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Sample records for approaches retrospective comparison

  1. How to measure renal artery stenosis - a retrospective comparison of morphological measurement approaches in relation to hemodynamic significance

    International Nuclear Information System (INIS)

    Andersson, Malin; Jägervall, Karl; Eriksson, Per; Persson, Anders; Granerus, Göran; Wang, Chunliang; Smedby, Örjan

    2015-01-01

    Although it is well known that renal artery stenosis may cause renovascular hypertension, it is unclear how the degree of stenosis should best be measured in morphological images. The aim of this study was to determine which morphological measures from Computed Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA) are best in predicting whether a renal artery stenosis is hemodynamically significant or not. Forty-seven patients with hypertension and a clinical suspicion of renovascular hypertension were examined with CTA, MRA, captopril-enhanced renography (CER) and captopril test (Ctest). CTA and MRA images of the renal arteries were analyzed by two readers using interactive vessel segmentation software. The measures included minimum diameter, minimum area, diameter reduction and area reduction. In addition, two radiologists visually judged the diameter reduction without automated segmentation. The results were then compared using limits of agreement and intra-class correlation, and correlated with the results from CER combined with Ctest (which were used as standard of reference) using receiver operating characteristics (ROC) analysis. A total of 68 kidneys had all three investigations (CTA, MRA and CER + Ctest), where 11 kidneys (16.2 %) got a positive result on the CER + Ctest. The greatest area under ROC curve (AUROC) was found for the area reduction on MRA, with a value of 0.91 (95 % confidence interval 0.82–0.99), excluding accessory renal arteries. As comparison, the AUROC for the radiologists’ visual assessments on CTA and MRA were 0.90 (0.82–0.98) and 0.91 (0.83–0.99) respectively. None of the differences were statistically significant. No significant differences were found between the morphological measures in their ability to predict hemodynamically significant stenosis, but a tendency of MRA having higher AUROC than CTA. There was no significant difference between measurements made by the radiologists and measurements made with

  2. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach

    Science.gov (United States)

    2011-01-01

    Background Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-loaded 14-gauge core biopsy approach. Methods A retrospective analysis was done of all ultrasound-guided diagnostic breast biopsy procedures performed by either the 8-gauge vacuum-assisted biopsy approach or the spring-loaded 14-gauge core biopsy approach by a single surgeon from July 2001 through June 2009. Results Among 1443 ultrasound-guided diagnostic breast biopsy procedures performed, 724 (50.2%) were by the 8-gauge vacuum-assisted biopsy technique and 719 (49.8%) were by the spring-loaded 14-gauge core biopsy technique. The total number of false negative cases (i.e., benign findings instead of invasive breast carcinoma) was significantly greater (P = 0.008) in the spring-loaded 14-gauge core biopsy group (8/681, 1.2%) as compared to in the 8-gauge vacuum-assisted biopsy group (0/652, 0%), with an overall false negative rate of 2.1% (8/386) for the spring-loaded 14-gauge core biopsy group as compared to 0% (0/148) for the 8-gauge vacuum-assisted biopsy group. Significantly more (P guided diagnostic breast biopsy procedure. Significantly more (P guided diagnostic breast biopsy procedure. Conclusions In appropriately selected cases, the 8-gauge vacuum-assisted biopsy approach appears to be advantageous to the spring-loaded 14-gauge core biopsy approach for providing the most accurate and optimal diagnostic information. PMID:21835024

  3. Multicenter retrospective study of noncompressible torso hemorrhage: Anatomic locations of bleeding and comparison of endovascular versus open approach.

    Science.gov (United States)

    Chang, Ronald; Fox, Erin E; Greene, Thomas J; Eastridge, Brian J; Gilani, Ramyar; Chung, Kevin K; DeSantis, Stacia M; DuBose, Joseph J; Tomasek, Jeffrey S; Fortuna, Gerald R; Sams, Valerie G; Todd, S Rob; Podbielski, Jeanette M; Wade, Charles E; Holcomb, John B

    2017-07-01

    Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012. Inclusion criteria include named axial torso vessel disruption, Abbreviated Injury Scale chest or abdomen score of 3 or higher with shock (base excess, bleeding locations were 25% chest, 41% abdomen, and 31% pelvis. ENDO was used to treat relatively few types of vascular injuries, whereas OPEN and RT injuries were more diverse. ENDO patients had more blunt trauma (95% vs. 34% vs. 32%); severe injuries (median Injury Severity Score, 34 vs. 27 vs. 21), and increased time to intervention (median, 298 vs. 92 vs. 51 minutes) compared with OPEN and RT. Mortality was 15% versus 20% versus 79%. ENDO was associated with decreased mortality compared to OPEN (relative risk, 0.58; 95% confidence interval, 0.46-0.73). Although ENDO may reduce mortality in NCTH patients, significant group differences limit the generalizability of this finding. Therapeutic, level V.

  4. A retrospective metagenomics approach to studying Blastocystis.

    Science.gov (United States)

    Andersen, Lee O'Brien; Bonde, Ida; Nielsen, Henrik Bjørn; Stensvold, Christen Rune

    2015-07-01

    Blastocystis is a common single-celled intestinal parasitic genus, comprising several subtypes. Here, we screened data obtained by metagenomic analysis of faecal DNA for Blastocystis by searching for subtype-specific genes in coabundance gene groups, which are groups of genes that covary across a selection of 316 human faecal samples, hence representing genes originating from a single subtype. The 316 faecal samples were from 236 healthy individuals, 13 patients with Crohn's disease (CD) and 67 patients with ulcerative colitis (UC). The prevalence of Blastocystis was 20.3% in the healthy individuals and 14.9% in patients with UC. Meanwhile, Blastocystis was absent in patients with CD. Individuals with intestinal microbiota dominated by Bacteroides were much less prone to having Blastocystis-positive stool (Matthew's correlation coefficient = -0.25, P < 0.0001) than individuals with Ruminococcus- and Prevotella-driven enterotypes. This is the first study to investigate the relationship between Blastocystis and communities of gut bacteria using a metagenomics approach. The study serves as an example of how it is possible to retrospectively investigate microbial eukaryotic communities in the gut using metagenomic datasets targeting the bacterial component of the intestinal microbiome and the interplay between these microbial communities. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Comparison of transradial and transfemoral artery approach for percutaneous coronary angiography and angioplasty: A retrospective seven-year experience from a north Indian center

    Directory of Open Access Journals (Sweden)

    Satyendra Tewari

    2013-07-01

    Conclusion: The number of percutaneous transradial procedures have increased significantly with reduced complication rates and comparable success rate to transfemoral approach, along with the additional benefits to patient in terms of patient comfort, preference and reduced cost of health delivery.

  6. Comparison of single-injection ultrasound-guided approach versus multilevel landmark-based approach for thoracic paravertebral blockade for breast tumor resection: a retrospective analysis at a tertiary care teaching institution

    Directory of Open Access Journals (Sweden)

    Saran JS

    2017-06-01

    Full Text Available Jagroop Singh Saran,1 Amie L Hoefnagel,1 Kristin A Skinner,2 Changyong Feng,3 Daryl Irving Smith1 1Acute Pain Service, Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, 2Department of Surgical Oncology, University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, 3Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA Background: The role of thoracic paravertebral blockade (TPVB in decreasing opioid requirements in breast cancer surgery is well documented, and there is mounting evidence that this may improve survival and reduce the rate of malignancy recurrence following cancer-related mastectomy. We compared the two techniques currently in use at our institution, the anatomic landmark-guided (ALG multilevel versus an ultrasound-guided (USG single injection, to determine an optimal technique.Methods: We retrospectively reviewed records of patients who received TPVB from January 2013 to December 2014. Perioperative opioid use, post anesthesia care unit (PACU pain scores and length of stay, block performance, and complications were compared between the two groups.Results: We found no statistical difference between the two approaches in the studied outcomes. We did find that the number of times attending physicians in the ALG group took over the blocks from residents was significantly greater than that of the USG group (p=0.006 and more local anesthetic was used in the USG group (p=0.04.Conclusion: This study compared the ALG approach with the USG approach for patients undergoing mastectomy for breast cancer. Based on our observations, an attending physician is more likely to take over an ALG injection, and more local anesthetic is administered during USG single injection. Keywords: thoracic paravertebral block, regional anesthesia, mastectomy, breast cancer 

  7. A comparison of conventional and retrospective measures of change in symptoms after elective surgery

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    Dörning Hans

    2011-04-01

    Full Text Available Abstract Background Measuring change is fundamental to evaluations, health services research and quality management. To date, the Gold-Standard is the prospective assessment of pre- to postoperative change. However, this is not always possible (e.g. in emergencies. Instead a retrospective approach to the measurement of change is one alternative of potential validity. In this study, the Gold-Standard 'conventional' method was compared with two variations of the retrospective approach: a perceived-change design (model A and a design that featured observed follow-up minus baseline recall (model B. Methods In a prospective longitudinal observational study of 185 hernia patients and 130 laparoscopic cholecystectomy patients (T0: 7-8 days pre-operative; T1: 14 days post-operative and T2: 6 months post-operative changes in symptoms (Hernia: 9 Items, Cholecystectomy: 8 Items were assessed at the three time points by patients and the conventional method was compared to the two alternatives. Comparisons were made regarding the percentage of missing values per questionnaire item, correlation between conventional and retrospective measurements, and the degree to which retrospective measures either over- or underestimated changes and time-dependent effects. Results Single item missing values in model A were more frequent than in model B (e.g. Hernia repair at T1: model A: 23.5%, model B: 7.9%. In all items and at both postoperative points of measurement, correlation of change between the conventional method and model B was higher than between the conventional method and model A. For both models A and B, correlation with the change calculated with the conventional method was higher at T1 than at T2. Compared to the conventional model both models A and B also overestimated symptom-change (i.e. improvement with similar frequency, but the overestimation was higher in model A than in model B. In both models, overestimation was lower at T1 than at T2 and lower

  8. A Retrospective Introduction to Religious Education: An Interpretive Approach

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    Jackson Robert

    2016-12-01

    Full Text Available The author takes a retrospective look at his book Religious Education: An Interpretive Approach, first published in 1997, and now available to readers, open access, via the European Wergeland Centre website (http://www.theewc.org/Content/Library/Research-Development/Literature/Introducing-Religious-Education-an-Interpretive-Approach. He tells a personal story of teaching, broadcasting and research, moving from the design of a methodology for studying the religions of minority groups in Britain to identifying the main concepts used for teaching about religions to children and young people in an engaging way, which relates to their own personal and social experience. The article, explains the key concept of representation – looking, for example, at how religions are often represented in ways that play down their internal diversity. Next the concept of interpretation is considered, emphasising the activity through which learners can compare and contrast the use of language by religious believers with their own nearest equivalent language uses, in trying, with sensitivity, to get as close as possible to their meanings. Finally, the process of reflexivity is explained; this gives learners an opportunity for three activities – to re-assess their understanding of their own world view (called edification in the interpretive approach, to make a distanced critique of beliefs and ideas they have studied, and to evaluate the methods that they have been using to learn about the religious meanings of others. Finally the author illustrates how the key concepts from the interpretive approach have been adapted for use in field research studies on teaching and learning about religions.

  9. Approach to design space from retrospective quality data.

    Science.gov (United States)

    Puñal Peces, Daniel; García-Montoya, Encarna; Manich, Albert; Suñé-Negre, Josep Maria; Pérez-Lozano, Pilar; Miñarro, Montse; Ticó, Josep Ramon

    2016-01-01

    Nowadays, the entire manufacturing process is based on the current GMPs, which emphasize the reproducibility of the process, and companies have a lot of recorded data about their processes. The establishment of the design space (DS) from retrospective data for a wet compression process. A design of experiments (DoE) with historical data from 4 years of industrial production has been carried out using the experimental factors as the results of the previous risk analysis and eight key parameters (quality specifications) that encompassed process and quality control data. Software Statgraphics 5.0 was applied, and data were processed to obtain eight DS as well as their safe and working ranges. Experience shows that it is possible to determine DS retrospectively, being the greatest difficulty in handling and processing of high amounts of data; however, the practicality of this study is very interesting as it let have the DS with minimal investment in experiments since actual production batch data are processed statistically.

  10. Crafting a Software Process Improvement Approach - A Retrospective Systematization

    DEFF Research Database (Denmark)

    Kuhrmann, Marco

    2015-01-01

    Structured approaches are beneficial for successful software process improvement (SPI). However, process engineers often struggle with standardized SPI methods, such as capability maturity model integration (CMMI) or International Organization for Standardization (ISO) 15504, and complain about too...... and provide a structured reflection on our experiences from creating and adopting the Artifact-based Software Process Improvement & Management (ArSPI) model. We present the steps of the construction procedure, the validation, and the dissemination of the model. Furthermore, we detail on the applied methods...... generic or voluminous approaches or methods that are alien to the organizations in which SPI is conducted. Therefore, process engineers need to customize existing SPI models or develop new approaches for company-specific SPI programs. While conducting SPI in the context of the German V-Modell XT, we faced...

  11. Comparison of retrospective and contemporary indoor radon measurements in a high-radon area of Serbia

    International Nuclear Information System (INIS)

    Zunic, Z.S.; Yarmoshenko, I.V.; Kelleher, K.; Paridaens, J.; Mc Laughlin, J.P.; Celikovic, I.; Ujic, P.; Onischenko, A.D.; Jovanovic, S.; Demajo, A.; Birovljev, A.; Bochicchio, F.

    2007-01-01

    In Niska Banja, Serbia, which is a high-radon area, a comparison was made between two retrospective radon measuring methods and contemporary radon measurements. The two retrospective methods derive the radon concentrations that occurred in dwellings over longer periods in the past, based on the amount of trapped 210 Po on the surface of glass objects (surface traps, ST) or in the bulk of porous materials (volume traps, VT). Both surface implanted 210 Po in glass objects and contemporary radon in air were measured in 46 rooms, distributed in 32 houses of this radon spa-town, using a dual alpha track detector configuration (CR-39 and LR115) and CR-39 track etched detectors, respectively. In addition to the use of surface trap measurements, in 18 rooms (distributed in 15 houses) VT samples of suitable material were also collected, allowing to compare ST and VT retrospective radon concentration estimates. For each room, contemporary annual radon concentrations (CONT) were measured or estimated using seasonal correction factors. The distribution of the radon concentration in all data sets was found to be close to lognormal (Chi-square test > 0.05). Geometric means (GM) are similar, ranging from 1040 to 1380 Bq m -3 , whereas geometric standard deviations (GSD) for both the retrospective methods are greater than for the CONT method, showing reasonable agreement between VT, ST and CONT measurements. A regression analysis, with respect to the lognormal distribution of each data set, shows that for VT-ST the correlation coefficient r is 0.85, for VT-CONT r is 0.82 and for ST-CONT r is 0.73. Comparison of retrospective and contemporary radon concentrations with regard to supposed long-term indoor radon changes further supports the principal agreement between the retrospective and conventional methods

  12. Dostoevsky's epilepsy: a new approach to retrospective diagnosis.

    Science.gov (United States)

    Rayport, Shirley M Ferguson; Rayport, Mark; Schell, Carolyn A

    2011-11-01

    There has been considerable debate about Fyodor Dostoevsky's epilepsy. Was his epilepsy generalized or focal? Was the dramatic ecstatic experience an epileptic phenomenon or a literary invention? We compared probable epileptically related behavioral manifestations in The Idiot with experiences of current patients, studied with a modern interdisciplinary approach involving neurosurgery, neurology, and neuropsychiatry. Patients were studied by all disciplines starting with their initial evaluation and trial of antiseizure medication, during hospitalization for long-term monitoring for epilepsy at scalp and depth levels with electrical brain stimulation, during intraoperative interviews, and in long-term postoperative follow-up. Behavioral manifestations, clearly shown to be phenomena of the epilepsy in our patients, were the template for defining the epileptic nature of the behavioral symptomatology described by Dostoevsky in his literary character, Prince Myshkin. We conclude that Dostoevsky had temporolimbic epilepsy and that the ecstatic experience is an epileptic phenomenon. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Andragogical Approach to the Quality and Effectiveness of Vocational Adults Training (A Retrospective Study [In Bulgarian

    Directory of Open Access Journals (Sweden)

    C. Katansky

    2009-06-01

    Full Text Available The article describes the basic results of a study dealing with the problem of quality and effectiveness of vocational training of adults in Bulgaria. Why is it retrospective? Because the subject of study is previous author’s andragogical investigations on the vocational qualification system, adults learners, training process and principals. The author uses the andragogigal methodology and results in order to develop a new approach to the problem and original definitions of vocational training quality and effectiveness.

  14. Robot Trajectories Comparison: A Statistical Approach

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    A. Ansuategui

    2014-01-01

    Full Text Available The task of planning a collision-free trajectory from a start to a goal position is fundamental for an autonomous mobile robot. Although path planning has been extensively investigated since the beginning of robotics, there is no agreement on how to measure the performance of a motion algorithm. This paper presents a new approach to perform robot trajectories comparison that could be applied to any kind of trajectories and in both simulated and real environments. Given an initial set of features, it automatically selects the most significant ones and performs a statistical comparison using them. Additionally, a graphical data visualization named polygraph which helps to better understand the obtained results is provided. The proposed method has been applied, as an example, to compare two different motion planners, FM2 and WaveFront, using different environments, robots, and local planners.

  15. Robot Trajectories Comparison: A Statistical Approach

    Science.gov (United States)

    Ansuategui, A.; Arruti, A.; Susperregi, L.; Yurramendi, Y.; Jauregi, E.; Lazkano, E.; Sierra, B.

    2014-01-01

    The task of planning a collision-free trajectory from a start to a goal position is fundamental for an autonomous mobile robot. Although path planning has been extensively investigated since the beginning of robotics, there is no agreement on how to measure the performance of a motion algorithm. This paper presents a new approach to perform robot trajectories comparison that could be applied to any kind of trajectories and in both simulated and real environments. Given an initial set of features, it automatically selects the most significant ones and performs a statistical comparison using them. Additionally, a graphical data visualization named polygraph which helps to better understand the obtained results is provided. The proposed method has been applied, as an example, to compare two different motion planners, FM2 and WaveFront, using different environments, robots, and local planners. PMID:25525618

  16. Infraclavicular versus axillary nerve catheters: A retrospective comparison of early catheter failure rate.

    Science.gov (United States)

    Quast, Michaela B; Sviggum, Hans P; Hanson, Andrew C; Stoike, David E; Martin, David P; Niesen, Adam D

    2018-05-01

    Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery. Retrospective study. Postoperative recovery unit and inpatient hospital floor. 328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database. Data collected included unplanned catheter dislodgement, catheter replacement rate, postoperative pain scores, and opioid administration on postoperative day 1. Catheter failure was defined as unplanned dislodging within 24 h of placement or requirement for catheter replacement and evaluated using a covariate adjusted model. 119 IC catheters and 209 AX catheters were evaluated. There were 8 (6.7%) failed IC catheters versus 13 (6.2%) failed AX catheters. After adjusting for age, BMI, and gender there was no difference in catheter failure rate between IC and AX nerve catheters (p = 0.449). These results suggest that IC and AX nerve catheters do not differ in the rate of early catheter failure, despite differences in anatomic location and catheter placement techniques. Both techniques provided effective postoperative analgesia with median pain scores < 3/10 for patients following elbow surgery. Reasons other than rate of early catheter failure should dictate which approach is performed. Copyright © 2018. Published by Elsevier Inc.

  17. Fundoplication after heller myotomy: a retrospective comparison between nissen and dor.

    Science.gov (United States)

    Cuttitta, Antonello; Tancredi, Antonio; Andriulli, Angelo; De Santo, Ermelinda; Fontana, Andrea; Pellegrini, Fabio; Scaramuzzi, Roberto; Scaramuzzi, Gerardo

    2011-12-01

    A retrospective comparison between Nissen and Dor fundoplication after laparoscopic Heller myotomy for achalasia. From 1998 to 2004 a first group of 48 patients underwent Heller myotomy and Nissen fundoplication for idiopathic achalasia (H+N group). From 2004 to 2010 a second group of 40 patients underwent Heller myotomy followed by Dor fundoplication (H+D group). Some patients received a previous endoscopic treatment with pneumatic dilatation or endoscopic injection of botulinum toxin that provided them only a temporary clinical benefit. Changes in clinical and instrumental examinations from before to after surgery were evaluated in all patients. Clinical evaluation was carried out using a modified DeMeester symptom score system. Dor fundoplication treatment reduced both dysphagia and regurgitation severity scores significantly more than Nissen fundoplication (pHeller myotomy followed by Dor fundoplication is a safe and valuable treatment. The procedure showed a lower incidence of postoperative dysphagia versus Nissen fundoplication and a negligible incidence of postoperative GERD in a long-term postoperative follow-up.

  18. Roller and Centrifugal Pumps: A Retrospective Comparison of Bleeding Complications in Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Halaweish, Ihab; Cole, Adam; Cooley, Elaine; Lynch, William R; Haft, Jonathan W

    2015-01-01

    Centrifugal pumps are increasingly used for extracorporeal membrane oxygenation (ECMO) rather than roller pumps. However, shear forces induced by these types of continuousflow pumps are associated with acquired von Willebrand factor deficiency and bleeding complications. This study was undertaken to compare adverse bleeding complications with the use of centrifugal and roller pumps in patients on prolonged ECMO support. The records of all adult ECMO patients from June 2002 to 2013 were retrospectively reviewed using the University of Michigan Health System database and the Extracorporeal Life Support Organization registry, focusing on patients supported for at least 5 days. Ninety-five ECMO patients met criteria for inclusion (48 roller vs. 47 centrifugal pump). Indications included pulmonary (79%), cardiac (15%), and extracorporeal cardiopulmonary resuscitation (6%), without significant difference between the two groups. Despite lower heparin anticoagulation (10.9 vs. 13.7 IU/kg/hr) with centrifugal pumps, there was a higher incidence of nonsurgical bleeding (gastrointestinal, pulmonary, and neurological) in centrifugal pump patients (26.1 vs. 9.0 events/1,000 patient-days, p = 0.024). In conclusion, in our historical comparison, despite reduced anticoagulation, ECMO support using centrifugal pumps was associated with a higher incidence of nonsurgical bleeding. The mechanisms behind this are multifactorial and require further investigation.

  19. Temporary Decompression in Critically Ill Patients: Retrospective Comparison of Ileostomy and Colostomy.

    Science.gov (United States)

    Lin, Zhi-Liang; Yu, Wen-Kui; Shi, Jia-Liang; Chen, Qi-Yi; Tan, Shan-Jun; Li, Ning

    2014-05-01

    In critically ill patients, gastrointestinal function plays an important role in multiple organ dysfunction syndrome. Patients suffering from acute lower gastrointestinal dysfunction need to be performed a temporary fecal diversion after the failure of conservative treatment. This study aims to determine which type of fecal diversion is associated with better clinical outcomes in critically ill patients. Data of critically ill patients requiring surgical decompression following acute lower gastrointestinal dysfunction between January 2008 and June 2013 were retrospectively analyzed. Comparison was made between ileostomy group and colostomy group regarding the stoma-related complications and the recovery after stoma creation. 63 patients consisted of temporary ileostomy group (n = 35) and temporary colostomy group (n = 28) were included in this study. First bowel movement and length of enteral nutrition intolerance after fecal diversion were both significantly shorter in the ileostomy group than in the colostomy group (1.70 ± 0.95 vs. 3.04 ± 1.40; p colostomy group. Both procedures provide an effective defunctioning of the distant gastrointestinal tract with a low complication incidence. We prefer a temporary ileostomy to temporary colostomy for acute lower gastrointestinal dysfunction in critically ill patients.

  20. Assessing the clinical effectiveness of an algorithmic approach for mucosal lichen planus (MLP): A retrospective review.

    Science.gov (United States)

    Ashack, Kurt A; Haley, Laura L; Luther, Chelsea A; Riemer, Christie A; Ashack, Richard J

    2016-06-01

    Mucosal lichen planus (MLP) is a therapeutic challenge in need of a new treatment approach because of its debilitating effect on patient's quality of life. We sought to evaluate a standardized treatment plan for patients with MLP. A second objective was to describe the effect of mycophenolate mofetil in this patient population. The study retrospectively analyzed 53 patients with MLP treated using a standardized algorithm. The number of MLP lesions, disease activity, and pain at the last visit were compared with baseline scores determined at the initial visit. Results were analyzed using the paired samples t test and confirmed with the Wilcoxon matched pairs signed rank test. The average number of lesions was reduced from 3.77 to 1.67 (P < .001). The average disease activity was reduced from 2.73 to 0.90 (P < .001). Average pain reported decreased from 2.03 to 1.03 (P < .001). This study was a retrospective analysis of a small patient population. There was no universal symptom severity scale used at the time of treatment for some patients. The standardized treatment plan reduced symptoms for patients with MLP. Mycophenolate mofetil appears to be a reasonable treatment option for these patients. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. A retrospective comparison of microwave ablation and high intensity focused ultrasound for treating symptomatic uterine fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Wen-Peng, E-mail: zwp215@163.com; Han, Zhi-Yu, E-mail: hanzhiyu301@hotmail.com; Zhang, Jing, E-mail: zjbch@sina.com; Liang, Ping, E-mail: liangping301@hotmail.com

    2015-03-15

    Highlights: •Both HIFU and PMWA are thermal ablation techniques and they all provide safe and reliable alternative treatment methods for uterine fibroids. •However, whether there are obvious difference between these two kinds of approaches in improving symptom, treatment time, ablation rate, regression rate and adverse events, until now, there are no clinical trials which have been performed to compare the therapeutic effects of HIFU and PMWA. •In this research, we retrospectively compare the results of these two treatment methods. •To our knowledge, our study is the first directly comparing long-term outcome after PMWA and HIFU in patients with uterine fibroids. -- Abstract: Objectives: To retrospectively compare the effectiveness and safety of percutaneous microwave ablation (PMWA) and ultrasound-guided high-intensity focused ultrasound (USgHIFU) for treating symptomatic uterine fibroids. Methods: Seventy-three women with symptomatic uterine fibroids who met the inclusion criteria were enrolled in our study from September 2012 to December 2013. Thirty-one patients with forty uterine fibroids underwent PMWA, and forty-two patients with fifty-one uterine fibroids underwent USgHIFU. A contrast-enhanced MRI was performed before and after treatment, and all patients were followed up for 6 months. Assessment endpoints included symptom severity scores (SSS), treatment time, ablation rate, fibroid regression rate and adverse events. Results: The mean age of the patients in our study was 35.4 ± 6.2 years (range, 21–49 years), and the median volume of uterine fibroids was 95.7 cm{sup 3} (60.3–131.5 cm{sup 3}). The ablation rate of uterine fibroids was 79.8 ± 18.2% and 77.1 ± 14.9% in the PMWA group and the USgHIFU group, respectively, and showed no significant difference between the groups. Changes in SSS after PMWA were similar in the PMWA group (47.7 pre-treatment vs. 29.9 post-treatment) and USgHIFU group (42.1 pre-treatment vs. 24.6 post-treatment). The

  2. Comparison between retrospective gating and ECG triggering in magnetic resonance velocity mapping

    DEFF Research Database (Denmark)

    Søndergaard, L; Ståhlberg, F; Thomsen, C

    1993-01-01

    ECG-triggered cinematographic studies of the cardiovascular system are hampered by several technical restrictions such as the inability to image end-diastole, ghosting, varying signal intensity, and phase contributions from eddy currents. Retrospective gating may solve these problems, but involves...... of flow pulses. However, by reducing the time window retrospectively gated flow measurements were in good agreement with those that are ECG triggered. When fulfilling the demand of a narrow time window for interpolation, retrospective gating offers several advantages in MR velocity mapping....

  3. A comparison of contemporary and retrospective radon gas measurements in high radon dwellings in Ireland

    International Nuclear Information System (INIS)

    Kelleher, K.; McLaughlin, J.P.; Fenton, D.; Colgan, P.A.

    2006-01-01

    Little correlations has been found between contemporary radon gas measurements made in the past and retrospective radon gas measurements in Irish dwellings. This would suggest that these two techniques would result in two significantly different cumulative radon exposure estimates. Contemporary radon gas measurements made a few years apart in the same room of a dwelling were found to be significantly different. None of these differences could be explained by known changes to the rooms themselves., such ventilation or structural alterations to the room. This highlights the limitations of the contemporary radon gas measurements as a surrogate measurement for use in residential radon epidemiology. The contemporary radon gas measurements made by the Radiological Protection Institute of Ireland (R.P.I.I.) and University College of Dublin (U.C.D.) do not cover the same exposure period as the retrospective estimates and so the accuracy of the retrospective measurements cannot be demonstrated. A weak correlation can be seen between the retrospective radon gas estimates and a combination of the two contemporary radon gas estimates. It is not unreasonable to expect improvement in the correlation if further contemporary radon gas measurements were made in these rooms. (N.C.)

  4. The utility of QSARs in predicting acute fish toxicity of pesticide metabolites: A retrospective validation approach.

    Science.gov (United States)

    Burden, Natalie; Maynard, Samuel K; Weltje, Lennart; Wheeler, James R

    2016-10-01

    The European Plant Protection Products Regulation 1107/2009 requires that registrants establish whether pesticide metabolites pose a risk to the environment. Fish acute toxicity assessments may be carried out to this end. Considering the total number of pesticide (re-) registrations, the number of metabolites can be considerable, and therefore this testing could use many vertebrates. EFSA's recent "Guidance on tiered risk assessment for plant protection products for aquatic organisms in edge-of-field surface waters" outlines opportunities to apply non-testing methods, such as Quantitative Structure Activity Relationship (QSAR) models. However, a scientific evidence base is necessary to support the use of QSARs in predicting acute fish toxicity of pesticide metabolites. Widespread application and subsequent regulatory acceptance of such an approach would reduce the numbers of animals used. The work presented here intends to provide this evidence base, by means of retrospective data analysis. Experimental fish LC50 values for 150 metabolites were extracted from the Pesticide Properties Database (http://sitem.herts.ac.uk/aeru/ppdb/en/atoz.htm). QSAR calculations were performed to predict fish acute toxicity values for these metabolites using the US EPA's ECOSAR software. The most conservative predicted LC50 values generated by ECOSAR were compared with experimental LC50 values. There was a significant correlation between predicted and experimental fish LC50 values (Spearman rs = 0.6304, p < 0.0001). For 62% of metabolites assessed, the QSAR predicted values are equal to or lower than their respective experimental values. Refined analysis, taking into account data quality and experimental variation considerations increases the proportion of sufficiently predictive estimates to 91%. For eight of the nine outliers, there are plausible explanation(s) for the disparity between measured and predicted LC50 values. Following detailed consideration of the robustness of

  5. Comparison between Fisherian and Bayesian approach to ...

    African Journals Online (AJOL)

    ... of its simplicity and optimality properties is normally used for two group cases. However, Bayesian approach is found to be better than Fisher's approach because of its low misclassification error rate. Keywords: variance-covariance matrices, centroids, prior probability, mahalanobis distance, probability of misclassification ...

