29.90% for lnCRP. Using the repeated measures, individual samples were identified that reflected a 'suspicious' unreliable high value, i.e. a value that was more than 2 standard deviations higher than the lowest value obtained from the same subject. In an a posteriori analysis, three strategies to identify these suspicious high CRP values were then tested. In terms of maximizing detection of suspicious values and minimizing unnecessary resampling, best results were obtained for the most pragmatic criterion of using an absolute level, stratified for gender, and OC-use, to decide whether a second sample should be obtained. Conclusion A single high CRP value must be followed by re-sampling when it is above 1.75 mg/l for men, above 1.00 mg/l for no OC-using women, and above 2.00 mg/l for OC-using women.

  7. Characterization of alternative FBR development strategies

    International Nuclear Information System (INIS)

    Near-term decisions regarding the nature and place of the FBR development program must be made. This study is part of a larger program designed to provide the Department of Energy (DOE) with imformation that can be used to make strategic programmatic decisions. The focus of this report is the description of alternative approaches for developing the FBR and the quantification of the duration and cost of each alternative. The time frames of the alternative approaches are investigated in companion reports (White 1981 and Fraley 1981). The results of these analyses will be described in a summary report

  8. Towards Personalized Cancer Therapy : New Diagnostic Biomarkers and Radiosensitization Strategies

    OpenAIRE

    Spiegelberg, Diana

    2015-01-01

    This thesis focuses on the evaluation of biomarkers for radio-immunodiagnostics and radio-immunotherapy and on radiosensitization strategies after HSP90 inhibition, as a step towards more personalized cancer medicine. There is a need to develop new tracers that target cancer-specific biomarkers to improve diagnostic imaging, as well as to combine treatment strategies to potentiate synergistic effects. Special focus has been on the cell surface molecule CD44 and its oncogenic variants, which w...

  9. Alternative Instructional Strategies in an IS Curriculum

    Science.gov (United States)

    Parker, Kevin R.; LeRouge, Cynthia; Trimmer, Ken

    2005-01-01

    Systems Analysis and Design is a core component of an education in information systems. To appeal to a wider range of constituents and facilitate the learning process, the content of a traditional Systems Analysis and Design course has been supplemented with an alternative modeling approach. This paper presents an instructional design that…

  10. Introducing Complementary/Alternative Strategies in a Baccalaureate Curriculum.

    Science.gov (United States)

    Pepa, Carole Anne; Russell, Cynthia Ann

    2000-01-01

    An undergraduate nursing course explores healing strategies based on mind-body-spirit connections. It examines research on the efficacy of these alternative/complementary methods and their health care policy implications. (SK)

  11. The role of strategy and redundancy in diagnostic reasoning

    Directory of Open Access Journals (Sweden)

    Feller Sabine

    2003-01-01

    Full Text Available Abstract Background Diagnostic reasoning is a key competence of physicians. We explored the effects of knowledge, practice and additional clinical information on strategy, redundancy and accuracy of diagnosing a peripheral neurological defect in the hand based on sensory examination. Method Using an interactive computer simulation that includes 21 unique cases with seven sensory loss patterns and either concordant, neutral or discordant textual information, 21 3rd year medical students, 21 6th year and 21 senior neurology residents each examined 15 cases over the course of one session. An additional 23 psychology students examined 24 cases over two sessions, 12 cases per session. Subjects also took a seven-item MCQ exam of seven classical patterns presented visually. Results Knowledge of sensory patterns and diagnostic accuracy are highly correlated within groups (R2 = 0.64. The total amount of information gathered for incorrect diagnoses is no lower than that for correct diagnoses. Residents require significantly fewer tests than either psychology or 6th year students, who in turn require fewer than the 3rd year students (p Conclusions Knowledge and practice are both important for diagnostic success. For complex diagnostic situations reasoning components employing redundancy seem more essential than those using strategy.

  12. An alternative model for the description of computational estimation strategies

    OpenAIRE

    Castro Hernández, Carlos de; Segovia Álex, Isidoro; Castro Martínez, Enrique

    2002-01-01

    In this study we have analyzed the estimation strategies employed by preservice elementary teachers. It has been used an alternative model for the description of computational estimation strategies. In this model, strategies are integrated by approximation skills, mental computation algorithms, cognitive processes (reformulation, translation and compensation) and metacognitive processes (as the assessment of the outcome). The adoption of this model allows making the identification and charact...

  13. Rational design of diagnostic and vaccination strategies for tuberculosis

    Directory of Open Access Journals (Sweden)

    Sibele Borsuk

    2012-02-01

    Full Text Available The development of diagnostic tests which can readily differentiate between vaccinated and tuberculosis-infected individuals is crucial for the wider utilization of bacillus Calmette-Guérin (BCG as vaccine in humans and animals. BCG_0092 is an antigen that elicits specific delayed type hypersensitivity reactions similar in size and morphological aspects to that elicited by purified protein derivative, in both animals and humans infected with the tubercle bacilli. We carried out bioinformatics analyses of the BCG_0092 and designed a diagnostic test by using the predicted MHC class I epitopes. In addition, we performed a knockout of this gene by homologous recombination in the BCG vaccine strain to allow differentiation of vaccinated from infected individuals. For that, the flanking sequences of the target gene (BCG_0092were cloned into a suicide vector. Spontaneous double crossovers, which result in wild type revertants or knockouts were selected using SacB. BCG_0092 is present only in members of the Mycobacterium tuberculosis complex. Eight predicted MHC class I epitopes with potential for immunological diagnosis were defined, allowing the design of a specific diagnostic test. The strategy used to delete the (BCG_0092 gene from BCG was successful. The knockout genotype was confirmed by PCR and by Southern blot. The mutant BCG strain has the potential of inducing protection against tuberculosis without interfering with the diagnostic test based on the use of selected epitopes from BCG_0092.

  14. Proteinuria: The diagnostic strategy based on urine proteins differentiation

    Directory of Open Access Journals (Sweden)

    Stojimirović Biljana B.

    2004-01-01

    Full Text Available Basal glomerular membrane represents mechanical and electrical barrier for passing of the plasma proteins. Mechanical barrier is composed of cylindrical pores and filtration fissure, and negative layer charge in exterior and interior side of basal glomerular membrane, made of heparan sulphate and sialoglicoproteine, provides certain electrical barrier. Diagnostic strategy based on different serum and urine proteins enables the differentiation of various types of proteinuria. Depending on etiology of proteinuria it can be prerenal, renal and postrenal. By analyzing albumin, armicroglobulin, immunoglobulin G and armacroglobulin, together with total protein in urine, it is possible to detect and differentiate causes of prerenal, renal (glomerular, tubular, glomerulo-tubular and postrenal proteinuria. The adequate and early differentiation of proteinuria type is of an immense diagnostic and therapeutic importance.

  15. Alternative Splicing and Its Impact as a Cancer Diagnostic Marker

    OpenAIRE

    Kim, Yun-Ji; Kim, Heui-Soo

    2012-01-01

    Most genes are processed by alternative splicing for gene expression, resulting in the complexity of the transcriptome in eukaryotes. It allows a limited number of genes to encode various proteins with intricate functions. Alternative splicing is regulated by genetic mutations in cis-regulatory factors and epigenetic events. Furthermore, splicing events occur differently according to cell type, developmental stage, and various diseases, including cancer. Genome instability and flexible proteo...

  16. [Diagnostics and treatment strategies for multiple trauma patients].

    Science.gov (United States)

    Pfeifer, R; Pape, H-C

    2016-02-01

    Severe trauma is still one of the leading causes of death worldwide. The initial treatment and diagnostics are of immense importance in polytraumatized patients. The initial approach mainly focuses on the advanced trauma life support (ATLS) concept. This includes the identification of life-threatening conditions and application of life-saving interventions. Depending on the physiological condition of the patient, the surgical treatment strategies of early total care (ETC) or damage control orthopedics (DCO) can be chosen. Appropriate surgical management can reduce the incidence of associated delayed systemic complications. This review summarizes the most commonly used definitions of polytrauma (including the Berlin polytrauma definition) and classification systems of severely injured patients. Moreover, the recently introduced treatment strategy of the safe definitive surgery concept for severely injured patients is also discussed in this article. PMID:26830303

  17. [Acceptance of alternative disease control strategies in the European Union].

    Science.gov (United States)

    Nigsch, Annette; Depner, Klaus

    2012-01-01

    The European Commission intends to change its animal disease control strategy following the slogan "Prevention is better than cure". Vaccination and diagnostics should play a major role in emergency situations. A policy paper regarding the use of vaccines has been discussed with all Member States and the main aspects were evaluated in a questionnaire. In principle, the majority of Member States are in favour of a future strategy in which vaccination is replacing culling. However, questions regarding the pathogen freedom and the trade of vaccinated animals and animal products from vaccinated animals still remain open. PMID:22372318

  18. Application of alternative fixatives to formalin in diagnostic pathology

    Directory of Open Access Journals (Sweden)

    L. Benerini Gatta

    2012-05-01

    Full Text Available Fixation is a critical step in the preparation of tissues for histopathology. The objective of this study was to investigate the effects of different fixatives vs formalin on proteins and DNA, and to evaluate alternative fixation for morphological diagnosis and nucleic acid preservation for molecular methods. Forty tissues were fixed for 24 h with six different fixatives: the gold standard fixative formalin, the historical fixatives Bouin and Hollande, and the alternative fixatives Greenfix, UPM and CyMol. Tissues were stained (Haematoxylin-Eosin, Periodic Acid Schiff, Trichromic, Alcian-blue, High Iron Diamine, and their antigenicity was determined by immunohistochemistry (performed with PAN-CK, CD31, Ki-67, S100, CD68, AML antibodies. DNA extraction, KRAS sequencing, FISH for CEP-17, and flow cytometry analysis of nuclear DNA content were applied. For cell morphology the alternative fixatives (Greenfix, UPM, CyMol were equivalent to formalin. As expected, Hollande proved the best fixative for morphology. The morphology obtained with Bouin was comparable to that with formalin. Hollande was the best fixative for histochemistry. Bouin proved equivalent to formalin. The alternative fixatives were equivalent to formalin, although with greater variability in haematoxylin-eosin staining. It proved possible to obtain immunohistochemical staining largely equivalent to that following formalin-fixation with the following fixatives: Greenfix, Hollande, UPM and CyMol. The tissues fixed in Bouin did not provide results comparable to those obtained with formalin. The DNA extracted from samples fixed with alternative fixatives was found to be suitable for molecular analysis.

  19. Telemetry with an Optical Fiber Revisited: An Alternative Strategy

    Science.gov (United States)

    Kraftmakher, Yaakov

    2014-01-01

    With a new data-acquisition system developed by PASCO scientific, an experiment on telemetry with an optical fiber can be made easier and more accurate. For this aim, an alternative strategy of the remote temperature measurements is proposed: the frequency of light pulses transmitted via the light guide numerically equals the temperature using…

  20. Supporting Alternative Strategies for Learning Chemical Applications of Group Theory

    Science.gov (United States)

    Southam, Daniel C.; Lewis, Jennifer E.

    2013-01-01

    A group theory course for chemists was taught entirely with process oriented guided inquiry learning (POGIL) to facilitate alternative strategies for learning. Students completed a test of one aspect of visuospatial aptitude to determine their individual approaches to solving spatial tasks, and were sorted into groups for analysis on the basis of…

  1. Testing and assessment strategies, including alternative and new approaches

    DEFF Research Database (Denmark)

    Meyer, Otto A.

    2003-01-01

    ethical concern. However, irrespective of animal welfare it is an important aspect of the discipline of toxicology that the primary object is human health. The ideal testing and assessment strategy is simple to use all the available test methods and preferably more in laboratory animal species from which...... there are more than 100000 chemicals which are potential for human exposure, so the development of alternative testing and assessment strategies has taken place in the recent years. The toxicological evaluation should enable the society to cope with the simultaneous requirement of many chemicals for...

  2. Female impersonation as an alternative reproductive strategy in giant cuttlefish

    OpenAIRE

    Norman, M. D.; Finn, J.; Tregenza, T.

    1999-01-01

    Out of all the animals, cephalopods possess an unrivalled ability to change their shape and body patterns. Our observations of giant cuttlefish (Sepia apama) suggest this ability has allowed them to evolve alternative mating strategies in which males can switch between the appearance of a female and that of a male in order to foil the guarding attempts of larger males. At a mass breeding aggregation in South Australia, we repeatedly observed single small males accompanying mating pairs. While...

  3. Change communication : the impact on satisfaction with alternative workplace strategies

    OpenAIRE

    Bull, Melanie; Brown, Tim

    2012-01-01

    Communication is fundamental to the Facilities Management (FM) role within organisations; especially when the FM department is implementing changes to the workplace. An evaluation of an instance is presented. A self- administered online questionnaire was used to collect quantitative and qualitative data. The research focused on responses to satisfaction with the communication methods rather than reviewing the merits of alternative workplace strategies. Findings included the impact of...

  4. Identifying Differences in Diagnostic Skills between Physics Students: Students' Self-Diagnostic Performance Given Alternative Scaffolding

    CERN Document Server

    Cohen, Elisheva; Singh, Chandralekha; Yerushalmi, Edit

    2016-01-01

    "Self-diagnosis tasks" aim at fostering diagnostic behavior by explicitly requiring students to present diagnosis as part of the activity of reviewing their problem solutions. We have been investigating the extent to which introductory physics students can diagnose their own mistakes when explicitly asked to do so with different levels of scaffolding support provided to them. In our study in an introductory physics class with more than 200 students, the recitation classes were split into three different experimental groups in which different levels of guidance were provided for performing the self-diagnosis activities. We present our findings that students' performance was far from perfect. However, differences in the scaffolding in the three experimental groups (i.e. providing a correct solution and a self-diagnosis rubric) noticeably affected the resulting diagnosis.

  5. Energy demand analysis in the workshop on alternative energy strategies

    Energy Technology Data Exchange (ETDEWEB)

    Carhart, S C

    1978-04-01

    The Workshop on Alternative Energy Strategies, conducted from 1974 through 1977, was an international study group formed to develop consistent national energy alternatives within a common analytical framework and global assumptions. A major component of this activity was the demand program, which involved preparation of highly disaggregated demand estimates based upon estimates of energy-consuming activities and energy requirements per unit of activity reported on a consistent basis for North America, Europe, and Japan. Comparison of the results of these studies reveals that North America requires more energy per unit of activity in many consumption categories, that major improvements in efficiency will move North America close to current European and Japanese efficiencies, and that further improvements in European and Japanese efficiencies may be anticipated as well. When contrasted with expected availabilities of fuels, major shortfalls of oil relative to projected demands emerge in the eighties and nineties. Some approaches to investment in efficiency improvements which will offset these difficulties are discussed.

  6. Comparative cost analysis -- computed tomography vs. alternative diagnostic procedures, 1977-1980

    International Nuclear Information System (INIS)

    In comparing the total national cost of utilizing computed tomography (CT) for medically indicated diagnoses with that of conventional x-ray, ultrasonography, nuclear medicine, and exploratory surgery, this investigation concludes that there was little, if any, added net cost from CT use in 1977 or will there be in 1980. Computed tomography, generally recognized as a reliable and useful diagnostic modality, has the potential to reduce net costs provided that an optimal number of units can be made available to physicians and patients to achieve projected reductions in alternative procedures. This study examines the actual cost impact of CT on both cranial and body diagnostic procedures. For abdominal and mediastinal disorders, CT scanning is just beginning to emerge as a diagnostic modality. As such, clinical experience is somewhat limited and the authors assume that no significant reduction in conventional procedures took place in 1977. It is estimated that the approximately 375,000 CT body procedures performed in 1977 represent only a 5 percent cost increase over use of other diagnostic modalities. It is projected that 2,400,000 CT body procedures will be performed in 1980 and, depending on assumptions used, total body diagnostic costs will increase only slightly or be reduced. Thirty-one tables appear throughout the text presenting cost data broken down by types of diagnostic procedures used and projections by years. Appendixes present technical cost components for diagnostic procedures, the comparative efficacy of CT as revealed in abstracts of published literature, selected medical diagnoses, and references

  7. [Pilon fractures. Part 1: Diagnostics, treatment strategies and approaches].

    Science.gov (United States)

    Krettek, C; Bachmann, S

    2015-01-01

    Intraarticular fractures of the distal tibia (pilon fractures) are caused by axial forces, usually in combination with torsional moments. Routine diagnostics include plain films and three dimensional (3D) imaging with computed tomography (CT). Treatment is often impaired by complex fracture configurations and thin soft tissue layers. The management of complex pilon fractures with soft tissue injuries has seen many trends, with changes toward staged protocols of temporary external fixation followed by delayed open reduction and internal fixation (ORIF), minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques and special implants, the benefits of negative pressure wound sealing and early "fix and flap" efforts to reconstruct soft tissue defects. Reduction and fixation must involve respectful management and careful handling of soft tissues in order to minimize the well-known complications of this difficult fracture. The proper approach is one of the keys to success. Approach planning is based on the careful and thorough analysis of the fracture pattern in the 3D data set, which is the basis for a successful strategy for articular reconstruction. PMID:25591416

  8. Recursive Algorithm and Alternate Operation Strategy in Sequential Tests

    Institute of Scientific and Technical Information of China (English)

    XU Hong-lin; CHEN Zhan-qi; GUO Lue

    2009-01-01

    Based on the sequential probability ratio test (SPRT) developed by Wald, an improved method for successful probability test of missile flight is proposed. A recursive algorithm and its program in Matlab are designed to calculate the real risk level of the sequential test decision and the average number of samples under various test conditions. A concept, that is "rejecting as soon as possible", is put forward and an alternate operation strategy is conducted. The simulation results show that it can reduce the test expenses.

  9. Testing and assessment strategies, including alternative and new approaches.

    Science.gov (United States)

    Meyer, Otto

    2003-04-11

    The object of toxicological testing is to predict possible adverse effect in humans when exposed to chemicals whether used as industrial chemicals, pharmaceuticals or pesticides. Animal models are predominantly used in identifying potential hazards of chemicals. The use of laboratory animals raises ethical concern. However, irrespective of animal welfare it is an important aspect of the discipline of toxicology that the primary object is human health. The ideal testing and assessment strategy is simple to use all the available test methods and preferably more in laboratory animal species from which we get as many data as possible in order to obtain the most extensive database for the toxicological evaluation of a chemical. Consequently, the society has decided that certain group of chemicals should be tested accordingly. However, realising that, this idea is not obtainable in practice because there are more than 100000 chemicals which are potential for human exposure, so the development of alternative testing and assessment strategies has taken place in the recent years. The toxicological evaluation should enable the society to cope with the simultaneous requirement of many chemicals for different uses and of the absence of health problems involved with their use. Thus, the regulatory toxicology is a cocktail of science and pragmatism added a crucial concern for animal welfare. Test methods are most often used in a testing sequence as bricks in a testing strategy. The main key driving forces for introducing assessment and testing strategies e.g. using a limited number of tests and/or alternative test methods are: (a) animal welfare considerations; (b) new scientific knowledge i.e. introducing tests for new endpoints and tests for better understanding of mode of action; and (c) lack of testing capacity/reduction of required resources economically as well as time wise. PMID:12676447

  10. Alternative Sampling Strategies for Cytochrome P450 Phenotyping.

    Science.gov (United States)

    De Kesel, Pieter M M; Lambert, Willy E; Stove, Christophe P

    2016-02-01

    Interindividual variability in the expression and function of drug metabolizing cytochrome P (CYP) 450 enzymes, determined by a combination of genetic, non-genetic and environmental parameters, is a major source of variable drug response. Phenotyping by administration of a selective enzyme substrate, followed by the determination of a specific phenotyping metric, is an appropriate approach to assess the in vivo activity of CYP450 enzymes as it takes into account all influencing factors. A phenotyping protocol should be as simple and convenient as possible. Typically, phenotyping metrics are determined in traditional matrices, such as blood, plasma or urine. Several sampling strategies have been proposed as an alternative for these traditional sampling techniques. In this review, we provide a comprehensive overview of available methods using dried blood spots (DBS), hair, oral fluid, exhaled breath and sweat for in vivo CYP450 phenotyping. We discuss the relation between phenotyping metrics measured in these samples and those in conventional matrices, along with the advantages and limitations of the alternative sampling techniques. Reliable phenotyping procedures for several clinically relevant CYP450 enzymes, including CYP1A2, CYP2C19 and CYP2D6, are currently available for oral fluid, breath or DBS, while additional studies are needed for other CYP450 isoforms, such as CYP3A4. The role of hair analysis for this purpose remains to be established. Being non- or minimally invasive, these sampling strategies provide convenient and patient-friendly alternatives for classical phenotyping procedures, which may contribute to the implementation of CYP450 phenotyping in clinical practice. PMID:26239501

  11. A Positive Diagnostic Strategy Is Noninferior to a Strategy of Exclusion for Patients With Irritable Bowel Syndrome

    DEFF Research Database (Denmark)

    Begtrup, Luise M; Engsbro, Anne Line; Kjeldsen, Jens;

    2013-01-01

    assessed by a strategy of exclusion (analyses of blood, stool samples for intestinal parasites, and sigmoidoscopies with biopsies) or a positive strategy (analyses of blood cell count and C-reactive protein). Patients were followed for 1 year. The primary end point was difference in change of HRQOL from......BACKGROUND & AIMS: Guidelines recommend a positive strategy based on symptom criteria to diagnose patients with irritable bowel syndrome (IBS). We conducted a randomized noninferiority trial to determine whether a positive diagnostic strategy is noninferior to a strategy of exclusion, with regard...... were registered. RESULTS: A positive strategy was noninferior to a strategy of exclusion (difference, 0.64; 95% confidence interval, -2.74 to 1.45). The positive diagnostic strategy had lower direct costs. Each approach had similar effects on symptoms, satisfaction, and subsequent use of health...

  12. Diagnostic Errors in Ambulatory Care: Dimensions and Preventive Strategies

    Science.gov (United States)

    Singh, Hardeep; Weingart, Saul N.

    2009-01-01

    Despite an increasing focus on patient safety in ambulatory care, progress in understanding and reducing diagnostic errors in this setting lag behind many other safety concerns such as medication errors. To explore the extent and nature of diagnostic errors in ambulatory care, we identified five dimensions of ambulatory care from which errors may…

  13. Alternating-time temporal logic with finite-memory strategies

    Directory of Open Access Journals (Sweden)

    Steen Vester

    2013-07-01

    Full Text Available Model-checking the alternating-time temporal logics ATL and ATL* with incomplete information is undecidable for perfect recall semantics. However, when restricting to memoryless strategies the model-checking problem becomes decidable. In this paper we consider two other types of semantics based on finite-memory strategies. One where the memory size allowed is bounded and one where the memory size is unbounded (but must be finite. This is motivated by the high complexity of model-checking with perfect recall semantics and the severe limitations of memoryless strategies. We show that both types of semantics introduced are different from perfect recall and memoryless semantics and next focus on the decidability and complexity of model-checking in both complete and incomplete information games for ATL/ATL*. In particular, we show that the complexity of model-checking with bounded-memory semantics is Delta_2p-complete for ATL and PSPACE-complete for ATL* in incomplete information games just as in the memoryless case. We also present a proof that ATL and ATL* model-checking is undecidable for n >= 3 players with finite-memory semantics in incomplete information games.

  14. Long-term alternative energy R and D strategies

    International Nuclear Information System (INIS)

    Within the coming decades a transition must be initiated from oil and gas to 'unlimited' primary energy sources, i.e., nuclear and solar energy. Ever more expensive fossil energy forms will have to provide for an intermediary solution to the growing global energy demand. While a rather clear-cut picture of the energy problem has emerged on the global level, a straightforward translation to the national or even to the company level is not available. The current study contract between the European Economic Community and the International Institute for Applied Systems Analysis (IIASA) is a first exercice designed to transfer the global results to the intermediary level of the ''Subregion'' of the European Community. In operational terms the contract aims at identifying long-term (up to 2030) alternative energy R and D strategies for twelve European countries that would be consistent with the global scenarios, identified by IIASA

  15. Outcome modelling strategies in epidemiology: traditional methods and basic alternatives.

    Science.gov (United States)

    Greenland, Sander; Daniel, Rhian; Pearce, Neil

    2016-04-01

    Controlling for too many potential confounders can lead to or aggravate problems of data sparsity or multicollinearity, particularly when the number of covariates is large in relation to the study size. As a result, methods to reduce the number of modelled covariates are often deployed. We review several traditional modelling strategies, including stepwise regression and the 'change-in-estimate' (CIE) approach to deciding which potential confounders to include in an outcome-regression model for estimating effects of a targeted exposure. We discuss their shortcomings, and then provide some basic alternatives and refinements that do not require special macros or programming. Throughout, we assume the main goal is to derive the most accurate effect estimates obtainable from the data and commercial software. Allowing that most users must stay within standard software packages, this goal can be roughly approximated using basic methods to assess, and thereby minimize, mean squared error (MSE). PMID:27097747

  16. Towards an alternative testing strategy for nanomaterials used in nanomedicine

    DEFF Research Database (Denmark)

    Dusinska, M; Boland, S; Saunders, M;

    2015-01-01

    project ( www.nanotest-fp7.eu ) was a better understanding of mechanisms of interactions of NPs employed in nanomedicine with cells, tissues and organs and to address critical issues relating to toxicity testing especially with respect to alternatives to tests on animals. Here we describe an approach...... types and concentrations taking into account the inherent impact of NP properties and the effects of changes in experimental conditions using well-characterized NPs. The results of the studies have been used to generate recommendations for a suitable and robust testing strategy which can be applied to...... scientists, politicians and the public about potential health hazards associated with NPs need to be answered. With the variety of exposure routes available, there is potential for NPs to reach every organ in the body but we know little about the impact this might have. The main objective of the FP7 NanoTEST...

  17. Nonequilibrium relaxation method – An alternative simulation strategy

    Indian Academy of Sciences (India)

    Nobuyasu Ito

    2005-06-01

    One well-established simulation strategy to study the thermal phases and transitions of a given microscopic model system is the so-called equilibrium method, in which one first realizes the equilibrium ensemble of a finite system and then extrapolates the results to infinite system. This equilibrium method traces over the standard theory of the thermal statistical mechanics, and over the idea of the thermodynamic limit. Recently, an alternative simulation strategy has been developed, which analyzes the nonequilibrium relaxation (NER) process. It is called the NER method. NER method has some advantages over the equilibrium method. The NER method provides a simpler analyzing procedure. This implies less systematic error which is inevitable in the simulation and provides efficient resource usage. The NER method easily treats not only the thermodynamic limit but also other limits, for example, non-Gibbsian nonequilibrium steady states. So the NER method is also relevant for new fields of the statistical physics. Application of the NER method have been expanding to various problems: from basic first- and second-order transitions to advanced and exotic phases like chiral, KT spin-glass and quantum phases. These studies have provided, not only better estimations of transition point and exponents, but also qualitative developments. For example, the universality class of a random system, the nature of the two-dimensional melting and the scaling behavior of spin-glass aging phenomena have been clarified.

  18. Alternative energy supply strategies for Pakistan and their economic implications

    International Nuclear Information System (INIS)

    Pakistan is beset with serious energy supply difficulties arising from a fast growing demand for commercial energy, a poor energy resource base and the high cost of imported energy. The commercial energy requirements are expected to rise from 22.4 million tonnes of coal equivalent (tce) in 1980 to 80 million tce by the year 2000 and to about 200 million tce by 2020, while the country's proven fossil-fuel reserves are only 440 million tce and cannot cope with the demand for long. Pakistan is already dependent on imported energy for 90% of its oil requirements or 30% of the total commercial energy, and is spending 5.5% of its gross domestic product (GDP) on energy imports. The paper analyses the economic implications of a few alternative energy supply strategies. These strategies correspond to two different rates of petroleum exploration and development activity, a high and a low average size of new petroleum finds, and the large-scale use of nuclear power starting in 1990 or after the year 2000. It is found that in the most favourable case (high level of petroleum drilling activity with a high success rate and nuclear power use starting in 1990) Pakistan would be able to achieve self-sufficiency in oil by 2010 and in the total energy supply shortly after 2020. The energy sector's investment requirement will, however, increase gradually from 3% of GDP now to almost 6% of GDP by 2020. (author)

  19. Economic Analysis of Alternative Strategies for Detection of ALK Rearrangements in Non Small Cell Lung Cancer.

    Science.gov (United States)

    Doshi, Shivang; Ray, David; Stein, Karen; Zhang, Jie; Koduru, Prasad; Fogt, Franz; Wellman, Axel; Wat, Ricky; Mathews, Charles

    2016-01-01

    Identification of alterations in ALK gene and development of ALK-directed therapies have increased the need for accurate and efficient detection methodologies. To date, research has focused on the concordance between the two most commonly used technologies, fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC). However, inter-test concordance reflects only one, albeit important, aspect of the diagnostic process; laboratories, hospitals, and payors must understand the cost and workflow of ALK rearrangement detection strategies. Through literature review combined with interviews of pathologists and laboratory directors in the U.S. and Europe, a cost-impact model was developed that compared four alternative testing strategies-IHC only, FISH only, IHC pre-screen followed by FISH confirmation, and parallel testing by both IHC and FISH. Interviews were focused on costs of reagents, consumables, equipment, and personnel. The resulting model showed that testing by IHC alone cost less ($90.07 in the U.S., $68.69 in Europe) than either independent or parallel testing by both FISH and IHC ($441.85 in the U.S. and $279.46 in Europe). The strategies differed in cost of execution, turnaround time, reimbursement, and number of positive results detected, suggesting that laboratories must weigh the costs and the clinical benefit of available ALK testing strategies. PMID:26838801

  20. Electrical signature analysis applications for non-intrusive automotive alternator diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Ayers, C.W.

    1996-03-01

    Automotive alternators are designed to supply power for automobile engine ignition systems as well as charge the storage battery. This product is used in a large market where consumers are concerned with acoustic noise and vibration that comes from the unit. as well as overall quality and dependability. Alternators and generators in general are used in industries other than automotive, such as transportation and airline industries and in military applications. Their manufacturers are interested in pursuing state-of-the-art methods to achieve higher quality and reduced costs. Preliminary investigations of non-intrusive diagnostic techniques utilizing the inherent voltage signals of alternators have been performed with promising results. These techniques are based on time and frequency domain analyses of specially conditioned signals taken from several alternators under various test conditions. This paper discusses investigations that show correlations of the alternator output voltage to airborne noise production. In addition these signals provide insight into internal magnetic characteristics that relate to design and/or assembly problems.

  1. Economic Analysis of Alternative Strategies for Detection of ALK Rearrangements in Non Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Shivang Doshi

    2016-01-01

    Full Text Available Identification of alterations in ALK gene and development of ALK-directed therapies have increased the need for accurate and efficient detection methodologies. To date, research has focused on the concordance between the two most commonly used technologies, fluorescent in situ hybridization (FISH and immunohistochemistry (IHC. However, inter-test concordance reflects only one, albeit important, aspect of the diagnostic process; laboratories, hospitals, and payors must understand the cost and workflow of ALK rearrangement detection strategies. Through literature review combined with interviews of pathologists and laboratory directors in the U.S. and Europe, a cost-impact model was developed that compared four alternative testing strategies—IHC only, FISH only, IHC pre-screen followed by FISH confirmation, and parallel testing by both IHC and FISH. Interviews were focused on costs of reagents, consumables, equipment, and personnel. The resulting model showed that testing by IHC alone cost less ($90.07 in the U.S., $68.69 in Europe than either independent or parallel testing by both FISH and IHC ($441.85 in the U.S. and $279.46 in Europe. The strategies differed in cost of execution, turnaround time, reimbursement, and number of positive results detected, suggesting that laboratories must weigh the costs and the clinical benefit of available ALK testing strategies.

  2. Cost effectiveness of diagnostic strategies for patients with acute, undifferentiated chest pain

    OpenAIRE

    Goodacre, S; Calvert, N.

    2003-01-01

    Objectives: Patients presenting to hospital with acute, undifferentiated chest pain have a low, but important, risk of significant myocardial ischaemia. Potential diagnostic strategies for patients with acute, undifferentiated chest pain vary from low cost, poor effectiveness (discharging all home) to high cost, high effectiveness (admission and intensive investigation). This paper aimed to estimate the relative cost effectiveness of these strategies.

  3. Implications of caries diagnostic strategies for clinical management decisions

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Hintze, Hanne; Wenzel, Ann;

    2012-01-01

    OBJECTIVES: In clinical practice, a visual-tactile caries examination is frequently supplemented by bitewing radiography. This study evaluated strategies for combining visual-tactile and radiographic caries detection methods and determined their implications for clinical management decisions in a...

  4. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

    Directory of Open Access Journals (Sweden)

    Godshall William T

    2006-12-01

    Full Text Available Abstract According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in

  5. Molecular diagnostics clinical utility strategy: a six-part framework.

    Science.gov (United States)

    Frueh, Felix W; Quinn, Bruce

    2014-09-01

    The clinical utility of a molecular test rises proportional to a favorable regulatory risk/benefit assessment, and clinical utility is the driver of payer coverage decisions. Although a great deal has been written about clinical utility, debates still center on its 'definition.' We argue that the definition (an impact on clinical outcomes) is self-evident, and improved communications should focus on sequential steps in building and proving an adequate level of confidence for the diagnostic test's clinical value proposition. We propose a six-part framework to facilitate communications between test developers and health technology evaluators, relevant to both regulatory and payer decisions. PMID:25109921

  6. Strategies for adding adaptive learning mechanisms to rule-based diagnostic expert systems

    Science.gov (United States)

    Stclair, D. C.; Sabharwal, C. L.; Bond, W. E.; Hacke, Keith

    1988-01-01

    Rule-based diagnostic expert systems can be used to perform many of the diagnostic chores necessary in today's complex space systems. These expert systems typically take a set of symptoms as input and produce diagnostic advice as output. The primary objective of such expert systems is to provide accurate and comprehensive advice which can be used to help return the space system in question to nominal operation. The development and maintenance of diagnostic expert systems is time and labor intensive since the services of both knowledge engineer(s) and domain expert(s) are required. The use of adaptive learning mechanisms to increment evaluate and refine rules promises to reduce both time and labor costs associated with such systems. This paper describes the basic adaptive learning mechanisms of strengthening, weakening, generalization, discrimination, and discovery. Next basic strategies are discussed for adding these learning mechanisms to rule-based diagnostic expert systems. These strategies support the incremental evaluation and refinement of rules in the knowledge base by comparing the set of advice given by the expert system (A) with the correct diagnosis (C). Techniques are described for selecting those rules in the in the knowledge base which should participate in adaptive learning. The strategies presented may be used with a wide variety of learning algorithms. Further, these strategies are applicable to a large number of rule-based diagnostic expert systems. They may be used to provide either immediate or deferred updating of the knowledge base.

  7. Optimal diagnostic strategy for infantile cholestasis in pediatric surgery

    International Nuclear Information System (INIS)

    The initial goal in treatment for infantile cholestasis is to exclude surgical cholestasis, especially biliary atresia (BA). In this study, we retrospectively reviewed the diagnostic course of infantile cholestasis. Between 2000 and 2009, a total of 44 infants with cholestasis were referred to our department. The median age at admission was 54 days (range: 0-143 days). The medical charts of these infants were reviewed. The initial diagnostic approach was ultrasonography followed by the qualitative detection of bilirubin in stool. The 35 infants with acholic stool and/or a small or absent gallbladder on ultrasonography were subsequently examined by hepatobiliary scintigraphy (HBS). Twenty-nine infants with negative scintigraphy findings underwent intraoperative cholangiography (lOC), and BA was finally confirmed in 24 of 44. A choledochal cyst was noted in 2, Alagille syndrome in 2, cytomegalovirus infection in 2, panhypopituitarism in 2, multiple hemangiomas of the liver in 1, and cholecystolithiasis in 1. The remaining 10 infants were diagnosed as having neonatal hepatitis. The sensitivity and specificity of HBS for BA were 100% and 54.5%, respectively. HBS is a useful modality for detection of BA with a sensitivity of 100%. The indication for IOC should depend on these scan results. (author)

  8. Optimal Sequential Diagnostic Strategy Generation Considering Test Placement Cost for Multimode Systems

    Directory of Open Access Journals (Sweden)

    Shigang Zhang

    2015-10-01

    Full Text Available Sequential fault diagnosis is an approach that realizes fault isolation by executing the optimal test step by step. The strategy used, i.e., the sequential diagnostic strategy, has great influence on diagnostic accuracy and cost. Optimal sequential diagnostic strategy generation is an important step in the process of diagnosis system construction, which has been studied extensively in the literature. However, previous algorithms either are designed for single mode systems or do not consider test placement cost. They are not suitable to solve the sequential diagnostic strategy generation problem considering test placement cost for multimode systems. Therefore, this problem is studied in this paper. A formulation is presented. Two algorithms are proposed, one of which is realized by system transformation and the other is newly designed. Extensive simulations are carried out to test the effectiveness of the algorithms. A real-world system is also presented. All the results show that both of them have the ability to solve the diagnostic strategy generation problem, and they have different characteristics.

  9. [Acute necrotizing pancreatitis--diagnostic and treatment strategy].

    Science.gov (United States)

    Madzhov, R; Georgiev, K; Arnaudov, P; Radev, R; Bankov, P

    2003-01-01

    Despite of the current achievements of medicine, the mortality of necrotizing pancreatitis (NP) is still too high--up to 35-40% and stands as a serious diagnostic and treatment problem. The results of treatment of 148 patients, admitted in the clinic with diagnosis NP, 95 males and 53 females, are discussed. The ratio between patients with acute oedematic and acute NP is 81.1% to 18.9%. According to the hystopatology findings, the results are as follows: pancreatic necrosis--128 patients, peripancreatic necrosis--42 patients, retropancreatic necrosis--29 patients, phlegmonous cholecystitis--31 patients. For the exact diagnostic estimation of the development and prognosis of NP, we are based on: Clinic symptomatology, biochemical constellations (the prognostic scale of Ranson), ultrasonography, CT, ERCP, ES, laparoscopy (48 pts), and laparoscopic drainage (34 pts) of the abdominal cavity with one or two drains, in order to decrease the intoxication and manage intraperitoneal irrigation with antibiotics and enzymes. The operative intervations consists of a thorough exploration, broad necrectomy combined with lavage and large drainage. COLD (controlled open lesser sac drainage) has been performed at 34 cases. In 31 pts cholecystectomy and choledochotomy with T-tube drainage of d. choledochus (Kehr drainage) was performed. Reoperations have been made at 34 pts (22.9%); in 11 of them--2 operative revisions have been carried out, in 3 cases--three, and in 3 cases--4 operative revisions were performed. The total postoperative death rate was 21.6% (32 patients). The most common postoperative complications were as follows: pulmonary complications at 11 cases, pleural effusions--9 pts, intraabdominal abscesses--6 patients, postnecrotic pseudocysts--9 cases, pancreatic fistulas--6 cases, fistulas of the colon--2 pts, bleeding--4 patients. PMID:15584453

  10. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    OpenAIRE

    Asgar Aghaei Hashjin; Dionne Kringos; Hamid Ravaghi; Jila Manoochehri; Hassan Abolghasem Gorji; Niek Klazinga

    2015-01-01

    Background Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A d...

  11. How does a change in the control room design affect diagnostic strategies in nuclear power plants?

    International Nuclear Information System (INIS)

    Recently, main control rooms have been considerably changed by modern computer techniques. Some of the features that distinguish digital control rooms from conventional, analog rooms in nuclear power plants include advanced alarm systems, graphic information display systems, computerized procedure systems, and soft control. These features can bring changes in operator tasks, changing the characteristics of tasks or creating new tasks for operators. It is especially expected that these features may bring out changes in the operator's diagnostic tasks and strategies in a digital control room as compared with an analog control room. This study investigates the differences in the operator's diagnostic tasks and strategies in analog and digital control rooms. This study also attempts to evaluate how new systems in a digital control room affect diagnostic strategies. Three different approaches, which are complementary, are used to identify diagnostic strategies in the digital control room and in the analog control room: (1) observation in the simulator, (2) interview with operators, and (3) a literature review. The results show that the digital control room introduces new diagnosis strategies compared with the analog control room while also changing the characteristics of the strategies, mostly by gaining more support from the computerized system. (author)

  12. 78 FR 68076 - Request for Information on Alternative Skin Sensitization Test Methods and Testing Strategies and...

    Science.gov (United States)

    2013-11-13

    ...The Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) is developing a U.S. plan for the evaluation of alternative skin sensitization test methods and testing strategies. The National Toxicology Program (NTP) Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM) requests information that ICCVAM might use to develop this plan and......

  13. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  14. Cognitive strategies: a method to reduce diagnostic errors in ER

    Directory of Open Access Journals (Sweden)

    Carolina Prevaldi

    2009-02-01

    Full Text Available I wonder why sometimes we are able to rapidly recognize patterns of disease presentation, formulate a speedy diagnostic closure, and go on with a treatment plan. On the other hand sometimes we proceed studing in deep our patient in an analytic, slow and rational way of decison making. Why decisions sometimes can be intuitive, while sometimes we have to proceed in a rigorous way? What is the “back ground noise” and the “signal to noise ratio” of presenting sintoms? What is the risk in premature labeling or “closure” of a patient? When is it useful the “cook-book” approach in clinical decision making? The Emergency Department is a natural laboratory for the study of error” stated an author. Many studies have focused on the occurrence of errors in medicine, and in hospital practice, but the ED with his unique operating characteristics seems to be a uniquely errorprone environment. That's why it is useful to understand the underlying pattern of thinking that can lead us to misdiagnosis. The general knowledge of thought processes gives the psysician awareness an the ability to apply different tecniques in clinical decision making and to recognize and avoid pitfalls.

  15. Diagnostic strategy for occult hepatitis B virus infection

    Institute of Scientific and Technical Information of China (English)

    Sara Ocana; Maria Luisa Casas; Ingrid Buhigas; Jose Luis Lledo

    2011-01-01

    In 2008, the European Association for the study of the liver (EASL) defined occult hepatitis B virus infection (OBI) as the "presence of hepatitis B virus (HBV) DNA in the liver (with detectable or undetectable HBV DNA in the serum) of individuals testing hepatitis B surface antigen (HBsAg) negative by currently available assays". Several aspects of occult HBV infection are still poorly understood, including the definition itself and a standardized approach for laboratory-based detection, which is the purpose of this review. The clinical significance of OBI has not yet been established; however, in terms of public health, the clinical importance arises from the risk of HBV transmission. Consequently, it is important to detect high-risk groups for occult HBV infection to prevent transmission. The main issue is, perhaps, to identify the target population for screening OBI. Viremia is very low or undetectable in occult HBV infection, even when the most sensitive methods are used, and the detection of the viral DNA reservoir in hepatocytes would provide the best evaluation of occult HBV prevalence in a defined set of patients. However, this diagnostic approach is obviously unsuitable: blood detection of occult hepatitis B requires assays of the highest sensitivity and specificity with a lower limit of detection < 10 IU/mL for HBV DNA and < 0.1 ng/mL for HBsAg.

  16. Strategies for laboratory HIV testing: an examination of alternative approaches not requiring Western blot.

    OpenAIRE

    Sato, P. A.; Maskill, W. J.; Tamashiro, H.; Heymann, D L

    1994-01-01

    Advances in laboratory tests for antibodies to human immunodeficiency virus (HIV) have permitted the development of alternative HIV testing strategies that do not require use of the Western blot approach. Three strategies are proposed. In strategy I, sera are tested for HIV antibody using an enzyme-linked immunosorbent assay (ELISA)/rapid/simple (ERS) test; in strategy II, sera reactive in an initial ERS test are retested using a second ERS test; strategy III involves retesting with a third E...

  17. Short Horizon Control Strategies for an Alternating Activated Sludge Process

    DEFF Research Database (Denmark)

    Isaacs, Steven Howard

    dissolved oxygen level during aerobic periods. All three strategies attempt to satisfy a common control criterion representing optimal performance over the time length of one process cycle (typically I to 3 hours) and are based on models developed from simple mass balances or which have been experimentally...... determined. The effects of the strategies on short term nitrogen dynamics are explained in terms of the potential and capacity of denitrification. The relative effectiveness of the strategies are compared and where the strategies would be located in a hierarchical control structure is discussed. Copyright (C...

  18. INDOT Fleet Management Strategies: Implementing Alternative Fuel Technologies

    OpenAIRE

    Rudolph, Joseph

    2012-01-01

    This session will discuss INDOT’s initiative to introduce vechicles fueled by propane and compressed natural gas (CNG) to their fleet. Successes to date will be shared as well as recommendations for fleet managers considering these alternative technologies.

  19. Economics of eradicating Foot-and-Mouth disease epidemics with alternative control strategies

    NARCIS (Netherlands)

    Bergevoet, R.H.M.; Asseldonk, van M.A.P.M.

    2014-01-01

    The paper presents an economic analysis of Foot-and-Mouth Disease (FMD) control strategies for livestock herds. Alternative vaccination-to-live control strategies were compared to the strategy that involves culling of all susceptible animals in an area of 1 km around infected herds in addition to st

  20. Diagnostic approach and management strategy of childhood stroke

    International Nuclear Information System (INIS)

    Prompt recognition and early intervention, with pertinent management and medication, may reduce subsequent neurologic deficits in stroke, which constitutes a devastating event in children. This is due to the tasking and demanding consequences including death or residual neurological deficits, which may last for many decades, in over 60% of survivors. Evidence based treatment for children with stroke is still lacking, reflecting scarcity in base line epidemiological data on pediatric stroke, the multitude of underlying risk factors, and ethical and practical challenges incurred in conducting clinical trials. Based on the experience we gained from a combined a combined prospective and retrospective study on childhood stroke (covering 10 years and 7 months and involving a cohort of 104 Saudi children), a diagnostic algorithm, which outlines the approach to a child with suspected stroke/cerebovascular lesion was designed. This algorithm might also be of use for managing other children with stroke from the Arabian Peninsula and Middle East Region with similar demographic, socioeconomic, and ethnic backgrounds. Underlying risk factors which need special attention, include thrombophilia and hypercoagulable states and sickle cell diseases (SCD), which contrary to previous studies from Saudi Arabia, were found to constitute a common risk factor with severe manifestations. Other risk factors include infections (especially neurobrucellosis), cardiac diseases, and hypernatremic dehydration. Recognition of an identifiable syndrome or inherited metabolic cause may unravel an underlying cerebovascular disease. This is particularly important in this region, given the large pool of autosomal recessive diseases and the high rate of consanguinity. In the evaluation of a suspected case of stroke, important imaging modalities include cranial CT, MRI (including diffusion-weighted images), magnetic resonance angiography (MRA), magnetic resonance venography (MRV) and conventional

  1. Alternative energy development strategies for China towards 2030

    Institute of Scientific and Technical Information of China (English)

    Linwei MA; Zheng LI; Feng FU; Xiliang ZHANG; Weidou NI

    2009-01-01

    The purposes, objectives and technology path-ways for alternative energy development are discussed with the aim of reaching sustainable energy development in China. Special attention has been paid to alternative power and alternative vehicle fuels. Instead of limiting alternative energy to energy sources such as nuclear and renewable energy, the scope of discussion is extended to alternative technologies such as coal power with carbon capture and sequestration (CCS), electric and hydrogen vehicles. In order to take account of the fact that China's sustainable energy development involves many dimen-sions, a six-dimensional indicator set has been established and applied with the aim of comprehensively evaluating different technology pathways in a uniform way. The ana-lysis reaches the following conclusions: (a) in the power sector, wind power, nuclear power and hydro power should be developed as much as possible, while R&D of solar power and coal power with CCS should be strengthened continuously for future deployment. (b) in the transporta-tion sector, there is no foreseeable silver bullet to replace oil on a large scale within the time frame of 20 to 30 years. To ease the severe energy security situation, expedient choices like coal derived fuels could be developed. However, its scale should be optimized in accordance to the trade-off of energy security benefits, production costs and environmental costs. Desirable alternative fuels (or technologies) like 2nd generation biofuels and electrical vehicles should be the subject of intensive R&D with the objective to be cost effective as early as possible.

  2. Improving diagnostic strategies for predicting serious bacterial infections in children with fever

    NARCIS (Netherlands)

    R.G. Nijman (Ruud)

    2014-01-01

    textabstractThis thesis aimed to improve diagnostic strategies for predicting SBI in febrile children in emergency care settings. Generally, clinical signs and symptoms were of limited use in detecting SBI, even when using modelling techniques that best reflected their predictive ability. C-reactive

  3. Propulsion Diagnostic Method Evaluation Strategy (ProDiMES) User's Guide

    Science.gov (United States)

    Simon, Donald L.

    2010-01-01

    This report is a User's Guide for the Propulsion Diagnostic Method Evaluation Strategy (ProDiMES). ProDiMES is a standard benchmarking problem and a set of evaluation metrics to enable the comparison of candidate aircraft engine gas path diagnostic methods. This Matlab (The Mathworks, Inc.) based software tool enables users to independently develop and evaluate diagnostic methods. Additionally, a set of blind test case data is also distributed as part of the software. This will enable the side-by-side comparison of diagnostic approaches developed by multiple users. The Users Guide describes the various components of ProDiMES, and provides instructions for the installation and operation of the tool.

  4. Alternative Dispute Resolution: A Business (and) Communication Strategy.

    Science.gov (United States)

    Netzley, Michael

    2001-01-01

    Investigates Alternative Dispute Resolution (ADR) and its potential as a topic for business communication practice and research. Explores what ADR is; how mediation and ADR are used in business; how mediation and ADR are similar to and different from negotiating; and two or three essential learning points or skills to teach business students about…

  5. Unit Pricing and Alternatives: Developing an Individualized Shopping Strategy.

    Science.gov (United States)

    Cude, Brenda; Walker, Rosemary

    1985-01-01

    This article offers a new perspective on the teaching of unit pricing in consumer economics classes by identifying ways to teach the costs as well as the benefits of unit pricing and realistic guidelines for suggesting situations in which it is most appropriate. Alternatives to unit pricing will also be explored. (CT)

  6. Alternative pharmacological strategies for adult ADHD treatment: a systematic review.

    Science.gov (United States)

    Buoli, Massimiliano; Serati, Marta; Cahn, Wiepke

    2016-01-01

    Adult Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition associated with high disability and frequent comorbidity. Current standard pharmacotherapy (methylphenidate and atomoxetine) improves ADHD symptoms in the short-term, but poor data were published about long-term treatment. In addition a number of patients present partial or no response to methylphenidate and atomoxetine. Research into the main database sources has been conducted to obtain an overview of alternative pharmacological approaches in adult ADHD patients. Among alternative compounds, amphetamines (mixed amphetamine salts and lisdexamfetamine) have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension). Antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of efficacy, but they should be avoided in patients with comorbid bipolar disorder. Finally metadoxine and lithium may be particularly suitable in case of comorbid alcohol misuse or bipolar disorder. PMID:26693882

  7. Selecting alternative strategies for community health education in guineaworm control.

    Science.gov (United States)

    Brieger, W R; Ramakrishna, J; Akpovi, S U; Adeniyi, J D

    1984-01-01

    Community health education strategies in guineaworm control can be applied at several intervention levels. Community development mobilizes local resources to provide safe water supplies such as wells. Mass education in schools and communities can teach personal protection measures such as filtering water. Training of volunteer community health workers produces front line staff, who by being culturally in tune with the community can demonstrate and promote the use of appropriate prevention and treatment measures. Advocacy assists community members to express their needs to government and ministry decision makers. All of these strategies have been applied in a community health education/primary health care program in Idere, Ibarapa District, Oyo State. Community development for well construction was found to be a long-term strategy that first must overcome problems of village organization and resource location. Mass education, to be effective, must have a simple and acceptable technology to promote. Trained village health workers must overcome traditional beliefs that inhibit use of preventive and treatment measures. Advocacy requires basic political education of community leaders. A variety of health education strategies is needed to address short- and long-term priorities as well as to overcome the different barriers to guineaworm control. PMID:20841266

  8. Alternative strategies of nuclear industry development in XXI century

    International Nuclear Information System (INIS)

    The actual status and the role of world nuclear industry are considered, as well as the state and problems of nuclear industry in Russia. The present concepts of the long-term nuclear engineering development strategy are analyzed. It is shown that the most perspective variant is orientation on the closed fuel cycle with fast reactors which is satisfy the acceptable safety requirements

  9. Economic Impact Assessment of Alternative Climate Policy Strategies

    International Nuclear Information System (INIS)

    This paper investigates the world economic implications of climate change policy strategies, especially the evaluation of impacts by an implementation of Clean Development Mechanisms, Joint Implementation and Emissions trading with a world integrated assessment model. Of special interest in this context are the welfare spill over and competitiveness effects that result from diverse climate policy strategies. In particular, this study elaborates and compares multi gas policy strategies and explores the impacts of the inclusion of sinks. Because of the recent decision of an isolated climate policy strategy by the United States of America, we examine the economic impacts of all world regions by a non cooperative and free rider position of the USA. It turns out that Clean Development Mechanisms and Joint Implementation show evidence of improvement in the economic development in the host countries and increase the share of new applied technologies. The decomposition of welfare effects demonstrates that the competitiveness effect including the spill over effects from trade have the strongest importance because of the intense trade relations between countries. Climatic effects have a significant impact within the next 50 years, cause considerable welfare losses to world regions and will intensify if some highly responsible nations like the USA do not reduce their emissions

  10. Alternative testing strategies for predicting developmental toxicity of antifungal compound

    OpenAIRE

    Li, H.

    2016-01-01

    Determination of safe human exposure levels of chemicals in toxicological risk assessments largely relies on animal toxicity data. In these toxicity studies, the highest number of animals are used for reproductive and developmental toxicity testing. Because of economic and ethical reasons, there is large interest in the development of in vitro and/or in silico test systems as alternatives for the animal studies. The aim of the present thesis was to evaluate the applicability of combined in vi...

  11. Alternative strategies to reduce public deficits: Taxes vs. spending

    OpenAIRE

    Oscar Bajo-Rubio; Gómez-Plana, Antonio G.

    2015-01-01

    We examine the effects of several alternative measures intended to reduce government deficits for the case of Spain, distinguishing between those acting through taxes and through spending. The Spanish case is relevant as an example of front-loaded fiscal adjustment that has led to a large GDP fall, where (unlike the cases of Greece, Ireland and Portugal) the authorities were able to choose the composition of the adjustment measures. The empirical methodology is based on a computable general e...

  12. Alternative strategies to reduce public deficits: Taxes vs. spending

    OpenAIRE

    Oscar Bajo-Rubio; Gómez-Plana, Antonio G.

    2013-01-01

    In this paper, we examine the effects of several alternative measures intended to reduce government deficits, distinguishing between those acting through either taxes or spending, for the case of Spain. The empirical methodology is based on a computable general equilibrium model. All the simulated policies lead to a decrease in the levels of output and employment, and to a higher unemployment rate. Spending cuts show greater contractionary effects than tax increases, and are associated with a...

  13. Cost-Effectiveness of Different Diagnostic Strategies in Suspected Stable Coronary Artery Disease in Portugal

    International Nuclear Information System (INIS)

    Cost-effectiveness is an increasingly important factor in the choice of a test or therapy. To assess the cost-effectiveness of various methods routinely used for the diagnosis of stable coronary disease in Portugal. Seven diagnostic strategies were assessed. The cost-effectiveness of each strategy was defined as the cost per correct diagnosis (inclusion or exclusion of obstructive coronary artery disease) in a symptomatic patient. The cost and effectiveness of each method were assessed using Bayesian inference and decision-making tree analyses, with the pretest likelihood of disease ranging from 10% to 90%. The cost-effectiveness of diagnostic strategies was strongly dependent on the pretest likelihood of disease. In patients with a pretest likelihood of disease of ≤50%, the diagnostic algorithms, which include cardiac computed tomography angiography, were the most cost-effective. In these patients, depending on the pretest likelihood of disease and the willingness to pay for an additional correct diagnosis, computed tomography angiography may be used as a frontline test or reserved for patients with positive/inconclusive ergometric test results or a calcium score of >0. In patients with a pretest likelihood of disease of ≥ 60%, up-front invasive coronary angiography appears to be the most cost-effective strategy. Diagnostic algorithms that include cardiac computed tomography angiography are the most cost-effective in symptomatic patients with suspected stable coronary artery disease and a pretest likelihood of disease of ≤50%. In high-risk patients (pretest likelihood of disease ≥ 60%), up-front invasive coronary angiography appears to be the most cost-effective strategy. In all pretest likelihoods of disease, strategies based on ischemia appear to be more expensive and less effective compared with those based on anatomical tests

  14. Development and Assessment of a Diagnostic Tool to Identify Organic Chemistry Students' Alternative Conceptions Related to Acid Strength

    Science.gov (United States)

    McClary, LaKeisha M.; Bretz, Stacey Lowery

    2012-01-01

    The central goal of this study was to create a new diagnostic tool to identify organic chemistry students' alternative conceptions related to acid strength. Twenty years of research on secondary and college students' conceptions about acids and bases has shown that these important concepts are difficult for students to apply to qualitative problem…

  15. The Social Organization of Care Work in India: Challenges and alternative strategies

    OpenAIRE

    Neetha N

    2010-01-01

    Care work is organized differently in varied economies, though the broader contours may suggest some degree of uniformity. Understanding the social organization of care work and, the processes involved are important in evolving alternative strategies that are otherwise guided by the existing normative assumptions of care. Neetha Pillai addresses care work in social and labour policies, drawing attention to the possibilities of alternative care strategies, beyond the market, in the context of ...

  16. Alternative Schooling Strategies and the Religious Lives of American Adolescents.

    Science.gov (United States)

    Uecker, Jeremy E

    2008-12-01

    I analyze the effects of Catholic schooling, Protestant schooling, and homeschooling on adolescents' religious lives and test three mechanisms through which these schooling strategies might influence religiosity: friendship networks, network closure, and adult mentors. Data from Wave 1 of the National Survey of Youth and Religion suggest that Catholic schoolers attend religious services more frequently and value their faith more highly than public schoolers, but attend religious education classes and youth group less often. Protestant schoolers' involvement in their local congregation is similar to public schoolers', but their faith plays a more salient role in their life and they are more active in private religious activities. Homeschoolers do not differ significantly from public schoolers on any outcome considered. Moreover, friendship networks, network closure, and adult mentors play a very limited role in mediating the relationships between schooling strategies and adolescent religiosity. Interpretations of these findings are presented and discussed. PMID:21709822

  17. Alternative Schooling Strategies and the Religious Lives of American Adolescents

    OpenAIRE

    Uecker, Jeremy E.

    2008-01-01

    I analyze the effects of Catholic schooling, Protestant schooling, and homeschooling on adolescents’ religious lives and test three mechanisms through which these schooling strategies might influence religiosity: friendship networks, network closure, and adult mentors. Data from Wave 1 of the National Survey of Youth and Religion suggest that Catholic schoolers attend religious services more frequently and value their faith more highly than public schoolers, but attend religious education cla...

  18. EFFECTIVENESS OF ALTERNATIVE EXPORT PROMOTION STRATEGIES FOR BRANDED FOOD PRODUCTS

    OpenAIRE

    Brenes, Jose R.; Henderson, Dennis R.; Sheldon, Ian M.

    1992-01-01

    This study examines the impact on export sales of various promotional strategies for branded food products in foreign markets. It is an empirical analysis using data obtained from organizations that administer the High Value Export Incentive Program (HVEIP) for branded food products, part of USDA's Targeted Export Assistance (TEA) program and its successor, the Marketing Assistance Program (MAP). To respect the proprietary nature of the data, the identity of individual firms and brand names h...

  19. Disciplinary practices in schools and principles of alternatives to corporal punishment strategies

    OpenAIRE

    George Moyo; Noncedo PD Khewu; Anass Bayaga

    2014-01-01

    The aim of the study was to determine the consistency prevailing between the disciplinary practices in the schools and the principles of the Alternatives-to-Corporal Punishment strategy. The three main research questions that guided the study were to determine (1) How much variance of offences can be explained by disciplinary measures of alternative corporal punishment? (2) How well do the different measures of alternative corporal punishment predict offences? (3) Which is the best predictor ...

  20. Histone deacetylase inhibition as an alternative strategy against invasive aspergillosis

    Directory of Open Access Journals (Sweden)

    Frederic eLamoth

    2015-02-01

    Full Text Available Invasive aspergillosis (IA is a life-threatening infection due to Aspergillus fumigatus and other Aspergillus spp. Drugs targeting the fungal cell membrane (triazoles, amphotericin B or cell wall (echinocandins are currently the sole therapeutic options against IA. Their limited efficacy and the emergence of resistance warrant the identification of new antifungal targets. Histone deacetylases (HDACs are enzymes responsible of the deacetylation of lysine residues of core histones, thus controlling chromatin remodeling and transcriptional activation. HDACs also control the acetylation and activation status of multiple non-histone proteins, including the heat shock protein 90 (Hsp90, an essential molecular chaperone for fungal virulence and antifungal resistance. This review provides an overview of the different HDACs in Aspergillus spp. as well as their respective contribution to total HDAC activity, fungal growth, stress responses, and virulence. The potential of HDAC inhibitors, currently under development for cancer therapy, as novel alternative antifungal agents against IA is discussed.

  1. Evaluating alternative offering strategies for wind producers in a pool

    International Nuclear Information System (INIS)

    Highlights: → Out-of-sample analysis allows comparing diverse offers using real-world data. → Offering the best production forecast is not optimal for a wind producer. → Stochastic programming offers lead to maximum expected profit. → Offering the best production forecast is not generally optimal for risk control. → Stochastic programming offers lead to the best tradeoff profit versus risk. -- Abstract: As wind power technology matures and reaches break-even cost, wind producers find it increasingly attractive to participate in pool markets instead of being paid feed-in tariffs. The key issue is then how a wind producer should offer in the pool markets to achieve maximum profit while controlling the variability of such profit. This paper compares two families of offering strategies based, respectively, on a naive use of wind production forecasts and on stochastic programming models. These strategies are compared through a comprehensive out-of-sample chronological analysis based on real-world data. A number of relevant conclusions are then duly drawn.

  2. [The diagnostic and therapeutic strategies in neoplasms of the adrenal cortex: the authors' own experience].

    Science.gov (United States)

    Giordano, G; Angelelli, G; Losacco, T; Mustacchio, N; Macarini, L; Grimaldi, F; Cannone, G; Colelli, P; Spada, I S

    1993-01-01

    The Authors report their limited series of neoplasms of the adrenal cortex, and underline the decisive role of the modern diagnostics based on imaging techniques (US--TC--NMR). These, in fact, often allow a good definition also in the non-functioning adrenal masses incidentally discovered (incidentalomas). The authors emphasize the high quality of such diagnostic methods offering a good reliability in discriminating the nature of the adrenal mass. These undeniable diagnostic advantages have a positive impact on the surgical strategy, allowing together with a careful morphological study of the lesion, to program in detail possible demolitive operations. The authors finally underline the importance of the surgical access: they are persuaded the best is the bilateral under-rib incision. This surgical approach assures a complete exploration of the abdominal and pelvic cavity; moreover, it allows to face every complication. PMID:8481276

  3. Cognitive schemes and strategies in diagnostic and therapeutic decision making: a primer for trainees

    OpenAIRE

    Hassan, Imad Salah Ahmed

    2013-01-01

    Unlike novices, expert clinicians develop refined schemes and strategies that predictably allow them to provide a better quality, prompt and less error-prone patient care input. Empowering novices with cognitive aids or mental schemes as early as possible in their clinical career may significantly improve their critical thinking, problem-solving and decision-making skills. These cognitive aids may also improve trainees’ use of evidence-based medicine in addition to reducing their diagnostic e...

  4. An alternative strategy to teach biomechanics: The long jump

    Energy Technology Data Exchange (ETDEWEB)

    Vega, G J de la [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina); Aguilera, J A [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina); Puzzella, A E [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina); Mallamaci, C C [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina)

    2007-11-15

    The work develops an alternative methodology to teach the Physics principles of Parabolic Cannon Shot in the career of Bioengineering using instead the physic-biological relationship of the long jump performed in Athletics. This is a closer-to-reality example for this discipline, and it is a field- and computer laboratory-reproducible practice that is simple to do by using affordable technology, because the practice can be filmed by the students in a real setting for future analysis off classroom hours. The data extracted from the film can be analysed and used to learn the physics of motion of the participating athletes, and to draw conclusions from their hands-on experience. As a main factor of the proposal, this latter characteristic aims at motivating the students to work and participate within a collaborative framework, so as to motivate them to reason and respond the questionnaire issues that stems from a real experience. A significant improvement of knowledge transference is thus attained by promoting teaching (and self-teaching) through reality-based perception, analysis and learning). This work is undergoing its first stage, and its conclusions arise from the observations on team-work dynamics. Quantitative results are expected for the following stages which are under way of execution.

  5. An alternative strategy to teach biomechanics: The long jump

    International Nuclear Information System (INIS)

    The work develops an alternative methodology to teach the Physics principles of Parabolic Cannon Shot in the career of Bioengineering using instead the physic-biological relationship of the long jump performed in Athletics. This is a closer-to-reality example for this discipline, and it is a field- and computer laboratory-reproducible practice that is simple to do by using affordable technology, because the practice can be filmed by the students in a real setting for future analysis off classroom hours. The data extracted from the film can be analysed and used to learn the physics of motion of the participating athletes, and to draw conclusions from their hands-on experience. As a main factor of the proposal, this latter characteristic aims at motivating the students to work and participate within a collaborative framework, so as to motivate them to reason and respond the questionnaire issues that stems from a real experience. A significant improvement of knowledge transference is thus attained by promoting teaching (and self-teaching) through reality-based perception, analysis and learning). This work is undergoing its first stage, and its conclusions arise from the observations on team-work dynamics. Quantitative results are expected for the following stages which are under way of execution

  6. Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning

    Directory of Open Access Journals (Sweden)

    Gabriel A

    2013-01-01

    Full Text Available Adel Gabriel,1,2 Claudio Violato21Departments of Psychiatry, University of Calgary, Calgary; 2Medical Education, Community Health Sciences, University of Calgary Calgary, CanadaBackground: The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry.Methods: Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempting to make a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of a selected case with both Axis I and Axis III diagnoses.Results: Expert psychiatrists made significantly more successful diagnoses for both the primary psychiatric and medical diagnoses than clinical clerks. Expert psychiatrists also gave fewer differential options. Analyzing the think-aloud protocols, expert psychiatrists were much more organized, made fewer mistakes, and utilized significantly less time to access their knowledge than clinical clerks. Both novices and experts seemed to use the hypothetic-deductive and scheme-inductive approaches to diagnosis. However, experts utilized hypothetic-deductive approaches significantly more often than novices.Conclusion: The hypothetic-deductive diagnostic strategy was utilized more than the scheme-inductive approach by both expert psychiatrists and clinical clerks. However, a specific relationship between diagnostic reasoning and diagnostic success could not be identified in this small pilot study. The author recommends a larger study that would include a detailed analysis of the think-aloud protocols.Keywords: diagnostic reasoning, knowledge structure, psychiatric diagnosis, hypothetic-deductive, scheme-inductive

  7. A field trial of alternative targeted screening strategies for Chagas disease in Arequipa, Peru.

    Directory of Open Access Journals (Sweden)

    Gabrielle C Hunter

    2012-01-01

    Full Text Available BACKGROUND: Chagas disease is endemic in the rural areas of southern Peru and a growing urban problem in the regional capital of Arequipa, population ∼860,000. It is unclear how to implement cost-effective screening programs across a large urban and periurban environment. METHODS: We compared four alternative screening strategies in 18 periurban communities, testing individuals in houses with 1 infected vectors; 2 high vector densities; 3 low vector densities; and 4 no vectors. Vector data were obtained from routine Ministry of Health insecticide application campaigns. We performed ring case detection (radius of 15 m around seropositive individuals, and collected data on costs of implementation for each strategy. RESULTS: Infection was detected in 21 of 923 (2.28% participants. Cases had lived more time on average in rural places than non-cases (7.20 years versus 3.31 years, respectively. Significant risk factors on univariate logistic regression for infection were age (OR 1.02; p = 0.041, time lived in a rural location (OR 1.04; p = 0.022, and time lived in an infested area (OR 1.04; p = 0.008. No multivariate model with these variables fit the data better than a simple model including only the time lived in an area with triatomine bugs. There was no significant difference in prevalence across the screening strategies; however a self-assessment of disease risk may have biased participation, inflating prevalence among residents of houses where no infestation was detected. Testing houses with infected-vectors was least expensive. Ring case detection yielded four secondary cases in only one community, possibly due to vector-borne transmission in this community, apparently absent in the others. CONCLUSIONS: Targeted screening for urban Chagas disease is promising in areas with ongoing vector-borne transmission; however, these pockets of epidemic transmission remain difficult to detect a priori. The flexibility to adapt to the

  8. Strategy for production and use of alternative fuels

    International Nuclear Information System (INIS)

    The use of bio-components in the former Czechoslovakia has a long tradition. It was mandatory to add bio-fermentation ethanol into petrol in the 1930s. Rapeseed oil methylesters production and sales were quickly and successfully launched in the 1990s. The current fall in their consumption has been caused by changes in taxation and price support. One of major obstacles to more extensive use of biofuels in the transport sector is their price. Currently it is more difficult to effectively sell biofuels than to produce them. Some specific properties of biofuels require to make changes in logistics, storage, particularly long-term one, as well as to introduce mandatory certification of producers and to make inspections in the petrol station network. Fuel price depends mainly on taxes and crude oil price. The biofuel production sector should be stabilized by defining and implementing a medium-term national strategy. The Slovak Republic has a chance to cut unemployment and to use its surplus farm products and forest wastes for the production of high-quality bio-components for transport. (authors)

  9. WRAP Module 1 sampling strategy and waste characterization alternatives study

    Energy Technology Data Exchange (ETDEWEB)

    Bergeson, C.L.

    1994-09-30

    The Waste Receiving and Processing Module 1 Facility is designed to examine, process, certify, and ship drums and boxes of solid wastes that have a surface dose equivalent of less than 200 mrem/h. These wastes will include low-level and transuranic wastes that are retrievably stored in the 200 Area burial grounds and facilities in addition to newly generated wastes. Certification of retrievably stored wastes processing in WRAP 1 is required to meet the waste acceptance criteria for onsite treatment and disposal of low-level waste and mixed low-level waste and the Waste Isolation Pilot Plant Waste Acceptance Criteria for the disposal of TRU waste. In addition, these wastes will need to be certified for packaging in TRUPACT-II shipping containers. Characterization of the retrievably stored waste is needed to support the certification process. Characterization data will be obtained from historical records, process knowledge, nondestructive examination nondestructive assay, visual inspection of the waste, head-gas sampling, and analysis of samples taken from the waste containers. Sample characterization refers to the method or methods that are used to test waste samples for specific analytes. The focus of this study is the sample characterization needed to accurately identify the hazardous and radioactive constituents present in the retrieved wastes that will be processed in WRAP 1. In addition, some sampling and characterization will be required to support NDA calculations and to provide an over-check for the characterization of newly generated wastes. This study results in the baseline definition of WRAP 1 sampling and analysis requirements and identifies alternative methods to meet these requirements in an efficient and economical manner.

  10. WRAP Module 1 sampling strategy and waste characterization alternatives study

    International Nuclear Information System (INIS)

    The Waste Receiving and Processing Module 1 Facility is designed to examine, process, certify, and ship drums and boxes of solid wastes that have a surface dose equivalent of less than 200 mrem/h. These wastes will include low-level and transuranic wastes that are retrievably stored in the 200 Area burial grounds and facilities in addition to newly generated wastes. Certification of retrievably stored wastes processing in WRAP 1 is required to meet the waste acceptance criteria for onsite treatment and disposal of low-level waste and mixed low-level waste and the Waste Isolation Pilot Plant Waste Acceptance Criteria for the disposal of TRU waste. In addition, these wastes will need to be certified for packaging in TRUPACT-II shipping containers. Characterization of the retrievably stored waste is needed to support the certification process. Characterization data will be obtained from historical records, process knowledge, nondestructive examination nondestructive assay, visual inspection of the waste, head-gas sampling, and analysis of samples taken from the waste containers. Sample characterization refers to the method or methods that are used to test waste samples for specific analytes. The focus of this study is the sample characterization needed to accurately identify the hazardous and radioactive constituents present in the retrieved wastes that will be processed in WRAP 1. In addition, some sampling and characterization will be required to support NDA calculations and to provide an over-check for the characterization of newly generated wastes. This study results in the baseline definition of WRAP 1 sampling and analysis requirements and identifies alternative methods to meet these requirements in an efficient and economical manner

  11. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Directory of Open Access Journals (Sweden)

    Asgar Aghaei Hashjin

    2015-10-01

    Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA

  12. Equipment availability and diagnostic strategies for suspected pulmonary embolism in Austria

    Energy Technology Data Exchange (ETDEWEB)

    Schibany, N.; Fleischmann, D.; Thallinger, C.; Ba-Ssalamah, A. [Vienna Univ. (Austria). Inst. fuer Radiologie; Schibany, A. [Joanneum Research, Vienna (Austria); Hahne, J. [Ludwig Boltzmann Inst. for Clinical and Experimental Radiology, Vienna (Austria); Herold, C.J. [Vienna Univ. (Austria). Inst. fuer Radiologie; Ludwig Boltzmann Inst. for Clinical and Experimental Radiology, Vienna (Austria)

    2001-11-01

    The aim of this study was to investigate equipment availability and current diagnostic strategies for suspected pulmonary embolism (PE) in Austrian hospitals. A questionnaire was sent to the medical directors of all Austrian hospitals with emergency and/or surgical, orthopedic, and medical departments. The questionnaire contained questions regarding the available equipment suitable for the imaging diagnosis of PE, the first-line and second-line imaging tests for patients with suspected PE, and additional lower extremity venous imaging and laboratory tests that complement the diagnostic armamentarium. The return rate for questionnaires was 81% (127 of 157 hospitals). There were 97% of hospitals that had the equipment to perform sonography, 59% could perform pulmonary angiography, 54% spiral CT, 19% ventilation/perfusion (V/P) scintigraphy, and 4% perfusion scintigraphy alone. Spiral-CT angiography (SCTA) was the first-line imaging study for suspected PE in 56% of hospitals, followed by echocardiography and V/P scintigraphy. Lower extremity venous imaging (47%) and, interestingly, V/P scintigraphy (43%), served as second-line imaging tests. D-dimer tests were included in the diagnostic strategy in 74% of hospitals. Spiral-CT angiography is the most commonly used primary method for suspected PE in Austrian hospitals. The V/P scintigraphy is available only in a minority of hospitals to investigate patients with suspected PE. When V/P scintigraphy is available, however, it is employed in a large number of patients per annum. (orig.)

  13. Alternative Media and the Learning Culture of Civil Society: Outreach and Teach Strategies

    OpenAIRE

    Caton-Rosser, Mary; McGinley, Jennifer A.

    2006-01-01

    A media literate citizenry is at the core of vibrant democracy in civil society. However, local issues are frequently neglected in mass media, de-legitimizing the existence of real democracy. Alternative media mediate this discrepancy in providing access to communication venues through outreach and teach strategies. Many segments of civil society are searching for opportunities to voice their opinions through alternative media. Studies of citizen-produced media indicate that there are links...

  14. The Assessment of the Colo-rectal Polyps in Order to the New Diagnostic and Therapeutic Strategies

    Directory of Open Access Journals (Sweden)

    Raluca Diac Andreea

    2015-09-01

    Full Text Available Objective. Assessment of the histological and endoscopic features of the colo-rectal polyps is requered for the application of the new diagnostic and therapeutical strategies in the managment of the diminutive polyps.

  15. A Current Review of the Diagnostic and Treatment Strategies of Hepatic Encephalopathy

    Directory of Open Access Journals (Sweden)

    Z. Poh

    2012-01-01

    Full Text Available Hepatic encephalopathy (HE is a serious and potentially fatal complication in patients with cirrhotic liver disease. It is a spectrum ranging from minimal hepatic encephalopathy (MHE without recognizable clinical symptoms or signs, to overt HE with risk of cerebral edema and death. HE results in diminished quality of life and survival. The broad range of neuropsychiatric manifestations reflects the range of pathophysiological mechanisms and impairment in neurotransmission that are purported to cause HE including hyperammonemia, astrocyte swelling, intra-astrocytic glutamine, upregulation of 18-kDa translocator protein (TSPO (formerly known as peripheral benzodiazepine receptor or PBTR, and manganese. There is a myriad of diagnostic tools including simple bedside clinical assessment, and more complex neuropsychological batteries and neurophysiological tests available today. Current treatment strategies are directed at reducing ammonia, with newer agents showing some early promise. This paper describes the pathophysiology of the disease and summarises current diagnostic and treatment therapies available.

  16. Cognitive schemes and strategies in diagnostic and therapeutic decision making: a primer for trainees.

    Science.gov (United States)

    Hassan, Imad Salah Ahmed

    2013-11-01

    Unlike novices, expert clinicians develop refined schemes and strategies that predictably allow them to provide a better quality, prompt and less error-prone patient care input. Empowering novices with cognitive aids or mental schemes as early as possible in their clinical career may significantly improve their critical thinking, problem-solving and decision-making skills. These cognitive aids may also improve trainees' use of evidence-based medicine in addition to reducing their diagnostic errors and improving their therapeutic care inputs. PMID:24203860

  17. 77 FR 47361 - Proposed Information Collection; Comment Request; 2013 Alternative Contact Strategy Test

    Science.gov (United States)

    2012-08-08

    .... Census Bureau Proposed Information Collection; Comment Request; 2013 Alternative Contact Strategy Test... agencies to take this opportunity to comment on proposed and/or continuing information collections, as...@doc.gov ). FOR FURTHER INFORMATION CONTACT: Requests for additional information or copies of...

  18. Minimally invasive and alternative approaches for long-term LVAD placement: the Vanderbilt strategy

    Science.gov (United States)

    Davis, Mary E.; Haglund, Nicholas

    2014-01-01

    Background Minimally invasive and alternative strategies for implantation have been anecdotally reported for contemporary continuous-flow left ventricular assist device (CF-LVAD) placement. Methods We reviewed our experience at a single center with alternative strategies for implantation of the HeartMate II and HeartWare CF-LVADs, in patients with advanced heart failure (HF). This featured article focuses on the associated surgical techniques and patient management pitfalls. Results For appropriately selected cases, our group believes that these alternative strategies allow for the development of novel and less traumatic surgical approaches for CF-LVAD implantation. With reproducible outcomes, these approaches also promise the possibility of increasing the number of high-risk surgical patients who could benefit from CF-LVAD therapies. Conclusions This work has detailed a variety of less invasive alternative strategies for implantation of long-term LVADs. These newer approaches have the potential for significant advancements in the field of cardiothoracic surgery. Large-scale collaborative studies will be needed to clarify the potential advantages and disadvantages of these novel techniques on patient outcomes. PMID:25512895

  19. Improved AFEM algorithm for bioluminescence tomography based on dual-mesh alternation strategy

    Institute of Scientific and Technical Information of China (English)

    Wei Li; Heng Zhao; Xiaochao Qu; Yanbin Hou; Xueli Chen; Duofang Chen; Xiaowei He; Qitan Zhang; Jimin Liang

    2012-01-01

    Adaptive finite element method (AFEM) is broadly adopted to recover the internal source in biological tissues.In this letter,a novel dual-mesh alternation strategy (dual-mesh AFEM) is developed for bioluminescence tomography.By comprehensively considering the error estimation of the finite element method solution on each mesh,two different adaptive strategies based on the error indicator of the reconstructed source and the photon flux density are used alternately in the process.Combined with the constantly adjusted permissible region in the adaptive process,the new algorithm can achieve a more accurate source location compared with the AFEM in the previous experiments.%Adaptive finite element method (AFEM) is broadly adopted to recover the internal source in biological tissues. In this letter, a novel dual-mesh alternation strategy (dual-mesh AFEM) is developed for biolumi-nescence tomography. By comprehensively considering the error estimation of the finite element method solution on each mesh, two different adaptive strategies based on the error indicator of the reconstructed source and the photon flux density are used alternately in the process. Combined with the constantly adjusted permissible region in the adaptive process, the new algorithm can achieve a more accurate source location compared with the AFEM in the previous experiments.

  20. Alternative strategies to improve the beneficial effects of exercise throughout life : dietary and physiological aspects

    NARCIS (Netherlands)

    R.T. Mankowski (Robert Tomasz)

    2015-01-01

    markdownabstractAbstract It is certain that the aging process leads to death, but decreasing the levels of pathology throughout life improves the quality of life and extends life span. Therefore, this dissertation focuses on alternative strategies that may contribute to improving the aging process

  1. Long-term Cost-Effectiveness of Diagnostic Tests for Assessing Stable Chest Pain: Modeled Analysis of Anatomical and Functional Strategies.

    Science.gov (United States)

    Bertoldi, Eduardo G; Stella, Steffan F; Rohde, Luis E; Polanczyk, Carisi A

    2016-05-01

    Several tests exist for diagnosing coronary artery disease, with varying accuracy and cost. We sought to provide cost-effectiveness information to aid physicians and decision-makers in selecting the most appropriate testing strategy. We used the state-transitions (Markov) model from the Brazilian public health system perspective with a lifetime horizon. Diagnostic strategies were based on exercise electrocardiography (Ex-ECG), stress echocardiography (ECHO), single-photon emission computed tomography (SPECT), computed tomography coronary angiography (CTA), or stress cardiac magnetic resonance imaging (C-MRI) as the initial test. Systematic review provided input data for test accuracy and long-term prognosis. Cost data were derived from the Brazilian public health system. Diagnostic test strategy had a small but measurable impact in quality-adjusted life-years gained. Switching from Ex-ECG to CTA-based strategies improved outcomes at an incremental cost-effectiveness ratio of 3100 international dollars per quality-adjusted life-year. ECHO-based strategies resulted in cost and effectiveness almost identical to CTA, and SPECT-based strategies were dominated because of their much higher cost. Strategies based on stress C-MRI were most effective, but the incremental cost-effectiveness ratio vs CTA was higher than the proposed willingness-to-pay threshold. Invasive strategies were dominant in the high pretest probability setting. Sensitivity analysis showed that results were sensitive to costs of CTA, ECHO, and C-MRI. Coronary CT is cost-effective for the diagnosis of coronary artery disease and should be included in the Brazilian public health system. Stress ECHO has a similar performance and is an acceptable alternative for most patients, but invasive strategies should be reserved for patients at high risk. PMID:27080921

  2. Performance of psychiatric diagnostic groups on measures and strategies of verbal fluency.

    Science.gov (United States)

    Helmes, Edward; Hall, Fiona

    2016-01-01

    Analysis of cognitive deficits in people with psychiatric disorders can increase our understanding of those disorders. Here we contrast the performance of 5 diagnostic groups (n = 120; schizophrenia, mild-to-moderate and moderate-to-severe depression, panic disorder, and healthy controls) on word and letter fluency tasks using 3 scoring systems (Abwender, Swan, Bowerman, & Connolly, 2001 ; Raskin, Silwinski, & Brood, 1992 ; Troyer, Moscovitch, & Winocur, 1997 ) that differ in complexity to determine what system best differentiates diagnostic groups. The 3 scoring methods differ in the range of cognitive strategies assessed and how strategies are defined. Groups with schizophrenia and major depression were hypothesized to show greater deficits in fluency than groups with panic disorder and healthy controls. Results showed that the group with schizophrenia had the lowest level of fluency regardless of scoring method, with the group with severe major depression also showing deficits. The healthy control and panic disorder groups, and unexpectedly, the mild-to-moderate depression group showed few, if any, deficits. The scoring method proposed by Abwender et al. ( 2001 ) proved to be most comprehensive and sensitive to group differences. PMID:26571034

  3. Subgroup report on alternative technology strategies for the isolation of nuclear waste

    International Nuclear Information System (INIS)

    The purpose of this report is to provide information to support programmatic approaches to the disposal of high-level and transuranic-contaminated (TRU) wastes. For this purpose the report describes, in Appendices A through F, the state of knowledge relevant to selected nuclear waste disposal technologies. Within the main report a number of alternative technological strategies that could lead to a disposal facility are specified for illustrative and analytical purposes. These strategies span a wide range of variations of technological emphasis and programmatic diversity. Selected implications of these strategies are analyzed. In addition, subjects such as technical conservatism, retrievability, and intermediate scale facilities, that apply to any strategy, are examined and implications of each are discussed

  4. Assessment of an alternative postdeployment reintegration strategy with soldiers returning from Iraq.

    Science.gov (United States)

    Sipos, Maurice L; Foran, Heather M; Wood, Michael D; Wright, Kathleen M; Barnhart, Vincent J; Riviere, Lyndon A; Adler, Amy B

    2014-05-01

    The present study examined behavioral health outcomes, risk behaviors, aggression, alcohol misuse, marital satisfaction, and attitudes toward reintegration associated with an alternative, front-loaded reintegration strategy compared with a more standardized reintegration process in soldiers returning from combat deployments. The type of reintegration strategy used did not predict differences in posttraumatic stress disorder (PTSD) symptoms, alcohol misuse, aggression, and marital satisfaction, although slightly higher reports of risk behaviors were found in the unit using the standard reintegration approach even after controlling for demographic covariates and combat exposure. These findings may help guide leadership when making decisions regarding reintegration approaches in the future. PMID:24079352

  5. Strategies to teach alternative and complementary therapies in nursing: an integrative review

    Directory of Open Access Journals (Sweden)

    Natália Chantal Magalhães da Silva

    2013-12-01

    Full Text Available The lack of discussions that clarify the teaching of alternative and complementary therapies in undergraduate nursing programs shows the need for developing research on this topic. The objective of this study was to identify, in scientific literature, the strategies for teaching alternative and complementary therapies in nursing undergraduate programs. The guiding methodology used was integrative review. The search was performed on SCIENCE DIRECT, LILACS and MEDLINE databases. According to the articles included in this study, the proposals for including these therapies in the program are by: lectures, theoretical courses and discussion groups. However, studies should be conducted to confirm the efficacy of these strategies so these therapeutic methods can be included in the Pedagogical Political Project of the nursing undergraduate program, thus allowing for the consolidation of those practices. Descriptors: Education, Nursing; Education, Higher; Complementary Therapies.

  6. Alternative life cycle strategies of Megalodiscus temperatus in tadpoles and metamorphosed anurans

    Directory of Open Access Journals (Sweden)

    Bolek M.G.

    2008-09-01

    Full Text Available Megalodiscus temperatus (Stafford, 1905 is a common paramphistome trematode of North American amphibians with a two host life cycle and has been reported to infect frogs and rarely tadpoles. In this study we document the alternative life cycle strategy of M. temperatus in tadpoles and metamorphosed anurans. We show through field work and experimental infections that M. temperatus can establish in both anuran life stages and worms become gravid and release eggs in both tadpoles and metamorphosed frogs. However, worms exhibit differences in route of infection, development, egg production, and diet in tadpoles and metamorphosed anurans. These alternative life history strategies of M. temperatus suggest different selective pressures on the development and reproductive success of these worms in tadpoles and metamorphosed anurans, and we discuss the evolutionary avenues for and constraints on amphibian trematode life cycles presented by these two different anuran life stages.

  7. Evaluation of new alternative strategies to predict neurotoxicity with human based test systems

    OpenAIRE

    Krug, Anne-Kathrin

    2013-01-01

    Animal experiments are still the ‘gold standard’ in safety evaluation defined by the OECD (Organisation for Economic Co-operation and Development) or the US EPA (Environmental Protection Agency). Millions of animals are used each year to assess the risk of chemical toxicities for human health. But animal experiments are expensive, time-consuming and have a restricted prediction capacity regarding human toxicity. Hence the demand for validated alternative strategies is high. Validated differen...

  8. An alternative strategy to generate coding sequence of macrophage migration inhibitory factor-2 of Wuchereria bancrofti

    OpenAIRE

    Nikhil Chauhan; Hoti, S.L.

    2016-01-01

    Background & objectives: Different developmental stages of Wuchereria bancrofti, the major causal organism of lymphatic filariasis (LF), are difficult to obtain. Beside this limitation, to obtain complete coding sequence (CDS) of a gene one has to isolate mRNA and perform subsequent cDNA synthesis which is laborious and not successful at times. In this study, an alternative strategy employing polymerase chain reaction (PCR) was optimized and validated, to generate CDS of Macrophage migration ...

  9. Analysis of Alternative Rework Strategies for Printed Wiring Assembly Manufacturing Systems

    OpenAIRE

    Driels, Morris; Klegka, John S.

    1991-01-01

    This paper presents a model for predicting the cost of test, diagnosis, and rework activities in the manufacture of printed wiring assemblies (PWA's). Rework is defined as all actions taken to correct or improve the basic assembly process. These actions may include those of inspectors and solder touchup technicians who do not add value to the PWA, but whose actions are required in order to produce acceptable yields from the manufacturing process. Two alternative rework strategies for cont...

  10. Calibration diagnostic and updating strategy based on quantitative modeling of near-infrared spectral residuals.

    Science.gov (United States)

    Yu, Hua; Small, Gary W

    2015-02-01

    A diagnostic and updating strategy is explored for multivariate calibrations based on near-infrared spectroscopy. For use with calibration models derived from spectral fitting or decomposition techniques, the proposed method constructs models that relate the residual concentrations remaining after a prediction to the residual spectra remaining after the information associated with the calibration model has been extracted. This residual modeling approach is evaluated for use with partial least-squares (PLS) models for predicting physiological levels of glucose in a simulated biological matrix. Residual models are constructed with both PLS and a hybrid technique based on the use of PLS scores as inputs to support vector regression. Calibration and residual models are built with both absorbance and single-beam data collected over 416 days. Effective models for the spectral residuals are built with both types of data and demonstrate the ability to diagnose and correct deviations in performance of the calibration model with time. PMID:25473807

  11. Performance and suggested alternative strategies in developing Indonesian cocoa export business

    Directory of Open Access Journals (Sweden)

    Bambang Dradjat

    2009-08-01

    Full Text Available This research focussed on the export development of cocoa bean with respect to its export growth, values and competitiveness. Based on this deve-lopment, the aim of this research is to propose alternative development strategies of export business for cocoa bean in the future. The Analysis Hierarchie Process (AHP framework of export business of cocoa bean was arranged consecutively from formulation of focuss or goals, identification of affecting factors and actors, deter mination of actor objectives, and recognition of alternative strategies needed. Each component of goals, factors, actors, objectives, and alternative strategies were valued on the basis of their importance using Saaty scales. Results of interviews with experts were analyzed using AHP technique. The development of cocoa bean export from 2000 to 2006 showed the competitiveness position of Indonesia in the world market was fairly good. In order to increase the growth and values of cocoa bean export, the experts consider the role of government as regulators and facilitators is very important. The government became the main actor for the export development through de/regulation related to the cocoa bean commodity. The objectives of actors could be achieved by combining strategies (i provision of fund in national and regional budget, as well as other sources (ii implementation of recomended technologies of cocoa, (iii acceleration of replanting program, (iv improvement of research productivity in producing high yielding plant materials, (v development of transportation facilities from farms to harbours, (vi development of farmers’ organization and partnerships as well as strategic alliance, and (viii pests and diseases control. Key words: Cocoa bean, expor, role of government, objectives and strategies.

  12. Diagnostic accuracy of a step-up imaging strategy in pediatric patients with blunt abdominal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Schuppen, J. van [Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Olthof, D.C. [Trauma Unit Department of Surgery, Academic Medical Centre, Amsterdam (Netherlands); Wilde, J.C.H. [Department of Paediatric Surgery, Emma' s Children Hospital/Academic Medical Centre, Amsterdam (Netherlands); Beenen, L.F.M.; Rijn, R.R. van [Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Goslings, J.C., E-mail: j.c.goslings@amc.nl [Trauma Unit Department of Surgery, Academic Medical Centre, Amsterdam (Netherlands)

    2014-01-15

    Introduction: Blunt abdominal trauma (BAT) is an important but often unrecognized cause of death in children. Imaging plays a vital role in the early detection of abdominal trauma. The exact role of imaging in the management of BAT in children is still under research. The aim of this study was to assess diagnostic accuracy of a step-up imaging strategy, where the decision to observe or to perform an intervention depends on the vital parameters of the patient, in combination with the presence or absence of free fluid at Focused Assessment with Sonography for Trauma (FAST) and the findings on CT (performed selectively), for pediatric patients presenting to the ED with a blunt abdominal trauma. Methods: Consecutive patients aged ≤16 years admitted between January 2008 and December 2012 to a Dutch level 1 trauma centre were included in this retrospective study. Sensitivity, negative predictive value (NPV) and the negative likelihood ratio (LR−) of the imaging strategy were calculated. Results: The cohort consisted of 122 patients; 66 (54%) patients were discharged home after primary survey, 51 (41%) patients were admitted and observed, 3 (2%) patients underwent transarterial embolization and 2 (2%) patients underwent surgery. Treatment failed in 1 patient, initially selected for observation. The sensitivity of the imaging strategy was 0.833 (0.446–0.990). The NPV and LR− were 0.991 (0.963–1.000) and 0.167 (0.028–0.997), respectively. Conclusion: The step-up imaging strategy that is applied in our academic level 1 trauma centre has a high sensitivity and a high negative predictive value. No clinically relevant injuries were missed without doing unnecessary harm, e.g. radiation or an intervention.

  13. Diagnostic accuracy of a step-up imaging strategy in pediatric patients with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Introduction: Blunt abdominal trauma (BAT) is an important but often unrecognized cause of death in children. Imaging plays a vital role in the early detection of abdominal trauma. The exact role of imaging in the management of BAT in children is still under research. The aim of this study was to assess diagnostic accuracy of a step-up imaging strategy, where the decision to observe or to perform an intervention depends on the vital parameters of the patient, in combination with the presence or absence of free fluid at Focused Assessment with Sonography for Trauma (FAST) and the findings on CT (performed selectively), for pediatric patients presenting to the ED with a blunt abdominal trauma. Methods: Consecutive patients aged ≤16 years admitted between January 2008 and December 2012 to a Dutch level 1 trauma centre were included in this retrospective study. Sensitivity, negative predictive value (NPV) and the negative likelihood ratio (LR−) of the imaging strategy were calculated. Results: The cohort consisted of 122 patients; 66 (54%) patients were discharged home after primary survey, 51 (41%) patients were admitted and observed, 3 (2%) patients underwent transarterial embolization and 2 (2%) patients underwent surgery. Treatment failed in 1 patient, initially selected for observation. The sensitivity of the imaging strategy was 0.833 (0.446–0.990). The NPV and LR− were 0.991 (0.963–1.000) and 0.167 (0.028–0.997), respectively. Conclusion: The step-up imaging strategy that is applied in our academic level 1 trauma centre has a high sensitivity and a high negative predictive value. No clinically relevant injuries were missed without doing unnecessary harm, e.g. radiation or an intervention

  14. Energy abatement in Chinese industry: Cost evaluation of regulation strategies and allocation alternatives

    International Nuclear Information System (INIS)

    For Chinese industry, the costs of different energy consumption abatement scenarios are evaluated by the method of directional distance function. These scenarios are based on the combinations of regulation strategies and allocation alternatives—the former are sectors and provinces, and the latter include the five principles of average, intensity share, absolute share, discriminatory absolute and discriminatory intensity. For all the scenarios, the quantitative impacts in terms of output potential loss are calculated and compared. Due to less output potential loss for all the allocation alternatives, the sector regulation strategy is shown to be more effective than the province regulation strategy. It is also demonstrated that, among all the scenarios considered, the sector regulation based on the intensity share principle and the province regulation based on the absolute share principle are the two optimal. The performances of energy abatement allocation of the 11th and 12th Five Year Plans of China are assessed against the simulated scenarios. - Highlights: ► The costs of different energy consumption abatement scenarios are evaluated for Chinese industry. ► The impacts on all entities under all allocation alternatives are calculated and compared. ► The optimal scenarios for the different strategies are identified. ► The performances of the 11th and 12th Five Year Plans are assessed.

  15. Barriers, strategies, and lessons learned from complementary and alternative medicine curricular initiatives.

    Science.gov (United States)

    Sierpina, Victor S; Schneeweiss, Ronald; Frenkel, Moshe A; Bulik, Robert; Maypole, Jack

    2007-10-01

    Fifteen U.S. academic programs were the recipients of a National Center for Complementary and Alternative Medicine R25 Education Grant Program to introduce curricular changes in complementary and alternative medicine (CAM) in their institutions. The authors describe the lessons learned during the implementation of these CAM education initiatives. Principal investigators identified these lessons along with discovered barriers and strategies, both those traditionally related to medical and nursing education and those unique to CAM education. Many lessons, barriers, and strategies were common across multiple institutions. Most significant among the barriers were issues such as the resistance by faculty; the curriculum being perceived as too full; presenting CAM content in an evidence-based and even-handed way; providing useful, reliable resources; and developing teaching and assessment tools. Strategies included integration into existing curriculum; creating increased visibility of the curriculum; placing efforts into faculty development; cultivating and nurturing leadership at all levels in the organization, including among students, faculty, and administration; providing access to CAM-related databases through libraries; and fostering efforts to maintain sustainability of newly established CAM curricular elements through institutionalization and embedment into overall educational activities. These lessons, along with some detail on barriers and strategies, are reported and summarized here with the goal that they will be of practical use to other institutions embarking on new CAM education initiatives. PMID:17895653

  16. Cost-effectiveness of alternative conservation strategies with application to the Pacific leatherback turtle.

    Science.gov (United States)

    Gjertsen, Heidi; Squires, Dale; Dutton, Peter H; Eguchi, Tomoharu

    2014-02-01

    Although holistic conservation addressing all sources of mortality for endangered species or stocks is the preferred conservation strategy, limited budgets require a criterion to prioritize conservation investments. We compared the cost-effectiveness of nesting site and at-sea conservation strategies for Pacific leatherback turtles (Dermochelys coriacea). We sought to determine which conservation strategy or mix of strategies would produce the largest increase in population growth rate per dollar. Alternative strategies included protection of nesters and their eggs at nesting beaches in Indonesia, gear changes, effort restrictions, and caps on turtle takes in the Hawaiian (U.S.A.) longline swordfish fishery, and temporal and area closures in the California (U.S.A.) drift gill net fishery. We used a population model with a biological metric to measure the effects of conservation alternatives. We normalized all effects by cost to prioritize those strategies with the greatest biological effect relative to its economic cost. We used Monte Carlo simulation to address uncertainty in the main variables and to calculate probability distributions for cost-effectiveness measures. Nesting beach protection was the most cost-effective means of achieving increases in leatherback populations. This result creates the possibility of noncompensatory bycatch mitigation, where high-bycatch fisheries invest in protecting nesting beaches. An example of this practice is U.S. processors of longline tuna and California drift gill net fishers that tax themselves to finance low-cost nesting site protection. Under certain conditions, fisheries interventions, such as technologies that reduce leatherback bycatch without substantially decreasing target species catch, can be cost-effective. Reducing bycatch in coastal areas where bycatch is high, particularly adjacent to nesting beaches, may be cost-effective, particularly, if fisheries in the area are small and of little commercial value. PMID

  17. AB016. Developing diagnostic strategy of multiple congenital anomalies in Indonesia

    Science.gov (United States)

    Sjarif, Damayanti Rusli; Aswin, Yulia Ariani

    2015-01-01

    Background Pediatricians quite often must deal with multiple congenital anomalies (MCA). Without a correct diagnosis, many available forms of therapy will be under-or-overused and counseling about prognosis and recurrence risk maybe unrealistic. The basis for diagnosis of MCA involves a combination of defining the physical manifestations and diagnostic genetic testing. Chromosome analysis is a standard practice to unravel the etiology of MCA. Conventional cytogenetic method has limitation in detecting abe1rrations less than 5 Mb in size. Microarray technology could overcome this obstacle. The aim of this study is to develop diagnosis strategy of MCA cases. Methods Seventy two MCA cases were recruited from July 2013 until June 2014. Fifty one subjects were diagnosed phenotypically using OMIM and POSSUM databases. Subsequently, chromosome analysis were performed as a first step of diagnosis strategy. Nine cases among those subjects found to have chromosome aberrations, whereas twelve cases showed normal karyotypes. Eight subjects from the normal karyotype group have a good quality of DNA and proceed to microarray examination. Microarray examination were done at Department of Medical Genetics, UMC Utrecht, Netherlands, using Infinium CytoSNP-850K DNA analysis bead chip kit from Illumina. Chips were scanned using Hi-scan scanner from Illumina. Data were extracted using genome studio software. Data were analyzed using Nexus software. Results Nine out of twenty cases were found to have chromosome aberrations. Those aberrations are:46,XY,add(13)(q34); 46,XY,6 Mar, 17 dmin; 46,XX,r(4)(p16q35); 46,XY,22ps+; 46,XY,add(5)(p15); 47,XX+G; 46,XX/45XX Rob (13,15/q10.2,q10), 45XX Rob (13,14)(q10,q10); 46,XX, ring 13; 45,XY,der(2)del(2)(q37.3)t(2;15)(q37.2;q11.2). Five out of eight subjects which tested by microarray showed normal array. Two subjects showed well known deletion syndrome, which are Wolf-Hirschhorn syndrome and Williams-Beuren syndrome. One case has normal array with

  18. The effect of alternative testing strategies and bio-exclusion practices on Johne's disease risk in test-negative herds.

    Science.gov (United States)

    More, S J; Sergeant, E S G; Strain, S; Cashman, W; Kenny, Kevin; Graham, D

    2013-03-01

    Herd classification is a key component of national Johne's disease (JD) control programs. Herds are categorized on the basis of test results, and separate sub-programs are followed for test-positive and test-negative herds. However, a test-negative herd result does not necessarily equate to JD freedom for reasons relating to disease pathogenesis and available diagnostic tests. Thus, in several countries, JD control programs define test-negative herds as having a "low risk" of infection below a specified prevalence. However, the approach is qualitative, and little quantitative work is available on herd-level estimates of probability of freedom in test-negative herds. This paper examines the effect over time of alternative testing strategies and bio-exclusion practices on JD risk in test-negative herds. A simulation model was developed in the programming language R. Key model inputs included sensitivity and specificity estimates for 3 individual animal diagnostic tests (serum ELISA, milk ELISA, and fecal culture), design prevalence, testing options, and testing costs. Key model outputs included the probability that infection will be detected if present at the design prevalence or greater (herd sensitivity; SeH), the probability that infection in the herd is either absent or at very low prevalence (i.e., less than the design prevalence; ProbF), the probability of an uninfected herd producing a false-positive result [P(False+)], and mean testing cost (HerdCost) for different testing strategies. The output ProbF can be updated periodically, incorporating data from additional herd testing and information on cattle purchases, and could form the basis for an output-based approach to herd classification. A high ProbF is very difficult to achieve, reflecting the low sensitivity of the evaluated tests. Moreover, ProbF is greatly affected by any risk of introduction of infection, decreasing in herds with poor bio-exclusion practices despite ongoing negative test results. The

  19. Opportunities for an alternative integrating testing strategy for carcinogen hazard assessment?

    Science.gov (United States)

    Doktorova, Tatyana Y; Pauwels, Marleen; Vinken, Mathieu; Vanhaecke, Tamara; Rogiers, Vera

    2012-02-01

    The 2-year rodent carcinogenicity bioassay evolved more than 40 years ago, and although it is complex, long lasting, expensive, and animal consuming, it is still the only generally accepted test for assessing the carcinogenicity of chemicals. Over time, different alternative approaches have been developed with the final goal to replace the bioassay. Unfortunately, at present, none of these strategies alone provides sufficient assurance of accurate prediction. In this review paper, we discuss the major advantages and pitfalls of the existing alternative methodologies to the carcinogenicity bioassay. Finally, based on the available scientific data in the public domain, we propose what we would like to call a "feasible integrated testing strategy" which incorporates some promising alternatives, providing at the same time information on the mechanism of action and the toxic nature of the compounds tested. It is, however, clear that the adoption of whatever "new" testing scheme should be considered with caution and its effectiveness should be experimentally demonstrated in advance by addressing a reasonable number of chemical carcinogens and non-carcinogens from a variety of structural and functional classes. PMID:22141324

  20. How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs

    OpenAIRE

    Lim, Cherry; Paris, Daniel H.; Blacksell, Stuart D.; Laongnualpanich, Achara; Kantipong, Pacharee; Chierakul, Wirongrong; Wuthiekanun, Vanaporn; Day, Nicholas P. J.; Cooper, Ben S.; Limmathurotsakul, Direk

    2015-01-01

    Background The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian latent class models (LCMs) to estimate the true accuracy of each diagnostic test, and of STIC, for diagnosing scrub typhus. Methods/Principal Findings Data from 161 patients with undiff...

  1. Robust versus optimal strategies for two-alternative forced choice tasks.

    Science.gov (United States)

    Zacksenhouse, M; Bogacz, R; Holmes, P

    2010-04-01

    It has been proposed that animals and humans might choose a speed-accuracy tradeoff that maximizes reward rate. For this utility function the simple drift-diffusion model of two-alternative forced-choice tasks predicts a parameter-free optimal performance curve that relates normalized decision times to error rates under varying task conditions. However, behavioral data indicate that only ≈ 30% of subjects achieve optimality, and here we investigate the possibility that, in allowing for uncertainties, subjects might exercise robust strategies instead of optimal ones. We consider two strategies in which robustness is achieved by relinquishing performance: maximin and robust-satisficing. The former supposes maximization of guaranteed performance under a presumed level of uncertainty; the latter assumes that subjects require a critical performance level and maximize the level of uncertainty under which it can be guaranteed. These strategies respectively yield performance curves parameterized by presumed uncertainty level and required performance. Maximin performance curves for uncertainties in response-to-stimulus interval match data for the lower-scoring 70% of subjects well, and are more likely to explain it than robust-satisficing or alternative optimal performance curves that emphasize accuracy. For uncertainties in signal-to-noise ratio, neither maximin nor robust-satisficing performance curves adequately describe the data. We discuss implications for decisions under uncertainties, and suggest further behavioral assays. PMID:23180885

  2. Resurvey of symptomatics of the Jaipur district population and suggestion for alternative diagnostic criteria of asthma for epidemiological surveys

    Science.gov (United States)

    Gupta, Prahlad Rai; Bansal, Ankit; Singh, Anupam

    2016-01-01

    Introduction: The prevalence of asthma in Jaipur district of Rajasthan was reported as 0.96% in an earlier survey. It was far below the national average of 2.38%. It was reasoned then that this could be due to under diagnosis of asthma in the Jaipur population. Material and Methods: A resurvey of the symptomatics, not diagnosed as asthma at time of the original survey was, therefore, undertaken. The resurvey data were analysed and those who now fulfilled the twin criteria for diagnosis of asthma, as used in the original survey, were diagnosed as having asthma. The original data of these newly diagnosed asthma patients were reanalyzed in search for an alternative diagnostic criterion. Results: Of the 382 symptomatics, 344 (90%) could be resurveyed and of them, 85 now fulfilled the twin diagnostic criteria for asthma. The reanalysis of the original survey data of these patients revealed that presence of shortness of breath (SOB) had the highest sensitivity, the presence of allergic symptoms in self or the family had the highest specificity and the presence of wheezing had the highest odds ratio (OR) for diagnosing asthma. Further, the OR for diagnosing asthma increased further and was highest with the presence of SOB and 2 additional symptoms. With the use of the “symptom criteria” for diagnosis of asthma i.e. the presence of SOB with 2 additional symptoms, it would have been possible to diagnose majority of the missed cases at the time of the original survey itself. Conclusions: Based on this study data it can be concluded that (a) the twin criteria for diagnosing asthma as used in earlier surveys led to under diagnosis of asthma and (b) the use of symptom criteria alone effectively checks the problem of under diagnosis of asthma. The symptom criteria are being suggested as an alternative method for use in future epidemiological surveys on asthma. PMID:26933304

  3. Alternative Strategies for the Treatment of Classical Congenital Adrenal Hyperplasia: Pitfalls and Promises

    Directory of Open Access Journals (Sweden)

    Calikoglu AliS

    2010-06-01

    Full Text Available Despite decades of different treatment algorithms, the management of congenital adrenal hyperplasia (CAH remains clinically challenging. This is due to the inherent difficulty of suppressing adrenal androgen production using near physiological dosing of glucocorticoids (GC. As a result, alternating cycles of androgen versus GC excess can occur and may lead to short stature, obesity, virilization, and alterations in puberty. Novel therapeutic alternatives, including new and more physiological means of GC delivery, inhibitors at the level of CRH or ACTH secretion and/or action, as well as "rescue strategies", such as GnRH analogs, anti-androgens, aromatase inhibitors, and estrogen receptor blockers, are available; many of these agents, however, still require active investigation in CAH. Bilateral adrenalectomy is effective but it is also still an experimental approach. Gene therapy and stem cells, to provide functional adrenal cortical tissue, are at preclinical stage but provide exciting avenues for a potential cure for CAH.

  4. Implementation of alternative test strategies for the safety assessment of engineered nanomaterials.

    Science.gov (United States)

    Nel, A E

    2013-12-01

    Nanotechnology introduces a new field that requires novel approaches and methods for hazard and risk assessment. For an appropriate scientific platform for safety assessment, nanoscale properties and functions of engineered nanomaterials (ENMs), including how the physicochemical properties of the materials relate to mechanisms of injury at the nano-bio interface, must be considered. Moreover, this rapidly advancing new field requires novel test strategies that allow multiple toxicants to be screened in robust, mechanism-based assays in which the bulk of the investigation can be carried out at the cellular and biomolecular level whilst maintaining limited animal use and is based on the contribution of toxicological pathways to the pathophysiology of disease. First, a predictive toxicological approach for the safety assessment of ENMs will be discussed against the background of a '21st-century vision' for using alternative test strategies (ATSs) to perform toxicological assessment of large numbers of untested chemicals, thereby reducing a backlog that could otherwise become a problem for nanotechnology. An ATS is defined here as an alternative to animal experiments or refinement/reduction alternative to traditional animal testing. Secondly, the approach of selecting pathways of toxicity to screen for the pulmonary hazard potential of carbon nanotubes and metal oxides will be discussed, as well as how to use these pathways to perform high-content or high-throughput testing and how the data can be used for hazard ranking, risk assessment, regulatory decision-making and 'safer-by-design' strategies. Finally, the utility and disadvantages of this predictive toxicological approach to ENM safety assessment, and how it can assist the 21st-century vision, will be addressed. PMID:23879741

  5. Early diagnostic value of survivin and its alternative splice variants in breast cancer

    International Nuclear Information System (INIS)

    The inhibitor of apoptosis (IAP) protein Survivin and its splice variants are differentially expressed in breast cancer tissues. Our previous work showed Survivin is released from tumor cells via small membrane-bound vesicles called exosomes. We, therefore, hypothesize that analysis of serum exosomal Survivin and its splice variants may provide a novel biomarker for early diagnosis of breast cancer. We collected sera from forty breast cancer patients and ten control patients who were disease free for 5 years after treatment. In addition, twenty-three paired breast cancer tumor tissues from those same 40 patients were analyzed for splice variants. Serum levels of Survivin were analyzed using ELISA and exosomes were isolated from this serum using the commercially available ExoQuick kit, with subsequent Western blots and immunohistochemistry performed. Survivin levels were significantly higher in all the breast cancer samples compared to controls (p < 0.05) with exosome amounts significantly higher in cancer patient sera compared to controls (p < 0.01). While Survivin and Survivin-∆Ex3 splice variant expression and localization was identical in serum exosomes, differential expression of Survivin-2B protein existed in the exosomes. Similarly, Survivin and Survivin-∆Ex3 proteins were the predominant forms detected in all of the breast cancer tissues evaluated in this study, whereas a more variable expression of Survivin-2B level was found at different cancer stages. In this study we show for the first time that like Survivin, the Survivin splice variants are also exosomally packaged in the breast cancer patients’ sera, mimicking the survivin splice variant pattern that we also report in breast cancer tissues. Differential expression of exosomal-Survivin, particularly Survivin-2B, may serve as a diagnostic and/or prognostic marker, a “liquid biopsy” if you will, in early breast cancer patients. Furthermore, a more thorough understanding of the role of this

  6. Effects of winter feeding strategies with alternative feeds on the performance of mature suckler cows and their progeny

    OpenAIRE

    Manninen, Merja; Saarijärvi, Kirsi; Huhta, Harri; Jauhiainen, Lauri; Aspila, Pentti

    2004-01-01

    The present study evaluated the effects of feeding strategies with alternative feeds on the performance of mature suckler cows and their progeny during indoor feeding and subsequent grazing. In both experiments, a 2 × 2 factorially arranged design consisted of two feeding strategies (Step-up, S; Flat-rate, F) and two diets (Control, C; Alternative, A). The aim of Strategy F was to offer the cows the same amount of energy as offered on Strategy S, but at a constant daily level. In Experiment 1...

  7. Equilibrium balking strategies for a clearing queueing system in alternating environment

    CERN Document Server

    Economou, Antonis

    2011-01-01

    We consider a Markovian clearing queueing system, where the customers are accumulated according to a Poisson arrival process and the server removes all present customers at the completion epochs of exponential service cycles. This system may represent the visits of a transportation facility with unlimited capacity at a certain station. The system evolves in an alternating environment that influences the arrival and the service rates. We assume that the arriving customers decide whether to join the system or balk, based on a natural linear reward-cost structure. We study the balking behavior of the customers and derive the corresponding Nash equilibrium strategies under various levels of information.

  8. The role of utilities in enabling technology innovation: The BC hydro alternative & emerging energy strategy

    Energy Technology Data Exchange (ETDEWEB)

    Tu, Alex; Leclair, Donna; Morrison, Allison

    2010-09-15

    In order for renewable energy to play a dominant role in the global electricity supply mix, emerging renewable energy technologies - such as wave, tidal, enhanced geothermal, and 3rd generation photovoltaic technologies - must prove their technical merits and achieve cost parity with conventional sources of supply. BC Hydro, a government-owned electric utility, launched an Alternative and Emerging Energy Strategy that describes its role as an enabler of technology innovation. This paper describes BC Hydro's goal, objectives and actions to accelerate the commercialization that will yield a diversity of supply options and a growing, local clean-tech cluster.

  9. Longitudinal exchange: an alternative strategy towards quantification of dynamics parameters in ZZ exchange spectroscopy

    International Nuclear Information System (INIS)

    Longitudinal exchange experiments facilitate the quantification of the rates of interconversion between the exchanging species, along with their longitudinal relaxation rates, by analyzing the time-dependence of direct correlation and exchange cross peaks. Here we present a simple and robust alternative to this strategy, which is based on the combination of two complementary experiments, one with and one without resolving exchange cross peaks. We show that by combining the two data sets systematic errors that are caused by differential line-broadening of the exchanging species are avoided and reliable quantification of kinetic and relaxation parameters in the presence of additional conformational exchange on the ms–μs time scale is possible. The strategy is applied to a bistable DNA oligomer that displays different line-broadening in the two exchanging species.