  6. A retrospective cross-sectional quantitative molecular approach in biological samples from patients with syphilis.

    Science.gov (United States)

    Pinto, Miguel; Antelo, Minia; Ferreira, Rita; Azevedo, Jacinta; Santo, Irene; Borrego, Maria José; Gomes, João Paulo

    2017-03-01

    Syphilis is the sexually transmitted disease caused by Treponema pallidum, a pathogen highly adapted to the human host. As a multistage disease, syphilis presents distinct clinical manifestations that pose different implications for diagnosis. Nevertheless, the inherent factors leading to diverse disease progressions are still unknown. We aimed to assess the association between treponemal loads and dissimilar disease outcomes, to better understand syphilis. We retrospectively analyzed 309 DNA samples distinct anatomic sites associated with particular syphilis manifestations. All samples had previously tested positive by a PCR-based diagnostic kit. An absolute quantitative real-time PCR procedure was used to precisely quantify the number of treponemal and human cells to determine T. pallidum loads in each sample. In general, lesion exudates presented the highest T. pallidum loads in contrast with blood-derived samples. Within the latter, a higher dispersion of T. pallidum quantities was observed for secondary syphilis. T. pallidum was detected in substantial amounts in 37 samples of seronegative individuals and in 13 cases considered as syphilis-treated. No association was found between treponemal loads and serological results or HIV status. This study suggests a scenario where syphilis may be characterized by: i) heterogeneous and high treponemal loads in primary syphilis, regardless of the anatomic site, reflecting dissimilar duration of chancres development and resolution; ii) high dispersion of bacterial concentrations in secondary syphilis, potentially suggesting replication capability of T. pallidum while in the bloodstream; and iii) bacterial evasiveness, either to the host immune system or antibiotic treatment, while remaining hidden in privileged niches. This work highlights the importance of using molecular approaches to study uncultivable human pathogens, such as T. pallidum, in the infection process. Copyright © 2017 Elsevier Ltd. All rights

  7. Diagnosis and surgical approach of popliteal artery entrapment syndrome: a retrospective study

    Directory of Open Access Journals (Sweden)

    Stavros Gourgiotis

    2008-02-01

    Full Text Available Stavros Gourgiotis1, John Aggelakas1, Nikolaos Salemis1, Charalabos Elias2, Charalabos Georgiou11Second Surgical Department, 401 General Army Hospital of Athens, Greece; 2Second Surgical Department, 417 NIMTS Veterans General Hospital of Athens, GreeceBackground: Popliteal artery entrapment syndrome (PAES is a rare but potentially limb threatening peripheral vascular disease occurring predominantly in young adults. This study is a retrospective review of 49 limbs in 38 patients with PAES treated surgically over an 8-year period.Patients and methods: From 1995 to 2002, 38 patients with a mean age of 21 years (range, 18–29 years underwent surgery for PAES at a single institution. The patients’ demographic data and clinical features are recorded. The preoperative diagnosis of PAES was made based on various combinations of investigations including positional stress test, duplex ultrasonography, computed tomography, computed tomographic angiography, and angiography. Results: Nine, 33, and 7 patients had Delaney’s type I, II, and III PAES respectively. The surgical procedures consisted of simple release of the popliteal artery in 33 limbs (67.3%, autogenous saphenous vein (ASV patch angioplasty with or without thromboendarterectomy (TEA in 5 limbs (10.2% and ASV graft interposition or bypass in 11 limbs (22.5%. At a median follow up of 34 months (range, 8–42 months, there were no postoperative complications and all the patients were cured of their symptoms.Conclusions: PAES is an unusual but important cause of peripheral vascular insufficiency especially in young patients. Early diagnosis through a combined approach is necessary for exact diagnosis. Popliteal artery release alone or with vein bypass is the treatment of choice when intervention is indicated for good operative outcome and to prevent limb loss.Keywords: popliteal artery, entrapment syndrome, diagnosis, surgery, treatment

  8. Retrospective analysis of 104 histologically proven adult brainstem gliomas: clinical symptoms, therapeutic approaches and prognostic factors

    International Nuclear Information System (INIS)

    Reithmeier, Thomas; Kuzeawu, Aanyo; Hentschel, Bettina; Loeffler, Markus; Trippel, Michael; Nikkhah, Guido

    2014-01-01

    Adult brainstem gliomas are rare primary brain tumors (<2% of gliomas). The goal of this study was to analyze clinical, prognostic and therapeutic factors in a large series of histologically proven brainstem gliomas. Between 1997 and 2007, 104 patients with a histologically proven brainstem glioma were retrospectively analyzed. Data about clinical course of disease, neuropathological findings and therapeutic approaches were analyzed. The median age at diagnosis was 41 years (range 18-89 years), median KPS before any operative procedure was 80 (range 20-100) and median survival for the whole cohort was 18.8 months. Histopathological examinations revealed 16 grade I, 31 grade II, 42 grade III and 14 grade IV gliomas. Grading was not possible in 1 patient. Therapeutic concepts differed according to the histopathology of the disease. Median overall survival for grade II tumors was 26.4 months, for grade III tumors 12.9 months and for grade IV tumors 9.8 months. On multivariate analysis the relative risk to die increased with a KPS ≤ 70 by factor 6.7, with grade III/IV gliomas by the factor 1.8 and for age ≥ 40 by the factor 1.7. External beam radiation reduced the risk to die by factor 0.4. Adult brainstem gliomas present with a wide variety of neurological symptoms and postoperative radiation remains the cornerstone of therapy with no proven benefit of adding chemotherapy. Low KPS, age ≥ 40 and higher tumor grade have a negative impact on overall survival

  9. Retrospective comparison of abdominal ultrasonography and radiography in the investigation of feline abdominal disease

    Science.gov (United States)

    Won, Wylen Wade; Sharma, Ajay; Wu, Wenbo

    2015-01-01

    Abdominal radiography and ultrasonography are commonly used as part of the initial diagnostic plan for cats with nonspecific signs of abdominal disease. This retrospective study compared the clinical usefulness of abdominal radiography and ultrasonography in 105 feline patients with signs of abdominal disease. The final diagnosis was determined more commonly with ultrasonography (59%) compared to radiography (25.7%). Ultrasonography was also able to provide additional clinically relevant information in 76% of cases, and changed or refined the diagnosis in 47% of cases. Based on these findings, ultrasonography may be sufficient as an initial diagnostic test for the investigation of feline abdominal disease. PMID:26483582

  10. Retrospective methods of dose assessment of the Chernobyl 'liquidators'. A comparison

    International Nuclear Information System (INIS)

    Schmidt, M.; Ziggel, H.; Schmitz-Feuerhaake, I.; Dannheim, B.; Schikalov, V.; Usatyj, A.; Shevchenko, V.; Snigireva, G.; Serezhenkov, V.; Klevezal, G.

    1998-01-01

    A database of biomedical and dosimetric data of participants in the liquidation work at Chernobyl was set up. Dose profiles were created by using suitable dose modelling. EPR spectrometric measurements of the tooth enamel was performed as a routine method of retrospective dosimetry for radiation workers at medium to low exposures. Chromosome analyses were carried out in peripheral blood lymphocytes of a cohort of the liquidation workers. Fluorescence in-situ hybridization was also used. The number of workers volunteering to take part in the research, however, was too small to allow statistically relevant results to be obtained. (P.A.)

  11. Comparison of Traditional and Constructivist Teaching Approaches ...

    African Journals Online (AJOL)

    The second section of students had 47 students and was taught using traditional teaching approach. Learning strategy inventory questionnaire which was adapted from strategy inventory for language learning (SILL) L2 students of English, (Oxford, 1990) was employed before and after students were taught using two ...

  12. An ecological approach to prospective and retrospective timing of long durations: a study involving gamers.

    Directory of Open Access Journals (Sweden)

    Simon Tobin

    Full Text Available To date, most studies comparing prospective and retrospective timing have failed to use long durations and tasks with a certain degree of ecological validity. The present study assessed the effect of the timing paradigm on playing video games in a "naturalistic environment" (gaming centers. In addition, as it involved gamers, it provided an opportunity to examine the effect of gaming profile on time estimation. A total of 116 participants were asked to estimate prospectively or retrospectively a video game session lasting 12, 35 or 58 minutes. The results indicate that time is perceived as longer in the prospective paradigm than in the retrospective one, although the variability of estimates is the same. Moreover, the 12-minute session was perceived as longer, proportionally, than the 35- and 58-minute sessions. The study also revealed that the number of hours participants spent playing video games per week was a significant predictor of time estimates. To account for the main findings, the differences between prospective and retrospective timing are discussed in quantitative terms using a proposed theoretical framework, which states that both paradigms use the same cognitive processes, but in different proportions. Finally, the hypothesis that gamers play more because they underestimate time is also discussed.

  13. The effectiveness of specialist roles in mental health metabolic monitoring: a retrospective cross-sectional comparison study.

    Science.gov (United States)

    McKenna, Brian; Furness, Trentham; Wallace, Elizabeth; Happell, Brenda; Stanton, Robert; Platania-Phung, Chris; Edward, Karen-leigh; Castle, David

    2014-09-02

    People with serious mental illness (SMI) exhibit a high prevalence of cardiovascular diseases. Mental health services have a responsibility to address poor physical health in their consumers. One way of doing this is to conduct metabolic monitoring (MM) of risk factors for cardiovascular diseases. This study compares two models of MM among consumers with SMI and describes referral pathways for those at high risk of cardiovascular diseases. A retrospective cross-sectional comparison design was used. The two models were: (1) MM integrated with case managers, and (2) MM integrated with case managers and specialist roles. Retrospective data were collected for all new episodes at two community mental health services (CMHS) over a 12-month period (September 2012 - August 2013). A total of 432 consumers with SMI across the two community mental health services were included in the analysis. At the service with the specialist roles, MM was undertaken for 78% of all new episode consumers, compared with 3% at the mental health service with case managers undertaking the role. Incomplete MM was systemic to both CMHS, although all consumers identified with high risk of cardiovascular diseases were referred to a general practitioner or other community based health services. The specialist roles enabled more varied referral options. The results of this study support incorporating specialist roles over case manager only roles for more effective MM among new episode consumers with SMI.

  14. Retrospective radiation dosimetry using OSL of electronic components: Results of an inter-laboratory comparison

    International Nuclear Information System (INIS)

    Bassinet, C.; Woda, C.; Bortolin, E.; Della Monaca, S.; Fattibene, P.; Quattrini, M.C.; Bulanek, B.; Ekendahl, D.; Burbidge, C.I.; Cauwels, V.; Kouroukla, E.; Geber-Bergstrand, T.; Mrozik, A.; Marczewska, B.; Bilski, P.; Sholom, S.; McKeever, S.W.S.; Smith, R.W.; Veronese, I.

    2014-01-01

    In the framework of the EU-FP7 MULTIBIODOSE project, two protocols using OSL of resistors removed from the circuit board of mobile phones were developed with the aim to use the resistors as fortuitous dosimeters in the event of a large scale radiological accident. This paper presents the results of an inter-laboratory comparison carried out under the umbrella of EURADOS. The two aims of this exercise were the validation of the MULTIBIODOSE protocols by a large number of laboratories and the dissemination of the method with the objective of preparing the basis for a network that could increase Europe's response capacity in the case of a mass casualty radiological emergency. Twelve institutes from eleven European countries and one institute from the USA, with various degrees of expertise in OSL dosimetry, took part in the OSL inter-laboratory comparison. Generally, a good agreement within uncertainties was observed between estimated and nominal doses. - Highlights: • Resistors in mobile phones could function as reliable fortuitous dosimeters in case of a large scale radiological accident. • Two OSL protocols were validated by an inter-laboratory comparison. • It is feasible to set up a network of laboratories so as to increase the measurement capacity

  15. Retrospective comparison of perinatal outcomes following emergency cervical cerclage with or without prolapsed membranes.

    Science.gov (United States)

    Steenhaut, Patricia; Hubinont, Corinne; Bernard, Pierre; Debiève, Frédéric

    2017-06-01

    To compare perinatal outcomes following emergency cerclage between patients with singleton pregnancies with prolapsed and non-prolapsed membranes. The present retrospective cohort study included data from women who underwent physical examination-indicated emergency cerclage at between 15 and 25 weeks of pregnancy at Saint Luc University Hospital, Brussels, Belgium, between January 1, 2000, and December 31, 2014. Outcomes were compared based on the presence of prolapsed or non-prolapsed membranes. The primary outcome measures were the duration of pregnancy at delivery and the interval between cerclage and delivery. Secondary outcomes included delivery weight, fetal or neonatal death, and neonatal morbidity, including neonatal intensive care unit admission. Data were included from 140 patients with cervical dilation of at least 1 cm; 85 women had non-prolapsed membranes and 55 women had prolapsed membranes. Among patients with non-prolapsed membranes, the mean duration of pregnancy at delivery was later (Pmembranes was associated with improved perinatal outcomes following emergency cerclage. © 2017 International Federation of Gynecology and Obstetrics.

  16. Retrospective Comparison of Visual Outcomes After KAMRA Corneal Inlay Implantation With Simultaneous PRK or LASIK.

    Science.gov (United States)

    Moshirfar, Majid; Bean, Andrew E; Albarracin, Julio C; Rebenitsch, Ronald L; Wallace, Ryan T; Birdsong, Orry C

    2018-05-01

    To report a retrospective study of simultaneous LASIK versus photorefractive keratectomy (PRK) with accompanying small-aperture cornea inlay implantation (KAMRA; AcuFocus, Inc., Irvine, CA) in treating presbyopia. Simultaneous LASIK/inlay and simultaneous PRK/inlay was performed on 79 and 47 patients, respectively. Follow-up examinations were conducted at 1, 3, and 6 months postoperatively. The main outcome measures were safety, efficacy, predictability, and stability with primary emphasis on monocular uncorrected near visual acuity (UNVA). Both groups met U.S. Food and Drug Administration criteria for efficacy with 95% and 55% of the LASIK/inlay group and 83% and 52% of the PRK/inlay group having a monocular UNVA of 20/40 (J5) and 20/25 (J2), respectively, at 6-month follow-up. Ninety-two percent of the LASIK/inlay group and 95% of the PRK/inlay group had a UDVA of 20/40 or better at 6 months. Two eyes lost one line of corrected distance visual acuity (CDVA). Mild hyperopic shift was noted in both groups at 6 months. Simultaneous PRK/inlay and LASIK/inlay meet the U.S. Food and Drug Administration standards for efficacy and safety based on 6-month preliminary results and have similar outcomes to emmetropic eyes. [J Refract Surg. 2018;34(5):310-315.]. Copyright 2018, SLACK Incorporated.

  17. Does specialization of treatment influence mortality in eating disorders?--A comparison of two retrospective cohorts.

    Science.gov (United States)

    Winkler, Laura Al-Dakhiel; Bilenberg, Niels; Hørder, Kirsten; Støving, René Klinkby

    2015-12-15

    Eating disorders (EDs) are psychiatric disorders associated with high morbidity and mortality. It is well established that patients with anorexia nervosa (AN) have an increased risk of premature death, whereas mortality data are lacking for the other EDs. This study aimed to establish mortality rates in a sample of ED patients (n=998) with a mean follow-up of 12 years. This was compared to previous data from the same catchment area before a multidisciplinary centre was established. The standardized mortality ratio (SMR) was calculated. To compare the two cohorts, adjusted crude ratios were calculated with the confounding variables: body mass index (BMI), age at referral and diagnosis. In the latest cohort the SMR for AN was 2.89 vs 11.16 in the time before our specialization. SMR for bulimia nervosa (BN) and for eating disorder not otherwise specified (EDNOS) in the latest cohort were 2.37 and 1.14 respectively. When comparing two retrospective cohorts it is not possible to draw a definite conclusion, however the present study supports that integrating a somatic unit in a multidisciplinary centre may have a favourable influence on mortality in AN. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. A retrospective comparison of dental treatment under general anesthesia on children with and without mental disabilities.

    Science.gov (United States)

    Sari, M E; Ozmen, B; Koyuturk, A E; Tokay, U

    2014-01-01

    The purpose of this study is to determine the properties of the dental procedures performed on children with dental problems under general anesthesia and compared between the patterns of dental treatment provided for intellectual disability and non-cooperate healthy child. In this retrospective study, the records of patients between the ages of 4 and 18 who were treated under general anesthesia were evaluated. Patients were divided into two groups: Those with intellectual disability and healthy patients who had difficulty cooperating. A statistical analysis of the mean standard deviation was conducted with a focus on two factors: Age and dental treatment methods. In this study, it was observed that restorative treatment and tooth extraction was generally higher in intellectual disability children than in their healthy children. When evaluating the health status of teeth, the value of decayed missing and filled teeth (dmf-t) was observed to be close in healthy and intellectual disability individuals in the 4-6 age groups; it was higher in individuals with intellectual disability in the 7-12 age groups. There was no significant difference in terms of periodontal treatment and fissure sealants in the 12-18 age groups. By comparing the different patient groups who received dental treatment under general anesthesia, both the number of teeth extracted and DMF-T indices were higher in the disabled group. Therefore, especially more efforts should be made at encouraging these patients to visit the dentist earlier and receive primary preventive care.

  19. Comparison of patients with and without intellectual disability under general anesthesia: A retrospective study.

    Science.gov (United States)

    Sitilci, T; Demirgan, S; Akcay, C; Kahraman, N; Koseoglu, B G; Erdem, M A; Cankaya, A B

    2017-04-01

    We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia. A total of 348 patients were selected from the Department of Maxillofacial Surgery and the Department of Pedodontics who underwent surgery with general anesthesia. Medical histories of all patients were taken, and their electrocardiography, chest X-rays, complete blood count, and blood clotting tests were checked during a preoperative assessment. Mallampati evaluations were also performed. Patients were grouped into ASA I, II, or III according to the ASA classification and were treated under general anesthesia. There was no significant difference between normal and intellectually disabled patients in terms of gender, Mallampati scores, intubation difficulties, mean anesthetic period, time to discharge, or postoperative nausea and vomiting. Epilepsy and genetic diseases in intellectually disabled patients were significantly more common than in non-ID (NID) patients. However, the frequency of diabetes and chronic obstructive pulmonary disease in NID patients was significantly higher than in the intellectually disabled patients. Dental treatment of intellectually disabled patients under general anesthesia can be performed just as safely as that with NID patients.

  20. Comparison of Routable Control System Security Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Edgar, Thomas W.; Hadley, Mark D.; Carroll, Thomas E.; Manz, David O.; Winn, Jennifer D.

    2011-06-01

    This document is an supplement to the 'Secure and Efficient Routable Control Systems.' It addressed security in routable control system communication. The control system environment that monitors and manages the power grid historically has utilized serial communication mechanisms. Leased-line serial communication environments operating at 1200 to 9600 baud rates are common. However, recent trends show that communication media such as fiber, optical carrier 3 (OC-3) speeds, mesh-based high-speed wireless, and the Internet are becoming the media of choice. In addition, a dichotomy has developed between the electrical transmission and distribution environments, with more modern communication infrastructures deployed by transmission utilities. The preceding diagram represents a typical control system. The Communication Links cloud supports all of the communication mechanisms a utility might deploy between the control center and devices in the field. Current methodologies used for security implementations are primarily led by single vendors or standards bodies. However, these entities tend to focus on individual protocols. The result is an environment that contains a mixture of security solutions that may only address some communication protocols at an increasing operational burden for the utility. A single approach is needed that meets operational requirements, is simple to operate, and provides the necessary level of security for all control system communication. The solution should be application independent (e.g., Distributed Network Protocol/Internet Protocol [DNP/IP], International Electrotechnical Commission [IEC] C37.118, Object Linking and Embedding for Process Control [OPC], etc.) and focus on the transport layer. In an ideal setting, a well-designed suite of standards for control system communication will be used for vendor implementation and compliance testing. An expected outcome of this effort is an international standard.

  1. Comparison of filtering methods for the modeling and retrospective forecasting of influenza epidemics.

    Directory of Open Access Journals (Sweden)

    Wan Yang

    2014-04-01

    Full Text Available A variety of filtering methods enable the recursive estimation of system state variables and inference of model parameters. These methods have found application in a range of disciplines and settings, including engineering design and forecasting, and, over the last two decades, have been applied to infectious disease epidemiology. For any system of interest, the ideal filter depends on the nonlinearity and complexity of the model to which it is applied, the quality and abundance of observations being entrained, and the ultimate application (e.g. forecast, parameter estimation, etc.. Here, we compare the performance of six state-of-the-art filter methods when used to model and forecast influenza activity. Three particle filters--a basic particle filter (PF with resampling and regularization, maximum likelihood estimation via iterated filtering (MIF, and particle Markov chain Monte Carlo (pMCMC--and three ensemble filters--the ensemble Kalman filter (EnKF, the ensemble adjustment Kalman filter (EAKF, and the rank histogram filter (RHF--were used in conjunction with a humidity-forced susceptible-infectious-recovered-susceptible (SIRS model and weekly estimates of influenza incidence. The modeling frameworks, first validated with synthetic influenza epidemic data, were then applied to fit and retrospectively forecast the historical incidence time series of seven influenza epidemics during 2003-2012, for 115 cities in the United States. Results suggest that when using the SIRS model the ensemble filters and the basic PF are more capable of faithfully recreating historical influenza incidence time series, while the MIF and pMCMC do not perform as well for multimodal outbreaks. For forecast of the week with the highest influenza activity, the accuracies of the six model-filter frameworks are comparable; the three particle filters perform slightly better predicting peaks 1-5 weeks in the future; the ensemble filters are more accurate predicting peaks in

  2. Regorafenib Versus Trifluridine/Tipiracil for Refractory Metastatic Colorectal Cancer: A Retrospective Comparison.

    Science.gov (United States)

    Masuishi, Toshiki; Taniguchi, Hiroya; Hamauchi, Satoshi; Komori, Azusa; Kito, Yosuke; Narita, Yukiya; Tsushima, Takahiro; Ishihara, Makoto; Todaka, Akiko; Tanaka, Tsutomu; Yokota, Tomoya; Kadowaki, Shigenori; Machida, Nozomu; Ura, Takashi; Fukutomi, Akira; Ando, Masashi; Onozawa, Yusuke; Tajika, Masahiro; Yasui, Hirofumi; Muro, Kei; Mori, Keita; Yamazaki, Kentaro

    2017-06-01

    Regorafenib and trifluridine/tipiracil (TAS-102) both prolong survival for patients with refractory metastatic colorectal cancer. However, it is unclear which drug should be administered first. We retrospectively evaluated the data from patients who had received regorafenib or TAS-102 at 2 institutions from May 2013 to March 2015. The inclusion criteria were disease refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, anti-vascular endothelial growth factor antibodies, and anti-epidermal growth factor receptor (EGFR) antibodies (if KRAS exon 2 wild-type), and no previous treatment with regorafenib or TAS-102. A total of 146 and 54 patients received regorafenib and TAS-102, respectively. The baseline characteristics were similar between the 2 groups, except for a history of irinotecan and anti-EGFR therapy and high alkaline phosphatase levels. The median progression-free survival and overall survival were 2.1 months and 6.7 months, respectively, with regorafenib and 2.1 months and 6.5 months, respectively, with TAS-102 (progression-free survival hazard ratio 1.20, P = .27; overall survival hazard ratio, 1.01, P = .97). The analysis of overall survival for patients after the approval of TAS-102 in Japan was similar to the overall survival for the entire population. The frequency of hand-foot syndrome and increased aspartate aminotransferase, alanine aminotransferase, and bilirubin levels was higher and the frequency of neutropenia, leukopenia, anemia, nausea, and febrile neutropenia was lower with regorafenib than with TAS-102. No remarkable differences were found in the efficacy and safety of TAS-102 between patients with and without previous regorafenib and vice versa. Regorafenib and TAS-102 had similar efficacy but resulted in different toxicities, which could guide the agent choice. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Proton or photon irradiation for hemangiomas of the choroid? A retrospective comparison

    International Nuclear Information System (INIS)

    Hoecht, Stefan; Wachtlin, Joachim; Bechrakis, Nikolaos E.; Schaefer, Christiane; Heufelder, Jens; Cordini, Dino; Kluge, Heinz; Foerster, Michael; Hinkelbein, Wolfgang

    2006-01-01

    Purpose: The aim of this study was to compare, on a retrospective basis, the results of therapy in patients with uveal hemangioma treated with photon or proton irradiation at a single center. Methods and Materials: From 1993 to 2002 a total of 44 patients were treated. Until 1998 radiotherapy was given with 6 MV photons in standard fractionation of 2.0 Gy 5 times per week. In 1998 proton therapy became available and was used since then. A dose of 20 to 22.5 Cobalt Gray Equivalent (CGE) 68 MeV protons was given on 4 consecutive days. Progressive symptoms or deterioration of vision were the indications for therapy. Results: Of the 44 patients treated, 36 had circumscribed choroidal hemangiomas and 8 had diffuse choroidal hemangiomas (DCH) and Sturge-Weber syndrome. Of the patients, 19 were treated with photons with a total dose in the range of 16 to 30 Gy. A total of 25 patients were irradiated with protons. All patients with DCH but 1 were treated with photons. Stabilization of visual acuity was achieved in 93.2% of all patients. Tumor thickness decreased in 95.4% and retinal detachment resolved in 92.9%. Late effects, although generally mild or moderate, were frequently detected. In all, 40.9% showed radiation-induced optic neuropathy, maximum Grade I. Retinopathy was found in 29.5% of cases, but only 1 patient experienced more than Grade II severity. Retinopathy and radiation-induced optic neuropathy were reversible in some of the patients and in some resolved completely. No differences could be detected between patients with circumscribed choroidal hemangiomas treated with protons and photons. Treatment was less effective in DCH patients (75%). Conclusions: Radiotherapy is effective in treating choroidal hemangiomas with respect to visual acuity and tumor thickness but a benefit of proton therapy could not be detected. Side effects are moderate but careful monitoring for side effects should be part of the follow-up procedures

  4. Retrospective comparison of three-dimensional imaging sequences in the visualization of posterior fossa cranial nerves.

    Science.gov (United States)

    Ors, Suna; Inci, Ercan; Turkay, Rustu; Kokurcan, Atilla; Hocaoglu, Elif

    2017-12-01

    To compare efficancy of three-dimentional SPACE (sampling perfection with application-optimized contrasts using different flip-angle evolutions) and CISS (constructive interference in steady state) sequences in the imaging of the cisternal segments of cranial nerves V-XII. Temporal MRI scans from 50 patients (F:M ratio, 27:23; mean age, 44.5±15.9 years) admitted to our hospital with vertigo, tinnitus, and hearing loss were retrospectively analyzed. All patients had both CISS and SPACE sequences. Quantitative analysis of SPACE and CISS sequences was performed by measuring the ventricle-to-parenchyma contrast-to-noise ratio (CNR). Qualitative analysis of differences in visualization capability, image quality, and severity of artifacts was also conducted. A score ranging 'no artefact' to 'severe artefacts and unreadable' was used for the assessment of artifacts and from 'not visualized' to 'completely visualized' for the assesment of image quality, respectively. The distribution of variables was controlled by the Kolmogorov-Smirnov test. Samples t-test and McNemar's test were used to determine statistical significance. Rates of visualization of posterior fossa cranial nerves in cases of complete visualization were as follows: nerve V (100% for both sequences), nerve VI (94% in SPACE, 86% in CISS sequences), nerves VII-VIII (100% for both sequences), IX-XI nerve complex (96%, 88%); nerve XII (58%, 46%) (p<0.05). SPACE sequences showed fewer artifacts than CISS sequences (p<0.002). Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Comparison of external dacryocystorhinostomy and 5-fluorouracil augmented endonasal laser dacryocystorhinostomy. A Retrospective review

    Directory of Open Access Journals (Sweden)

    Watts Patrick

    2001-01-01

    Full Text Available Purpose: To compare the success rates of external dacryocystorhinostomy (EXT-DCR with 5-fluorouracil (5-FU augmented endonasal laser dacryocystorhinostomy (ENL-DCR and to record the complications associated with 5-FU augmented ENL-DCR Materials and Methods: This was a retrospective non-randomised study. Forty-one patients with primary acquired nasolacrimal duct obstruction underwent an EXT-DCR (19 patients or an ENL-DCR (22 patients over a 3-year period. A Holmium YAG laser (Ho:YAG was used in the latter group of patients. Silicone tubes intubated in all patients were removed at three months. 5-FU was applied intraoperatively at the site of the ostium in the ENL-DCR patients. The median follow-up was 12 months (range 3-24 months for the ENL-DCR group and 22 months (range 6-28 months for the EXT-DCR group. The patency of the lacrimal system and the severity of epiphora were assessed at a final-review. Results: The median age of the EXT-DCR group was 77 years (range 53-87 and that of the ENL-DCR group was 71 years (range 23 to 84. There were 12 female patients in the former group and 19 in the latter. The percentage of success in the EXT-DCR group was 94.7% (95% confidence interval (CI = 75.4-99.1 = , and 63.6% in the ENL-DCR group (95% CI= 43.0-80.3. The confidence interval for the difference of 31.1% was 5.6-52.2. There was a statistically significant difference between the two groups, p=0.024 (Fisher exact test. Conclusions: These data suggest that EXT-DCR provides better results than 5-FU augmented ENL-DCR. However, ENL-DCR is the procedure of choice in certain circumstances such as in elderly, frail or medically unfit patients. Our results of 5-FU augmented ENL-DCR compare favourably with other published series.

  6. A retrospective evaluation of the efficacy of intravenous bumetanide and comparison of potency with furosemide

    Directory of Open Access Journals (Sweden)

    Nappi JM

    2013-03-01

    Full Text Available Background: The potency of intravenous bumetanide to furosemide using a ratio of 1:40 has been suggested; however, there are little data supporting this ratio. Recent drug shortages required the use of bumetanide in a large patient population, enabling further characterization of the efficacy of IV bumetanide.Objective: The primary objective of this study was to estimate a dose-response effect of IV bumetanide on urine output (UOP in all patients that received 48 hours of therapy as well as in a subgroup of patients with heart failure (HF. This subgroup was used to compare the potency of bumetanide with furosemide. A secondary safety objective described electrolyte replacement required during therapy. Methods: This was a single-center retrospective study examining the dose-response effect of IV bumetanide in patients receiving at least 48 hours of intermittent (iIV or continuous (cIV dosing, measured by UOP per mg of drug received (mL/mg. The potency of IV bumetanide was compared with furosemide in a subset of patients with HF using pre-existing data. The safety of IV bumetanide was analyzed by quantifying electrolyte replacement received during the study period.Results: The primary outcome was higher in the iIV group (n=93 at 1273 ± 844 mL/mg compared with the cIV group (n=16 at 749 ± 370 mL/mg (P=0.002. Among patients with HF who received furosemide (iIV n=30, cIV n=26 or bumetanide (iIV n=30, cIV n=3, a potency ratio of 41:1 was found for the iIV group and 34:1 for all patients with HF. There was no significant difference in electrolyte replacement between groups.Conclusion: A greater response was seen with intermittent bumetanide compared with continuous infusion bumetanide. This study supports the 40:1 dose equivalence ratio (furosemide:bumetanide in patients with HF receiving at least 48 hours of intravenous intermittent bumetanide.

  7. A Comparison of MOOC Development and Delivery Approaches

    Science.gov (United States)

    Smith, Neil; Caldwell, Helen; Richards, Mike; Bandara, Arosha

    2017-01-01

    Purpose: The purpose of this paper is to present a comparison of two ways of developing and delivering massive open online courses (MOOCs). One was developed by The Open University in collaboration with FutureLearn; the other was developed independently by a small team at the Northampton University. Design/methodology/approach: The different…

  8. Large-scale retrospective evaluation of regulated liquid chromatography-mass spectrometry bioanalysis projects using different total error approaches.

    Science.gov (United States)

    Tan, Aimin; Saffaj, Taoufiq; Musuku, Adrien; Awaiye, Kayode; Ihssane, Bouchaib; Jhilal, Fayçal; Sosse, Saad Alaoui; Trabelsi, Fethi

    2015-03-01

    The current approach in regulated LC-MS bioanalysis, which evaluates the precision and trueness of an assay separately, has long been criticized for inadequate balancing of lab-customer risks. Accordingly, different total error approaches have been proposed. The aims of this research were to evaluate the aforementioned risks in reality and the difference among four common total error approaches (β-expectation, β-content, uncertainty, and risk profile) through retrospective analysis of regulated LC-MS projects. Twenty-eight projects (14 validations and 14 productions) were randomly selected from two GLP bioanalytical laboratories, which represent a wide variety of assays. The results show that the risk of accepting unacceptable batches did exist with the current approach (9% and 4% of the evaluated QC levels failed for validation and production, respectively). The fact that the risk was not wide-spread was only because the precision and bias of modern LC-MS assays are usually much better than the minimum regulatory requirements. Despite minor differences in magnitude, very similar accuracy profiles and/or conclusions were obtained from the four different total error approaches. High correlation was even observed in the width of bias intervals. For example, the mean width of SFSTP's β-expectation is 1.10-fold (CV=7.6%) of that of Saffaj-Ihssane's uncertainty approach, while the latter is 1.13-fold (CV=6.0%) of that of Hoffman-Kringle's β-content approach. To conclude, the risk of accepting unacceptable batches was real with the current approach, suggesting that total error approaches should be used instead. Moreover, any of the four total error approaches may be used because of their overall similarity. Lastly, the difficulties/obstacles associated with the application of total error approaches in routine analysis and their desirable future improvements are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Frontolateral Approach Applied to Sellar Region Lesions: A Retrospective Study in 79 Patients

    Directory of Open Access Journals (Sweden)

    Hao-Cheng Liu

    2016-01-01

    Conclusions: FLA was an effective approach in the treatment of sellar region lesions with good preservation of visual function. FLA classification enabled tailored craniotomies for each patient according to the anatomic site of tumor invasion. This study found that FLA had similar outcomes to other surgical approaches of sellar region lesions.

  10. A retrospective likelihood approach for efficient integration of multiple omics factors in case-control association studies.