  10. Economical analysis of an alternative strategy for CO2 mitigation based on nuclear power

    International Nuclear Information System (INIS)

    Many countries are pursuing greenhouse gas (GHG) mitigation policies resulting in the increase of use of renewable sources in the electricity sector to mitigate CO2 emissions. Nuclear energy is a non-emitting CO2 source that could be used as part of that policy. However, its main drawback is the high investment required for its deployment. On the other hand, wind power is the clean source preferred option to mitigate CO2 emissions. However, due to its intermittence backup power is needed, in most of the cases it must be provided with combined cycle thermal plants using natural gas. This study performs an economical comparison of a hypothetical implementation of a nuclear strategy to meet the same CO2 emissions reduction goal that has been obtained by the actual Spaniard strategy (2005–2010) based on wind power. The investment required in both strategies is assessed under different investment scenarios and electricity production conditions for nuclear power. Also, the cost of electricity generation is compared for both strategies. - Highlights: ► Wind power electricity cost including its backup in Spain is assessed. ► Nuclear power is proposed as an alternative to produce the same CO2 reduction. ► Nuclear power requires less installed capacity deployment. ► Investment to produce the same CO2 reduction is smaller using nuclear power. ► Electricity generating cost is less expensive using the nuclear option

  11. Treatment guided by rapid diagnostic tests for malaria in Tanzanian children: safety and alternative bacterial diagnoses

    Directory of Open Access Journals (Sweden)

    Sykes Alma

    2011-10-01

    Full Text Available Abstract Background WHO guidelines for the treatment of young children with suspected malaria have recently changed from presumptive treatment to anti-malarial treatment guided by a blood slide or malaria rapid diagnostic test (RDT. However, there is limited evidence of the safety of this policy in routine outpatient settings in Africa. Methods Children 3-59 months of age with a non-severe febrile illness and no obvious cause were enrolled over a period of one year in a malaria endemic area of Tanzania. Treatment was determined by the results of a clinical examination and RDT result, and blood culture and serum lactate were also collected. RDT-negative children were followed up over 14 days. Results Over the course of one year, 965 children were enrolled; 158 (16.4% were RDT-positive and treated with artemether-lumefantrine and 807 (83.4% were RDT-negative and treated with non-anti-malarial medicines. Compared with RDT-positives, RDT-negative children were on average younger with a lower axillary temperature and more likely to have a history of cough or difficulty in breathing. Six (0.6% children became RDT-positive after enrolment, all of whom were PCR-negative for Plasmodium falciparum DNA at enrolment. In addition, 12 (1.2% children were admitted to hospital, one with possible malaria, none of whom died. A bacterial pathogen was identified in 9/965 (0.9% children, eight of whom were RDT-negative and one was RDT-positive, but slide-negative. Excluding three children with Salmonella typhi, all of the children with bacteraemia were ≤12 months of age. Compared to double-read research slide results RDTs had a sensitivity of 97.8% (95%CI 96.9-98.7 and specificity of 96.3% (95%CI 96.3-98.4. Conclusions Use of RDTs to direct the use of anti-malarial drugs in young children did not result in any missed diagnoses of malaria although new infections soon after a consultation with a negative RDT result may undermine confidence in results. Invasive

  12. Segmental enhancement on breast MR images: differential diagnosis and diagnostic strategy

    Energy Technology Data Exchange (ETDEWEB)

    Yuen, Sachiko [Shizuoka Cancer Center Hospital, Division of Diagnostic Radiology, Shizuoka (Japan); Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan); Uematsu, Takayoshi [Shizuoka Cancer Center Hospital, Division of Diagnostic Radiology, Shizuoka (Japan); Masako, Kasami [Shizuoka Cancer Center Hospital, Division of Pathology, Shizuoka (Japan); Uchida, Yoshihiro [Shizuoka Cancer Center Hospital, Division of Breast Surgery, Shizuoka (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2008-10-15

    The histopathological variations of segmental enhancement on breast magnetic resonance imaging (MRI) were investigated, with the aim of identifying imaging characteristic clues to their differential diagnosis. We reviewed 70 breast MRI examinations demonstrating segmental enhancement, classified them based on their histopathology, and assessed their MRI findings as follows: (1) confluent or not confluent, (2) late enhancement pattern, and the absence or presence of (3) clustered ring enhancements and (4) surrounding high signal intensity (SI) on T2-weighted imaging. Thirteen lesions (18.5%) were benign, eight (11.5%) were high risk, 25 (36%) were ductal carcinoma in situ (DCIS) and 24 (34%) were infiltrating mammary carcinomas (IMC). Clustered ring enhancements were demonstrated in 74% of malignancies (high risk, DCIS and IMC) but no benign lesions (P = 0.0001). The surrounding high SI on T2-weighted imaging was seen in four of five IMC with marked lymphatic involvement. Clustered ring enhancement was not demonstrated in six of seven IMC of tubular and/or lobular types. Segmental enhancement was seen in not only DCIS but also IMC, high-risk and benign lesions. Clustered ring enhancement and surrounding high SI on T2-weighted imaging were clues to their differential diagnosis and helpful to decide their diagnostic strategy. (orig.)

  13. Diagnostic performance of contrast-enhanced MR for acute appendicitis and alternative causes of abdominal pain in children

    International Nuclear Information System (INIS)

    Unenhanced MRI has emerged as a useful tool for diagnosing pediatric acute appendicitis. The use of contrast-enhanced MRI for diagnosing pediatric appendicitis has not been documented. The purpose of this study is to examine the diagnostic performance of contrast-enhanced MRI for acute appendicitis and alternative entities in the pediatric population presenting with acute abdominal pain. A retrospective review was conducted of 364 consecutive pediatric patients undergoing contrast-enhanced MRI for the evaluation of possible appendicitis at a single institution between November 2012 and September 2013. There were 132 cases of pathologically confirmed appendicitis out of 364 pediatric patients (36.3%) included in the study. Overall sensitivity and specificity were 96.2% (95% CI [91.4-98.4%]) and 95.7% (95% CI [92.3-97.6%]), respectively. Positive predictive value and negative predictive value were 92.7% (95% CI [86.6-96.3%]) and 97.8% (95% CI [94.7-99.1%]), respectively. The appendix was visualized in 243 cases (66.8%). Imaging confirmed alternative diagnoses in 75 patients, including most commonly colitis, enteritis or terminal ileitis (n = 25, 6.9%), adnexal cysts (n = 25, 6.9%) and mesenteric adenitis (n = 7, 1.9%). Contrast-enhanced MRI is capable of accurately diagnosing acute appendicitis while detecting many alternative entities of abdominal pain, and it allows good visualization of the appendix. Further evaluation is needed to determine whether contrast-enhanced MRI provides an advantage over non-enhanced MRI for imaging evaluation of acute abdominal pain in the pediatric population. (orig.)

  14. Diagnostic performance of contrast-enhanced MR for acute appendicitis and alternative causes of abdominal pain in children

    Energy Technology Data Exchange (ETDEWEB)

    Koning, Jeffrey L. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Naheedy, John H.; Kruk, Peter G. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Rady Children' s Hospital, Department of Radiology, San Diego, CA (United States)

    2014-08-15

    Unenhanced MRI has emerged as a useful tool for diagnosing pediatric acute appendicitis. The use of contrast-enhanced MRI for diagnosing pediatric appendicitis has not been documented. The purpose of this study is to examine the diagnostic performance of contrast-enhanced MRI for acute appendicitis and alternative entities in the pediatric population presenting with acute abdominal pain. A retrospective review was conducted of 364 consecutive pediatric patients undergoing contrast-enhanced MRI for the evaluation of possible appendicitis at a single institution between November 2012 and September 2013. There were 132 cases of pathologically confirmed appendicitis out of 364 pediatric patients (36.3%) included in the study. Overall sensitivity and specificity were 96.2% (95% CI [91.4-98.4%]) and 95.7% (95% CI [92.3-97.6%]), respectively. Positive predictive value and negative predictive value were 92.7% (95% CI [86.6-96.3%]) and 97.8% (95% CI [94.7-99.1%]), respectively. The appendix was visualized in 243 cases (66.8%). Imaging confirmed alternative diagnoses in 75 patients, including most commonly colitis, enteritis or terminal ileitis (n = 25, 6.9%), adnexal cysts (n = 25, 6.9%) and mesenteric adenitis (n = 7, 1.9%). Contrast-enhanced MRI is capable of accurately diagnosing acute appendicitis while detecting many alternative entities of abdominal pain, and it allows good visualization of the appendix. Further evaluation is needed to determine whether contrast-enhanced MRI provides an advantage over non-enhanced MRI for imaging evaluation of acute abdominal pain in the pediatric population. (orig.)

  15. Workgroup Report: Incorporating In Vitro Alternative Methods for Developmental Neurotoxicity into International Hazard and Risk Assessment Strategies

    OpenAIRE

    Coecke S.; Goldberg A.M.; Allen S; Buzanska L.; Calamandrei G.; Crofton K.; Hareng L.; Hartung T.; Knaut H.; Honegger P.; Jacobs M.; Lein P.; Li A.; Mundy W.; Owen D.

    2007-01-01

    This is the report of the first workshop on Incorporating In Vitro Alternative Methods for Developmental Neurotoxicity (DNT) Testing into International Hazard and Risk Assessment Strategies, held in Ispra, Italy, on 19-21 April 2005. The workshop was hosted by the European Centre for the Validation of Alternative Methods (ECVAM) and jointly organized by ECVAM, the European Chemical Industry Council, and the Johns Hopkins University Center for Alternatives to Animal Testing. The primary aim of...

  16. Perspectives and strategies of alternative methods used in the risk assessment of personal care products.

    Science.gov (United States)

    Quantin, P; Thélu, A; Catoire, S; Ficheux, H

    2015-11-01

    Risk assessment for personal care products requires the use of alternative methods since animal testing is now totally banned. Some of these methods are effective and have been validated by the "European Union Reference Laboratory for alternatives to animal testing"; but there is still a need for development and implementation of methods for specific endpoints. In this review, we have focused on dermal risk assessment because it is the prime route of absorption and main target organ for personal care products. Within this field, various areas must be assessed: irritation, sensitisation and toxicokinetic. Personal care product behaviour after use by the consumer and potential effects on the environment are also discussed. The purpose of this review is to show evolution and the prospects of alternative methods for safety dermal assessment. Assessment strategies must be adapted to the different chemical classes of substances studied but also to the way in which they are used. Finally, experimental and theoretical technical parameters that may impact on measured effects have been identified and discussed. PMID:26184446

  17. Implications for local and global climate of alternative forest management strategies in Norway

    Science.gov (United States)

    Bright, Ryan M.; Antón-Fernández, Clara; Astrup, Rasmus; Cherubini, Francesco; Kvalevåg, Maria; Hammer Strømman, Anders

    2014-05-01

    We applied a mix of observation and empirical models to evaluate both local and global climate effects of three realistic alternative forest management scenarios in the boreal forests of Norway's largest logging region. The alternative management scenarios embraced strategies aimed at increasing harvest intensities and allowing harvested conifer sites to regenerate naturally with broadleaved species. Stand-level analysis was firstly executed to attribute differences in daily, seasonal, and annual mean surface temperatures to differences in surface intrinsic biophysical properties across coniferous, deciduous, and clear-cut sites. Relative to a coniferous site, we observed a slight local cooling of 0.13 °C at a deciduous site and 0.25 °C at a clear-cut site over a 6-year period which was mostly attributed to a higher albedo throughout the year. When monthly mean albedo trajectories over the entire managed forest landscape were taken into consideration, we found that strategies promoting natural regeneration of coniferous sites with native deciduous species led to substantial global direct climate cooling benefits relative to those maintaining current silviculture regimes - despite predicted long-term regional warming feedbacks and a reduced albedo in spring and autumn months. The magnitude and duration of the cooling benefit depended largely on whether management strategies simultaneously promoted an enhanced material supply over business-as-usual levels. While additional climate impact linked to changes in life-cycle emissions and to changes in the global supply and demand of timber products ought to be factored into any mitigation-oriented climate policy involving the forestry sector, our analysis demonstrates that - within the boundaries of the managed forest ecosystem - excluding important biogeophysical considerations like surface albedo change may lead to sub-optimal climate policy.

  18. Resource acquisition policy: Multiple account evaluation of electricity resource alternatives [and] resource acquisition strategy

    International Nuclear Information System (INIS)

    British Columbia Hydro has been directed by the provincial government to develop evaluation procedures to rank electricity resource alternatives in terms of their social benefits and costs, and to acquire resources on the basis of need. The current state of development of social costing at BC Hydro is detailed along with its application to the multiple account evaluation of resources. In this evaluation, BC Hydro's corporate costs, customer cost, transfer payments to the province, direct costs incurred by provincial or regional governments or other Crown agences, direct environmental impact costs from air emissions and land/water use, community and social impact costs, and economic development impacts are taken into account. The BC Hydro resource acquisition strategy is also described as it was developed in response to provincial policy on electricity supply from independent power producers. This strategy includes a determination of need, a decision to acquire need-determined resources either by itself or from a private sector developer, and decisions to acquire resources in advance of need for reasons such as economic opportunity, long-term strategies, or load displacement. Background information is included on calculation of air emissions costs. An illustrative example is provided of the multiple account evaluation of several types of resource projects. 1 fig., 5 tabs

  19. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  20. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  1. Copy number variation in Williams-Beuren syndrome: suitable diagnostic strategy for developing countries

    Directory of Open Access Journals (Sweden)

    Dutra Roberta L

    2012-01-01

    Full Text Available Abstract Background Williams-Beuren syndrome (WBS; OMIM 194050 is caused by a hemizygous contiguous gene microdeletion at 7q11.23. Supravalvular aortic stenosis (SVAS, mental retardation, and overfriendliness comprise typical symptoms of WBS. Although fluorescence in situ hybridization (FISH is considered the gold standard technique, the microsatellite DNA markers and multiplex ligation-dependent probe amplification (MLPA could be used for to confirm the diagnosis of WBS. Results We have evaluated a total cohort of 88 patients with a suspicion clinical diagnosis of WBS using a collection of five markers (D7S1870, D7S489, D7S613, D7S2476, and D7S489_A and a commercial MLPA kit (P029. The microdeletion was present in 64 (72.7% patients and absent in 24 (27.3% patients. The parental origin of deletion was maternal in 36 of 64 patients (56.3% paternal in 28 of 64 patients (43.7%. The deletion size was 1.55 Mb in 57 of 64 patients (89.1% and 1.84 Mb in 7 of 64 patients (10.9%. The results were concordant using both techniques, except for four patients whose microsatellite markers were uninformative. There were no clinical differences in relation to either the size or parental origin of the deletion. Conclusion MLPA was considered a faster and more economical method in a single assay, whereas the microsatellite markers could determine both the size and parental origin of the deletion in WBS. The microsatellite marker and MLPA techniques are effective in deletion detection in WBS, and both methods provide a useful diagnostic strategy mainly for developing countries.

  2. Gamma knife surgery for pineal region tumors: an alternative strategy for negative pathology

    Directory of Open Access Journals (Sweden)

    Peng Wang

    2014-02-01

    Full Text Available Objective : Pineal region tumors (PRTs are uncommon, and treatments vary among neoplasm types. The authors report their experience with gamma knife surgery (GKS as an initial treatment in a series of PRT patients with unclear pathological diagnoses. Method : Seventeen PRT patients with negative pathology who underwent GKS were retrospectively studied. Nine patients had further whole-brain and spinal cord radiotherapy and chemotherapy 6–9 months after GKS. Results : Sixteen of 17 cases were followed up over a mean of 33.3 months. The total response rate was 75%, and the control rate was 81.3%. No obvious neurological deficits or complications were attributable to GKS. Conclusion : The findings indicate that GKS may be an alternative strategy in selected PRT patients who have negative pathological diagnoses, and that good outcomes and quality of life can be obtained with few complications.

  3. Gamma knife surgery for pineal region tumors: an alternative strategy for negative pathology

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Peng [Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu (China); Department of Neurosurgery, The Fifth People' s Hospital of Chengdu, Chengdu (China); Mao, Qing; Wang, Wei; Zhou, Liang-Xue; Liu, Yan-Hui, E-mail: liuyanhui9@gmail.com [Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu (China)

    2014-03-01

    Objective: pineal region tumors (PRTs) are uncommon, and treatments vary among neoplasm types. The authors report their experience with gamma knife surgery (GKS) as an initial treatment in a series of PRT patients with unclear pathological diagnoses. Method: seventeen PRT patients with negative pathology who underwent GKS were retrospectively studied. Nine patients had further whole-brain and spinal cord radiotherapy and chemotherapy 6-9 months after GKS. Results: Sixteen of 17 cases were followed up over a mean of 33.3 months. The total response rate was 75%, and the control rate was 81.3%. No obvious neurological deficits or complications were attributable to GKS. Conclusion: the findings indicate that GKS may be an alternative strategy in selected PRT patients who have negative pathological diagnoses, and that good outcomes and quality of life can be obtained with few complications. (author)

  4. Gamma knife surgery for pineal region tumors: an alternative strategy for negative pathology

    International Nuclear Information System (INIS)

    Objective: pineal region tumors (PRTs) are uncommon, and treatments vary among neoplasm types. The authors report their experience with gamma knife surgery (GKS) as an initial treatment in a series of PRT patients with unclear pathological diagnoses. Method: seventeen PRT patients with negative pathology who underwent GKS were retrospectively studied. Nine patients had further whole-brain and spinal cord radiotherapy and chemotherapy 6-9 months after GKS. Results: Sixteen of 17 cases were followed up over a mean of 33.3 months. The total response rate was 75%, and the control rate was 81.3%. No obvious neurological deficits or complications were attributable to GKS. Conclusion: the findings indicate that GKS may be an alternative strategy in selected PRT patients who have negative pathological diagnoses, and that good outcomes and quality of life can be obtained with few complications. (author)

  5. The alternative strategies of the development of the nuclear power industry in the 21st century

    Science.gov (United States)

    Goverdovskii, A. A.; Kalyakin, S. G.; Rachkov, V. I.

    2014-05-01

    This paper emphasizes the urgency of scientific-and-technical and sociopolitical problems of the modern nuclear power industry without solving of which the transition from local nuclear power systems now in operation to a large-scale nuclear power industry would be impossible. The existing concepts of the longterm strategy of the development of the nuclear power industry have been analyzed. On the basis of the scenarios having been developed it was shown that the most promising alternative is the orientation towards the closed nuclear fuel cycle with fast neutron reactors (hereinafter referred to as fast reactors) that would meet the requirements on the acceptable safety. It was concluded that the main provisions of "The Strategy of the Development of the Nuclear Power Industry of Russia for the First Half of the 21st Century" approved by the Government of the Russian Federation in the year 2000 remain the same at present as well, although they require to be elaborated with due regard for new realities in the market for fossil fuels, the state of both the Russian and the world economy, as well as tightening of requirements related to safe operation of nuclear power stations (NPSs) (for example, after the severe accident at the Fukushima nuclear power station, Japan) and nonproliferation of nuclear weapons.

  6. Targeted alternative splicing of TAF4: a new strategy for cell reprogramming.

    Science.gov (United States)

    Kazantseva, Jekaterina; Sadam, Helle; Neuman, Toomas; Palm, Kaia

    2016-01-01

    Reprogramming of somatic cells has become a versatile tool for biomedical research and for regenerative medicine. In the current study, we show that manipulating alternative splicing (AS) is a highly potent strategy to produce cells for therapeutic applications. We demonstrate that silencing of hTAF4-TAFH activity of TAF4 converts human facial dermal fibroblasts to melanocyte-like (iMel) cells. iMel cells produce melanin and express microphthalmia-associated transcription factor (MITF) and its target genes at levels comparable to normal melanocytes. Reprogramming of melanoma cells by manipulation with hTAF4-TAFH activity upon TAFH RNAi enforces cell differentiation towards chondrogenic pathway, whereas ectoptic expression of TAF4 results in enhanced multipotency and neural crest-like features in melanoma cells. In both cell states, iMels and cancer cells, hTAF4-TAFH activity controls migration by supporting E- to N-cadherin switches. From our data, we conclude that targeted splicing of hTAF4-TAFH coordinates AS of other TFIID subunits, underscoring the role of TAF4 in synchronised changes of Pol II complex composition essential for efficient cellular reprogramming. Taken together, targeted AS of TAF4 provides a unique strategy for generation of iMels and recapitulating stages of melanoma progression. PMID:27499390

  7. Field Evaluation of Alternative Testing Strategies for the Detection of HIV Infection in Beijing

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To identify a cost-efficient alternative antibody testing strategy for screening and confirmation of HIV infection by rapid simple tests (RSTs) and enzyme-linked immunosorbent assays (ELISAs). Methods Four RSTs (RST1,RST2, RST3, and RST4 ) and five ELISAs (ELISA1, ELISA2, ELISA3, ELISA4, and ELISA5) were evaluated in two phases by using banked and serum specimens prospectively collected at regional hospitals and voluntary counseling and testing (VCT)centers in Beijing. A total of 200 banked serum specimens were included in the first phase, including 62 HIV-positive, 127 HIV-negative and 11 indeterminate specimens. All specimens were tested by four RSTs and five ELISAs respectively. The second phase involved prospective testing of 389 routine specimens, including 92 HIV-positive, 287 HIV-negative, and 10 indeterminate specimens. All the specimens were tested by two RSTs (RST2 and RST4) and three ELISAs (ELISA1, ELISA3,and ELISA4), which were selected for their respective excellent sensitivity and/or specificity. Western blot (WB) was used as a gold standard for confirming the reactivity of all the specimens. Results Sensitivity, specificity, and efficacy were calculated for each assay in two phases. In the first phase, four assays (ELISA4, RST2, RST3, and RST4) had a specificity of 100%. For the determination of efficacy, ELISA4, RST2, and RST4 were selected in the second phase. ELISA1 and ELISA3 which have a sensitivity of 95.9% and 93.2% respectively also entered this phase. In the second phase, all the five assays (ELISA1, ELISA3, ELISA4, RST2, and RST4) had a sensitivity and specifity of over 90%. ELISA1 had a sensitivity of 99% and ELISA4 a specificity of 99%. Conclusion The sensitivity ELISA1 and the specificit of ELISA4 are comparable to ELISA/WB standard strategy. Application of this alternative testing strategy provides a cost-effective method for determining HIV prevalence in Beijing.

  8. Database Objects vs Files: Evaluation of alternative strategies for managing large remote sensing data

    Science.gov (United States)

    Baru, Chaitan; Nandigam, Viswanath; Krishnan, Sriram

    2010-05-01

    Increasingly, the geoscience user community expects modern IT capabilities to be available in service of their research and education activities, including the ability to easily access and process large remote sensing datasets via online portals such as GEON (www.geongrid.org) and OpenTopography (opentopography.org). However, serving such datasets via online data portals presents a number of challenges. In this talk, we will evaluate the pros and cons of alternative storage strategies for management and processing of such datasets using binary large object implementations (BLOBs) in database systems versus implementation in Hadoop files using the Hadoop Distributed File System (HDFS). The storage and I/O requirements for providing online access to large datasets dictate the need for declustering data across multiple disks, for capacity as well as bandwidth and response time performance. This requires partitioning larger files into a set of smaller files, and is accompanied by the concomitant requirement for managing large numbers of file. Storing these sub-files as blobs in a shared-nothing database implemented across a cluster provides the advantage that all the distributed storage management is done by the DBMS. Furthermore, subsetting and processing routines can be implemented as user-defined functions (UDFs) on these blobs and would run in parallel across the set of nodes in the cluster. On the other hand, there are both storage overheads and constraints, and software licensing dependencies created by such an implementation. Another approach is to store the files in an external filesystem with pointers to them from within database tables. The filesystem may be a regular UNIX filesystem, a parallel filesystem, or HDFS. In the HDFS case, HDFS would provide the file management capability, while the subsetting and processing routines would be implemented as Hadoop programs using the MapReduce model. Hadoop and its related software libraries are freely available

  9. Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning

    OpenAIRE

    Gabriel A; Violato C

    2013-01-01

    Adel Gabriel,1,2 Claudio Violato21Departments of Psychiatry, University of Calgary, Calgary; 2Medical Education, Community Health Sciences, University of Calgary Calgary, CanadaBackground: The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry.Methods: Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempt...

  10. A diagnostic of the strategy employed for communicating nuclear related information to Brazilian communities around uranium mining areas

    International Nuclear Information System (INIS)

    This paper presents a diagnostic of the strategy used by the Brazilian uranium mining industry to communicate nuclear related information to communities around a mining area. The uranium mining industry in Brazil, which is run by the government, has been concerned with communication issues for quite some time. The need to communicate became more apparent after new mining operations started in the Northern region of Brazil. The fact that the government does not have a clear communication guideline made the operators of the uranium mining industry aware of the increasing demand for establishment of a good relationship with several types of Stake holders as well as employment of personnel with experience in dealing with them. A diagnostic of the current communication situation in Brazil and an analysis of the approaches over the past years was done through interviews with employees of the mining industry and review of institutional communication materials. The results were discussed during a Consultant's Meeting organized by the IAEA 's Seibersdorf Laboratory in October 2007. The output of the meeting included an overview of modern communication strategies used by different countries and a suggestion for new uranium mining operations in developing or under developed countries. The strategy for communicating nuclear related information to Brazilian communities varied according to the influence of different Stake holder groups. One initiative worth mentioning was the creation of a Mobile Nuclear Information Thematic Room, which was installed in several locations. This project was seen as one of the main tools to relate to community. Many Stake holders were identified during the diagnostic phase in preparation for the IAEA 's meeting on communication strategy: children, NGOs (Non Government Organizations), local churches, media and internal Stake holders, among others. An initial evaluation showed that the perception of a neighbouring community regarding an uranium

  11. A diagnostic of the strategy employed for communicating nuclear related information to Brazilian communities around uranium mining areas

    International Nuclear Information System (INIS)

    This paper presents a diagnostic of the strategy used by the Brazilian uranium mining industry to communicate nuclear related information to communities around a mining area. The uranium mining industry in Brazil, which is run by the government, has been concerned with communication issues for quite some time. The need to communicate became more apparent after new mining operations started in the Northern region of Brazil. The fact that the government does not have a clear communication guideline made the operators of the uranium mining industry aware of the increasing demand for establishment of a good relationship with several types of Stakeholders as well as employment of personnel with experience in dealing with them. A diagnostic of the current communication situation in Brazil and an analysis of the approaches over the past years was done through interviews with employees of the mining industry and review of institutional communication materials. The results were discussed during a Consultant's Meeting organized by the IAEA's Seibersdorf Laboratory in October 2007. The output of the meeting included an overview of modern communication strategies used by different countries and a suggestion for new uranium mining operations in developing or under developed countries. The strategy for communicating nuclear related information to Brazilian communities varied according to the influence of different Stakeholder groups. One initiative worth mentioning was the creation of a 'Mobile Nuclear Information Thematic Room', which was installed in several locations. This project was seen as one of the main tools to relate to community. Many Stakeholders were identified during the diagnostic phase in preparation for the IAEA's meeting on communication strategy: children, NGOs (Non Government Organizations), local churches, media, and internal Stakeholders, among others. An initial evaluation showed that the perception of a neighbouring community regarding an uranium mining

  12. Modeling the Impact of Alternative Immunization Strategies: Using Matrices as Memory Lanes.

    Directory of Open Access Journals (Sweden)

    Wladimir J Alonso

    Full Text Available Existing modeling approaches are divided between a focus on the constitutive (micro elements of systems or on higher (macro organization levels. Micro-level models enable consideration of individual histories and interactions, but can be unstable and subject to cumulative errors. Macro-level models focus on average population properties, but may hide relevant heterogeneity at the micro-scale. We present a framework that integrates both approaches through the use of temporally structured matrices that can take large numbers of variables into account. Matrices are composed of several bidimensional (time×age grids, each representing a state (e.g. physiological, immunological, socio-demographic. Time and age are primary indices linking grids. These matrices preserve the entire history of all population strata and enable the use of historical events, parameters and states dynamically in the modeling process. This framework is applicable across fields, but particularly suitable to simulate the impact of alternative immunization policies. We demonstrate the framework by examining alternative strategies to accelerate measles elimination in 15 developing countries. The model recaptured long-endorsed policies in measles control, showing that where a single routine measles-containing vaccine is employed with low coverage, any improvement in coverage is more effective than a second dose. It also identified an opportunity to save thousands of lives in India at attractively low costs through the implementation of supplementary immunization campaigns. The flexibility of the approach presented enables estimating the effectiveness of different immunization policies in highly complex contexts involving multiple and historical influences from different hierarchical levels.

  13. Magnetopriming - an alternate strategy for crop stress management of field crops

    International Nuclear Information System (INIS)

    Abiotic stresses are major deterrent to sustainable crop production worldwide. Seed germination and early seedling growth are considered as the most critical stages of plant growth under stress conditions. Maximising stress tolerance of crop species by breeding is an integral part of development of strategies for improving sustainable food production under stressed environment but the unprecedented rate at which stress is increasing vis-a-vis the time taken for development of a tolerant variety, necessitates exploring alternate strategies of crop stress management. Seed priming has emerged as a promising crop stress management technique that increases the speed of germination thus ensuring synchronized field emergence of the crop. Magnetopriming (exposure of seeds to magnetic field) is a non invasive physical stimulant used for improving seedling vigour that helps in establishment of crop stand under stress. In our experiments on maize; chickpea and wheat under water deficit and salinity, respectively, improved seed water absorption characteristics resulted in faster hydration of enzymes (amylases, protease and dehydrogenase) leading to early germination and enhanced vigour of seedlings under stress. Increased levels of hydrogen peroxide in faster germinating - magnetoprimed seeds, under both the growing conditions, suggested its role in oxidative signaling during seed germination process. An 'oxidative window' for reactive oxygen species ensured that faster germination rate in magnetoprimed seeds led to vigourous seedlings. Improved root system integrated with higher photosynthetic efficiency and efficient partitioning of Na+ increased yield from magnetoprimed seeds under salinity in controlled experiments. Magnetopriming can be effectively used as a pre-sowing treatment for mitigating adverse effects of water deficit and salinity at seed germination and early seedling growth. Unlike other conventional priming techniques it avoids seed hydration and

  14. The strategy for diagnostic ability improvement of PAD by 3DCT and clinical outcome

    International Nuclear Information System (INIS)

    In order to improve the diagnostic ability of three-dimensional computed tomography (3DCT) of the lower extremities to assess peripheral arterial disease (PAD), we performed a computed tomography (CT) for PAD diagnosis. We utilized a protocol to change imaging conditions for individual patients, based on blood flow rates. This was determined by the test injection method developed in the department of radiological technology. After implementation of the protocol, operations were performed for PAD in 43 patients, and percutaneous transluminal angioplasty (PTA) in 65 patients. CT served as a final diagnostic imaging tool in all the patients. (author)

  15. Evidence for alternative trapping strategies in two forms of the pitcher plant, Nepenthes rafflesiana.

    Science.gov (United States)

    Bauer, Ulrike; Grafe, T Ulmar; Federle, Walter

    2011-06-01

    Nepenthes pitchers are specialized leaves that function as insect traps. Several pitcher components may contribute to trapping, including the pitcher fluid, slippery wax crystals and downward-pointing epidermal cells on the inner pitcher wall, and the wetness-dependent pitcher rim (peristome), but the relative importance of these traits is unclear. Mechanisms of prey capture and retention in the field were investigated by quantifying the effect of 'knock-out' manipulations of individual pitcher structures, and by testing the ability of pitcher fluids and water to retain insects. Two forms of Nepenthes rafflesiana Jack ('elongate' and 'typical') with contrasting combinations of pitcher traits were compared. Wax crystals on the inner pitcher wall were found to be the most important trapping structure in the elongate form, whereas the typical form relied primarily on the peristome. The pitcher fluids of both forms, differing markedly in the degree of viscoelasticity, retained significantly more ants than water. The present results show that pitcher plants utilize several mechanisms for prey capture and retention, varying in efficiency and relative importance between forms. It is proposed that these differences represent alternative prey capture strategies that may provide a mechanism to reduce competition and facilitate species co-existence in nutrient-limited habitats. PMID:21459766

  16. Unraveling the evolution of the Atlantic cod's (Gadus morhua L. alternative immune strategy.

    Directory of Open Access Journals (Sweden)

    Martin Malmstrøm

    Full Text Available Genes encoding the major histocompatibility complex (MHC have been thought to play a vital role in the adaptive immune system in all vertebrates. The discovery that Atlantic cod (Gadus morhua has lost important components of the MHC II pathway, accompanied by an unusually high number of MHC I genes, shed new light on the evolution and plasticity of the immune system of teleosts as well as in higher vertebrates. The overall aim of this study was to further investigate the highly expanded repertoire of MHC I genes using a cDNA approach to obtain sequence information of both the binding domains and the sorting signaling potential in the cytoplasmic tail. Here we report a novel combination of two endosomal sorting motifs, one tyrosine-based associated with exogenous peptide presentation by cross-presenting MHCI molecules, and one dileucine-based associated with normal MHC II functionality. The two signal motifs were identified in the cytoplasmic tail in a subset of the genes. This indicates that these genes have evolved MHC II-like functionality, allowing a more versatile use of MHC I through cross-presentation. Such an alternative immune strategy may have arisen through adaptive radiation and acquisition of new gene function as a response to changes in the habitat of its ancestral lineage.

  17. Alternative strategies: A means for saving money and time on the Yucca Mountain Project

    International Nuclear Information System (INIS)

    The United States Department of Energy (DOE) is undertaking studies to determine the suitability of Yucca Mountain (YM) as a potential site for disposal of high level nuclear waste. Yucca Mountain is located in an arid environment. Many processes that could contribute to mobilization of radionuclides are either absent or minimized in a dry site. Therefore, Yucca Mountain should have the potential of being a veryfavorable site for disposal of waste. The determination of suitability has no precedence, and the characterization of an and site is complex, requiring intensive studies to determine suitability. The studies undertaken by the Yucca Mountain Site Characterization Project (YMP) are very costly. By a process called performance allocation, the YMP determined strategies to satisfy regulations or meet performance while minimizing costs and schedules. Those involved recognized that allocations should be reviewed as additional information became available. The allocation has not been reviewed nor revised since the initial allocation in the Site Characterization Plan (SCP). The purpose of this paper is to outline alternative allocations that the author feels should be considered based on the additional information that is available at this time

  18. Myocardial Bridging: Contemporary Understanding of Pathophysiology with Implications for Diagnostic and Therapeutic Strategies

    OpenAIRE

    Corban, Michel T.; Hung, Olivia Y; Eshtehardi, Parham; Rasoul-Arzrumly, Emad; McDaniel, Michael; Mekonnen, Girum; Timmins, Lucas H.; Lutz, Jerre; Guyton, Robert A; Samady, Habib

    2014-01-01

    Patients with myocardial bridges are often asymptomatic but this anomaly may be associated with exertional angina, acute coronary syndromes, cardiac arrhythmias, syncope or even sudden cardiac death. This review presents our understanding of the pathophysiology of myocardial bridging and describes prevailing diagnostic modalities and therapeutic options for this challenging clinical entity.

  19. Educational Strategies to Reduce Diagnostic Error: Can You Teach This Stuff?

    Science.gov (United States)

    Graber, Mark L.

    2009-01-01

    Diagnostic error typically involves both system-related and cognitive root causes. Educational interventions are proposed to address both of these dimensions: In regard to system-related origins, education should focus on communication skills, including handoffs. In regard to cognitive shortcomings, educators need to consider both normative…

  20. Use of time and materials and cost reimbursement subcontracts for remedial actions under the alternative remedial contracting strategy contracts. Directive

    International Nuclear Information System (INIS)

    The directive is intended to establish agency guidance on the use of time and materials and cost reimbursement contracts for remedial actions in general and to provide specific instruction regarding the use of these approaches in subcontracting under the Alternative Remedial Contracting Strategy (ARCS) contracts

  1. Ecology of Fungus Gnats (Bradysia spp. in Greenhouse Production Systems Associated with Disease-Interactions and Alternative Management Strategies

    Directory of Open Access Journals (Sweden)

    Raymond A. Cloyd

    2015-04-01

    Full Text Available Fungus gnats (Bradysia spp. are major insect pests of greenhouse-grown horticultural crops mainly due to the direct feeding damage caused by the larvae, and the ability of larvae to transmit certain soil-borne plant pathogens. Currently, insecticides and biological control agents are being used successively to deal with fungus gnat populations in greenhouse production systems. However, these strategies may only be effective as long as greenhouse producers also implement alternative management strategies such as cultural, physical, and sanitation. This includes elimination of algae, and plant and growing medium debris; placing physical barriers onto the growing medium surface; and using materials that repel fungus gnat adults. This article describes the disease-interactions associated with fungus gnats and foliar and soil-borne diseases, and the alternative management strategies that should be considered by greenhouse producers in order to alleviate problems with fungus gnats in greenhouse production systems.

  2. Diagnostic strategy and differential therapeutic approach for cystic lesions of the pancreas

    International Nuclear Information System (INIS)

    Cystic pancreatic lesions (CPL) are diagnosed with increasing frequency. Because up to 60 % of CPL are classified as malignant or premalignant, every CPL should be fully investigated and clarified. Serous CPL with low risk of malignancy must be differentiated from mucinous CPL with relevant potential malignancy (intraductal papillary mucinous neoplasm IPMN) and mucinous cystic neoplasm (MCN) as well as from harmless pseudocysts. Cross-sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) plays a crucial role in the diagnostics of CPL. An algorithm for the differential diagnostic classification of CPL is presented. The connection to the pancreatic duct is the key diagnostic criterion to differentiate IPMN from all other CPL. An exception to this rule is that pseudocysts can also show a connection to the pancreatic duct. A further classification of CPL with no connection to the pancreatic duct can be made by morphological criteria and correlation of the radiological findings with patient age, sex, history and symptoms. Depending on the diagnosis and hence the malignant potential the indications for surgery or watch and wait have to be discussed in an interdisciplinary cooperation. Due to its higher soft tissue contrast MRI is often superior to CT for depiction of CPL morphology. (orig.)

  3. The Importance of Alternative Diagnostic Modalities in the Diagnosis of Small Bowel Tumors After a Negative Capsule Endoscopy

    OpenAIRE

    Iolanda Ribeiro; Rolando Pinho; Adélia Rodrigues; Carlos Fernandes; Joana Silva; Ana Ponte; Davide Tente; João Carvalho

    2015-01-01

    Capsule endoscopy is widely accepted as the preferred diagnostic test in the evaluation of small bowel diseases, especially in the setting of obscure gastrointestinal bleeding. It has revolutionized small bowel examination and has improved the detection of small bowel tumors. However, small bowel tumors are sometimes missed by capsule endoscopy. Furthermore, there are several recent reports comparing capsule endoscopy with other diagnostic modalities, such as double balloon enteroscopy and CT...

  4. A cluster randomized controlled trial of the Promoting Alternative Thinking Strategies (PATHS) curriculum.

    Science.gov (United States)

    Humphrey, Neil; Barlow, Alexandra; Wigelsworth, Michael; Lendrum, Ann; Pert, Kirsty; Joyce, Craig; Stephens, Emma; Wo, Lawrence; Squires, Garry; Woods, Kevin; Calam, Rachel; Turner, Alex

    2016-10-01

    This randomized controlled trial (RCT) evaluated the efficacy of the Promoting Alternative Thinking Strategies curriculum (PATHS; Kusche & Greenberg, 1994) as a means to improve children's social-emotional competence (assessed via the Social Skills Improvement System (SSIS); Gresham & Elliot, 2008) and mental health outcomes (assessed via the Strengths and Difficulties Questionnaire (SDQ); Goodman, 1997). Forty-five schools in Greater Manchester, England, were randomly assigned to treatment and control groups. Allocation was balanced by proportions of children eligible for free school meals and speaking English as an additional language via minimization. Children (N=4516) aged 7-9years at baseline in the participating schools were the target cohort. During the two-year trial period, teachers of this cohort in schools allocated to the intervention group delivered the PATHS curriculum, while their counterparts in the control group continued their usual provision. Teachers in PATHS schools received initial training and on-going support and assistance from trained coaches. Hierarchical linear modeling of outcome data was undertaken to identify both primary (e.g., for all children) and secondary (e.g., for children classified as "at-risk") intervention effects. A primary effect of the PATHS curriculum was found, demonstrating increases in teacher ratings of changes in children's social-emotional competence. Additionally, secondary effects of PATHS were identified, showing reductions in teacher ratings of emotional symptoms and increases in pro-social behavior and child ratings of engagement among children identified as at-risk at baseline. However, our analyses also identified primary effects favoring the usual provision group, showing reductions in teacher ratings of peer problems and emotional symptoms, and secondary effects demonstrating reductions in teacher ratings of conduct problems and child ratings of co-operation among at-risk children. Effect sizes were small

  5. An alternative validation strategy for the Planck cluster catalogue and y-distortion maps

    Science.gov (United States)

    Khatri, Rishi

    2016-07-01

    We present an all-sky map of the y-type distortion calculated from the full mission Planck High Frequency Instrument (HFI) data using the recently proposed approach to component separation, which is based on parametric model fitting and model selection. This simple model-selection approach enables us to distinguish between carbon monoxide (CO) line emission and y-type distortion, something that is not possible using the internal linear combination based methods. We create a mask to cover the regions of significant CO emission relying on the information in the χ2 map that was obtained when fitting for the y-distortion and CO emission to the lowest four HFI channels. We revisit the second Planck cluster catalogue and try to quantify the quality of the cluster candidates in an approach that is similar in spirit to Aghanim et al. (2015, A&A, 580, A138). We find that at least 93% of the clusters in the cosmology sample are free of CO contamination. We also find that 59% of unconfirmed candidates may have significant contamination from molecular clouds. We agree with Planck Collaboration XXVII (2016, A&A, in press) on the worst offenders. We suggest an alternative validation strategy of measuring and subtracting the CO emission from the Planck cluster candidates using radio telescopes, thus improving the reliability of the catalogue. Our CO mask and annotations to the Planck cluster catalogue, identifying cluster candidates with possible CO contamination, are made publicly available. The full Tables 1-3 are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/592/A48

  6. A multi-stakeholder perspective on the use of alternative test strategies for nanomaterial safety assessment.

    Science.gov (United States)

    Nel, Andre E; Nasser, Elina; Godwin, Hilary; Avery, David; Bahadori, Tina; Bergeson, Lynn; Beryt, Elizabeth; Bonner, James C; Boverhof, Darrell; Carter, Janet; Castranova, Vince; Deshazo, J R; Hussain, Saber M; Kane, Agnes B; Klaessig, Frederick; Kuempel, Eileen; Lafranconi, Mark; Landsiedel, Robert; Malloy, Timothy; Miller, Mary Beth; Morris, Jeffery; Moss, Kenneth; Oberdorster, Gunter; Pinkerton, Kent; Pleus, Richard C; Shatkin, Jo Anne; Thomas, Russell; Tolaymat, Thabet; Wang, Amy; Wong, Jeffrey

    2013-08-27

    There has been a conceptual shift in toxicological studies from describing what happens to explaining how the adverse outcome occurs, thereby enabling a deeper and improved understanding of how biomolecular and mechanistic profiling can inform hazard identification and improve risk assessment. Compared to traditional toxicology methods, which have a heavy reliance on animals, new approaches to generate toxicological data are becoming available for the safety assessment of chemicals, including high-throughput and high-content screening (HTS, HCS). With the emergence of nanotechnology, the exponential increase in the total number of engineered nanomaterials (ENMs) in research, development, and commercialization requires a robust scientific approach to screen ENM safety in humans and the environment rapidly and efficiently. Spurred by the developments in chemical testing, a promising new toxicological paradigm for ENMs is to use alternative test strategies (ATS), which reduce reliance on animal testing through the use of in vitro and in silico methods such as HTS, HCS, and computational modeling. Furthermore, this allows for the comparative analysis of large numbers of ENMs simultaneously and for hazard assessment at various stages of the product development process and overall life cycle. Using carbon nanotubes as a case study, a workshop bringing together national and international leaders from government, industry, and academia was convened at the University of California, Los Angeles, to discuss the utility of ATS for decision-making analyses of ENMs. After lively discussions, a short list of generally shared viewpoints on this topic was generated, including a general view that ATS approaches for ENMs can significantly benefit chemical safety analysis. PMID:23924032

  7. Piramal Diagnostics

    OpenAIRE

    Neeraj Dwivedi; Arvinder Singh

    2011-01-01

    The case presents a decision situation facing the Vice President of strategic planning at Piramal Diagnostics Limited, who has to formulate the future growth strategy and decide on the roadmap. The company is the largest player in the organized medical diagnostics industry in India and has shown attractive growth in the past few years. The case describes the structural characteristics of the medical diagnostics industry in India and follows it with a description of the strengths and weaknesse...

  8. The role of positron emission tomography in the diagnostic strategy of lung cancers

    International Nuclear Information System (INIS)

    Position emission tomography provides metabolic images with approximately 90% sensitivity and specificity. This imaging technique should allow better selection of operable patients and a change in therapeutic strategies used to treat lung nodules and in the method used to evaluate the extension and the following of broncho-pulmonary cancers. (author)

  9. Current developments in therapeutic and diagnostic strategies for Q fever: glimpses of patent analysis.

    Science.gov (United States)

    Chauhan, Rashi; Wadhwa, Gulshan; Sharma, Sanjeev K; Jain, Chakresh K

    2014-01-01

    Coxiella burnetii is an infectious and etiological agent responsible for causing Q fever. There are mainly two forms of the Q fever that are chronic and acute. Though the acute type is usually linked with symptoms like pneumonia and hepatitis, the chronic form is shown to have mortality rate of 5%. Percentage of mortality rate might increases from 5% to 25% if left untreated. The present treatments of disease include the recommended dose of drugs and vaccine. Presently, extensive attempt is in progress to find novel therapies to combat the disease. This review is projected to provide a brief introduction of C. burnetii and Q fever while emphasizing therapeutics, prophylactic measures and diagnostic applications based on recent patents prospects. PMID:25409874

  10. A diagnostic strategy for pulmonary embolism based on standardised pretest probability and perfusion lung scanning: a management study

    Energy Technology Data Exchange (ETDEWEB)

    Miniati, Massimo; Monti, Simonetta; Bauleo, Carolina; Scoscia, Elvio; Tonelli, Lucia; Dainelli, Alba; Catapano, Giosue; Formichi, Bruno; Di Ricco, Giorgio; Prediletto, Renato; Carrozzi, Laura; Marini, Carlo [Istituto di Fisiologia, Clinica del Consiglio Nazionale delle Ricerche, Via G. Moruzzi 1, 56124, Pisa (Italy)

    2003-11-01

    Pulmonary embolism remains a challenging diagnostic problem. We developed a simple diagnostic strategy based on combination of assessment of the pretest probability with perfusion lung scan results to reduce the need for pulmonary angiography. We studied 390 consecutive patients (78% in-patients) with suspected pulmonary embolism. The pretest probability was rated low (<10%), intermediate (>10%, {<=}50%), moderately high (>50%, {<=}90%) or high (>90%) according to a structured clinical model. Perfusion lung scans were independently assigned to one of four categories: normal; near-normal; abnormal, suggestive of pulmonary embolism (wedge-shaped perfusion defects); abnormal, not suggestive of pulmonary embolism (perfusion defects other than wedge shaped). Pulmonary embolism was diagnosed in patients with abnormal scans suggestive of pulmonary embolism and moderately high or high pretest probability. Patients with normal or near-normal scans and those with abnormal scans not suggestive of pulmonary embolism and low pretest probability were deemed not to have pulmonary embolism. All other patients were allocated to pulmonary angiography. Patients in whom pulmonary embolism was excluded were left untreated. All patients were followed up for 1 year. Pulmonary embolism was diagnosed non-invasively in 132 patients (34%), and excluded in 191 (49%). Pulmonary angiography was required in 67 patients (17%). The prevalence of pulmonary embolism was 41% (n=160). Patients in whom pulmonary embolism was excluded had a thrombo-embolic risk of 0.4% (95% confidence interval: 0.0%-2.8%). Our strategy permitted a non-invasive diagnosis or exclusion of pulmonary embolism in 83% of the cases (95% confidence interval: 79%-86%), and appeared to be safe. (orig.)

  11. A diagnostic strategy for pulmonary embolism based on standardised pretest probability and perfusion lung scanning: a management study

    International Nuclear Information System (INIS)

    Pulmonary embolism remains a challenging diagnostic problem. We developed a simple diagnostic strategy based on combination of assessment of the pretest probability with perfusion lung scan results to reduce the need for pulmonary angiography. We studied 390 consecutive patients (78% in-patients) with suspected pulmonary embolism. The pretest probability was rated low (10%, ≤50%), moderately high (>50%, ≤90%) or high (>90%) according to a structured clinical model. Perfusion lung scans were independently assigned to one of four categories: normal; near-normal; abnormal, suggestive of pulmonary embolism (wedge-shaped perfusion defects); abnormal, not suggestive of pulmonary embolism (perfusion defects other than wedge shaped). Pulmonary embolism was diagnosed in patients with abnormal scans suggestive of pulmonary embolism and moderately high or high pretest probability. Patients with normal or near-normal scans and those with abnormal scans not suggestive of pulmonary embolism and low pretest probability were deemed not to have pulmonary embolism. All other patients were allocated to pulmonary angiography. Patients in whom pulmonary embolism was excluded were left untreated. All patients were followed up for 1 year. Pulmonary embolism was diagnosed non-invasively in 132 patients (34%), and excluded in 191 (49%). Pulmonary angiography was required in 67 patients (17%). The prevalence of pulmonary embolism was 41% (n=160). Patients in whom pulmonary embolism was excluded had a thrombo-embolic risk of 0.4% (95% confidence interval: 0.0%-2.8%). Our strategy permitted a non-invasive diagnosis or exclusion of pulmonary embolism in 83% of the cases (95% confidence interval: 79%-86%), and appeared to be safe. (orig.)

  12. Statistical Significance of the Contribution of Variables to the PCA Solution: An Alternative Permutation Strategy

    Science.gov (United States)

    Linting, Marielle; van Os, Bart Jan; Meulman, Jacqueline J.

    2011-01-01

    In this paper, the statistical significance of the contribution of variables to the principal components in principal components analysis (PCA) is assessed nonparametrically by the use of permutation tests. We compare a new strategy to a strategy used in previous research consisting of permuting the columns (variables) of a data matrix…

  13. Self-regulation from Educational Psychology to L2 Pedagogy: an Alternative to Language Learning Strategies

    Directory of Open Access Journals (Sweden)

    Maryam Banisaeid

    2014-01-01

    Full Text Available Language learning strategy was the focus of many studies during the last two decades. Because of definitional fuzziness and unreliable instrument, the concept of language learning strategy was replaced by self-regulation in educational psychology. Subsequently, this shift affected L2 research. The notion of self-regulation is used in some L2 studies today (Tseng, Dörnyei & Schmitt, 2006; Rose, 2011b, Banisaeid, 2013a, 2013b. Self-regulation is more process-oriented while language learning strategy is more product-oriented. Although it only encompasses the metacognitive strategy, the general domain of it is meaningfully wider than the strategic framework. It covers some aspects in the learning process as motivation, goals and self-efficacy.Keywords: self-regulation, language learning strategy, L2 studies, educational psychology

  14. IDegLira Versus Alternative Intensification Strategies in Patients with Type 2 Diabetes Inadequately Controlled on Basal Insulin Therapy

    DEFF Research Database (Denmark)

    Freemantle, Nick; Mamdani, Muhammad; Vilsbøll, Tina; Kongsø, Jens Harald; Kvist, Kajsa; Bain, Stephen C

    2015-01-01

    = 225) [glucagon-like peptide-1 receptor agonist (GLP-1RA) add-on strategy]; basal-bolus (BB) insulin [insulin glargine (IGlar) + insulin aspart] (N = 56); or up-titration of IGlar (N = 329). A supplementary analysis was performed with the BB arm including patients who received IGlar or IDeg as basal......INTRODUCTION: IDegLira is a once-daily combination of insulin degludec (IDeg) and liraglutide. Trials directly comparing IDegLira with alternative strategies for intensifying basal insulin are ongoing. While awaiting results, this analysis compared indirectly how different strategies affected...... glycated hemoglobin (HbA1c) and other outcomes. METHODS: A pooled analysis of five completed Novo Nordisk randomized clinical trials in patients with type 2 diabetes inadequately controlled on basal insulin was used to compare indirectly IDegLira (N = 199) with: addition of liraglutide to basal insulin (N...

  15. The Importance of Alternative Diagnostic Modalities in the Diagnosis of Small Bowel Tumors After a Negative Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Iolanda Ribeiro

    2015-05-01

    We report the case of a patient with overt obscure gastrointestinal bleeding due to a gastrointestinal stromal tumor diagnosed by CT enterography after two negatives capsule endoscopies. This case shows that capsule endoscopy may overlook significant life threatening lesions and highlights the importance of using other diagnostic modalities after a negative capsule endoscopy, especially in patients with a high index of suspicion for small bowel tumoral pathology or persistent/recurrent bleeding.

  16. Solitary pulmonary nodules and masses: a meta-analysis of the diagnostic utility of alternative imaging tests

    Energy Technology Data Exchange (ETDEWEB)

    Cronin, Paul [University of Michigan Medical Center, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States); University of Michigan Medical Center, Department of Radiology, Ann Arbor (United States); Dwamena, Ben A. [University of Michigan Medical Center, Division of Nuclear Medicine, Ann Arbor, MI (United States); Kelly, Aine Marie [University of Michigan Medical Center, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States); Bernstein, Steven J. [University of Michigan Medical Center, Department of Internal Medicine, Ann Arbor, MI (United States); VA HSR and D Center of Excellence, Ann Arbor, MI (United States); Carlos, Ruth C. [University of Michigan Medical Center, Division of Magnetic Resonance Imaging, Ann Arbor, MI (United States); University of Michigan Medical Center, Department of Radiology, Ann Arbor (United States)

    2008-09-15

    The purpose was to assess the clinical utility of diagnostic tests for identifying malignancy within a solitary pulmonary nodule (SPN), and to create a nomogram or ''look-up'' table using clinical data and non-invasive radiology (positive) test results to estimate post-test probability of malignancy. Studies that examined computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT) for the evaluation of SPN. Two reviewers independently abstracted data and assessed study quality. Study-specific and overall positive likelihood ratios (LRs) for each diagnostic test confirming a diagnosis of malignancy and negative LR for each diagnostic test excluding a diagnosis of malignancy within an SPN were calculated. Forty-four of 242 articles were included. Positive LRs for diagnostic tests were: CT 3.91 (95% confidence interval 2.42, 5.40), MRI 4.57 (3.03, 6.1), PET 5.44 (3.56, 7.32) and SPECT 5.16 (4.03, 6.30). Negative LRs were: CT 0.10 (0.03, 0.16), MRI 0.08 (0.03, 0.12), PET 0.06 (0.02, 0.09) and SPECT 0.06 (0.04, 0.08). Differences in performance for all tests were negligible; therefore, the clinician may confidently use any of the four tests presented in further evaluating an SPN. Given the low cost and prevalence of the technology, SPECT appears to be the leading choice for additional testing in SPN evaluation. (orig.)

  17. High impact of FDG-PET/CT in diagnostic strategies for ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zytoon, Ashraf Anas [Radiology Dept., Faculty of Medicine, Menoufiya Univ. (Egypt); PET Center, Dokkyo Medical Univ. (Japan)], e-mail: ashradio@gmail.com; Murakami, Koji [PET Center, Dokkyo Medical Univ. (Japan); Eid, Hazem; El-Gammal, Mahmoud [Medical Imaging Sciences and Biostatistics Dept.s, Al-Ghad International Coll.s of Health Sciences (Saudi Arabia)

    2013-04-15

    Background: Ovarian cancer has the highest mortality of all gynecologic malignancies. FDG-PET/CT was proven to be accurate for identification of primary ovarian tumors, regional lymph nodes, and distant metastases. Purpose: To evaluate ovarian masses at FDG-PET/CT in correlation with histopathologic findings. Material and Methods: Ninety-eight patients underwent whole body FDG-PET/CT examination. Eighty-six patients with primary ovarian cancer and 12 patients with metastatic disease to the ovaries were included. Results: PET/CT imaging was true-positive in 87/94 patients with malignant tumors. In 4/4 patients with benign tumors, PET/CT results were true-negative, with sensitivity of 92.6%, specificity 100%, total test accuracy 92.9%. Fifty-seven patients were diagnosed as stage IV ovarian cancer with distant metastasis. Conclusion: The anatomical/functional examination by FDG-PET/CT was proven to be valuable in increasing the diagnostic accuracy that can help improve patient management.