    Science.gov (United States)

    Balliu, Brunilda; Tsonaka, Roula; Boehringer, Stefan; Houwing-Duistermaat, Jeanine

    2015-03-01

    Integrative omics, the joint analysis of outcome and multiple types of omics data, such as genomics, epigenomics, and transcriptomics data, constitute a promising approach for powerful and biologically relevant association studies. These studies often employ a case-control design, and often include nonomics covariates, such as age and gender, that may modify the underlying omics risk factors. An open question is how to best integrate multiple omics and nonomics information to maximize statistical power in case-control studies that ascertain individuals based on the phenotype. Recent work on integrative omics have used prospective approaches, modeling case-control status conditional on omics, and nonomics risk factors. Compared to univariate approaches, jointly analyzing multiple risk factors with a prospective approach increases power in nonascertained cohorts. However, these prospective approaches often lose power in case-control studies. In this article, we propose a novel statistical method for integrating multiple omics and nonomics factors in case-control association studies. Our method is based on a retrospective likelihood function that models the joint distribution of omics and nonomics factors conditional on case-control status. The new method provides accurate control of Type I error rate and has increased efficiency over prospective approaches in both simulated and real data. © 2015 Wiley Periodicals, Inc.

  11. Clinical and imaging characteristics of localized megalencephaly: a retrospective comparison of diffuse hemimegalencephaly and multilobar cortical dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Nakahashi, Masumi; Tsushima, Yoshito; Amanuma, Makoto; Endo, Keigo [Gunma University Graduate School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Maebashi, Gunma (Japan); Sato, Noriko; Ota, Miho [National Center Hospital of Neurology and Psychiatry, Department of Radiology, Kodaira, Tokyo (Japan); Yagishita, Akira [Tokyo Metropolitan Neurological Hospital, Department of Neuroradiology, Kokubunji, Tokyo (Japan); Saito, Yoshiaki; Sugai, Kenji; Sasaki, Masayuki [National Center Hospital of Neurology and Psychiatry, Department of Child Neurology, Kodaira, Tokyo (Japan); Natsume, Jun [Nagoya University Graduate School of Medicine, Department of Pediatrics, Nagoya, Aichi (Japan)

    2009-12-15

    Hemimegalencephaly is a well-known congenital malformation. However, localized megalencephaly, which may be one of the subtypes of hemimegalencephaly, has not been separately investigated. In the present study, we attempted to characterize the clinical and magnetic resonance (MR) imaging features of localized megalencephaly in comparison with ordinary diffuse hemimegalencephaly and multilobar cortical dysplasia. MR findings for 43 patients with hemimegalencephaly and ten with multilobar cortical dysplasia, which is the differential diagnosis of localized megalencephaly, were retrospectively reviewed. Clinical findings such as the onset and severity of seizures and imaging findings including the affected area of the brain, structures outside of the hemisphere, and interval morphological changes were examined. Of the 43 patients, 11 showed signs of localized megalencephaly (25.6%). Localized megalencephaly was predominantly seen on the left side (72.7%) and had a tendency toward severe-grade seizures compared to multilobar cortical dysplasia. The frequencies of the extracerebral abnormalities in the diffuse hemimegalencephaly, localized megalencephaly, and multilobar cortical dysplasia groups were 84.4%, 36.4%, and 0.0%, respectively. There were three localized megalencephaly patients whose affected areas shrank and whose images were similar to those of multilobar cortical dysplasia. Localized megalencephaly accounts for one quarter of all hemimegalencephaly cases in this study. The incidence of extracerebral abnormalities in patients with localized hemimegalencephaly was almost half that of patients with diffuse hemimegalencephaly. Extracerebral abnormalities were absent in patients with multilobar cortical dysplasia. Associated extracerebral abnormalities may be a clue to differentiating localized megalencephaly from multilobar cortical dysplasia. (orig.)

  12. Ranking of MR tomography after transsphenoidal resection of the pituitary. Retrospective comparison between endocrinology, surgery and MRT

    International Nuclear Information System (INIS)

    Siewert, B.; Kaiser, W.A.; Hochstetter, A.; Solymosi, L.; Bootsveld, K.

    1994-01-01

    Postoperative magnetic resonance images of 40 patients after transsphenoidal surgery for pituitary adenoma were evaluated retrospectively. The signal intensities of packing material and residual tumour were analysed. T 1 -weighted spin-echo sequences were obtained in coronal and sagittal views with and without intravenous injection of contrast media. Residual tumour demonstrated homogeneous or inhomogeneous signal intensity on the native scan with homogeneous or inhomogeneous enhancement. Packing material demonstrated a homogeneous signal intensity on the images obtained without injection of contrast media with a peripheral enhancement or alternate layers of low and intermediate signal intensity with alternate enhancement after injection of contrast media. In 5 of 54 examinations different results were found in MRI, endocrinology and surgery (two false negative and one false positive MRI in correlation with endocrinology; two residual tumours on MRI where surgery was supposed to be complete). Application of intravenous contrast media facilitates the interpretation of postoperative examination of the pituitary gland as well as comparison with preoperative examinations and the knowledge of the intraoperative procedure. (orig.) [de

  13. Childhood risk factors in Korean women with anorexia nervosa: two sets of case-control studies with retrospective comparisons.

    Science.gov (United States)

    Kim, Youl-Ri; Heo, Si Young; Kang, Heechan; Song, Ki Jun; Treasure, Janet

    2010-11-01

    The aim of this study was to investigate the characteristics of the risk factors for anorexia nervosa (AN) in Korean women. Two sets of case-control comparisons were conducted, in which 52 women with lifetime AN from Seoul, S. Korea, were compared with 108 Korean healthy controls and also with 42 women with lifetime AN from the UK in terms of their childhood risk factors. A questionnaire designed to conduct a retrospective assessment of the childhood risk factors was administered to all participants. The Korean AN women were more likely to report premorbid anxiety, perfectionism, and emotional undereating and were less likely to report having supportive figures in their childhood than the Korean healthy controls. There were no overall differences in the childhood risk factors between the Korean and British women with AN. Premorbid anxiety, perfectionism, less social support, and emotional undereating merit attention as risk factors in Korean AN. The current results are informative, but an epidemiologically robust prospective case-control study would be needed to validate these findings. © 2009 by Wiley Periodicals, Inc.

  14. Data Analysis A Model Comparison Approach, Second Edition

    CERN Document Server

    Judd, Charles M; Ryan, Carey S

    2008-01-01

    This completely rewritten classic text features many new examples, insights and topics including mediational, categorical, and multilevel models. Substantially reorganized, this edition provides a briefer, more streamlined examination of data analysis. Noted for its model-comparison approach and unified framework based on the general linear model, the book provides readers with a greater understanding of a variety of statistical procedures. This consistent framework, including consistent vocabulary and notation, is used throughout to develop fewer but more powerful model building techniques. T

  15. A Comparison of Microeconomic and Macroeconomic Approaches to Deforestation Analysis

    Directory of Open Access Journals (Sweden)

    Jeff Felardo

    2016-01-01

    Full Text Available The economics of deforestation has been explored in detail. Generally, the frame of analysis takes either a microeconomics or macroeconomics approach. The microeconomics approach assumes that individual decision makers are responsible for deforestation as a result of utility maximizing behavior and imperfect property right regimes. The macroeconomics approach explores nationwide trends thought to be associated with forest conversion. This paper investigates the relationship between these two approaches by empirically testing the determinants of deforestation using the same data set from Thailand. The theory for both the microeconomics-based and macroeconomics-based approaches are developed and then tested statistically. The models were constructed using established theoretical frames developed in the literature. The results from both models show statistical significance consistent with prior results in the tropical deforestation literature. A comparison of the two approaches demonstrates that the macro approach is useful in identifying relevant aggregate trends in the deforestation process; the micro approach provides the opportunity to isolate factors of those trends which are necessary for effective policy decisions.

  16. Employment for adults with autism spectrum disorders: A retrospective review of a customized employment approach.

    Science.gov (United States)

    Wehman, Paul; Brooke, Valerie; Brooke, Alissa Molinelli; Ham, Whitney; Schall, Carol; McDonough, Jennifer; Lau, Stephanie; Seward, Hannah; Avellone, Lauren

    2016-01-01

    Over the past few decades, there has been an increase in prevalence of children with autism spectrum disorders (ASD), and those children are now becoming young adults in need of competitive integrated employment (CIE). Customized employment (CE) is one pathway to employment that has been successful for other individuals with developmental disabilities (DD), though research has been very limited on the effectiveness with individuals with ASD. This paper provides a retrospective review of 64 individuals with ASD who came to our program from 2009 to 2014 for supported employment services as referred by the state vocational rehabilitation services agency. Employment specialists engaged in situational assessment, discovery, job development, customized job descriptions, on-site training and support, positive behavioral supports, and job retention techniques. The employment specialists were responsible for tracking their actual time spent working directly with or for the jobseeker with autism spectrum disorders (ASD). All vocational rehabilitation clients with ASD served during this time successfully secured CIE, and maintained their employment with ongoing supports, with intensity of support time decreasing over time. The majority (63/64, 98.4%) of individuals successfully secured CIE through the use of supported employment, in 72 unique employment positions. Of the majority of the individuals who secured employment, 77% (50) individuals indicated that they had never worked before and additional 18% (12) reported having short intermittent histories of employment. Despite this lack of employment experience, in all cases the jobseeker directed the job search and ultimately the job selection. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. The strategy of parallel approaches in projects with unforeseeable uncertainty: the Manhattan case in retrospect

    OpenAIRE

    Sylvain Lenfle

    2011-01-01

    International audience; This paper discusses the literature on the management of projects with unforeseeable uncertainty. Recent work demonstrates that, when confronted with unforeseeable uncertainties, managers can adopt either a learning, trial-and-error-based strategy, or a parallel approach. In the latter, different solutions are developed in parallel and the best one is chosen when enough information becomes available. Studying the case of the Manhattan Project, which historically exempl...

  18. Contrast-enhanced spectral mammography (CESM) versus breast magnetic resonance imaging (MRI): A retrospective comparison in 66 breast lesions.

    Science.gov (United States)

    Li, L; Roth, R; Germaine, P; Ren, S; Lee, M; Hunter, K; Tinney, E; Liao, L

    2017-02-01

    The purpose of this study was to retrospectively compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) with that of breast magnetic resonance imaging (BMRI) in breast cancer detection using parameters, including sensitivity, positive predictive value (PPV), lesion size, morphology, lesion and background enhancement, and examination time. A total of 48 women (mean age, 56years±10.6 [SD]) with breast lesions detected between October 2012 and March 2014 were included. Both CESM and BMRI were performed for each patient within 30 days. The enhancement intensity of lesions and breast background parenchyma was subjectively assessed for both modalities and was quantified for comparison. Statistical significance was analyzed using paired t-test for mean size of index lesions in all malignant breasts (an index lesion defined as the largest lesion in each breast), and a mean score of enhancement intensity for index lesions and breast background. PPV, sensitivity, and accuracy were calculated for both CESM and BMRI. The average duration time of CESM and MRI examinations was also compared. A total of 66 lesions were identified, including 62 malignant and 4 benign lesions. Both CESM and BMRI demonstrated a sensitivity of 100% for detection of breast cancer. There was no statistically significant difference between the mean size of index lesions (P=0.108). The enhancement intensity of breast background was significantly lower for CESM than for BMRI (P0.05). The average examination time for CESM was significantly shorter than that of BMRI (P<0.01). CESM has similar sensitivity than BMRI in breast cancer detection, with higher PPV and less background enhancement. CESM is associate with significantly shorter exam time thus a more accessible alternative to BMRI, and has the potential to play an important tool in breast cancer detection and staging. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights

  19. A pragmatic approach to infants with Robin sequence: a retrospective cohort study and presence of a treatment algorithm.

    Science.gov (United States)

    Paes, Emma C; van Nunen, Daan P F; Speleman, Lucienne; Muradin, Marvick S M; Smarius, Bram; Kon, Moshe; Mink van der Molen, Aebele B; van der Molen, Aebele B Mink; Niers, Titia L E M; Veldhoen, Esther S; Breugem, Corstiaan C

    2015-11-01

    Initial approaches to and treatments of infants with Robin sequence (RS) is diverse and inconsistent. The care of these sometimes critically ill infants involves many different medical specialties, which can make the decision process complex and difficult. To optimize the care of infants with RS, we present our institution's approach and a review of the current literature. A retrospective cohort study was conducted among 75 infants diagnosed with RS and managed at our institution in the 1996-2012 period. Additionally, the conducted treatment regimen in this paper was discussed with recent literature describing the approach of infants with RS. Forty-four infants (59%) were found to have been treated conservatively. A significant larger proportion of nonisolated RS infants than isolated RS infants needed surgical intervention (53 vs. 25%, p = .014). A mandibular distraction was conducted in 24% (n = 18) of cases, a tracheotomy in 9% (n = 7), and a tongue-lip adhesion in 8% (n = 6). Seventy-seven percent of all infants had received temporary nasogastric tube feeding. The literature review of 31 studies showed that initial examinations and the indications to perform a surgical intervention varied and were often not clearly described. RS is a heterogenic group with a wide spectrum of associated anomalies. As a result, the decisional process is challenging, and a multidisciplinary approach to treatment is desirable. Current treatment options in literature vary, and a more uniform approach is recommended. We provide a comprehensive and pragmatic approach to the analysis and treatment of infants with RS, which could serve as useful guidance in other clinics.

  20. HUMAN CAPITAL IN ROMANIA - BETWEEN CAPITALISATION AND DISSIPATION - A RETROSPECTIVE APPROACH OVER THE LAST CENTURY

    Directory of Open Access Journals (Sweden)

    Valentina VASILE

    2018-05-01

    Full Text Available A century of human capital evolution in Romania, from the labour market perspective, meant the transition from the strictly quantitative approach, namely from the labour force / labour resources (due to the emergence of the unemployment phenomenon, but also the industrial relations development to the integrative human capital one (tangible and intangible in which skills(professional and those so called „soft” and lifelong learning are associated with technology transfer while decent and efficient employment becomes conditionality to company efficiency. The labour market was developed as the most regulated market, highly dependent on the business environment and labour demand in number and/or skills. Being related to technological transfer human capital becomes a factor of performance and development through its three dimensions: quantitative (indicators that quantify employment and labour, qualitative (the efficiency of labour as production factor and the comparative advantages of education and behavioural (aspects of industrial relations, in both micro and macroeconomic approach. The paper aims to present the evolution and main peculiarities of the human capital in Modern Romania during the last 100 years, focussed on economy profile - competitive / market oriented (1918- 1947 and after 1989 or centralized (1948- 1989. How much we gain and lost in preserving, valuing and efficient allocation of the most valuable asset of a nation? Finally, looking forward to economic, social and societal challenges we are desingning some benchmarks and select few relevant policy recommendations for responsible and accountable management of this wealth of the nation

  1. Value of image fusion using single photon emission computed tomography with integrated low dose computed tomography in comparison with a retrospective voxel-based method in neuroendocrine tumours

    International Nuclear Information System (INIS)

    Amthauer, H.; Denecke, T.; Ruf, J.; Gutberlet, M.; Felix, R.; Lemke, A.J.; Rohlfing, T.; Boehmig, M.; Ploeckinger, U.

    2005-01-01

    The objective was the evaluation of single photon emission computed tomography (SPECT) with integrated low dose computed tomography (CT) in comparison with a retrospective fusion of SPECT and high-resolution CT and a side-by-side analysis for lesion localisation in patients with neuroendocrine tumours. Twenty-seven patients were examined by multidetector CT. Additionally, as part of somatostatin receptor scintigraphy (SRS), an integrated SPECT-CT was performed. SPECT and CT data were fused using software with a registration algorithm based on normalised mutual information. The reliability of the topographic assignment of lesions in SPECT-CT, retrospective fusion and side-by-side analysis was evaluated by two blinded readers. Two patients were not enrolled in the final analysis because of misregistrations in the retrospective fusion. Eighty-seven foci were included in the analysis. For the anatomical assignment of foci, SPECT-CT and retrospective fusion revealed overall accuracies of 91 and 94% (side-by-side analysis 86%). The correct identification of foci as lymph node manifestations (n=25) was more accurate by retrospective fusion (88%) than from SPECT-CT images (76%) or by side-by-side analysis (60%). Both modalities of image fusion appear to be well suited for the localisation of SRS foci and are superior to side-by-side analysis of non-fused images especially concerning lymph node manifestations. (orig.)

  2. Comparison of Different Approaches for Measuring Tibial Cartilage Thickness

    Directory of Open Access Journals (Sweden)

    Maier Jennifer

    2017-07-01

    Full Text Available Osteoarthritis is a degenerative disease affecting bones and cartilage especially in the human knee. In this context, cartilage thickness is an indicator for knee cartilage health. Thickness measurements are performed on medical images acquired in-vivo. Currently, there is no standard method agreed upon that defines a distance measure in articular cartilage. In this work, we present a comparison of different methods commonly used in literature. These methods are based on nearest neighbors, surface normal vectors, local thickness and potential field lines. All approaches were applied to manual segmentations of tibia and lateral and medial tibial cartilage performed by experienced raters. The underlying data were contrast agent-enhanced cone-beam C-arm CT reconstructions of one healthy subject’s knee. The subject was scanned three times, once in supine position and two times in a standing weight-bearing position. A comparison of the resulting thickness maps shows similar distributions and high correlation coefficients between the approaches above 0.90. The nearest neighbor method results on average in the lowest cartilage thickness values, while the local thickness approach assigns the highest values. We showed that the different methods agree in their thickness distribution. The results will be used for a future evaluation of cartilage change under weight-bearing conditions.

  3. A posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study.

    Science.gov (United States)

    Xiao, Lizu; Li, Jie; Li, Disen; Yan, Dong; Yang, Jun; Wang, Daniel; Cheng, Jianguo

    2015-09-01

    Catastrophic complications have been reported for selective cervical nerve root block (SCNRB) or pulsed radiofrequency (PRF) via an anterolateral transforaminal approach. A posterior approach to these procedures under computed tomography guidance has been reported. Here, we report the clinical outcomes of 42 patients with chronic cervical radicular pain (CCRP) treated with a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. We retrospectively reviewed the clinical outcomes of 42 consecutive patients with CCRP who received a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. The thresholds of electrical stimulation and imaging of the nerve roots after contrast injection were used to evaluate the accuracy of needle placement. The numeric rating scale was used to measure the pain and numbness levels as primary clinical outcomes, which were evaluate in scheduled follow-up visits of up to 3 months. A total of 53 procedures were performed on 42 patients at the levels of C5-C8. All patients reported concordant paresthesia in response to electrical stimulation. The average sensory and motor thresholds of stimulation were 0.28 ± 0.14 and 0.36 ± 0.14 V, respectively. Injection of nonionic contrast resulted in excellent spread along the target nerve root in large majority of the procedures. The numeric rating scale scores for both pain and numbness improved significantly at 1 day, 1 week, and 1 and 3 months after the treatment. No serious adverse effects were observed in any of the patients. The posterior approach to combined SCNRB and PRF under fluoroscopy guidance appears to be safe and efficacious in the management of CCRP. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Central nervous system histoplasmosis: Multicenter retrospective study on clinical features, diagnostic approach and outcome of treatment.

    Science.gov (United States)

    Wheat, Joseph; Myint, Thein; Guo, Ying; Kemmer, Phebe; Hage, Chadi; Terry, Colin; Azar, Marwan M; Riddell, James; Ender, Peter; Chen, Sharon; Shehab, Kareem; Cleveland, Kerry; Esguerra, Eden; Johnson, James; Wright, Patty; Douglas, Vanja; Vergidis, Pascalis; Ooi, Winnie; Baddley, John; Bamberger, David; Khairy, Raed; Vikram, Holenarasipur R; Jenny-Avital, Elizabeth; Sivasubramanian, Geetha; Bowlware, Karen; Pahud, Barbara; Sarria, Juan; Tsai, Townson; Assi, Maha; Mocherla, Satish; Prakash, Vidhya; Allen, David; Passaretti, Catherine; Huprikar, Shirish; Anderson, Albert

    2018-03-01

    Central nervous system (CNS) involvement occurs in 5 to 10% of individuals with disseminated histoplasmosis. Most experience has been derived from small single center case series, or case report literature reviews. Therefore, a larger study of central nervous system (CNS) histoplasmosis is needed in order to guide the approach to diagnosis, and treatment.A convenience sample of 77 patients with histoplasmosis infection of the CNS was evaluated. Data was collected that focused on recognition of infection, diagnostic techniques, and outcomes of treatment.Twenty nine percent of patients were not immunosuppressed. Histoplasma antigen, or anti-Histoplasma antibodies were detected in the cerebrospinal fluid (CSF) in 75% of patients. One year survival was 75% among patients treated initially with amphotericin B, and was highest with liposomal, or deoxycholate formulations. Mortality was higher in immunocompromised patients, and patients 54 years of age, or older. Six percent of patients relapsed, all of whom had the acquired immunodeficiency syndrome (AIDS), and were poorly adherent with treatment.While CNS histoplasmosis occurred most often in immunocompromised individuals, a significant proportion of patients were previously, healthy. The diagnosis can be established by antigen, and antibody testing of the CSF, and serum, and antigen testing of the urine in most patients. Treatment with liposomal amphotericin B (AMB-L) for at least 1 month; followed by itraconazole for at least 1 year, results in survival among the majority of individuals. Patients should be followed for relapse for at least 1 year, after stopping therapy.

  5. A risk based approach for SSTO/TSTO comparisons

    Science.gov (United States)

    Greenberg, Joel S.

    1996-03-01

    An approach has been developed for performing early comparisons of transportation architectures explicitly taking into account quantitative measures of uncertainty and resulting risk. Risk considerations are necessary since the transportation systems are likely to have significantly different levels of risk, both because of differing degrees of freedom in achieving desired performance levels and their different states of development and utilization. The approach considers the uncertainty of achievement of technology goals, effect that the achieved technology level will have on transportation system performance and the relationship between system performance/capability and the ability to accommodate variations in payload mass. The consequences of system performance are developed in terms of nonrecurring, recurring, and the present value of transportation system life cycle costs.

  6. A Comparison of Machine Learning Approaches for Corn Yield Estimation

    Science.gov (United States)

    Kim, N.; Lee, Y. W.

    2017-12-01

    Machine learning is an efficient empirical method for classification and prediction, and it is another approach to crop yield estimation. The objective of this study is to estimate corn yield in the Midwestern United States by employing the machine learning approaches such as the support vector machine (SVM), random forest (RF), and deep neural networks (DNN), and to perform the comprehensive comparison for their results. We constructed the database using satellite images from MODIS, the climate data of PRISM climate group, and GLDAS soil moisture data. In addition, to examine the seasonal sensitivities of corn yields, two period groups were set up: May to September (MJJAS) and July and August (JA). In overall, the DNN showed the highest accuracies in term of the correlation coefficient for the two period groups. The differences between our predictions and USDA yield statistics were about 10-11 %.

  7. Comparison of Human Exploration Architecture and Campaign Approaches

    Science.gov (United States)

    Goodliff, Kandyce; Cirillo, William; Mattfeld, Bryan; Stromgren, Chel; Shyface, Hilary

    2015-01-01

    As part of an overall focus on space exploration, National Aeronautics and Space Administration (NASA) continues to evaluate potential approaches for sending humans beyond low Earth orbit (LEO). In addition, various external organizations are studying options for beyond LEO exploration. Recent studies include NASA's Evolvable Mars Campaign and Design Reference Architecture (DRA) 5.0, JPL's Minimal Mars Architecture; the Inspiration Mars mission; the Mars One campaign; and the Global Exploration Roadmap (GER). Each of these potential exploration constructs applies unique methods, architectures, and philosophies for human exploration. It is beneficial to compare potential approaches in order to better understand the range of options available for exploration. Since most of these studies were conducted independently, the approaches, ground rules, and assumptions used to conduct the analysis differ. In addition, the outputs and metrics presented for each construct differ substantially. This paper will describe the results of an effort to compare and contrast the results of these different studies under a common set of metrics. The paper will first present a summary of each of the proposed constructs, including a description of the overall approach and philosophy for exploration. Utilizing a common set of metrics for comparison, the paper will present the results of an evaluation of the potential benefits, critical challenges, and uncertainties associated with each construct. The analysis framework will include a detailed evaluation of key characteristics of each construct. These will include but are not limited to: a description of the technology and capability developments required to enable the construct and the uncertainties associated with these developments; an analysis of significant operational and programmatic risks associated with that construct; and an evaluation of the extent to which exploration is enabled by the construct, including the destinations

  8. Employee and family assistance video counseling program: a post launch retrospective comparison with in-person counseling outcomes.

    Science.gov (United States)

    Veder, Barbara; Pope, Stan; Mani, Michèle; Beaudoin, Kelly; Ritchie, Janice

    2014-01-01

    Access to technologically mediated information and services under the umbrella of mental and physical health has become increasingly available to clients via Internet modalities, according to a recent study. In May 2010, video counseling was added to the counseling services offered through the Employee and Family Assistance Program at Shepell·fgi as a pilot project with a full operational launch in September 2011. The objective of this study was to conduct a retrospective post launch examination of the video counseling service through an analysis of the reported clinical outcomes of video and in-person counseling modalities. A chronological sample of 68 video counseling (VC) cases and 68 in-person (IP) cases were collected from a pool of client clinical files closed in 2012. To minimize the variables impacting the study and maintain as much clinical continuity as possible, the IP and the VC clients must have attended clinical sessions with any one of six counselors who provided both the VC and the IP services. The study compared the two counseling modalities along the following data points (see glossary of terms): (1) client demographic profiles (eg, age, gender, whether the sessions involved individuals or conjoint sessions with couples or families, etc), (2) presenting issue, (3) average session hours, (4) client rating of session helpfulness, (5) rates of goal completion, (6) client withdrawal rates, (7) no show and late cancellation rates, and (8) pre/post client self-assessment. Specific to VC, we examined client geographic location. Data analysis demonstrates that the VC and the IP showed a similar representation of presenting issues with nearly identical outcomes for client ratings of session helpfulness, rates of goal completion, pre/post client self-assessment, average session duration, and client geographic location. There were no statistically significant differences in the rates of withdrawal from counseling, no shows, and late cancellations between

  9. Multidisciplinary Approach to Wilms’ Tumor: A Retrospective Analytical Study of 53 Patients

    International Nuclear Information System (INIS)

    NAGUIB, S.F.; ZAGHLOUL, A.S.; EL HADDAD, A.; EL BADAWY, S.A.

    2008-01-01

    Aim of the Work: The aim of this work was to assess the epidemiologic aspects, clinico-pathological features and the results of multidisciplinary treatment of Wilms' tumor (WT) in pediatric patients treated at the National Cancer Institute (NCI), Cairo University, between January 2002 and December 2004. Patients and Methods: This study included 53 patients, all under the age of 16 years, with previously untreated WT. Initial evaluation of all patients comprised laboratory investigations and radiological assessment which included chest X-ray and CT, abdomin-opelvic ultrasonography and CT. Doppler study of the renal vein and vena cava and bone scan were done when needed. Neoadjuvant chemotherapy was given to patients suffering from poor general condition, extensive tumor thrombus in the renal vein, irresectable and bilateral (stage V) nephroblastoma. Otherwise, up-front nephrectomy was the standard therapeutic approach in this study. Results: The age of the patients ranged from 2 to 108 months with a mean of 39.9 months ( ± 22.56). Males and females were almost equal in number (50.9% and 49.1% respectively). Tumors were located in the left kidney in 52.8%, right kidney in 41.5% and bilaterally in only 5.7% of the cases. An abdominal mass was the most common clinical presentation (77.4%). Favorable histology was found in 86.3% while unfavorable histology was elicited in 13.7% of the cases. Congenital anomalies were recorded in 4 patients. Stage I and III were the most common (29.4% each), followed by stage II and IV (17.7% each), and finally by stage V (5.9%). Neoadjuvant chemotherapy was given to 27 cases while up-front nephrectomy was undertaken in 26 cases. Intra-operative spillage occurred in 12% of patients who had preoperative chemotherapy and 31% of those who had up front nephrectomy. Postoperative abdominal radiotherapy was given to 32 patients. Twenty five patients underwent renal bed irradiation only, while in the other 7 whole abdominal irradiation was

  10. A Comparison of Routing Protocol for WSNs: Redundancy Based Approach A Comparison of Routing Protocol for WSNs: Redundancy Based Approach

    Directory of Open Access Journals (Sweden)

    Anand Prakash

    2014-03-01

    Full Text Available Wireless Sensor Networks (WSNs with their dynamic applications gained a tremendous attention of researchers. Constant monitoring of critical situations attracted researchers to utilize WSNs at vast platforms. The main focus in WSNs is to enhance network localization as much as one could, for efficient and optimal utilization of resources. Different approaches based upon redundancy are proposed for optimum functionality. Localization is always related with redundancy of sensor nodes deployed at remote areas for constant and fault tolerant monitoring. In this work, we propose a comparison of classic flooding and the gossip protocol for homogenous networks which enhances stability and throughput quiet significantly.  

  11. Comparison of two Minkowski-space approaches to heavy quarkonia

    Energy Technology Data Exchange (ETDEWEB)

    Leitao, Sofia; Biernat, Elmar P. [Universidade de Lisboa, CFTP, Instituto Superior Tecnico, Lisbon (Portugal); Li, Yang [Iowa State University, Department of Physics and Astronomy, Ames, IA (United States); College of William and Mary, Department of Physics, Williamsburg, VA (United States); Maris, Pieter; Vary, James P. [Iowa State University, Department of Physics and Astronomy, Ames, IA (United States); Pena, M.T. [Universidade de Lisboa, CFTP, Instituto Superior Tecnico, Lisbon (Portugal); Universidade de Lisboa, Departamento de Fisica, Instituto Superior Tecnico, Lisbon (Portugal); Stadler, Alfred [Universidade de Lisboa, CFTP, Instituto Superior Tecnico, Lisbon (Portugal); Universidade de Evora, Departamento de Fisica, Evora (Portugal)

    2017-10-15

    In this work we compare mass spectra and decay constants obtained from two recent, independent, and fully relativistic approaches to the quarkonium bound-state problem: the Basis Light-Front Quantization approach, where light-front wave functions are naturally formulated; and, the Covariant Spectator Theory (CST), based on a reorganization of the Bethe-Salpeter equation. Even though conceptually different, both solutions are obtained in Minkowski space. Comparisons of decay constants for more than ten states of charmonium and bottomonium show favorable agreement between the two approaches as well as with experiment where available. We also apply the Brodsky-Huang-Lepage prescription to convert the CST amplitudes into functions of light-front variables. This provides an ideal opportunity to investigate the similarities and differences at the level of the wave functions. Several qualitative features are observed in remarkable agreement between the two approaches even for the rarely addressed excited states. Leading-twist distribution amplitudes as well as parton distribution functions of heavy quarkonia are also analyzed. (orig.)

  12. Urban pavement surface temperature. Comparison of numerical and statistical approach

    Science.gov (United States)

    Marchetti, Mario; Khalifa, Abderrahmen; Bues, Michel; Bouilloud, Ludovic; Martin, Eric; Chancibaut, Katia

    2015-04-01

    The forecast of pavement surface temperature is very specific in the context of urban winter maintenance. to manage snow plowing and salting of roads. Such forecast mainly relies on numerical models based on a description of the energy balance between the atmosphere, the buildings and the pavement, with a canyon configuration. Nevertheless, there is a specific need in the physical description and the numerical implementation of the traffic in the energy flux balance. This traffic was originally considered as a constant. Many changes were performed in a numerical model to describe as accurately as possible the traffic effects on this urban energy balance, such as tires friction, pavement-air exchange coefficient, and infrared flux neat balance. Some experiments based on infrared thermography and radiometry were then conducted to quantify the effect fo traffic on urban pavement surface. Based on meteorological data, corresponding pavement temperature forecast were calculated and were compared with fiels measurements. Results indicated a good agreement between the forecast from the numerical model based on this energy balance approach. A complementary forecast approach based on principal component analysis (PCA) and partial least-square regression (PLS) was also developed, with data from thermal mapping usng infrared radiometry. The forecast of pavement surface temperature with air temperature was obtained in the specific case of urban configurtation, and considering traffic into measurements used for the statistical analysis. A comparison between results from the numerical model based on energy balance, and PCA/PLS was then conducted, indicating the advantages and limits of each approach.

  13. Energetics of Brazilian ethanol: Comparison between assessment approaches

    International Nuclear Information System (INIS)

    Ramirez Triana, Carlos Ariel

    2011-01-01

    As with any other bioenergy product, bioethanol production requires fossil fuel inputs; hence the alleged benefits of energy security and carbon mitigation depend on the extent to which these inputs are capable of drawing a substantive bioenergetic yield. Brazilian ethanol, made out of sugarcane, has been reported as the most efficient gasoline substitute that is commercially available nowadays. For that reason it has been the object of several analyses on the energetics, i.e. energy balances. These studies surprisingly vary widely according with the scholar approach and are not fully comparable among them due to divergences in the assessment method. This paper standardises results of the four most prominent authors in the field, establishing a point of comparison and drawing some light on the energetics studies on biofuels. The main result is shown in , which homogenises the outcomes for referred studies in terms of unit of assessment in the energy input analysis. Subsequently, this information is also charted () explaining the source of divergence among authors. This work ends with a short reference and comparison to some energy balance studies carried out on feedstocks of diverse nature, highlighting the potential that sugarcane-based bioethanol represents nowadays. - Highlights: → Distribution stage could reduce energy ratio but its contribution is not significant. → In Pimentel and Patzek there is an evident impact of the industrial stage. → A coincidence across the studies was the major impact of the agricultural stage. → Brazilian technology to produce ethanol was proved the most energy efficient one.

  14. Comparison of different approaches of modelling in a masonry building

    Science.gov (United States)

    Saba, M.; Meloni, D.

    2017-12-01

    The present work has the objective to model a simple masonry building, through two different modelling methods in order to assess their validity in terms of evaluation of static stresses. Have been chosen two of the most commercial software used to address this kind of problem, which are of S.T.A. Data S.r.l. and Sismicad12 of Concrete S.r.l. While the 3Muri software adopts the Frame by Macro Elements Method (FME), which should be more schematic and more efficient, Sismicad12 software uses the Finite Element Method (FEM), which guarantees accurate results, with greater computational burden. Remarkably differences of the static stresses, for such a simple structure between the two approaches have been found, and an interesting comparison and analysis of the reasons is proposed.

  15. A comparison of approaches in fitting continuum SEDs

    International Nuclear Information System (INIS)

    Liu Yao; Wang Hong-Chi; Madlener David; Wolf Sebastian

    2013-01-01

    We present a detailed comparison of two approaches, the use of a pre-calculated database and simulated annealing (SA), for fitting the continuum spectral energy distribution (SED) of astrophysical objects whose appearance is dominated by surrounding dust. While pre-calculated databases are commonly used to model SED data, only a few studies to date employed SA due to its unclear accuracy and convergence time for this specific problem. From a methodological point of view, different approaches lead to different fitting quality, demand on computational resources and calculation time. We compare the fitting quality and computational costs of these two approaches for the task of SED fitting to provide a guide to the practitioner to find a compromise between desired accuracy and available resources. To reduce uncertainties inherent to real datasets, we introduce a reference model resembling a typical circumstellar system with 10 free parameters. We derive the SED of the reference model with our code MC3 D at 78 logarithmically distributed wavelengths in the range [0.3 μm, 1.3 mm] and use this setup to simulate SEDs for the database and SA. Our result directly demonstrates the applicability of SA in the field of SED modeling, since the algorithm regularly finds better solutions to the optimization problem than a pre-calculated database. As both methods have advantages and shortcomings, a hybrid approach is preferable. While the database provides an approximate fit and overall probability distributions for all parameters deduced using Bayesian analysis, SA can be used to improve upon the results returned by the model grid.

  16. PSA data base, comparison of the German and French approach

    International Nuclear Information System (INIS)

    Kreuser, A.; Tirira, J.

    2001-01-01

    The results of probabilistic safety assessments (PSA) of nuclear power plants strongly depend on the reliability data used. This report describes coarsely the general process to generate reliability data for components and resumes the differences between the German and French approaches. As has been shown in former studies which compared international PSA data, PSA data are closely related to the model definitions of the PSA. Therefore single PSA data cannot be compared directly without regard e.g. to the corresponding fault trees. These findings are confirmed by this study. The comparison of German and French methods shows a lot of differences concerning various details of the data generation process. Some differences between single reliability data should be eliminated when taking into account the complete fault tree analysis. But there are some other differences which have a direct impact on the obtained results of a PSA. In view of the all differences between both approaches concerning the definition of data and the data collection process, it is not possible to compare directly German and French PSA data. However, the database differences give no indication on the influence on the PSA results. Therefore, it is a need to perform a common IPSN/GRS assessment on how the different databases impact the PSA results. (orig.)

  17. Robotic Enucleation for Benign or Borderline Tumours of the Pancreas: A Retrospective Analysis and Comparison from a High-Volume Centre in Asia.

    Science.gov (United States)

    Jin, Jia-Bin; Qin, Kai; Li, Hua; Wu, Zhi-Chong; Zhan, Qian; Deng, Xia-Xing; Chen, Hao; Shen, Bai-Yong; Peng, Cheng-Hong; Li, Hong-Wei

    2016-12-01

    Enucleation is increasingly performed for benign or borderline tumours of the pancreas because it is a parenchyma-sparing and less invasive procedure compared to conventional pancreatectomy, which reduces the risk of exocrine and endocrine insufficiency. This study retrospectively evaluated and compared the pre-, intra-, and post-operative clinical characteristics after open and robotic approaches for pancreatic enucleation. Fifty-six cases of enucleation for benign or borderline tumours of the pancreas treated from March 2010 to July 2015 were identified by a retrospective search. These included 25 patients who underwent an open approach and 31 patients who underwent a robotic approach. The clinical characteristics were extracted and compared. The two groups had a similar location and pathology of the tumour. The robotic group had a significantly shorter operation time and significantly less blood loss than the open group. The rates of clinical pancreatic fistula (PF) formation and major complications were similar. The robotic approach could be applied for a tumour on the right side of the pancreas without increasing the incidence of clinical PF or other major complications. The patients with clinical PF had a significantly shorter distance between the lesion and the main pancreatic duct (MPD). Robotic enucleation appears to be a feasible and safe approach for benign or borderline tumours of the pancreas and was associated with similarly favourable surgical outcomes as the open approach. Identifying and avoiding the MPD is an important step during enucleation.

  18. Comparison of posterior retroperitoneal and transabdominal lateral approaches in robotic adrenalectomy: an analysis of 200 cases.

    Science.gov (United States)

    Kahramangil, Bora; Berber, Eren

    2018-04-01

    Although numerous studies have been published on robotic adrenalectomy (RA) in the literature, none has done a comparison of posterior retroperitoneal (PR) and transabdominal lateral (TL) approaches. The aim of this study was to compare the outcomes of robotic PR and TL adrenalectomy. This is a retrospective analysis of a prospectively maintained database. Between September 2008 and January 2017, perioperative outcomes of patients undergoing RA through PR and TL approaches were recorded into an IRB-approved database. Clinical and perioperative parameters were compared using Student's t test, Wilcoxon rank-sum test, and χ 2 test. Multivariate regression analysis was performed to determine factors associated with total operative time. 188 patients underwent 200 RAs. 110 patients were operated through TL and 78 patients through PR approach. Overall, conversion rate to open was 2.5% and 90-day morbidity 4.8%. The perioperative outcomes of TL and PR approaches were similar regarding estimated blood loss, rate of conversion to open, length of hospital stay, and 90-day morbidity. PR approach resulted in a shorter mean ± SD total operative time (136.3 ± 38.7 vs. 154.6 ± 48.4 min; p = 0.005) and lower visual analog scale pain score on postoperative day #1 (4.3 ± 2.5 vs. 5.4 ± 2.4; p = 0.001). After excluding tumors larger than 6 cm operated through TL approach, the difference in operative times persisted (136.3 ± 38.7 vs. 153.7 ± 45.7 min; p = 0.009). On multivariate regression analysis, increasing BMI and TL approaches were associated with longer total operative time. This study shows that robotic PR and TL approaches are equally safe and efficacious. With experience, shorter operative time and less postoperative pain can be achieved with PR technique. This supports the preferential utilization of PR approach in high-volume centers with enough experience.

  19. Employee and Family Assistance Video Counseling Program: A Post Launch Retrospective Comparison With In-Person Counseling Outcomes

    OpenAIRE

    Veder, Barbara; Pope, Stan; Mani, Michèle; Beaudoin, Kelly; Ritchie, Janice

    2014-01-01

    Background Access to technologically mediated information and services under the umbrella of mental and physical health has become increasingly available to clients via Internet modalities, according to a recent study. In May 2010, video counseling was added to the counseling services offered through the Employee and Family Assistance Program at Shepell·fgi as a pilot project with a full operational launch in September 2011. Objective The objective of this study was to conduct a retrospective...

  20. Comparison of ductile-to-brittle transition curve fitting approaches

    International Nuclear Information System (INIS)

    Cao, L.W.; Wu, S.J.; Flewitt, P.E.J.

    2012-01-01

    Ductile-to-brittle transition (DBT) curve fitting approaches are compared over the transition temperature range for reactor pressure vessel steels with different kinds of data, including Charpy-V notch impact energy data and fracture toughness data. Three DBT curve fitting methods have been frequently used in the past, including the Burr S-Weibull and tanh distributions. In general there is greater scatter associated with test data obtained within the transition region. Therefore these methods give results with different accuracies, especially when fitting to small quantities of data. The comparison shows that the Burr distribution and tanh distribution can almost equally fit well distributed and large data sets extending across the test temperature range to include the upper and lower shelves. The S-Weibull distribution fit is poor for the lower shelf of the DBT curve. Overall for both large and small quantities of measured data the Burr distribution provides the best description. - Highlights: ► Burr distribution offers a better fit than that of a S-Weibull and tanh fit. ► Burr and tanh methods show similar fitting ability for a large data set. ► Burr method can fit sparse data well distributed across the test temperature. ► S-Weibull method cannot fit the lower shelf well and show poor fitting quality.

  1. The 1st Nuclear Test in the former USSR of 29 August 1949: Comparison of individual dose estimates by modeling with EPR retrospective dosimetry and luminescence retrospective dosimetry data for Dolon village, Kazakhstan

    International Nuclear Information System (INIS)

    Stepanenko, V.F.; Hoshi, M.; Ivannikov, A.I.; Bailiff, I.K.; Zhumadilov, K.; Skvortsov, V.G.; Argembaeva, R.; Tsyb, A.F.

    2007-01-01

    Three methods of individual dose reconstruction, namely dose calculations based on the available archive data and on the individual questioning of inhabitants, EPR dosimetry in human tooth enamel, and retrospective luminescence dosimetry (RLD) with quartz inclusions in the bricks were applied for assessment of accumulated external doses in Dolon village (Kazakhstan), which is one of the most affected settlements as a result of 29.08.1949 nuclear test at Semipalatinsk nuclear test site. Dose values obtained by EPR and RLD methods were compared with computed dose values. The available data on soil contamination with 137 Cs and 239+240 Pu in the vicinity and inside Dolon village were used for interpretation of the results of comparison. Based on a calculated value of 2260 mGy for the dose in the air along the central axis of the trace located NW of Dolon, the doses in the air over whole village and for the south-eastern part of the village containing the RLD sampling points were estimated as 775±40 and 645±70mGy, respectively, the latter correlates well with the RLD dose value of 460±92mGy. The 'upper level' of the mean 'shielding and behavior' factor of dose reduction for inhabitants of Dolon village was estimated as 0.28±0.07; this was performed by comparing the individual EPR tooth enamel doses with the calculated mean dose for the settlement. The individual dose estimates by EPR dosimetry were compared with individual dose values obtained by modeling. Uncertainties of the calculated individual doses were evaluated using Monte Carlo simulations. The individual dose estimates by EPR method are lower in comparison with mean computed doses and with RLD data, but they are in a good consistency with computed individual dose values in Dolon village based on the results of individual questioning with account of individual 'shielding and behavior' factors

  2. The 1st Nuclear Test in the former USSR of 29 August 1949: Comparison of individual dose estimates by modeling with EPR retrospective dosimetry and luminescence retrospective dosimetry data for Dolon village, Kazakhstan

    Energy Technology Data Exchange (ETDEWEB)

    Stepanenko, V.F. [Medical Radiological Research Center of RAMS, 4 Korolev Str., Obninsk 249036 (Russian Federation); Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi 1-2-3, Minami-ku, Hiroshima 734-8553 (Japan)], E-mail: mrrc@obninsk.ru; Hoshi, M. [Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi 1-2-3, Minami-ku, Hiroshima 734-8553 (Japan); Ivannikov, A.I. [Medical Radiological Research Center of RAMS, 4 Korolev Str., Obninsk 249036 (Russian Federation); Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi 1-2-3, Minami-ku, Hiroshima 734-8553 (Japan); Bailiff, I.K. [Luminescence Dating and Dosimetry Laboratory, University of Durham, South Road, Durham, DHI 3LE (United Kingdom); Zhumadilov, K. [Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi 1-2-3, Minami-ku, Hiroshima 734-8553 (Japan); Skvortsov, V.G. [Medical Radiological Research Center of RAMS, 4 Korolev Str., Obninsk 249036 (Russian Federation); Argembaeva, R. [Scientifical Research Institute for Radiation Medicine, 258, Gagarina Str., P.B. 49, Semipalatinsk 490026 (Kazakhstan); Tsyb, A.F. [Medical Radiological Research Center of RAMS, 4 Korolev Str., Obninsk 249036 (Russian Federation)

    2007-07-15

    Three methods of individual dose reconstruction, namely dose calculations based on the available archive data and on the individual questioning of inhabitants, EPR dosimetry in human tooth enamel, and retrospective luminescence dosimetry (RLD) with quartz inclusions in the bricks were applied for assessment of accumulated external doses in Dolon village (Kazakhstan), which is one of the most affected settlements as a result of 29.08.1949 nuclear test at Semipalatinsk nuclear test site. Dose values obtained by EPR and RLD methods were compared with computed dose values. The available data on soil contamination with {sup 137}Cs and {sup 239+240}Pu in the vicinity and inside Dolon village were used for interpretation of the results of comparison. Based on a calculated value of 2260 mGy for the dose in the air along the central axis of the trace located NW of Dolon, the doses in the air over whole village and for the south-eastern part of the village containing the RLD sampling points were estimated as 775{+-}40 and 645{+-}70mGy, respectively, the latter correlates well with the RLD dose value of 460{+-}92mGy. The 'upper level' of the mean 'shielding and behavior' factor of dose reduction for inhabitants of Dolon village was estimated as 0.28{+-}0.07; this was performed by comparing the individual EPR tooth enamel doses with the calculated mean dose for the settlement. The individual dose estimates by EPR dosimetry were compared with individual dose values obtained by modeling. Uncertainties of the calculated individual doses were evaluated using Monte Carlo simulations. The individual dose estimates by EPR method are lower in comparison with mean computed doses and with RLD data, but they are in a good consistency with computed individual dose values in Dolon village based on the results of individual questioning with account of individual 'shielding and behavior' factors.

  3. Anterior Versus Posterior Approach for Multilevel Degenerative Cervical Disease: A Retrospective Propensity Score-Matched Study of the MarketScan Database.

    Science.gov (United States)

    Cole, Tyler; Veeravagu, Anand; Zhang, Michael; Azad, Tej D; Desai, Atman; Ratliff, John K

    2015-07-01

    Retrospective 2:1 propensity score-matched analysis on a national longitudinal database between 2006 and 2010. To compare rates of adverse events, revisions procedure rates, and payment differences in anterior cervical fusion procedures compared with posterior laminectomy and fusion procedures with at least 3 levels of instrumentation. The comparative benefits of anterior versus posterior approach to multilevel degenerative cervical disease remain controversial. Recent systematic reviews have reached conflicting conclusions. We demonstrate the comparative economic and clinical outcomes of anterior and posterior approaches for multilevel cervical degenerative disk disease. We identified 13,662 patients in a national billing claims database who underwent anterior or posterior cervical fusion procedures with 3 or more levels of instrumentation. Cohorts were balanced using 2:1 propensity score matching and outcomes were compared using bivariate analysis. With the exception of dysphagia (6.4% in anterior and 1.4% in posterior), overall 30-day complication rates were lower in the anterior approach group. The rate of any complication excluding dysphagia with anterior approaches was 12.3%, significantly lower (P disease provide clinical advantages over posterior approaches, including lower overall complication rates, revision procedure rates, and decreased length of stay. Anterior approach procedures are also associated with decreased overall payments. These findings must be interpreted in light of limitations inherent to retrospective longitudinal studies including absence of subjective and radiographical outcomes. 3.

  4. Risk of Nonfatal Stroke in Type 2 Diabetes Mellitus Patients: A Retrospective Comparison Between Disease Management Programs and Standard Care.

    Science.gov (United States)

    Wiefarn, Stefan; Heumann, Christian; Rettelbach, Anja; Kostev, Karel

    2017-07-01

    The present retrospective study examines the influence of disease management programs on nonfatal stroke in type 2 diabetes mellitus (T2DM) patients in Germany. The evaluation is based on retrospective patient data from the Disease Analyzer (IMS Health). The analysis included 169 414 T2DM patients aged 40 years and older with an initial prescription of antihyperglycemic therapy between January 2004 and December 2014. A total of 86 713 patients participated in a disease management program (DMP) for T2DM and 82 701 patients received standard care. The main outcome measure of this study was nonfatal stroke. Kaplan-Meier curves of DMP and SC patients were compared using log rank test. The Cox proportional hazards model was used to provide an adjusted estimate of the DMP effect. It is apparent from the baseline characteristics that the general health of patients receiving standard care was poorer than that of patients participating in a DMP. The baseline HbA1c value was 7.6% in the DMP group and 7.8% in the SC group. Furthermore, the SC group had a higher proportion of preexisting conditions, such as coronary heart disease (CHD), peripheral arterial occlusive disease (pAOD), and renal insufficiency. The proportion of patients who received insulin in first year therapy was higher in the SC group. Time to event analysis showed that DMP was associated with a delayed occurrence of stroke, because stroke occurred an average of 350 days later in DMP patients than in patients receiving SC (DMP: 1.216 days, RV: 866 days). The Cox model with covariable adjustment confirmed the significant association of DMPs with nonfatal stroke in patients with type 2 diabetes mellitus (HR 0.71; 95% CI: 0.69-0.74). The present study indicates that DMPs are positively associated with stroke. The possible reasons for this must be verified in further studies.

  5. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    Energy Technology Data Exchange (ETDEWEB)

    Kawasumi, Yusuke, E-mail: ssu@rad.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Usui, Akihito, E-mail: t7402r0506@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosokai, Yoshiyuki, E-mail: hosokai@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Igari, Yui, E-mail: igari@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosoya, Tadashi [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hayashizaki, Yoshie, E-mail: yoshie@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Saito, Haruo, E-mail: hsaito@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Ishibashi, Tadashi, E-mail: tisibasi@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Funayama, Masato, E-mail: funayama@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan)

    2015-04-15

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  6. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    International Nuclear Information System (INIS)

    Kawasumi, Yusuke; Usui, Akihito; Hosokai, Yoshiyuki; Igari, Yui; Hosoya, Tadashi; Hayashizaki, Yoshie; Saito, Haruo; Ishibashi, Tadashi; Funayama, Masato

    2015-01-01

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  7. Comparison of immune manifestations between refractory cytopenia of childhood and aplastic anemia in children: A single-center retrospective study.

    Science.gov (United States)

    Wu, Jun; Cheng, Yifei; Zhang, Leping

    2015-12-01

    This retrospective single-center study assessed the incidence and clinical features of immune manifestations of refractory cytopenia of childhood (RCC) and childhood aplastic anemia (AA). We evaluated 72 children with RCC and 123 with AA between February 2008 and March 2013. RCC was associated with autoimmune disease in 4 children, including 1 case each with autoimmune hemolytic anemia, rheumatoid arthritis, systemic lupus erythematosus, and anaphylactoid purpura. No children with AA were diagnosed with autoimmune diseases. Immune abnormalities were common in both RCC and AA; the most significant reductions were in the relative numbers of CD3-CD56+ subsets found in RCC. Despite the many similar immunologic abnormalities in AA and RCC, the rate of autoimmune disease was significantly lower in childhood AA than RCC (p=0.008, χ2=6.976). The relative numbers of natural killer cells were significantly lower in RCC patients than AA patients. By month 6, there was no significant difference in autoimmune manifestations between RCC and AA in relation to the response to immunosuppressive therapy (p=0.907, χ2=0.014). The large overlap of analogous immunologic abnormalities indicates that RCC and childhood AA may share the same pathogenesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Eun Jung; Kim, Young Hwan; Kim, Si Hyung; Choi, Jin Soo; Park, Jun Cheol; Kwon, Sang Hun; Jo, Chi Heum; Cha, Soon Do [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2008-12-15

    We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility.

  9. Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

    International Nuclear Information System (INIS)

    Ahn, Eun Jung; Kim, Young Hwan; Kim, Si Hyung; Choi, Jin Soo; Park, Jun Cheol; Kwon, Sang Hun; Jo, Chi Heum; Cha, Soon Do

    2008-01-01

    We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility

  10. A retrospective comparison of VLBW outcomes before and after implementing new delivery room guidelines at a regional tertiary care center.

    Science.gov (United States)

    Wlodaver, A; Blunt, M; Satnes, K; Escobedo, M; Hallford, G; Szyld, E

    2016-03-01

    To evaluate the impact of implemented protocol changes on delivery room interventions and very low birth weight (VLBW) health outcomes. Retrospective study comparing birth characteristics, interventions and health outcomes of VLBW infants born in a tertiary care center before (calendar years 2008 to 2009) and after (calendar years 2012 to 2013) implementing new protocols using Chi-square analyses. Four hundred and nine were born before and 303 after changes were implemented. Postimplementation infants had more use of antenatal steroids (P=0.02), gestational age ⩽24 weeks (P=0.03) and birth weights between 501 and 750 g (P=0.04) and less oxygen administration (P=0.002), face mask ventilation (P=0.0001), surfactant use (P=0.0001), chest compressions (P=0.0001), intubation (P=0.002), epinephrine use (P=0.011), hypothermia (P=0.0001) and discharges home on supplemental oxygen (P=0.05). Changes creating a new delivery team, adopting new delivery practice guidelines and updating delivery room equipment resulted in positive outcomes for delivery room practices and patient outcomes.

  11. Enhancement of abdominal structures on MRI at 1.5 and 3 T: a retrospective intraindividual crossover comparison

    Energy Technology Data Exchange (ETDEWEB)

    AlObaidy, Mamdoh [King Faisal Specialist Hospital and Research Center, Department of Radiology, Riyadh (Saudi Arabia); University of North Carolina at Chapel Hill, Department of Radiology, Chapel Hill, NC (United States); Ramalho, Miguel; Velloni, Fernanda; Matos, Antonio P.; Herman, Kevin; Semelka, Richard C. [University of North Carolina at Chapel Hill, Department of Radiology, Chapel Hill, NC (United States)

    2017-04-15

    To quantitatively compare the extent of enhancement of abdominal structures on MRI in an intraindividual fashion at 1.5 and 3 T. HIPAA-compliant, retrospective, longitudinal, intraindividual, crossover study, with waived informed consent, of consecutive individuals scanned at both 1.5 and 3 T closed-bore magnets using gadobenate dimeglumine during different phases of enhancement at tightly controlled arterial phase timing. Quantitative ROI measurements and qualitative sub-phase arterial phase assignments were independently performed by two radiologists. Qualitative discrepancies were resolved by a senior radiologist. Final population included 60 patients [41 female and 19 male; age, 49.35 ± 18.31 years (range 16-81); weight, 78.88 ± 20.3 kg (range 44.5-136)]. Similar enhancement peak patterns were noted at both field strengths. Interobserver agreement of quantitative evaluations was substantial. Significantly higher amplitudes of enhancement peaks were noted for all abdominal solid organs during all phases at 3 T, except for the pancreas (p = 0.17-0.30). Significantly higher amplitudes of enhancement peaks of the abdominal aorta at 1.5 T were noted. Similar peak patterns of enhancement for abdominal structures were observed at 1.5 and 3 T, with solid abdominal organs showing a higher percentage enhancement at 3 T, while unexpectedly higher aortic higher percentage enhancement was observed at 1.5 T. (orig.)

  12. Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty for the management of Kümmell's disease: A retrospective study.

    Science.gov (United States)

    Zhang, Guang-Quan; Gao, Yan-Zheng; Chen, Shu-Lian; Ding, Shuai; Gao, Kun; Wang, Hong-Qiang

    2015-01-01

    Post traumatic osteonecrosis of a vertebral body occurring in a delayed fashion was first described by the German doctor Kümmell in 1895. Several studies have reported percutaneous vertebroplasty (PVP), or percutaneous kyphoplasty (PKP) for Kümmell's disease achieves good outcomes. However, it is unknown whether a technique is superior for the treatment of this disease. The objective of the study is to compare the efficacy of PVP and PKP for the treatment of Kümmell's disease. A retrospective review was conducted for 73 patients with Kümmell's disease. PVP was performed in 38 patients and PKP in 35 patients. Visual analogue score (VAS) was used to evaluate pain. The anterior vertebral height was measured. The operative time, the incidence of cement leakage and the costs were recorded. In both PVP group and PKP group, the VAS and anterior vertebral height significantly improved at 1-day postoperatively (P 0.05). Between the PVP and PKP groups, there were no significant differences in VAS and the anterior vertebral height at 1-day postoperatively and at the final followup (P > 0.05). The operating time and expense in the PKP group were higher than the PVP group (P pain relief and restoration of vertebral height to PKP for the treatment of Kümmell's disease. PKP has a significant advantage over PVP in term of the fewer cement leakages.

  13. Caval penetration by retrievable inferior vena cava filters: a retrospective comparison of Option and Günther Tulip filters.

    Science.gov (United States)

    Olorunsola, Olufoladare G; Kohi, Maureen P; Fidelman, Nicholas; Westphalen, Antonio C; Kolli, Pallav K; Taylor, Andrew G; Gordon, Roy L; LaBerge, Jeanne M; Kerlan, Robert K

    2013-04-01

    To compare the frequency of vena caval penetration by the struts of the Option and Günther Tulip cone filters on postplacement computed tomography (CT) imaging. All patients who had an Option or Günther Tulip inferior vena cava (IVC) filter placed between January 2010 and May 2012 were identified retrospectively from medical records. Of the 208 IVC filters placed, the positions of 58 devices (21 Option filters, 37 Günther Tulip filters [GTFs]) were documented on follow-up CT examinations obtained for reasons unrelated to filter placement. In cases when multiple CT studies were obtained after placement, each study was reviewed, for a total of 80 examinations. Images were assessed for evidence of caval wall penetration by filter components, noting the number of penetrating struts and any effect on pericaval tissues. Penetration of at least one strut was observed in 17% of all filters imaged by CT between 1 and 447 days following placement. Although there was no significant difference in the overall prevalence of penetration when comparing the Option filter and GTF (Option, 10%; GTF, 22%), only GTFs showed time-dependent penetration, with penetration becoming more likely after prolonged indwelling times. No patient had damage to pericaval tissues or documented symptoms attributed to penetration. Although the Günther Tulip and Option filters exhibit caval penetration at CT imaging, only the GTF exhibits progressive penetration over time. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  14. Comparison of quality of life following total ankle arthroplasty and ankle arthrodesis: Retrospective study of 54 cases.

    Science.gov (United States)

    Dalat, F; Trouillet, F; Fessy, M H; Bourdin, M; Besse, J-L

    2014-11-01

    The benefit of ankle arthroplasty compared to arthrodesis continues to be debated, but the quality of life after these two interventions has rarely been assessed. We conducted a case-control study to compare quality of life and functional and athletic ability. Functional results, athletic ability, and quality of life after total ankle arthroplasty (TAA) are better than after ankle arthrodesis. Two continuous series of 59 TAAs and 46 arthrodeses (operated on between 1997 and 2009) were evaluated retrospectively using a questionnaire including the functional items of the AOFAS score, the Foot Function Index (FFI) score, the Foot Ankle Ability Measure (FAAM), and the SF-36. Eighty-three responses (79% of the overall series) were matched in two groups: 32 TAAs [age at the intervention, 51.4years (range, 21-63years); follow-up, 52.2months (range, 30-146months); age at revision, 55.8years (range, 26-67years); BMI, 27.7 (range, 21.7-36.7)] and 22 arthrodeses [age at intervention, 50.1years (range, 24-72years); follow-up 57.9months (range, 12-147months); age at revision 54.9 years (range, 31-75years); BMI, 26.8 (range, 17.6-37)] (NS on all items between the two groups). The pain results were better after TAA, but with no statistically significant difference: AOFAS pain, (/40) 28.1±8.2 vs. 24.5±9.6; FFI pain, 16.6±18.8 vs. 24.3±21.5. The overall FFI score (/100) was better (P=0.048) after TAA (16.2±16.5 vs. 24.8±18.2). The overall mean athletic level compared to the state prior to the injury was relatively low in both groups, but significantly (p=0.007) higher in the TAA group: FAAM sports score (/100), 49.5±24.4 vs. 29.8±26.2. The quality-of-life scores, SF-36 physical health, mental health, and general health were not significantly different after TAA and arthrodesis: mental health score, 63.1±14.7 vs. 57.8±21.5; physical health score, 61.3±17.8 vs. 53.7±23.9, overall score, 63.2±16.4 vs. 55.9±23.5. Very few publications describe activities and quality of

  15. Comparison of two novel approaches to model fibre reinforced concrete

    NARCIS (Netherlands)

    Radtke, F.K.F.; Simone, A.; Sluys, L.J.

    2009-01-01

    We present two approaches to model fibre reinforced concrete. In both approaches, discrete fibre distributions and the behaviour of the fibre-matrix interface are explicitly considered. One approach employs the reaction forces from fibre to matrix while the other is based on the partition of unity

  16. Splenic Artery Embolization in Blunt Trauma: A Single-Center Retrospective Comparison of the Use of Gelatin Sponge Versus Coils.

    Science.gov (United States)

    Rasuli, Pasteur; Moosavi, Bardia; French, Gordon J; Petrcich, William; Hammond, Ian

    2017-12-01

    The purpose of this study was to compare the efficacy of gelatin sponge with that of coils for splenic artery embolization in the treatment of blunt splenic injury. A single-center retrospective review was performed with the records of 63 patients (45 men, 18 women; mean age, 45.5 years; range, 16-84 years) with blunt splenic injury treated at a tertiary care trauma center by splenic artery embolization with gelatin sponge (n = 30 patients) or metallic coils (n = 33 patients) between 2005 and 2014. The two groups had comparable median American Association for the Surgery of Trauma grades of IV and comparable angiographic appearances regarding active extravasation and pseudoaneurysm formation at preembolization splenic arteriography (p = 0.32). Clinical outcomes and procedure-related outcomes were evaluated. The success rates were similar in the two groups: splenic artery embolization failed in 6.6% (2/30) of patients in the gelatin sponge group and 12.1% (4/33) in the coil embolization group (p = 0.45; 95% CI, -30.1% to 19.2%). Major complications occurred in six patients (20.0%) in the gelatin sponge group and in six patients (18.1%) in the coil group (p = 0.85; 95% CI, -23.0% to 26.6%). Minor complications occurred in three patients (10.0%) in the gelatin sponge group and seven patients (21.2%) in the coil group (p = 0.21; 95% CI, -35.4% to 14.0%). Procedure time was significantly shorter in the gelatin sponge group (median, 32 minutes; interquartile range, 18-48 minutes) than in the coil group (median, 53 minutes; interquartile range, 30-76 minutes) (p = 0.01). Splenic artery embolization with gelatin sponge appears to be as effective and as safe as coil embolization and can be completed in a shorter time.

  17. A retrospective comparison of cyclophosphamide plus antithymocyte globulin with cyclophosphamide plus busulfan as the conditioning regimen for severe aplastic anemia

    Directory of Open Access Journals (Sweden)

    L.V.M. Ommati

    2009-03-01

    Full Text Available Allogeneic hematopoietic stem cell transplantation (AHSCT is the treatment of choice for young patients with severe aplastic anemia (SAA. The association of antithymocyte globulin (ATG and cyclophosphamide (CY is the most frequently used conditioning regimen for this disease. We performed this retrospective study in order to compare the outcomes of HLA-matched sibling donor AHSCT in 41 patients with SAA receiving cyclophosphamide plus ATG (ATG-CY, N = 17 or cyclophosphamide plus busulfan (BU-CY, N = 24. The substitution of BU for ATG was motivated by the high cost of ATG. There were no differences in the clinical features between the two groups, including age, gender, cytomegalovirus status, ABO match, interval between diagnosis and transplant, and number of total nucleated cells infused. No differences were observed in the time to neutrophil and platelet engraftment, or in the risk of veno-occlusive disease and hemorrhage. However, there was a higher risk of mucositis in the BU-CY group (71 vs 24%, P = 0.004. There were no differences in the incidence of neutrophil and platelet engraftment, acute and chronic graft-versus-host disease, and transplant-related mortality. There was a higher incidence of late rejection in the ATG-CY group (41 vs 4%, P = 0.009. Although the ATG-CY group had a longer follow-up (101 months than the BU-CY group (67 months, P = 0.04, overall survival was similar between the groups (69 vs 58%, respectively, P = 0.32. We conclude that the association BU-CY is a feasible option to the conventional ATG-CY regimen in this population.