  18. High impact of FDG-PET/CT in diagnostic strategies for ovarian cancer

    International Nuclear Information System (INIS)

    Background: Ovarian cancer has the highest mortality of all gynecologic malignancies. FDG-PET/CT was proven to be accurate for identification of primary ovarian tumors, regional lymph nodes, and distant metastases. Purpose: To evaluate ovarian masses at FDG-PET/CT in correlation with histopathologic findings. Material and Methods: Ninety-eight patients underwent whole body FDG-PET/CT examination. Eighty-six patients with primary ovarian cancer and 12 patients with metastatic disease to the ovaries were included. Results: PET/CT imaging was true-positive in 87/94 patients with malignant tumors. In 4/4 patients with benign tumors, PET/CT results were true-negative, with sensitivity of 92.6%, specificity 100%, total test accuracy 92.9%. Fifty-seven patients were diagnosed as stage IV ovarian cancer with distant metastasis. Conclusion: The anatomical/functional examination by FDG-PET/CT was proven to be valuable in increasing the diagnostic accuracy that can help improve patient management

  19. Sedation for pediatric diagnostic imaging: use of pediatric and nursing resources as an alternative to a radiology department sedation team

    International Nuclear Information System (INIS)

    Objective. To develop a pathway to provide safe, effective, and efficient sedation for pediatric diagnostic imaging studies using non-radiology personnel. Materials and methods. A multidisciplinary team considered manpower and training requirements and national sedation standards before designing a sedation pathway, which included scheduling, pre-sedation history and physical, medication protocols, and monitoring. Oral and IV medication protocols were developed based on patient age and weight. Sedation delays were defined as >15 min (IV) or >30 min (PO) from start of sedation to start of imaging. A sedation failure resulted in an incomplete diagnostic imaging study. Failure rates of 124 sedations before and 388 sedations after the pathway were compared.Results. The sedation failure rate for 7 months prior to pathway initiation was 15% (19/124). In the first 25 months after pathway initiation, failures were significantly reduced to 1.5% (6/388) (P55 min). Deviation from the recommended medication protocol accounted for most of the 115 delays. Only minor adverse events were seen (12/388, 3.1%).Conclusion. Implementing a pediatric sedation pathway significantly decreases the sedation failure rate. Pediatric residents and nurses can safely, effectively and efficiently sedate pediatric patients for routine diagnostic imaging procedures without the need for a radiology department sedation team in a department with a small-to-moderate volume of pediatric patients. (orig.)

  20. An Alternative EDR Retrieval Strategy for the NPP OMPS Limb Profiler

    Science.gov (United States)

    Hornstein, J.; Eden, T. D.; Lumpe, J. D.; Rault, D. F.

    2009-12-01

    The Ozone Mapping and Profiler Suite Limb Profiler (OMPS/LP), slated for launch on the NPOESS Preparatory Project in Spring 2011, will derive vertical profiles of ozone from measurements of limb-scattered solar radiation in the UV-visible region (between 290-1000 nm), at an altitude range of 15-60 km. The OMPS instrument, which includes the Limb Profiler, was designed and built by Ball Aerospace Technologies Corporation under a subcontract to Northrop Grumman, the prime contractor for NPOESS. OMPS/LP views the limb through three narrow vertical fields of view, separated cross-track by 250 km at the limb tangent point. This will allow three simultaneous ozone retrievals per exposure time. Each vertical field of view is viewed by a narrow slit and a wide slit, which, combined with a multiplicity of integration times, accommodates the enormous dynamic range of the limb-scattered radiances. The light is then dispersed by a prism and projected onto a single, two-dimensional (740x340) CCD focal plane array. During each integration time the three vertical fields of view with their narrow and wide slits produce six distinct images on the CCD. That, coupled with the large inherent dynamic range of the limb-scattered signal, means that stray light will be a significant concern. If the stray light is not treated effectively, then the ozone data product will not achieve its desired accuracy. The instrument's point spread functions determine the stray light, and must be known to correct for it. They were measured during the prelaunch testing. The traditional approach is to correct for the stray light by deconvolving it from the radiances that are fed to the geophysical retrieval algorithm. But deconvolution is ill-posed and tends to amplify measurement noise. This paper presents an alternative strategy, which uses the raw pixel signals (i.e., raw pixel counts) as the data vector. In this approach, instrument effects such as stray light and spatial and spectral smile, are

  1. Transformation of theoretical-methodological approaches and methodical tools of the individual and territory welfare diagnostics. Part 1. From spreading to the alternative diagnostics approaches (background

    Directory of Open Access Journals (Sweden)

    Aleksandr Anatolyevich Kuklin

    2014-09-01

    Full Text Available This article presents an evolution of theoretical and methodological approaches to the welfare study. Existing theories of wellbeing are grouped according to accounted method of goods and resources distribution among society members. As a welfare future as a category we highlight objective (measured and subjective (estimated components. Based on the analysis of scientific literature we determine the ratio of individual and social welfare. The main differences between the categories of “ welfare” and “wealth” are given. The main difference consists in multidirectional changes of welfare and wealth for an increase (decrease in income of the individual (country. In this article we present an analysis of modern approaches to the definition of welfare: state, institutional and expendable approach. The welfare level estimation is complicated due to the need to consider the subjective component. The article provides an analysis of existing approaches to quantitative welfare evaluation ranging from the most common techniques (HDI, GDP to alternative techniques (Happy Planet Index.Methodological devices are structured by levels of welfare assessment objects (world, country, region, people. Based on the analysis of the advantages and disadvantages of methods we can conclude that the most reliable method is a comprehensive approach, which includes economic, environmental, social, vital and infrastructure indicators. The author’s approach to the formation of a complex methodological tool for individual and territory welfare estimation is presented in this article.

  2. Biosensor-based diagnostics of contaminated groundwater: assessment and remediation strategy

    International Nuclear Information System (INIS)

    Shallow groundwater beneath a former airfield site in southern England has been heavily contaminated with a wide range of chlorinated solvents. The feasibility of using bacterial biosensors to complement chemical analysis and enable cost-effective, and focussed sampling has been assessed as part of a site evaluation programme. Five different biosensors, three metabolic (Vibrio fischeri, Pseudomonas fluorescens 10568 and Escherichia coli HB101) and two catabolic (Pseudomonas putida TVA8 and E. coli DH5α), were employed to identify areas where the availability and toxicity of pollutants is of most immediate environmental concern. The biosensors used showed different sensitivities to each other and to the groundwater samples tested. There was generally a good agreement with chemical analyses. The potential efficacy of remediation strategies was explored by coupling sample manipulation to biosensor tests. Manipulation involved sparging and charcoal treatment procedures to simulate remediative engineering solutions. Sparging was sufficient at most locations. - Luminescent bacteria complement chemical analysis and support remediation technology

  3. BRAF-mutant melanoma: treatment approaches, resistance mechanisms, and diagnostic strategies

    Directory of Open Access Journals (Sweden)

    Spagnolo F

    2015-01-01

    available today for patients affected by BRAF V600-mutated metastatic melanoma, as well as to summarize the mechanisms of resistance to BRAF inhibitors and discuss the possible strategies to overcome them. Moreover, since the molecular analysis of tumor specimens is now a pivotal and decisional factor in the treatment strategy of metastatic melanoma patients, the advances in the molecular detection techniques for the BRAF V600 mutation will be reported. Keywords: melanoma, BRAF, vemurafenib, dabrafenib, resistance, BRAF inhibitor

  4. Assessing Tuition and Student Aid Strategies: Using Price-Response Measures to Simulate Pricing Alternatives.

    Science.gov (United States)

    St. John, Edward P.

    1994-01-01

    A study used price-response measures from recent national studies to assess college and university pricing (tuition and student aid) alternatives in diverse institutional settings. It is concluded that such analyses are feasible. Analysis indicated limits to "Robin Hood" pricing patterns are predominant in private colleges. Consideration of new…

  5. Long-term strategies for flood risk management: scenario definition and strategic alternative design

    NARCIS (Netherlands)

    Bruijn, de K.; Klijn, F.; McGahey, C.; Mens, M.; Wolfert, H.P.

    2008-01-01

    This report reviews some mainstream existing methods of scenario development and use, as well as experiences with the design and assessment of strategic alternatives for flood risk management. Next, a procedure and methods are proposed and discussed. Thirdly, the procedure and methods are tried on t

  6. Alternative intrapopulation life-history strategies and their trade-offs in an African annual fish

    Czech Academy of Sciences Publication Activity Database

    Polačik, Matej; Blažek, Radim; Řežucha, Radomil; Vrtílek, Milan; Terzibasi Tozzini, E.; Reichard, Martin

    2014-01-01

    Roč. 27, č. 5 (2014), s. 854-865. ISSN 1010-061X R&D Projects: GA ČR GPP505/11/P646 Institutional support: RVO:68081766 Keywords : phenotypic plasticity * periodic habitat * senescence rate * polyphenism * lifespan * alternative embryonic pathway Subject RIV: EG - Zoology Impact factor: 3.232, year: 2014

  7. Alternative Strategies for Maximizing the Output of Multi-Junction Photovoltaic Panels

    CERN Document Server

    Abrams, Ze'ev R

    2014-01-01

    Multi-junction photovoltaics provide a logical method of increasing the utilization of solar power for a given area. However, their current design and fabrication methods invoke numerous material and cost complexities that limit their potential, particularly for flat panel paradigms. In this paper, three general strategies based on the electrical isolation of the internal sub-layers are described. These strategies involve current or voltage matching the sub-layers by varying of fractional absorption and areal coverage of individual cells within each sub-layer, as well as modifying their combined output using power electronics. A simplified theoretical description of these strategies is provided for pairs of junction materials that allows a more streamlined description of the requirements.

  8. Mixed strategies for energy conservation and alternative energy utilization (solar) in buildings. Final report. Volume III. Appendixes. [10 appendices

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-06-01

    This appendix summarizes building characteristics used to determine heating and cooling loads for each of the five building types in each of the four regions. For the selected five buildings, the following data are attached: new and existing construction characteristics; new and existing construction thermal resistance; floor plan and elevation; people load schedule; lighting load schedule; appliance load schedule; ventilation schedule; and hot water use schedule. For the five building types (single family, apartment buildings, commercial buildings, office buildings, and schools), data are compiled in 10 appendices. These are Building Characteristics; Alternate Energy Sources and Energy Conservation Techniques Description, Costs, Fuel Price Scenarios; Life Cycle Cost Model; Simulation Models; Solar Heating/Cooling System; Condensed Weather; Single and Multi-Family Dwelling Characteristics and Energy Conservation Techniques; Mixed Strategies for Energy Conservation and Alternative Energy Utilization in Buildings. An extensive bibliography is given in the final appendix. (MCW)

  9. An alternative strategy to generate coding sequence of macrophage migration inhibitory factor-2 of Wuchereria bancrofti

    Directory of Open Access Journals (Sweden)

    Nikhil Chauhan

    2016-01-01

    Results: A simple strategy was developed based on PCR, which is used routinely in molecular biology laboratories. The amplified CDS of 363 bp of wbMIF-2 generated using genomic DNA splicing technique was devoid of any intronic sequence. Interpretation & conclusions: The cDNA of wbMIF-2 gene was successfully amplified from genomic DNA of microfilarial stage of W. bancrofti thus circumventing the use of inaccessible L3-L4 transitional stage of this parasite. This strategy is useful for generating CDS of genes from parasites that have restricted availability.

  10. Differences in Regional Diagnostic Strategies and in Intended Versus Actual First-Line Treatment of Patients With Advanced Ovarian Cancer in Denmark

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten Lindberg; Ottesen, Bent; Kehlet, Henrik;

    2014-01-01

    BACKGROUND: Triage of patients with ovarian cancer to primary debulking surgery (PDS) or neoadjuvant chemotherapy (NACT) is challenging. In Denmark, the use of NACT has increased, but substantial differences in the use of NACT or PDS exist among centers. We aimed to characterize the differences...... and 4% never had debulking surgery. Of the 288 patients (53%) referred to NACT, 44% were never debulked. Fourteen patients (3%) were referred to palliative treatment. The use of different imaging modalities, diagnostic laparoscopy, and laparotomy varied significantly among the centers. Diagnostic......-line treatments as well as in the diagnostic process and use of NACT, calling for further discussion on diagnostic strategy and therapeutically approach for patients with advanced ovarian cancer....

  11. Alternative Strategies for the Treatment of Classical Congenital Adrenal Hyperplasia: Pitfalls and Promises

    Directory of Open Access Journals (Sweden)

    Ali S. Calikoglu

    2010-01-01

    Full Text Available Despite decades of different treatment algorithms, the management of congenital adrenal hyperplasia (CAH remains clinically challenging. This is due to the inherent difficulty of suppressing adrenal androgen production using near physiological dosing of glucocorticoids (GC. As a result, alternating cycles of androgen versus GC excess can occur and may lead to short stature, obesity, virilization, and alterations in puberty. Novel therapeutic alternatives, including new and more physiological means of GC delivery, inhibitors at the level of CRH or ACTH secretion and/or action, as well as “rescue strategies”, such as GnRH analogs, anti-androgens, aromatase inhibitors, and estrogen receptor blockers, are available; many of these agents, however, still require active investigation in CAH. Bilateral adrenalectomy is effective but it is also still an experimental approach. Gene therapy and stem cells, to provide functional adrenal cortical tissue, are at preclinical stage but provide exciting avenues for a potential cure for CAH.

  12. Project Cerberus: tobacco industry strategy to create an alternative to the Framework Convention on Tobacco Control.

    Science.gov (United States)

    Mamudu, Hadii M; Hammond, Ross; Glantz, Stanton A

    2008-09-01

    Between 1999 and 2001, British American Tobacco, Philip Morris, and Japan Tobacco International executed Project Cerberus to develop a global voluntary regulatory regime as an alternative to the Framework Convention on Tobacco Control (FCTC). They aimed to develop a global voluntary regulatory code to be overseen by an independent audit body and to focus attention on youth smoking prevention. The International Tobacco Products Marketing Standards announced in September 2001, however, did not have the independent audit body. Although the companies did not stop the FCTC, they continue to promote the International Tobacco Products Marketing Standards youth smoking prevention as an alternative to the FCTC. Public health civil society groups should help policymakers and governments understand the importance of not working with the tobacco industry. PMID:18633079

  13. Mindfulness-Based Exposure Strategies as a Transdiagnostic Mechanism of Change: An Exploratory Alternating Treatment Design.

    Science.gov (United States)

    Brake, C Alex; Sauer-Zavala, Shannon; Boswell, James F; Gallagher, Matthew W; Farchione, Todd J; Barlow, David H

    2016-03-01

    The present study explored whether distress reduction in response to strong negative emotions, a putative transdiagnostic mechanism of action, is facilitated by mindfulness strategies. Seven patients (mean age=31.14years, SD=12.28, range 19-48 years, 43% female, 86% Caucasian) with heterogeneous anxiety disorders (i.e., panic disorder with or without agoraphobia, social anxiety, generalized anxiety) were assigned a randomized order of weeklong blocks utilizing either mindfulness- or avoidance-based strategies while ascending a 6-week emotion exposure hierarchy. Participants completed three exposures per block and provided distress and avoidance use ratings following each exposure. Anxiety severity, distress aversion, and distraction/suppression tendencies were also assessed at baseline and the conclusion of each block. Visual, descriptive, and effect size results showing exposures utilizing mindfulness were associated with higher overall distress levels, compared with those utilizing avoidance. Within blocks, the majority of participants exhibited declining distress levels when employing mindfulness strategies, as opposed to more static distress levels in the avoidance condition. Systematic changes in anxiety severity, distress aversion, and distraction/suppression were not observed. These results suggest mindfulness strategies may be effective in facilitating emotion exposure; however, a minimum dosage may be necessary to overcome initial distress elevation. Potential transdiagnostic change mechanisms and clinical implications are discussed. PMID:26956654

  14. Jobs for the Future: Strategies in a New Framework. Alternatives for the 1980's, No. 13.

    Science.gov (United States)

    Baily, Martin Neil; And Others

    This volume consists of four articles dealing with strategies for combatting unemployment in the 1980s. In the first article, entitled "The Problem of Unemployment in the United States," Martin Neil Baily examines the nature of unemployment, the inflation trade-off and the natural rate of unemployment, indicators of structural change, and sources…

  15. A Culturally Responsive Alternative to "Drill and Kill" Literacy Strategies: Deep Roots, Civil Rights

    Science.gov (United States)

    Peterson, Deborah S.

    2014-01-01

    This article describes two approaches to improving literacy in a high poverty, diverse urban high school. One curriculum program, "Striving Readers," included a prescribed course of study for students reading below grade level along with schoolwide strategies. This approach did not improve targeted students' reading scores or…

  16. Note-Taking with Computers: Exploring Alternative Strategies for Improved Recall

    Science.gov (United States)

    Bui, Dung C.; Myerson, Joel; Hale, Sandra

    2013-01-01

    Three experiments examined note-taking strategies and their relation to recall. In Experiment 1, participants were instructed either to take organized lecture notes or to try and transcribe the lecture, and they either took their notes by hand or typed them into a computer. Those instructed to transcribe the lecture using a computer showed the…

  17. A life cycle assessment method for alternative material selection strategies in boat structures

    OpenAIRE

    Bardet, Raphaël Régis

    2010-01-01

    In general the use of composites results in shorter production time, lightweight and lower maintenance costs to the marine industry in the leisure, fast and fishing boats sectors. The social and economic benefits of using composite materials have made users complacent about the pollution and the health and safety issues associated with these materials. As the perception of environmental problems changes with time, alternatives with lower emissions allowing for cleaner production and easier di...

  18. Greenways – an alternative mobility structure and an urban development strategy

    OpenAIRE

    Calhau, Rita; Matos, Rute; Lisboa, Alexandre

    2015-01-01

    Greenways are fundamental in establishing a continuous landscape structure. This landscape structure involves natural and cultural factors that determine flows and processes both at the ecological level, both social and aesthetic. Within the extensive range of functions that green corridors play, one should highlight the implementation of an alternative mobility structure enhancer of natural and artificial flows in the landscape. We intend to establish a strategic plan implemented through ...

  19. Elicitors as alternative strategy to pesticides in grapevine? Current knowledge on their mode of action from controlled conditions to vineyard.

    Science.gov (United States)

    Delaunois, Bertrand; Farace, Giovanni; Jeandet, Philippe; Clément, Christophe; Baillieul, Fabienne; Dorey, Stéphan; Cordelier, Sylvain

    2014-04-01

    Development and optimisation of alternative strategies to reduce the use of classic chemical inputs for protection against diseases in vineyard is becoming a necessity. Among these strategies, one of the most promising consists in the stimulation and/or potentiation of the grapevine defence responses by the means of elicitors. Elicitors are highly diverse molecules both in nature and origins. This review aims at providing an overview of the current knowledge on these molecules and will highlight their potential efficacy from the laboratory in controlled conditions to vineyards. Recent findings and concepts (especially on plant innate immunity) and the new terminology (microbe-associated molecular patterns, effectors, etc.) are also discussed in this context. Other objectives of this review are to highlight the difficulty of transferring elicitors use and results from the controlled conditions to the vineyard, to determine their practical and effective use in viticulture and to propose ideas for improving their efficacy in non-controlled conditions. PMID:23719689

  20. Cost-Effectiveness of Alternative Blood-Screening Strategies for West Nile Virus in the United States.

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available BACKGROUND: West Nile virus (WNV is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist. METHODS AND FINDINGS: We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients was the most cost-effective strategy. Seasonal screening of the entire recipient pool added minimal clinical benefit, with incremental cost-effectiveness ratios exceeding US$1.7 million per quality-adjusted life-year gained. Year-round screening offered no additional benefit compared to seasonal screening in any of the transmission settings. CONCLUSIONS: In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations

  1. Alternative Approach Strategies For Buyer-Seller Relations With The Peoples Republic Of China

    OpenAIRE

    Johnston, W.J.

    1988-01-01

    This paper examines the issues involved in buyer-seller relations for industrial product sales in the People's Republic of China. The need is genuine in many product categories including plant technology, high technology, and infrastructure. The problem is that buying policies and procedures for foreign firms are still emerging, and therefore, unclear and confusing. Three approach strategies for buyer-seller relations with China are presented: the authorized "buying group," the "agency" repre...

  2. Implementation of Alternative Test Strategies for the Safety Assessment of Engineered Nanomaterials

    OpenAIRE

    Nel, Andre

    2013-01-01

    Nanotechnology introduces a new field that requires novel approaches and methods for hazard and risk assessment. For an appropriate scientific platform for safety assessment, nanoscale properties and functions of engineered nanomaterials (ENMs), including how the physicochemical properties of the materials related to mechanisms of injury at the nano-bio interface, must be considered. Moreover, this rapidly advancing new field requires novel test strategies that allow multiple toxicants to be ...

  3. 'Doctor Google' ending the diagnostic odyssey in lysosomal storage disorders: parents using internet search engines as an efficient diagnostic strategy in rare diseases.

    Science.gov (United States)

    Bouwman, Machtelt G; Teunissen, Quirine G A; Wijburg, Frits A; Linthorst, Gabor E

    2010-08-01

    The expansion of the internet has resulted in widespread availability of medical information for both patients and physicians. People increasingly spend time on the internet searching for an explanation, diagnosis or treatment for their symptoms. Regarding rare diseases, the use of the internet may be an important tool in the diagnostic process. The authors present two cases in which concerned parents made a correct diagnosis of a lysosomal storage disorder in their child by searching the internet after a long doctor's delay. These cases illustrate the utility of publicly available internet search engines in diagnosing rare disorders and in addition illustrate the lengthy diagnostic odyssey which is common in these disorders. PMID:20418338

  4. Prospects for a nicotine-reduction strategy in the cigarette endgame: Alternative tobacco harm reduction scenarios.

    Science.gov (United States)

    Kozlowski, Lynn T

    2015-06-01

    Some major national and international tobacco control organisations favour mandating a reduction in nicotine content of cigarettes to non-addictive levels as a tobacco control tool. Reducing nicotine content, it is argued, will make tobacco smoking less attractive. The 2009 U.S. Food and Drug Administration's regulation of cigarettes appears to have the power to reduce nicotine to non-addictive levels provided it is not taken to zero. A consideration of the U.S. context, however, raises doubts about (a) whether this will ever be practicable and (b), if practicable, how long it will take to implement. Current versions of the nicotine-reducing strategy propose the systematic, incentivised use of less harmful nicotine/tobacco products as elements of the mandatory cigarette nicotine-reduction strategy. Time will tell if and when mandatory nicotine reduction in tobacco cigarettes will occur and what impact it might have on smoking prevalence. The question posed here is "Why wait?" Resources used in implementing reduction in nicotine content have an opportunity cost. In the meantime, nicotine-maintaining harm reduction strategies can have nearer term effects on tobacco use as an individual and a public health issue. PMID:25795345

  5. Alternative Composite Lisbon Development Strategy Indices: A Comparison of EU, USA, Japan and Korea

    Directory of Open Access Journals (Sweden)

    JongEun Oh

    2006-12-01

    Full Text Available This study addresses the measurement of two composite Lisbon strategy indices that quantifies the level and patterns of development for ranking countries. The first index is nonparametric labelled as Lisbon strategy index (LSI. It is composed of six components: general economics, employment, innovation research, economic reform, social cohesion and environment, each generated from a number of Lisbon indicators. LSI by reducing the complexity of the set of indicators, it makes the ranking procedures quite simple. The second and parametric index is based on principal component analysis. Despite the difference in the ranking by the two indices, it is shown that the United States outperformed most EU-member states. Our investigations also show evidence of significant dynamic changes taking place, as the countries of the Union struggle to achieve the Lisbon goals. The necessity of a real reform agenda in several old and new members and candidate countries emerges from our analysis. We briefly refer to two important European phenomena emerging from our data analysis and discuss the possible lessons learned from the Korean development strategy

  6. Optimization studies for the prism alternative oxide core, and its response to the actinide burning strategy

    International Nuclear Information System (INIS)

    The PRISM advanced liquid metal reactor is designed by General Electric in a reference solution equipped by a metal fuelled core. An alternative oxide core is studied by General Electric and ENEA in the frame of a collaboration existing since 1989. This paper deals with the ENEA contribution on the oxide solution, aimed at the core optimization both from safety parameters and fuel cycle economy points of view. Moreover, synthetic information about ENEA evaluations about the minor actinide burning capability of the PRISM oxide core are given. (author)

  7. Evaluation of alternative pollutant emission control strategies to urban water systems using substance flow analysis

    DEFF Research Database (Denmark)

    Lundy, L.; Revitt, D. M.; Eriksson, Eva;

    2011-01-01

    The EU Water Framework Directive (WFD) requires Member States to protect their inland (and coastal) surface and groundwater bodies. However, the way in which WFD requirements can be met, including the associated stringent environmental quality standards, is less clear. This paper presents selected...... emissions on a compartment-by-compartment basis indicates that the impact of a particular ECS is sensitive to both pollutant and city-specific characteristics. Whilst reductions in emissions to one compartment are typically associated with an increase in emissions to an alternative compartment, the final...

  8. Leishmania spp. AS A DIAGNOSTIC STRATEGY AND AS A TREATMENT OF LeishmaniaSIS; AN ARTICLE OF REVISION

    Directory of Open Access Journals (Sweden)

    Beltran-Cifuentes Martha Cecilia

    2007-09-01

    Full Text Available Introduction: Some emerging and reemerging infirmities have been increasing in an almost unpredictable manner as far as site of origin. Such is the case with such diseases as Chagas, malaria, dengue, yellow fever, rabies, and Leishmaniasis. Various demographic, social, and economic factors, as well as population mobility have allowed microorganisms to generate adaptations to changing environments and thus make diagnosis and treatment by conventional methods more difficult.Methodology: An exhaustive search was undertaken in the data bases related to genome and protein sequence information found at the NCBI (National Center for Biotechnology Information, part of the United States National Library of Medicine and the National Institutes of Health, all with direct access to PubMed.Results: Today techniques using molecular markers, PCR (Polymerase Chain Reaction, are being used to complement the biochemical and microbiological tests commonly used in diagnoses. Understanding the genome of parasites allows researchers to design new more effective methods against strains resistant to current drugs and to enable early prevention.Conclusions: This article presents a bibliographical revision where the clinical information of the patient is a major determinant in a diagnosis which can be confirmed through molecular techniques developed in real time to contribute to molecular knowledge of Leishmania spp. as a diagnostic strategy and treatment of this pathology.

  9. Investigating portable fluorescent microscopy (CyScope® as an alternative rapid diagnostic test for malaria in children and women of child-bearing age

    Directory of Open Access Journals (Sweden)

    Sousa-Figueiredo José

    2010-08-01

    Full Text Available Abstract Background Prompt and correct diagnosis of malaria is crucial for accurate epidemiological assessment and better case management, and while the gold standard of light microscopy is often available, it requires both expertise and time. Portable fluorescent microscopy using the CyScope® offers a potentially quicker, easier and more field-applicable alternative. This article reports on the strengths, limitations of this methodology and its diagnostic performance in cross-sectional surveys on young children and women of child-bearing age. Methods 552 adults (99% women of child-bearing age and 980 children (99% ≤ 5 years of age from rural and peri-urban regions of Ugandan were examined for malaria using light microscopy (Giemsa-stain, a lateral-flow test (Paracheck-Pf® and the CyScope®. Results from the surveys were used to calculate diagnostic performance (sensitivity and specificity as well as to perform a receiver operating characteristics (ROC analyses, using light microscopy as the gold-standard. Results Fluorescent microscopy (qualitative reads showed reduced specificity (400 parasites/μL blood: sensitivity of 64.2% and specificity of 86.0%. Overall, the diagnostic performance of the CyScope was found inferior to that of Paracheck-Pf®. Discussion Fluorescent microscopy using the CyScope® is certainly a field-applicable and relatively affordable solution for malaria diagnoses especially in areas where electrical supplies may be lacking. While it is unlikely to miss higher parasitaemia, its application in cross-sectional community-based studies leads to many false positives (i.e. small fluorescent bodies of presently unknown origin mistaken as malaria parasites. Without recourse to other technologies, arbitration of these false positives is presently equivocal, which could ultimately lead to over-treatment; something that should be further explored in future investigations if the CyScope® is to be more widely implemented.

  10. An alternative flow cytometry strategy for peripheral blood dendritic cell enumeration in the setting of repetitive GM-CSF dosing

    Directory of Open Access Journals (Sweden)

    Mehta Rita S

    2006-04-01

    Full Text Available Abstract Background Enumeration of circulating peripheral blood dendritic cells (DCs is complicated by the absence of a unique cell surface marker expressed on all DC subsets and by the use of various biological adjuvants to modulate the DC compartment, including granulocyte macrophage colony stimulating factor (GM-CSF. Common methods employ a cocktail of antibodies, typically including anti-CD14, to define a lineage negative, MHC class II positive, putative DC population. Reported flow cytometry protocols include highly variable gating strategies and DC identification criteria. Increasing appreciation of DC pleiomorphism, GM-CSF biology, and recognition of CD14 expression in some DC subsets led us to consider an alternative lineage cocktail to improve identification of the circulating DC pool. Methods Standard whole blood staining with appropriate fluorochrome conjugated antibodies to MHC class II and either standard CD14 containing, or an alternate CD66acde containing, lineage cocktail was performed on samples obtained from normal donors and breast cancer patients before and after administration of dose-dense, cytotoxic chemotherapy with daily GM-CSF hematopoetic growth factor support. Putative DCs were enumerated by standard flow cytometry. Data set differences were evaluated using two tailed Mann-Whitney or Wilcoxon signed rank tests. Cellular morphology was examined in cell-sorted populations from post GM-CSF samples. Results Use of either antibody cocktail defined comparably sized lineage negative, MHC class II positive populations in normal donors and at baseline in cancer patients. However, selection of lineage negative subsets with increasing MHC class II expression levels yielded larger putative DC populations identified with the alternate cocktail. Both cocktails yielded highly reproducible data. Use of the alternate cocktail: 1 yielded a putative DC population, post GM-CSF that was more homogenous and consistent with DCs, 2 resulted

  11. Computer-assisted learning as an alternative to didactic lectures: a study of teaching the physics of diagnostic imaging

    Directory of Open Access Journals (Sweden)

    V.H. M. Dale

    1999-12-01

    Full Text Available In recent years there has been an expansion in the number of undergraduate students recruited to the veterinary courses in the UK veterinary schools. This growth in student numbers has not been matched by an increase in academic staff devoted to teaching. In addition, higher education has in the 1990s suffered an approximate 20 per cent reduction in government funding if the effects of inflation and student numbers are taken into account. At the same time there has been a demand for the investigation of teaching quality, leading to the Teaching Quality Assurance process (Ellis, 1993. Thus a number of converging factors have stimulated the need to look for alternative and innovative methods of teaching in veterinary undergraduate education.

  12. Diagnosis of an anaerobic pond treating temperate domestic wastewater: An alternative sludge strategy for small works

    OpenAIRE

    Cruddas, Peter; Wang, K.; Best, D.; Jefferson, Bruce; Cartmell, Elise; Parker, Alison; McAdam, Ewan J.

    2014-01-01

    An anaerobic pond (AP) for treatment of temperate domestic wastewater has been studied as a small works sludge management strategy to challenge existing practice which comprises solids separation followed by open sludge storage, for up to 90 days. During the study, effluent temperature ranged between 0.1 °C and 21.1 °C. Soluble COD production was noted in the AP at effluent temperatures typically greater than 10 °C and was coincident with an increase in effluent volatile fatty acids (VFA) con...

  13. Biosolids management strategies: an evaluation of energy production as an alternative to land application.

    Science.gov (United States)

    Egan, Maureen

    2013-07-01

    Currently, more than half of the biosolids produced within the USA are land applied. Land application of biosolids introduces organic contaminants into the environment. There are potential ecological and human health risks associated with land application of biosolids. Biosolids may be used as a renewable energy source. Nutrients may be recovered from biosolids used for energy generation for use as fertilizer. The by-products of biosolids energy generation may be used beneficially in construction materials. It is recommended that energy generation replace land application as the leading biosolids management strategy. PMID:23529399

  14. Is the strategy of alternative fuels production and their use in Slovak Republic necessary?

    International Nuclear Information System (INIS)

    Effective and flexible system of transport is an essential tool for contemporary economics and quality of life. Enormous growth of transport however brings major problems, which negatively affect environment as well as health of the population, especially in large cities. The sector of transport is the largest consumer of energies as well as the largest producer of gases causing greenhouse effect. In the course of 1990's, a significant improvement in automotive fuels quality in automobile technologies has been achieved. These technologies considerably cut the volume of emissions. Other important factor to find alternative solution for is the dependence of European countries including Slovakia on crude oil imports. Natural resources of oil are located in politically unstable regions. One of the possible solutions is to make a greater use of alternative fuels, especially renewable ones, which may support agriculture. It is very important that majority of cars driven nowadays are able to run on fuels with low volume of bio-components. New development in technologies will also allow the use of higher share of bio-components. Adapted vehicles that run on clean bio-fuels are already used nowadays in public transportation. This approach is significantly positive in respect to environment. Support of biofuels usage should become the next step towards a wider biomass use. Such a policy could create new opportunities for a sustainable regional development and for opening a new market of innovation agricultural products. In the past, the development, production and use of canola oil esters started to accelerate. However, their use was not based on long-term complex considerations. The program has collapsed already with the first amendment to the Act on Consumption Tax of Mineral Oils, which has been harmonized with the European Union (EU) legislation. Introduction of the use of bio-components must be based on expertise and long term strategic support and development with

  15. Common Errors in Conducting Psychodynamic Psychotherapy: Illustrative Vignettes and Alternative Strategies.

    Science.gov (United States)

    Trimboli, Frank; Keenan, Charles W; Marshall, Rycke L

    2016-01-01

    In this paper 12 common errors that occur in the course of psychodynamic psychotherapy are reviewed. Rationales for why we consider these to be errors are described, and vignettes are used to illustrate the errors, lastly, recommendations for alternate approaches consistent with effective psychodynamic psychotherapy are presented. The errors reviewed include concerns regarding the maintenance of appropriate limits and boundaries; decisions regarding the focus and form of treatment; no-suicide contracts; fee arrangements; missed sessions; psychological testing of psychotherapy patients; selecting appropriate patients for psychotherapy; and the importance of personal psychotherapy for the therapist. The suggestions provided are consistent with what we believe are the goals of psychodynamic psychotherapy: autonomy, insight, and self-determination. PMID:27329406

  16. Peptide-Centric Proteome Analysis: An Alternative Strategy for the Analysis of Tandem Mass Spectrometry Data

    Energy Technology Data Exchange (ETDEWEB)

    Ting, Ying S.; Egertson, Jarrett D.; Payne, Samuel H.; Kim, Sangtae; MacLean, Brendan; Kall, Lukas; Aebersold, Ruedi; Smith, Richard D.; Noble, William; MacCoss, Michael

    2015-09-01

    In mass spectrometry-based bottom-up proteomics, data-independent acquisition (DIA) is an emerging technique due to its comprehensive and unbiased sampling of precursor ions. However, current DIA methods use wide precursor isolation windows, resulting in co- fragmentation and complex mixture spectra. Thus, conventional database searching tools that identify peptides by interpreting individual MS/MS spectra are inherently limited in analyzing DIA data. Here we discuss an alternative approach, peptide-centric analysis, which tests directly for the presence and absence of query peptides. We discuss how peptide-centric analysis resolves some limitations of traditional spectrum-centric analysis, and we outline the benefits of peptide-centric analysis in general.

  17. Strategies for cost-effective carbon reductions: A sensitivity analysis of alternative scenarios

    International Nuclear Information System (INIS)

    Analyses of alternative futures often present results for a limited set of scenarios, with little if any sensitivity analysis to identify the factors affecting the scenario results. This approach creates an artificial impression of certainty associated with the scenarios considered, and inhibits understanding of the underlying forces. This paper summarizes the economic and carbon savings sensitivity analysis completed for the Scenarios for a Clean Energy Future study (IWG, 2000). Its 19 sensitivity cases provide insight into the costs and carbon-reduction impacts of a carbon permit trading system, demand-side efficiency programs, and supply-side policies. Impacts under different natural gas and oil price trajectories are also examined. The results provide compelling evidence that policy opportunities exist to reduce carbon emissions and save society money

  18. Alternative strategies - a means for saving money and time on the Yucca Mountain Project

    International Nuclear Information System (INIS)

    The United States Department of Energy (DOE) is undertaking studies to determine the suitability of Yucca Mountain (YM) as a potential site for disposal of high-level nuclear waste. Yucca Mountain is located approximately 120 miles northwest of Las Vegas in an arid environment. Many processes that could contribute to mobilization of radionuclides are either absent or minimized in a dry site. Therefore, Yucca Mountain should have the potential of being a very favorable site for disposal of waste. However, the determination of suitability has no precedence, and the characterization of an arid site is complex, requiring intensive studies to determine suitability. The studies undertaken by the Yucca Mountain Site Characterization Project (YMP) are very costly. Unfortunately many people have concluded that the costs are so excessive that the project should not proceed, but rather should be curtailed. The author feels this is unfortunate for two reasons. First, the solution of what to do with nuclear waste is a clear and urgent national need if we are to have a balanced US energy strategy. Second, the excessive cost and lengthy schedule are in part artifacts of the strategy that has been developed for satisfying regulations and providing for isolation of the waste. It is this latter point that will be addressed in this paper

  19. Donation in Private Clinics as an Alternate Strategy to Increase the Pool of Donors.

    Science.gov (United States)

    Revuelto-Rey, J; Aldabó-Pallás, T; Egea-Guerrero, J J; Martín-Villén, L; Correa-Chamorro, E; Gallego-Corpa, A

    2015-11-01

    In recent years, the donation process is being characterized by a decreased number of brain deaths and a logistical shift toward cardiac-death donation, both controlled and uncontrolled, in Spain. As we know, cardiac-death donors produce fewer usable organs than brain-death donors. Therefore, many of the Spanish transplant coordinators are working to find new strategies that bring efficiency to donor detection. Since 2012, at the Virgen del Rocío University Hospital, Seville, we have been trying to obtain more donors with the use of a huge logistical and administrative effort of all the elements that make up the donation and transplantation teams, because we have sought to get organ donors in all private clinics in the city. The result of this effort has succeeded in increasing the donation rate in Seville to 3 donors and >6 usable organs per year. This paper also analyzes the characteristics of these donors, comparing our results with our community and the country. The conclusion of all this, we believe, encourages persevering in those efforts and endorses a strategy that could be applied in other parts of the world with good results in terms of transplanted organs. PMID:26680037

  20. Alternative Assessment Strategy and Its Impact on Student Comprehension in an Undergraduate Microbiology Course

    Directory of Open Access Journals (Sweden)

    Barry J. Margulies

    2009-12-01

    Full Text Available Medical Microbiology is a content-intensive course that requires a large time commitment from the students. Students are typically biology or prenursing majors, including students headed for professional schools, such as medical school and pharmacy school. This group is somewhat diverse in terms of background science coursework, so it can be difficult to teach in a way that benefits all the students. Numerous changes have been implemented in our microbiology curriculum to address the different abilities of our students by altering assessment and teaching strategies. It was hypothesized that changing the assessment strategy from the traditional scheme of two or three exams and one final to a new model of seven or eight shorter exams would have a positive impact on student comprehension and retention. The quantity of material taught or expected of the students to learn did not change, but there was definitely an impact on them. Although 30.0% of students routinely did not pass microbiology in previous semesters, the new method of assessment resulted in only 9.63% not completing the semester successfully, as determined by earning a grade of C or better. There is some evidence from conversations and interviews with students that indicates a positive impact of this methodology on student attitude. Implementation of these changes in other courses and their current effectiveness will be examined in the future, with an eye towards more broadly applicable successful teaching techniques in the sciences, especially for nonmajors.

  1. Evaluation of research activities and research needs to increase the impact and applicability of alternative testing strategies in risk assessment practice

    NARCIS (Netherlands)

    Punt, A.; Schiffelers, M.J.W.A.; Jean Horbach, G.; Sandt, J.J.M. van de; Groothuis, G.M.M.; Rietjens, I.M.C.M.; Blaauboer, B.J.

    2011-01-01

    The present paper aims at identifying strategies to increase the impact and applicability of alternative testing strategies in risk assessment. To this end, a quantitative and qualitative literature evaluation was performed on (a) current research efforts in the development of in vitro methods aimin

  2. Environmental assessment of alternative municipal solid waste management strategies. A Spanish case study.

    Science.gov (United States)

    Bovea, M D; Ibáñez-Forés, V; Gallardo, A; Colomer-Mendoza, F J

    2010-11-01

    The aim of this study is to compare, from an environmental point of view, different alternatives for the management of municipal solid waste generated in the town of Castellón de la Plana (Spain). This town currently produces 207 ton of waste per day and the waste management system employed today involves the collection of paper/cardboard, glass and light packaging from materials banks and of rest waste at street-side containers. The proposed alternative scenarios were based on a combination of the following elements: selective collection targets to be accomplished by the year 2015 as specified in the Spanish National Waste Plan (assuming they are reached to an extent of 50% and 100%), different collection models implemented nationally, and diverse treatments of both the separated biodegradable fraction and the rest waste to be disposed of on landfills. This resulted in 24 scenarios, whose environmental behaviour was studied by applying the life cycle assessment methodology. In accordance with the ISO 14040-44 (2006) standard, an inventory model was developed for the following stages of the waste management life cycle: pre-collection (bags and containers), collection, transport, pre-treatment (waste separation) and treatment/disposal (recycling, composting, biogasification+composting, landfill with/without energy recovery). Environmental indicators were obtained for different impact categories, which made it possible to identify the key variables in the waste management system and the scenario that offers the best environmental behaviour. Finally, a sensitivity analysis was used to test some of the assumptions made in the initial life cycle inventory model. PMID:20381331

  3. Transcranial Alternating Current Stimulation in Patients with Chronic Disorder of Consciousness: A Possible Way to Cut the Diagnostic Gordian Knot?

    Science.gov (United States)

    Naro, Antonino; Bramanti, Placido; Leo, Antonino; Russo, Margherita; Calabrò, Rocco Salvatore

    2016-07-01

    Unresponsive wakefulness syndrome (UWS) is a chronic disorder of consciousness (DOC) characterized by a lack of awareness and purposeful motor behaviors, owing to an extensive brain connectivity impairment. Nevertheless, some UWS patients may retain residual brain connectivity patterns, which may sustain a covert awareness, namely functional locked-in syndrome (fLIS). We evaluated the possibility of bringing to light such residual neural networks using a non-invasive neurostimulation protocol. To this end, we enrolled 15 healthy individuals and 26 DOC patients (minimally conscious state-MCS- and UWS), who underwent a γ-band transcranial alternating current stimulation (tACS) over the right dorsolateral prefrontal cortex. We measured the effects of tACS on power and partial-directed coherence within local and long-range cortical networks, before and after the protocol application. tACS was able to specifically modulate large-scale cortical effective connectivity and excitability in all the MCS participants and some UWS patients, who could be, therefore, considered as suffering from fLIS. Hence, tACS could be a useful approach in supporting a DOC differential diagnosis, depending on the level of preservation of the cortical large-scale effective connectivity. PMID:27062669

  4. Diagnostic strategies in osteomyelitis

    International Nuclear Information System (INIS)

    Technetium-99 pyrophosphate bone scanning often identifies patients with osteomyelitis before roentgenographic findings appear. However, recent studies have shown that 99Tc bone scanning often gives false-negative results, especially in neonates. The accuracy of computed tomographic scanning and indium-111 leukocyte scanning for diagnosis of early osteomyelitis has not been established. 99Tc bone scanning often gives false-positive results in patients with other conditions leading to bone injury and repair, such as trauma or recent surgery, further limiting the usefulness of this imaging procedure. Newer imaging techniques have not been adequately evaluated to establish their specificity. Because of their high cost and unproved accuracy, these new imaging procedures should not be routinely applied until their usefulness has been established. Bone biopsy remains the procedure of choice for establishing the diagnosis in patients suspected clinically to have osteomyelitis with negative findings on roentgenography and 99Tc bone scanning. Although Staphylococcus aureus is the leading cause of osteomyelitis, other pathogens cause 30 to 40 percent of cases. Aspiration or biopsy of the involved bone is usually required to choose appropriate antibiotic therapy. Bone biopsy is essential in chronic osteomyelitis, since cultures of sinus drainage are unreliable. Osteomyelitis in diabetics with foot infection and in association with decubitus ulcers presents special problems. Radionuclide scanning often give false-positive results in these patients. Proper diagnosis usually requires careful assessment of clinical and roentgenographic findings. 33 references

  5. Alternating current electrical stimulation enhanced chemotherapy: a novel strategy to bypass multidrug resistance in tumor cells

    International Nuclear Information System (INIS)

    Tumor burden can be pharmacologically controlled by inhibiting cell division and by direct, specific toxicity to the cancerous tissue. Unfortunately, tumors often develop intrinsic pharmacoresistance mediated by specialized drug extrusion mechanisms such as P-glycoprotein. As a consequence, malignant cells may become insensitive to various anti-cancer drugs. Recent studies have shown that low intensity very low frequency electrical stimulation by alternating current (AC) reduces the proliferation of different tumor cell lines by a mechanism affecting potassium channels while at intermediate frequencies interfere with cytoskeletal mechanisms of cell division. The aim of the present study is to test the hypothesis that permeability of several MDR1 over-expressing tumor cell lines to the chemotherapic agent doxorubicin is enhanced by low frequency, low intensity AC stimulation. We grew human and rodent cells (C6, HT-1080, H-1299, SKOV-3 and PC-3) which over-expressed MDR1 in 24-well Petri dishes equipped with an array of stainless steel electrodes connected to a computer via a programmable I/O board. We used a dedicated program to generate and monitor the electrical stimulation protocol. Parallel cultures were exposed for 3 hours to increasing concentrations (1, 2, 4, and 8 μM) of doxorubicin following stimulation to 50 Hz AC (7.5 μA) or MDR1 inhibitor XR9576. Cell viability was assessed by determination of adenylate kinase (AK) release. The relationship between MDR1 expression and the intracellular accumulation of doxorubicin as well as the cellular distribution of MDR1 was investigated by computerized image analysis immunohistochemistry and Western blot techniques. By the use of a variety of tumor cell lines, we show that low frequency, low intensity AC stimulation enhances chemotherapeutic efficacy. This effect was due to an altered expression of intrinsic cellular drug resistance mechanisms. Immunohistochemical, Western blot and fluorescence analysis revealed

  6. Alternating current electrical stimulation enhanced chemotherapy: a novel strategy to bypass multidrug resistance in tumor cells

    Directory of Open Access Journals (Sweden)

    Dini Gabriele

    2006-03-01

    Full Text Available Abstract Background Tumor burden can be pharmacologically controlled by inhibiting cell division and by direct, specific toxicity to the cancerous tissue. Unfortunately, tumors often develop intrinsic pharmacoresistance mediated by specialized drug extrusion mechanisms such as P-glycoprotein. As a consequence, malignant cells may become insensitive to various anti-cancer drugs. Recent studies have shown that low intensity very low frequency electrical stimulation by alternating current (AC reduces the proliferation of different tumor cell lines by a mechanism affecting potassium channels while at intermediate frequencies interfere with cytoskeletal mechanisms of cell division. The aim of the present study is to test the hypothesis that permeability of several MDR1 over-expressing tumor cell lines to the chemotherapic agent doxorubicin is enhanced by low frequency, low intensity AC stimulation. Methods We grew human and rodent cells (C6, HT-1080, H-1299, SKOV-3 and PC-3 which over-expressed MDR1 in 24-well Petri dishes equipped with an array of stainless steel electrodes connected to a computer via a programmable I/O board. We used a dedicated program to generate and monitor the electrical stimulation protocol. Parallel cultures were exposed for 3 hours to increasing concentrations (1, 2, 4, and 8 μM of doxorubicin following stimulation to 50 Hz AC (7.5 μA or MDR1 inhibitor XR9576. Cell viability was assessed by determination of adenylate kinase (AK release. The relationship between MDR1 expression and the intracellular accumulation of doxorubicin as well as the cellular distribution of MDR1 was investigated by computerized image analysis immunohistochemistry and Western blot techniques. Results By the use of a variety of tumor cell lines, we show that low frequency, low intensity AC stimulation enhances chemotherapeutic efficacy. This effect was due to an altered expression of intrinsic cellular drug resistance mechanisms. Immunohistochemical

  7. 'Doctor Google' ending the diagnostic odyssey in lysosomal storage disorders: parents using internet search engines as an efficient diagnostic strategy in rare diseases

    OpenAIRE

    Bouwman, M.G.; Teunissen, Q.G.A.; Wijburg, F A; Linthorst, G.E.

    2010-01-01

    The expansion of the internet has resulted in widespread availability of medical information for both patients and physicians. People increasingly spend time on the internet searching for an explanation, diagnosis or treatment for their symptoms. Regarding rare diseases, the use of the internet may be an important tool in the diagnostic process. The authors present two cases in which concerned parents made a correct diagnosis of a lysosomal storage disorder in their child by searching the int...

  8. Finding Happiness in Wisdom and Compassion - The Real Challenge for an Alternative Development Strategy

    Directory of Open Access Journals (Sweden)

    Dr. Ross McDonald

    2003-01-01

    Full Text Available The underlying development philosophy of globalisation seeks to maximise happiness through the cultivation of a narrow materialist self-interest and competitiveness, both at the level of the individual and at the level of the nation-state. Despite voluminous evidence that this growth-fixated model of material economy polarises global well-being and seriously undermines environmental security, most, in the developed world at least, seem perfectly content to continue achieving happiness in irresponsible ways. This paper explores the deeper dynamics of an economic ideology of which GNP is only the most visible aspect and asks whether Bhutan’s search for an alternative approach really entails the search for a more responsible form of happiness – one that inherently involves a more compassionate mode of being in the world. Using the Four Pillars of Gross National Happinessas a framework, it argues that the cultivation of a deeper happiness lies in ensuring that the inter-dependent realms of culture, good governance, economy and the environment remain in sustainable balance. If Buddhist understandings are accurate, then on-going happiness can only be truly found through this critical balancing. Thus, if a means for measuring the vitality of these four components can be developed then Bhutan can build a strong foundation for genuinely advancing beyond the irresponsible and unsustainable means employed by others in their search for a more fleeting form of satisfaction.

  9. HLA mismatching as a strategy to reduce relapse after alternative donor transplantation.

    Science.gov (United States)

    Fleischhauer, Katharina; Beelen, Dietrich W

    2016-04-01

    Human leukocyte antigen (HLA) mismatches are targets of alloreactive T cells, mediators of graft-versus-leukemia (GvL) and graft-versus-host disease (GvHD) after alternative donor transplantation. Exploitation of HLA mismatching in order to reduce relapse is hampered by necessary interventions aimed at controlling GvHD on the one hand, and by the possibility of immune escape through selective loss of mismatched HLA in relapsing leukemia on the other. Retrospective studies reporting the impact of HLA mismatches on post-transplant relapse need to be interpreted with caution, due to many confounding factors, including disease and use of T-cell depletion, and to be constantly updated to the rapidly changing clinical protocols. Current evidence suggests similar relapse rates for 8/8, 7/8 HLA-matched unrelated, T-cell-replete haploidentical and umbilical cord blood transplantation; however, investigations of locus-specific effects are still scarce in the latter two settings. In unrelated transplantation, a specific role for mismatches at HLA-C and HLA-DPB1, and therein of permissive mismatches defined on the basis of T-cell alloreactivity and/or expression levels, in reducing relapse has been demonstrated in independent studies. This observation suggests new approaches to utilize HLA matching in unrelated donor searches, and the need for further research in the field. PMID:27000727

  10. A simplified and less expensive strategy for confirming anti HIV-1 screening results in a diagnostic laboratory in Lubumbashi, Zaire.

    Science.gov (United States)

    Laleman, G; Kambale, M; Van Kerckhoven, I; Kapila, N; Konde, M; Selemani, U; Piot, P; van der Groen, G

    1991-12-01

    The conventional algorithm for HIV testing based on the confirmation of all positive anti-HIV screening reactions by Western blot (WB) is too expensive for developing countries. We investigated the validity of confirming positive screening assay reactions by a second screening test, limiting the use of the supplemental assay to the discrepant test results (algorithm 3), or screening all sera with 2 different assays and retesting all discrepant results by a supplemental assay (algorithm 4) on a panel of 519 sera in a regional reference laboratory in Lubumbashi, Zaire. Combining the Vironostika anti-HTLV-III ELISA with HIV Chek 1 + 2 or Clonatec Rapid HIV 1/2 Ab on all samples and retesting the discrepant results in WB or a line immunoassay (INNO-LIA) (algorithm 4), yielded a sensitivity of 100% and specificities of 98.4% and 99.0% respectively, at costs of 7.3 US $ and 9.3 US $ per test, respectively, for a 40% prevalence of HIV antibody positive samples. The conventional algorithm scored a sensitivity of 97.1% and a specificity of 100% for 11.3 US $ per test. The testing strategy of combining HIV Chek 1 + 2 and Clonatec Rapid HIV 1/2 Ab, an interesting option for small isolated centra, had a 96.6% sensitivity, but yielded only a slightly better specificity of 99.0%, as compared to 97.8% for HIV Chek alone. The price of combining the two simple assays using algorithm 3 was 6.8 US $ per test, using algorithm 4 was 10.6 US $. HIV testing strategies based on ELISA and a simple HIV test are a valuable alternative for reference laboratories faced with a high prevalence of HIV positive samples. PMID:1789703

  11. Draft Programmatic Environmental Impact Statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 2: Appendices

    International Nuclear Information System (INIS)

    This PEIS assesses the potential impacts of alternative management of alternative management strategies for depleted uranium hexafluoride (UF6) currently stored at three DOE sites: Paducah site near Paducah, Kentucky; Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF6, long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. The preferred alternative for the long-term management of depleted UF6 is to use the entire inventory of material. This volume contains the appendices to volume I

  12. Draft Programmatic Environmental Impact Statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 1: Main text

    International Nuclear Information System (INIS)

    This PEIS assesses the potential impacts of alternative management of alternative management strategies for depleted uranium hexafluoride (UF6) currently stored at three DOE sites: Paducah site near Paducah, Kentucky; Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF6, long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. The preferred alternative for the long-term management of depleted UF6 is to use the entire inventory of material

  13. Control strategy minimizing the converter-alternating current motor losses: application to electric traction; Strategies de commande minimisant les pertes d'un ensemble convertisseur - machine alternative: application a la traction electrique

    Energy Technology Data Exchange (ETDEWEB)

    Bastiani, Ph.

    2001-02-01

    Improving the efficiency of the converter-alternating current motor system is a major task in electric traction. Global energy optimisation implies a specific approach at system scale. To reach this goal, we have chosen an algebraic method using sub-system models. To start with, a synchronous machine Park model is developed to take account magnetic saturation and iron losses. Then, an averaged model of the voltage inverter is used in order to obtain a simplified model of the losses to be implemented in our optimisation method. This is how the global model is built including losses in the synchronous machine along with the losses of the power converter. Experimental results are there to validate our approach. This study proposes a method based on algebraic formulation of the general laws to control torque. Algorithms take into account magnetic circuits saturation and power losses in both the machine and its converter. Here again, experimental results validate the algorithm on several test benches. Achieved efficiency improvement is important compared to existing usual control strategies. The proposed method can be generalised to other machine-converter systems. As a matter of fact we have extended our study to the induction machine. As a complement ti this study we have looked at the effects natural limitations of voltages and currents in the torque-speed plane. Therefore algebraic formulation of the torque-speed plane and optimisation strategies are proposed including those constraints. (author)

  14. Optimum depressurization and an alternate injection strategy for a station blackout event

    International Nuclear Information System (INIS)

    Since the crisis at the Fukushima plants, the severe accident progression during a station blackout accident in nuclear power plants is recognized as a very important area for accident management and emergency planning. A station blackout (SBO) scenario for an APR1400 nuclear power plant is simulated using the MELCOR computer code. A reactor coolant system (RCS) depressurization by a safety depressurization system (SDS) for water to be injected into the reactor pressure vessel (RPV) is performed as a mitigation action. The purpose of this study is to investigate the effect of the SDS actuation timing on the accident progression and determine the optimum depressurization strategy to prevent core damage and a reactor vessel failure. SBO without SDS actuation is analyzed as a base case to understand the main phenomena during SBO accident. In base case, the RPV lower head will fail after 4.2 hours since SBO occurs. SBO with SDS actuation is performed by changing the SDS actuation timing to inject water into RPV. The results show that the RPV lower head failure can be prevented if SDS is opened no later than 3.5 hour. Sensitivity study on some main parameters in MELCOR is also performed to see the effect of these parameters on the failure time of the lower head in an SBO accident. (author)

  15. Alternate strategy for commercial high-level radioactive-waste management

    International Nuclear Information System (INIS)

    A current strategy of geologic disposal of immobilized commercial, high-level, nuclear wastes provides long-term storage (hundreds of thousands of years) for a wide spectrum of wastes from the Purex process which would be immobilized in a borosilicate glass. When implaced in a repository, the temperature increases and peaks within the geologic formations housing the waste repository during the first several hundred years after burial and then declines towards the initial temperature. During this thermal and radiolysis pulse period, the geologic formation and waste packages could be significantly perturbed unless the effects are controlled by some engineered approach. Many of the proposed solutions introduce new economic penalties and/or have serious impacts on how the volume of waste must be handled in production, transportation and final interment in the repository. It is noted that the majority of the thermal energy (has high as 98% after 30 years) in commercial waste aged between 3 and 150 years is due to only two radioactive isotopes, 90Sr and 137Cs and their decay chains, which constitute < 10 wt. % of the total elements in HLW. Thus removal of cesium and strontium from all the other HLW components greatly reduces the geologic/waste package perturbations caused by the thermal/radiolysis pulse

  16. Alternative feeding strategies and potential disease transmission in Wisconsin white-tailed deer

    Science.gov (United States)

    Thompson, A.K.; Samuel, M.D.; VanDeelen, T.R.