  18. Comparison of Alcohol Withdrawal Outcomes in Patients Treated with Benzodiazepines Alone versus Adjunctive Phenobarbital: a Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Lauren Z. Gashlin

    2015-03-01

    Full Text Available Background: For treatment of severe alcohol withdrawal syndrome, high dose benzodiazepines (BZDs may cause delirium and over-sedation. Phenobarbital (PBT is a long-acting barbiturate effective for the treatment of alcohol withdrawal. Given the potential benefits of PBT, we sought to investigate the effectiveness of PBT as adjunctive treatment for alcohol withdrawal. Methods: This was a retrospective cohort study on patients with a diagnosis of alcohol withdrawal who had a CIWA-Ar score > 10 treated with either BZDs alone (BZD alone group or BZDs with adjunctive PBT (PBT-adjunct group. The patients received at least one dose of PBT in addition to BZDs (variable doses in the PBT-adjunct group, and three doses of 20 mg diazepam equivalents within 6 hours in the BZD alone group. The primary endpoint was the proportion of patients with a CIWA-Ar score < 10 at 24 hours after initial treatment. Duration of withdrawal and cumulative dose of BZDs were also assessed. Results: Seven subjects in the adjunctive phenobarbital and 21 in the benzodiazepine group were included in the final analysis. Two patients (28.6% in the PBT-adjunct group and 5 patients (23.8% in the BZD only group achieved the primary endpoint, though the difference between the two groups was not statistically significant (P = 0.588. The median (IQR duration of withdrawal symptoms was 44 (12-62 hours in the PBT-adjunct group compared to 53 (37-87 hours in the BZD only group, with no significant difference between the groups (P = 0.249. The median (IQR cumulative BZD dose requirement (diazepam equivalent in the PBT-adjunct group was significantly lower than BZD alone group (25 (20-226 vs. 326 (160-550 mg, P = 0.02. Conclusion: PBT appears to be a safe and effective alternative to BZDs for the treatment of alcohol withdrawal in non-critically ill patients and may be BZD sparing.

  19. Effect of transarterial chemoembolization with miriplatin plus epirubicin on local control of hepatocellular carcinoma: a retrospective comparison with miriplatin monotherapy

    Directory of Open Access Journals (Sweden)

    Hashimoto N

    2013-08-01

    Full Text Available Naoko Hashimoto,1 Jin Iwazawa,1 Shoichi Ohue,2 Takashi Mitani11Department of Radiology, Nissay Hospital, Nishiku, Osaka, Japan; 2Department of Radiology, Komatsu Hospital, Neyagawa, JapanObjective: We aimed to evaluate local tumor control after transarterial chemoembolization (TACE for hepatocellular carcinoma using miriplatin and low-dose epirubicin combination therapy.Methods: We retrospectively analyzed the records of patients who underwent TACE using miriplatin plus low-dose epirubicin (30 patients, 61 nodules, August 2011–March 2012 and control patients who underwent TACE using miriplatin alone (36 patients, 70 nodules, June 2010–July 2011. The local control rate was compared between the two groups using the Kaplan–Meier estimator and the log-rank test. Factors affecting local tumor recurrence were analyzed using multivariate logistic regression analysis. Treatment-related toxicity was evaluated using the Common Terminology Criteria for Adverse Events.Results: The local control rates at 6 months and 1 year were 87% and 65% for the miriplatin plus low-dose epirubicin group, and 61% and 43% for the miriplatin group, respectively. Local tumor control rates were significantly better in the miriplatin plus low-dose epirubicin group than in the miriplatin group (P = 0.038. Multivariate analysis showed that the addition of epirubicin was an independent factor associated with better local tumor control (hazard ratio 0.2, P = 0.001. Overall incidence rates for adverse events were not significantly different between the two groups.Conclusion: Additional usage of low-dose epirubicin for TACE using miriplatin improved local tumor control of hepatocellular carcinoma with adverse effects comparable to those observed with TACE using miriplatin alone.Keywords: combination therapy, local recurrence, liver, embolization, comparative study

  20. Carbapenem-resistant Enterobacteriaceae colonization and infection in critically ill patients: a retrospective matched cohort comparison with non-carriers.

    Science.gov (United States)

    Dickstein, Y; Edelman, R; Dror, T; Hussein, K; Bar-Lavie, Y; Paul, M

    2016-09-01

    To examine whether carbapenem-resistant Enterobacteriaceae (CRE) carriage is associated with incidence of clinical infection as a means of assessing whether the morbidity and mortality associated with these bacteria are mediated by underlying conditions or intrinsic properties of CRE. This retrospective matched cohort study compared the incidence of invasive infections in CRE-colonized patients and matched non-carriers in the intensive care unit (ICU). The primary outcome was infection caused by CRE of the same species as the colonizing strain among CRE carriers, and infections caused by carbapenem-sensitive strains of the same organism in non-carriers. Hospital discharge and death were considered as competing events. Competing-risks hazard analysis was performed for the entire cohort and for a nested cohort matched by Acute Physiology and Chronic Health Evaluation (APACHE) II scores, stratified by matching. In total, 146 CRE carriers were compared with 292 non-carriers. Patients were well matched for most risk factors for Enterobacteriaceae infection, including age, renal failure, previous invasive infection, previous hospitalization, APACHE II score, length of mechanical ventilation, length of hospitalization and CRE carriage. On regression analysis, colonization with CRE was independently associated with Enterobacteriaceae infection {cause-specific hazard ratio (CSHR) 2.06 [95% confidence interval (CI) 1.03-4.09]}. On regression analysis of the APACHE-II-matched cohort (N=284), colonization with CRE remained significantly associated with Enterobacteriaceae infection [CSHR 3.32 (95% CI 1.31-8.43)]. Colonization with CRE was associated with at least a two-fold increased risk of infection by the colonizing strain amongst ICU patients. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty for the management of Kümmell's disease: A retrospective study

    Directory of Open Access Journals (Sweden)

    Guang-Quan Zhang

    2015-01-01

    Full Text Available Background: Post traumatic osteonecrosis of a vertebral body occurring in a delayed fashion was first described by the German doctor Kümmell in 1895. Several studies have reported percutaneous vertebroplasty (PVP, or percutaneous kyphoplasty (PKP for Kümmell's disease achieves good outcomes. However, it is unknown whether a technique is superior for the treatment of this disease. The objective of the study is to compare the efficacy of PVP and PKP for the treatment of Kümmell's disease. Materials and Methods: A retrospective review was conducted for 73 patients with Kümmell's disease. PVP was performed in 38 patients and PKP in 35 patients. Visual analogue score (VAS was used to evaluate pain. The anterior vertebral height was measured. The operative time, the incidence of cement leakage and the costs were recorded. Results: In both PVP group and PKP group, the VAS and anterior vertebral height significantly improved at 1-day postoperatively (P 0.05. Between the PVP and PKP groups, there were no significant differences in VAS and the anterior vertebral height at 1-day postoperatively and at the final followup (P > 0.05. The operating time and expense in the PKP group were higher than the PVP group (P < 0.001. Cement leakages in the PKP group were fewer than PVP group (P < 0.05. Conclusions: PVP is a faster, less expensive option that still provides a comparable pain relief and restoration of vertebral height to PKP for the treatment of Kümmell's disease. PKP has a significant advantage over PVP in term of the fewer cement leakages.

  2. Retrospective comparison of the Low Risk Ankle Rules and the Ottawa Ankle Rules in a pediatric population.

    Science.gov (United States)

    Ellenbogen, Amy L; Rice, Amy L; Vyas, Pranav

    2017-09-01

    A recent multicenter prospective Canadian study presented prospective evidence supporting the Low Risk Ankle Rules (LRAR) as a means of reducing the number of ankle radiographs ordered for children presenting with an ankle injury while maintaining nearly 100% sensitivity. This is in contrast to a previous prospective study which showed that this rule yielded only 87% sensitivity. It is important to further investigate the LRAR and compare them with the already validated Ottawa Ankle Rules (OAR) to potentially curb healthcare costs and decrease unnecessary radiation exposure without compromising diagnostic accuracy. We conducted a retrospective chart review of 980 qualifying patients ages 12months to 18years presenting with ankle injury to a commonly staffed 310 bed children's hospital and auxiliary site pediatric emergency department. There were 28 high-risk fractures identified. The Ottawa Ankle Rules had a sensitivity of 100% (95% CI 87.7-100), specificity of 33.1% (95% CI 30.1-36.2), and would have reduced the number of ankle radiographs ordered by 32.1%. The Low Risk Ankle Rules had a sensitivity of 85.7% (95% CI 85.7-96), specificity of 64.9% (95% CI 61.8-68), and would have reduced the number of ankle radiographs ordered by 63.1%. The latter rule missed 4 high-risk fractures. The Low Risk Ankle Rules may not be sensitive enough for use in Pediatric Emergency Departments, while the Ottawa Ankle Rules again demonstrated 100% sensitivity. Further research on ways to implement the Ottawa Ankle Rules and maximize its ability to decrease wait times, healthcare costs, and improve patient satisfaction are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Integration of new biological and physical retrospective dosimetry methods into EU emergency response plans - joint RENEB and EURADOS inter-laboratory comparisons.

    Science.gov (United States)

    Ainsbury, Elizabeth; Badie, Christophe; Barnard, Stephen; Manning, Grainne; Moquet, Jayne; Abend, Michael; Antunes, Ana Catarina; Barrios, Lleonard; Bassinet, Celine; Beinke, Christina; Bortolin, Emanuela; Bossin, Lily; Bricknell, Clare; Brzoska, Kamil; Buraczewska, Iwona; Castaño, Carlos Huertas; Čemusová, Zina; Christiansson, Maria; Cordero, Santiago Mateos; Cosler, Guillaume; Monaca, Sara Della; Desangles, François; Discher, Michael; Dominguez, Inmaculada; Doucha-Senf, Sven; Eakins, Jon; Fattibene, Paola; Filippi, Silvia; Frenzel, Monika; Georgieva, Dimka; Gregoire, Eric; Guogyte, Kamile; Hadjidekova, Valeria; Hadjiiska, Ljubomira; Hristova, Rositsa; Karakosta, Maria; Kis, Enikő; Kriehuber, Ralf; Lee, Jungil; Lloyd, David; Lumniczky, Katalin; Lyng, Fiona; Macaeva, Ellina; Majewski, Matthaeus; Vanda Martins, S; McKeever, Stephen W S; Meade, Aidan; Medipally, Dinesh; Meschini, Roberta; M'kacher, Radhia; Gil, Octávia Monteiro; Montero, Alegria; Moreno, Mercedes; Noditi, Mihaela; Oestreicher, Ursula; Oskamp, Dominik; Palitti, Fabrizio; Palma, Valentina; Pantelias, Gabriel; Pateux, Jerome; Patrono, Clarice; Pepe, Gaetano; Port, Matthias; Prieto, María Jesús; Quattrini, Maria Cristina; Quintens, Roel; Ricoul, Michelle; Roy, Laurence; Sabatier, Laure; Sebastià, Natividad; Sholom, Sergey; Sommer, Sylwester; Staynova, Albena; Strunz, Sonja; Terzoudi, Georgia; Testa, Antonella; Trompier, Francois; Valente, Marco; Hoey, Olivier Van; Veronese, Ivan; Wojcik, Andrzej; Woda, Clemens

    2017-01-01

    RENEB, 'Realising the European Network of Biodosimetry and Physical Retrospective Dosimetry,' is a network for research and emergency response mutual assistance in biodosimetry within the EU. Within this extremely active network, a number of new dosimetry methods have recently been proposed or developed. There is a requirement to test and/or validate these candidate techniques and inter-comparison exercises are a well-established method for such validation. The authors present details of inter-comparisons of four such new methods: dicentric chromosome analysis including telomere and centromere staining; the gene expression assay carried out in whole blood; Raman spectroscopy on blood lymphocytes, and detection of radiation-induced thermoluminescent signals in glass screens taken from mobile phones. In general the results show good agreement between the laboratories and methods within the expected levels of uncertainty, and thus demonstrate that there is a lot of potential for each of the candidate techniques. Further work is required before the new methods can be included within the suite of reliable dosimetry methods for use by RENEB partners and others in routine and emergency response scenarios.

  4. Comparison of Australian and US Cost-Benefit Approaches to MEPS

    Energy Technology Data Exchange (ETDEWEB)

    McMahon, James E.

    2004-03-12

    The Australian Greenhouse Office contracted with the Collaborative Labeling and Appliance Standards Program (CLASP) for LBNL to compare US and Australian approaches to analyzing costs and benefits of minimum energy performance standards (MEPS). This report compares the approaches for three types of products: household refrigerators and freezers, small electric storage water heaters, and commercial/industrial air conditioners. This report presents the findings of similarities and differences between the approaches of the two countries and suggests changes to consider in the approach taken in Australia. The purpose of the Australian program is to reduce greenhouse gas emissions, while the US program is intended to increase energy efficiency; each program is thus subject to specific constraints. The market and policy contexts are different, with the USA producing most of its own products and conducting pioneering engineering-economic studies to identify maximum energy efficiency levels that are technologically feasible and economically justified. In contrast, Australia imports a large share of its products and adopts MEPS already in place elsewhere. With these differences in circumstances, Australia's analysis approach could be expected to have less analytical detail and still result in MEPS levels that are appropriate for their policy and market context. In practice, the analysis required to meet these different objectives is quite similar. To date, Australia's cost-benefit analysis has served the goals and philosophies of the program well and been highly effective in successfully identifying MEPS that are significantly reducing greenhouse gas emissions while providing economic benefits to consumers. In some cases, however, the experience of the USA--using more extensive data sets and more detailed analysis--suggests possible improvements to Australia's cost-benefit analysis. The principal findings of the comparison are: (1) The Technology and Market

  5. Comparison of hand-assisted laparoscopy with open total colectomy for slow transit constipation: a retrospective study.

    Science.gov (United States)

    Sheng, Qin Song; Lin, Jian Jiang; Chen, Wen Bin; Liu, Fan Long; Xu, Xiang Ming; Hua, Han Ju; Lin, Cai Zhao; Wang, Jin Hai

    2014-08-01

    To compare the efficacy and safety of hand-assisted laparoscopic colectomy (HALC) and open colectomy (OC) for patients with slow transit constipation (STC). Data of patients with STC who underwent total colectomy from January 2008 to December 2012 were retrospectively reviewed after clinical evaluation and an exclusion of secondary causes. These patients were further divided into the HALC and OC groups. Patients' outcomes, including intraoperative and postoperative data on their recovery and complications were compared between the two groups. A total of 68 patients with STC were finally enrolled in the study, including 32 in the HALC group and 36 in the OC group. The baseline characteristics did not significantly differ between the two groups. Compared with the OC group, patients in the HALC group had a shorter length of incision, a longer operative time and less blood loss volume. There was no conversion to OC for patients undergoing HALC and no intraoperative complications in both groups. Furthermore, after operation, patients in HALC group experienced less pain (3.4 ± 0.7 vs 4.8 ± 1.0), earlier first passage of flatus (58.3 ± 6.3 h vs 73.4 ± 13.0 h), shorter length of postoperative hospital stay (8.8 ± 1.2 days vs 11.3 ± 1.7 days) but higher medical cost (RMB 33 979 ± 3 135 vs RMB 29 828 ± 3 216). The overall postoperative complications and the satisfaction in defecation were comparable in the two groups. HALC is a safe, minimally invasive and effective surgical alternative for treating STC, which is comparable to OC. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  6. A Fiducial Approach to Extremes and Multiple Comparisons

    Science.gov (United States)

    Wandler, Damian V.

    2010-01-01

    Generalized fiducial inference is a powerful tool for many difficult problems. Based on an extension of R. A. Fisher's work, we used generalized fiducial inference for two extreme value problems and a multiple comparison procedure. The first extreme value problem is dealing with the generalized Pareto distribution. The generalized Pareto…

  7. Mixed Approach Retrospective Analyses of Suicide and Suicidal Ideation for Brand Compared with Generic Central Nervous System Drugs.

    Science.gov (United States)

    Cheng, Ning; Rahman, Md Motiur; Alatawi, Yasser; Qian, Jingjing; Peissig, Peggy L; Berg, Richard L; Page, C David; Hansen, Richard A

    2018-04-01

    Several different types of drugs acting on the central nervous system (CNS) have previously been associated with an increased risk of suicide and suicidal ideation (broadly referred to as suicide). However, a differential association between brand and generic CNS drugs and suicide has not been reported. This study compares suicide adverse event rates for brand versus generic CNS drugs using multiple sources of data. Selected examples of CNS drugs (sertraline, gabapentin, zolpidem, and methylphenidate) were evaluated via the US FDA Adverse Event Reporting System (FAERS) for a hypothesis-generating study, and then via administrative claims and electronic health record (EHR) data for a more rigorous retrospective cohort study. Disproportionality analyses with reporting odds ratios and 95% confidence intervals (CIs) were used in the FAERS analyses to quantify the association between each drug and reported suicide. For the cohort studies, Cox proportional hazards models were used, controlling for demographic and clinical characteristics as well as the background risk of suicide in the insured population. The FAERS analyses found significantly lower suicide reporting rates for brands compared with generics for all four studied products (Breslow-Day P brand CNS drugs in FAERS and adjusted retrospective cohort analyses remained significant only for sertraline. However, even for sertraline, temporal confounding related to the close proximity of black box warnings and generic availability is possible. Additional analyses in larger data sources with additional drugs are needed.

  8. A multicenter retrospective comparison of goniotomy versus trabecular bypass device implantation in glaucoma patients undergoing cataract extraction

    Directory of Open Access Journals (Sweden)

    Dorairaj SK

    2018-04-01

    Full Text Available Syril K Dorairaj,1 Malik Y Kahook,2 Blake K Williamson,3 Leonard K Seibold,4 Mohammed K ElMallah,5 Inder P Singh6 On behalf of the KDB Goniotomy Study Group 1Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, 2School of Medicine, University of Colorado, Denver, CO, 3Williamson Eye Center, Baton Rouge, LA, 4School of Medicine, University of Colorado, Aurora, CO, 5Ocala Eye, Ocala, FL, 6The Eye Center of Racine and Kenosha, Kenosha, WI, USA Purpose: The aim of this study was to compare intraocular pressure (IOP outcomes in eyes with cataract and glaucoma undergoing phacoemulsification (phaco in combination with goniotomy using the Kahook Dual Blade (KDB or implantation of a single iStent trabecular bypass device.Methods: Retrospective analysis of IOP and IOP-lowering medication reduction in eyes undergoing phaco-goniotomy with KDB (n=237 or phaco-iStent (n=198. Preoperative, intraoperative, and postoperative data were collected through 6 months of follow-up. Outcome measures included mean IOP reduction, mean reduction in IOP-lowering medications, and the proportion of eyes achieving ≥20% IOP reduction or ≥1 medication reduction from baseline.Results: Mean IOP in the phaco-goniotomy with KDB group decreased from 17.9±4.4 mmHg at baseline to 13.6±2.7 mmHg at Month 6 (P<0.001, with mean medication use decreasing from 1.7±0.9 to 0.6±1.0 (P<0.001. In the phaco-iStent group, mean IOP decreased from 16.7±4.4 mmHg to 13.9±2.7 mmHg (P<0.001, with mean IOP-lowering medication use decreasing from 1.9±0.9 to 1.0±1.0 (P<0.001. Mean IOP reduction from baseline was significantly greater in the phaco-goniotomy with KDB group at Month 6 (phaco-goniotomy with KDB −4.2 mmHg [23.7%] vs phaco-iStent −2.7 mmHg [16.4%]; P<0.001. IOP-lowering medication reduction was greater in the phaco-goniotomy with KDB group compared to the phaco-iStent group (1.1 vs 0.9 medications, respectively; P=0.001. The most common adverse event was IOP spikes

  9. A Quantitative Comparison of Semantic Web Page Segmentation Approaches

    NARCIS (Netherlands)

    Kreuzer, Robert; Hage, J.; Feelders, A.J.

    2015-01-01

    We compare three known semantic web page segmentation algorithms, each serving as an example of a particular approach to the problem, and one self-developed algorithm, WebTerrain, that combines two of the approaches. We compare the performance of the four algorithms for a large benchmark of modern

  10. Hong Kong Students' Approaches to Learning: Cross-Cultural Comparisons

    Science.gov (United States)

    Dasari, Bhoomiah

    2009-01-01

    Anecdotal evidence abounds in Hong Kong to the effect that students entering tertiary education are predisposed to a "rote" learning approach. With the internalisation of higher education in many countries, there is still insufficient understanding of how Chinese students approach their learning. Except few studies were conducted…

  11. Comparison of effective Hough transform-based fingerprint alignment approaches

    CSIR Research Space (South Africa)

    Mlambo, CS

    2014-08-01

    Full Text Available points set with larger rotation and small number of points. The DRBA approach was found to perform better with minutiae points with large amount of translation, and the computational time was less than that of LMBA approach. However, the memory usage...

  12. Investigating design: A comparison of manifest and latent approaches

    DEFF Research Database (Denmark)

    Cash, Philip; Snider, Chris

    2014-01-01

    This paper contributes to the on-going focus on improving design research methods, by exploring and synthesising two key interrelated research approaches e manifest and latent. These approaches are widely used individually in design research, however, this paper represents the first work bringing...

  13. Noninvasive coronary artery imaging by multislice spiral computed tomography. A novel approach for a retrospectively ECG-gated reconstruction technique

    International Nuclear Information System (INIS)

    Sato, Yuichi; Kanmatsuse, Katsuo; Inoue Fumio

    2003-01-01

    Although the excellent spatial resolution of multislice spiral computed tomography (MSCT) enables the coronary arteries to be visualized, its limited temporal resolution results in poor image reproducibility because of cardiac motion artifact (CMA) and hence limits its widespread clinical use. A novel retrospectively electrocardiogram (ECG)-gated reconstruction method has been developed to minimize CMA. In 88 consecutive patients, the scan data were reconstructed using 2 retrospectively ECG-gated reconstruction methods. Method 1: the end of the reconstruction window (250 ms) was positioned at the peak of the P wave on ECG, which corresponded to the end of the slow filling phase during diastole immediately before atrial contraction. Method 2 (conventional method): relative retrospective gating with 50% referred to the R-R interval was performed so that the beginning of the reconstruction window (250 ms) was positioned at the halfway point between the R-R intervals of the heart cycle. The quality of the coronary artery images was evaluated according to the presence or absence of CMA. The assessment was applied to the left main coronary artery (LMCA), the left anterior descending artery (LAD, segments no.6, no.7, and no.8), the left circumflex artery (LCx, segments no.11 and no.13) and the right coronary artery (RCA, segments no.1, no.2 and no.3). The first diagonal artery (no.9-1), the obtuse marginal artery (no.12-1), the posterior descending artery (no.4-PD), the atrioventricular node branch (no.4-AV) and the first right ventricular branch (RV) were also evaluated. Of the 88 patients, 85 were eligible for image evaluation. Method 1 allowed visualization of the major coronary arteries without CMA in the majority of patients. The left coronary artery (LCA) system (segments no.5-7, no.11 and no.13) and the proximal portion of the RCA were visualized in more than 94% of patients. Artifact-free visualization of the distal portion of the LAD (segment no.8) and RCA (no.4

  14. Refractive outcomes of an advanced aspherically optimized profile for myopia corrections by LASIK: a retrospective comparison with the standard aspherically optimized profile

    Directory of Open Access Journals (Sweden)

    Meyer B

    2015-02-01

    Full Text Available Bertram Meyer,1 Georg Sluyterman van Langeweyde,2 Matthias Wottke2 1Augencentrum Köln, Cologne, Germany; 2Carl Zeiss Meditec AG, Jena, Germany Purpose: A retrospective comparison of refractive outcomes of a new, aspherically optimized profile with an enhanced energy correction feature (Triple-A and the conventionally used aspherically optimized profile (ASA, or aberration smart ablation for correction of low-to-high myopia.Setting: Augen-OP-Centrum, Cologne, GermanyDesign: Retrospective nonrandomized comparative studyMethods: A central database at the Augen-OP-Centrum was used to gather retrospective data for low-to-high myopia (up to -10 D. One hundred and seven eyes (56 patients were treated with the ASA profile, and 79 eyes (46 patients were treated with the Triple-A profile. Postoperative outcomes were evaluated at 1 month, 3 months, 6 months, and 1 year follow-up time points.Results: The Triple-A profile showed better predictability indicated by a significantly lower standard deviation of residuals (0.32–0.34 vs 0.36–0.44, Triple-A vs ASA in the 6-month to 1-year period. The Triple-A group had better stability across all time intervals and achieved better postoperative astigmatism improvements with significantly lower scatter. This group achieved better safety at 1 year, with 100% of eyes showing no change or gain in Snellen lines, compared with 97% in the ASA group. A better safety index was observed for the Triple-A group at later time points. The Triple-A group had a better efficacy index and a higher percentage of eyes with an uncorrected Snellen visual acuity of 20/20 or greater at all investigated follow-up time points.Conclusion: The new aspherically optimized Triple-A profile can safely and effectively correct low-to-high myopia. It has demonstrated superiority over the ASA profile in most refractive outcomes. Keywords: Triple-A, wavefront measurements, corneal aberrations, corneal asphericity, ablation profile

  15. A Comparison of Five Alternative Approaches to Information Systems Development

    Directory of Open Access Journals (Sweden)

    Rudy Hirschheim

    1997-11-01

    Full Text Available The field of information systems (IS has grown dramatically over the past three decades. Recent trends have transformed the IS landscape. These trends include: the evolution of implementation technology from centralized mainframe environments towards distributed client-server architectures, embracing the internet and intranets; changes in user interface technology from character-based to graphical user interfaces, multimedia, and the World Wide Web; changes in applications from transaction processing systems towards systems supporting collaborative work; and the use of information technology as an enabler of business process reengineering and redesign. These technology changes coupled with changes in organizations and their operating environment, such as the growth of the network and virtual organization, internationalization and globalization of many organizations, intensified global competition, changes in values such as customer orientation (service quality and Quality of Working Life, have imposed new demands on the development of information systems. These changes have led to an increasing discussion about information systems development (ISO, and in particular, the various methods, tools, methodologies, and approaches for ISD. We believe such discussion has opened the door for new, alternative IS development approaches and methodologies. Our paper takes up this theme by describing five alternative ISD approaches, namely the Interactionist approach, the Speech Act-based approach, Soft Systems Methodology, the Trade Unionist approach, and the Professional Work Practices approach. Despite the fact that most of these approaches have a history of over 15 years, their relevance to IS development is not well recognized in the mainstream of IS practice and research, nor is their institutional status comparable to traditional approaches such as structured analysis and design methods. Therefore we characterize the five approaches as 'alternative' in

  16. Knowledge-based biomedical word sense disambiguation: comparison of approaches

    Directory of Open Access Journals (Sweden)

    Aronson Alan R

    2010-11-01

    Full Text Available Abstract Background Word sense disambiguation (WSD algorithms attempt to select the proper sense of ambiguous terms in text. Resources like the UMLS provide a reference thesaurus to be used to annotate the biomedical literature. Statistical learning approaches have produced good results, but the size of the UMLS makes the production of training data infeasible to cover all the domain. Methods We present research on existing WSD approaches based on knowledge bases, which complement the studies performed on statistical learning. We compare four approaches which rely on the UMLS Metathesaurus as the source of knowledge. The first approach compares the overlap of the context of the ambiguous word to the candidate senses based on a representation built out of the definitions, synonyms and related terms. The second approach collects training data for each of the candidate senses to perform WSD based on queries built using monosemous synonyms and related terms. These queries are used to retrieve MEDLINE citations. Then, a machine learning approach is trained on this corpus. The third approach is a graph-based method which exploits the structure of the Metathesaurus network of relations to perform unsupervised WSD. This approach ranks nodes in the graph according to their relative structural importance. The last approach uses the semantic types assigned to the concepts in the Metathesaurus to perform WSD. The context of the ambiguous word and semantic types of the candidate concepts are mapped to Journal Descriptors. These mappings are compared to decide among the candidate concepts. Results are provided estimating accuracy of the different methods on the WSD test collection available from the NLM. Conclusions We have found that the last approach achieves better results compared to the other methods. The graph-based approach, using the structure of the Metathesaurus network to estimate the relevance of the Metathesaurus concepts, does not perform well

  17. Green Infrastructure and German Landscape Planning: A Comparison of Approaches

    Directory of Open Access Journals (Sweden)

    Catalina VIEIRA MEJÍA

    2015-11-01

    Full Text Available A variety of similarities between green infrastructure and the German landscape planning can be found in comparing the approaches of the two planning instruments. Principles of green infrastructure such as multifunctionality, the multi-scale approach and connectivity show correspondences with landscape planning elements. However, some differences are apparent. The objective of this paper is to determine whether the main aims of these two frameworks overlap. It also seeks to deduce what benefits from ecosystem services could be provided by integrating the green infrastructure approach into the German landscape planning system. The results show that the green infrastructure concept is not well-known in German planning practice, although its principles are generally implemented through traditional landscape planning. Nevertheless, green infrastructure could act as a supplementary approach to current landscape planning practices by improving public acceptance and strengthening the social focus of the current landscape planning system.

  18. Comparisons on International Approaches of Business and Project Risk Management

    OpenAIRE

    Nadia Carmen ENE

    2005-01-01

    In this article we intend to present a comparative approach between three recognized international methodologies for risk management: RISKMAN, Project Management Institute Methodology-PMBoK and Project Risk Analysis and Management Guide (produced by Association for Project Management).

  19. Comparison of topic extraction approaches and their results

    NARCIS (Netherlands)

    Velden, Theresa; Boyack, Kevin W.; Gläser, Jochen; Koopman, Rob; Scharnhorst, Andrea; Wang, Shenghui

    2017-01-01

    This is the last paper in the Synthesis section of this special issue on ‘Same Data, Different Results’. We first provide a framework of how to describe and distinguish approaches to topic extraction

  20. Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves' disease: a comparison of surgical results with open thyroidectomy.

    Science.gov (United States)

    Jitpratoom, Pornpeera; Ketwong, Khwannara; Sasanakietkul, Thanyawat; Anuwong, Angkoon

    2016-12-01

    Transoral endoscopic thyroidectomy vestibular approach (TOETVA) provides excellent cosmetic results from its potential for scar-free operation. The procedure has been applied successfully for Graves' disease by the authors of this work and compared with the standard open cervical approach to evaluate its safety and outcomes. From January 2014 to November 2016, a total of 97 patients with Graves' disease were reviewed retrospectively. Open thyroidectomy (OT) and TOETVA were performed in 49 patients and 46 patients, respectively. For TOETVA, a three-port technique through the oral vestibule was utilized. The thyroidectomy was done endoscopically using conventional laparoscopic instruments and an ultrasonic device. Patient demographics and surgical variables, including operative time, blood loss, and complications, were investigated and compared. TOETVA was performed successfully in all 45 patients, although conversion to open surgery was deemed necessary in one patient. All patient characteristics for both groups were similar. Operative time was shorter for the OT group compared to the TOETVA group, which totaled 101.97±24.618 and 134.11±31.48 minutes, respectively (PGraves' disease in comparison to the standard open cervical approach. It is considered a viable alternative for patients who have been indicated for surgery with excellent cosmetic results.

  1. Muscle gap approach under a minimally invasive channel technique for treating long segmental lumbar spinal stenosis: A retrospective study.

    Science.gov (United States)

    Bin, Yang; De Cheng, Wang; Wei, Wang Zong; Hui, Li

    2017-08-01

    This study aimed to compare the efficacy of muscle gap approach under a minimally invasive channel surgical technique with the traditional median approach.In the Orthopedics Department of Traditional Chinese and Western Medicine Hospital, Tongzhou District, Beijing, 68 cases of lumbar spinal canal stenosis underwent surgery using the muscle gap approach under a minimally invasive channel technique and a median approach between September 2013 and February 2016. Both approaches adopted lumbar spinal canal decompression, intervertebral disk removal, cage implantation, and pedicle screw fixation. The operation time, bleeding volume, postoperative drainage volume, and preoperative and postoperative visual analog scale (VAS) score and Japanese Orthopedics Association score (JOA) were compared between the 2 groups.All patients were followed up for more than 1 year. No significant difference between the 2 groups was found with respect to age, gender, surgical segments. No diversity was noted in the operation time, intraoperative bleeding volume, preoperative and 1 month after the operation VAS score, preoperative and 1 month after the operation JOA score, and 6 months after the operation JOA score between 2 groups (P > .05). The amount of postoperative wound drainage (260.90 ± 160 mL vs 447.80 ± 183.60 mL, P gap approach group than in the median approach group (P gap approach under a minimally invasive channel group, the average drainage volume was reduced by 187 mL, and the average VAS score 6 months after the operation was reduced by an average of 0.48.The muscle gap approach under a minimally invasive channel technique is a feasible method to treat long segmental lumbar spinal canal stenosis. It retains the integrity of the posterior spine complex to the greatest extent, so as to reduce the adjacent spinal segmental degeneration and soft tissue trauma. Satisfactory short-term and long-term clinical results were obtained.