    2008-01-01

    We conducted experimental feeding using 3 feeding methods (pile, spread, trough) and 2 quantities (rationed, ad libitum) of shelled corn to compare deer activity and behavior with control sites and evaluate potential direct and indirect transmission of infectious disease in white-tailed deer (Odocoileus virginianus) in central Wisconsin, USA. Deer use was higher at 2 of the feeding sites than at natural feeding areas (P ??? 0.02). Deer spent a higher proportion of time (P < 0.01) feeding at pile (49%) and spread (61%) treatments than at natural feeding areas (36%). We found higher deer use for rationed than ad libitum feeding quantities and feeding intensity was greatest at rationed piles and lowest at ad libitum spreads. We also observed closer pairwise distances (???0.3 m) among deer when corn was provided in a trough relative to spread (P=0.03). Supplemental feeding poses risks for both direct and indirect disease transmission due to higher deer concentration and more intensive use relative to control areas. Concentrated feeding and contact among deer at feeding sites can also increase risk for disease transmission. Our results indicated that restrictions on feeding quantity would not mitigate the potential for disease transmission None of the feeding strategies we evaluated substantially reduced the potential risk for disease transmission and banning supplemental feeding to reduce transmission is warranted.

  17. Alternative Glycerol Balance Strategies among Saccharomyces Species in Response to Winemaking Stress

    Science.gov (United States)

    Pérez-Torrado, Roberto; Oliveira, Bruno M.; Zemančíková, Jana; Sychrová, Hana; Querol, Amparo

    2016-01-01

    Production and balance of glycerol is essential for the survival of yeast cells in certain stressful conditions as hyperosmotic or cold shock that occur during industrial processes as winemaking. These stress responses are well-known in S. cerevisiae, however, little is known in other phylogenetically close related Saccharomyces species associated with natural or fermentation environments such as S. uvarum, S. paradoxus or S. kudriavzevii. In this work we have investigated the expression of four genes (GPD1, GPD2, STL1, and FPS1) crucial in the glycerol pool balance in the four species with a biotechnological potential (S. cerevisiae; S. paradoxus; S. uvarum; and S. kudriavzevii), and the ability of strains to grow under osmotic and cold stresses. The results show different pattern and level of expression among the different species, especially for STL1. We also studied the function of Stl1 glycerol symporter in the survival to osmotic changes and cell growth capacity in winemaking environments. These experiments also revealed a different functionality of the glycerol transporters among the different species studied. All these data point to different strategies to handle glycerol accumulation in response to winemaking stresses as hyperosmotic or cold-hyperosmotic stress in the different species, with variable emphasis in the production, influx, or efflux of glycerol. PMID:27064588

  18. Multiple intelligences and alternative teaching strategies: The effects on student academic achievement, conceptual understanding, and attitude

    Science.gov (United States)

    Baragona, Michelle

    The purpose of this study was to investigate the interactions between multiple intelligence strengths and alternative teaching methods on student academic achievement, conceptual understanding and attitudes. The design was a quasi-experimental study, in which students enrolled in Principles of Anatomy and Physiology, a developmental biology course, received lecture only, problem-based learning with lecture, or peer teaching with lecture. These students completed the Multiple Intelligence Inventory to determine their intelligence strengths, the Students' Motivation Toward Science Learning questionnaire to determine student attitudes towards learning in science, multiple choice tests to determine academic achievement, and open-ended questions to determine conceptual understanding. Effects of intelligence types and teaching methods on academic achievement and conceptual understanding were determined statistically by repeated measures ANOVAs. No significance occurred in academic achievement scores due to lab group or due to teaching method used; however, significant interactions between group and teaching method did occur in students with strengths in logical-mathematical, interpersonal, kinesthetic, and intrapersonal intelligences. Post-hoc analysis using Tukey HSD tests revealed students with strengths in logical-mathematical intelligence and enrolled in Group Three scored significantly higher when taught by problem-based learning (PBL) as compared to peer teaching (PT). No significance occurred in conceptual understanding scores due to lab group or due to teaching method used; however, significant interactions between group and teaching method did occur in students with strengths in musical, kinesthetic, intrapersonal, and spatial intelligences. Post-hoc analysis using Tukey HSD tests revealed students with strengths in logical-mathematical intelligence and enrolled in Group Three scored significantly higher when taught by lecture as compared to PBL. Students with

  19. Mentoring for text editors: Fit for purpose in the era of freelancing, more so than alternative development strategies

    Directory of Open Access Journals (Sweden)

    John Linnegar

    2015-12-01

    Full Text Available In this article, the supportive role that mentoring relationships currently do and should play in the development and careers of text editors is described against the background of the particular circumstances of these service providers in a sector experiencing great organisational and technological changes. This is a group that is much neglected in the literature on mentoring. Since the mentoring of text editors is distinct from other forms of mentoring in a number of key respects, this article draws together what the literature has to say about both conventional and online or distance mentoring as performed in a range of contexts. I consider the application of Knowles’ (1970, 1984 adult learning theory and Bandura’s (1977 self-efficacy mechanisms to be important potential contributors to the success of mentorships, in particular those involving adult text editors. The article also critically analyses how mentoring for text editors can be distinguished from alternative development strategies such as coaching, training, teaching and counselling. It shows that mentoring is fundamentally different from these strategies according to ten criteria, and is better suited to text editors’ need for professional development as a form of lifelong adult e-learning. The lack of any form of assessment of mentees, in particular, is regarded as a weakness of the currently available mentorship programmes aiming to professionalise adult text editors through a process of lifelong learning.

  20. Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro [National Cancer Center Hospital, Division of Diagnostic Radiology, Tokyo (Japan); Kobe University, Department of Radiology, Graduate School of Medicine, Kobe (Japan); Tsurusaki, Masakatsu [National Cancer Center Hospital, Division of Diagnostic Radiology, Tokyo (Japan); Kinki University, Department of Radiology, Faculty of Medicine, Osakasayama, Osaka (Japan); Murakami, Takamichi [Kinki University, Department of Radiology, Faculty of Medicine, Osakasayama, Osaka (Japan); Onoe, Shunsuke [National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Surgery, Tokyo (Japan); Tokue, Hiroyuki; Shibamoto, Kentaro; Arai, Yasuaki [National Cancer Center Hospital, Division of Diagnostic Radiology, Tokyo (Japan); Sugimura, Kazuro [Kobe University, Department of Radiology, Graduate School of Medicine, Kobe (Japan)

    2014-10-15

    To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy. A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated. Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients. The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients. (orig.)

  1. Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?

    International Nuclear Information System (INIS)

    To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy. A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated. Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients. The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients. (orig.)

  2. FUZZY SIMPLE ADDITIVE WEIGHTING BASED, DECISION SUPPORT SYSTEM APPLICATION FOR ALTERNATIVE CONFUSION REDUCTION STRATEGY IN SMARTPHONE PURCHASES

    Directory of Open Access Journals (Sweden)

    Robertus Nugroho Perwiro Atmojo

    2014-01-01

    Full Text Available Consumer confusion is a phenomena when the consumer experiencing several confusion problems when she/he should to purchase products/services. Usually, consumer will do a strategy to coping the confusion, that strategy is known as Confusion Reduction Strategy. The conventional ways usually taken by the consumer to reduce the confusion are, such as: Asking for product recommendation to close relatives, seeking for an additional product information on the internet and so on. However, suggestions and recommendations from conventional sources obtained by the consumer, sometimes are not always accurate (not objective and time consuming (inefficient. Therefore, this research proposes a Decision Support System (DSS application to cope with the confusion. In this study, the comparison results between conventional methods (such as: Asking advice to close relatives or seeking for an additional information on the internet with the proposed method (the DSS were presented. In addition, another implication of this study is to get the factors that causing consumer confusion in case of smartphone purchases. This research used mixed-method approach, implemented through interview and survey. Research samples were 136 potential smartphone buyers which are converted to 27 smartphone buyers; brand image is the main source of consumer confusion (mean 3.98, std. dev 0.86, followed by proliferation of brands, services and models of smartphone products (mean 3.89, std. dev 0.82. Respondents often use Word of Mouth (WoM communication as main source of information to reduce the confusion, results of 16 from 27 transactions were contributed from WoM. DSS application contributed only 2 of 27 smartphone transactions. Further research for the development of mobile based DSS application as an alternative conventional CRS needs to be conducted, because of the potential success of static desktop based DSS application in reducing potential consumer confusion especially for value

  3. Methodology for assessing alternative water-acquisition-and-use strategies for energy facilities in the American West

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, J.J.; Adams, E.E.; Harleman, D.R.F.; Marks, D.H.

    1981-12-01

    A method for assessing alternative strategies for acquiring and using water at western energy plants was developed. The method was tested in a case study of cooling-water use for a hypothetical steam-electric power plant on the Crazy Woman Creek, an unregulated stream in Wyoming. The results from the case study suggest a careful analysis of reservoir design and water-right purchase strategies can reduce the cost of acquiring and using water at an energy facility. The method uses simulation models to assess the capital and operating costs and expected monthly water-consumption rates for different cooling-system designs. The method also uses reservoir operating algorithms to select, for a fixed cooling-system design, the optimal tradeoff between building a make-up water reservoir and purchasing water rights. These tradeoffs can be used to derive the firm's true demand curve for different sources of water. The analysis also reveals the implicit cost of selecting strategies that minimize conflicts with other water users. Results indicate that: (1) cooling ponds are as good as or preferred to wet towers because their costs already include provisions for storing water for use during the normally dry summer months and during occasional drought years; (2) the energy firm's demand for overall water consumption in the cooling system was found to be inversely proportional to both the cost of installing make-up water reservoirs, and the size of the energy facility; and (3) the firm's willingness to pay for existing rights is proportional to both the cost of installing reservoirs, and the size of the energy facility.

  4. Modeling Hydrology, Phosphorus and Ecology in the Hampshire Avon Catchment to Assess Alternative Strategies to Improve Water Quality

    Science.gov (United States)

    Jin, L.; Whitehead, P. G.; Crossman, J.

    2013-12-01

    Phosphorus (P) enrichment is a worldwide issue of fresh river systems that causes algae blooms, oxygen decline and eutrophication. Therefore, controlling the input of nutrients especially P into aquatic ecosystems is a crucial management focus across much of the world. For example, approximately 70% of water bodies in the Hampshire Avon catchment (UK) are considered not in a good ecological condition due to excess soluble reactive phosphorus (SRP) in the water. In this work, we explored the issues of diffuse and point source P pollution in the Hampshire Avon catchment using an integrated catchment model (INCA) and further we used the model to assess different management options for P reduction. A multi-branch, process based, dynamic water quality model (INCA-P) has been applied to the whole Hampshire Avon river system to simulate water fluxes, concentrations of total phosphorus (TP) and SRP, and ecology. The model has been used to assess impacts of both agricultural runoff and point sources from Waste Water Treatment Plants (WWTPs) on water quality. The results showed that agriculture contributes approximately 40% of the P load and point sources contribute the other 60%. A set of scenarios have been investigated to assess the impacts of alternative P reduction strategies and results suggest that a combined strategy of agricultural P reduction through either fertilizer reductions or better P management together with improved treatment at WWTPs would reduce the SRP concentrations in the river to acceptable levels to meet the European legislation e.g. Water Framework Directive requirements. A seasonal strategy for P reductions from WWTPs would achieve significant benefits at reduced cost.

  5. Strategies in protein sequencing and characterization: Multi-enzyme digestion coupled with alternate CID/ETD tandem mass spectrometry

    International Nuclear Information System (INIS)

    Highlights: • Multi-enzyme digestion for protein sequencing and characterization by CID/ETD. • Simultaneous use of trypsin/chymotrypsin for the maximization of sequence. • Identification of PTMs, sequence variants and species-specific residues. • Increase of accuracy in sequence assignments by orthogonal fragmentation techniques. - Abstract: A strategy based on a simultaneous multi-enzyme digestion coupled with electron transfer dissociation (ETD) and collision-induced dissociation (CID) was developed for protein sequencing and characterization, as a valid alternative platform in ion-trap based proteomics. The effect of different proteolytic procedures using chymotrypsin, trypsin, a combination of both, and Lys-C, was carefully evaluated in terms of number of identified peptides, protein coverage, and score distribution. A systematic comparison between CID and ETD is shown for the analysis of peptides originating from the in-solution digestion of standard caseins. The best results were achieved with a trypsin/chymotrypsin mix combined with CID and ETD operating in alternating mode. A post-database search validation of MS/MS dataset was performed, then, the matched peptides were cross checked by the evaluation of ion scores, rank, number of experimental product ions, and their relative abundances in the MS/MS spectrum. By integrated CID/ETD experiments, high quality-spectra have been obtained, thus allowing a confirmation of spectral information and an increase of accuracy in peptide sequence assignments. Overlapping peptides, produced throughout the proteins, reduce the ambiguity in mapping modifications between natural variants and animal species, and allow the characterization of post translational modifications. The advantages of using the enzymatic mix trypsin/chymotrypsin were confirmed by the nanoLC and CID/ETD tandem mass spectrometry of goat milk proteins, previously separated by two-dimensional gel electrophoresis

  6. Strategies in protein sequencing and characterization: Multi-enzyme digestion coupled with alternate CID/ETD tandem mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Nardiello, Donatella; Palermo, Carmen, E-mail: carmen.palermo@unifg.it; Natale, Anna; Quinto, Maurizio; Centonze, Diego

    2015-01-07

    Highlights: • Multi-enzyme digestion for protein sequencing and characterization by CID/ETD. • Simultaneous use of trypsin/chymotrypsin for the maximization of sequence. • Identification of PTMs, sequence variants and species-specific residues. • Increase of accuracy in sequence assignments by orthogonal fragmentation techniques. - Abstract: A strategy based on a simultaneous multi-enzyme digestion coupled with electron transfer dissociation (ETD) and collision-induced dissociation (CID) was developed for protein sequencing and characterization, as a valid alternative platform in ion-trap based proteomics. The effect of different proteolytic procedures using chymotrypsin, trypsin, a combination of both, and Lys-C, was carefully evaluated in terms of number of identified peptides, protein coverage, and score distribution. A systematic comparison between CID and ETD is shown for the analysis of peptides originating from the in-solution digestion of standard caseins. The best results were achieved with a trypsin/chymotrypsin mix combined with CID and ETD operating in alternating mode. A post-database search validation of MS/MS dataset was performed, then, the matched peptides were cross checked by the evaluation of ion scores, rank, number of experimental product ions, and their relative abundances in the MS/MS spectrum. By integrated CID/ETD experiments, high quality-spectra have been obtained, thus allowing a confirmation of spectral information and an increase of accuracy in peptide sequence assignments. Overlapping peptides, produced throughout the proteins, reduce the ambiguity in mapping modifications between natural variants and animal species, and allow the characterization of post translational modifications. The advantages of using the enzymatic mix trypsin/chymotrypsin were confirmed by the nanoLC and CID/ETD tandem mass spectrometry of goat milk proteins, previously separated by two-dimensional gel electrophoresis.

  7. Advancing Risk Analysis for Nanoscale Materials: Report from an International Workshop on the Role of Alternative Testing Strategies for Advancement.

    Science.gov (United States)

    Shatkin, J A; Ong, Kimberly J; Beaudrie, Christian; Clippinger, Amy J; Hendren, Christine Ogilvie; Haber, Lynne T; Hill, Myriam; Holden, Patricia; Kennedy, Alan J; Kim, Baram; MacDonell, Margaret; Powers, Christina M; Sharma, Monita; Sheremeta, Lorraine; Stone, Vicki; Sultan, Yasir; Turley, Audrey; White, Ronald H

    2016-08-01

    The Society for Risk Analysis (SRA) has a history of bringing thought leadership to topics of emerging risk. In September 2014, the SRA Emerging Nanoscale Materials Specialty Group convened an international workshop to examine the use of alternative testing strategies (ATS) for manufactured nanomaterials (NM) from a risk analysis perspective. Experts in NM environmental health and safety, human health, ecotoxicology, regulatory compliance, risk analysis, and ATS evaluated and discussed the state of the science for in vitro and other alternatives to traditional toxicology testing for NM. Based on this review, experts recommended immediate and near-term actions that would advance ATS use in NM risk assessment. Three focal areas-human health, ecological health, and exposure considerations-shaped deliberations about information needs, priorities, and the next steps required to increase confidence in and use of ATS in NM risk assessment. The deliberations revealed that ATS are now being used for screening, and that, in the near term, ATS could be developed for use in read-across or categorization decision making within certain regulatory frameworks. Participants recognized that leadership is required from within the scientific community to address basic challenges, including standardizing materials, protocols, techniques and reporting, and designing experiments relevant to real-world conditions, as well as coordination and sharing of large-scale collaborations and data. Experts agreed that it will be critical to include experimental parameters that can support the development of adverse outcome pathways. Numerous other insightful ideas for investment in ATS emerged throughout the discussions and are further highlighted in this article. PMID:27510619

  8. Ketamine Infusion Therapy as an Alternative Pain Control Strategy in Patients with Multi-Trauma including Rib Fracture; Case Report and Literature Review

    OpenAIRE

    Ashley K Losing; Justin M Jones; Adis Keric; Steven E Briggs; Leedahl, David D.

    2016-01-01

    Ketamine is a promising alternative agent for pain control that offers benefit to traditional strategies, particularly in the setting of rib fracture. Current pharmacologic therapies have clear adverse effects, and other options may be invasive, cost prohibitive, or marginally effective. We describe three consecutive patients with traumatic injuries including rib fracture for which a ketamine infusion was utilized as part of their pain control strategy. For each patient, use of a ketamine in...

  9. Currently Available Biomarkers and Strategies for the Validation of Novel Candidates for Neurochemical Dementia Diagnostics in Alzheimer’s Disease and Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Piotr Lewczuk

    2014-01-01

    Full Text Available The number of people afflicted with Alzheimer’s disease (AD and other types of dementing conditions has grown exponentially in the last decades. This review focuses on the diagnostic role of the classic cerebrospinal fluid (CSF biomarkers of neurochemical dementia diagnostics (NDD and critically discusses potential strategies for the development and validation of novel potential candidates. In some countries, NDD is already established as a routine diagnostic tool, used for the evaluation of patients with cognitive impairments. On the other hand, preanalytical and technical issues, partly discussed in this paper, prevent NDD from the general acceptance worldwide. Currently, two groups of biomarkers in the CSF are considered in NDD: amyloid β (Aβ peptides and Tau proteins, including the hyperphosphorylated forms of the latter (pTau. The analyses of these two groups of biomarkers can reveal pathologic alterations as early as twenty years before the onset of clinical symptoms. In mild cognitive impairment (MCI, NDD can reliably predict which individuals are at risk of converting to AD. The roles of biomarkers of amyloid β deposition in the brain tissue (including the CSF concentration of Aβ42 and biomarkers of neurodegeneration (including the CSF concentrations of Tau/pTau proteins are reflected in the currently proposed diagnostic criteria for AD and MCI.

  10. The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke

    Directory of Open Access Journals (Sweden)

    Barela Ana MF

    2009-12-01

    Full Text Available Abstract Background Body weight support (BWS systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training. Methods Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments. Results The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions. Conclusion Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical

  11. Evaluation Outcomes Associated with Alternative Dosing Strategies for Piperacillin/Tazobactam: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Yang, Hui; Cui, Xiangli; Ma, Zhuo; Liu, Lihong

    2016-01-01

    A better dosing strategy can improve clinical outcomes for patients. We systematically reviewed the literatures to determine whether any clinical benefits exist for piperacillin/tazobactam by extended or continuous infusion. Methods - A search of PubMed, Web of Science, ProQuest, ScienceDirect, Cochrane, Embase and related ICAAC and ACCP conferences were conducted up to September 5, 2015. Randomized controlled and observational studies that compared extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam were identified from the databases above and analyzed. Two reviewers independently evaluated the methodology and extracted data from primary studies. A meta-analysis was performed using Revman 5.2 software. The quality of each study was assessed. Sensitivity analysis and publication bias were evaluated. Results - Three randomized controlled trials and twelve observational studies were included in this study. All included studies had high quality and no publication bias was found. Compared to the conventional intermittent infusion approach, the extended or continuous infusion group had a significant cost effectiveness (OR -0.89.02, CI (-114.69,-63.35), P<0.00001). No statistical difference was observed for clinical cure rate (OR 1.64, 95% CI (0.88, 3.30), P=0.12) between the two dosing regimens. The sensitivity analysis showed the results were stable. Conclusions - Our systematic review and meta-analysis found that the outcomes associated with alternative dosing strategies of piperacillin/tazobactam have changed compared with conclusions before for several literatures with large samples published. Further data on the outcomes should be generated for a better understanding of the extended or continuous infusion strategy. On the whole, our meta-analysis suggested that the extended or continuous infusion should be recommended for clinical use only considering its economic advantage, but there was no significantly higher

  12. Augmented telomerase activity, reduced telomere length and the presence of alternative lengthening of telomere in renal cell carcinoma: plausible predictive and diagnostic markers.

    Science.gov (United States)

    Pal, Deeksha; Sharma, Ujjawal; Khajuria, Ragini; Singh, Shrawan Kumar; Kakkar, Nandita; Prasad, Rajendra

    2015-05-15

    In this study, we analyzed 100 cases of renal cell carcinoma (RCC) for telomerase activity, telomere length and alternative lengthening of telomeres (ALT) using the TRAP assay, TeloTTAGGG assay kit and immunohistochemical analysis of ALT associated promyelocytic leukemia (PML) bodies respectively. A significantly higher (P=0.000) telomerase activity was observed in 81 cases of RCC which was correlated with clinicopathological features of tumor for instance, stage (P=0.008) and grades (P=0.000) but not with the subtypes of RCC (P = 0.355). Notwithstanding, no correlation was found between telomerase activity and subtypes of RCC. Strikingly, the telomere length was found to be significantly shorter in RCC (P=0.000) to that of corresponding normal renal tissues and it is well correlated with grades (P=0.016) but not with stages (P=0.202) and subtypes (P=0.669) of RCC. In this study, telomere length was also negatively correlated with the age of patients (r(2)=0.528; P=0.000) which supports the notion that it could be used as a marker for biological aging. ALT associated PML bodies containing PML protein was found in telomerase negative cases of RCC. It suggests the presence of an ALT pathway mechanism to maintain the telomere length in telomerase negative RCC tissues which was associated with high stages of RCC, suggesting a prevalent mechanism for telomere maintenance in high stages. In conclusion, the telomerase activity and telomere length can be used as a diagnostic as well as a predictive marker in RCC. The prevalence of ALT mechanism in high stages of RCC is warranted for the development of anti-ALT inhibitors along with telomerase inhibitor against RCC as a therapeutic approach. PMID:25769384

  13. Designing alternative strategies for the European industry according to its strength and weaknesses and taking into consideration the opportunities and threats of the PV market

    International Nuclear Information System (INIS)

    The objectives were to generate a variety of strategies to identify alternative ways that the PV Sector can use its specific strengths to capitalize on opportunities or to avoid threats and to overcome its weaknesses. The so-called SWOT analysis provides a matrix illustrating how businesses can match the external opportunities and threats facing the sector with its internal strengths and weaknesses to yield in possible strategic alternatives. This method lends itself to brainstorming to create alternative strategies and actions, which might not otherwise be considered. In two working group meetings with participants from the PV industry, research and other stakeholders the SWOT were performed to result into implications for the PV sector. Through workshops the results will be discussed within an expert group and priorities for the future activities will be defined. The project is co-financed through the 6. Framework Programme of the EC. (authors)

  14. Designing alternative strategies for the European industry according to its strength and weaknesses and taking into consideration the opportunities and threats of the PV market

    Energy Technology Data Exchange (ETDEWEB)

    Viaud, M.; Despotou, E.; Latour, M.; Cameron, M. [European Photovoltaic Industry Association (EPIA), Brussels (Belgium); Weiss, I.; Baumann, J.; Stierstorfer, J.; Gisler, R. [WIP, Sylvensteinstr. 2, Munich (Germany)

    2004-07-01

    The objectives were to generate a variety of strategies to identify alternative ways that the PV Sector can use its specific strengths to capitalize on opportunities or to avoid threats and to overcome its weaknesses. The so-called SWOT analysis provides a matrix illustrating how businesses can match the external opportunities and threats facing the sector with its internal strengths and weaknesses to yield in possible strategic alternatives. This method lends itself to brainstorming to create alternative strategies and actions, which might not otherwise be considered. In two working group meetings with participants from the PV industry, research and other stakeholders the SWOT were performed to result into implications for the PV sector. Through workshops the results will be discussed within an expert group and priorities for the future activities will be defined. The project is co-financed through the 6. Framework Programme of the EC. (authors)

  15. A strategy for establishing diagnostic and related services to dairy farmers in developing countries based on radioimmunoassay of progesterone in milk

    International Nuclear Information System (INIS)

    The radioimmunoassay (RIA) for progesterone in milk samples collected from cattle has been used for monitoring ovarian activity, diagnosis of pregnancy and non-pregnancy, assessment of the accuracy of oestrus detection and for surveying efficiency of artificial insemination services. The establishment of a service to dairy farmers in developing countries based on this technique has not been previously reported but there are clear potential benefits in such a service. A strategy was therefore developed for the establishment of diagnostic and related services to dairy farmers in Morocco on a pilot basis, using RIA of progesterone in milk for possible adoption as a model for other developing countries. (author)

  16. Optimising the diagnostic strategy for onychomycosis from sample collection to FUNGAL identification evaluation of a diagnostic kit for real-time PCR.

    Science.gov (United States)

    Petinataud, Dimitri; Berger, Sibel; Ferdynus, Cyril; Debourgogne, Anne; Contet-Audonneau, Nelly; Machouart, Marie

    2016-05-01

    Onychomycosis is a common nail disorder mainly due to dermatophytes for which the conventional diagnosis requires direct microscopic observation and culture of a biological sample. Nevertheless, antifungal treatments are commonly prescribed without a mycological examination having been performed, partly because of the slow growth of dermatophytes. Therefore, molecular biology has been applied to this pathology, to support a quick and accurate distinction between onychomycosis and other nail damage. Commercial kits are now available from several companies for improving traditional microbiological diagnosis. In this paper, we present the first evaluation of the real-time PCR kit marketed by Bio Evolution for the diagnosis of dermatophytosis. Secondly, we compare the efficacy of the kit on optimal and non-optimal samples. This study was conducted on 180 nails samples, processed by conventional methods and retrospectively analysed using this kit. According to our results, this molecular kit has shown high specificity and sensitivity in detecting dermatophytes, regardless of sample quality. On the other hand, and as expected, optimal samples allowed the identification of a higher number of dermatophytes by conventional mycological diagnosis, compared to non-optimal samples. Finally, we have suggested several strategies for the practical use of such a kit in a medical laboratory for quick pathogen detection. PMID:26806228

  17. Ketamine Infusion Therapy as an Alternative Pain Control Strategy in Patients with Multi-Trauma including Rib Fracture; Case Report and Literature Review.

    Science.gov (United States)

    Losing, Ashley K; Jones, Justin M; Keric, Adis; Briggs, Steven E; Leedahl, David D

    2016-07-01

    Ketamine is a promising alternative agent for pain control that offers benefit to traditional strategies, particularly in the setting of rib fracture. Current pharmacologic therapies have clear adverse effects, and other options may be invasive, cost prohibitive, or marginally effective. We describe three consecutive patients with traumatic injuries including rib fracture for which a ketamine infusion was utilized as part of their pain control strategy.  For each patient, use of a ketamine infusion trended toward reduced opioid requirements with stable pain scores. One patient experienced a dissociative adverse effect prompting decrease and discontinuation of ketamine. No pulmonary complications in the form of emergent intubation or new diagnosis of pneumonia were observed. We believe the addition of ketamine infusion to be a valid alternative strategy for managing pain associated with rib fracture. PMID:27540552

  18. Ketamine Infusion Therapy as an Alternative Pain Control Strategy in Patients with Multi-Trauma including Rib Fracture; Case Report and Literature Review

    Science.gov (United States)

    Losing, Ashley K; Jones, Justin M; Keric, Adis; Briggs, Steven E; Leedahl, David D

    2016-01-01

    Ketamine is a promising alternative agent for pain control that offers benefit to traditional strategies, particularly in the setting of rib fracture. Current pharmacologic therapies have clear adverse effects, and other options may be invasive, cost prohibitive, or marginally effective. We describe three consecutive patients with traumatic injuries including rib fracture for which a ketamine infusion was utilized as part of their pain control strategy.  For each patient, use of a ketamine infusion trended toward reduced opioid requirements with stable pain scores. One patient experienced a dissociative adverse effect prompting decrease and discontinuation of ketamine. No pulmonary complications in the form of emergent intubation or new diagnosis of pneumonia were observed. We believe the addition of ketamine infusion to be a valid alternative strategy for managing pain associated with rib fracture.

  19. Cost-effectiveness of diagnostic strategies for the management of abnormal uterine bleeding (heavy menstrual bleeding and post-menopausal bleeding): a decision analysis.

    Science.gov (United States)

    Cooper, Natalie A M; Barton, Pelham M; Breijer, Maria; Caffrey, Orla; Opmeer, Brent C; Timmermans, Anne; Mol, Ben W J; Khan, Khalid S; Clark, T Justin

    2014-01-01

    BACKGROUND Heavy menstrual bleeding (HMB) and post-menopausal bleeding (PMB) together constitute the commonest gynaecological presentation in secondary care and impose substantial demands on health service resources. Accurate diagnosis is of key importance to realising effective treatment, reducing morbidity and, in the case of PMB, reducing mortality. There are many tests available, including transvaginal scan (TVS), endometrial biopsy (EBx), saline infusion sonography and outpatient hysteroscopy (OPH); however, optimal diagnostic work-up is unclear. OBJECTIVES To determine the most cost-effective diagnostic testing strategy for the diagnosis and treatment of (i) HMB and (ii) PMB. DATA SOURCES Parameter inputs were derived from systematic quantitative reviews, individual patient data (IPD) from existing data sets and focused searches for specific data. In the absence of data estimates, the consensus view of an expert clinical panel was obtained. METHODS Two clinically informed decision-analytic models were constructed to reflect current service provision for the diagnostic work-up of women presenting with HMB and PMB. The model-based economic evaluation took the form of a cost-effectiveness analysis from the perspective of the NHS in a contemporary, 'one-stop' secondary care clinical setting, where all indicated testing modalities would be available during a single visit. RESULTS Two potentially cost-effective testing strategies for the initial investigation of women with HMB were identified: OPH alone or in combination with EBx. Although a combination testing strategy of OPH + EBx was marginally more effective, the incremental cost-effectiveness ratio (ICER) was approximately £21,000 to gain one more satisfied patient, whereas for OPH it was just £360 when compared with treatment with the levonorgestrel intrauterine system (LNG-IUS) without investigation. Initial testing with OPH was the most cost-effective testing approach for women wishing to preserve

  20. Balance sheet method assessment for nitrogen fertilization in winter wheat: II. alternative strategies using the CropSyst simulation model

    Directory of Open Access Journals (Sweden)

    Maria Corbellini

    2006-09-01

    Full Text Available It is important, both for farmer profit and for the environment, to correctly dose fertilizer nitrogen (N for winter wheat growth. Balance-sheet methods are often used to calculate the recommended dose of N fertilizer. Other methods are based on the dynamic simulation of cropping systems. Aim of the work was to evaluate the balance-sheet method set up by the Region Emilia-Romagna (DPI, by comparing it with the cropping systems simulation model CropSyst (CS, and with an approach based on fixed supplies of N (T. A 3-year trial was structured as a series of N fertility regimes at 3 sites (Papiano di Marsciano, Ravenna, San Pancrazio. The N-regimes were generated at each site-year as separate trials in which 3 N rates were applied: N1 (DPI, N2 (DPI+50 kg ha-1 N at spike initiation, N3 (DPI + 50 kg ha-1 N at early booting. Above ground biomass and soil data (NO3-N and water were sampled and used to calibrate CS. Doses of fertilizer N were calculated by both DPI and CS for winter wheat included in three typical rotations for Central and Northern Italy. Both these methods and method T were simulated at each site over 50 years, by using daily generated weather data. The long-term simulation allowed evaluating such alternative fertilization strategies. DPI and CS estimated comparable crop yields and N leached amounts, and both resulted better than T. Minor risk of leaching emerged for all N doses. The N2 and N3 rates allowed slightly higher crop yields than N1.

  1. Genotyping-by-Sequencing SNP Identification for Crops without a Reference Genome: Using Transcriptome Based Mapping as an Alternative Strategy.

    Science.gov (United States)

    Berthouly-Salazar, Cécile; Mariac, Cédric; Couderc, Marie; Pouzadoux, Juliette; Floc'h, Jean-Baptiste; Vigouroux, Yves

    2016-01-01

    Next-generation sequencing opens the way for genomic studies of diversity even for non-model crops and animals. Genome reduction techniques are becoming progressively more popular as they allow a fraction of the genome to be sequenced for multiple individuals and/or populations. These techniques are an efficient way to explore genome diversity in non-model crops and animals for which no reference genome is available. Genome reduction techniques emerged with the development of specific pipelines such as UNEAK (Universal Network Enabled Analysis Kit) and Stacks. However, even for non-model crops and animals, transcriptomes are easier to obtain, thereby making it possible to directly map reads. We investigate the direct use of transcriptome as an alternative strategy. Our specific objective was to compare SNPs obtained from the UNEAK pipeline as well as SNPs obtained by directly mapping genotyping-by-sequencing reads on a transcriptome. We assessed the feasibility of both SNP datasets, UNEAK and transcriptome mapping, to investigate the diversity of 91 samples of wild pearl millet sampled across its distribution area. Both approaches produced several tens of thousands of single nucleotide variants, but differed in the way the variants were identified, leading to differences in the frequency spectrum associated with marked differences in the assessment of diversity. Difference in the frequency spectrum significantly biased a large set of diversity analyses as well as detection of selection approaches. However, whatever the approach, we found very similar inference of genetic structure, with three major genetic groups from West, Central, and East Africa. For non-model crops, using transcriptome data as a reference is thus a particularly promising way to obtain a more thorough analysis of datasets generated using genome reduction techniques. PMID:27379109

  2. The Northeastern United States Energy-Water Nexus: Climate Change Impacts and Alternative Water Management Strategies for the Power Sector

    Science.gov (United States)

    Miara, A.; Macknick, J.; Vorosmarty, C. J.; Cohen, S. M.; Rosenzweig, B.

    2014-12-01

    The Northeastern United States (NE) relies heavily on thermoelectric power plants (90% of total capacity) to provide electricity to more than 70 million people. This region's power plants require consistent, large volumes of water at sufficiently cold temperatures to generate electricity efficiently, and withdraw approximately 10.5 trillion gallons of water annually. Previous findings indicate that assessments of future electricity pathways must account for water availability, water temperature and the changing climate, as changes in these conditions may limit operational efficiency in the future. To account for such electric system vulnerabilities, we have created a link between an electricity system capacity expansion model (ReEDS) and a hydrologic model that is coupled to a power plant simulation model (FrAMES-TP2M) that allows for a new approach to analyze electricity system development, performance, and environmental impacts. Together, these coupled tools allow us to estimate electricity development and operations in the context of a changing climate and impacts on the seasonal spatial and temporal variability of water resources, downstream thermal effluents that cause plant-to-plant interferences and harm aquatic habitat, economic costs of water conservation methods and associated carbon emissions. In this study, we test and compare a business-as-usual strategy with three alternative water management scenarios that include changes in cooling technologies and water sources utilized for the years 2014-2050. Results of these experiments can provide useful insight into the feasibility of the electricity expansion scenarios in terms of associated water use and thermal impacts, carbon emissions, the cost of generating electricity, and also highlight the importance of accounting for water resources in future power sector planning and performance assessments.

  3. Assessment of off-design performance of a small-scale combined cooling and power system using an alternative operating strategy for gas turbine

    International Nuclear Information System (INIS)

    Highlights: • We develop an off-design model for a CCP system driven by gas turbine. • An alternative operating strategy is proposed to improve the system performance. • Off-design performance of the combined cooling and power system (CCP) is enhanced. • Effects of both the different operating strategy are analyzed and compared. • Performance enhancement mechanism of the proposed operating strategy is presented. - Abstract: A small-scale combined cooling and power (CCP) system usually serves district air conditioning apart from power generation purposes. The typical system consists of a gas turbine and an exhaust gas-fired absorption refrigerator. The surplus heat of the gas turbine is recovered to generate cooling energy. In this way, the CCP system has a high overall efficiency at the design point. However, the CCP system usually runs under off-design conditions because the users’ demand varies frequently. The operating strategy of the gas turbine will affect the thermodynamic performance of itself and the entire CCP system. The operating strategies for gas turbines include the reducing turbine inlet temperature (TIT) and the compressor inlet air throttling (IAT). A CCP system, consisting of an OPRA gas turbine and a double effects absorption refrigerator, is investigated to identify the effects of different operating strategies. The CCP system is simulated based on the partial-load model of gas turbine and absorption refrigerator. The off-design performance of the CCP system is compared under different operating strategies. The results show that the IAT strategy is the better one. At 50% rated power output of the gas turbine, the IAT operating strategy can increase overall system efficiency by 10% compared with the TIT strategy. In general, the IAT operating strategy is suited for other gas turbines. However, the benefits of IAT should be investigated in the future, when different gas turbine is adopted. This study may provide a new operating

  4. COMPAS: a European project on the ''comparison of alternative waste management strategies for long-lived radioactive wastes''. Scope, working methods and conclusions

    International Nuclear Information System (INIS)

    The paper presents the content and major findings of a project on the ''COMParison of Alternative waste management Strategies for long-lived radioactive wastes'' (COMPAS) carried out within the 5th framework programme of the European commission. Under the leadership of NNC (UK), the project was carried out by individuals representing waste management organisations from 15 European countries. After having compiled information on the nature and amount of long-lived radioactive waste to be managed, issues influencing the selection of waste management strategies and options, presently adopted national strategies as well as options for the future were addressed. Conclusions concerning key issues for the success or otherwise of strategies and management solutions were drawn. (orig.)

  5. Diagnostic strategy and differential therapeutic approach for cystic lesions of the pancreas; Diagnostische Strategie und differenzialtherapeutisches Vorgehen bei zystischen Laesionen des Pankreas

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, P.; Klauss, M. [Universitaetsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Tjaden, C. [Universitaetsklinikum Heidelberg, Chirurgie, Heidelberg (Germany)

    2016-04-15

    Cystic pancreatic lesions (CPL) are diagnosed with increasing frequency. Because up to 60 % of CPL are classified as malignant or premalignant, every CPL should be fully investigated and clarified. Serous CPL with low risk of malignancy must be differentiated from mucinous CPL with relevant potential malignancy (intraductal papillary mucinous neoplasm IPMN) and mucinous cystic neoplasm (MCN) as well as from harmless pseudocysts. Cross-sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) plays a crucial role in the diagnostics of CPL. An algorithm for the differential diagnostic classification of CPL is presented. The connection to the pancreatic duct is the key diagnostic criterion to differentiate IPMN from all other CPL. An exception to this rule is that pseudocysts can also show a connection to the pancreatic duct. A further classification of CPL with no connection to the pancreatic duct can be made by morphological criteria and correlation of the radiological findings with patient age, sex, history and symptoms. Depending on the diagnosis and hence the malignant potential the indications for surgery or watch and wait have to be discussed in an interdisciplinary cooperation. Due to its higher soft tissue contrast MRI is often superior to CT for depiction of CPL morphology. (orig.) [German] Zystische Pankreaslaesionen (ZPL) werden zunehmend haeufiger diagnostiziert. Da bis zu 60 % der ZPL als praemaligne oder maligne einzustufen sind, sollte jede ZPL diagnostisch abgeklaert werden. Seroese ZPL mit geringem Entartungsrisiko (seroes zystische Neoplasien, SZN) muessen von muzinoesen ZPL mit relevantem Malignitaetspotenzial (intraduktale papillaer-muzinoese Neoplasien [IPMN] und muzinoes zystische Neoplasie [MZN]) und harmlosen Pseudozysten unterschieden werden. Die Schnittbildgebung mithilfe der CT und MRT spielt bei der Diagnostik von ZPL eine entscheidende Rolle. Vorgestellt wird ein Algorithmus zur differenzialdiagnostischen

  6. Does the availability of positron emission tomography modify diagnostic strategies for solitary pulmonary nodules? An observational study in France

    International Nuclear Information System (INIS)

    Previous studies showed that at the individual level, positron emission tomography (PET) has some benefits for patients and physicians in terms of cancer management and staging. We aimed to describe the benefits of (PET) in the management of solitary pulmonary nodules (SPNs) in a population level, in terms of the number of diagnostic and invasive tests performed, time to diagnosis and factors determining PET utilization. In an observational study, we examined reports of computed tomography (CT) performed and mentioning 'spherical lesion', 'nodule' or synonymous terms. We found 11,515 reports in a before-PET period, 2002–2003, and 20,075 in an after-PET period, 2004–2005. Patients were followed through their physician, who was responsible for diagnostic management. We had complete data for 112 patients (73.7%) with new cases of SPN in the before-PET period and 250 (81.4%) in the after-PET period. Patients did not differ in mean age (64.9 vs. 64.8 years). The before-PET patients underwent a mean of 4 tests as compared with 3 tests for the after-PET patients (p = 0.08). Patients in the before-PET period had to wait 41.4 days, on average, before receiving a diagnosis as compared with 24.0 days, on average, for patients in the after-PET period who did not undergo PET (p < 0.001). In the after-PET period, 11% of patients underwent PET during the diagnostic process. A spiculated nodule was more likely to determine prescription for PET (p < 0.001). Multivariate analysis revealed that patients in both periods underwent fewer tests when PET was prescribed by general practitioners (p < 0.001) and if the nodule was not spiculated (p < 0.001). The proportion of unnecessary invasive approaches prescribed (47% vs. 49%) did not differ between the groups. In our study, 1 year after the availability of PET, the technology was not the first choice for diagnostic management of SPN. Even though we observed a tendency for reduced number of tests and mean time to

  7. The Repellent DEET Potentiates Carbamate Effects via Insect Muscarinic Receptor Interactions: An Alternative Strategy to Control Insect Vector-Borne Diseases

    OpenAIRE

    Abd-Ella, Aly; Stankiewicz, Maria; Mikulska, Karolina; Nowak, Wieslaw; Pennetier, Cédric; Goulu, Mathilde; Fruchart-Gaillard, Carole; Licznar, Patricia; Apaire-Marchais, Véronique; List, Olivier; Corbel, Vincent; Servent, Denis; Lapied, Bruno

    2015-01-01

    Insect vector-borne diseases remain one of the principal causes of human mortality. In addition to conventional measures of insect control, repellents continue to be the mainstay for personal protection. Because of the increasing pyrethroid-resistant mosquito populations, alternative strategies to reconstitute pyrethroid repellency and knock-down effects have been proposed by mixing the repellent DEET (N,N-Diethyl-3-methylbenzamide) with non-pyrethroid insecticide to better control resistant ...

  8. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 1: Main text

    International Nuclear Information System (INIS)

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF6) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF6, long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible

  9. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 2: Appendices

    International Nuclear Information System (INIS)

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF6) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF6, long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible. This volume contains Appendices A--O

  10. How to diagnose a child? Atention Deficit-Hiperactivity Disorder diagnostic strategies from a critical discursive perspective

    Directory of Open Access Journals (Sweden)

    Mónica Peña Ochoa

    2015-03-01

    Full Text Available This work examines from the perspective of critical discourse analysis, the Attention Deficit with Hyperactivity Disorder diagnosis as stated by the DSM–IV and ICD-10. It considers as basis the difficulties posed by medical taxonomy of childhood as a distinct social category from adulthood, the using the sign of hyperkinesia as an evidence of the disorder, and the utilization of auxiliary instruments, external to the clinical “setting”, as the “Test of Conners”. The context of analysis refers to conditions present in Chile. Specifically, taking into consideration the diagnostic applications in the institutional space of the school. Finally, the diagnosis is analyzed from the uses and effects in regulating and self-government of individuals and bodies.

  11. Classification diagnostic assessment strategies of psychosomatic medicine%心身医学分类诊断评估策略

    Institute of Scientific and Technical Information of China (English)

    吴爱勤

    2015-01-01

    心身疾病的心理病理与心理生理机理和临床特征不同于精神疾病。影响心身疾病患者的易损性、病程、预后、康复的心理社会因素的评估受到日益关注。提出心身疾病临床多轴诊断系统( MAS),心身医学研究的诊断标准( DCPR)临床诊断概念和结构框架。 DCPR将来源于心身研究的心理变量转变成用以鉴别诊断的可操作性诊断标准。 DCPR是一个简单、有效和可靠的定式访谈工具,可用于筛查、诊断心身疾病和心理生理障碍,补充ICD-10、DSM、CCMD的临床诊断应用的不足。包含了十二组心身疾病综合症,将影响躯体状况预后和治疗价值中的心理变量转化为客观的心身医学研究用诊断标准用工具。十二组症状包括健康焦虑、死亡恐惧症、疾病恐惧症、疾病否认、持续的躯体化症状、转换性障碍、继发于精神障碍的功能性躯体症状、周年反应、精神消沉、易激惹心境、A型行为和述情障碍。%[Abstarct] The psychological pathology and psychological physiological mechanism of psychosomatic diseases are different from mental diseases.So are the clinical characteristics.Evaluation of psychological social factors that affect the vulnerability, the course of the disease, the prognosis and the recovery in patients with psychosomatic disease has been attracted an increasing attention.The con-cept and structure framework of clinical diagnosis such as clinical multiaxial system( MAS) of psychosomatic disease and diagnostic cri-teria for psychosomatic research( DCPR) have been proposed.The DCPR that derives from the psychological variables in psychosomatic research will translate into operational diagnostic criteria for differential diagnosis.DCPR is a simple, effective and reliable stereotypes interview tool that can be used for screening and diagnosing the psychosomatic diseases and psychophysiological disorders.This can also replenish the

  12. Rational diagnostic strategies for Lyme borreliosis in children and adolescents: recommendations by the Committee for Infectious Diseases and Vaccinations of the German Academy for Pediatrics and Adolescent Health.

    Science.gov (United States)

    Huppertz, H I; Bartmann, P; Heininger, U; Fingerle, V; Kinet, M; Klein, R; Korenke, G C; Nentwich, H J

    2012-11-01

    The varying clinical manifestations of Lyme borreliosis, transmitted by Ixodes ricinus and caused by Borrelia burgdorferi, frequently pose diagnostic problems. Diagnostic strategies vary between early and late disease manifestations and usually include serological methods. Erythema migrans is pathognomonic and does not require any further laboratory investigations. In contrast, the diagnosis of neuroborreliosis requires the assessment of serum and cerebrospinal fluid. Lyme arthritis is diagnosed in the presence of newly recognized arthritis and high-titer serum IgG antibodies against B. burgdorferi. The committee concludes the following recommendations: Borrelial serology should only be ordered in case of well-founded clinical suspicion for Lyme borreliosis, i.e., manifestations compatible with the diagnosis. Tests for borrelial genomic sequences in ticks or lymphocyte proliferation assays should not be ordered. When results of such tests or of serological investigations that were not indicated are available, they should not influence therapeutic decisions. Laboratories should be cautious when interpreting results of serological tests and abstain from giving therapeutic recommendations and from proposing retesting after some time without intimate knowledge of patient's history and disease manifestations. PMID:22782450

  13. Pulmonary embolism. Clinical relevance, requirements for diagnostic and therapeutic strategies; Lungenembolie. Klinische Bedeutung, Anforderung an die Diagnostik und Behandlungsoptionen

    Energy Technology Data Exchange (ETDEWEB)

    Nowak, F.G.; Halbfass, P.; Hoffmann, E. [Herzzentrum Muenchen-Bogenhausen, Staedtisches Klinikum Muenchen GmbH, Klinik fuer Kardiologie und Internistische Intensivmedizin, Muenchen (Germany)

    2007-08-15

    In the population the annual incidence of pulmonary embolism amounts to 1.3-2.8 per 1000 at the age of 65-89 years. Mortality reaches about 17% within the first 3 months. Acute pulmonary embolism is characterized by an increase in pulmonary arterial pressure and an impairment of the pulmonary gas exchange. Elevation of the right cardiac pressure up to right heart decompensation may follow. In addition, hypoxemia, hyperventilation, dead space ventilation, right to left shunting, bronchoconstriction, and vasoconstriction may occur. Clinical examination, ECG, laboratory findings such as elevated D-dimer, blood gas analysis, ultrasound examination of the veins of the lower extremities, and transthoracic echocardiography are acutely available diagnostic methods of an emergency department. In addition, extensive diagnostic procedures like pulmonary scintigraphy and pulmonary angiography may be required. The aim is to get a definite diagnosis as quickly as possible to direct therapy. In acute pulmonary embolism with cardiac shock, monitoring and stabilization of the circulatory function as well as an appropriate anticoagulant therapy are essential. In some cases surgery or a local fibrinolytic intervention is indicated. (orig.) [German] Die Lungenembolie stellt eine potenziell lebensbedrohliche akute Erkrankung dar, deren Prognose durch die fruehzeitige Diagnostik und effektive gerinnungshemmende Therapie bestimmt wird. Die jaehrliche Inzidenz der Lungenembolie liegt zwischen 1,3-2,8/1000 Einwohner im Alter zwischen 65 und 89 Jahren. Die Mortalitaet einer akuten Lungenembolie erreicht etwa 17% innerhalb der ersten 3 Monate. Die akute Lungenembolie ist durch Erhoehung des pulmonalarteriellen Drucks mit Stoerung des Gasaustauschs und Anstieg des Drucks im rechten Herzen bis hin zur Rechtsherzdekompensation gekennzeichnet. Weitere Folgen sind Hypoxaemie, Hyperventilation, Totraumventilation, Rechts-links-Shunt und Broncho- sowie auch Vasokonstriktion. Anamnese und klinische

  14. A comparison of the suitability of patient dosimetry methods for establishing diagnostic dose reference levels and optimisation strategies

    International Nuclear Information System (INIS)

    For 50 adult patients referred for chest radiography, air kerma at the diaphragm KD, dose area product and entrance skin dose were measured. The air kerma at the diaphragm and the dose area product were determined using Diamentor M4KDK(PTW) which allows measuring air kerma and dose area product simultaneously. For the measurement of entrance skin dose TLDs are used. A 50% variation in dose, incident dose as well as entrance skin dose, was registered for the same patient thickness. The recommendation of ICRP to perform the measurements for DRLs at 'representative patients' and that of the CEC to use 'standard-sized patients' seem to make little sense in the case of chest radiography. It could be demonstrated, that the dose area product is the least appropriate dose quantity for patient measurements and to define dose reference levels. For some radiological examinations like chest, pelvis and lumbar spine the dose area product is even sex dependent. Incident dose and entrance surface dose are of equal quality for patient dose measurements in diagnostic radiography. (author)

  15. Optimality of the barrier strategy in de Finetti's dividend problem for spectrally negative Lévy processes: An alternative approach

    Science.gov (United States)

    Yin, Chuancun; Wang, Chunwei

    2009-11-01

    The optimal dividend problem proposed in de Finetti [1] is to find the dividend-payment strategy that maximizes the expected discounted value of dividends which are paid to the shareholders until the company is ruined. Avram et al. [9] studied the case when the risk process is modelled by a general spectrally negative Lévy process and Loeffen [10] gave sufficient conditions under which the optimal strategy is of the barrier type. Recently Kyprianou et al. [11] strengthened the result of Loeffen [10] which established a larger class of Lévy processes for which the barrier strategy is optimal among all admissible ones. In this paper we use an analytical argument to re-investigate the optimality of barrier dividend strategies considered in the three recent papers.

  16. Impact Assessment and Multicriteria Decision Analysis of Alternative Managed Aquifer Recharge Strategies Based on Treated Wastewater in Northern Gaza

    Directory of Open Access Journals (Sweden)

    Mohammad Azizur Rahman

    2014-12-01

    Full Text Available For better planning of a managed aquifer recharge (MAR project, the most promising strategies should analyze the environmental impact, socio-economic efficiency, and their contribution to the existing or future water resource conditions in the region. The challenge of such studies is to combine and quantify a wide range of criteria from the environment and society. This necessity leads to an integrated concept and analysis. This paper outlines an integrated approach considering environmental, health, social and economic aspects to support in the decision-making process to implement a managed aquifer recharge project as a potential response to water resource problems. In order to demonstrate the approach in detail, this paper analysed several water resources management strategies based on MAR implementation, by using treated wastewater in the Northern Gaza Strip and the potential impacts of the strategies on groundwater resources, agriculture, environment, health, economy and society. Based on the Palestinian water policy (Year 2005–2025 on wastewater reuse, three MAR strategies were developed in close cooperation with the local decision makers. The strategies were compared with a base line strategy referred to as the so-called “Do Nothing Approach”. The results of the study show that MAR project implementation with treated wastewater at a maximum rate, considered together with sustainable development of groundwater, is the best and most robust strategy amongst those analyzed. The analysis shows the defined MAR strategies contribute to water resources development and environmental protection or improvement including an existing eutrophic lake. The integrated approach used in this paper may be applicable not only to MAR project implementation but also to other water resources and environmental development projects.

  17. Is case-based learning an effective teaching strategy to challenge students' alternative conceptions regarding chemical kinetics?

    Science.gov (United States)

    Yalçınkaya, Eylem; Taştan-Kırık, Özgecan; Boz, Yezdan; Yıldıran, Demet

    2012-07-01

    Background: Case-based learning (CBL) is simply teaching the concept to the students based on the cases. CBL involves a case, which is a scenario based on daily life, and study questions related to the case, which allows students to discuss their ideas. Chemical kinetics is one of the most difficult concepts for students in chemistry. Students have generally low levels of conceptual understanding and many alternative conceptions regarding it. Purpose: This study aimed to explore the effect of CBL on dealing with students' alternative conceptions about chemical kinetics. Sample: The sample consists of 53 high school students from one public high school in Turkey. Design and methods : Nonequivalent pre-test and post-test control group design was used. Reaction Rate Concept Test and semi-structured interviews were used for data collection. Convenience sampling technique was followed. For data analysis, the independent samples t-test and ANOVA was performed. Results : Both concept test and interview results showed that students instructed with cases had better understanding of core concepts of chemical kinetics and had less alternative conceptions related to the subject matter compared to the control group students, despite the fact that it was impossible to challenge all the alternative conceptions in the experimental group. Conclusions: CBL is an effective teaching method for challenging students' alternative conceptions in the context of chemical kinetics. Since using cases in small groups and whole class discussions has been found to be an effective way to cope with the alternative conceptions, it can be applied to other subjects and grade levels in high schools with a higher sample size. Furthermore, the effect of this method on academic achievement, motivation and critical thinking skills are other variables that can be investigated for future studies in the subject area of chemistry.

  18. Adverse learning strategy: the Adelaide Diagnostic Learning Inventory and its subscale replicability in a medical student population.

    Science.gov (United States)

    Welch, G; Pearce, K; Lewis, M; Mellsop, G

    1990-03-01

    The Adelaide Diagnostic Learning Inventory (ADLIMS) is a measure of learning styles and learning pathologies that was designed to investigate the impact of traditional approaches to learning versus problem-based learning and to identify students whose approach to learning tasks predicted poor academic performance. In this study, some important psychometric properties of the ADLIMS were examined, including its factor structure. In this study, factor replicability across samples was argued to provide a more robust and psychologically meaningful factor solution than that which can be obtained using traditional mathematical criteria. The results of the factor analysis did not confirm the presence of the four factor solution earlier reported for the ADLIMS, but did identify three clear factors that had very high replicability. An inspection of the items comprising these three factors showed that factor 1 tapped subjective distress related to poor study habits, lack of motivation to study, and distraction from social activities. Factor 2 tapped distress arising from high achievement expectations that were hampered by superficial or disorganized study habits that did not enable the student to grasp the relationships between concepts and ideas. Factor 3 tapped positive feelings and a sense of satisfaction associated with a problem-based approach to the learning of new study material. Although the internal reliability of the ADLIMS subscales met the requirements of a measure to be used in general research such as in the investigation of correlates among groups of medical students, they did not meet the higher requirements of a measure to be used to identify or predict individuals with pathological learning styles. PMID:2319969

  19. Terrorism and Counter-Terrorism Strategies in a Globalised World : alternative perceptiveness of terrorist emergence theory and policing strategies confrontation with human rights

    OpenAIRE

    Kikkas, Margit

    2015-01-01

    Globalisation and development in technology have advanced terrorism to reach a broader target audience. Especially focussing at the international co-operation strategies and combined social networks, terrorist activities have an direct- and indirect effect on private households, international commerce and local governments. Security institutions and state organisations use various combinations of counter- terrorism measures, that are mostly social-, political-, or financial in nature. Neverth...

  20. Evaluation of alternative groundwater-management strategies for the Bureau of Reclamation Klamath Project, Oregon and California

    Science.gov (United States)

    Wagner, Brian J.; Gannett, Marshall W.