  2. Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach

    Directory of Open Access Journals (Sweden)

    Yatinder Kharbanda

    2016-11-01

    Full Text Available Abstract Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

  3. Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach.

    Science.gov (United States)

    Kharbanda, Yatinder; Tanwar, Yashwant Singh; Srivastava, Vishal; Birla, Vikas; Rajput, Ashok; Pandit, Ramsagar

    2017-04-01

    Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

  4. The benefits of a laparoscopic approach in ileal pouch anal anastomosis formation: a single institutional retrospective case-matched experience.

    LENUS (Irish Health Repository)

    Kelly, J

    2010-06-01

    A laparoscopic approach to ileoanal pouch formation is novel. By using prospectively gathered data, laparoscopic and open restorative proctocolectomy procedures in mucosal ulcerative colitis (UC) and familial adenomatous polyposis (FAP) patients were compared using a case-matched design.

  5. Comparison of dignity determination of mammographic microcalcification with two systems for digital full-field mammography with different detector resolution. A retrospective clinical study

    International Nuclear Information System (INIS)

    Schulz-Wendtland, R.; Adamietz, B.; Meier-Meitinger, M.; Wenkel, E.; Lell, M.; Anders, K.; Uder, M.; Hermann, K.P.

    2011-01-01

    The aim of this retrospective clinical study was to compare the diagnostic accuracy of the novel 50 μm FFDM (full-field digital mammography) system (DR) with an established 70 μm system (DR) in the differential diagnosis between benign and malignant clusters of microcalcification (n=50) (BI-RADS trademark classification 4/5) and to assess the possible incremental value of the 50 μm pixel-pitch on specificity. From March 2009 to September 2009, 50 patients underwent full-field digital mammography (FFDM) (detector resolution 70 μm) (Novation, Siemens, Erlangen, Germany). As there were suspicious signs of microcalcification classified with BI-RADS trademark 4/5 after diagnosis and preoperative wire localization, control images were made with the new FFDM system (detector: resolution 50 μm) (Amulet, Fujifilm, Tokyo, Japan) with the same exposure parameters. The diagnosis was determined after the operation by five radiologists with different experience in digital mammography from randomly distributed mediolateral views (monitor reading) whose results were correlated with the final histology of all lesions. Histopathology revealed 19 benign and 31 malignant lesions in 50 patients after open biopsy. The results of the five readers showed a higher sensitivity of the new FFDM system (80.0%) in the ability to recognize malignant microcalcification in comparison to the established system (74.8%). The specificity (75.8 versus 71.6%) was slightly higher for the new system but hese results were not statistically significant (p [de

  6. A Comparison of Cats (Felis silvestris catus Housed in Groups and Single Cages at a Shelter: A Retrospective Matched Cohort Study

    Directory of Open Access Journals (Sweden)

    Malini Suchak

    2018-02-01

    Full Text Available The merits of various housing options for domestic cats in shelters have been debated. However, comparisons are difficult to interpret because cats are typically not able to be randomly assigned to different housing conditions. In the current study, we attempted to address some of these issues by creating a retrospective matched cohort of cats in two housing types. Cats in group housing (GH were matched with cats in single housing (SH that were the same age, sex, breed, coat color, and size. Altogether we were able to find a match for 110 GH cats. We compared these two groups on several measures related to their experience at the shelter such as moves and the development of behavioral problems. We also compared these groups on outcomes including length of stay, live release, and returns after adoption. We found that while the frequency of moves was similar in both groups, SH cats were more likely to be moved to offsite facilities than GH cats. SH cats also spent a smaller proportion of time on the adoption floor. Length of stay and, live release and returns after adoption did not significantly differ across groups, however GH cats were two times as likely to be returned after adoption. Future research should look at the behavioral impacts of shelter decision-making regarding moving and management of cats in different housing systems.

  7. A Multiple Cross-Cultural Comparison of Approaches to Learning

    Science.gov (United States)

    Bowden, Mark P.; Abhayawansa, Subhash; Manzin, Gregoria

    2015-01-01

    This study compares learning approaches of local English-speaking students and students from Asian countries studying at an Australian metropolitan university. The sample consists of students across 13 different countries. Unlike previous studies, students from Asian countries are subdivided into two categories: students from Confucian Heritage…

  8. Comparison of educational facilitation approaches for Grade R ...

    African Journals Online (AJOL)

    The Early Childhood Development Manager in Mpumalanga is faced with the problem of providing evidence-based guidance of the best facilitation approach in the Grade R context. An investigation on the effect of facilitation, i.e. play-based or formal instruction, on Grade R performance scores in English Additional ...

  9. A Comparison of HPT and Traditional Training Approaches.

    Science.gov (United States)

    Kretz, Richard

    2002-01-01

    Focuses on the comparative use of training from human performance technology (HPT) and traditional training perspectives, based on taxonomy. Concludes that the primary difference is a holistic systems performance improvement approach by eliminating barriers with HPT versus reaction or response to a set of business objectives in traditional…

  10. Comparison of Calculation Approaches for Monopiles for Offshore Wind Turbines

    DEFF Research Database (Denmark)

    Augustesen, Anders Hust; Sørensen, Søren Peder Hyldal; Ibsen, Lars Bo

    2010-01-01

    Large-diameter (4 to 6m) monopiles are often used as foundations for offshore wind turbines. The monopiles are subjected to large horizontal forces and overturning moments and they are traditionally designed based on the p-y curve method (Winkler type approach). The p-y curves recommended in offs...

  11. Comparison of attitude determination approaches using multiple Global Positioning System (GPS antennas

    Directory of Open Access Journals (Sweden)

    Wang Bing

    2013-02-01

    Full Text Available GPS-based attitude system is an important research field, since it is a valuable technique for the attitude determination of platforms. There exist two classes approaches for attitude determination using the GPS. The one determines attitude via baseline estimates in two frames, the other one solves for attitude by incorporating the attitude parameters directly into the GPS measurements. However, comparisons between these two classes approaches have been unexplored. First of all, two algorithms are introduced in detail which on behalf of these two kinds of approaches. Then we present numerical simulations demonstrating the performance of our algorithms and provide a comparison evaluating.

  12. Comparison of short-term outcomes between laparoscopically-assisted vs. transverse-incision open right hemicolectomy for right-sided colon cancer: a retrospective study

    Directory of Open Access Journals (Sweden)

    Akaraviputh Thawatchai

    2007-05-01

    Full Text Available Abstract Background Laparoscopically-assisted right hemicolectomy (LRH is an acceptable alternative to open surgery for right-sided colon cancer which offers patients less pain and faster recovery. However, special equipment and substantial surgical experience are required. The aim of the study is to compare the short-term surgical outcomes of LRH and open right hemicolectomy through right transverse skin crease incision (ORHT for right-sided colon cancer. Patients and methods This retrospective study included 33 patients with right-sided colon cancer who underwent elective right hemicolectomy by laparoscopic or open approaches through right transverse skin crease incision between March 2004 and September 2006 at the Department of Surgery, Faculty of Medicine Siriraj Hospital. Operative details, postoperative requirement of narcotics, recovery of bowel function, and oncological parameters were analyzed. Results Thirteen patients underwent LRH and 20 patients underwent ORHT. Both approaches achieved adequate oncological resection of the tumor. The laparoscopic group were characterized by shorter average incision lengths (7.7 vs 10.3 cm; p Conclusion LRH and ORHT for right-sided colon cancer resulted in the same short-term surgical outcomes including postoperative bowel function, narcotics consumption and length of hospital stay. However, LRH required a significantly longer operating time.

  13. Comparison of Plant Life Management Approaches for Long Term Operations

    International Nuclear Information System (INIS)

    Kang, Kisig

    2012-01-01

    Plant life management can be defined as the integration of ageing and economic planning to maintain a high level of safety and optimize operations. Many Member States have given high priority to long term operation of nuclear power plants beyond the time frame originally anticipated (e. g. 30 or 40 years). Out of a total of 445 (369 GWe) operating nuclear power plants, 349 units (297 GWe) have been in operation for more than 20 years (as of November 2011). The need for engineering support to operation, maintenance, safety review and life management for long term operation as well as education and training in the field is increasingly evident. In addition the Fukushima accident has rendered all stake holders even more attentive to safety concerns and to the provision of beyond safety measures in the preparation and scrutiny of applications for operational design life extensions. In many countries, the safety performance of NPPs is periodically followed and characterized via the periodic safety review (PSR) approach. The regulatory The regulatory review and acceptance of the PSR gives the licensee the permission to operate the plant for up to the end of the next PSR cycle (usually 10 years). In the USA and other countries operating US designed plants, the license renewal application is based on the five pre-requisite requirements and ageing management programme for passive long life system structure and components(SSCs) and active systems is adequately addressed by the maintenance rule (MR) requirements and other established regulatory processes. Other Member States have adopted a combined approach that incorporates elements of both PSR and additional LRA specific requirements primarily focused on time limited ageing analysis. Taking into account this variety of approaches, the international atomic energy agency (IAEA) initiated work for collecting and sharing information among Member States about good practices on plant life management for long term operation in

  14. Comparison of Different Approaches to the Cutting Plan Scheduling

    Directory of Open Access Journals (Sweden)

    Peter Bober

    2011-10-01

    Full Text Available Allocation of specific cutting plans and their scheduling to individual cutting machines presents a combinatorial optimization problem. In this respect, various approaches and methods are used to arrive to a viable solution. The paper reports three approaches represented by three discreet optimization methods. The first one is back-tracing algorithm and serves as a reference to verify functionality of the other two ones. The second method is optimization using genetic algorithms, and the third one presents heuristic approach to optimization based on anticipated properties of an optimal solution. Research results indicate that genetic algorithms are demanding to calculate though not dependant on the selected objective function. Heuristic algorithm is fast but dependant upon anticipated properties of the optimal solution. Hence, at change of the objective function it has to be changed. When the scheduling by genetic algorithms is solvable in a sufficiently short period of time, it is more appropriate from the practical point than the heuristic algorithm. The back-tracing algorithm usually does not provide a result in a feasible period of time.

  15. Pro-active approaches to the identification of emerging risks in the food chain: Retrospective case studies.

    NARCIS (Netherlands)

    Hagenaars, T.H.J.; Elbers, A.R.W.; Kleter, G.A.; Kreft, F.; Leeuwen, van P.; Waalwijk, C.; Hoogenboom, L.A.P.; Marvin, H.J.P.

    2006-01-01

    In this report six case studies are carried out on food-safety and animal-health crises that have occurred in the recent past. The aim is to learn from these cases if and how the identification of emerging food-safety (and animal-health) risks can be improved by adopting a (more) pro-active approach

  16. An ANOVA approach for statistical comparisons of brain networks.

    Science.gov (United States)

    Fraiman, Daniel; Fraiman, Ricardo

    2018-03-16

    The study of brain networks has developed extensively over the last couple of decades. By contrast, techniques for the statistical analysis of these networks are less developed. In this paper, we focus on the statistical comparison of brain networks in a nonparametric framework and discuss the associated detection and identification problems. We tested network differences between groups with an analysis of variance (ANOVA) test we developed specifically for networks. We also propose and analyse the behaviour of a new statistical procedure designed to identify different subnetworks. As an example, we show the application of this tool in resting-state fMRI data obtained from the Human Connectome Project. We identify, among other variables, that the amount of sleep the days before the scan is a relevant variable that must be controlled. Finally, we discuss the potential bias in neuroimaging findings that is generated by some behavioural and brain structure variables. Our method can also be applied to other kind of networks such as protein interaction networks, gene networks or social networks.

  17. Comparison of different homogenization approaches for elastic–viscoplastic materials

    International Nuclear Information System (INIS)

    Mercier, S; Molinari, A; Berbenni, S; Berveiller, M

    2012-01-01

    Homogenization of linear viscoelastic and non-linear viscoplastic composite materials is considered in this paper. First, we compare two homogenization schemes based on the Mori–Tanaka method coupled with the additive interaction (AI) law proposed by Molinari et al (1997 Mech. Mater. 26 43–62) or coupled with a concentration law based on translated fields (TF) originally proposed for the self-consistent scheme by Paquin et al (1999 Arch. Appl. Mech. 69 14–35). These methods are also evaluated against (i) full-field calculations of the literature based on the finite element method and on fast Fourier transform, (ii) available analytical exact solutions obtained in linear viscoelasticity and (iii) homogenization methods based on variational approaches. Developments of the AI model are obtained for linear and non-linear material responses while results for the TF method are shown for the linear case. Various configurations are considered: spherical inclusions, aligned fibers, hard and soft inclusions, large material contrasts between phases, volume-preserving versus dilatant anelastic flow, non-monotonic loading. The agreement between the AI and TF methods is excellent and the correlation with full field calculations is in general of quite good quality (with some exceptions for non-linear composites with a large volume fraction of very soft inclusions for which a discrepancy of about 15% was found for macroscopic stress). Description of the material behavior with internal variables can be accounted for with the AI and TF approaches and therefore complex loadings can be easily handled in contrast with most hereditary approaches. (paper)

  18. A comparison of the Bayesian and frequentist approaches to estimation

    CERN Document Server

    Samaniego, Francisco J

    2010-01-01

    This monograph contributes to the area of comparative statistical inference. Attention is restricted to the important subfield of statistical estimation. The book is intended for an audience having a solid grounding in probability and statistics at the level of the year-long undergraduate course taken by statistics and mathematics majors. The necessary background on Decision Theory and the frequentist and Bayesian approaches to estimation is presented and carefully discussed in Chapters 1-3. The 'threshold problem' - identifying the boundary between Bayes estimators which tend to outperform st

  19. A comprehensive comparison of comparative RNA structure prediction approaches

    DEFF Research Database (Denmark)

    Gardner, P. P.; Giegerich, R.

    2004-01-01

    -finding and multiple-sequence-alignment algorithms. Results Here we evaluate a number of RNA folding algorithms using reliable RNA data-sets and compare their relative performance. Conclusions We conclude that comparative data can enhance structure prediction but structure-prediction-algorithms vary widely in terms......Background An increasing number of researchers have released novel RNA structure analysis and prediction algorithms for comparative approaches to structure prediction. Yet, independent benchmarking of these algorithms is rarely performed as is now common practice for protein-folding, gene...

  20. Comparison of interbody fusion approaches for disabling low back pain.

    Science.gov (United States)

    Hacker, R J

    1997-03-15

    This is a study comparing two groups of patients surgically treated for disabling low back pain. One group was treated with lumbar anteroposterior fusion (360 degrees fusion), the other with posterior lumbar interbody fusion and an interbody fixation device. To determine which approach provided the best and most cost-effective outcome using similar patient selection criteria. Others have shown that certain patients with disabling low back pain benefit from lumbar fusion. Although rarely reported, the costs of different surgical treatments appear to vary significantly, whereas the patient outcome may vary little. Since 1991, 75 patients have been treated Starting in 1993, posterior lumbar interbody fusion BAK was offered to patients as an alternative to 360 degrees fusion. The treating surgeon reviewed the cases. The interbody fixation device used (BAK; Spine-Tech, Inc., Minneapolis, MN) was part of a Food and Drug Administration study. Patient selection criteria included examination, response to conservative therapy, imaging, psychological profile, and discography. North American Spine Society outcome questionnaires, BAK investigation data radiographs, chart entries, billing records and patient interviews were the basis for assessment. Age, sex compensable injury history and history of previous surgery were similar. Operative time; blood loss, hospitalization time, and total costs were significantly different. There was a quicker return to work and closure of workers compensation claims for the posterior lumbar interbody fusion-BAK group. Patient satisfaction was comparable at last follow-up. Posterior lumbar interbody fusion-BAK achieves equal patient satisfaction but fiscally surpasses the 360 degrees fusion approach. Today's environment of regulated medical practice requires the surgeon to consider cost effectiveness when performing fusion for low back pain.

  1. Evaluating models of population process in a threatened population of Steller’s eiders: A retrospective approach

    Science.gov (United States)

    Dunham, Kylee; Grand, James B.

    2016-10-11

    The Alaskan breeding population of Steller’s eiders (Polysticta stelleri) was listed as threatened under the Endangered Species Act in 1997 in response to perceived declines in abundance throughout their breeding and nesting range. Aerial surveys suggest the breeding population is small and highly variable in number, with zero birds counted in 5 of the last 25 years. Research was conducted to evaluate competing population process models of Alaskan-breeding Steller’s eiders through comparison of model projections to aerial survey data. To evaluate model efficacy and estimate demographic parameters, a Bayesian state-space modeling framework was used and each model was fit to counts from the annual aerial surveys, using sequential importance sampling and resampling. The results strongly support that the Alaskan breeding population experiences population level nonbreeding events and is open to exchange with the larger Russian-Pacific breeding population. Current recovery criteria for the Alaskan breeding population rely heavily on the ability to estimate population viability. The results of this investigation provide an informative model of the population process that can be used to examine future population states and assess the population in terms of the current recovery and reclassification criteria.

  2. Erroneous cardiac ECG-gated PET list-mode trigger events can be retrospectively identified and replaced by an offline reprocessing approach: first results in rodents

    International Nuclear Information System (INIS)

    Böning, Guido; Todica, Andrei; Vai, Alessandro; Lehner, Sebastian; Xiong, Guoming; Mille, Erik; Ilhan, Harun; Fougère, Christian la; Bartenstein, Peter; Hacker, Marcus

    2013-01-01

    The assessment of left ventricular function, wall motion and myocardial viability using electrocardiogram (ECG)-gated [ 18 F]-FDG positron emission tomography (PET) is widely accepted in human and in preclinical small animal studies. The nonterminal and noninvasive approach permits repeated in vivo evaluations of the same animal, facilitating the assessment of temporal changes in disease or therapy response. Although well established, gated small animal PET studies can contain erroneous gating information, which may yield to blurred images and false estimation of functional parameters. In this work, we present quantitative and visual quality control (QC) methods to evaluate the accuracy of trigger events in PET list-mode and physiological data. Left ventricular functional analysis is performed to quantify the effect of gating errors on the end-systolic and end-diastolic volumes, and on the ejection fraction (EF). We aim to recover the cardiac functional parameters by the application of the commonly established heart rate filter approach using fixed ranges based on a standardized population. In addition, we propose a fully reprocessing approach which retrospectively replaces the gating information of the PET list-mode file with appropriate list-mode decoding and encoding software. The signal of a simultaneously acquired ECG is processed using standard MATLAB vector functions, which can be individually adapted to reliably detect the R-peaks. Finally, the new trigger events are inserted into the PET list-mode file. A population of 30 mice with various health statuses was analyzed and standard cardiac parameters such as mean heart rate (119 ms ± 11.8 ms) and mean heart rate variability (1.7 ms ± 3.4 ms) derived. These standard parameter ranges were taken into account in the QC methods to select a group of nine optimal gated and a group of eight sub-optimal gated [ 18 F]-FDG PET scans of mice from our archive. From the list-mode files of the optimal gated group

  3. A retrospective approach to assess human health risks associated with growing air pollution in urbanized area of Thar Desert, western Rajasthan, India.

    Science.gov (United States)

    Rumana, Harcharan Singh; Sharma, Ramesh Chandra; Beniwal, Vikas; Sharma, Anil Kumar

    2014-01-09

    : Air pollution has been a matter of great concern globally because of the associated health risks to individuals. The situation is getting worse in developing countries with more urbanization, industrialization and more importantly the rapidly growing population posing a threat to human life in the form of pulmonary, cardiovascular, carcinogenic or asthmatic diseases by accumulating toxic pollutants, harmful gases, metals, hydrocarbons etc. The present study was undertaken to assess the magnitude of ambient air pollutants and their human health risks like respiratory ailments, infectious diseases, cardiovascular diseases and cancer using a Retrospective Approach of Bart Ostra. The parameters PM2.5, PM10, NOx, SO2, NH3 and O3 were monitored at all selected study sites monitored through a high volume sampler (APM 451 Envirotech, Envirotech Instruments Pvt. Ltd., New Delhi, India). Retrospective Approach was used for assessment of risk factors and disease burden of respiratory and cardiopulmonary health problems. Environmental burden of disease showed that the problem of health related to air pollution is a main concern particularly in the growing cities of India. High to critical level of air pollution including PM10, PM2.5, NOx, SO2, NH3 and O3 was observed in all seasons at traffic intersections and commercial sites. The respiratory infections (25% incidence in population exposed to indoor smoke problems) and a prevalence of asthma/COPD (4.4%) in households exposed to high vehicular pollution along with signs of coronary artery/heart disease and/or hypertension and cancers (37.9-52.2%), were reported requiring preventive measures. The study reflects a great concern for the mankind with the need of having streamline ways to limit air pollution and emphasize upon efficiently determining the risk of illness upon exposure to air pollution.

  4. Comparison of Salivary pH, Buffering Capacity and Alkaline Phosphatase in Smokers and Healthy Non-Smokers: Retrospective cohort study.

    Science.gov (United States)

    Ahmadi-Motamayel, Fatemeh; Falsafi, Parisa; Goodarzi, Mohammad T; Poorolajal, Jalal

    2016-08-01

    Saliva contains alkaline phosphatase (ALP)-a key intracellular enzyme related to destructive processes and cellular damage-and has buffering capacity (BC) against acids due to the presence of bicarbonate and phosphate ions. Smoking may have deleterious effects on the oral environment due to pH changes which can affect ALP activity. This study aimed to evaluate the salivary pH, BC and ALP activity of male smokers and healthy non-smokers. This retrospective cohort study took place between August 2012 and December 2013. A total of 251 healthy male non-smokers and 259 male smokers from Hamadan, Iran, were selected. Unstimulated whole saliva was collected from each participant and pH and BC were determined using a pH meter. Salivary enzymes were measured by spectrophotometric assay. Mean salivary pH (7.42 ± 0.48 and 7.52 ± 0.43, respectively; P = 0.018) and BC (3.41 ± 0.54 and 4.17 ± 0.71; P = 0.001) was significantly lower in smokers compared to non-smokers. Mean ALP levels were 49.58 ± 23.33 IU/L among smokers and 55.11 ± 27.85 IU/L among non-smokers (P = 0.015). Significantly lower pH, BC and ALP levels were observed among smokers in comparison to a healthy control group. These salivary alterations could potentially be utilised as biochemical markers for the evaluation of oral tissue function and side-effects among smokers. Further longitudinal studies are recommended to evaluate the effects of smoking on salivary components.

  5. Comparison of Salivary pH, Buffering Capacity and Alkaline Phosphatase in Smokers and Healthy Non-Smokers; Retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Fatemeh Ahmadi-Motamayel

    2016-08-01

    Full Text Available Objectives: Saliva contains alkaline phosphatase (ALP—a key intracellular enzyme related to destructive processes and cellular damage—and has buffering capacity (BC against acids due to the presence of bicarbonate and phosphate ions. Smoking may have deleterious effects on the oral environment due to pH changes which can affect ALP activity. This study aimed to evaluate the salivary pH, BC and ALP activity of male smokers and healthy non-smokers. Methods: This retrospective cohort study took place between August 2012 and December 2013. A total of 251 healthy male non-smokers and 259 male smokers from Hamadan, Iran, were selected. Unstimulated whole saliva was collected from each participant and pH and BC were determined using a pH meter. Salivary enzymes were measured by spectrophotometric assay. Results: Mean salivary pH (7.42 ± 0.48 and 7.52 ± 0.43, respectively; P = 0.018 and BC (3.41 ± 0.54 and 4.17 ± 0.71; P = 0.001 was significantly lower in smokers compared to non-smokers. Mean ALP levels were 49.58 ± 23.33 IU/L among smokers and 55.11 ± 27.85 IU/L among non-smokers (P = 0.015. Conclusion: Significantly lower pH, BC and ALP levels were observed among smokers in comparison to a healthy control group. These salivary alterations could potentially be utilised as biochemical markers for the evaluation of oral tissue function and side-effects among smokers. Further longitudinal studies are recommended to evaluate the effects of smoking on salivary components.

  6. [Comparison of dignity determination of mammographic microcalcification with two systems for digital full-field mammography with different detector resolution: a retrospective clinical study].

    Science.gov (United States)

    Schulz-Wendtland, R; Hermann, K-P; Adamietz, B; Meier-Meitinger, M; Wenkel, E; Lell, M; Anders, K; Uder, M

    2011-02-01

    The aim of this retrospective clinical study was to compare the diagnostic accuracy of the novel 50 µm FFDM (full-field digital mammography) system (DR) with an established 70 µm system (DR) in the differential diagnosis between benign and malignant clusters of microcalcification (n=50) (BI-RADS™ classification 4/5) and to assess the possible incremental value of the 50 µm pixel-pitch on specificity. From March 2009 to September 2009, 50 patients underwent full-field digital mammography (FFDM) (detector resolution 70 µm) (Novation, Siemens, Erlangen, Germany). As there were suspicious signs of microcalcification classified with BI-RADS™ 4/5 after diagnosis and preoperative wire localization, control images were made with the new FFDM system (detector: resolution 50 µm) (Amulet, Fujifilm, Tokyo, Japan) with the same exposure parameters. The diagnosis was determined after the operation by five radiologists with different experience in digital mammography from randomly distributed mediolateral views (monitor reading) whose results were correlated with the final histology of all lesions. Histopathology revealed 19 benign and 31 malignant lesions in 50 patients after open biopsy. The results of the five readers showed a higher sensitivity of the new FFDM system (80.0%) in the ability to recognize malignant microcalcification in comparison to the established system (74.8%). The specificity (75.8 versus 71.6%) was slightly higher for the new system but these results were not statistically significant (pdetector: resolution 50 µm) was also slightly superior to the well-known system (detector: resolution 70 µm) (80.1% versus 76.4%). Our study has shown that the new full-field digital mammography system using the novel detector compared with the already established FFDM system with respect to the assessment of microcalcification is at least equivalent.

  7. A Retrospective Comparison of Robotic Stereotactic Body Radiotherapy and Three-Dimensional Conformal Radiotherapy for the Reirradiation of Locally Recurrent Nasopharyngeal Carcinoma

    International Nuclear Information System (INIS)

    Ozyigit, Gokhan; Cengiz, Mustafa; Yazici, Gozde; Yildiz, Ferah; Gurkaynak, Murat; Zorlu, Faruk; Yildiz, Demet; Hosal, Sefik; Gullu, Ibrahim; Akyol, Fadil

    2011-01-01

    Purpose: We assessed therapeutic outcomes of reirradiation with robotic stereotactic radiotherapy (SBRT) for locally recurrent nasopharyngeal carcinoma (LRNPC) patients and compared those results with three-dimensional conformal radiotherapy (CRT) with or without brachytherapy (BRT). Methods and Materials: Treatment outcomes were evaluated retrospectively in 51 LRNPC patients receiving either robotic SBRT (24 patients) or CRT with or without BRT (27 patients) in our department. CRT was delivered with a 6-MV linear accelerator, and a median total reirradiation dose of 57 Gy in 2 Gy/day was given. Robotic SBRT was delivered with CyberKnife (Accuray, Sunnyvale, CA). Patients in the SBRT arm received 30 Gy over 5 consecutive days. We calculated actuarial local control and cancer-specific survival rates for the comparison of treatment outcomes in SBRT and CRT arms. The Common Terminology Criteria for Adverse Events v3.0 was used for toxicity evaluation. Results: The median follow-up was 24 months for all patients. Two-year actuarial local control rates were 82% and 80% for SBRT and CRT arms, respectively (p = 0.6). Two-year cancer-specific survival rates were 64% and 47% for the SBRT and CRT arms, respectively (p = 0.4). Serious late toxicities (Grade 3 and above) were observed in 21% of patients in the SBRT arm, whereas 48% of patients had serious toxicity in the CRT arm (p = 0.04). Fatal complications occurred in three patients (12.5%) of the SBRT arm, and four patients (14.8%) of the CRT arm (p = 0.8). T stage at recurrence was the only independent predictor for local control and survival. Conclusion: Our robotic SBRT protocol seems to be feasible and less toxic in terms of late effects compared with CRT arm for the reirradiation of LRNPC patients.

  8. Comparison of four approaches to a rock facies classification problem

    Science.gov (United States)

    Dubois, M.K.; Bohling, Geoffrey C.; Chakrabarti, S.

    2007-01-01

    In this study, seven classifiers based on four different approaches were tested in a rock facies classification problem: classical parametric methods using Bayes' rule, and non-parametric methods using fuzzy logic, k-nearest neighbor, and feed forward-back propagating artificial neural network. Determining the most effective classifier for geologic facies prediction in wells without cores in the Panoma gas field, in Southwest Kansas, was the objective. Study data include 3600 samples with known rock facies class (from core) with each sample having either four or five measured properties (wire-line log curves), and two derived geologic properties (geologic constraining variables). The sample set was divided into two subsets, one for training and one for testing the ability of the trained classifier to correctly assign classes. Artificial neural networks clearly outperformed all other classifiers and are effective tools for this particular classification problem. Classical parametric models were inadequate due to the nature of the predictor variables (high dimensional and not linearly correlated), and feature space of the classes (overlapping). The other non-parametric methods tested, k-nearest neighbor and fuzzy logic, would need considerable improvement to match the neural network effectiveness, but further work, possibly combining certain aspects of the three non-parametric methods, may be justified. ?? 2006 Elsevier Ltd. All rights reserved.

  9. Comparison of Resource Platform Selection Approaches for Scientific Workflows

    Energy Technology Data Exchange (ETDEWEB)

    Simmhan, Yogesh; Ramakrishnan, Lavanya

    2010-03-05

    Cloud computing is increasingly considered as an additional computational resource platform for scientific workflows. The cloud offers opportunity to scale-out applications from desktops and local cluster resources. At the same time, it can eliminate the challenges of restricted software environments and queue delays in shared high performance computing environments. Choosing from these diverse resource platforms for a workflow execution poses a challenge for many scientists. Scientists are often faced with deciding resource platform selection trade-offs with limited information on the actual workflows. While many workflow planning methods have explored task scheduling onto different resources, these methods often require fine-scale characterization of the workflow that is onerous for a scientist. In this position paper, we describe our early exploratory work into using blackbox characteristics to do a cost-benefit analysis across of using cloud platforms. We use only very limited high-level information on the workflow length, width, and data sizes. The length and width are indicative of the workflow duration and parallelism. The data size characterizes the IO requirements. We compare the effectiveness of this approach to other resource selection models using two exemplar scientific workflows scheduled on desktops, local clusters, HPC centers, and clouds. Early results suggest that the blackbox model often makes the same resource selections as a more fine-grained whitebox model. We believe the simplicity of the blackbox model can help inform a scientist on the applicability of cloud computing resources even before porting an existing workflow.

  10. A Comparison of the Approaches to Customer Experience Analysis

    Directory of Open Access Journals (Sweden)

    Havíř David

    2017-08-01

    Full Text Available Nowadays, customer experience is receiving much attention in scientific and managerial community. Scholars and practitioners state that customer experience is the next area of competition. For a long time, there has been a call for a uniform, accurate definition, definition of its components, and the development of the customer experience frameworks. As this topic is new, there has been a considerable fragmentation. The question is if the fragmentation is still present and how can we address it. The aim of this paper is to summarize research on customer experience analysis and to explore and compare the dimensions describing customer experience listed in seven conceptual models with findings from 17 research projects on customer experience conducted after the year 2010. The purpose of this is to summarize recent knowledge, get the most comprehensive view on customer experience and its possible decomposition, and to reveal possible relationships between the dimensions. Based on a review of the available literature, the paper juxtaposes several approaches to customer experience analysis and compares their results to find similarities and differences among them. In the first step, the dimensions and factors of the customer experience were extracted from the seven models to analyze customer experience and they were compared with each other. This resulted in a set of dimensions and factors. In the next step, customer experience factors and dimensions were extracted from 17 practical research papers on customer experience. Finally, based on their descriptions and found similarities, the dimensions and factors were put together into several groups, as this grouping and creation of the new universal set of dimensions might solve the fragmentation issue.

  11. Comparison of wind mill cluster performance: A multicriteria approach

    Energy Technology Data Exchange (ETDEWEB)

    Rajakumar, D.G.; Nagesha, N. [Visvesvaraya Technological Univ., Karnataka (India)

    2012-07-01

    Energy is a crucial input for the economic and social development of any nation. Both renewable and non-renewable energy contribute in meeting the total requirement of the economy. As an affordable and clean energy source, wind energy is amongst the world's fastest growing renewable energy forms. Though there are several wind-mill clusters producing energy in different geographical locations, evaluating their performance is a complex task and not much of literature is available in this area. In this backdrop, an attempt is made in the current paper to estimate the performance of a wind-mill cluster through an index called Cluster Performance Index (CPI) adopting a multi-criteria approach. The proposed CPI comprises four criteria viz., Technical Performance Indicators (TePI), Economic Performance Indicators (EcPI), Environmental Performance Indicators (EnPI), and Sociological Performance Indicators (SoPI). Under each performance criterion a total of ten parameters are considered with five subjective and five objective oriented responses. The methodology is implemented by collecting empirical data from three wind-mill clusters located at Chitradurga, Davangere, and Gadag in the southern Indian State of Karnataka. Totally fifteen different stake holders are consulted through a set of structured researcher administered questionnaire to collect the relevant data in each wind farm. Stake holders involved engineers working in wind farms, wind farm developers, Government officials from energy department and a few selected residential people near the wind farms. The results of the study revealed that Chitradurga wind farm performed much better with a CPI of 45.267 as compared to Gadag (CPI of 28.362) and Davangere (CPI of 19.040) wind farms. (Author)

  12. Use of an excess variance approach for the certification of reference materials by interlaboratory comparison

    International Nuclear Information System (INIS)

    Crozet, M.; Rigaux, C.; Roudil, D.; Tuffery, B.; Ruas, A.; Desenfant, M.

    2014-01-01

    In the nuclear field, the accuracy and comparability of analytical results are crucial to insure correct accountancy, good process control and safe operational conditions. All of these require reliable measurements based on reference materials whose certified values must be obtained by robust metrological approaches according to the requirements of ISO guides 34 and 35. The data processing of the characterization step is one of the key steps of a reference material production process. Among several methods, the use of interlaboratory comparison results for reference material certification is very common. The DerSimonian and Laird excess variance approach, described and implemented in this paper, is a simple and efficient method for the data processing of interlaboratory comparison results for reference material certification. By taking into account not only the laboratory uncertainties but also the spread of the individual results into the calculation of the weighted mean, this approach minimizes the risk to get biased certified values in the case where one or several laboratories either underestimate their measurement uncertainties or do not identify all measurement biases. This statistical method has been applied to a new CETAMA plutonium reference material certified by interlaboratory comparison and has been compared to the classical weighted mean approach described in ISO Guide 35. This paper shows the benefits of using an 'excess variance' approach for the certification of reference material by interlaboratory comparison. (authors)

  13. Evaluating response shift in training evaluation: comparing the retrospective pretest with an adapted measurement invariance approach in a classroom management training program.

    Science.gov (United States)

    Piwowar, Valentina; Thiel, Felicitas

    2014-10-01

    Response shift (RS) can threaten the internal validity of pre-post designs. As RS may indicate a redefinition of the target construct, its occurrence in training evaluation is rather likely. The most common approach to deal with RS is to implement a retrospective pretest (then-test) instead of the traditional pre-test. In health psychology, an adapted measurement invariance approach (MIad) was developed as an alternative technique to study RS. Results produced by identifying RS with the two approaches were rarely studied simultaneously or within an experimental framework. To study RS in two different treatment conditions and compare results produced by both techniques in identifying various types of RS. We further studied validity aspects of the then-test. We evaluated RS by applying the then-test procedure (TP) and the measurement invariance apporach MIad within an experimental design: Participants either attended a short-term or a long-term classroom management training program. Participants were 146 student teachers in their first year of master's study. Pre (before training), post, and then self-ratings (after training) on classroom management knowledge were administered. Results indicated that the two approaches do not yield the same results. The MIad identified more and also group-specific RS as opposed to the findings of the TP, which found less and only little evidence for group-specific RS. Further research is needed to study the usability and validity of the respective approaches. In particular, the usability of the then-test seems to be challenged. © The Author(s) 2014.

  14. Comparison of qualitative and quantitative approach to prostate MR spectroscopy in peripheral zone cancer detection

    International Nuclear Information System (INIS)

    Klijn, Stijn; De Visschere, Pieter J.; De Meerleer, Gert O.; Villeirs, Geert M.

    2012-01-01

    Objective: To compare the diagnostic performance of a qualitative (pattern recognition) and a quantitative (numerical assessment) approach to magnetic resonance spectroscopy (MRS) in the diagnosis of peripheral zone prostate cancer. Methods: 185 patients (131 with histopathologically proven cancer, 54 normal/benign after at least 12 months follow-up) were prospectively evaluated with qualitative MRS using a 4-point scale between 3/2004 and 1/2008, and retrospectively reassessed using a prototype quantitative postprocessing software in April 2008. Based on pathology and follow-up data, diagnostic performance parameters were calculated. Results: The qualitative and quantitative approaches were concordant in 78.9% (146/185) of cases. The difference between the areas under the ROC curve (0.791 versus 0.772, respectively) was not statistically significant. The sensitivity, specificity and accuracy were 55.7%, 94.4% and 67.0% for the qualitative approach, and 55.0%, 83.3% and 63.2% for the quantitative approach. The sensitivity for high grade tumours (Gleason 4 + 3 or higher) was 85.2% (23/27) for both approaches. All cancers missed on either one approach separately (31/31) and 91% of cancers missed on both approaches together (23/27) were of lower grade (Gleason 3 + 4 or lower). Conclusions: Qualitative and quantitative approaches to MRS yield similar diagnostic results. Discordances in tumour detection only occurred in lower grade cancers.

  15. A shell-neutral modeling approach yields sustainable oyster harvest estimates: a retrospective analysis of the Louisiana state primary seed grounds

    Science.gov (United States)

    Soniat, Thomas M.; Klinck, John M.; Powell, Eric N.; Cooper, Nathan; Abdelguerfi, Mahdi; Hofmann, Eileen E.; Dahal, Janak; Tu, Shengru; Finigan, John; Eberline, Benjamin S.; La Peyre, Jerome F.; LaPeyre, Megan K.; Qaddoura, Fareed

    2012-01-01

    A numerical model is presented that defines a sustainability criterion as no net loss of shell, and calculates a sustainable harvest of seed (<75 mm) and sack or market oysters (≥75 mm). Stock assessments of the Primary State Seed Grounds conducted east of the Mississippi from 2009 to 2011 show a general trend toward decreasing abundance of sack and seed oysters. Retrospective simulations provide estimates of annual sustainable harvests. Comparisons of simulated sustainable harvests with actual harvests show a trend toward unsustainable harvests toward the end of the time series. Stock assessments combined with shell-neutral models can be used to estimate sustainable harvest and manage cultch through shell planting when actual harvest exceeds sustainable harvest. For exclusive restoration efforts (no fishing allowed), the model provides a metric for restoration success-namely, shell accretion. Oyster fisheries that remove shell versus reef restorations that promote shell accretion, although divergent in their goals, are convergent in their management; both require vigilant attention to shell budgets.

  16. On the equivalence of generalized least-squares approaches to the evaluation of measurement comparisons

    Science.gov (United States)

    Koo, A.; Clare, J. F.

    2012-06-01

    Analysis of CIPM international comparisons is increasingly being carried out using a model-based approach that leads naturally to a generalized least-squares (GLS) solution. While this method offers the advantages of being easier to audit and having general applicability to any form of comparison protocol, there is a lack of consensus over aspects of its implementation. Two significant results are presented that show the equivalence of three differing approaches discussed by or applied in comparisons run by Consultative Committees of the CIPM. Both results depend on a mathematical condition equivalent to the requirement that any two artefacts in the comparison are linked through a sequence of measurements of overlapping pairs of artefacts. The first result is that a GLS estimator excluding all sources of error common to all measurements of a participant is equal to the GLS estimator incorporating all sources of error, including those associated with any bias in the standards or procedures of the measuring laboratory. The second result identifies the component of uncertainty in the estimate of bias that arises from possible systematic effects in the participants' measurement standards and procedures. The expression so obtained is a generalization of an expression previously published for a one-artefact comparison with no inter-participant correlations, to one for a comparison comprising any number of repeat measurements of multiple artefacts and allowing for inter-laboratory correlations.

  17. Next-Generation Mitogenomics: A Comparison of Approaches Applied to Caecilian Amphibian Phylogeny

    OpenAIRE

    Maddock, Simon T.; Briscoe, Andrew G.; Wilkinson, Mark; Waeschenbach, Andrea; San Mauro, Diego; Day, Julia J.; Littlewood, D. Tim J.; Foster, Peter G.; Nussbaum, Ronald A.; Gower, David J.

    2016-01-01

    Mitochondrial genome (mitogenome) sequences are being generated with increasing speed due to the advances of next-generation sequencing (NGS) technology and associated analytical tools. However, detailed comparisons to explore the utility of alternative NGS approaches applied to the same taxa have not been undertaken. We compared a ‘traditional’ Sanger sequencing method with two NGS approaches (shotgun sequencing and non-indexed, multiplex amplicon sequencing) on four different sequencing pla...

  18. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong [Huazhong University of Science and Technology, Cancer Center, Union Hospital, Tongji Medical College, Wuhan (China)

    2017-08-15

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. (orig.)

  19. Preliminary comparison of the endoscopic transnasal vs the sublabial transseptal approach for clinically nonfunctioning pituitary macroadenomas.

    Science.gov (United States)

    Sheehan, M T; Atkinson, J L; Kasperbauer, J L; Erickson, B J; Nippoldt, T B

    1999-07-01

    To assess the advantages and disadvantages of an endoscopic transnasal approach to pituitary surgery for a select group of clinically nonfunctioning macroadenomas and to compare results of this approach with the sublabial transseptal approach at a single institution. We retrospectively reviewed the records of 26 patients with clinically nonfunctioning pituitary macroadenomas approached endoscopically and 44 matched control patients with the same tumors approached sublabially between January 1, 1995, and October 31, 1997. At baseline, the groups were not significantly different for age, sex distribution, number of comorbid conditions, visual field defects, degree of anterior pituitary insufficiency, or preoperative assessment of tumor volume or invasiveness. Mean (SD) operative times were significantly reduced in the endoscopic group vs the sublabial group: 2.7 (0.7) hours vs 3.4 (0.9) hours (P working channel to the sella turcica. For these reasons, the endoscopic approach or its variation is an alternative to the sublabial approach but should be considered only by experienced pituitary neurosurgeons.

  20. Fluoroscopically-Guided Posterior Approach for Shoulder Magnetic Resonance Arthrography: Comparison with Conventional Anterior Approach

    International Nuclear Information System (INIS)

    Yoo, Koun J.; Ha, Doo Hoe; Lee, Sang Min

    2011-01-01

    To prospectively evaluate the usefulness of the fluoroscopically-guided posterior approach compared with the anterior approach for shoulder magnetic resonance(MR) arthrography. Institutional review board approval and informed consent were obtained. Among 60 shoulder MR arthrographies performed on 59 patients with symptomatic shoulders, an intra-articular injection was performed (30 cases using the anterior approach and 30 using the posterior approach). Procedure-related pain was assessed by using a 5 score visual analogue scale (VAS). Depth of the puncture and standardized depth of puncture by body mass index (BMI) were recorded. The contrast leakage along the course of the puncture was evaluated by reviewing the MR. The statistical analyses included the Mann-Whitney U and Kruskal-Wallis test. There was no significant difference in VAS scores between the anterior and posterior groups (1.77 ± 1.10 vs. 1.80 ± 0.96). Depth of puncture and standardized depth of puncture by BMI were significantly shorter in the posterior group than those in the anterior group (4.4 ± 0.8 cm and 1.8 ± 0.3 cm vs. 6.6 ± 0.9 cm and 2.8 ± 0.4 cm, p < 0.001), respectively. The incidence of contrast leakage was more frequent in the posterior group (p = 0.003). The posterior approach will be useful in shoulder MR arthrography with a suspected anterior pathology, a postoperative follow-up study or obese patient.

  1. Assessing the Accuracy of Generalized Inferences From Comparison Group Studies Using a Within-Study Comparison Approach: The Methodology.

    Science.gov (United States)

    Jaciw, Andrew P

    2016-06-01

    Various studies have examined bias in impact estimates from comparison group studies (CGSs) of job training programs, and in education, where results are benchmarked against experimental results. Such within-study comparison (WSC) approaches investigate levels of bias in CGS-based impact estimates, as well as the success of various design and analytic strategies for reducing bias. This article reviews past literature and summarizes conditions under which CGSs replicate experimental benchmark results. It extends the framework to, and develops the methodology for, situations where results from CGSs are generalized to untreated inference populations. Past research is summarized; methods are developed to examine bias in program impact estimates based on cross-site comparisons in a multisite trial that are evaluated against site-specific experimental benchmarks. Students in Grades K-3 in 79 schools in Tennessee; students in Grades 4-8 in 82 schools in Alabama. Grades K-3 Stanford Achievement Test (SAT) in reading and math scores; Grades 4-8 SAT10 reading scores. Past studies show that bias in CGS-based estimates can be limited through strong design, with local matching, and appropriate analysis involving pretest covariates and variables that represent selection processes. Extension of the methodology to investigate accuracy of generalized estimates from CGSs shows bias from confounders and effect moderators. CGS results, when extrapolated to untreated inference populations, may be biased due to variation in outcomes and impact. Accounting for effects of confounders or moderators may reduce bias. © The Author(s) 2016.

  2. Surveillance of Salmonella enteritidis in layer houses: a retrospective comparison of the Food and Drug Administration's egg safety rule (2010-2011) and the California Egg Quality Assurance Program (2007-2011).

    Science.gov (United States)

    Pitesky, Maurice; Charlton, Bruce; Bland, Mark; Rolfe, Dan

    2013-03-01

    Between July 2007 and December 2011, 2660 environmental drag swab samples were collected in total from California layer flocks on behalf of the California Egg Quality Assurance Program (CEQAP), the egg safety rule (21 CFR Parts 16 and 118) of the Food and Drug Administration (FDA), or both. The samples were processed by the California Animal Health and Food Safety Lab, and positive or negative results for Salmonella enterica serovar Enteritidis (SE) were recorded. This study retrospectively compares the differences between the FDA and CEQAP programs with respect to their SE environmental sampling surveillance results. To accomplish this comparison, two different CEQAP (new and old) data sets representing different SE environmental surveillance approaches in the life of the flock were compared against each other and against the FDA's SE environmental testing plan. Significant differences were noted between the CEQAP and FDA programs with respect to the prevalence of SE in the farm environment. Analyses of the prevalence of SE at different stages in the flock's life cycle (chick papers, preproduction, midproduction, postmolt, and premarket) found the highest prevalence of SE in premarket (11.9%), followed by postmolt (3.5%) and midproduction (3.4%), and there was a tie between chick papers and preproduction (2.1%). To assess the main effects of the presence of SE in the farm environment, backwards binary logistic regression was used. Of six independent variables examined (age of flock, year, season, owner, CEQAP membership, and analysis of pooled samples vs. individual swabs), only age of flock, owner, and year were determined to be significant factors in the final model. Although CEQAP membership and pooling vs. individuals swabs were not included in the final model, Pearson chi-square tests did show significantly higher odds of SE for non-CEQAP member farms and higher odds of SE in pooled samples vs. individual swabs.

  3. Robotic longitudinal pancreaticojejunostomy for chronic pancreatitis: Comparison of clinical outcomes and cost to the open approach.

    Science.gov (United States)

    Kirks, Russell C; Lorimer, Patrick D; Fruscione, Michael; Cochran, Allyson; Baker, Erin H; Iannitti, David A; Vrochides, Dionisios; Martinie, John B

    2017-09-01

    This study compares clinical and cost outcomes of robot-assisted laparoscopic (RAL) and open longitudinal pancreaticojejunostomy (LPJ) for chronic pancreatitis. Clinical and cost data were retrospectively compared between open and RAL LPJ performed at a single center from 2008-2015. Twenty-six patients underwent LPJ: 19 open and 7 RAL. Two robot-assisted cases converted to open were included in the open group for analysis. Patients undergoing RAL LPJ had less intraoperative blood loss, a shorter surgical length of stay, and lower medication costs. Operation supply cost was higher in the RAL group. No difference in hospitalization cost was found. Versus the open approach, RAL LPJ performed for chronic pancreatitis shortens hospitalization and reduces medication costs; hospitalization costs are equivalent. A higher operative cost for RAL LPJ is mitigated by a shorter hospitalization. Decreased morbidity and healthcare resource economy support use of the robotic approach for LPJ when appropriate. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Lei; Yang, Lin; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); Wang, Yining; Jin, Zhengyu [Chinese Academy of Medical Sciences, Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Zhang, Longjiang; Lu, Guangming [Nanjing University, Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing, Jiangsu (China)

    2013-07-15

    To investigate the feasibility of applying prospectively ECG-triggered sequential coronary CT angiography (CCTA) to patients with atrial fibrillation (AF) and evaluate the image quality and radiation dose compared with a retrospectively ECG-gated helical protocol. 100 patients with persistent AF were enrolled. Fifty patients were randomly assigned to a prospective protocol and the other patients to a retrospective protocol using a second-generation dual-source CT (DS-CT). Image quality was evaluated using a four-point grading scale (1 = excellent, 2 = good, 3 = moderate, 4 = poor) by two reviewers on a per-segment basis. The coronary artery segments were considered non-diagnostic with a quality score of 4. The radiation dose was evaluated. Diagnostic segment rate in the prospective group was 99.4 % (642/646 segments), while that in the retrospective group was 96.5 % (604/626 segments) (P < 0.001). Effective dose was 4.29 {+-} 1.86 and 11.95 {+-} 5.34 mSv for each of the two protocols (P < 0.001), which was a 64 % reduction in the radiation dose for prospective sequential imaging compared with retrospective helical imaging. In AF patients, prospectively ECG-triggered sequential CCTA is feasible using second-generation DS-CT and can decrease >60 % radiation exposure compared with retrospectively ECG-gated helical imaging while improving diagnostic image quality. (orig.)

  5. Probabilistic approach to decision making under uncertainty during volcanic crises. Retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands

    Science.gov (United States)

    Sobradelo, Rosa; Martí, Joan; Kilburn, Christopher; López, Carmen

    2014-05-01

    Understanding the potential evolution of a volcanic crisis is crucial to improving the design of effective mitigation strategies. This is especially the case for volcanoes close to densely-populated regions, where inappropriate decisions may trigger widespread loss of life, economic disruption and public distress. An outstanding goal for improving the management of volcanic crises, therefore, is to develop objective, real-time methodologies for evaluating how an emergency will develop and how scientists communicate with decision makers. Here we present a new model BADEMO (Bayesian Decision Model) that applies a general and flexible, probabilistic approach to managing volcanic crises. The model combines the hazard and risk factors that decision makers need for a holistic analysis of a volcanic crisis. These factors include eruption scenarios and their probabilities of occurrence, the vulnerability of populations and their activities, and the costs of false alarms and failed forecasts. The model can be implemented before an emergency, to identify actions for reducing the vulnerability of a district; during an emergency, to identify the optimum mitigating actions and how these may change as new information is obtained; and after an emergency, to assess the effectiveness of a mitigating response and, from the results, to improve strategies before another crisis occurs. As illustrated by a retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands, BADEMO provides the basis for quantifying the uncertainty associated with each recommended action as an emergency evolves, and serves as a mechanism for improving communications between scientists and decision makers.

  6. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years.

    Science.gov (United States)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong

    2017-08-01

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. • CT-guided core needle biopsy is an accurate technique for diagnosing mediastinal nodes. • The rates of complications are similar to those for pulmonary lesion biopsy. • Pneumothorax risk factors include distance from pleura to target lesion and number of visceral pleura. • Distance from pleura to target lesion is the risk factor for hemoptysis. • CT-guided core needle biopsy is an important diagnostic method for mediastinal nodes.

  7. COMPARISON OF THE TRADITIONAL STRENGTH OF MATERIALS APPROACH TO DESIGN WITH THE FRACTURE MECHANICS APPROACH

    International Nuclear Information System (INIS)

    Z. Ceylan

    2002-01-01

    The objective of this activity is to show that the use of the traditional strength of materials approach to the drip shield and the waste package (WP) designs is bounding and appropriate when compared to the fracture mechanics approach. The scope of this activity is limited to determining the failure assessment diagrams for the two materials at issue: Ti-7 and Alloy 22. This calculation is intended for use in support of the license application design of the drip shield and the WP. This activity is associated with the drip shield and the WP designs. The activity evaluation for work package number P32 12234F2, included in ''Technical Work Plan for: Waste Package Design Description for LA'' (Ref. 1, p. A-6), has determined that the development of this document is subject to ''Quality Assurance Requirements and Description'' requirements. The control of the electronic management of data is accomplished in accordance with the methods specified in Reference 1, Section 10. AP-3.124, ''Design Calculations and Analysis'' (Ref. 2), is used to develop and document the calculation

  8. Prospective ECG triggering versus low-dose retrospective ECG-gated 128-channel CT coronary angiography: comparison of image quality and radiation dose

    International Nuclear Information System (INIS)

    Feng, Q.; Yin, Y.; Hua, X.; Zhu, R.; Hua, J.; Xu, J.

    2010-01-01

    Aim: To evaluate image quality and radiation dose for 128-detector prospective electrocardiogram (ECG)-gated computed tomography coronary angiography (CTCA) compared with a low-dose retrospective ECG-gated imaging protocol. Materials and methods: Thirty-one and 47 patients suspected of having coronary artery disease were enrolled into groups examined using prospective and low-dose retrospective ECG-gated CT protocols respectively. All examinations were performed on a 128-detector CT system (Definition AS, Siemens Healthcare, Forchheim, Germany). Prospective CTCA was performed using following parameters: tube voltage 100 kV; tube current 205 mAs; centre of acquisition window 70% of the RR interval. The tube current for low-dose retrospective ECG-gated CTCA was full dose during 40-70% of the RR interval and partial dose for the rest of RR interval. The pitch varied between 0.2 and 0.5 depending on heart rate and patient size. Image quality of coronary arteries was evaluated using a four-point grading scale. The signal-to-noise ratios (SNRs) of enhanced arteries and myocardium were also measured, corresponding contrast-to-noise ratios (CNRs) were calculated, and the radiation doses received were recorded. Results: There was a significant difference in the image quality scores between the retrospective and prospective gating protocols (Chi-square = 15.331, p = 0.009). There was no significant difference between the SNRs of the contrasted artery and myocardium in these two groups, but the CNRs were increased in the prospective group. The mean radiation dose of prospective gating group was 2.71 ± 0.67 mSv (range, 1.67-3.59 mSv), which was significantly lower than that of the retrospective group (p < 0.001). Conclusion: Prospective CT angiography can achieve lower radiation dose than that of low-dose retrospective CT angiography, with preserved image quality.

  9. Prospective ECG triggering versus low-dose retrospective ECG-gated 128-channel CT coronary angiography: comparison of image quality and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Q.; Yin, Y.; Hua, X.; Zhu, R.; Hua, J. [Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (China); Xu, J., E-mail: xujianr@hotmail.co [Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (China)

    2010-10-15

    Aim: To evaluate image quality and radiation dose for 128-detector prospective electrocardiogram (ECG)-gated computed tomography coronary angiography (CTCA) compared with a low-dose retrospective ECG-gated imaging protocol. Materials and methods: Thirty-one and 47 patients suspected of having coronary artery disease were enrolled into groups examined using prospective and low-dose retrospective ECG-gated CT protocols respectively. All examinations were performed on a 128-detector CT system (Definition AS, Siemens Healthcare, Forchheim, Germany). Prospective CTCA was performed using following parameters: tube voltage 100 kV; tube current 205 mAs; centre of acquisition window 70% of the RR interval. The tube current for low-dose retrospective ECG-gated CTCA was full dose during 40-70% of the RR interval and partial dose for the rest of RR interval. The pitch varied between 0.2 and 0.5 depending on heart rate and patient size. Image quality of coronary arteries was evaluated using a four-point grading scale. The signal-to-noise ratios (SNRs) of enhanced arteries and myocardium were also measured, corresponding contrast-to-noise ratios (CNRs) were calculated, and the radiation doses received were recorded. Results: There was a significant difference in the image quality scores between the retrospective and prospective gating protocols (Chi-square = 15.331, p = 0.009). There was no significant difference between the SNRs of the contrasted artery and myocardium in these two groups, but the CNRs were increased in the prospective group. The mean radiation dose of prospective gating group was 2.71 {+-} 0.67 mSv (range, 1.67-3.59 mSv), which was significantly lower than that of the retrospective group (p < 0.001). Conclusion: Prospective CT angiography can achieve lower radiation dose than that of low-dose retrospective CT angiography, with preserved image quality.

  10. Prospective versus retrospective ECG gating for dual source CT of the coronary stent: Comparison of image quality, accuracy, and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Zhao Lei, E-mail: zhaolei219@sohu.com [Beijing Anzhen Hospital of the Capital University of Medical Sciences (China); Zhang Zhaoqi; Fan Zhanming; Yang Lin; Du Jing [Beijing Anzhen Hospital of the Capital University of Medical Sciences (China)

    2011-03-15

    Objective: To compare image quality, diagnostic accuracy and radiation dose of prospective and retrospective electrocardiogram (ECG) gated dual source computed tomography (DSCT) for the evaluation of the coronary stent, using conventional coronary angiography (CA) as a standard reference. Design, setting and patients: Sixty patients (heart rates {<=}70 bpm) with previous stent implantation who were scheduled for CA were divided in two groups, receiving either prospective or retrospective ECG gated DSCT separately. Two reviewers scored coronary stent image quality and evaluated stent lumen. Results: There was no significant difference in image quality between the two groups. In the prospective group, there were 86.4% (51/59) stents with interpretable images, in the retrospective group, there were 87.5% (49/56) stents with interpretable images. Image quality was not influenced by age, body mass index or heart rate in either group, but heart rate variability had a weak impact on the image quality of the prospective group. Image noise was higher in the prospective group, but this difference reached statistical significance only by using a smooth kernel reconstruction. Per-stent based sensitivity, specificity, and positive and negative predictive value were 100%, 84.1%, 68.2%, and 100%, respectively, in the prospective CT angiography group and 94.4%, 86.8%, 77.3%, and 97.1%, respectively, in the retrospective CT angiography group. There was a significant difference in the effective radiation dose between the two groups, mean effective dose in the prospective and retrospective group was 2.2 {+-} 0.5 mSv (1.5-3.2 mSv) and 14.6 {+-} 3.3 mSv (10.0-20.4 mSv) (p < .001) respectively. Conclusions: Compared with retrospective CT angiography, prospective CT angiography has a similar performance in assessing coronary stent patency, but a lower effective dose in selected patients with regular heart rates {<=}70 bpm.

  11. Comparison of mandibular stability after SSRO with surgery-first approach versus conventional ortho-first approach.

    Science.gov (United States)

    Akamatsu, Tadashi; Hanai, Ushio; Miyasaka, Muneo; Muramatsu, Hiroyuki; Yamamoto, Shou

    2016-01-01

    Postoperative mandibular stability in the surgery-first (SF) approach and ortho-first (OF) approach in orthognathic surgery was retrospectively assessed using the lateral cephalo X-P in 38 patients with skeletal Angle Class III malocclusion who underwent sagittal split ramus osteotomy (SSRO). The postoperative mandibular relapse of the two groups observed from T1 (2 weeks after the surgery) to T2 (for the OF group, a year after surgery; for the SF group, the day orthodontic treatment was completed) was compared. The mean (SD) horizontal relapse at pogonion was 0.86 (0.92) mm in the forward direction in the SF group and 0.90 (1.09) mm in the forward direction in the OF group. No significant difference was found in the amount of horizontal movement between the two groups. On the other hand, the mean (SD) vertical relapse at pogonion was 1.59 (2.91) mm in the downward direction in the SF group and 0.14 (1.30) mm in the upward direction in the OF group, showing a significant difference in the amount of movement between the two groups. The degree of completion of the occlusion at T2 in the SF group was compared with that in the OF group by measuring OB, OJ, L1-occlusal plane angle, and interincisal angle. No significant difference was found between the two groups and the post-treatment occlusion was clinically favourable. Although the SF approach has several advantages for patients, the method of operation and fixation should be selected carefully to maintain postoperative mandibular stability.

  12. Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores

    Directory of Open Access Journals (Sweden)

    Sarah R. Haile

    2017-12-01

    Full Text Available Abstract Background Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but practitioners may find it difficult to choose between them due to lack of external validation as well as lack of comparisons between them. Methods Borrowing methodology from network meta-analysis, we describe an approach to Multiple Score Comparison meta-analysis (MSC which permits concurrent external validation and comparisons of prognostic scores using individual patient data (IPD arising from a large-scale international collaboration. We describe the challenges in adapting network meta-analysis to the MSC setting, for instance the need to explicitly include correlations between the scores on a cohort level, and how to deal with many multi-score studies. We propose first using IPD to make cohort-level aggregate discrimination or calibration scores, comparing all to a common comparator. Then, standard network meta-analysis techniques can be applied, taking care to consider correlation structures in cohorts with multiple scores. Transitivity, consistency and heterogeneity are also examined. Results We provide a clinical application, comparing prognostic scores for 3-year mortality in patients with chronic obstructive pulmonary disease using data from a large-scale collaborative initiative. We focus on the discriminative properties of the prognostic scores. Our results show clear differences in performance, with ADO and eBODE showing higher discrimination with respect to mortality than other considered scores. The assumptions of transitivity and local and global consistency were not violated. Heterogeneity was small. Conclusions We applied a network meta-analytic methodology to externally validate and concurrently compare the prognostic properties

  13. Biotic interactions in the face of climate change: a comparison of three modelling approaches.

    Directory of Open Access Journals (Sweden)

    Anja Jaeschke

    Full Text Available Climate change is expected to alter biotic interactions, and may lead to temporal and spatial mismatches of interacting species. Although the importance of interactions for climate change risk assessments is increasingly acknowledged in observational and experimental studies, biotic interactions are still rarely incorporated in species distribution models. We assessed the potential impacts of climate change on the obligate interaction between Aeshna viridis and its egg-laying plant Stratiotes aloides in Europe, based on an ensemble modelling technique. We compared three different approaches for incorporating biotic interactions in distribution models: (1 We separately modelled each species based on climatic information, and intersected the future range overlap ('overlap approach'. (2 We modelled the potential future distribution of A. viridis with the projected occurrence probability of S. aloides as further predictor in addition to climate ('explanatory variable approach'. (3 We calibrated the model of A. viridis in the current range of S. aloides and multiplied the future occurrence probabilities of both species ('reference area approach'. Subsequently, all approaches were compared to a single species model of A. viridis without interactions. All approaches projected a range expansion for A. viridis. Model performance on test data and amount of range gain differed depending on the biotic interaction approach. All interaction approaches yielded lower range gains (up to 667% lower than the model without interaction. Regarding the contribution of algorithm and approach to the overall uncertainty, the main part of explained variation stems from the modelling algorithm, and only a small part is attributed to the modelling approach. The comparison of the no-interaction model with the three interaction approaches emphasizes the importance of including obligate biotic interactions in projective species distribution modelling. We recommend the use of

  14. Comparison of two approaches for establishing performance criteria related to Maintenance Rule

    International Nuclear Information System (INIS)

    Jerng, Dong-Wook; Kim, Man Cheol

    2015-01-01

    Probabilistic safety assessment (PSA) serves as a tool for systemically analyzing the safety of nuclear power plants. This paper explains and compares two approaches for the establishment of performance criteria related to the Maintenance Rule: (1) the individual reliability-based approach, and (2) the PSA importance measure-based approach. Different characteristics of the two approaches were compared in a qualitative manner, while a quantitative comparison was performed through application of the two approaches to a nuclear power plant. It was observed that the individual reliability-based approach resulted in more conservative performance criteria, compared to the PSA importance measure-based approach. It is thus expected that the PSA importance measure-based approach will allow for more flexible maintenance policy under conditions of limited resources, while providing for a macroscopic view of overall plant safety. Based on insights derived through this analysis, we emphasize the importance of a balance between reliability and safety significance, and propose a balance measure accordingly. The conclusions of this analysis are likely to be applicable to other types of nuclear power plants. (author)

  15. An algorithm-based approach to first-episode schizophrenia: response rates over 3 prospective antipsychotic trials with a retrospective data analysis.