    2014-01-01

    The water resources of the upper Klamath Basin, in southern Oregon and northern California, are managed to achieve various complex and interconnected purposes. Since 2001, irrigators in the Bureau of Reclamation Klamath Irrigation Project (Project) have been required to limit surface-water diversions to protect habitat for endangered freshwater and anadromous fishes. The reductions in irrigation diversions have led to an increased demand for groundwater by Project irrigators, particularly in drought years. The potential effects of sustained pumping on groundwater and surface-water resources have caused concern among Federal and state agencies, Indian tribes, wildlife groups, and groundwater users. To aid in the development of a viable groundwater-management strategy for the Project, the U.S. Geological Survey, in collaboration with the Klamath Water and Power Agency and the Oregon Water Resources Department, developed a groundwater-management model that links groundwater simulation with techniques of constrained optimization. The overall goal of the groundwater-management model is to determine the patterns of groundwater pumping that, to the extent possible, meet the supplemental groundwater demands of the Project. To ensure that groundwater development does not adversely affect groundwater and surface-water resources, the groundwater-management model includes constraints to (1) limit the effects of groundwater withdrawal on groundwater discharge to streams and lakes that support critical habitat for fish listed under the Endangered Species Act, (2) ensure that drawdowns do not exceed limits allowed by Oregon water law, and (3) ensure that groundwater withdrawal does not adversely affect agricultural drain flows that supply a substantial portion of water for irrigators and wildlife refuges in downslope areas of the Project. Groundwater-management alternatives were tested and designed within the framework of the Klamath Basin Restoration Agreement (currently [2013

  1. Preliminary Study on the Role of Alternative Educational Pathways in Promoting the Use of Problem-Focused Coping Strategies

    Science.gov (United States)

    Shankland, Rebecca; Franca, Lionel Riou; Genolini, Christophe M.; Guelfi, Julien-Daniel; Ionescu, Serban

    2009-01-01

    Coping styles are generally considered to be environmentally driven. Up to now, research has mainly focused on family influences. However, some studies underline the effect of educational settings on the development of problem-focused coping strategies. Consistently with previous reports on the enhancement of autonomy and problem-solving in…

  2. Adverse Outcome Pathways During Early Fish Development: A Framework for Identifying and Implementing Alternative Chemical Prioritization Strategies

    Science.gov (United States)

    In accordance with recommendations contained in a National Research Council Report on Toxicity Testing in the 21st Century: A Vision and Strategy, as well as European goals pertaining to reducing, refining, and replacing the use of animals in ecotoxicology safety testing there is...

  3. The Strategic Alternatives for Emerging Markets Entry Strategies of Multinational Companies and Their Main Investments in Romania

    OpenAIRE

    Elena SERBAN

    2012-01-01

    The article presents the strategic alternatives which are considered by a multinational company before deciding to enter on an emerging market. The decision is based on the long term opportunity of the selling market in the analyzed country, on the cultural and institutional differences between the multinational native and local environment, resources and business partners’ availability, as well as on the market share it can acquire since the entrance. Romania is considered one of the emergin...

  4. Wealth tax as alternative minimum tax? The impact of a wealth tax on business structure and strategy

    OpenAIRE

    Sureth, Caren; Maiterth, Ralf

    2005-01-01

    An alternative minimum tax (AMT) is often regarded as desirable. We analyze a wealth tax at corporate and personal level that is designed as an AMT as proposed by the German Green Party. This wealth tax is imputable to profit taxes and is hence intended to prevent multiple (multistage) taxation. Referring to data from annual reports and the German Central Bank we model enterprises of different structure, industry, size and legal status. We show that companies in the service sector which gener...

  5. Strategy integrating stepped fragmentation and glycan diagnostic ion-based spectrum refinement for the identification of core fucosylated glycoproteome using mass spectrometry.

    Science.gov (United States)

    Cao, Qichen; Zhao, Xinyuan; Zhao, Qing; Lv, Xiaodong; Ma, Cheng; Li, Xianyu; Zhao, Yan; Peng, Bo; Ying, Wantao; Qian, Xiaohong

    2014-07-15

    Core fucosylation (CF) is a special glycosylation pattern of proteins that has a strong relationship with cancer. The Food and Drug Administration (FDA) has approved the core fucosylated α-fetoprotein as a biomarker for the early diagnosis of hepatocellular carcinoma (HCC). The technology for identifying core fucosylated proteins has significant practical value. The major method for core fucosylated glycoprotein/glycopeptide analysis is neutral loss-based MS(3) scanning under collision-induced dissociation (CID) by ion trap mass spectrometry. However, due to the limited speed and low resolution of the MS(3) scan mode, it is difficult to achieve high-throughput, with only dozens of core fucosylated proteins identified in a single run. In this work, we developed a novel strategy for the identification of CF glycopeptides at a large scale, integrating the stepped fragmentation function, one novel feature of quadrupole-orbitrap mass spectrometry, with "glycan diagnostic ion"-based spectrum optimization. By using stepped fragmentation, we were able to obtain both highly accurate glycan and peptide information of a simplified CF glycopeptide in one spectrum. Moreover, the spectrum could be recorded with the same high speed as the conventional MS(2) scan. By using the "glycan diagnostic ion"-based spectrum refinement method, the efficiency of the CF glycopeptide discovery was significantly improved. We demonstrated the feasibility and reproducibility of our method by analyzing CF glycoproteomes of mouse liver tissue and HeLa cell samples spiked with standard CF glycoprotein. In total, 1364 and 856 CF glycopeptides belonging to 702 and 449 CF glycoproteins were identified, respectively, within a 78-min gradient analysis, which was approximately a 7-fold increase in the identification efficiency of CF glycopeptides compared to the currently used method. In this work, we took core fucosylated glycopeptides as a practical example to demonstrate the great potential of our

  6. Evaluation of alternative PCB clean-up strategies using an individual-based population model of mink

    International Nuclear Information System (INIS)

    Population models can be used to place observed toxic effects into an assessment of the impacts on population-level endpoints, which are generally considered to provide greater ecological insight and relevance. We used an individual-based model of mink to evaluate the population-level effects of exposure to polychlorinated biphenyls (PCBs) and the impact that different remediation strategies had on mink population endpoints (population size and extinction risk). Our simulations indicated that the initial population size had a strong impact on mink population dynamics. In addition, mink populations were extremely responsive to clean-up scenarios that were initiated soon after the contamination event. In fact, the rate of PCB clean-up did not have as strong a positive effect on mink as did the initiation of clean-up (start time). We show that population-level approaches can be used to understand adverse effects of contamination and to also explore the potential benefits of various remediation strategies. - Highlights: → We used an individual-based model of mink to evaluate population-level impacts of PCB contamination. → The model was also used to explore the population responses to different PCB remediation strategies. → Population size had a large impact on whether mink populations persisted or went extinct. → Starting remediation sooner had a stronger positive effect on mink populations than did the rate of PCB clean-up. → Individual-based models are useful in understanding effects of contamination and different remediation strategies. - An individual-based model of mink showed strong population-level effects of PCB contamination and provided insight into optimal PCB remediation strategies.

  7. Impact Assessment and Multicriteria Decision Analysis of Alternative Managed Aquifer Recharge Strategies Based on Treated Wastewater in Northern Gaza

    OpenAIRE

    Mohammad Azizur Rahman; Bernd Rusteberg; Mohammad Salah Uddin; Muath Abu Saada; Ayman Rabi; Martin Sauter

    2014-01-01

    For better planning of a managed aquifer recharge (MAR) project, the most promising strategies should analyze the environmental impact, socio-economic efficiency, and their contribution to the existing or future water resource conditions in the region. The challenge of such studies is to combine and quantify a wide range of criteria from the environment and society. This necessity leads to an integrated concept and analysis. This paper outlines an integrated approach considering environmental...

  8. Alternative schedules or integration strategies to maximise treatment duration with sunitinib in patients with gastrointestinal stromal tumours

    OpenAIRE

    Saponara, Maristella; Lolli, Cristian; Nannini, Margherita; Di Scioscio, Valerio; SERRA, CARLA; Mandrioli, Anna; PALLOTTI, MARIA CATERINA; Biasco, Guido; Pantaleo, Maria Abbondanza

    2014-01-01

    Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumour of the gastrointestinal tract. The advent of targeted kinase-inhibitors has revolutionised treatment strategies and clinical outcomes for patients with advanced GIST. In the majority of countries, sunitinib is the only approved second-line treatment option for advanced GIST patients, who are resistant or intolerant to imatinib. However, sunitinib is associated with various adverse events, which often result in a r...

  9. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 3: Responses to public comments

    International Nuclear Information System (INIS)

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF6) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF6, long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible. This volume of the Final PEIS contains the comments and DOE's responses to comments received during the comment period. Chapter 2 contains photocopies of written submissions received by DOE on the Draft PEIS; DOE's responses to those comments are listed in Chapter 3. Chapter 4 provides the oral comments received at the public hearings and DOE's responses. Chapter 5 provides indices to comments and responses arranged by commentor name and by comment number

  10. Cost-effectiveness analysis of the direct and indirect impact of intranasal live attenuated influenza vaccination strategies in children: alternative country profiles

    Science.gov (United States)

    Gibson, Edward; Begum, Najida; Martinón-Torres, Federico; Safadi, Marco Aurélio; Sackeyfio, Alfred; Hackett, Judith; Rajaram, Sankarasubramanian

    2016-01-01

    Background Influenza poses a significant burden on healthcare systems and society, with under-recognition in the paediatric population. Existing vaccination policies (largely) target the elderly and other risk groups where complications may arise. Objective The goal of this study was to evaluate the cost-effectiveness of annual paediatric vaccination (in 2–17-year-olds) with live attenuated influenza vaccination (LAIV), as well as the protective effect on the wider population in England and Wales (base). The study aimed to demonstrate broad applications of the model in countries where epidemiological and transmission data is limited and that have sophisticated vaccination policies (Brazil, Spain, and Taiwan). Methods The direct and indirect impact of LAIV in the paediatric cohort was simulated using an age-stratified dynamic transmission model over a 5-year time horizon of daily cycles and applying discounting of 3.5% in the base case. Pre-existing immunity structure was based on a 1-year model run. Sensitivity analyses were conducted. Results In the base case for England and Wales, the annual paediatric strategy with LAIV was associated with improvements in influenza-related events and quality-adjusted life years (QALYs) lost, yielding an incremental cost per QALY of £6,208. The model was robust to change in the key input parameters. The probabilistic analysis demonstrated LAIV to be cost effective in more than 99% of iterations, assuming a willingness-to-pay threshold of £30,000. Incremental costs per QALY for Brazil were £2,817, and for the cases of Spain and Taiwan the proposed strategy was dominant over the current practice. Conclusion In addition to existing policies, annual paediatric vaccination using LAIV provides a cost-effective strategy that offers direct and indirect protection in the wider community. Paediatric vaccination strategies using LAIV demonstrated clinical and economic benefits over alternative (current vaccination) strategies in

  11. 自发性气胸致失血性休克诊疗策略%The Diagnostic and Therapeutic Strategies of Spontaneous Pneumothorax with Hemorrhagic Shock

    Institute of Scientific and Technical Information of China (English)

    柯弢; 刘青; 范菁

    2011-01-01

    To understand the clinical features and research diagnostic and therapeutic strategies of spontaneous pneumothorax (SP) with hemorrhagic shock, 331 cases of SP with hemorrhagic shock were analyzed. The Operative treatment has the best effects. SP with hemorrhagic shock is found mostly in young males. The site of bleeding was mostly located in a torn adhesion of parietal pleura. Emergency minimally invasive technique is the direction of development.%分析自发性气胸(spontaneous pneumothorax,SP)出现失血性休克时的临床特点、探讨诊疗策略.分析331例SP并失血性休克的病例资料.结果采用手术治疗者效果最佳.SP致失血性休克者多见于青年男性,多为胸膜顶粘连带出血,急诊微创手术是治疗发展方向.

  12. Development and Integration of Alternative Management Strategies Using Inherited Sterility and Natural Enemies to Control Lepidopteran Pests

    International Nuclear Information System (INIS)

    Lepidopteran pests such as corn earworm, Helicoverpa zea, fall armyworm, Spodoptera frugiperda, beet armyworm, Spodoptera exigua, and diamondback moth, Plutella xylostella, are often the most destructive pests of field crops in the United States. Insecticide resistance, increasing concern over pesticide pollution, and the desire to effectively manage lepidopteran pests on an area-wide basis have motivated scientists to identify and develop new pest management tactics that are compatible with current IPM practices. IPM-based systems, including genetic methods and biological control, offer the best long-term solutions to pesticide reduction and the management of destructive agricultural pests. F1 sterility has emerged as a promising control strategy for lepidopteran pests.

  13. Sustainable alternatives for land-based biofuels in the European Union. Assessment of options and development of a policy strategy

    Energy Technology Data Exchange (ETDEWEB)

    Kampman, B.; Van Grinsven, A.; Croezen, H.

    2012-12-15

    It is feasible for EU member states to meet their commitments regarding transport fuels under the Renewable Energy Directive (RED) and the Fuel Quality Directive (FQD) without resorting to biofuels from food crops. The RED target (10% renewable transport energy in 2020) can be met by a mix of measures aimed at improving energy efficiency, combined with a strong focus on growth of renewable electricity use and biofuels and biomethane from waste and residues. These measures also contribute to the FQD target (6% reduction in carbon intensity of fuels by 2020), but will need to be complemented by other measures such as reduced flaring and venting during oil production. The report shows how EU transport energy policy could reduce its reliance on biofuels from food crops that are likely to cause land use change. This alternative vision for the transport sector in 2020 would cut CO2 emissions by 205 million tonnes.

  14. Diagnostic, Explanatory, and Detection Models of Munchausen by Proxy: Extrapolations from Malingering and Deception

    Science.gov (United States)

    Rogers, Richard

    2004-01-01

    Objective: The overriding objective is a critical examination of Munchausen syndrome by proxy (MSBP) and its closely-related alternative, factitious disorder by proxy (FDBP). Beyond issues of diagnostic validity, assessment methods and potential detection strategies are explored. Methods: A painstaking analysis was conducted of the MSBP and FDBP…

  15. The Unsuccessful Poverty Reduction Strategies in Indonesia and the Alternatives Solutions (The Study on BLT and Jamkesmas

    Directory of Open Access Journals (Sweden)

    Dewi Iriani

    2014-08-01

    Full Text Available Indonesia as the 16th largest economy in the world, the 4th in Asia-after China, Japan and India as well as Southeast Asia’s largest-has the potential to be the seventh biggest by 2030, due to the increasing economic. Indonesia also has many potential natural resources that can be utilized to support development in order to increase the nation welfare. However, the number of poor people still has not been significantly reduced, reaching 28.07 million or 11.37% of the total population in 2013. The Government has tried to reduce poverty with some programs such as BLT (Bantuan Langsung Tunai/Direct Cash Assistance and Jamkesmas (Jaminan Kesehatan Masyarakat/ Community Health Protection Scheme. However, the programs are considered not effective and do not make poor people become financially independent. Ironically, in inadequate evaluation, the Government continues to runs the programs. By using a qualitative approach, researchers will provide policy alternatives that can be implemented by Government.

  16. Diagnostic ion filtering strategy for chemical characterization of Guge Fengtong Tablet with high-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry.

    Science.gov (United States)

    Zeng, Su-Ling; Liu, Xin-Guang; Lai, Chang-Jiang-Sheng; Liu, E-Hu; Li, Ping

    2015-05-01

    The present study was designed to characterize the chemical constituents of Guge Fengtong Tablet (GGFTT). Based on the chromatographic retention behavior, fragmentation pathways of chemical components and the published literatures, a diagnostic ion filtering strategy with electrospray ionization quadrupole time-of-flight tandem mass spectrometry (HPLC-ESI-Q-TOF/MS) was established to identify the multiple bioactive constituents of GGFTT. The rapid identification of forty-seven components, including 18 phenolic acids, 8 saponins, 14 gingerol-related compounds, and 7 diarylhepatonoids, was accomplished using this newly developed method. The coupling of HPLC-ESI-Q-TOF/MS with the diagnostic ion filtering strategy was useful and efficient for the in-depth structural elucidation of chemical compounds of GGFTT. PMID:25986289

  17. The architecture of diagnostic research

    DEFF Research Database (Denmark)

    Colli, Agostino; Fraquelli, Mirella; Casazza, Giovanni; Conte, Dario; Nikolova, Dimitrinka; Duca, Piergiorgio; Thorlund, Kristian; Gluud, Christian

    2014-01-01

    the present strategy. Phase 4 comprises large surveillance cohort studies that aim to assess the effectiveness of the new diagnostic-therapeutic strategy in clinical practice. As common in clinical research, putting excessive weight on the results of single studies and trials is likely to divert from......The diagnostic research process can be divided into five phases, designed to establish the clinical utility of a new diagnostic test - the index test. The aim of the present review is to illustrate the study designs that are appropriate for each diagnostic phase, using clinical examples regarding...

  18. An alternative diagnostic test for active Ménière's disease and cochlear hydrops using high-pass noise masked responses: the complex amplitude ratio.

    Science.gov (United States)

    Don, Manuel; Kwong, Betty; Tanaka, Chiemi

    2007-01-01

    We [Don et al.: Otol Neurotol 2005;26:711-722] previously demonstrated that patients diagnosed with an active case of Ménière's disease could be distinguished from non-Ménière's normal-hearing subjects by a special auditory brainstem response method involving clicks and ipsilateral high-pass masking pink noise. Specifically, auditory brainstem responses to clicks presented alone and clicks with masking noise high-pass filtered at 8, 4, 2, 1 and 0.5 kHz were recorded. It was shown that the level of masking noise sufficient to progressively mask the response to clicks in non-Ménière's normal-hearing subjects was insufficient to appropriately mask the responses in Ménière's disease subjects, resulting in an obvious undermasked component. A relative latency measure of wave V or the undermasked component in the response to clicks with 0.5 kHz high-pass masking noise and wave V in the response to clicks presented alone clearly distinguished these two groups on an individual level, thus making it a valuable clinical tool. However, determining the peak latency of wave V or the undermasked component can be difficult in some cases. In anticipation of this difficulty, we investigated and present in this paper several amplitude measures that may help in the evaluation of these cases. One amplitude measure, the 'complex amplitude ratio', appears to be a good alternative when the latency measure of the undermasked component is difficult to determine. PMID:17664867

  19. Bolivia : Poverty Diagnostic 2000

    OpenAIRE

    World Bank

    2002-01-01

    The report presents a diagnostic of poverty, human development, and access to social infrastructure in Bolivia, based on analytical work, to serve as an input for the Poverty Reduction Strategy Paper (PRSP). Findings suggest that poverty affects half of the population in large cities, two thirds in other urban areas, and eighty percent in rural areas. Nonetheless, there is seemingly a rece...

  20. Comparative assessment of alternative electricity supply strategies in Romania. Results of a case study carried out using the DECADES computer tools

    International Nuclear Information System (INIS)

    There will be a significant growth of the electricity demand in Romania over the period 2005-2015; therefore, it will be necessary to devise an optimized strategy for electricity generation in order to ensure the economic development of the country and to achieve a standard of living that is similar to that of people in western European countries. For the development of electricity generation capacities in Romania it will be necessary to consider the security of supply of primary energies as well as the prospects of utilizing clean technologies in order to fulfill the requirements for environmental protection. In view of the medium and long term forecasts of the electricity demand in Romania, it is expected that the import of fuels will increase. Therefore, it is very important to make comprehensive comparative assessments of different energy chains for electricity generation, incorporating health and environmental issues in the planning and decision making process. Since 1994, Romania has participated in the DECADES project and has used the DECPAC software to work out a country specific database. It was found that the 'least cost' development programme of power plants comprises new plants equipped with 660 MW combined cycle natural gas units. All expansion options and the fuel price escalation on the international market were taken into account. The nuclear power alternative is attractive as regards environmental protection and because it is not possible for Romania to secure the necessary gas supply. (author). 6 refs, 7 figs

  1. Teacher Observations for Diagnostic Teaching.

    Science.gov (United States)

    Saunders, Russell W., Jr.

    Teachers at the primary level should resume the neglected practice of diagnostic teaching. This means that the teacher should observe all aspects of a student's cognitive behavior in the teaching/learning act and then plan instructional strategies for subsequent lessons. Some significant cognitive behaviors observable in diagnostic teaching are…

  2. Feasibility and acceptability of home-based management of malaria strategy adapted to Sudan's conditions using artemisinin-based combination therapy and rapid diagnostic test

    Directory of Open Access Journals (Sweden)

    Mudather Mahmoud A

    2009-03-01

    Full Text Available Abstract Background Malaria remains a major public health problem especially in sub-Saharan Africa. Despite the efforts exerted to provide effective anti-malarial drugs, still some communities suffer from getting access to these services due to many barriers. This research aimed to assess the feasibility and acceptability of home-based management of malaria (HMM strategy using artemisinin-based combination therapy (ACT for treatment and rapid diagnostic test (RDT for diagnosis. Methods This is a study conducted in 20 villages in Um Adara area, South Kordofan state, Sudan. Two-thirds (66% of the study community were seeking treatment from heath facilities, which were more than 5 km far from their villages with marked inaccessibility during rainy season. Volunteers (one per village were trained on using RDTs for diagnosis and artesunate plus sulphadoxine-pyrimethamine for treating malaria patients, as well as referral of severe and non-malaria cases. A system for supply and monitoring was established based on the rural health centre, which acted as a link between the volunteers and the health system. Advocacy for the policy was done through different tools. Volunteers worked on non-monetary incentives but only a consultation fee of One Sudanese Pound (equivalent to US$0.5. Pre- and post-intervention assessment was done using household survey, focus group discussion with the community leaders, structured interview with the volunteers, and records and reports analysis. Results and discussion The overall adherence of volunteers to the project protocol in treating and referring cases was accepted that was only one of the 20 volunteers did not comply with the study guidelines. Although the use of RDTs seemed to have improved the level of accuracy and trust in the diagnosis, 30% of volunteers did not rely on the negative RDT results when treating fever cases. Almost all (94.7% the volunteers felt that they were satisfied with the spiritual outcome of

  3. The Repellent DEET Potentiates Carbamate Effects via Insect Muscarinic Receptor Interactions: An Alternative Strategy to Control Insect Vector-Borne Diseases.

    Directory of Open Access Journals (Sweden)

    Aly Abd-Ella

    Full Text Available Insect vector-borne diseases remain one of the principal causes of human mortality. In addition to conventional measures of insect control, repellents continue to be the mainstay for personal protection. Because of the increasing pyrethroid-resistant mosquito populations, alternative strategies to reconstitute pyrethroid repellency and knock-down effects have been proposed by mixing the repellent DEET (N,N-Diethyl-3-methylbenzamide with non-pyrethroid insecticide to better control resistant insect vector-borne diseases. By using electrophysiological, biochemichal, in vivo toxicological techniques together with calcium imaging, binding studies and in silico docking, we have shown that DEET, at low concentrations, interacts with high affinity with insect M1/M3 mAChR allosteric site potentiating agonist effects on mAChRs coupled to phospholipase C second messenger pathway. This increases the anticholinesterase activity of the carbamate propoxur through calcium-dependent regulation of acetylcholinesterase. At high concentrations, DEET interacts with low affinity on distinct M1/M3 mAChR site, counteracting the potentiation. Similar dose-dependent dual effects of DEET have also been observed at synaptic mAChR level. Additionally, binding and in silico docking studies performed on human M1 and M3 mAChR subtypes indicate that DEET only displays a low affinity antagonist profile on these M1/M3 mAChRs. These results reveal a selective high affinity positive allosteric site for DEET in insect mAChRs. Finally, bioassays conducted on Aedes aegypti confirm the synergistic interaction between DEET and propoxur observed in vitro, resulting in a higher mortality of mosquitoes. Our findings reveal an unusual allosterically potentiating action of the repellent DEET, which involves a selective site in insect. These results open exciting research areas in public health particularly in the control of the pyrethroid-resistant insect-vector borne diseases. Mixing low

  4. ITER diagnostics

    International Nuclear Information System (INIS)

    As part of the ITER Conceptual Design Activity (CDA), three workshops were held on plasma diagnostics. From these conference, a set of diagnostics for the full operation of ITER has been developed. This report summarizes the results of these design and discussion activities, and the incorporation of the concepts developed into the overall ITER experiment. Refs, figs and tabs

  5. Molecular Diagnostics

    OpenAIRE

    Choe, Hyonmin; Deirmengian, Carl A; Hickok, Noreen J.; Morrison, Tiffany N.; Tuan, Rocky S.

    2015-01-01

    Orthopaedic infections are complex conditions that require immediate diagnosis and accurate identification of the causative organisms to facilitate appropriate management. Conventional methodologies for diagnosis of these infections sometimes lack accuracy or sufficient rapidity. Current molecular diagnostics are an emerging area of bench-to-bedside research in orthopaedic infections. Examples of promising molecular diagnostics include measurement of a specific biomarker in the synovial fluid...

  6. Diagnostic dilemma

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Dobrovolny, Robert; Nazarenko, Irina;

    2011-01-01

    in two expert laboratories did not identify a confirmatory mutation, presenting a diagnostic dilemma. A renal biopsy proved diagnostic and renewed efforts to detect an a-Gal A mutation. Subsequent gene dosage analyses identified a large a-Gal A deletion confirming her heterozygosity, and she was...

  7. Molecular diagnostics in endodontics

    OpenAIRE

    Rechenberg, Dan-Krister; Zehnder, Matthias

    2014-01-01

    Recent systematic reviews have substantiated the fact that current testing methods to assess the inflammatory state of the pulp and the periapical tissues are of limited value. Consequently, it may be time to search for alternative routes in endodontic diagnostics. Molecular assessment methods could be the future. However, in the field of endodontics, the research in that direction is only about to evolve. Because pulpal and periradicular diseases are related to opportunistic infections, diag...

  8. Diagnostic laboratory testing for Charcot Marie Tooth disease (CMT): the spectrum of gene defects in Norwegian patients with CMT and its implications for future genetic test strategies

    OpenAIRE

    Østern, Rune André Helland; Fagerheim, Toril; Hjellnes, Helene; Nygård, Bjørn; Mellgren, Svein Ivar; Nilssen, Øivind

    2013-01-01

    Background Current genetic test algorithms for Charcot Marie Tooth (CMT) disease are based on family details and comprehensive clinical and neurophysiological data gathered under ideal conditions for clinical assessment. However, in a diagnostic laboratory setting relying on external test requisitions and patient samples, such conditions are not always met. Our objective was therefore to perform a retrospective evaluation of the data given in laboratory request forms and to assess their quali...

  9. Alternative security

    International Nuclear Information System (INIS)

    This book contains the following chapters: The Military and Alternative Security: New Missions for Stable Conventional Security; Technology and Alternative Security: A Cherished Myth Expires; Law and Alternative Security: Toward a Just World Peace; Politics and Alternative Security: Toward a More Democratic, Therefore More Peaceful, World; Economics and Alternative Security: Toward a Peacekeeping International Economy; Psychology and Alternative Security: Needs, Perceptions, and Misperceptions; Religion and Alternative Security: A Prophetic Vision; and Toward Post-Nuclear Global Security: An Overview

  10. Diagnostic Imaging

    Science.gov (United States)

    Diagnostic imaging lets doctors look inside your body for clues about a medical condition. A variety of machines and ... and activities inside your body. The type of imaging your doctor uses depends on your symptoms and ...

  11. Alternate strategies to obtain mass balance without the use of radiolabeled compounds: application of quantitative fluorine (19F) nuclear magnetic resonance (NMR) spectroscopy in metabolism studies.

    Science.gov (United States)

    Mutlib, Abdul; Espina, Robert; Atherton, James; Wang, Jianyao; Talaat, Rasmy; Scatina, JoAnn; Chandrasekaran, Appavu

    2012-03-19

    Nuclear magnetic resonance (NMR) spectroscopy is playing an increasingly important role in the quantitation of small and large molecules. Recently, we demonstrated that (1)H NMR could be used to quantitate drug metabolites isolated in submilligram quantities from biological sources. It was shown that these metabolites, once quantitated by NMR, were suitable to be used as reference standards in quantitative LC/MS-based assays, hence circumventing the need for radiolabeled material or synthetic standards to obtain plasma exposure estimates in humans and preclinical species. The quantitative capabilities of high-field NMR is further demonstrated in the current study by obtaining the mass balance of fluorinated compounds using (19)F-NMR. Two fluorinated compounds which were radio-labeled with carbon-14 on metabolically stable positions were dosed in rats and urine and feces collected. The mass balance of the compounds was obtained initially by counting the radioactivity present in each sample. Subsequently, the same sets of samples were analyzed by (19)F-NMR, and the concentrations determined by this method were compared with data obtained using radioactivity counting. It was shown that the two methods produced comparable values. To demonstrate the value of this analytical technique in drug discovery, a fluorinated compound was dosed intravenously in dogs and feces and urine collected. Initial profiling of samples showed that this compound was excreted mainly unchanged in feces, and hence, an estimate of mass balance was obtained using (19)F-NMR. The data obtained by this method was confirmed by additional quantitative studies using mass spectrometry. Hence cross-validations of the quantitative (19)F-NMR method by radioactivity counting and mass spectrometric analysis were demonstrated in this study. A strategy outlining the use of fluorinated compounds in conjunction with (19)F-NMR to understand their routes of excretion or mass balance in animals is proposed. These

  12. Inflammation in human cerebral aneurysms: pathogenesis, diagnostic imaging, genetics, and therapeutics

    Directory of Open Access Journals (Sweden)

    Sarah A Dooley

    2015-06-01

    Full Text Available Intracranial aneurysms are a life-threatening cerebrovascular pathology with a probability of spontaneous rupture. Current intervention techniques carry inherent risk. Recent investigation has reinforced inflammation's role in the pathophysiological process of cerebral aneurysms. These data suggest alternative diagnostic and noninvasive therapeutic strategies. Furthermore, novel characteristics of the underlying disease have been elucidated through distinct bioinformatic and gene expression profile analyses. This article will emphasize the most recent investigation, highlighting findings of clinical significance and etiological relevance.

  13. Plasma Diagnostics

    International Nuclear Information System (INIS)

    The success in achieving peaceful fusion power depends on the ability to control a high temperature plasma, which is an object with unique properties, possibly the most complicated object created by humans. Over years of fusion research a new branch of science has been created, namely plasma diagnostics, which involves knowledge of almost all fields of physics, from electromagnetism to nuclear physics, and up-to-date progress in engineering and technology (materials, electronics, mathematical methods of data treatment). Historically, work on controlled fusion started with pulsed systems and accordingly the methods of plasma parameter measurement were first developed for short lived and dense plasmas. Magnetically confined hot plasmas require the creation of special experimental techniques for diagnostics. The diagnostic set is the most scientifically intensive part of a plasma device. During many years of research operation some scientific tasks have been solved while new ones arose. New tasks often require significant changes in the diagnostic system, which is thus a very flexible part of plasma machines. Diagnostic systems are designed to solve several tasks. As an example here are the diagnostic tasks for the International Thermonuclear Experimental Reactor - ITER: (1) Measurements for machine protection and basic control; (2) Measurements for advanced control; (3) Additional measurements for performance evaluation and physics. Every new plasma machine is a further step along the path to the main goal - controlled fusion - and nobody knows in advance what new phenomena will be met on the way. So in the planning of diagnostic construction we should keep in mind further system upgrading to meet possible new scientific and technical challenges. (author)

  14. Diagnostic development

    International Nuclear Information System (INIS)

    During the past year the far-infrared or submillimeter diagnostic research program resulted in three major developments: (1) an optically pumped 0.385-μm D2O-laser oscillator-amplifier system was operated at a power level of 1 MW with a line width of less than 50 MHz; (2) a conical Pyrex submillimeter laser beam dump with a retention efficiency greater than 104 was developed for the ion temperature Thompson scattering experiment; and (3) a new diagnostic technique was developed that makes use of the Faraday rotation of a modulated submillimeter laser beam to determine plasma current profile. Measurements of the asymmetric distortion of the H/sub α/ (6563 A) spectral line profile show that the effective toroidal drift velocity, dv/sub two vertical bars i/dT/sub i/, may be used as an indicator of plasma quality and as a complement to other ion temperature diagnostics

  15. Applications of a Rapid and Sensitive Dengue DUO Rapid Immunochromatographic Test Kit as a Diagnostic Strategy during a Dengue Type 2 Epidemic in an Urban City

    Science.gov (United States)

    Shih, Hsin-I; Hsu, Hsiang-Chin; Wu, Chi-Jung; Lin, Chih-Hao; Chang, Chia-Ming; Tu, Yi-Fang; Hsieh, Chih-Chia; Chi, Chih-Hsien; Sung, Tzu-Ching

    2016-01-01

    Dengue infection is a major health problem in tropical and subtropical countries. A prospective observational study in a university-affiliated hospital was conducted between August 2015 and September 2015. Patients who visited the emergency department (ED) with a presentation of any symptoms of dengue were eligible for the dengue non-structural protein 1 (NS1), IgM/IgG rapid immunochromatographic tests and real-time polymerase chain reaction (RT-PCR) to evaluate the performance of the rapid tests. Considering the RT-PCR as the gold standard for the dengue diagnosis, the ideal primary results of sensitivity (80–100%), specificity (60–84%), positive predicted value(75%-95%), and negative predicted value (70–100%) suggested that the NS1-based test with or without a combination of IgM and IgG tests have good diagnostic performances in detecting dengue infections, even in the afebrile or elderly populations. PMID:27415767

  16. Comparison of different strategies of bearing with 99m Tc in the development of potentials radiopharmaceuticals for the diagnostic of hypoxia in nuclear medicine

    International Nuclear Information System (INIS)

    Comparison of different strategies of bearing with 99m Tc., in the development of potentials radiopharmaceuticals for diagnosis of hypoxia in nuclear medicine. With the aim of developing potentials radiopharmaceuticals of 99m Tc., for images of zones of hypoxia, several complexes have been prepared containing the aromatic pharmaceutical . This pharmaceutical in conditions of hypoxia is capable of suffering an irreversible reduction, transforming in cytotoxic groups, that would remain caught inside the cell

  17. Construction Strategy for an Internal Amplification Control for Real-Time Diagnostic Assays Using Nucleic Acid Sequence-Based Amplification: Development and Clinical Application

    OpenAIRE

    Rodríguez-Lázaro, David; D'Agostino, Martin; Pla, Maria; Cook, Nigel

    2005-01-01

    An important analytical control in molecular amplification-based methods is an internal amplification control (IAC), which should be included in each reaction mixture. An IAC is a nontarget nucleic acid sequence which is coamplified simultaneously with the target sequence. With negative results for the target nucleic acid, the absence of an IAC signal indicates that amplification has failed. A general strategy for the construction of an IAC for inclusion in molecular beacon-based real-time nu...

  18. Diagnostic test

    International Nuclear Information System (INIS)

    A diagnostic test is provided based on competitive binding in which a partition coefficient is established for the substance whose concentration is to be determined and for the radioactive labeled form of the substance between liquid and solid phases. 10 claims

  19. Establishing a Program for Behaviorally Disordered Students: Alternatives to Consider, Components to Include, and Strategies for Building Support: Monograph 3. Monograph Series in Behavior Disorders.

    Science.gov (United States)

    Heilman, Lanelle

    The types of programs that can be established for behaviorally disordered (BD) students are discussed, along with behavioral monitoring systems and approaches to establishing staff and administrative support for programs. In addition, a checklist of program components for BD students is included. The following program alternatives are described:…

  20. Status of US ITER Diagnostics

    Science.gov (United States)

    Stratton, B.; Delgado-Aparicio, L.; Hill, K.; Johnson, D.; Pablant, N.; Barnsley, R.; Bertschinger, G.; de Bock, M. F. M.; Reichle, R.; Udintsev, V. S.; Watts, C.; Austin, M.; Phillips, P.; Beiersdorfer, P.; Biewer, T. M.; Hanson, G.; Klepper, C. C.; Carlstrom, T.; van Zeeland, M. A.; Brower, D.; Doyle, E.; Peebles, A.; Ellis, R.; Levinton, F.; Yuh, H.

    2013-10-01

    The US is providing 7 diagnostics to ITER: the Upper Visible/IR cameras, the Low Field Side Reflectometer, the Motional Stark Effect diagnostic, the Electron Cyclotron Emission diagnostic, the Toroidal Interferometer/Polarimeter, the Core Imaging X-Ray Spectrometer, and the Diagnostic Residual Gas Analyzer. The front-end components of these systems must operate with high reliability in conditions of long pulse operation, high neutron and gamma fluxes, very high neutron fluence, significant neutron heating (up to 7 MW/m3) , large radiant and charge exchange heat flux (0.35 MW/m2) , and high electromagnetic loads. Opportunities for repair and maintenance of these components will be limited. These conditions lead to significant challenges for the design of the diagnostics. Space constraints, provision of adequate radiation shielding, and development of repair and maintenance strategies are challenges for diagnostic integration into the port plugs that also affect diagnostic design. The current status of design of the US ITER diagnostics is presented and R&D needs are identified. Supported by DOE contracts DE-AC02-09CH11466 (PPPL) and DE-AC05-00OR22725 (UT-Battelle, LLC).

  1. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions

    International Nuclear Information System (INIS)

    A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: -4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19 of 131 patients (14.5%) post Gd-EOB-DTPA-enhanced MRI. Gd-EOB-DTPA-enhanced MRI was superior in the diagnosis and therapeutic management of focal liver lesions compared with CT. (orig.)

  2. The alternative Pharaoh approach: stingless bees mummify beetle parasites alive

    Science.gov (United States)

    Greco, Mark K.; Hoffmann, Dorothee; Dollin, Anne; Duncan, Michael; Spooner-Hart, Robert; Neumann, Peter

    2010-03-01

    Workers from social insect colonies use different defence strategies to combat invaders. Nevertheless, some parasitic species are able to bypass colony defences. In particular, some beetle nest invaders cannot be killed or removed by workers of social bees, thus creating the need for alternative social defence strategies to ensure colony survival. Here we show, using diagnostic radioentomology, that stingless bee workers ( Trigona carbonaria) immediately mummify invading adult small hive beetles ( Aethina tumida) alive by coating them with a mixture of resin, wax and mud, thereby preventing severe damage to the colony. In sharp contrast to the responses of honeybee and bumblebee colonies, the rapid live mummification strategy of T. carbonaria effectively prevents beetle advancements and removes their ability to reproduce. The convergent evolution of mummification in stingless bees and encapsulation in honeybees is another striking example of co-evolution between insect societies and their parasites.

  3. Development of a two-line OH-laser-induced fluorescence thermometry diagnostics strategy for gas-phase temperature measurements in engines

    International Nuclear Information System (INIS)

    This study aims at optimizing two-line OH thermometry strategies for in-cylinder measurement in internal combustion engines. Various aspects are investigated experimentally, such as the selection of suitable OH lines and the possibility of using a single calibration coefficient for variable mixture composition, temperature, and pressure conditions. Two kinds of experimental systems have been investigated. First, a laminar methane-air burner flame at atmospheric pressure, whose stability allowed the determination of OH-laser-induced fluorescence (LIF) intensity ratios from nonsimultaneous imaging. The temperature distribution in the flame is presented for OH-transition pairs with various temperature sensitivities. The burner flame was studied for equivalence ratios from φ=0.93 to 1.30 in order to check for the stability of calibration over various flame conditions. Additionally, OH LIF images were acquired in an optical engine for the chosen OH transitions yielding data about the effect of pressure on OH LIF signals under realistic experimental conditions

  4. Secondary influences and ectopic causes of canine hip dysplasia. Critical constructive thoughts to hip dysplasia diagnostics and to current breeding strategies

    International Nuclear Information System (INIS)

    This article questions the stagnation of breeding results by hip dysplasia screening and its current etiology. The ''Coxa Valga Antetorta'', anteversion of the hip joint and ''soft tissue displasia'' are discussed besides a multitude of primary diseases leading to growth deformities and other diseases in the hip. Ectopic primary causes like malformation of the spine leading to a secondary ''dysplatic'' osteoarthritis of the hip (functional secondary dysplasia) are also discussed in this article. Recent and very promising breeding strategies (estimation of the breeding value) in the battle against hip dysplasia are presented. Biochemical, immunological and structural aspects are presented as a not totally utopic perspecitive. Molecular genetic markers for hip dysplasia will offer in the near future a possibility to detect carriers ct the disease by a blood sample ion before clinical manifestation

  5. Making Diagnostic and Therapeutic Strategies for Ankle Fractures Under the Guide of Lauge-Hansen Classification%Lauge-Hansen分型指导踝关节骨折的诊断及治疗决策

    Institute of Scientific and Technical Information of China (English)

    王海洲; 陈海云; 林强; 伍梓芳; 胡瀛宇

    2012-01-01

    [目的]观察Lauge-Hanse分型对踝关节骨折的诊断及治疗决策指导作用.[方法]使用Lauge-Hansen分型对32例踝关节骨折患者进行分型,分析受伤机制,评估损伤部位及损伤程度,据此制定治疗决策并进行治疗.[结果](1)本组32例均无术后感染、皮肤坏死、内固定失败及神经损伤等并发症发生.(2)所有患者均得到随访,随访时间8~46个月,平均27个月.32例均获得骨性愈合,完全负重时间2~3个月.足踝功能按AOFAS评分系统评分为80~100分,平均97.7分,其中优30例,良2例.[结论]Lauge-Hanse分型有助于充分诊断踝关节骨折损伤情况,利于做出正确的治疗决策,故获得良好的治疗效果.%Objective To summarize the experience of making diagnostic and therapeutic strategies for ankle fractures under the guide of Lauge-Hansen classification. Methods Thirty-two cases of ankle fractures were classified according to Lauge-Hansen classification system, and their injured mechanism was analyzed. The position and degree of ankle fracture injury were assessed for making therapeutic strategies for ankle fractures patients. Results After treatment, none of the cases had postoperative infection, cutaneous necrosis, failure in internal fixation or nerve injury. All of the patients got the follow-up, and the follow-up covered 8-46 months, averaging 27 months. The results of follow-up showed that bone union was obtained in all of the 32 patients, and time for complete weight loading was in 2-3 months. The ankle function score according to AOFAS system was 80-100, and the average score was 97. 7. Therapeutic effect on ankle function was excellent in 30 cases, and good in 2 cases. Conclusion Lauge-Hansen classification is benefit to making exact diagnostic and therapeutic strategies for ankle fractures.

  6. 40 CFR 86.005-17 - On-board diagnostics.

    Science.gov (United States)

    2010-07-01

    ... Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.005-17 On-board diagnostics. (a) General... alternate fueled engines. For alternate fueled heavy-duty engines (e.g. natural gas, liquefied petroleum...

  7. Alternative strategies to prevent and control endoparasite diseases in organic sheep and goat farming systems – a review of current scientific knowledge

    OpenAIRE

    Rahmann, Gerold (Ed.); Seip, Hannah

    2006-01-01

    Infestation with gastro-intestinal nematodes in small ruminants can cause server economic losses and endanger animal welfare. The development of organic farming systems, the increased public awareness for drug residues in agricultural products and the development of resistant strains of parasites have enforced the search for sustainable alternatives. The aim of this paper was to provide information about endoparasite infecting small ruminants, to give an overview of the legal background and t...

  8. Diagnostic fragment-ion-based and extension strategy coupled to DFIs intensity analysis for identification of chlorogenic acids isomers in Flos Lonicerae Japonicae by HPLC-ESI-MS(n).

    Science.gov (United States)

    Zhang, Jia-Yu; Zhang, Qian; Li, Ning; Wang, Zi-Jian; Lu, Jian-Qiu; Qiao, Yan-Jiang

    2013-01-30

    A method of modified diagnostic fragment-ion-based extension strategy (DFIBES) coupled to DFIs (diagnostic fragmentation ions) intensity analysis was successfully established to simultaneously screen and identify the chlorogenic acids (CGAs) in Flos Lonicerae Japonicae (FLJ) by HPLC-ESI-MS(n). DFIs, such as m/z 191 [quinic acid-H](-), m/z 179 [caffeic acid-H](-) and m/z 173 [quinic acid-H-H2O](-) were determined or proposed from the fragmentation patterns analysis of corresponding reference substances for every chemical family of CGAs. A "structure extension" method was then proposed based on the well-demonstrated fragmentation patterns and was successively applied into the rapid screening of CGAs in FLJ. Considering that substitution isomerism is a common phenomenon, a full ESI-MS(n) fragmentation analysis according to the intensity of DFIs has been performed to identify the CGA isomers. Based on the DFIs and intensity analysis, 41 peaks attributed to CGAs including 4 caffeoylquinic acids (CQA), 7 CQA glycosides, 6 dicaffeoylquinic acids (DiCQA), 10 DiCQA glycosides, 1 tricaffeoylquinic acids (TriCQA), 4p-coumaroylquinic acids (pCoQA), 3 feruloylquinic acids (FQA) and 6 caffeoylferuloylquinic acids (CFQA) were identified preliminarily in a 65-min chromatographic run. It was the first time to systematically report the presence of CGAs in FLJ, especially for CQA glycosides, DiCQA glycosides, TriCQA, pCoQA and CFQA. All the results indicated that the method of developed DFIBES coupled to DFIs analysis was feasible, reliable and universal for screening and identifying the constituents with the same carbon skeletons especially the isomeric compounds from the complex extract of TCMs. PMID:23597880

  9. Strategy Development in Organisations

    DEFF Research Database (Denmark)

    Sørensen, Lene

    1999-01-01

    There exist certain ambiguities with the converging fields of information technology and organisational strategy development. The term "IT strategy" has evolved and reflects in some respects this confusion. This paper discusses some of the ambiguities and difficulties of the term "IT strategy......" as used in practice and literature. Emphasis is put on how the term is related to the problem, the organisation, the strategy process and the practical way of methodologically developing the strategy. Finally, alternative strategy developing perspectives are presented....

  10. Experimental evidence of the efficiency of two resistance genes deployment strategies - pyramiding or alternating - for sustainable management of root-knot nematodes

    OpenAIRE

    Fazari, Ariane; Marteu, Nathalie; Sage-Palloix, Anne-Marie; Risso, S.; Lanza, R.; Palloix, Alain; Castagnone-Sereno, Philippe

    2012-01-01

    The current restrictions of the use of chemical nematicides have contributed to increase root-knot nematode (RKN) problems in horticultural crops. ln this context, plant resistance appears as the most effective and sustainable method of control. ln horticultural crops, a few major resistance (R) genes are available, but the possible occurrence of virulent nematode populations able to reproduce on R-plants may constitute a severe threat to this control strategy. Here, we tested several R-gene ...

  11. Alternative methods and strategies to reduce, refine, and replace animal use for veterinary vaccine post-licensing safety testing: state of the science and future directions

    OpenAIRE

    KULPA-EDDY Jodie; Srinivas, Geetha; HALDER Maria; Brown, Karen; DRAAYER Hans; GALVIN Jeffrey; CLAASEN Ivo; WOODLAND Ralph; DOELLING Vivian; JONES Brett; Stokes, William

    2011-01-01

    NICEATM and ICCVAM convened an international workshop to review the state of the science of human and veterinary vaccine potency and safety testing methods and to identify opportunities to advance new and improved methods that can further reduce, refine, and replace animal use. Six topics were addressed in detail by speakers and workshop participants and are reported in a series of six reports. This workshop report, the last in the series, addresses methods and strategies for veterinary vacci...

  12. The marketing strategies of electricity and natural gas providers in France. Which perspectives for alternate operators in front of EDF and GDF Suez?

    International Nuclear Information System (INIS)

    This article presents the content of a market study which aimed at gathering and analysing figures regarding electricity and natural gas (production, consumption, tariffs, gross prices, etc.), at assessing the market shares of the main providers and their commercial position, at understanding the impact of the Nome law and of the gas price problematic on providers and consumers, and at assessing the capacity of alternate operators to challenge the positions held by EDF and GDF Suez. Besides EDF and GDF Suez, the following providers are analysed: Alpiq, Electricite de Strasbourg, Enel France, ENI, E.ON France, Gas Natural Fenosa, Poweo Direct Energie, Soregies, Tegaz

  13. Thyroid diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Scriba, P.C.; Boerner, W.; Emrich, S.; Gutekunst, R.; Herrmann, J.; Horn, K.; Klett, M.; Krueskemper, H.L.; Pfannenstiel, P.; Pickardt, C.R.

    1985-03-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted.

  14. Sensitive Diagnostics for Chemically Reacting Flows

    KAUST Repository

    Farooq, Aamir

    2015-11-02

    This talk will feature latest diagnostic developments for sensitive detection of gas temperature and important combustion species. Advanced optical strategies, such as intrapulse chirping, wavelength modulation, and cavity ringdown are employed.

  15. PROcess Based Diagnostics PROBE

    Science.gov (United States)

    Clune, T.; Schmidt, G.; Kuo, K.; Bauer, M.; Oloso, H.

    2013-01-01

    Many of the aspects of the climate system that are of the greatest interest (e.g., the sensitivity of the system to external forcings) are emergent properties that arise via the complex interplay between disparate processes. This is also true for climate models most diagnostics are not a function of an isolated portion of source code, but rather are affected by multiple components and procedures. Thus any model-observation mismatch is hard to attribute to any specific piece of code or imperfection in a specific model assumption. An alternative approach is to identify diagnostics that are more closely tied to specific processes -- implying that if a mismatch is found, it should be much easier to identify and address specific algorithmic choices that will improve the simulation. However, this approach requires looking at model output and observational data in a more sophisticated way than the more traditional production of monthly or annual mean quantities. The data must instead be filtered in time and space for examples of the specific process being targeted.We are developing a data analysis environment called PROcess-Based Explorer (PROBE) that seeks to enable efficient and systematic computation of process-based diagnostics on very large sets of data. In this environment, investigators can define arbitrarily complex filters and then seamlessly perform computations in parallel on the filtered output from their model. The same analysis can be performed on additional related data sets (e.g., reanalyses) thereby enabling routine comparisons between model and observational data. PROBE also incorporates workflow technology to automatically update computed diagnostics for subsequent executions of a model. In this presentation, we will discuss the design and current status of PROBE as well as share results from some preliminary use cases.

  16. A microcosting study of diagnostic tests for the detection of coronary artery disease in the Netherlands

    International Nuclear Information System (INIS)

    Objective: The primary aim of the present study was to calculate the actual costs of four diagnostic tests for the detection of coronary artery disease in the Netherlands using a microcosting methodology. As a secondary objective, the cost effectiveness of eight diagnostic strategies was examined, using microcosting and reimbursement fees subsequently as the cost estimate. Design: A multicenter, retrospective cost analysis from a hospital perspective. Setting: The study was conducted in three general hospitals in the Netherlands for 2006. Interventions: Exercise electrocardiography (exECG), stress echocardiography (sECHO), single-photon emission computed tomography (SPECT) and coronary angiography (CA). Results: The actual costs of exECG, sECHO, SPECT and CA were Euro 33, 216, 614 and 1300 respectively. For all diagnostic tests, labour and indirect cost components (overheads and capital) together accounted for over 75% of the total costs. Consumables played a relatively important role in SPECT (14%). Hotel and nutrition were only applicable to SPECT and CA. Diagnostic services were solely performed for CA, but their costs were negligible (2%). Using microcosting estimates, exECG-sECHO-SPECT-CA was the most and CA the least cost effective strategy ( Euro 397 and 1302 per accurately diagnosed patient). Using reimbursement fees, exECG-sECHO-CA was most and SPECT-CA least cost effective ( Euro 147 and 567 per accurately diagnosed patient). Conclusions: The use of microcosting estimates instead of reimbursement fees led to different conclusions regarding the relative cost effectiveness of alternative strategies.

  17. "Eco-Infill" as an alternative strategy for postindustrial landscape in the light of climate change: The case of Belgrade shipyard

    Directory of Open Access Journals (Sweden)

    Nikezić Ana

    2012-01-01

    Full Text Available At this moment, and under the circumstances that surround us, we have recognized as a definite global challenge the problem of climate change, and in general, the ecological misbalance of cities. In an attempt to meet this challenge, we will try to discuss possibilities of implementing the "Eco-Infill" strategy (fragments of nature incorporated into abandoned artificial environment as a viable, somewhat “alternative”, urban development strategy. The contemporary matrix of the post-industrial urban landscape is dotted with large and small fragments of abandoned spaces, which need to be incorporated into the city texture. Belgrade is a city with a potential, one of the larger capitals of the region, standing on the threshold of the European Union and undergoing an intensive process of political, economic and social transition. Similar to other large cities, it was previously an industrial city, but is now increasingly relying on the tertiary sector, promoting itself through its geographical, morphological, and cultural advantages. The consequences of privatization during transition and an exceptionally long and difficult political and economic crisis produced Brownfield and other abandoned spaces of the city centre with a complicated proprietary-ownership status, and no realistic guidelines for a much needed regeneration of the city centre in terms of contemporary problems linked to ecological, social and cultural values. In this article, there is a tendency to define principles on which the transformation of these abandoned places is based on and to try to apply these strategies onto the Belgrade shipyard on the river Sava. If we accept the previously set general views, these spaces can become crucial in developing a strategy for mitigation and adaptation to climate change. Although these effects are primarily aimed at confronting climate change, they are bound to upgrade the quality of life and offer new life styles, potentially affecting

  18. Alternative affinity tools: more attractive than antibodies?

    NARCIS (Netherlands)

    Ruigrok, V.J.B.; Levisson, M.; Eppink, M.H.M.; Smidt, H.; Oost, van der J.

    2011-01-01

    Antibodies are the most successful affinity tools used today, in both fundamental and applied research (diagnostics, purification and therapeutics). Nonetheless, antibodies do have their limitations, including high production costs and low stability. Alternative affinity tools based on nucleic acids

  19. Alternative strategies to manipulate fibrocyte involvement in the fibrotic tissue response: pharmacokinetic inhibition and the feasibility of directed-adipogenic differentiation.

    Science.gov (United States)

    Baker, David W; Tsai, Yi-Ting; Weng, Hong; Tang, Liping

    2014-07-01

    Fibrocytes have previously been identified as important mediators in several inflammatory and fibrotic diseases. However, there is no effective treatment thus far to reduce fibrotic tissue responses without affecting wound healing reactions. Here we investigate two strategies to alleviate fibrocyte interactions at the biomaterial interface, reducing collagen production and scar tissue formation. First, in an indirect approach, TGF-β inhibitor-SB431542 and IL-1β/TNF-α inhibitor SB203580 were locally released from scaffold implants to block their respective signaling pathways. We show that the inhibition of IL-1β/TNF-α has no influence on overall fibrotic tissue reactions to the implants. However, the reduction of localized TGF-β significantly decreases the fibrocyte accumulation and myofibroblast activation while reducing the fibrotic tissue formation. Since fibrocytes can be differentiated into non-fibrotic cell types, such as adipocytes, we further sought a more direct approach to reduce fibrocyte responses by directing fibrocyte differentiation into adipocytes. Interestingly, by initiating fibrocyte-to-adipocyte differentiation through sustained differentiation cocktail release, we find that adipogenic differentiation forces incoming fibrocytes away from the traditional myofibroblast lineage, leading to a substantial reduction in the collagen formation and fibrotic response. Our results support a novel and effective strategy to improve implant safety by reducing implant-associated fibrotic tissue reactions via directing non-fibrotic differentiation of fibrocytes. PMID:24657674

  20. Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer

    DEFF Research Database (Denmark)

    Pedersen, Christina Gundgaard; Christensen, Søren; Jensen, Anders Bonde; Zachariae, Robert

    2009-01-01

    This study investigated the prevalence and predictors of use of complementary and alternative medicine (CAM) in a nationwide inception cohort of Danish women treated for early-stage breast cancer as well as differences in user patterns for individual types of CAM.......This study investigated the prevalence and predictors of use of complementary and alternative medicine (CAM) in a nationwide inception cohort of Danish women treated for early-stage breast cancer as well as differences in user patterns for individual types of CAM....

  1. New religious movements and alternative religions in France: the use of digital media as a counter-strategy against social and legal exclusion

    Directory of Open Access Journals (Sweden)

    Christiane Königstedt

    2016-08-01

    Full Text Available The internet is widely used internationally by individuals and groups who otherwise perceive and experience a lack of influence and even repression by authorities and whose opinions remain invisible in or are ignored by the mass media. The new media are a frequently-used means of expression in the political struggles of social and religious movements, especially as part of attempts to increase the number of supporters and to mobilise public opinion. The extent, of the usage as well as its degree of success, does vary and because of this variety, a comparative analysis can illuminate parts of the whole conflictuous configuration as well as the chances and limits of resistance and opposition via these media channels. Organisations which were chosen to be investigated here were the so-called ‘new religious movements’, or more precisely, the many forms of alternative religion in France who face significant levels of social and legal exclusion, while most of their members are themselves usually strongly committed to democracy and their identities as equal French citizens. Therefore, they choose to perform counter-actions which are within the law and act strategically, which makes them a special case compared to revolutionary political movements which may question the social order of the state as a whole. France, with its ‘anti-cult’ policy, has come to a unique standing within the Western world in this respect. Though religious freedom and state neutrality in relation to religious issues are constitutionally granted, a differentiation is made – and partially even legally enforced – between good religions and harmful ones which attempt to manipulate their adepts mentally. The debates are held in a constant dynamic between the struggling parties of ‘anti-cult’ movements and alternative religions. The exclusion of the latter from the mass media is revealed be one central means of hindering them from gaining approval within society

  2. CT guided diagnostic foot injections

    International Nuclear Information System (INIS)

    AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy

  3. CT guided diagnostic foot injections

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, A. [Department of Diagnostic Imaging, Royal National Orthopaedic Hospital NHS Trust, Stanmore (United Kingdom)]. E-mail: asaifuddin@aol.com; Abdus-Samee, M. [Department of Foot and Ankle Surgery, Royal National Orthopaedic Hospital NHS Trust, Stanmore (United Kingdom); Mann, C. [Department of Foot and Ankle Surgery, Royal National Orthopaedic Hospital NHS Trust, Stanmore (United Kingdom); Singh, D. [Department of Foot and Ankle Surgery, Royal National Orthopaedic Hospital NHS Trust, Stanmore (United Kingdom); Angel, J.C. [Department of Foot and Ankle Surgery, Royal National Orthopaedic Hospital NHS Trust, Stanmore (United Kingdom)

    2005-02-01

    AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy.

  4. Fetal exposure in diagnostic radiology

    International Nuclear Information System (INIS)

    The problem of possible radiation damage to the fetus or embryo as a result of diagnostic radiography during pregnancy, particularly in the early stages, is discussed. Recommendations of therapeutic abortion after fetal exposure require an adequate knowledge of the doses involved. In the absence of actual dose measurements or estimates, approximate exposure levels may be determined from the literature. A summary of published values for radiography involving the lower abdomen is given. Data is also presented from a series of fetal exposures resulting mostly from routine diagnostic radiography when pregnancy was not known at the time but was established later. Results of actual dose measurements using a phantom and of dose calculations based on published values are in reasonable agreement indicating that literature values of dose provide a satisfactory alternative to measurement. These data suggest that diagnostic radiography rarely, if ever, results in fetal exposures high enough to justify therapeutic abortion. (author)

  5. Mitigation diagnostics

    International Nuclear Information System (INIS)

    This paper reports that experience in the remediation of schools and other large buildings has shown the importance of the effects of both the location of geologic sources and HVAC-induced distribution of indoor radon. In general, elevated radon in areas of schools with evenly distributed HVAC pressures are correlated with maximum soil radon emanations. However, strong or unequal HVAC effects can redistribute indoor radon to areas away from the direct source. Effective remediation required a complete understanding of both contributions. In some schools, highest indoor radon levels were located near large return ducts and were attributed to proximity to negative HVAC pressure. Successful sub-slab depressurization systems were installed, however, in rooms with lower indoor but greatest sub-slab radon levels, closest to the source. This shows the inadequacy of using indoor radon levels alone as a basis for remediation. Wings of two other schools with radon problems have equivalent window fan coil units in rooms of equal size and no central HVAC system. Highest indoor radon levels correlated well with highest sub-slab radon levels due to the equivalent effects of the window units. Diagnostic tests in other schools have revealed: blockwall radon transport to upper floors; high blockwall radon adjacent to sub-slab sources; and elevated indoor radon over crawlspace being drawn upward by HVAC-induced negative pressure, determined from indoor to outdoor micromanometer measurements

  6. Diagnostic thoracoscopy

    Directory of Open Access Journals (Sweden)

    Plavec Goran

    2002-01-01

    Full Text Available Diagnostic thoracoscopy in patients with pleural effusion of unclear origin mostly provides the correct diagnosis. Results from published reports of previous researches are not uniform. In 47 male and 20 female patients with pleural effusion of unknown etiology, after receiving negative results obtained from cytological finding of pleural effusion and percutaneous needle biopsy, thoracoscopy with biopsy of one or both pleurae was performed. Procedure was done in local anesthesia using Stortz rigid thoracoscope. In 37 patients with malignant disease (primary or metastatic diagnosis was confirmed histopathologically in 31 patient (81.12%. In 27 patients with inflammatory pleural disease diagnosis was confirmed histopathologically in 22 patients (81.4%. Among 11 patients with specific pleural effusions, tuberculosis was confirmed in 10 (90.91%. Normal finding in cases of spontaneous pneumothorax and pulmonary embolism was taken as a positive result. Total number of positive findings was 55 (82.10%. In one patient, the third spontaneous pneumothorax was the indication for thoracoscopy, and after numerous bullae were seen during the procedure, talcum powder pleurodesis was done. In four patients low intensity subcutaneous emphysema occurred one day after thoracoscopy. It can be concluded that thoracoscopy in local anesthesia out of the operating room is good and practical method for solving the unclear pleural effusions, with neglectable rate of complications.

  7. Impact of alternative reimbursement strategies in the new cooperative medical scheme on caesarean delivery rates: a mixed-method study in rural China

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-07-01

    Full Text Available Abstract Background The rate of caesarean delivery (CD in rural China has been rapidly increasing in recent decades. Due to the exorbitant costs associated with CD, paying for this expensive procedure is often a great challenge for the majority of rural families. Since 2003, the Chinese government has re-established the New Cooperative Medical Scheme (NCMS, aimed to improve the access of essential healthcare to rural residents and reduce financial burden owing to high out of pocket payments. This paper seeks to test the hypothesis that NCMS may provide service users and providers with financial incentives to select CD. It also assesses the effect of different health insurance reimbursement strategies of NCMS on CD rates in rural China. Methods Mixed quantitative and qualitative methods were adopted for data collection. Two cross-sectional household surveys were conducted with women having babies delivered in 2006 and 2009; 2326 and 1515 women, respectively, from the study sites were interviewed using structured questionnaires, to collect demographic and socio-economic data, maternal and child care characteristics and health-related expenditures. Focus group discussions (FGDs and in-depth key informant interviews (KIIs were undertaken with policy makers, health managers, providers and mothers to understand their perceptions of the influence of NCMS on the choices of delivery mode. Results The CD rates in the two study counties were 46.0 percent and 64.7 percent in 2006, increasing to 63.6 percent and 82.1 percent, respectively, in 2009. The study found that decisions on the selection of CD largely came from the pregnant women. Logistic regression analysis, after adjusting for socio-economic, maternal and fetal characteristics, did not indicate a significant effect of either proportional reimbursement or fixed amount reimbursement on the choice of CD for both study years. Interviews with stakeholders reflected that different reimbursable rates for

  8. Economic feasibility of hydrogen enrichment for reducing NOx emissions from landfill gas power generation alternatives: A comparison of the levelized cost of electricity with present strategies

    International Nuclear Information System (INIS)

    Based on recent research showing that hydrogen enrichment can lower NOx emissions from landfill gas combustion below future NOx emission control standards imposed by both federal and California state regulations, an investigation was performed to compare the levelized cost of electricity of this technology with other options. In this cost study, a lean-burn reciprocating engine with no after-treatment was the baseline case to compare six other landfill gas-to-energy projects. These cases include a lean burn engine with selective catalytic reduction after treatment, a lean-burn microturbine, and four variations on an ultra-lean-burn engine utilizing hydrogen enrichment with each case using a different method of hydrogen production. Only hydrogen enrichment with an in-stream autothermal fuel reformer was shown to be potentially cost-competitive with current strategies for reaching the NOx reduction target in IC engines. - Highlights: ► Levelized cost of electricity for hydrogen enriched combustion was compared. ► Various ultra-lean-burn engines and microturbines with hydrogen were analyzed. ► Combustion with an autothermal fuel reformer was potentially cost-competitive.

  9. Diagnostic and treatment strategies in mucopolysaccharidosis VI

    OpenAIRE

    Giugliani, Roberto

    2015-01-01

    Filippo Vairo,1–3 Andressa Federhen,1,3,4 Guilherme Baldo,1,2,5–7 Mariluce Riegel,1,6 Maira Burin,1 Sandra Leistner-Segal,1,8 Roberto Giugliani1,5,6,81Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 2Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; 3Clinical Research Group on Medical Genetics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 4Post-Graduate Program...

  10. Diagnostic and treatment strategies in mucopolysaccharidosis VI

    OpenAIRE

    Vairo F; Federhen A; Baldo G; Riegel M.; Burin M; Leistner-Segal S; Giugliani R

    2015-01-01

    Filippo Vairo,1–3 Andressa Federhen,1,3,4 Guilherme Baldo,1,2,5–7 Mariluce Riegel,1,6 Maira Burin,1 Sandra Leistner-Segal,1,8 Roberto Giugliani1,5,6,81Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 2Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; 3Clinical Research Group on Medical Genetics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 4Post-Graduate Program in Child and Ad...

  11. Diagnostic and treatment strategies in mucopolysaccharidosis VI

    Science.gov (United States)

    Vairo, Filippo; Federhen, Andressa; Baldo, Guilherme; Riegel, Mariluce; Burin, Maira; Leistner-Segal, Sandra; Giugliani, Roberto

    2015-01-01

    Mucopolysaccharidosis VI (MPS VI) is a very rare autosomal recessive disorder caused by mutations in the ARSB gene, which lead to deficient activity of the lysosomal enzyme ASB. This enzyme is important for the breakdown of the glycosaminoglycans (GAGs) dermatan sulfate and chondroitin sulfate, which accumulate in body tissues and organs of MPS VI patients. The storage of GAGs (especially dermatan sulfate) causes bone dysplasia, joint restriction, organomegaly, heart disease, and corneal clouding, among several other problems, and reduced life span. Despite the fact that most cases are severe, there is a spectrum of severity and some cases are so attenuated that diagnosis is made late in life. Although the analysis of urinary GAGs and/or the measurement of enzyme activity in dried blood spots are useful screening methods, the diagnosis is based in the demonstration of the enzyme deficiency in leucocytes or fibroblasts, and/or in the identification of pathogenic mutations in the ARSB gene. Specific treatment with enzyme replacement has been available since 2005. It is safe and effective, bringing measurable benefits and increased survival to patients. As several evidences indicate that early initiation of therapy may lead to a better outcome, newborn screening is being considered for this condition, and it is already in place in selected areas where the incidence of MPS VI is increased. However, as enzyme replacement therapy is not curative, associated therapies should be considered, and research on innovative therapies continues. The management of affected patients by a multidisciplinary team with experience in MPS diseases is highly recommended. PMID:26586959

  12. Diagnostic and treatment strategies in mucopolysaccharidosis VI

    Directory of Open Access Journals (Sweden)

    Vairo F

    2015-10-01

    Full Text Available Filippo Vairo,1–3 Andressa Federhen,1,3,4 Guilherme Baldo,1,2,5–7 Mariluce Riegel,1,6 Maira Burin,1 Sandra Leistner-Segal,1,8 Roberto Giugliani1,5,6,81Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 2Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; 3Clinical Research Group on Medical Genetics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 4Post-Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; 5Gene Therapy Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 6Post-Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; 7Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; 8Post-Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilAbstract: Mucopolysaccharidosis VI (MPS VI is a very rare autosomal recessive disorder caused by mutations in the ARSB gene, which lead to deficient activity of the lysosomal enzyme ASB. This enzyme is important for the breakdown of the glycosaminoglycans (GAGs dermatan sulfate and chondroitin sulfate, which accumulate in body tissues and organs of MPS VI patients. The storage of GAGs (especially dermatan sulfate causes bone dysplasia, joint restriction, organomegaly, heart disease, and corneal clouding, among several other problems, and reduced life span. Despite the fact that most cases are severe, there is a spectrum of severity and some cases are so attenuated that diagnosis is made late in life. Although the analysis of urinary GAGs and/or the measurement of enzyme activity in dried blood spots are useful screening methods, the diagnosis is based in the demonstration of the enzyme deficiency in leucocytes or fibroblasts, and/or in the identification of pathogenic mutations in the ARSB gene. Specific treatment with enzyme replacement has been available since 2005. It is safe and effective, bringing measurable benefits and increased survival to patients. As several evidences indicate that early initiation of therapy may lead to a better outcome, newborn screening is being considered for this condition, and it is already in place in selected areas where the incidence of MPS VI is increased. However, as enzyme replacement therapy is not curative, associated therapies should be considered, and research on innovative therapies continues. The management of affected patients by a multidisciplinary team with experience in MPS diseases is highly recommended.Keywords: mucopolysaccharidosis VI, Maroteaux–Lamy syndrome, dermatan sulfate, arylsulfatase b, enzyme replacement therapy, lysosomal storage diseases

  13. [Unknown primary tumour - diagnostic strategies and treatment

    DEFF Research Database (Denmark)

    Møller, Anne Kirstine Hundahl; Gundgaard, M.G.; Petersen, Bodil Laub;

    2008-01-01

    Unknown primary tumour (UPT) is defined as a histologically confirmed metastatic malignancy for which no primary site has been detected. It accounts for approximately 3-5% of all malignant neoplasms. UPT represents a group of heterogeneous cancers with rapid progression and random, atypical metas...

  14. Diagnostic and treatment strategies in mucopolysaccharidosis VI.

    Science.gov (United States)

    Vairo, Filippo; Federhen, Andressa; Baldo, Guilherme; Riegel, Mariluce; Burin, Maira; Leistner-Segal, Sandra; Giugliani, Roberto

    2015-01-01

    Mucopolysaccharidosis VI (MPS VI) is a very rare autosomal recessive disorder caused by mutations in the ARSB gene, which lead to deficient activity of the lysosomal enzyme ASB. This enzyme is important for the breakdown of the glycosaminoglycans (GAGs) dermatan sulfate and chondroitin sulfate, which accumulate in body tissues and organs of MPS VI patients. The storage of GAGs (especially dermatan sulfate) causes bone dysplasia, joint restriction, organomegaly, heart disease, and corneal clouding, among several other problems, and reduced life span. Despite the fact that most cases are severe, there is a spectrum of severity and some cases are so attenuated that diagnosis is made late in life. Although the analysis of urinary GAGs and/or the measurement of enzyme activity in dried blood spots are useful screening methods, the diagnosis is based in the demonstration of the enzyme deficiency in leucocytes or fibroblasts, and/or in the identification of pathogenic mutations in the ARSB gene. Specific treatment with enzyme replacement has been available since 2005. It is safe and effective, bringing measurable benefits and increased survival to patients. As several evidences indicate that early initiation of therapy may lead to a better outcome, newborn screening is being considered for this condition, and it is already in place in selected areas where the incidence of MPS VI is increased. However, as enzyme replacement therapy is not curative, associated therapies should be considered, and research on innovative therapies continues. The management of affected patients by a multidisciplinary team with experience in MPS diseases is highly recommended. PMID:26586959

  15. Alternative Treatments

    Science.gov (United States)

    ... Find your chapter: search by state Home > Alzheimer's Disease > Treatments > Alternative Treatments Overview What Is Dementia? What Is Alzheimer's? Younger/Early Onset Facts and Figures Know the 10 Signs Stages Inside the Brain: ...

  16. Interior Least Tern (Sternula antillarum) breeding distribution and ecology: implications for population-level studies and the evaluation of alternative management strategies on large, regulated rivers.

    Science.gov (United States)

    Lott, Casey A; Wiley, Robert L; Fischer, Richard A; Hartfield, Paul D; Scott, J Michael

    2013-09-01

    Interior Least Terns (Sternula antillarum) (ILT) are colonial, fish-eating birds that breed within active channels of large sand bed rivers of the Great Plains and in the Lower Mississippi Valley. Multipurpose dams, irrigation structures, and engineered navigation systems have been present on these rivers for many decades. Despite severe alteration of channels and flow regimes, regulation era floods have remained effective at maintaining bare sandbar nesting habitat on many river segments and ILT populations have been stable or expanding since they were listed as endangered in 1985. We used ILT breeding colony locations from 2002 to 2012 and dispersal information to identify 16 populations and 48 subpopulations. More than 90% of ILT and >83% of river km with suitable nesting habitat occur within the two largest populations. However, replicate populations remain throughout the entire historical, geophysical, and ecological range of ILT. Rapid colonization of anthropogenic habitats in areas that were not historically occupied suggests metapopulation dynamics. The highest likelihood of demographic connectivity among ILT populations occurs across the Southern Plains and the Lower Mississippi River, which may be demographically connected with Least Tern populations on the Gulf Coast. Paired ecological and bird population models are needed to test whether previously articulated threats limit ILT population growth and to determine if management intervention is necessary and where. Given current knowledge, the largest sources of model uncertainty will be: (1) uncertainty in relationships between high flow events and subsequent sandbar characteristics and (2) uncertainty regarding the frequency of dispersal among population subunits. We recommend research strategies to reduce these uncertainties. PMID:24223295

  17. The urban solid wastes in La Habana (Cuba): management diagnostics and alternatives for their improvement; Los residuos solidos urbanos en la ciudad de La Habana: Diagnostico de la gestion y alternativas para su aprovechamiento

    Energy Technology Data Exchange (ETDEWEB)

    Ponjuan Reyes, G. T. [Univsersidad de Las Palmas de Gran Canaria (Spain)

    1999-11-01

    In this study, it is carried out a diagnosis of all the looks of the Systems of Administration of the R. S. U. in the country of Ciudad de la Habana and they propose alternating for the economical development of the R. S. U. in the county, starting from classifying and study the actions according to the politics of the country concerning the protection of the 2environment and the saving of natural resources. (Author) 22 refs.

  18. The Popcorn Book: A Diagnostic Teaching Unit.

    Science.gov (United States)

    Bock, Marjorie A.; Barger, Rita.

    1998-01-01

    Presents a diagnostic teaching unit designed to identify effective teaching strategies for fourth- or fifth-grade students with learning or behavior disorders. The unit uses "The Popcorn Book" (de Paola) for activities to evaluate the effectiveness of teaching strategies across the content areas of reading, writing, and mathematics. (CR)

  19. Lectures in plasma diagnostics

    International Nuclear Information System (INIS)

    This paper discusses the following topics on plasma diagnostics: Electric probes in flowing and magnetized plasmas; Electron cyclotron emission absorption; Magnetic diagnostics; Spectroscopy; and Thomson Scattering

  20. Strategie podniku

    OpenAIRE

    Paxová, Gabriela

    2013-01-01

    The point of the application part of the thesis is to define the position selected on the basis of competitive and industry pressures, as well as in the context of internal resources and skills, using appropriate analytical methods of strategic management. The analysis results are used as a basis for generating strategic alternatives, which are processed into various future scenarios. Subsequent design company strategy as the goal of the thesis, is a long-term plan acceptable to all stakehold...

  1. Alternative fuelds in urban fleets

    International Nuclear Information System (INIS)

    In this presentation the author addresses four main objectives. They are to: discuss programs that are driving the introduction of alternative fuels into fleet operations in urban areas around the country; define alternative fuels; quantify the present use and future projections on alternative fuel vehicles (AVFs) in the Chicago metropolitan statistical area; and discuss benefits of increased use of alternative fuels in urban areas. Factors which touch on these points include: present domestic dependence on petroleum for autos, with usage exceeding production; the large populations in urban areas which do not meet Clean Air Standards; recent legislative initiatives which give guidance and aid in the adoption of such strategies

  2. Alternative fuelds in urban fleets

    Energy Technology Data Exchange (ETDEWEB)

    Lindsay, T.

    1994-12-31

    In this presentation the author addresses four main objectives. They are to: discuss programs that are driving the introduction of alternative fuels into fleet operations in urban areas around the country; define alternative fuels; quantify the present use and future projections on alternative fuel vehicles (AVFs) in the Chicago metropolitan statistical area; and discuss benefits of increased use of alternative fuels in urban areas. Factors which touch on these points include: present domestic dependence on petroleum for autos, with usage exceeding production; the large populations in urban areas which do not meet Clean Air Standards; recent legislative initiatives which give guidance and aid in the adoption of such strategies.

  3. Cosmic alternatives?

    Science.gov (United States)

    Gregory, Ruth

    2009-04-01

    "Cosmologists are often in error but never in doubt." This pithy characterization by the Soviet physicist Lev Landau sums up the raison d'être of Facts and Speculations in Cosmology. Authors Jayant Narlikar and Geoffrey Burbidge are proponents of a "steady state" theory of cosmology, and they argue that the cosmological community has become fixated on a "Big Bang" dogma, suppressing alternative viewpoints. This book very much does what it says on the tin: it sets out what is known in cosmology, and puts forward the authors' point of view on an alternative to the Big Bang.

  4. Growing Alternatives

    DEFF Research Database (Denmark)

    Bagger-Petersen, Mai Corlin

    2014-01-01

    From 2014, Anhui Province will pilot a reform of the residential land market in China, thus integrating rural Anhui in the national housing market. In contrast, artist and activist Ou Ning has proposed the Bishan time money currency, intending to establish an alternative economic circuit in Bishan...

  5. Psychologists’ Diagnostic Processes during a Diagnostic Interview

    OpenAIRE

    Groenier, Marleen; Beerthuis, Vos R.J.; Pieters, Jules M.; Witteman, Cilia L. M.; Swinkels, Jan A.

    2011-01-01

    In mental health care, psychologists assess clients’ complaints, analyze underlying problems, and identify causes for these problems, to make treatment decisions. We present a study on psychologists’ diagnostic processes, in which a mixed-method approach was employed. We aimed to identify a common structure in the diagnostic processes of different psychologists. We engaged an actor to simulate a client. Participants were asked to perform a diagnostic interview with this “client”. This intervi...

  6. Development of mathematical models to elaborate strategies, select alternatives and development of plans for adaptation of communities to climate change in different geographical areas including costs to implement it

    Science.gov (United States)

    Anton, J. M.; Grau, J. B.; Tarquis, A. M.; Andina, D.; Cisneros, J. M.

    2012-04-01

    There is evidence that the climate changes and that now, the change is influenced and accelerated by the CO2 augmentation in atmosphere due to combustion by humans. Such "Climate change" is on the policy agenda at the global level, with the aim of understanding and reducing its causes and to mitigate its consequences. In most countries and international organisms UNO (e.g. Rio de Janeiro 1992), OECD, EC, etc … the efforts and debates have been directed to know the possible causes, to predict the future evolution of some variable conditioners, and trying to make studies to fight against the effects or to delay the negative evolution of such. The Protocol of Kyoto 1997 set international efforts about CO2 emissions, but it was partial and not followed e.g. by USA and China …, and in Durban 2011 the ineffectiveness of humanity on such global real challenges was set as evident. Among all that, the elaboration of a global model was not boarded that can help to choose the best alternative between the feasible ones, to elaborate the strategies and to evaluate the costs, and the authors propose to enter in that frame for study. As in all natural, technological and social changes, the best-prepared countries will have the best bear and the more rapid recover. In all the geographic areas the alternative will not be the same one, but the model must help us to make the appropriated decision. It is essential to know those areas that are more sensitive to the negative effects of climate change, the parameters to take into account for its evaluation, and comprehensive plans to deal with it. The objective of this paper is to elaborate a mathematical model support of decisions, which will allow to develop and to evaluate alternatives of adaptation to the climatic change of different communities in Europe and Latin-America, mainly in especially vulnerable areas to the climatic change, considering in them all the intervening factors. The models will consider criteria of physical

  7. Alternative 23

    OpenAIRE

    Jackson, Mark

    2014-01-01

    Alternative 23 is a curated exhibition of works by Steve Aylett, David Blandy & Daniel Locke, Let Me Feel Your Finger First, Laura Oldfield Ford, Plastique Fantastique and Henrik Schrat, including the first screening of Let Me Feel Your Finger First’s Postcolonial Capers. In 1985 DC Comics in the US had taken the commercial decision to unify the complex and contradictory character story arcs from its various strips such as Superman, Batman and Green Lantern. The resultant crossover series...

  8. Modeling alternative zoning strategies in forest management

    NARCIS (Netherlands)

    Krcmar, E.; Vertinsky, I.; Kooten, van G.C.

    2003-01-01

    To satisfy public demands for environmental values, forest companies are facing the prospect of a reduction in wood supply and increases in costs. Some Canadian provincial governments have proposed intensifying silviculture in special zones dedicated to timber production as the means for pushing out

  9. Modeling Alternative Zoning Strategies in Forest Management

    OpenAIRE

    Emina Krcmar; Ilan Vertinsky; G. Cornelis van Kooten

    2004-01-01

    To satisfy public demands for environmental values, forest companies face the prospect of reduced wood supply and increased costs. Some Canadian provincial governments have proposed intensifying silviculture in special zones dedicated to timber production as the means for pushing out the forest possibilities frontier. In this paper, we compare the traditional two-zone land allocation framework, which includes ecological reserves and integrated forest management zones, with the triad (three-zo...

  10. Assessing Impacts of Alternative Renewable Energy Strategies

    OpenAIRE

    d'Artis Kancs; Hans Kremers

    2002-01-01

    The preparation, implementation, coordination and verification of policy measures is a complex and difficult process. This paper presents the first results of an empirical ex-ante analysis which evaluates the effects of renewable energy policies on the bioenergy sector applying an Applied General Equilibrium model. The empirical results suggest that the bioenergy sector benefits more from an indirect tax reduction than from the removal of fossil energy sector subsidies. Reductions in fossil e...

  11. Greenhouse gas emissions from alternative strategies for waste management in the military - climate account for five selected localities; Klimagassutslipp fra alternative strategier for avfallsh#Latin Small Letter A With Ring Above#ndtering i Forsvaret #En Dash# et klimaregnskap for fem utvalgte lokaliteter

    Energy Technology Data Exchange (ETDEWEB)

    Myhre, Oddvar; Reistad, Trine; Longva, Kjetil

    2011-02-15

    Greenhouse gas (GHG) emissions emanating from waste management practices in the Norwegian Armed Forces were assessed. Focus was on use of a material recovery facility (MRF) where the initial sorting of waste takes place. The MRF upgrades the waste before it is delivered to other industries to produce new products; alternatively, it undergoes incineration with energy recovery as an alternative to burning fossil fuel. The GHG emissions accounting practices examined in this paper included upstream emissions from fuel consumption of collection and transport of waste, operational activities at the MRF, and downstream processes. The latter means recycling of waste (glass, plastics, paper, ferrous metal, electrical and electronic equipment, and tires) compared to primary production using virgin materials, or the incineration of waste with energy recovery (mixed waste, food waste, wood waste, and infectious waste) compared to energy production from sources of fossil origin. The results show that recycling proves to be beneficial over primary production, and incineration of waste in waste to energy plants is favorable compared to the use of fossil fuel (savings of 0.9 and 0.3 kg Co2-equivalents kg#Minus Sign#1 waste, respectively). Sorting of all the mixed waste at military camp collection sites followed by recycling of the separated fractions at MRF would result in avoided GHG emissions of 44%, compared to the current practice of incineration with energy recovery. Further research is needed to fully elucidate the importance and benefits of increased sorting of mixed waste in the Norwegian Armed Forces seen from a GHG perspective. (author)

  12. Alternative donor transplantation--"mixing and matching": the role of combined cord blood and haplo-identical donor transplantation (haplo-cord SCT) as a treatment strategy for patients lacking standard donors?

    Science.gov (United States)

    Liu, Hongtao; van Besien, Koen

    2015-03-01

    In the past decade, haplo-cord stem cell transplantation (SCT) using myeloablative or reduced intensive conditioning regimens has been shown to result in reliable and fast engraftment of neutrophils and platelets comparable to HLA-matched donors and much faster than after cord stem cell transplant. Haplo-cord SCT also has a low incidence of early non-relapse mortality, low incidences of acute and chronic graft-vs-host disease (GVHD), and excellent graft-vs-leukemia (GVL) effects. Favorable long-term outcomes for high-risk patients with hematologic malignancies have been reported, including older patients. Haplo-cord SCT will likely overcome the limitations of cell dose during cord stem cell selection and might significantly expand the use of cord stem cell transplant in the adult population. The comparable survival outcomes of matched related donor (MRD), matched unrelated donor (MUD), and haplo-cord stem cell transplant strongly argue that haplo-cord SCT should be considered as effective alternative stem cell transplant for high-risk patients lacking standard donors. Further improvement in supportive care and incorporation of a better understanding of the human fetal immune development into the haplo-cord SCT are required to further improve this strategy. PMID:25667129

  13. Endoscopic diagnostic of chronic pancreatitis.

    Science.gov (United States)

    Cubranić, Aleksandar; Dintinjana, Renata Dobrila; Vanis, Nenad

    2014-12-01

    Chronic pancreatitis is defined as a continuous inflammatory pancreatic disease, one characterized by irreversible morphological changes, often associates with pain and sometimes with the loss of endocrine and exocrine function. As a histological confirmation of chronic pancreatitis is often unavailable, the diagnosis is traditionally based on imaging methods such as computerized tomography (CT) or endoscopic retrograde cholangiopancreatography (ERCP), and recently magnetic resonance cholangiopancreatography (MRCP) as a noninvasive alternative to ERCP. Developments in the classification system of CP include the Marseille classification of 1963 which offered histopathologic criteria for CP, the Cambridge classification of 1984 which introduced imaging features of computed tomography (CT), transabdominal ultrasound (TUS) and endoscopic retrograde cholangiopancreatography (ERCP) for classification of CP as well as Rosemont classification system of 2007 which presented the endoscopic ultrasonography diagnosis of CP. Endoscopic ultra-sonography (EUS) was first introduced as a diagnostic method for evaluation of pancreatic disease in 1986. It has experienced significant improvements since then and allowed for an alternative approach in diagnosing patients with pancreatic diseases. In patients with suspected pancreatic masses EUS-guided fine needle aspiration (EUS-FNA) is the best method for obtaining tissue diagnosis and differentiating CP from pancreatic carcinoma. The recent studies indicate that EUS is the method of choice when compared with other imaging methods such as ERCP because it frequently provides more accurate diagnostics. The aim of this review is to discuss the findings in endoscopic diagnostics up to the present moment and to indicate advantages, limitations and possible complications along with the current recommendations in CP diagnostics. PMID:25842773

  14. Energy alternatives

    International Nuclear Information System (INIS)

    Due to sharp rise in oil proces after the 1973 Arab-Israeli War, world attention has been focussed on the energy problem. At present the energy problem is limited to the cost and reliability of supply, even though there are enough supplies to go round. However, in the future the problem will be of availability, because in spite of the full exploitation of currently available conventional energy sources, the supply will fall short of demand which will always be increasing. Hence, there is need to develop alternate energy sources, including fast breeder reactors, fusion reactors and MHD. Economic and technical aspects of these energy are discussed. (M.G.B.)

  15. Alternative detente

    International Nuclear Information System (INIS)

    The influence of the Chernobyl accident on the disarmament and anti-nuclear movements is discussed. The accident directed attention towards the areas in common rather than the areas of disagreement. It also demonstrated the environmental impact of radioactivity, strengthening the ecological case of the anti-nuclear movement. The issues are discussed for the Western and Eastern bloc countries and the relationship between the two. Sections focus on the Eco-protest, Green politics and economics and on the politics of minority protest and the Green alternative. (U.K.)

  16. [Alternatives to animal testing].

    Science.gov (United States)

    Fabre, Isabelle

    2009-11-01

    The use of alternative methods to animal testing are an integral part of the 3Rs concept (refine, reduce, replace) defined by Russel & Burch in 1959. These approaches include in silico methods (databases and computer models), in vitro physicochemical analysis, biological methods using bacteria or isolated cells, reconstructed enzyme systems, and reconstructed tissues. Emerging "omic" methods used in integrated approaches further help to reduce animal use, while stem cells offer promising approaches to toxicologic and pathophysiologic studies, along with organotypic cultures and bio-artificial organs. Only a few alternative methods can so far be used in stand-alone tests as substitutes for animal testing. The best way to use these methods is to integrate them in tiered testing strategies (ITS), in which animals are only used as a last resort. PMID:20669543

  17. Alternative crops

    International Nuclear Information System (INIS)

    Surplus cereal production in the EEC and decreasing product prices, mainly for cereals, has prompted considerable interest for new earnings in arable farming. The objective was to examine whether suggested new crops (fibre, oil, medicinal and alternative grains crops) could be considered as real alternatives. Whether a specific crop can compete economically with cereals and whether there is a market demand for the crop is analyzed. The described possibilities will result in ca. 50,000 hectares of new crops. It is expected that they would not immediately provide increased earnings, but in the long run expected price developments are more positive than for cereals. The area for new crops will not solve the current surplus cereal problem as the area used for new crops is only 3% of that used for cereals. Preconditions for many new crops is further research activities and development work as well as the establishment of processing units and organizational initiatives. Presumably, it is stated, there will then be a basis for a profitable production of new crops for some farmers. (AB) (47 refs.)

  18. Diagnostic Algorithm Benchmarking

    Science.gov (United States)

    Poll, Scott

    2011-01-01

    A poster for the NASA Aviation Safety Program Annual Technical Meeting. It describes empirical benchmarking on diagnostic algorithms using data from the ADAPT Electrical Power System testbed and a diagnostic software framework.

  19. Thioaptamer Diagnostic System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — AM Biotechnologies (AM) will develop a diagnostic system in response to SBIR Topic X10.01 Reusable Diagnostic Lab Technology that will simultaneously detect and...

  20. Concept paper: establishment of a diagnostics platform for South Africa.

    Science.gov (United States)

    Moodley, I; Bubb, M; Msomi, N

    2007-01-01

    This concept paper focuses on diagnostics as one of the key areas of strategic importance. Lifelab intends to specialise in the research and development of in vitro diagnostic test systems specifically for diseases of relevance to the Southern African region. The use of diagnostic tests is an essential but costly element in the diagnosis and treatment of infectious diseases and in particular, HIV/AIDS. Consistent with the need to improve affordability and accessibility, the strategy will be to research, develop, and manufacture promising diagnostic test systems and through mutually beneficial partnerships with joint venture companies and distributors, rapidly introduce these diagnostic systems to the market. PMID:17703559

  1. Radionuclides in diagnostic nuclear medicine

    International Nuclear Information System (INIS)

    Diagnostic Nuclear Medicine (NM) is an essential procedure in modern medical practice. Recent survey reported that more than 2 million NM examinations are conducted every year in Japan. Around 75% of diagnostic NM employs single photon emission tomography (SPECT) with 99mTc, 123I, 133Xe, or 201Tl-labeled compound, and 25% positron emission tomography (PET) with 18F-fluorodeoxy glucose, 15O-labeled H2O, CO, O2, or 11C-labeled compounds. Modern medicine is based on the intervention of molecular pathology of the diseases. Therefore, NM is expanding in number and in quality in daily medical practice including early diagnosis of Alzheimer’s diseases, cancer, and cardiovascular diseases, strategy decision of treatment, evaluation of regeneration medicine. Furthermore, the NM is being utilized to facilitate new drug development. Combining molecular diagnosis with radionuclide therapy (Theranostics) is another future direction of clinical NM. (author)

  2. Fuel-motion diagnostics and cineradiography

    International Nuclear Information System (INIS)

    Nuclear and non-nuclear applications of cineradiography are reviewed, with emphasis on diagnostic instrumentation for in-pile transient-reactor safety testing of nuclear fuel motion. The primary instrument for this purpose has been the fast-neutron hodoscope, which has achieved quantitative monitoring of time, location, mass, and velocity of fuel movement under the difficult conditions associated with transient-reactor experiments. Alternative diagnostic devices that have been developed have not matched the capabilities of the hodoscope. Other applications for the fuel-motion diagnostic apparatus are also evolving, including time-integrated radiography and direct time- and space-resolved fuel-pin power monitoring. Although only two reactors are now actively equipped with high-resolution fuel-motion diagnostic systems, studies and tests have been carried out in and for many other reactors

  3. Fuel-motion diagnostics and cineradiography

    Energy Technology Data Exchange (ETDEWEB)

    DeVolpi, A.

    1982-09-01

    Nuclear and non-nuclear applications of cineradiography are reviewed, with emphasis on diagnostic instrumentation for in-pile transient-reactor safety testing of nuclear fuel motion. The primary instrument for this purpose has been the fast-neutron hodoscope, which has achieved quantitative monitoring of time, location, mass, and velocity of fuel movement under the difficult conditions associated with transient-reactor experiments. Alternative diagnostic devices that have been developed have not matched the capabilities of the hodoscope. Other applications for the fuel-motion diagnostic apparatus are also evolving, including time-integrated radiography and direct time- and space-resolved fuel-pin power monitoring. Although only two reactors are now actively equipped with high-resolution fuel-motion diagnostic systems, studies and tests have been carried out in and for many other reactors.

  4. Energy alternatives

    International Nuclear Information System (INIS)

    English. A special committe of the Canadian House of Commons was established on 23 May 1980 to investigate the use of alternative energy sources such as 'gasohol', liquified coal, solar energy, methanol, wind and tidal power, biomass, and propane. In its final report, the committee envisions an energy system for Canada based on hydrogen and electricity, using solar and geothermal energy for low-grade heat. The committe was not able to say which method of generating electricty would dominate in the next century, although it recommends that fossil fuels should not be used. The fission process is not specifically discussed, but the outlook for fusion was investigated, and continued governmental support of fusion research is recommended. The report proposes some improvements in governmental energy organizations and programs

  5. Processes Affecting Phosphorus and Copper Concentrations and Their Relation to Algal Growth in Two Supply Reservoirs in the Lower Coastal Plain of Virginia, 2002-2003, and Implications for Alternative Management Strategies

    Science.gov (United States)

    Speiran, Gary K.; Simon, Nancy S.; Mood-Brown, Maria L.

    2007-01-01

    Elevated phosphorus concentrations commonly promote excessive growth of algae in waters nationwide. When such waters are used for public supply, the algae can plug filters during treatment and impart tastes and odors to the finished water. This increases treatment costs and results in finished water that may not be of the quality desired for public supply. Consequently, copper sulfate is routinely applied to many reservoirs to control algal growth but only is a 'temporary fix' and must be reapplied at intervals that can range from more than 30 days in the winter to less than 7 days in the summer. Because copper has a maximum allowable concentration in public drinking water and can be toxic to aquatic life, water suppliers commonly seek to develop alternative, long-term strategies for managing reservoirs. Because these are nationwide issues and part of the mission of the U.S. Geological Survey (USGS) is to define and protect the quality of the Nation's water resources and better understand the physical, chemical, and biological processes in wetlands, lakes, reservoirs, and estuaries, investigations into these issues are important to the fulfillment of the mission of the USGS. The City of Newport News, Virginia, provides 50 million gallons per day of treated water for public supply from Lee Hall and Harwoods Mill Reservoirs (terminal reservoirs) to communities on the lower York-James Peninsula. About 3,500 pounds of copper sulfate are applied to each reservoir at 3- to 99-day intervals to control algal growth. Consequently, the USGS, in cooperation with the City of Newport News, investigated the effects of management practices and natural processes on phosphorus (the apparent growth-limiting nutrient), copper, and algal concentrations in the terminal reservoirs to provide information that can be used to develop alternative management strategies for the terminal reservoirs. Initial parts of the research evaluated circulation and stratification in the reservoirs

  6. Study of methodology diversification in diagnostics

    International Nuclear Information System (INIS)

    There are several research activities to enhance safety and reliability of nuclear power plant operation and maintenance. We are developing a concept of an autonomous operation system where the role of operators is replaced with artificial intelligence. The purpose of the study described in this report is to develop a operator support system in abnormal plant situations. Conventionally, diagnostic modules based on individual methodology such as expert system have been developed and verified. In this report, methodology diversification is considered to integrate diagnostic modules which performance are confirmed using information processing technique. Technical issues to be considered in diagnostic methodology diversification are; 1)reliability of input data, 2)diversification of knowledge models, algorithms and reasoning schemes, 3)mutual complement and robustness. The diagnostic module utilizing the different approaches defined along with strategy of diversification was evaluated using fast breeder plant simulator. As a result, we confirmed that any singular diagnostic module can not meet accuracy criteria for the entire set of anomaly events. In contrast with this, we confirmed that every abnormality could be precisely diagnosed by a mutual combination. In other words, legitimacy of approach selected by strategy of diversification was shown, and methodology diversification attained clear efficiency for abnormal diagnosis. It has been also confirmed that the diversified diagnostic system implemented in this study is able to maintain its accuracy even in case that encountered scale of abnormality is different from reference cases embedded in the knowledge base. (author)

  7. Suspected acute pulmonary emboli: cost-effectiveness of chest helical computed tomography versus a standard diagnostic algorithm incorporating ventilation-perfusion scintigraphy

    International Nuclear Information System (INIS)

    There is a controversy regarding the investigation of patients with suspected acute pulmonary embolism (PE). To compare the cost-effectiveness of alternative methods of diagnosing acute PE, chest helical computed tomography (CT) alone and in combination with venous ultrasound (US) of legs and pulmonary angiography (PA) were compared to a conventional algorithm using ventilation-perfusion (V/Q) scintigraphy supplemented in selected cases by US and PA. A decision-analytical model was constructed to model the costs and effects of the three diagnostic strategies in a hypothetical cohort of 1000 patients each. Transition probabilities were based on published data. Life years gained by each strategy were estimated from published mortality rates. Schedule fees were used to estimate costs. The V/Q protocol is both more expensive and more effective than CT alone resulting in 20.1 additional lives saved at a (discounted) cost of $940 per life year gained. An additional 2.5 lives can be saved if CT replaces V/Q scintigraphy in the diagnostic algorithm but at a cost of $23,905 per life year saved. It resulted that the more effective diagnostic strategies are also more expensive. In patients with suspected PE, the incremental cost-effectiveness of the V/Q based strategy over CT alone is reasonable in comparison with other health interventions. The cost-effectiveness of the supplemented CT strategy is more questionable. Copyright (2000) The Australasian College of Physicians

  8. NATO strategy

    International Nuclear Information System (INIS)

    Nuclear weapons are for NATO both the primary instrument for deterring a nuclear attack and the fall-back option if, in the event of a conventional assault, NATO's non-nuclear defence forces cannot hold. The dilemma of depending upon potentially self-destructive nuclear responses if deterrence fails and defence falters has always haunted NATO strategy, but after the Soviets achieved nuclear parity with the United States, this dilemma became more intensely perceived. Now the credibility, viability, acceptability, sensibility and morality of nuclear weapons for deterrence and defence are increasingly at issue. As a result, an increasing variety of non-nuclear (conventional) alternatives are being advanced to replace or supplement nuclear deterrence for the Alliance. The thrust of the author of this paper remarks is to attempt to apply the definitions, requirements, and other key conceptual distinctions of nuclear deterrence found in the body of western strategic literature to three categories of non-nuclear alternatives currently in vogue: strengthened conventional forces; deployment of new, high-technology non-nuclear weapons; and adoption of an offensive manoeuvre strategy. Let me, therefore, begin by listing the basic definitions, concepts and apparent requirements of deterrence which the deterrence theory literature offers

  9. ISTTOK plasma control with the tomography diagnostic

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, H.; Caralho, P.J.; Duarte, P.; Pereira, T.; Coelho, R.; Silva, C. [Association Euratom/IST, Institute of Plasmas and Nuclear Fusion, Technology Graduate Institute, P-1049-001 Lisbon (Portugal)

    2011-07-01

    A real-time plasma position control system is mandatory to achieve long duration (up to 250 ms), Alternating Current (AC) discharges on the ISTTOK tokamak. Such a system has been used for some time supported only on magnetic field diagnostic data. However, this system does not function accurately when the plasma current is low, rendering it inoperative during the plasma current reversal. A tomography diagnostic with 3 pinhole cameras and 8 silicone photodiode channels per camera was installed and customized to supply alternative plasma position to be used for plasma position control. As no filtering is applied, most of the radiation detected is in the visible/near-UV range. This system (i) executes a tomographic reconstruction, (ii) determines the average emissivity position from it, (iii) calculates the shift from the required position and (iv) supplies the vertical field power supply unit with the desired current value, all in less than 100 {mu}s. The horizontal magnetic field power supply unit is expected to be included in the system and will have no impact in the process time. This paper presents the tomography diagnostic architecture together with results of its scientific exploitation in ISTTOK AC discharges, where it has proven to be capable of supplying an accurate plasma position during the current reversal. The use of the tomography diagnostic for plasma position overcomes some limitations of the magnetic diagnostics, but poses challenges of its own such as blindness to plasma current direction. (authors)

  10. INTEGRATING DESALINATION AND AGRICULTURAL SALINITY CONTROL ALTERNATIVES

    Science.gov (United States)

    The cost-effectiveness relationships for various agricultural and desalination alternatives for controlling salinity in irrigation return flows are developed. Selection of optimal salinity management strategies on a river basin scale is described as a problem of integrating optim...

  11. Diagnostics for mirror machines

    International Nuclear Information System (INIS)

    This paper is subdivided into three chapters to match three corresponding lectures. The goals of the first chapter are to define the neutral-beam-heated, quasi-d.c. mirror confinement systems under discussion here and to give a general example of mirror diagnostics by listing and very briefly discussing the diagnostics used on the 2XIIB experiment at the Lawrence Livermore Laboratory. The second chapter develops mirror machine diagnostics in more detail, and adds background for a few selected diagnostics of particular importance to mirror machine studies. The third chapter discusses the special diagnostic needs of future mirror machines, with emphasis on diagnostics involving the higher-power neutral beams used with them

  12. Alternative Splice in Alternative Lice.

    Science.gov (United States)

    Tovar-Corona, Jaime M; Castillo-Morales, Atahualpa; Chen, Lu; Olds, Brett P; Clark, John M; Reynolds, Stuart E; Pittendrigh, Barry R; Feil, Edward J; Urrutia, Araxi O

    2015-10-01

    Genomic and transcriptomics analyses have revealed human head and body lice to be almost genetically identical; although con-specific, they nevertheless occupy distinct ecological niches and have differing feeding patterns. Most importantly, while head lice are not known to be vector competent, body lice can transmit three serious bacterial diseases; epidemictyphus, trench fever, and relapsing fever. In order to gain insights into the molecular bases for these differences, we analyzed alternative splicing (AS) using next-generation sequencing data for one strain of head lice and one strain of body lice. We identified a total of 3,598 AS events which were head or body lice specific. Exon skipping AS events were overrepresented among both head and body lice, whereas intron retention events were underrepresented in both. However, both the enrichment of exon skipping and the underrepresentation of intron retention are significantly stronger in body lice compared with head lice. Genes containing body louse-specific AS events were found to be significantly enriched for functions associated with development of the nervous system, salivary gland, trachea, and ovarian follicle cells, as well as regulation of transcription. In contrast, no functional categories were overrepresented among genes with head louse-specific AS events. Together, our results constitute the first evidence for transcript pool differences in head and body lice, providing insights into molecular adaptations that enabled human lice to adapt to clothing, and representing a powerful illustration of the pivotal role AS can play in functional adaptation. PMID:26169943

  13. Child abuse. Diagnostic imaging of skeletal injuries

    International Nuclear Information System (INIS)

    Diagnostic imaging, besides medical history and clinical examination, is a major component in assessment of cases of suspected physical child abuse. Performance of proper imaging technique, and knowledge of specific injury patterns is required for accurate image interpretation by the radiologist, and serves protection of the child in case of proven abuse. On the other side, it is essential to protect the family in unjustified accusations. The reader will be familiarised with essentials of the topic 'Physical child abuse', in order to be able to correctly assess quality, completeness, and results of X-ray films. Moreover, opportunities and limitations of alternative diagnostic modalities will be discussed. (orig.)

  14. Diagnostics in critical conditions

    OpenAIRE

    SadchikovD.V.; PrigorodovM.V.; IvanovR.V.

    2011-01-01

    The purpose of research: improvement of quality of diagnostics at the patients in a critical condition in intensive care unit. Material and methods. In total have analyzed 1957 medical cards of the patients who have died in ICU»s. At the first stage studied the factors influencing on diagnostics of critically ill patients (medical cards of 1557 patients); at the second stage investigated influence of the diagnostic standards in ICU»s practice on improvement of quality of diag- nostics of crit...

  15. Assessment Strategies for the Handicapped.

    Science.gov (United States)

    Guidubaldi, John; And Others

    1979-01-01

    This review of assessment strategies for handicapped populations is intended to provide counselors with assessment perspectives as well as specific suggestions. The review emphasizes the counselor's role as a member of a diagnostic team and the need to consider a variety of information in formation of meaningful intervention strategies. (Author)

  16. Looking for an Alternative.

    Science.gov (United States)

    Kennedy, Jack

    1999-01-01

    Argues that high school newspapers might do well to create stronger ties with alternative weeklies. Discusses issues of niche marketing, alternative content, and alternative presentation. Notes that high school papers could learn a lot from alternative newspapers. (SR)

  17. Thematic plan on diagnostic radiology

    International Nuclear Information System (INIS)

    Due to the vital importance of diagnostic radiology in both the diagnosis and management of disease processes, there is a need for a greater coherent international effort to help the developing nations create strategies for the incorporation of imaging into their healthcare systems. To meet the needs of such countries, a comprehensive programme is required to take into consideration the availability of local expertise (medical and technical), the infrastructure (stable electrical supply, water and air-conditioning) and the disease pattern or burden. In short, the total solution requires coordinating the International Atomic Energy Agency efforts with those of other partners. The Agency already has programmes in nuclear medicine and radiation therapy supported by activities in dosimetry and medical physics. Through the Technical Co-operation fund the Agency already supports projects in some areas of diagnostic imaging, dosimetry and radiation protection, but it lacks a comprehensive programme to provide a systematic approach focusing on the medical aspects of imaging science and including all the imaging technologies. Member States require the Agency's assistance in this area since no single UN organisation has the resources or the expertise to do the entire job without help. This document presents the proposed programme strategy and action plan

  18. Alternative Lead Systems for Diagnostic Electrocardiography: Validation and Clinical Applicability

    OpenAIRE

    Welinder, Annika

    2009-01-01

    The standard 12-lead electrocardiogram (ECG) remains one of the most important and most frequently used tools for diagnosing cardiac diseases, although several different examination modalities in cardio¬logy have been developed over the years. The standard ECG uses 10 electrodes placed on well-defined positions on the body, 6 on the torso and 4 distally on the limbs. Both industry and academia have invested many years in development of the criteria used to interpret the “diagnostic” standard ...

  19. Cosmetics Europe compilation of historical serious eye damage/eye irritation in vivo data analysed by drivers of classification to support the selection of chemicals for development and evaluation of alternative methods/strategies: the Draize eye test Reference Database (DRD)

    OpenAIRE

    VIEGAS BARROSO JOAO FILIPE; PFANNENBECKER Uwe; Adriaens,Els; Alepee, Natalie; CLUZEL Magalie; De Smedt, Ann; HIBATALLAH Jalila; KLARIC Martina; Mewes, Karsten R.; MILLET Marion; TEMPLIER Marie; McNamee, Pauline

    2015-01-01

    A thorough understanding of which of the effects assessed in the in vivo Draize eye test are responsible for driving UN GHS/EU CLP classification is critical for an adequate selection of chemicals to be used in the development and/or evaluation of alternative methods/strategies and for properly assessing their predictive capacity and limitations. For this reason, Cosmetics Europe has compiled a database of Draize data (Draize eye test Reference Database, DRD) from external lists that were cre...

  20. Gas turbine diagnostic system

    CERN Document Server

    Talgat, Shuvatov

    2011-01-01

    In the given article the methods of parametric diagnostics of gas turbine based on fuzzy logic is proposed. The diagnostic map of interconnection between some parts of turbine and changes of corresponding parameters has been developed. Also we have created model to define the efficiency of the compressor using fuzzy logic algorithms.

  1. Present diagnostic strategies for acute pulmonary thromboembolism. Results of a questionnaire in a retrospective trial conducted by the Respiratory Nuclear Medicine Working Group of the Japanese Society of Nuclear Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, Masami; Inoue, Tomio [Yokohama City Univ. (Japan). School of Medicine; Ogura, Yasuharu; Narabayashi, Isamu [Osaka Medical Coll., Takatsuki (Japan); Honda, Norinari [Saitama Medical School, Kawagoe (Japan). Saitama Medical Center; Satoh, Katashi [Kagawa Medical Univ., Miki (Japan); Suga, Kazuyoshi [Yamaguchi Univ. (Japan). School of Medicine; Mori, Yutaka [Jikei Univ., Tokyo (Japan); Imai, Teruhiko [Nara Medical Univ., Kashihara (Japan)

    2002-12-01

    The aim of this study is to re-evaluate and clarify the diagnostic role of ventilation/perfusion lung scintigraphy in Japan, now that single-detector-row helical CT and multidetector-row CT are available in clinical practice. The Respiratory Nuclear Medicine Working Group of the Japanese Society of Nuclear Medicine distributed a questionnaire to institutions in Japan equipped with scintillation cameras as of September 2001. Of 1,222 institutions, 239 returned effective answers (19.6%). The most frequent combination for initial diagnosis of acute pulmonary thromboembolism was chest radiography, perfusion lung scintigraphy, and contrast-enhanced CT (111 institutions, 46.4%). The questionnaire revealed that the validity and usage of perfusion lung scintigraphy and those of contrast-enhanced CT were equivalent in the present clinical situation. On the other hand, the diagnostic value of ventilation lung scintigraphy in suspected pulmonary thromboembolism has not been established in Japan. Even though contrast-enhanced CT is widely used in Japan, perfusion lung scintigraphy is still required to determine disease severity and monitor its progress. (author)

  2. Present diagnostic strategies for acute pulmonary thromboembolism. Results of a questionnaire in a retrospective trial conducted by the Respiratory Nuclear Medicine Working Group of the Japanese Society of Nuclear Medicine

    International Nuclear Information System (INIS)

    The aim of this study is to re-evaluate and clarify the diagnostic role of ventilation/perfusion lung scintigraphy in Japan, now that single-detector-row helical CT and multidetector-row CT are available in clinical practice. The Respiratory Nuclear Medicine Working Group of the Japanese Society of Nuclear Medicine distributed a questionnaire to institutions in Japan equipped with scintillation cameras as of September 2001. Of 1,222 institutions, 239 returned effective answers (19.6%). The most frequent combination for initial diagnosis of acute pulmonary thromboembolism was chest radiography, perfusion lung scintigraphy, and contrast-enhanced CT (111 institutions, 46.4%). The questionnaire revealed that the validity and usage of perfusion lung scintigraphy and those of contrast-enhanced CT were equivalent in the present clinical situation. On the other hand, the diagnostic value of ventilation lung scintigraphy in suspected pulmonary thromboembolism has not been established in Japan. Even though contrast-enhanced CT is widely used in Japan, perfusion lung scintigraphy is still required to determine disease severity and monitor its progress. (author)

  3. Alternatives to fundholding.

    Science.gov (United States)

    Glennerster, H; Cohen, A; Bovell, V

    1998-01-01

    The new Labour government in the United Kingdom is proposing to adapt the reforms begun by the last Thatcher government. In particular, it is proposing to abolish the most controversial element--general practitioner (GP) fundholding. It is looking for alternatives. The study reported here followed and evaluated several such schemes. While fundholders use their purchasing power directly to force change by threatening "exit" to another provider, other GPs have evolved ways of influencing decisions--enhancing their "voice." The authors develop a theory to predict the conditions favoring the relative success of exit and voice strategies in health purchasing, and describe alternative GP-based purchasing schemes and the reasons they evolved in six sample districts. In four of these districts and eight practices in each, fundholding and non-fundholding GPs were then asked to describe their intentions and the outcomes of the purchasing process in which they had participated. Four specialties were taken as examples. The authors compare the relative success of fundholders and non-fundholders in achieving their objectives. PMID:9493753

  4. Diagnostics of thyroid diseases

    International Nuclear Information System (INIS)

    The recommendations of the Thyroid Section of the Deutsche Gesellschaft fuer Endokrinologie have been established with a view to diagnostic practice; they help to define the most appropriate diagnostic procedure in consideration of its diagnostic value, necessity, expenditure in terms of time and cost, and the hazard involved. Methodological progress and recent scientific findings have been considered as well as economic aspects and the available technical facilities. The decision on what method to apply in thyroid diagnostics and therapy should be based on a specific anamnesis and a detailed physical examination. The measured data must be compatible with the patient's symptoms and with unambiguously established clinical signs. In a progressively structured diagnostic procedure, one should always start with the simple, non-invasive in vitro techniques. Functional diagnostics of thyroid diseases is supplemented by thyroid scintiscanning with short-lived radionuclides and by thyroid cytology. Experience and precise knowledge help to save funds and reduce the radiation doses applied. Of course, uncertain diagnoses and untypical findings necessitate a wider application of diagnostic means than clinically more or less validated diagnoses. (orig./MG)

  5. Diagnostics in critical conditions

    Directory of Open Access Journals (Sweden)

    SadchikovD.V.

    2011-09-01

    Full Text Available The purpose of research: improvement of quality of diagnostics at the patients in a critical condition in intensive care unit. Material and methods. In total have analyzed 1957 medical cards of the patients who have died in ICU»s. At the first stage studied the factors influencing on diagnostics of critically ill patients (medical cards of 1557 patients; at the second stage investigated influence of the diagnostic standards in ICU»s practice on improvement of quality of diag- nostics of critically ill patients (400 medical cards of the patients who have died. Entry criterions were standards and algorithm of diagnostics. Techniques of research: average bed-day in groups, first-day lethality, quantity of the carried out laboratory tests and tool methods of research, level of consciousness of the patients (Glasgow come score, severity of disease by ICU»s patients (APACHE II scores. Results. Quality of diagnostics depend on carried out laboratory tests and tool methods of research, level of consciousness of the patients (Glasgow come score, severity of disease by ICU»s patients (APACHE II score. The conclusion. The laboratory tests and tool methods of research conforming to the standards of diagnostics are necessary for improvement of quality of diagnostics, it is necessary to take into account an altered level of consciousness (Glasgow come score and severity of disease by ICU»s patients (APACHE II scores

  6. Cable Diagnostic Focused Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hartlein, R.A.; Hampton, R.N.

    2010-12-30

    This report summarizes an extensive effort made to understand how to effectively use the various diagnostic technologies to establish the condition of medium voltage underground cable circuits. These circuits make up an extensive portion of the electric delivery infrastructure in the United States. Much of this infrastructure is old and experiencing unacceptable failure rates. By deploying efficient diagnostic testing programs, electric utilities can replace or repair circuits that are about to fail, providing an optimal approach to improving electric system reliability. This is an intrinsically complex topic. Underground cable systems are not homogeneous. Cable circuits often contain multiple branches with different cable designs and a range of insulation materials. In addition, each insulation material ages differently as a function of time, temperature and operating environment. To complicate matters further, there are a wide variety of diagnostic technologies available for assessing the condition of cable circuits with a diversity of claims about the effectiveness of each approach. As a result, the benefits of deploying cable diagnostic testing programs have been difficult to establish, leading many utilities to avoid the their use altogether. This project was designed to help address these issues. The information provided is the result of a collaborative effort between Georgia Tech NEETRAC staff, Georgia Tech academic faculty, electric utility industry participants, as well as cable system diagnostic testing service providers and test equipment providers. Report topics include: •How cable systems age and fail, •The various technologies available for detecting potential failure sites, •The advantages and disadvantages of different diagnostic technologies, •Different approaches for utilities to employ cable system diagnostics. The primary deliverables of this project are this report, a Cable Diagnostic Handbook (a subset of this report) and an online

  7. New tuberculosis diagnostics and rollout

    Directory of Open Access Journals (Sweden)

    Ruth McNerney

    2015-03-01

    Full Text Available Early detection and effective treatment are crucial for tuberculosis control, but global case detection rates remain low. The diagnosis of paediatric and extrapulmonary disease is problematic and there are, as yet, no rapid screening tests to assist active case finding in the community. Progress has been made in clinic-based detection tools with the introduction of Xpert MTB/RIF, a nucleic acid amplification test that combines sample processing and analysis in a single instrument to provide a diagnostic result and detection of resistance to rifampicin in under 2 h. Enthusiasm for Xpert MTB/RIF has been high and global rollout has been facilitated by donor agencies. However, concerns remain about access and sustainability due to the high cost and infrastructure requirements. Although more sensitive than smear microscopy, early studies suggest the impact of the new test on case detection rates and patient survival has been limited. Alternative technologies are being developed, including non-sputum-based tests to assist the detection of extrapulmonary disease. Evaluation studies are needed to provide evidence of the impact of the new technologies on patient outcomes. This will enable appropriate placement of new diagnostic products in the healthcare system to support the control and eventual eradication of tuberculosis disease.

  8. Laser fusion diagnostics

    International Nuclear Information System (INIS)

    High temporal and spatial resolution optical diagnostics of laser performance, energy balance, and applicable plasma probing techniques are reviewed. A variety of spatially, temporally and spectrally resolved x-ray diagnostics techniques and instruments are discussed. Particular emphasis is on high spatial resolution imaging techniques and applications and on high temporal resolution x-ray streak caera applications to exploding pusher target experiments. Finally, particle diagnostics and system designed to diagnose target performance via yield and temperature measurements and techniques designed to determine the characteristics of compressed targets are discussed

  9. Plasma diagnostic reflectometry

    International Nuclear Information System (INIS)

    Theoretical and experimental studies of plasma diagnostic reflectometry have been undertaken as a collaborative research project between the Lawrence Livermore National Laboratory (LLNL) and the University of California Department of Applied Science Plasma Diagnostics Group under the auspices of the Laboratory Directed Research and Development Program at LLNL. Theoretical analyses have explored the basic principles of reflectometry to understand its limitations, to address specific gaps in the understanding of reflectometry measurements in laboratory experiments, and to explore extensions of reflectometry such as ultra-short-pulse reflectometry. The theory has supported basic laboratory reflectometry experiments where reflectometry measurements can be corroborated by independent diagnostic measurements

  10. Marketing diagnostics in consumer cooperatives trade enterprises

    Directory of Open Access Journals (Sweden)

    O.S. Krivoruchko

    2013-09-01

    Full Text Available The aim of the article. The article highlights main demands and levels of realization of consumer cooperatives trade enterprises` diagnostics.We demonstrate the chain of marketing diagnostics; we offer the model of diagnostics process of marketing problems (opportunities of cooperative trade enterprises.The results of the analysis. Marketing diagnostics is one of the marketing researches directions, which is matching of the researched object characteristics with comparison base for definition of objects quality condition (its diagnosis. In the context of our research marketing diagnostics should be considered as separate technological module which enables to form development backgrounds of competitive marketing strategies of consumer cooperatives trade enterprises according to conditions of inner and outer environment.We consider the following demands of marketing diagnostics conduction of consumer cooperatives trade enterprises: authenticity, objectivity, accuracy, resultativity, systematicness, sequence, scientific foundation, flexibility, timeliness, effectiveness, validity.Strategic diagnostics is the direction of researches that is responsible for receiving the information, necessary for further functioning of the enterprise. We should refer to comparative researches of strategic state of enterprise economy portfolio, enterprise competitiveness estimation, and enterprise activity threats and possibilities definition.Tactical diagnostics is the researches direction which forms information for plans programs development. Economy interest matching of marketing activity participants in this situation gains special meaning. Due to this meaning the procedures of their sequence can be developed. We consider the mentioned type of diagnostics to be insufficiently researched nowadays, though it has significant importance in the process of managerial decisions supporting and making.The main task of operative diagnostics is defining deviation borders

  11. Infinite Portfolio Strategies

    Directory of Open Access Journals (Sweden)

    Stephen F. LeRoy

    2012-12-01

    Full Text Available In continuous-time stochastic calculus a limit in probability is used to extend the definition of the stochastic integral to the case where the integrand is not square-integrable at the endpoint of the time interval under consideration. When the extension is applied to portfolio strategies, absence of arbitrage in finite portfolio strategies is consistent with existence of arbitrage in infinite portfolio strategies. The doubling strategy is the most common example. We argue that this extension may or may not make economic sense, depending on whether or not one thinks that valuation should be continuous. We propose an alternative extension of the definition of the stochastic integral under which valuation is continuous and absence of arbitrage is preserved. The extension involves appending a date and state called to the payoff index set and altering the definition of convergence under which gains on infinite portfolio strategies are defined as limits of gains on finite portfolio strategies.

  12. Experiences in mainstreaming alternative energy

    Energy Technology Data Exchange (ETDEWEB)

    Cabraal, A.

    1997-12-01

    The author discusses efforts by the Asia Alternative Energy Unit (ASTAE) of the World Bank in supporting alternative energy source projects in Asia. Energy growth rates have been as high as 18% per year, with power capacity doubling each decade in the 1960`s, 70`s and 80`s. Much of this has come from fossil fuel projects coupled with major hydroelectric projects. One consequence is developing air pollution loads originating in Asia. ASTAE has been supporting pilot programs in applying alternative energy sources. The goal has been to mainstream renewable energy sources in World Bank operations, by working with managers from different countries to: include renewable energy in country assistance strategies and sectorial development plans; provide assistance to renewable energy initiatives; expand initiatives to new countries, sectors and technologies.

  13. Molecular Diagnostic Applications in Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Laura Huth

    2014-06-01

    Full Text Available Colorectal cancer, a clinically diverse disease, is a leading cause of cancer-related death worldwide. Application of novel molecular diagnostic tests, which are summarized in this article, may lead to an improved survival of colorectal cancer patients.  Distinction of these applications is based on the different molecular principles found in colorectal cancer (CRC. Strategies for molecular analysis of single genes (as KRAS or TP53 as well as microarray based techniques are discussed. Moreover, in addition to the fecal occult blood testing (FOBT and colonoscopy some novel assays offer approaches for early detection of colorectal cancer like the multitarget stool DNA test or the blood-based Septin 9 DNA methylation test. Liquid biopsy analysis may also exhibit great diagnostic potential in CRC for monitoring developing resistance to treatment. These new diagnostic tools and the definition of molecular biomarkers in CRC will improve early detection and targeted therapy of colorectal cancer.

  14. Optics/Optical Diagnostics Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Optics/Optical Diagnostics Laboratory supports graduate instruction in optics, optical and laser diagnostics and electro-optics. The optics laboratory provides...

  15. Diagnostics of Aerial Systems

    OpenAIRE

    Milan Simko; Milan Sebok; Milan Chupac

    2003-01-01

    Paper deals with the problem of thermovission and its application i diagnostic od antenna system for radio transmitters. on the bockrand of above mentioned theory laboratory measurements and measurements in the conditions of performance process were performed.

  16. Thioaptamer Diagnostic System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — AM Biotechnologies (AM) in partnership with Sandia National Laboratories will develop a Thioaptamer Diagnostic System (TDS) in response to Topic X10.01 Reusable...

  17. Rotorcraft Diagnostics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Under this SBIR program, Ridgetop will introduce the first low-cost, low-power, and lightweight data monitoring solution for rotorcraft diagnostics. The solution is...

  18. Textbook of diagnostic imaging

    International Nuclear Information System (INIS)

    Three volumes provide information organized by major topics covering the state-of-the-art for all imaging procedures. It includes coverage of the fundamentals of diagnostic imaging, and a system-by-system approach

  19. Diagnostic test accuracy

    DEFF Research Database (Denmark)

    Campbell, Jared M.; Klugar, Miloslav; Ding, Sandrine; Carmody, Dennis P.; Håkonsen, Sasja Jul; Jadotte, Yuri T.; White, Sarahlouise; Munn, Zachary

    2015-01-01

    in providing methodological guidance for the conduct of systematic reviews and has developed methods and guidance for reviewers conducting systematic reviews of studies of diagnostic test accuracy. Diagnostic tests are used to identify the presence or absence of a condition for the purpose of...... developing an appropriate treatment plan. Owing to demands for improvements in speed, cost, ease of performance, patient safety, and accuracy, new diagnostic tests are continuously developed, and there are often several tests available for the diagnosis of a particular condition. In order to provide the...... evidence necessary for clinicians and other healthcare professionals to make informed decisions regarding the optimum test to use, primary studies need to be carried out on the accuracy of diagnostic tests and the results of these studies synthesized through systematic review. The Joanna Briggs Institute...

  20. National Convective Weather Diagnostic

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Current convective hazards identified by the National Convective Weather Detection algorithm. The National Convective Weather Diagnostic (NCWD) is an automatically...

  1. Diagnostics for pulmonary tuberculosis

    Science.gov (United States)

    Cudahy, Patrick

    2016-01-01

    Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. The HIV epidemic has also led to new challenges in the diagnosis of TB. Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the ongoing challenges. PMID:27005271

  2. Procedures in diagnostic radiology

    International Nuclear Information System (INIS)

    A book has been written on the procedures used in diagnostic radiology covering the subject areas of the urinary tract, gastrointestinal and biliary tracts, vascular radiology, cerebral angiography and arthrography. The explanation of each procedure follows a common layout which includes indications, equipment, technique and complications. The book is intended to be a reference book for radiology trainees learning to do practical procedures for the first time and also for practising radiologists not habitually performing certain diagnostic procedures. (UK)

  3. Diagnostics for Developing Countries

    OpenAIRE

    Ruth McNerney

    2015-01-01

    Improving the availability of high quality diagnostic tests for infectious diseases is a global priority. Lack of access by people living in low income countries may deprive them of life saving treatment and reduces opportunities to prevent onward transmission and spread of the disease. Diagnostic laboratories are often poorly resourced in developing countries, and sparsely distributed. Improved access may be achieved by using tests that do not require laboratory support, including rapid test...

  4. Diagnostics for pulmonary tuberculosis

    OpenAIRE

    Cudahy, Patrick; Shenoi, Sheela

    2016-01-01

    Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. The HIV epidemic has also led to new challenges in the diagnosis of TB. Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the...

  5. Microscale diagnostic techniques

    CERN Document Server

    Breuer, Kenny

    2005-01-01

    Microscale Diagnostic Techniques highlights the most innovative and powerful developments in microscale diagnostics. It provides a resource for scientists and researchers interested in learning about the techniques themselves, including their capabilities and limitations. The fields of Micro- and Nanotechnology have emerged over the past decade as a major focus of modern scientific and engineering research and technology. Driven by advances in microfabrication, the investigation, manipulation and engineering of systems characterized by micrometer and, more recently, nanometer scales have becom

  6. Computerized Psychiatric Diagnostic Interview

    OpenAIRE

    Zetin, Mark; Warren, Stacey; Lanssens, Ed; Tominaga, Doris

    1987-01-01

    A computerized psychiatric diagnostic interview was developed and administered to 121 adult acute psychiatric inpatients. Data on the 100 completers was evaluated for sensitivity and specificity of the computer diagnostic evaluation relative to the hospital discharge diagnosis and revealed sensitivity greater than 70% for major depression, alcohol/substance abuse, adjustment disorder, bipolar/mania, dependent personaltiy disorder, and histrionic personality disorder. Specificity was greater t...

  7. [Diagnostics in osteology].

    Science.gov (United States)

    Jakob, F; Genest, F; Seefried, L; Tsourdi, E; Lapa, C; Hofbauer, L C

    2016-07-01

    Clinical diagnostics in metabolic bone diseases cover a broad spectrum of conventional and state of the art methods ranging from the medical history and clinical examination to molecular imaging. Patient treatment is carried out in an interdisciplinary team due to the multiple interactions of bone with other organ systems. Diagnosis of osteoporosis is supported by high level national guidelines. A paradigm shift concerning the clinical relevance of bone mineral density measurement renders this now to be a strong risk factor rather than a diagnostic parameter, while strengthening the value of other clinical factors for risk assessment. The impact of parameters for muscle mass, structure and function is steadily increasing in all age groups. In order to identify underlying diseases that influence bone metabolism a panel of general laboratory diagnostic parameters is recommended. Markers for bone formation and resorption and specific parameters for the regulation of calcium and phosphate metabolism should be evaluated by specialists because they require diligence in preanalytics and experience in interpretation. Genetic diagnosis is well established for rare bone diseases while diagnostic panels are not yet available for routine diagnostics in polygenetic diseases such as osteoporosis. Conventional radiology is still very important to identify, e. g. fractures, osteolytic and osteoblastic lesions and extraosseous calcifications; however tomography-based methods which combine, e. g. scintigraphy or positron emission technologies with anatomical imaging are of increasing significance. Clinical diagnostics in osteology require profound knowledge and are subject to a dynamic evolution. PMID:27307159

  8. Complementary alternative medicine and nuclear medicine

    International Nuclear Information System (INIS)

    Complementary alternative medicines (CAMs), including food supplements, are taken widely by patients, especially those with cancer. Others take CAMs hoping to improve fitness or prevent disease. Physicians (and patients) may not be aware of the potential side-effects and interactions of CAMs with conventional treatment. Likewise, their known physiological effects could interfere with radiopharmaceutical kinetics, producing abnormal treatment responses and diagnostic results. Nuclear medicine physicians are encouraged to question patients on their intake of CAMs when taking their history prior to radionuclide therapy or diagnosis. The potential effect of CAMs should be considered when unexpected therapeutic or diagnostic results are found. (orig.)

  9. Interstitial lung disease: Diagnostic approach

    Directory of Open Access Journals (Sweden)

    Kaushik Saha

    2014-01-01

    Full Text Available Interstitial lung disease (ILD is a final common pathway of a broad heterogeneous group of parenchymal lung disorders. It is characterized by progressive fibrosis of the lung leading to restriction and diminished oxygen transfer. Clinically, the presenting symptoms of ILD are non-specific (cough and progressive dyspnea on exertion and are often attributed to other diseases, thus delaying diagnosis and timely therapy. Clues from the medical history along with the clinical context and radiologic findings provide the initial basis for prioritizing diagnostic possibilities for a patient with ILD. An accurate prognosis and optimal treatment strategy for patients with ILDs can only be after an accurate diagnosis. This review will assist pulmonary physicians and medicine specialist in recognition of ILD. Extensive literature search has been made through PubMed and also Book References has been used for writing this review.

  10. Progress on ITER Diagnostic Integration

    Science.gov (United States)

    Johnson, David; Feder, Russ; Klabacha, Jonathan; Loesser, Doug; Messineo, Mike; Stratton, Brentley; Wood, Rick; Zhai, Yuhu; Andrew, Phillip; Barnsley, Robin; Bertschinger, Guenter; Debock, Maarten; Reichle, Roger; Udintsev, Victor; Vayakis, George; Watts, Christopher; Walsh, Michael

    2013-10-01

    On ITER, front-end components must operate reliably in a hostile environment. Many will be housed in massive port plugs, which also shield the machine from radiation. Multiple diagnostics reside in a single plug, presenting new challenges for developers. Front-end components must tolerate thermally-induced stresses, disruption-induced mechanical loads, stray ECH radiation, displacement damage, and degradation due to plasma-induced coatings. The impact of failures is amplified due to the difficulty in performing robotic maintenance on these large structures. Motivated by needs to minimize disruption loads on the plugs, standardize the handling of shield modules, and decouple the parallel efforts of the many parties, the packaging strategy for diagnostics has recently focused on the use of 3 vertical shield modules inserted from the plasma side into each equatorial plug structure. At the front of each is a detachable first wall element with customized apertures. Progress on US equatorial and upper plugs will be used as examples, including the layout of components in the interspace and port cell regions. Supported by PPPL under contract DE-AC02-09CH11466 and UT-Battelle, LLC under contract DE-AC05-00OR22725 with the U.S. DOE.

  11. Acoustic detection in superconducting magnets for performance characterization and diagnostics

    OpenAIRE

    Marchevsky, M.; Wang, X.; Sabbi, G.; Prestemon, S.

    2014-01-01

    Quench diagnostics in superconducting accelerator magnets is essential for understanding performance limitations and improving magnet design. Applicability of the conventional quench diagnostics methods such as voltage taps or quench antennas is limited for long magnets or complex winding geometries, and alternative approaches are desirable. Here, we discuss acoustic sensing technique for detecting mechanical vibrations in superconducting magnets. Using LARP high-field Nb3Sn quadrupole HQ01 [...

  12. Email for communicating results of diagnostic medical investigations to patients

    OpenAIRE

    Meyer, B.; Atherton, H; Sawmynaden, P.; Car, J.

    2012-01-01

    Background: As medical care becomes more complex and the ability to test for conditions grows, pressure on healthcare providers to convey increasing volumes of test results to patients is driving investigation of alternative technological solutions for their delivery. This review addresses the use of email for communicating results of diagnostic medical investigations to patients. Objectives: To assess the effects of using email for communicating results of diagnostic medical investigatio...

  13. Modern antenna measurements and diagnostics including phaseless techniques

    OpenAIRE

    Rahmat-Samii, Yahya; Yaccarino, R. G.

    1997-01-01

    Microwave antenna imaging techniques are a practical and popular method for antenna diagnostic analysis. Phase retrieval methods, however, are just beginning to emerge as an alternative mircowave antenna measurements technique when phase cannot be directly measured. This article focuses on recent advances in microwave antenna imaging, diagnostic techniques, and phase retrieval methods for bi-polar planar near-field antenna measurements. An overview of the bi-polar planar near-field technique ...

  14. Conceptualization of category-oriented likelihood ratio: a useful tool for clinical diagnostic reasoning

    OpenAIRE

    Moosapour Hamideh; Raza Mohsin; Rambod Mehdi; Soltani Akbar

    2011-01-01

    Abstract Background In the diagnostic reasoning process medical students and novice physicians need to be made aware of the diagnostic values of the clinical findings (including history, signs, and symptoms) to make an appropriate diagnostic decision. Diagnostic reasoning has been understood in light of two paradigms on clinical reasoning: problem solving and decision making. They advocate the reasoning strategies used by expert physicians and the statistical models of reasoning, respectively...

  15. Evaluation of rapid diagnostic test for influenza

    OpenAIRE

    Tiziano Allice; Valeria Ghisetti

    2009-01-01

    In high risk patients such as in eldery, newborns and immunosuppressed subjects, a timely diagnosis of influenza is required for the most appropriate antiviral strategy in order to avoid severe secondary respiratory complications and viral spreading. Influenza is preventable by vaccination and chemoprophylaxis and is treatable by specific antiviral indications. The need for a timely diagnosis has led to the introduction of numerous rapid diagnostic tests.These are mostly antigen detection tes...

  16. Automated diagnostics scoping study. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Quadrel, R.W.; Lash, T.A.

    1994-06-01

    The objective of the Automated Diagnostics Scoping Study was to investigate the needs for diagnostics in building operation and to examine some of the current technologies in automated diagnostics that can address these needs. The study was conducted in two parts. In the needs analysis, the authors interviewed facility managers and engineers at five building sites. In the technology survey, they collected published information on automated diagnostic technologies in commercial and military applications as well as on technologies currently under research. The following describe key areas that the authors identify for the research, development, and deployment of automated diagnostic technologies: tools and techniques to aid diagnosis during building commissioning, especially those that address issues arising from integrating building systems and diagnosing multiple simultaneous faults; technologies to aid diagnosis for systems and components that are unmonitored or unalarmed; automated capabilities to assist cause-and-effect exploration during diagnosis; inexpensive, reliable sensors, especially those that expand the current range of sensory input; technologies that aid predictive diagnosis through trend analysis; integration of simulation and optimization tools with building automation systems to optimize control strategies and energy performance; integration of diagnostic, control, and preventive maintenance technologies. By relating existing technologies to perceived and actual needs, the authors reached some conclusions about the opportunities for automated diagnostics in building operation. Some of a building operator`s needs can be satisfied by off-the-shelf hardware and software. Other needs are not so easily satisfied, suggesting directions for future research. Their conclusions and suggestions are offered in the final section of this study.

  17. Radiological diagnostics in CUP syndrome

    International Nuclear Information System (INIS)

    Imaging plays an essential role in the therapeutic management of cancer of unknown primary (CUP) patients for localizing the primary tumor, for the identification of tumor entities for which a dedicated therapy regimen is available and for the characterization of clinicopathological subentities that direct the subsequent diagnostic and therapeutic strategy. Modalities include conventional x-ray, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound as well as positron emission tomography (PET)-CT and MRI-PET. In whole body imaging CT has a high sensitivity for tumor entities which frequently present as a metastasized cancer illness. According to the current literature CT is diagnostic in 86% of patients with pancreatic carcinoma, in 36% of patients with colon carcinoma and in 74% of patients with lung carcinoma. Additionally a meta-analysis showed that for patients with squamous cell carcinoma and cervical lymph node metastases a positive diagnosis was possible in 22% of the cases using CT, in 36% using MRI and in 28-57% using 18F-fluorodeoxyglucose PET-CT (18F-FDG PET-CT). In addition, MRI plays an important role in the localization of primary occult tumors (e.g. breast and prostate) because of its high soft tissue contrast and options for functional imaging. At the beginning of the diagnostic algorithm stands the search for a possible primary tumor and CT of the neck, thorax and abdomen is most frequently used for whole body staging. Subsequent organ-specific imaging examinations follow, e.g. mammography in women with axillary lymphadenopathy. For histological and immunohistochemical characterization of tumor tissue, imaging is also applied to identify the most accessible and representative tumor manifestation for biopsy. Tumor biopsy may be guided by CT, MRI or ultrasound and MRI also plays a central role in the localization of primary occult tumors because of superior soft tissue contrast and options for functional imaging (perfusion

  18. Implementation of Targeted Next Generation Sequencing in Clinical Diagnostics

    DEFF Research Database (Denmark)

    Larsen, Martin Jakob; Burton, Mark; Thomassen, Mads;

    Accurate mutation detection is essential in clinical genetic diagnostics of monogenic hereditary diseases. Targeted next generation sequencing (NGS) provides a promising and cost-effective alternative to Sanger sequencing and MLPA analysis currently used in most diagnostic laboratories. One......, respectively. For diagnostics, the sequencing coverage is essential, wherefore a minimum coverage of 30x per nucleotide in the coding regions was used as our primary quality criterion. For the majority of the included genes, we obtained adequate gene coverage, in which we were able to detect 100% of the known...

  19. Pitfalls in diagnostic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Peh, Wilfred C.G. (ed.) [Khoo Teck Puat Hospital (Singapore). Dept. of Diagnostic Radiology

    2015-04-01

    Only textbook to focus primarily on the topic of pitfalls in diagnostic radiology. Highlights the pitfalls in a comprehensive and systematic manner. Written by experts in different imaging modalities and subspecialties from reputable centers across the world. The practice of diagnostic radiology has become increasingly complex, with the use of numerous imaging modalities and division into many subspecialty areas. It is becoming ever more difficult for subspecialist radiologists, general radiologists, and residents to keep up with the advances that are occurring year on year, and this is particularly true for less familiar topics. Failure to appreciate imaging pitfalls often leads to diagnostic error and misinterpretation, and potential medicolegal problems. Diagnostic errors may be due to various factors such as inadequate imaging technique, imaging artifacts, failure to recognize normal structures or variants, lack of correlation with clinical and other imaging findings, and poor training or inexperience. Many, if not most, of these factors are potentially recognizable, preventable, or correctable. This textbook, written by experts from reputable centers across the world, systematically and comprehensively highlights the pitfalls that may occur in diagnostic radiology. Both pitfalls specific to different modalities and techniques and those specific to particular organ systems are described with the help of numerous high-quality illustrations. Recognition of these pitfalls is crucial in helping the practicing radiologist to achieve a more accurate diagnosis.

  20. MJO Simulation Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Waliser, D; Sperber, K; Hendon, H; Kim, D; Maloney, E; Wheeler, M; Weickmann, K; Zhang, C; Donner, L; Gottschalck, J; Higgins, W; Kang, I; Legler, D; Moncrieff, M; Schubert, S; Stern, W; Vitart, F; Wang, B; Wang, W; Woolnough, S

    2008-06-02

    The Madden-Julian Oscillation (MJO) interacts with, and influences, a wide range of weather and climate phenomena (e.g., monsoons, ENSO, tropical storms, mid-latitude weather), and represents an important, and as yet unexploited, source of predictability at the subseasonal time scale. Despite the important role of the MJO in our climate and weather systems, current global circulation models (GCMs) exhibit considerable shortcomings in representing this phenomenon. These shortcomings have been documented in a number of multi-model comparison studies over the last decade. However, diagnosis of model performance has been challenging, and model progress has been difficult to track, due to the lack of a coherent and standardized set of MJO diagnostics. One of the chief objectives of the US CLIVAR MJO Working Group is the development of observation-based diagnostics for objectively evaluating global model simulations of the MJO in a consistent framework. Motivation for this activity is reviewed, and the intent and justification for a set of diagnostics is provided, along with specification for their calculation, and illustrations of their application. The diagnostics range from relatively simple analyses of variance and correlation, to more sophisticated space-time spectral and empirical orthogonal function analyses. These diagnostic techniques are used to detect MJO signals, to construct composite life-cycles, to identify associations of MJO activity with the mean state, and to describe interannual variability of the MJO.

  1. Real-time control for long ohmic alternate current discharges

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, Ivo S., E-mail: ivoc@ipfn.ist.utl.pt; Duarte, Paulo; Fernandes, Horácio; Valcárcel, Daniel F.; Carvalho, Pedro J.; Silva, Carlos; Duarte, André S.; Neto, André; Sousa, Jorge; Batista, António J.N.; Hekkert, Tiago; Carvalho, Bernardo B.; Gomes, Rui B.

    2014-05-15

    Highlights: • 40 Alternate plasma current (AC) semi-cycles without loss of ionization, more than 1 s of operation. • AC discharges automatic control: feedback loops, time-windows control strategy, goal oriented time-windows and exception handling. • Energy deposition and Carbon radiation evolution during the AC discharges. - Abstract: The ISTTOK tokamak has a long tradition on alternate plasma current (AC) discharges, but the old control system was limiting and lacked full system integration. In order to improve the AC discharges performance the ISTTOK fast control system was updated. This control system developed on site based on the Advanced Telecommunications Computing Architecture (ATCA) standard now integrates the information gathered by all the tokamak real-time diagnostics to produce an accurate observation of the plasma parameters. The real-time actuators were also integrated, allowing a Multiple Input Multiple Output (MIMO) control environment with several synchronization strategies available. The control system software was developed in C++ on top of a Linux system with the Multi-threaded Application Real-Time executor (MARTe) Framework to synchronize the real-time code execution under a 100μs control cycle. In addition, to simplify the discharge programming, a visual Human–Machine Interface (HMI) was also developed using the BaseLib2 libraries included in the MARTe Framework. This paper presents the ISTTOK control system and the optimizations that extended the AC current discharges duration to more than 1 s, corresponding to 40 semi-cycles without apparent degradation of the plasma parameters. This upgrade allows ISTTOK to be used as a low-cost material testing facility with long time exposures to nuclear fusion relevant plasmas, comparable (in duration) with medium size tokamaks.

  2. Real-time control for long ohmic alternate current discharges

    International Nuclear Information System (INIS)

    Highlights: • 40 Alternate plasma current (AC) semi-cycles without loss of ionization, more than 1 s of operation. • AC discharges automatic control: feedback loops, time-windows control strategy, goal oriented time-windows and exception handling. • Energy deposition and Carbon radiation evolution during the AC discharges. - Abstract: The ISTTOK tokamak has a long tradition on alternate plasma current (AC) discharges, but the old control system was limiting and lacked full system integration. In order to improve the AC discharges performance the ISTTOK fast control system was updated. This control system developed on site based on the Advanced Telecommunications Computing Architecture (ATCA) standard now integrates the information gathered by all the tokamak real-time diagnostics to produce an accurate observation of the plasma parameters. The real-time actuators were also integrated, allowing a Multiple Input Multiple Output (MIMO) control environment with several synchronization strategies available. The control system software was developed in C++ on top of a Linux system with the Multi-threaded Application Real-Time executor (MARTe) Framework to synchronize the real-time code execution under a 100μs control cycle. In addition, to simplify the discharge programming, a visual Human–Machine Interface (HMI) was also developed using the BaseLib2 libraries included in the MARTe Framework. This paper presents the ISTTOK control system and the optimizations that extended the AC current discharges duration to more than 1 s, corresponding to 40 semi-cycles without apparent degradation of the plasma parameters. This upgrade allows ISTTOK to be used as a low-cost material testing facility with long time exposures to nuclear fusion relevant plasmas, comparable (in duration) with medium size tokamaks

  3. On hydrogen energy strategies

    International Nuclear Information System (INIS)

    This article focuses on hydrogen energy strategies. Possible problems regarding world stability, progress of hydrogen energy, possible strategies for hydrogen, and essential factors for hydrogen energy technologies are investigated and discussed in detail. Technical, environmental, sustainability and other perspectives are taken into consideration. The importance of hydrogen energy in reducing world problems and achieving a sustainable energy system is also investigated. It is seen that hydrogen energy can play an important role in reducing global problems and improving the sustainability of energy systems. Accordingly, hydrogen strategies based non-fossil energy sources should be developed to reduce world problems and unrest and to increase the level of sustainable development. It is expected that this article will contribute to the development of hydrogen energy strategies that is alternative to fossil-based strategies. (author)

  4. A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis.

    Science.gov (United States)

    Dowdy, David W; Andrews, Jason R; Dodd, Peter J; Gilman, Robert H

    2014-01-01

    Most models of infectious diseases, including tuberculosis (TB), do not provide results customized to local conditions. We created a dynamic transmission model to project TB incidence, TB mortality, multidrug-resistant (MDR) TB prevalence, and incremental costs over 5 years after scale-up of nine alternative diagnostic strategies. A corresponding web-based interface allows users to specify local costs and epidemiology. In settings with little capacity for up-front investment, same-day microscopy had the greatest impact on TB incidence and became cost-saving within 5 years if delivered at $10/test. With greater initial investment, population-level scale-up of Xpert MTB/RIF or microcolony-based culture often averted 10 times more TB cases than narrowly-targeted strategies, at minimal incremental long-term cost. Xpert for smear-positive TB had reasonable impact on MDR-TB incidence, but at substantial price and little impact on overall TB incidence and mortality. This user-friendly modeling framework improves decision-makers' ability to evaluate the local impact of TB diagnostic strategies. PMID:24898755

  5. ORION laser target diagnostics

    International Nuclear Information System (INIS)

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  6. ORION laser target diagnostics.

    Science.gov (United States)

    Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P

    2012-10-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics. PMID:23126904

  7. Beamlet laser diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Burkhart, S.C.; Behrendt, W.C.; Smith, I.

    1996-06-01

    Beamlet is instrumented extensively to monitor the performance of the overall laser system and many of its subsystems. Beam diagnostics, installed in key locations, are used to fully characterize the beam during its propagation through the multipass cavity and the laser`s output section. This article describes the diagnostics stations located on Beamlet and discusses the design, calibration, and performance of the Beamlet calorimeters. The authors used Nova`s diagnostics packages to develop the Beamlet design to determine beam energy, spatial profile, temporal profile, and other beam parameters. Technologic improvements within the last several years in controls, charge-coupled device (CCD) cameras, and fast oscilloscopes have allowed the authors to obtain more accurate measurements on the Beamlet laser system. They briefly cover some of these techniques, including a description of their LabVIEW based data acquisition system.

  8. Diagnostic Imaging Workshop

    International Nuclear Information System (INIS)

    The American Association of Physicist in Medicine (AAPM), the International Organization for Medical Physics (IOMP) and the Argentina Society of Medical Physics (SAFIM) was organized the Diagnostic Imaging Workshop 2012, in the city of Buenos Aires, Argentina. This workshop was an oriented training and scientific exchange between professionals and technicians who work in medical physics, especially in the areas of diagnostic imaging, nuclear medicine and radiotherapy, with special emphasis on the use of multimodal imaging for radiation treatment, planning as well of quality assurance associates.

  9. Diagnostics - Crack Detection '87

    International Nuclear Information System (INIS)

    The Proceedings of the International Symposium Diagnostics -Crack Detection '87 which was held from June 23 to 26 1987 in Sala (CSSR) contains 5 papers falling under the INIS Subject Scope. The said papers mainly deal with the problems of in-service diagnostics of pumps and steam turbines of nuclear power plants with WWER reactors, as well as crack detection of materials and welded joints of equipment and the control of the water regimen of the primary circuit of such power plants. (Z.M.)

  10. Beam Instrumentation and Diagnostics

    CERN Document Server

    Strehl, Peter

    2006-01-01

    This treatise covers all aspects of the design and the daily operations of a beam diagnostic system for a large particle accelerator. A very interdisciplinary field, it involves contributions from physicists, electrical and mechanical engineers and computer experts alike so as to satisfy the ever-increasing demands for beam parameter variability for a vast range of operation modi and particles. The author draws upon 40 years of research and work, most of them spent as the head of the beam diagnostics group at GSI. He has illustrated the more theoretical aspects with many real-life examples that will provide beam instrumentation designers with ideas and tools for their work.

  11. Diagnostic and Therapeutic Strategies of Gastric Motility Disorder in Different Stages of Diabetes%不同阶段糖尿病胃运动障碍诊治对策

    Institute of Scientific and Technical Information of China (English)

    蓝宇; 路国涛

    2012-01-01

    Gastric motility disorder is common in patients with diabetes. The cardinal symptoms include bloating, early satiety, epigastric discomfort, nausea, vomiting and delayed gastric emptying. Delayed gastric emptying affects pharmacokinetics of hypoglycemic agents, causes mismatch of peak postprandial blood glucose level and peak concentration of insulin and oral hypoglycemic agents, thereby affects glycemic control. There are different patterns of gastric motility disorder in different stages of diabetes. The most commonly used diagnostic method for gastric emptying is scintigraphic measurement. Treatment of gastric motility disorder in diabetes includes dietary modifications and prokinetic agents to ameliorate symptoms and improve glycemic control. Therapeutic approaches of gastroparesis include gastric electrical stimulation, endoscopic pyloric injection of botulinum toxin A, endoscopic placement of nasal-jejunum nutrient feeding tube and percutaneous endoscopic gastrostomy/jejunostomy and surgical therapy.%糖尿病患者常见胃运动障碍,表现为上腹胀、早饱、上腹不适、恶心、呕吐等症状以及胃排空延迟,胃排空延迟影响降血糖药的药代动力学,造成餐后血糖升高与降血糖药或胰岛素的血浓度高峰不匹配,进而影响血糖的控制与稳定.糖尿病不同阶段胃运动障碍表现形式不同.核素法是最常用的胃排空诊断方法.糖尿病胃运动障碍的处理包括饮食调节、促动力药以减轻症状、控制血糖,针对胃轻瘫的治疗包括胃电刺激、内镜下幽门注射肉毒杆菌毒素A、内镜下放置鼻胃空肠营养管或经皮内镜下胃(空肠)造瘘、外科手术等.

  12. Diagnostic workup in carotid stenosis - a neurologist's perspective

    International Nuclear Information System (INIS)

    Carotid artery stenosis is associated with the risk of stroke, myocardial infarction, and vascular death. In selected patients, revascularization of carotid narrowing by endarterectomy may reduce the risk of stroke distal to the stenosis. Carotid artery stenting has evolved as a potential alternative to endarterectomy. Four randomized clinical trials comparing safety and efficacy of endarterectomy versus stenting of symptomatic carotid stenosis have been published in recent years, but there remains some uncertainty about the implications of these trials for clinical routine. Both carotid stenting and endarterectomy are based on different treatment strategies which may result in different specific risk factors associated with each procedure. Hence, the procedural risk of either modality varies not only with the skills of the surgeon or the interventionalist but may depend on patient characteristics. It appears that the most important question is not whether one revascularization modality is superior but for which patient one modality is better than the other. A comprehensive diagnostic workup of patients with carotid stenosis based on a broad panel of covariates that affect the risk of vascular events may improve selection of patients for carotid revascularization and may help to decide for whom one revascularization modality is likely to be better than the other. (orig.)

  13. The use and usefulness of OECDs Green growth diagnostics

    OpenAIRE

    Harald SANDER

    2012-01-01

    On 25 May 2011, the OECD launched a "Green Growth Strategy" and proposed a "Green Growth Diagnostics" approach to identify the binding constraints on green growth. This paper discusses the potential use and usefulness of this approach as a means to identify those binding constraints. It is argued that the approach is best used at the meso level for industries and certain environmental challenges. The paper proposes a modified green growth diagnostics approach for eco-innovations at the meso l...

  14. Diagnostic management of blunt abdominal trauma in children

    International Nuclear Information System (INIS)

    Children with abdominal injuries after blunt trauma can be managed non operatively in most cases. Rapid diagnosis is essential to select those patients who need immediate operation. Diagnostic methods of choice are ultrasonography, already performed in the emergency setting and contrast enhanced CT of the abdomen in hemodynamically stable patients. This work discusses the different diagnostic strategies and their use in the clinical practice. (orig.)

  15. Invasive diagnostic techniques in idiopathic interstitial pneumonias.

    Science.gov (United States)

    Poletti, Venerino; Ravaglia, Claudia; Gurioli, Carlo; Piciucchi, Sara; Dubini, Alessandra; Cavazza, Alberto; Chilosi, Marco; Rossi, Andrea; Tomassetti, Sara

    2016-01-01

    Fibrosing interstitial lung diseases (f-ILDs) represent a heterogeneous group of disorders in which the aetiology may be identified or, not infrequently, remain unknown. Establishing a correct diagnosis of a distinct f-ILD requires a multidisciplinary approach, integrating clinical profile, physiological and laboratory data, radiological appearance and, when appropriate, histological findings. Surgical lung biopsy is still considered the most important diagnostic tool as it is able to provide lung samples large enough for identification of complex patterns such as usual interstitial pneumonitis (UIP) and nonspecific interstitial pneumonitis. However, this procedure is accompanied by significant morbidity and mortality. Bronchoalveolar lavage is still a popular diagnostic tool allowing identification of alternative diagnoses in patients with suspected idiopathic pulmonary fibrosis (IPF) when an increase in lymphocytes is detected. Conventional transbronchial lung biopsy has a very low sensitivity in detecting the UIP pattern and its role in this clinical-radiological context is marginal. The introduction of less invasive methods such as transbronchial cryobiopsy show great promise to clinical practice as they can be used to obtain samples large enough to morphologically support a diagnosis of IPF or other idiopathic interstitial pneumonias, along with fewer complications. Recent advances in the field suggest that less invasive methods of lung sampling, without significant side effects, in combination with other diagnostic methods could replace the need for surgical lung biopsy in the future. Indeed, these new multidisciplinary procedures may become the main diagnostic work-up method for patients with suspected idiopathic interstitial pneumonia. PMID:26682637

  16. The Diagnostic Accuracy of Digitized Mammography

    Directory of Open Access Journals (Sweden)

    M. Guiti

    2008-06-01

    Full Text Available Background/Objective: Digitized mammography has several advantages over screen-film radiography in data storage and retrieval, making it a useful alternative to screen-film mammography in screening programs. The purpose of this study was to determine the diagnostic accuracy of digitized mammography in detecting breast cancer. "nPatients and Methods: 185 women (845 Images were digitized at 600 dpi. All images were reviewed by an expert radiologist. The mammograms were scored on a scale of breast imaging reporting and data system (BIRADS. The definite diagnosis was made either on the pathologic results of breast biopsy, or upon the follow-up of at least one year. The overall diagnostic accuracy of digitized mammography was calculated by the area under receiver operating characteristic curve."nResults: 242 sets of mammograms had no lesions. The total counts of masses, microcalcifications or both in one breast were 39 (11%, 42 (12%, and 25 (7%, respectively. There were 321 (92% benign and 27 (8% definite malignant lesions. The diagnostic accuracy of digitized images was 96.34% (95% CI: 94%-98%."nConclusion: The diagnostic accuracy of digitized mammography is comparably good or even better than the published results. The digitized mammography is a good substitute modality for screen-film mammography in screening programs.

  17. Aircraft Engine Gas Path Diagnostic Methods: Public Benchmarking Results

    Science.gov (United States)

    Simon, Donald L.; Borguet, Sebastien; Leonard, Olivier; Zhang, Xiaodong (Frank)

    2013-01-01

    Recent technology reviews have identified the need for objective assessments of aircraft engine health management (EHM) technologies. To help address this issue, a gas path diagnostic benchmark problem has been created and made publicly available. This software tool, referred to as the Propulsion Diagnostic Method Evaluation Strategy (ProDiMES), has been constructed based on feedback provided by the aircraft EHM community. It provides a standard benchmark problem enabling users to develop, evaluate and compare diagnostic methods. This paper will present an overview of ProDiMES along with a description of four gas path diagnostic methods developed and applied to the problem. These methods, which include analytical and empirical diagnostic techniques, will be described and associated blind-test-case metric results will be presented and compared. Lessons learned along with recommendations for improving the public benchmarking processes will also be presented and discussed.

  18. Sexual Addiction: Diagnostic Problems

    Science.gov (United States)

    Giugliano, John R.

    2009-01-01

    In recent years clinicians report a great deal of concern about definition, diagnostic assessment, and treatment modalities when dealing with what might be called out-of-control sexual behavior. Many terms have been used to describe the phenomenon of problematic sexual behavior. Many of these concepts overlap, some are no longer popular, and some…

  19. Radioactive diagnostic agent

    International Nuclear Information System (INIS)

    A dispersion of denatured aggregates of serum albumin to which tin is attached is prepared and lyophilized. A mixture of polycarboxylic acid and a disaccharide or monosaccharide is included in the dispersion in sufficient amount to reduce degradation during lyophilization and aging. The dispersion is suitable for radioactive labelling and use as a diagnostic agent

  20. Honduras : Poverty Diagnostic 2000

    OpenAIRE

    World Bank

    2001-01-01

    This report uses household surveys to provide a diagnostic of poverty, human development, and access to basic infrastructure. The report is based on analytical work conducted by a team comprising staff from the World Bank, Honduras' "Programa de Asignacion Familiar (PRAF), and the International Food Policy Research Institute (IFPRI). The objective of the present report is limited. It provi...

  1. Diagnostic and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

    2016-08-01

    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  2. Diagnosing Diagnostic Language Assessment

    Science.gov (United States)

    Lee, Yong-Won

    2015-01-01

    Diagnostic language assessment (DLA) is gaining a lot of attention from language teachers, testers, and applied linguists. With a recent surge of interest in DLA, there seems to be an urgent need to assess where the field of DLA stands at the moment and develop a general sense of where it should be moving in the future. The current article, as the…

  3. Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

    Directory of Open Access Journals (Sweden)

    Mehrdad Bakhshayeshkaram

    2016-01-01

    Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

  4. Alternative transportation fuels: Financing issues

    International Nuclear Information System (INIS)

    A multitude of alternative fuels could reduce air pollution and the impact of oil price shocks. Only a few of these fuels are readily available and inexpensive enough to merit serious consideration over the coming five years. In New York City, safety regulations narrow the field still further by eliminating propane. As a result, this study focuses on the three alternative fuels readily available in New York City: compressed natural gas, methanol, and electricity. Each has significant environmental benefits and each has different cost characteristics. With the Clean Air Act and the National Energy Strategy highlighting the country's need to improve urban air quality and move away from dependence on imported fuels, fleets may soon have little choice but to convert to altemative fuels. Given the potential for large infrastructure and vehicle costs, these fleets may have difficulty finding the capital to make that conversion. Ultimately, then, it will be the involvement of the private sector that will determine the success of alternative fuels. Whether it be utilities, fuel distributors or suppliers, private financing partners or others, it is critical that altemative fuels programs be structured and planned to attract their involvement. This report examines financing methods that do not involve government subsidies. It also explores financing methods that are specific to alternative fuels. Bond issues and other mechanisms that are used for conventional vehicles are not touched upon in this report. This report explores ways to spread the high cost of alternative fuels among a number of parties within the private sector. The emphasis is on structuring partnerships that suit methanol, electric, or natural gas vehicle fleets. Through these partnerships, alternative fuels may ultimately compete effectively against conventional vehicle fuels

  5. Set-up of a multivariate approach based on serum biomarkers as an alternative strategy for the screening evaluation of the potential abuse of growth promoters in veal calves

    OpenAIRE

    Pirro, Valentina; Girolami, Flavia; Spalenza, Veronica; Gardini, Giulia; Badino, Paola; Nebbia, Carlo

    2015-01-01

    A chemometric class modelling strategy (unequal dispersed classes – UNEQ) was applied for the first time as a possible screening method to monitor the abuse of growth promoters in veal calves. Five serum biomarkers, known to reflect the exposure to classes of compounds illegally used as growth promoters, were determined from 50 untreated animals in order to design a model of controls, representing veal calves reared under good, safe and highly standardised breeding conditions. The class model...

  6. Determine separations process strategy decision

    International Nuclear Information System (INIS)

    This study provides a summary level comparative analysis of selected, top-level, waste treatment strategies. These strategies include No Separations, Separations (high-level/low-level separations), and Deferred Separations of the tank waste. These three strategies encompass the full range of viable processing alternatives based upon full retrieval of the tank wastes. The assumption of full retrieval of the tank wastes is a predecessor decision and will not be revisited in this study

  7. Requirements for ITER diagnostics

    International Nuclear Information System (INIS)

    The development and design of plasma diagnostics for the International Thermonuclear Experimental Reactor (ITER) present a formidable challenge for experimental plasma physicists. The large plasma size, the high central density and temperature and the very high thermal wall loadings provide new challenges for present measurement techniques and lead to a search for new methods. But the physics and control requirements for the long burn phase of the discharge, combined with very limited access to the plasma, constrained by the requirement for radiation shielding of the coils and sharing of access ports with heating and current drive power, remote manipulation, fueling and turn blanket modules, make for very difficult design choices. An initial attempt at these choices has been made by an international team of diagnostic physicists, gathering together in a series of three workshops during the ITER Conceptual Design Activity. This paper is based on that report and provides a summary of its most important points. To provide a background against which to place the diagnostic requirements and design concepts, the ITER device, its most important plasma properties and the proposed experimental program will be described. The specifications for the measurement of the plasma parameters and the proposed diagnostics for these measurements will then be addressed, followed by some examples of the design concepts that have been proposed. As a result of these design studies, it was clear that there were many uncertainties associated with these concepts, particularly because of the nuclear radiation environment, so that a Research and Development Program for diagnostic hardware was established. It will also be briefly summarized

  8. Complementary and Alternative Medicine

    Science.gov (United States)

    ... Help a Friend Who Cuts? Complementary and Alternative Medicine KidsHealth > For Teens > Complementary and Alternative Medicine Print ... replacement. continue How Is CAM Different From Conventional Medicine? Conventional medicine is based on scientific knowledge of ...

  9. Diagnostic timelines and delays in diagnosing amyotrophic lateral sclerosis (ALS).

    Science.gov (United States)

    Paganoni, Sabrina; Macklin, Eric A; Lee, Alexandra; Murphy, Alyssa; Chang, Judith; Zipf, Amanda; Cudkowicz, Merit; Atassi, Nazem

    2014-09-01

    The objective of this study was to characterize the diagnostic timelines and their predictors in people with amyotrophic lateral sclerosis (ALS). Patients were identified through ALS billing codes. Time from presenting symptom to first doctor visit, first doctor visit to suspected ALS diagnosis, suspected to confirmed ALS diagnosis, and presenting symptom to confirmed ALS diagnosis (total diagnostic time) were collected. Regression models were used to analyze the predictors of diagnostic delay. Three hundred and four ALS patients were included in the analysis. Median total diagnostic time was 11.5 months. Diagnostic timelines were longer in patients with age > 60 years (p < 0.001), sporadic ALS (p = 0.043), and limb onset (p = 0.010). The presence of fasciculations, slurred speech, and lower extremity weakness when symptoms were first noted were independent predictors of shorter time to ALS diagnosis (p = 0.04, p = 0.02, and p = 0.04, respectively). About half of the patients (52%) received an alternative diagnosis and each patient saw an average of three different physicians before ALS diagnosis was confirmed. In conclusion, diagnostic timelines in ALS are long, and patients see many physicians and receive multiple alternative diagnoses before the diagnosis of ALS is confirmed. Older age, sporadic disease, and limb onset can delay ALS diagnosis. PMID:24981792

  10. Global Strategy

    DEFF Research Database (Denmark)

    Li, Peter Ping

    2013-01-01

    Global strategy differs from domestic strategy in terms of content and process as well as context and structure. The content of global strategy can contain five key elements, while the process of global strategy can have six major stages. These are expounded below. Global strategy is influenced by...... rich and complementary local contexts with diverse resource pools and game rules at the national level to form a broad ecosystem at the global level. Further, global strategy dictates the interaction or balance between different entry strategies at the levels of internal and external networks....

  11. Diagnostic reasoning and treatment planning: II. Treatment.

    Science.gov (United States)

    Nurcombe, B

    1987-12-01

    The concepts of therapy-oriented and problem-oriented plans are discussed and their advantages and disadvantages considered. Goal-directed planning is proposed as an alternative to intuitive decision making. Goal-directed planning involves the abstraction of pivotal problems from a diagnostic formulation, the restatement of problems as goals, the selection of appropriate therapy, the designation of a target date, the stipulation of objectives, the selection of methods of evaluation and the monitoring of progress. Systematic goal-directed planning fosters teamwork, promotes accountability, obviates therapeutic drift and enhances outcome evaluation. Its chief disadvantage is its unfamiliarity. PMID:3502386

  12. Progress in alternative testing strategies for human embryonic stem cell-based drug toxicity%基于人胚胎干细胞的药物毒性测试替代法研究进展

    Institute of Scientific and Technical Information of China (English)

    贾栗; 彭辉; 赵增明; 乌瀚宝栎尔; 彭双清

    2016-01-01

    传统的药物研发及安全性评价对实验动物的需求量大,费用高,周期长,种属差异性问题难以克服。人胚胎干细胞(hESC)可自我更新及定向分化为多种类型的细胞,逐渐成为毒性测试体外替代法的新工具。hESC的体外替代模型预测受试物对人体各种靶器官的毒性及毒作用机制,如生殖毒性测试模型、神经发育毒性测试模型及体外代谢模型等,结合基因组学、蛋白质组学和代谢组学等组学技术快速高效地分析多条代谢通路,寻找潜在的毒性生物标志物。在药物毒理学研究中具有广泛的应用前景。%Traditional drug development and pre-clinical tests are based on animals and involve large numbers of animals,costs and long periods. Meanwhile,inter-species differences are difficult to overcome. Human embryonic stem cells (hESCs),which can self-renew and directly differentiate to types of cells,have become a new tool for toxicity alternative testing. hESC-Based alternative testing models,such as the reproductive toxicity test system,neuro development toxicity test system and metabolic model,can be used to predict target organ toxicity and toxic mechanisms of chemicals, analyze metabolic pathways and to search for potential toxicity biomarkers, when combined with omics such techiniques as metabonomics , proteomics and genomics. Therefore, hESC-based alternative testing models have extensive application to toxicology.

  13. Animal Alternative Methods and the Development of Strategy for Toxicity Testing in the Twenty-first Century%动物实验替代方法与21世纪毒性测试发展策略

    Institute of Scientific and Technical Information of China (English)

    郭家彬; 彭双清

    2011-01-01

    随着新化学物质日益增多以及“3R”原则的广泛实施,传统的毒性测试面临着严峻挑战.毒性测试的发展正经历着一个关键时期,即从耗时、耗费的传统整体动物试验转向快速高通量的、含定量参数分析和机制研究的体外替代试验.实验动物替代方法不仅是出于遵行“3R”原则的考虑,也是毒理学学科发展以及社会经济发展的需要与科学要求.实验动物替代方法的发展与应用已成为21世纪毒性测试的重要方向,获得越来越广泛的支持和管理认可,具有广阔的发展前景和十分重要的应用价值.%Traditional toxicity testing is facing great challenging as increasing new chemicals and the implementation of "3R" principle. The development of toxicity testing is approaching a pivotal point where expensive and lengthy traditional in vivo animal tests are transformed to in vitro high-throughput alternative methods with quantitative parameters analysis and mechanistic exploration. Animal alternative methods are considered not only for the compliance of " 3 R" principle, but also for the demands and scientific requirements for the development of toxicology and social economy. The development and application of animal alternative methods have become an important direction of toxicity testing in the twenty-first century, and are gained increasingly wide support and regulatory acceptance with broad prospect and important value.

  14. [Over diagnostic imaging in cardiology].

    Science.gov (United States)

    Carpeggiani, Clara

    2014-03-01

    Medical imaging is one of the major cause of rising health care costs. Diagnostic imaging has increased more rapidly than any other component of medical care. About 5 billion imaging tests are performed worldwide each year. According to recent estimates, at least one-third of all examinations are partially or totally inappropriate. Two out of 3 imaging tests employ ionizing radiations with radiology or nuclear medicine. The medical use of radiation is the largest man-made source of radiation exposure. Medical X-rays and γ-rays are a proven human carcinogen. The attributable long-term extra-risk of cancer due to diagnostic testing is around 10% in industrialized countries. Cardiologists prescribe and/or directly perform >50% of all imaging examinations, accounting for about two-thirds of the total effective dose given to patients. The dose of common cardiological examinations may be significant: 500 chest X-rays= a stress scintigraphy with sestamibi, 750 chest X-rays= a Multislice Computed Tomography, 1,000 chest X-rays= a coronary angiography and stenting. Unfortunately, few doctors are aware of the level of radiation their patients are exposed to during radiological tests and more intensive use of ionizing testing was not associated with greater awareness. Also as a consequence of unawareness, the rate of inappropriate examinations is unacceptably high in cardiology, even for procedures with high radiation load. Higher exposure doses correspond to higher long-term risks; there are no safe doses, and all doses add up in determining the cumulative risks over a lifetime. Doctors should make every effort so that «each patient should get the right imaging exam, at the right time, with the right radiation dose», as suggested by US Food and Drug Administration in the 2010 initiative to reduce unnecessary radiation exposure from medical imaging. This is best obtained through a systematic implementation of the "3 A's strategy" proposed by the International Atomic Energy

  15. TMX-U diagnostic system

    International Nuclear Information System (INIS)

    Using data from the TMX-U diagnostic system, the production of sloshing ions has already been verified and the formation of electron thermal barriers is presently being investigated on the Tandem Mirror Experiment-Upgrade (TMX-U) at Lawrence Livermore National Laboratory. The TMX-U diagnostics are made up of the earlier TMX complement of diagnostics that determine confinement, microstability, and low-frequency stability, plus diagnostic instrumentation that measures electron parameters associated with mirror-confined electrons. This paper describes the three subsystems within the TMX-U diagnostic system: (1) the diagnostic facility (shot leader console, data cable system, and diagnostic timing system); (2) the individual diagnostic instruments that measure plasma and machine parameters; and (3) the data-acquisition and -analysis computer

  16. Ultrasound diagnostics of postpartum endometritis

    OpenAIRE

    Bratchikova О.А.; Chekhonatskaya M.L.; Yannaeva N.E.

    2014-01-01

    The purpose of the article is to present data on diagnostics of postpartum infectious diseases in women in childbirth. The aim of the conducted survey is to study modern ultrasound diagnostic methods of the given pathology.

  17. Ultrasound Diagnostics of Liver Cancer

    OpenAIRE

    Schukina О.Е.

    2014-01-01

    The literature review presents opportunities of the contemporary ultrasound technologies in diagnostics of liver cancer; diagnostic criteria have been determined; the accuracy degree of the ultrasound method in grey-scale and Doppler imaging have been also revealed.

  18. Nonequilibrium diagnostics of plasma thrusters

    Energy Technology Data Exchange (ETDEWEB)

    Eddy, T.L.; Grandy, J.D.

    1990-01-01

    This paper describes possible techniques by which the state of plasma thruster operation for space propulsion can be determined from a minimum set of experimental data in the laboratory. The kinetic properties of the nonequilibrium plasma plume usually can not be directly related to the observed radiation; hence, appropriate nonequilibrium diagnostic techniques must be employed. A newly developed multithermal, multichemical equilibrium method is discussed that uses measured line emission intensities and N equations to solve for N unknowns. The effect of arbitrarily changing the number of selected N unknowns and how one determines the optimum (minimum) number to be used for a given composition is also presented. The chemical nonequilibrium aspects and the application to molecular species have not yet been published. The important conclusions are that (1) complete thermodynamic systems in nonequilibrium can be described by relatively few variables if appropriate choices and filtering methods are used, (2) a few radiation measurements can yield valid kinetic properties, and (3) the major question in the relations to be used is in the form of the law of mass action. The results are substantiated in the laboratory by additional alternative methods of measurement of some of the kinetic properties. 13 refs., 1 fig.

  19. Cardiovascular modeling and diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Kangas, L.J.; Keller, P.E.; Hashem, S.; Kouzes, R.T. [Pacific Northwest Lab., Richland, WA (United States)

    1995-12-31

    In this paper, a novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

  20. Inertial confinement fusion diagnostics

    International Nuclear Information System (INIS)

    The concept and goals of ICF will be briefly reviewed and the new 100 kJ class Nova laser facility will be described. Experimental results obtained to date with Nova will be summarized, and the discussions of diagnostics will use examples on the present capabilities of Nova and new developments that are underway. The classes of diagnostic systems to be discussed fall into three basic categories: optical, x-ray, and particle. Examples of highly space resolved, time resolved, and spectrally resolved techniques as well as schemes involving combinations of these capabilities will be presented. A brief summary of the sophisticated acquisition and analysis system in use for Nova data will be provided