    Science.gov (United States)

    Agid, Ofer; Arenovich, Tamara; Sajeev, Gautam; Zipursky, Robert B; Kapur, Shitij; Foussias, George; Remington, Gary

    2011-11-01

    Early, effective treatment in first-episode schizophrenia is advocated, although evidence based on a systematic approach over multiple antipsychotic trials is lacking. Employing a naturalistic design, we examined response rates over 3 circumscribed antipsychotic trials. Between June 2003 and December 2008, 244 individuals with first-episode schizophrenia or schizoaffective disorder according to DSM-IV criteria were treated at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, following an algorithm that moved them through 2 antipsychotic trials, followed by a trial with clozapine. For the first 2 trials, treatment consisted of risperidone followed by olanzapine, or vice versa; each trial consisted of 3 stages (low-, full-, or high-dose) lasting up to 4 weeks at each level and adjusted according to response/tolerability. Clinical response was defined as a Clinical Global Impressions-Improvement score of 2 (much improved) or 1 (very much improved) and/or a Brief Psychiatric Rating Scale Thought Disorder subscale score ≤ 6. Data were analyzed retrospectively, and publication of anonymized clinical data was approved by the Research Ethics Board of the Centre for Addiction and Mental Health in May 2003. In trial 1, 74.5% of individuals responded, with rates significantly higher for olanzapine (82.1%, 115/140) versus risperidone (66.3%, 69/104; P = .005). With trial 2, response rate dropped dramatically to 16.6% but again was significantly higher for olanzapine (25.7%, 9/35) compared to risperidone (4.0%, 1/25; P = .04). Response rate climbed above 70% once more, specifically 75.0% (21/28), in those individuals who agreed to a third trial with clozapine. Results confirm a high response rate (75%) to initial antipsychotic treatment in first-episode schizophrenia. A considerably lower response rate (algorithm. © Copyright 2011 Physicians Postgraduate Press, Inc.

  16. Surgical treatment of choanal atresia with transnasal endoscopic approach with stentless single side-hinged flap technique: 5 year retrospective analysis

    Directory of Open Access Journals (Sweden)

    Carmelo Saraniti

    Full Text Available Abstract Introduction: Choanal atresia is a rare congenital malformation of the nasal cavity characterized by the complete obliteration of the posterior choanae. In 67% of cases choanal atresia is unilateral, affecting mainly (71% the right nasal cavity. In contrast to the unilateral form, bilateral choanal atresia is a life-threatening condition often associated with respiratory distress with feeding and intermittent cyanosis exacerbated by crying. Surgical treatment remains the only therapeutic option. Objective: To report our experience in the use of a transnasal endoscopic approach with stentless single side-hinged flap technique for the surgical management of choanal atresia. Methods: A 5 year retrospective analysis of surgical outcomes of 18 patients treated for choanal atresia with a transnasal technique employing a single side-hinged flap without stent placement. All subjects were assessed preoperatively with a nasal endoscopy and a Maxillofacial computed tomography scan. Results: Ten males and eight females with a mean age at the time of surgery of 20.05 ± 11.32 years, underwent surgery for choanal atresia. Fifteen subjects (83.33% had a bony while 3 (26.77% a mixed bony-membranous atretic plate. Two and sixteen cases suffered from bilateral and unilateral choanal atresia respectively. No intra- and/or early postoperative complications were observed. Between 2 and 3 months after surgery two cases (11.11% of partial restenosis were found. Only one of these presented a relapse of the nasal obstruction and was subsequently successfully repaired with a second endoscopic procedure. Conclusion: The surgical technique described follows the basic requirements of corrective surgery and allows good visualization, evaluation and treatment of the atretic plate and the posterior third of the septum, in order to create the new choanal opening. We believe that the use of a stent is not necessary, as recommended in case of other surgical techniques

  17. Comparison of Posteromedial Versus Posterolateral Approach for Posterior Malleolus Fixation in Trimalleolar Ankle Fractures.

    Science.gov (United States)

    Zhong, Sheng; Shen, Lin; Zhao, Jia-Guo; Chen, Jie; Xie, Jin-Feng; Shi, Qi; Wu, Ying-Hua; Zeng, Xian-Tie

    2017-02-01

    To compare clinical and radiographic outcomes of posterior malleolar fractures (PMF) treated with lag screws from anterior to posterior versus posterior to anterior approach. We retrospectively analyzed 48 patients with trimalleolar fractures who underwent open reduction and internal fixation (ORIF) with either posteromedial (PM) or posterolateral (PL) approaches between January 2012 and December 2014. Fixation of the posterior malleolus was made with anteroposterior screws in 20 patients using the PM approach and posteroanterior screws in 28 patients using the PL approach. The American Orthopedic Foot and Ankle Society (AOFAS) scores and range of motion (ROM) of the ankle were used as the main outcome measurements, and results were evaluated at the 6-month, 12-month and final follow-up. Postoperative radiographs and computed tomography scans were used to evaluate the residual gap/step-off. The degree of arthritis was evaluated on final follow-up using Bargon criteria. Other complications were also recorded to compare the clinical outcomes of the two approaches. The mean duration of follow-up regardless of the approaches was 21.1 months (range, 15-54 months). None of the patients developed delayed union or nonunion. Functional bone healing was obtained in all patients at 10.7 weeks (range, 8-16 weeks). The mean AOFAS scores of the PM group at the postoperative 6-mouth, 12-month, and final follow-up were 91.4 (range, 82-100), 92.5 (range, 84-100), and 92.9 (range, 86-100), respectively. In the PL group, the mean AOFAS scores were 89.9 (range, 72-100), 91.4 (range, 77-100), and 91.9 (range, 77-100), respectively. At the final follow-up, the median loss of range of motion (ROM) for dorsiflexion and plantaflexion were 0°(0°, 5°) and 0°(0°, 0°), respectively, in both groups. There were no significant differences between the two approaches in AOFAS scores and ROM of the ankle in each period postoperatively (P > 0.05). Two patients in the PL group and 1 in the PM

  18. Incarcerated inguinal hernia management in children: 'a comparison of the open and laparoscopic approach'.

    Science.gov (United States)

    Mishra, Pankaj Kumar; Burnand, Katherine; Minocha, Ashish; Mathur, Azad B; Kulkarni, Milind S; Tsang, Thomas

    2014-06-01

    To compare the outcomes of management of incarcerated inguinal hernia by open versus laparoscopic approach. This is a retrospective analysis of incarcerated inguinal hernina in a paediatric surgery centre involving four consultants. Manual reduction was attempted in all and failure was managed by emergency surgery. The laparoscopy group had 27 patients. Four patients failed manual reduction and underwent emergency laparoscopic surgery. Three of them had small bowel strangulation which was reduced laparoscopically. The strangulated bowel was dusky in colour initially but changed to normal colour subsequently under vision. The fourth patient required appendectomy for strangulated appendix. One patient had concomitant repair of umbilical hernia and one patient had laparoscopic pyloromyotomy at the same time. One patient had testicular atrophy, one had hydrocoele and one had recurrence of hernia on the asymptomatic side. The open surgery group had 45 patients. Eleven patients had failed manual reduction requiring emergency surgery, of these two required resection and anastomosis of small intestine. One patient in this group had concomitant repair of undescended testis. There was no recurrence in this group, one had testicular atrophy and seven had metachronous hernia. Both open herniotomy and laparoscopic repair offer safe surgery with comparable outcomes for incarcerated inguinal hernia in children. Laparoscopic approach and hernioscopy at the time of open approach appear to show the advantage of repairing the contralateral patent processus vaginalis at the same time and avoiding metachronous inguinal hernia.

  19. No post-no core approach to restore severely damaged posterior teeth: An up to 10-year retrospective study of documented endocrown cases.

    Science.gov (United States)

    Belleflamme, Marcia M; Geerts, Sabine O; Louwette, Marie M; Grenade, Charlotte F; Vanheusden, Alain J; Mainjot, Amélie K

    2017-08-01

    The objectives of the present study were to (1) retrospectively evaluate documented cases of ceramic and composite endocrowns performed using immediate dentin sealing (IDS); (2) correlate failures with clinical parameters such as tooth preparation characteristics and occlusal parameters. 99 documented cases of endocrowns were evaluated after a mean observation period of 44.7±34.6months. A classification of restorations was established in function of the level of damage of residual tooth tissues after preparation, from 1 to 3. Evaluation was performed according to FDI criteria and endodontic outcomes were analyzed. Occlusal risk factors were examined and fractographic analysis was performed in case of fracture. 48.4% of patients were shown to present occlusal risk factors. 75.8% of restorations were Class 3 endocrowns. 56.6% were performed on molars, 41.4% on premolars and 2.0% on canines. 84.8% were performed in lithium-disilicate glass-ceramic and 12.1% in Polymer-Infiltrated Ceramic Network (PICN) material. The survival and success rates of endocrowns were 99.0% and 89.9% respectively, while the 10-year Kaplan-Meier estimated survival and success rates were 98.8% and 54.9% respectively. Ten failures were detected: periodontal disease (n=3), endocrown debonding (n=2), minor chipping (n=2), caries recurrence (n=2) and major fractures (n=1). Due to the reduced amount of failures, no statistical correlation could be established with clinical parameters. Endocrowns were shown to constitute a reliable approach to restore severely damaged molars and premolars, even in the presence of extensive coronal tissue loss or occlusal risk factors, such as bruxism or unfavorable occlusal relationships. Practitioners should consider the endocrown instead of the post and core approach to restore severely damaged non-vital posterior teeth. This minimally invasive solution reduces the risk of catastrophic failures and is easily performed. The use of IDS procedure and lithium

  20. Self-Regulatory Behaviors and Approaches to Learning of Arts Students: A Comparison between Professional Training and English Learning

    Science.gov (United States)

    Tseng, Min-chen; Chen, Chia-cheng

    2017-01-01

    This study investigated the self-regulatory behaviors of arts students, namely memory strategy, goal-setting, self-evaluation, seeking assistance, environmental structuring, learning responsibility, and planning and organizing. We also explored approaches to learning, including deep approach (DA) and surface approach (SA), in a comparison between…

  1. Statistical comparison of a hybrid approach with approximate and exact inference models for Fusion 2+

    Science.gov (United States)

    Lee, K. David; Wiesenfeld, Eric; Gelfand, Andrew

    2007-04-01

    One of the greatest challenges in modern combat is maintaining a high level of timely Situational Awareness (SA). In many situations, computational complexity and accuracy considerations make the development and deployment of real-time, high-level inference tools very difficult. An innovative hybrid framework that combines Bayesian inference, in the form of Bayesian Networks, and Possibility Theory, in the form of Fuzzy Logic systems, has recently been introduced to provide a rigorous framework for high-level inference. In previous research, the theoretical basis and benefits of the hybrid approach have been developed. However, lacking is a concrete experimental comparison of the hybrid framework with traditional fusion methods, to demonstrate and quantify this benefit. The goal of this research, therefore, is to provide a statistical analysis on the comparison of the accuracy and performance of hybrid network theory, with pure Bayesian and Fuzzy systems and an inexact Bayesian system approximated using Particle Filtering. To accomplish this task, domain specific models will be developed under these different theoretical approaches and then evaluated, via Monte Carlo Simulation, in comparison to situational ground truth to measure accuracy and fidelity. Following this, a rigorous statistical analysis of the performance results will be performed, to quantify the benefit of hybrid inference to other fusion tools.

  2. Comparison of Salivary pH, Buffering Capacity and Alkaline Phosphatase in Smokers and Healthy Non-Smokers: Retrospective cohort study

    OpenAIRE

    Ahmadi-Motamayel, Fatemeh; Falsafi, Parisa; Goodarzi, Mohammad T.; Poorolajal, Jalal

    2016-01-01

    Objectives: Saliva contains alkaline phosphatase (ALP)—a key intracellular enzyme related to destructive processes and cellular damage—and has buffering capacity (BC) against acids due to the presence of bicarbonate and phosphate ions. Smoking may have deleterious effects on the oral environment due to pH changes which can affect ALP activity. This study aimed to evaluate the salivary pH, BC and ALP activity of male smokers and healthy non-smokers. Methods: This retrospective cohort study ...

  3. Computer-aided detection of masses in digital tomosynthesis mammography: Comparison of three approaches

    International Nuclear Information System (INIS)

    Chan Heangping; Wei Jun; Zhang Yiheng; Helvie, Mark A.; Moore, Richard H.; Sahiner, Berkman; Hadjiiski, Lubomir; Kopans, Daniel B.

    2008-01-01

    The authors are developing a computer-aided detection (CAD) system for masses on digital breast tomosynthesis mammograms (DBT). Three approaches were evaluated in this study. In the first approach, mass candidate identification and feature analysis are performed in the reconstructed three-dimensional (3D) DBT volume. A mass likelihood score is estimated for each mass candidate using a linear discriminant analysis (LDA) classifier. Mass detection is determined by a decision threshold applied to the mass likelihood score. A free response receiver operating characteristic (FROC) curve that describes the detection sensitivity as a function of the number of false positives (FPs) per breast is generated by varying the decision threshold over a range. In the second approach, prescreening of mass candidate and feature analysis are first performed on the individual two-dimensional (2D) projection view (PV) images. A mass likelihood score is estimated for each mass candidate using an LDA classifier trained for the 2D features. The mass likelihood images derived from the PVs are backprojected to the breast volume to estimate the 3D spatial distribution of the mass likelihood scores. The FROC curve for mass detection can again be generated by varying the decision threshold on the 3D mass likelihood scores merged by backprojection. In the third approach, the mass likelihood scores estimated by the 3D and 2D approaches, described above, at the corresponding 3D location are combined and evaluated using FROC analysis. A data set of 100 DBT cases acquired with a GE prototype system at the Breast Imaging Laboratory in the Massachusetts General Hospital was used for comparison of the three approaches. The LDA classifiers with stepwise feature selection were designed with leave-one-case-out resampling. In FROC analysis, the CAD system for detection in the DBT volume alone achieved test sensitivities of 80% and 90% at average FP rates of 1.94 and 3.40 per breast, respectively. With the

  4. Comparison of gimbal approaches to decrease drag force and radar cross sectional area in missile application

    Science.gov (United States)

    Sakarya, Doǧan Uǧur

    2017-05-01

    Drag force effect is an important aspect of range performance in missile applications especially for long flight time. However, old fashioned gimbal approaches force to increase missile diameter. This increase has negative aspect of rising in both drag force and radar cross sectional area. A new gimbal approach was proposed recently. It uses a beam steering optical arrangement. Therefore, it needs less volume envelope for same field of regard and same optomechanical assembly than the old fashioned gimbal approaches. In addition to longer range performance achieved with same fuel in the new gimbal approach, this method provides smaller cross sectional area which can be more invisible in enemies' radar. In this paper, the two gimbal approaches - the old fashioned one and the new one- are compared in order to decrease drag force and radar cross sectional area in missile application. In this study; missile parameters are assumed to generate gimbal and optical design parameters. Optical design is performed according to these missile criteria. Two gimbal configurations are designed with respect to modeled missile parameters. Also analyzes are performed to show decreased drag force and radar cross sectional area in the new approach for comparison.

  5. Technical note: Comparison of methane ebullition modelling approaches used in terrestrial wetland models

    Science.gov (United States)

    Peltola, Olli; Raivonen, Maarit; Li, Xuefei; Vesala, Timo

    2018-02-01

    Emission via bubbling, i.e. ebullition, is one of the main methane (CH4) emission pathways from wetlands to the atmosphere. Direct measurement of gas bubble formation, growth and release in the peat-water matrix is challenging and in consequence these processes are relatively unknown and are coarsely represented in current wetland CH4 emission models. In this study we aimed to evaluate three ebullition modelling approaches and their effect on model performance. This was achieved by implementing the three approaches in one process-based CH4 emission model. All the approaches were based on some kind of threshold: either on CH4 pore water concentration (ECT), pressure (EPT) or free-phase gas volume (EBG) threshold. The model was run using 4 years of data from a boreal sedge fen and the results were compared with eddy covariance measurements of CH4 fluxes.Modelled annual CH4 emissions were largely unaffected by the different ebullition modelling approaches; however, temporal variability in CH4 emissions varied an order of magnitude between the approaches. Hence the ebullition modelling approach drives the temporal variability in modelled CH4 emissions and therefore significantly impacts, for instance, high-frequency (daily scale) model comparison and calibration against measurements. The modelling approach based on the most recent knowledge of the ebullition process (volume threshold, EBG) agreed the best with the measured fluxes (R2 = 0.63) and hence produced the most reasonable results, although there was a scale mismatch between the measurements (ecosystem scale with heterogeneous ebullition locations) and model results (single horizontally homogeneous peat column). The approach should be favoured over the two other more widely used ebullition modelling approaches and researchers are encouraged to implement it into their CH4 emission models.

  6. Retrospective revaluation and its neural circuit in rats.

    Science.gov (United States)

    San-Galli, Aurore; Marchand, Alain R; Decorte, Laurence; Di Scala, Georges

    2011-10-01

    Contingency learning is essential for establishing predictive or causal judgements. Retrospective revaluation captures essential aspects of the updating of this knowledge, according to new experience. In the present study, retrospective revaluation and its neural substrate was investigated in a rat conditioned magazine approach. One element of a previously food-reinforced Tone-Light compound stimulus was either further reinforced (inflation) or extinguished (extinction). These treatments affected the predictive value of the alternate stimulus (target), but only when the target was a weakly salient stimulus such as a Light, and the inflation/extinction procedure concerned the more salient element, that is the Tone. As the predictive value of the Light was decreased in comparison with a relevant control group, this revaluation was interpreted as backward blocking, and not unovershadowing. This observation challenges retrospective revaluation models focused on acquisition and prediction error detection, and is better accounted for by retrieval-based associative theories such as the comparator model (Miller and Matzel) [5]. Immunohistochemical detection of the Fos protein after the test phase revealed activation of the orbitofrontal and infralimbic cortices as well as nucleus accumbens core and shell, in rats that exhibited retrospective revaluation. Our results suggest that rats integrate successive experiences at the retrieval stage of retrospective revaluation, and that prefronto-accumbal interactions are involved in this function. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Primary total hip arthroplasty: a comparison of the lateral Hardinge approach to an anterior mini-invasive approach

    Directory of Open Access Journals (Sweden)

    Nathan Wayne

    2009-11-01

    Full Text Available The anterior mini-invasive (MI approach to performing total hip arthroplasty (THA is associated with less soft tissue damage and shorter postoperative recovery than other methods. Our hospital recently abandoned the traditional lateral Hardinge (LH approach in favour of this new method. We compared the first 100 patients operated after the changeover to the new method (MI group to the last 100 patients operated using the traditional method (LH group. Clinical and radiological parameters and complications were recorded pre- and postoperatively and the collected data of the two groups were statistically compared. There were no statistically significant differences between either group with regard to patient demographics or procedural data, placement of the femur component, postoperative leg discrepancy, prosthesis dislocation, blood transfusion, or postoperative dislocation of the components. The MI group had a significantly longer operating time, more bleeding, higher rate of nerve damage, and a higher percentage of acetabular component malposition whilst having a significantly shorter hospital stay and significantly fewer infections of the operative site in comparison to the LH group. Additionally, and perhaps most worrying was the clinically significant increase in intraoperative femur fractures in the MI group. The changeover to the anterior mini-invasive approach, which was the surgeons' initial experience with the MI technique, resulted in a drastic increase in the number of overall complications accompanied by less soft tissue damage and a shorter period of rehabilitation. Our results suggest that further analysis of this surgical MI technique will be needed before it can be recommended for widespread adoption.

  8. Comparison of readmission rates between groups with early versus late discharge after vaginal or cesarean delivery: a retrospective analyzes of 14,460 cases.

    Science.gov (United States)

    Bostanci Ergen, Evrim; Ozkaya, Enis; Eser, Ahmet; Abide Yayla, Cigdem; Kilicci, Cetin; Yenidede, Ilter; Eser, Semra Kayatas; Karateke, Ates

    2018-05-01

    The aim of this retrospective analysis was to show the readmission rate of cases with and without early discharge following vaginal or cesarean delivery. After exclusion of cases with pregnancy, delivery and neonatal complications, a total of 14,460 cases who delivered at Zeynep Kamil Women and Children's Health Training and Research Hospital were retrospectively screened from hospital database. Subjects were divided into two groups as Group 1: early discharge (n = 6802) and Group 2: late discharge (n = 7658). Groups were compared in terms of readmission rates and indications for readmission. There were 6802 cases with early discharge whereas the remaining women were discharged after 24 h for vaginal delivery and 48 h following cesarean delivery on regular bases. Among cases with early discharge, 205 (3%) cases readmitted to emergency service with variable indications, while there were 216 (2.8%) readmitted women who were discharged on regular bases. Most common indication for readmission was wound infection in both groups. Neonatal sex distributions were similar between groups (p > .05), where as there was a higher rate of cesarean deliveries in Group 2 (p discharge (p discharges following vaginal or cesarean delivery without any mortality or permanent morbidity and cost analyses revealed 68 Turkish liras lower cost with early discharge.

  9. First Metatarsophalangeal Joint Arthrodesis: A Retrospective Comparison of Crossed-screws, Locking and Non-Locking Plate Fixation with Lag Screw

    Directory of Open Access Journals (Sweden)

    Leif Claassen

    2017-07-01

    Full Text Available Background:Locking plate fixation is increasingly used for first metatarsophalangeal joint (MTP-I arthrodesis. Still there is few comparable clinical data regarding this procedure. Methods:We retrospectively evaluated 60 patients who received an arthrodesis of the MTP-I between January 2008 and June 2010. With 20 patients each we performed a locking plate fixation with lag screw, arthrodesis with crossed-screwsor with a nonlocking plate with lag screw. Results: There were four non-unions in crossed-screws patients and one nonunion in non-locked plate group. All the patients in locking plate group achieved union. 90% of the patients were completely or mildly satisfied in locking plate group, whereas this rate was 80% for patients in both crossed screws and non-locking plate groups. Conclusions: Use of dorsal plating for arthrodesis of MTP1 joint either locking or non-locking were associated with high union rate and acceptable and comparable functional outcome. Although nonunion rate was high using two crossed screws but functional outcome was not significantly different compare to dorsal plating. Level of evidence:Ш, retrospective comparative study

  10. Sequence comparison alignment-free approach based on suffix tree and L-words frequency.

    Science.gov (United States)

    Soares, Inês; Goios, Ana; Amorim, António

    2012-01-01

    The vast majority of methods available for sequence comparison rely on a first sequence alignment step, which requires a number of assumptions on evolutionary history and is sometimes very difficult or impossible to perform due to the abundance of gaps (insertions/deletions). In such cases, an alternative alignment-free method would prove valuable. Our method starts by a computation of a generalized suffix tree of all sequences, which is completed in linear time. Using this tree, the frequency of all possible words with a preset length L-L-words--in each sequence is rapidly calculated. Based on the L-words frequency profile of each sequence, a pairwise standard Euclidean distance is then computed producing a symmetric genetic distance matrix, which can be used to generate a neighbor joining dendrogram or a multidimensional scaling graph. We present an improvement to word counting alignment-free approaches for sequence comparison, by determining a single optimal word length and combining suffix tree structures to the word counting tasks. Our approach is, thus, a fast and simple application that proved to be efficient and powerful when applied to mitochondrial genomes. The algorithm was implemented in Python language and is freely available on the web.

  11. Sequence Comparison Alignment-Free Approach Based on Suffix Tree and L-Words Frequency

    Directory of Open Access Journals (Sweden)

    Inês Soares

    2012-01-01

    Full Text Available The vast majority of methods available for sequence comparison rely on a first sequence alignment step, which requires a number of assumptions on evolutionary history and is sometimes very difficult or impossible to perform due to the abundance of gaps (insertions/deletions. In such cases, an alternative alignment-free method would prove valuable. Our method starts by a computation of a generalized suffix tree of all sequences, which is completed in linear time. Using this tree, the frequency of all possible words with a preset length L—L-words—in each sequence is rapidly calculated. Based on the L-words frequency profile of each sequence, a pairwise standard Euclidean distance is then computed producing a symmetric genetic distance matrix, which can be used to generate a neighbor joining dendrogram or a multidimensional scaling graph. We present an improvement to word counting alignment-free approaches for sequence comparison, by determining a single optimal word length and combining suffix tree structures to the word counting tasks. Our approach is, thus, a fast and simple application that proved to be efficient and powerful when applied to mitochondrial genomes. The algorithm was implemented in Python language and is freely available on the web.

  12. Retrospective report of social withdrawal during adolescence and current maladjustment in young adulthood: cross-cultural comparisons between Australian and South Korean students.

    Science.gov (United States)

    Kim, Jinkwan; Rapee, Ronald M; Ja Oh, Kyung; Moon, Hye-Shin

    2008-10-01

    The current study investigated associations between the frequency of and motivations for social withdrawal during adolescence and emotional distress in young adulthood. Perceived motivations for social withdrawal included unsociability, isolation, shyness, and low mood. Social withdrawal during adolescence was assessed using a retrospective questionnaire completed by Australian and Korean university students. They also completed measures of general self-worth, social relationships, loneliness, social anxiety, and depression at university. Partial correlations and path analyses revealed that different motivations for social withdrawal had different risk status for later adjustment across the two samples. In particular, it appeared that shy and unsociable individuals in Korea showed better social and emotional adjustment than their counterparts in Australia. In contrast, social relationships of sad/depressed and isolated respondents in Korea appeared to be more seriously impaired than their Australian counterparts. These cross-cultural differences are discussed in terms of socio-cultural values and environments unique to the two countries.

  13. A comparison of the efficacy and tolerability of oxcarbazepine oral suspension between infants and children with epilepsy: a retrospective chart review at a single medical center in Taiwan.

    Science.gov (United States)

    Wei, Shu-Hao; Liu, Cheng-Chao; Fan, Pi-Chuan

    2014-02-01

    Few clinical studies have assessed the efficacy and safety of oxcarbazepine (OXC) oral suspension in Asian pediatric patients and particularly in infants. The aim of this study was to investigate and compare the efficacy, tolerability, and side effects of OXC oral suspension in Taiwanese infants and children with various types of epilepsy. A retrospective review of the efficacy, tolerability, and side effects of OXC oral suspension in a tertiary medical center in Taiwan was conducted and included children (1-9 years old) and infants (effects (30 vs. 21 %, p = 0.525) after OXC oral suspension treatment. The efficacy was significantly correlated with the epilepsy subtype (p effective and well tolerated in both infants and children with partial epilepsy in Taiwan. Treatment efficacy was related to epilepsy subtype and number of combined AEDs before OXC treatment. Monotherapy had an excellent therapeutic response in partial epilepsy but not in multifocal epilepsy.

  14. Lateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis.

    Science.gov (United States)

    Haeseker, Guus A; Mureau, Marc A; Faber, Frank W M

    2010-01-01

    In this study, clinical and radiological results after lateral column lengthening by calcaneocuboid distraction arthrodesis and calcaneus osteotomy were compared. Thirty-three patients (35 feet) treated with lateral column lengthening by distraction arthrodesis (14 patients, 16 feet; group I) or by calcaneus osteotomy (19 patients, 19 feet; group II) for adult-acquired flatfoot deformity caused by stage II posterior tibial tendon dysfunction were compared retrospectively. Mean follow-up was 42.4 months (range, 6-78 months) for group I and 15.8 months (range, 6-32 months) for group II (P lengthening by means of calcaneus osteotomy rather than distraction arthrodesis of the calcaneocuboid joint, for correction of stage II posterior tibial tendon dysfunction. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities: a retrospective comparison of GESMD and GFM registries.

    Science.gov (United States)

    Díez-Campelo, María; Lorenzo, Jose I; Itzykson, Raphael; Rojas, Silvia M; Berthon, Céline; Luño, Elisa; Beyne-Rauzy, Odile; Perez-Oteyza, Jaime; Vey, Norbert; Bargay, Joan; Park, Sophie; Cedena, Teresa; Bordessoule, Dominique; Muñoz, Juan A; Gyan, Emmanuel; Such, Esperanza; Visanica, Sorin; López-Cadenas, Félix; de Botton, Stéphane; Hernández-Rivas, Jesús M; Ame, Shanti; Stamatoullas, Aspasia; Delaunay, Jacques; Salanoubat, Celia; Isnard, Françoise; Guieze, Romain; Pérez Guallar, Joan; Badiella, Llorenc; Sanz, Guillermo; Cañizo, Consuelo; Fenaux, Pierre

    2018-05-01

    Treatment with azacitidine (AZA) has been suggested to be of benefit for higher-risk myelodysplastic syndrome (HR-MDS) patients with chromosome 7 abnormalities (Abn 7). This retrospective study of 235 HR-MDS patients with Abn 7 treated with AZA (n = 115) versus best supportive care (BSC; n = 120), assessed AZA treatment as a time-varying variable in multivariable analysis. A Cox Regression model with time-interaction terms of overall survival (OS) at different time points confirmed that, while chromosome 7 cytogenetic categories (complex karyotype [CK] versus non-CK) and International Prognostic Scoring System risk (high versus intermediate-2) retained poor prognosis over time, AZA treatment had a favourable impact on OS during the first 3 years of treatment compared to BSC (Hazard ratio [HR] 0·5 P MDS and cytogenetic abnormalities involving chromosome 7, especially for those with CK. © 2018 John Wiley & Sons Ltd.

  16. Accurate estimation of global and regional cardiac function by retrospectively gated multidetector row computed tomography. Comparison with cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    Belge, Benedicte; Pasquet, Agnes; Vanoverschelde, Jean-Louis J.; Coche, Emmanuel; Gerber, Bernhard L.

    2006-01-01

    Retrospective reconstruction of ECG-gated images at different parts of the cardiac cycle allows the assessment of cardiac function by multi-detector row CT (MDCT) at the time of non-invasive coronary imaging. We compared the accuracy of such measurements by MDCT to cine magnetic resonance (MR). Forty patients underwent the assessment of global and regional cardiac function by 16-slice MDCT and cine MR. Left ventricular (LV) end-diastolic and end-systolic volumes estimated by MDCT (134±51 and 67±56 ml) were similar to those by MR (137±57 and 70±60 ml, respectively; both P=NS) and strongly correlated (r=0.92 and r=0.95, respectively; both P<0.001). Consequently, LV ejection fractions by MDCT and MR were also similar (55±21 vs. 56±21%; P=NS) and highly correlated (r=0.95; P<0.001). Regional end-diastolic and end-systolic wall thicknesses by MDCT were highly correlated (r=0.84 and r=0.92, respectively; both P<0.001), but significantly lower than by MR (8.3±1.8 vs. 8.8±1.9 mm and 12.7±3.4 vs. 13.3±3.5 mm, respectively; both P<0.001). Values of regional wall thickening by MDCT and MR were similar (54±30 vs. 51±31%; P=NS) and also correlated well (r=0.91; P<0.001). Retrospectively gated MDCT can accurately estimate LV volumes, EF and regional LV wall thickening compared to cine MR. (orig.)

  17. Coronary Artery Stent Evaluation Using a Vascular Model at 64-Detector Row CT: Comparison between Prospective and Retrospective ECG-Gated Axial Scans

    International Nuclear Information System (INIS)

    Suzuki, Shigeru; Furui, Shigeru; Kaminaga, Tatsuro; Miyazawa, Akiyoshi; Ueno, Yasunari; Konno, Kumiko; Kuwahara, Sadatoshi; Mehta, Dhruv

    2009-01-01

    We wanted to evaluate the performance of prospective electrocardiogram (ECG)-gated axial scans for assessing coronary stents as compared with retrospective ECG-gated helical scans. As for a vascular model of the coronary artery, a tube of approximately 2.5-mm inner diameter was adopted and as for stents, three (Bx-Velocity, Express2, and Micro Driver) different kinds of stents were inserted into the tube. Both patent and stenotic models of coronary artery were made by instillating different attenuation (396 vs. 79 Hounsfield unit [HU]) of contrast medium within the tube in tube model. The models were scanned with two types of scan methods with a simulated ECG of 60 beats per minute and using display field of views (FOVs) of 9 and 18 cm. We evaluated the in-stent stenosis visually, and we measured the attenuation values and the diameter of the patent stent lumen. The visualization of the stent lumen of the vascular models was improved with using the prospective ECG-gated axial scans and a 9-cm FOV. The inner diameters of the vascular models were underestimated with mean measurement errors of -1.10 to -1.36 mm. The measurement errors were smaller with using the prospective ECG-gated axial scans (Bx-Velocity and Express2, p < 0.0001; Micro Driver, p = 0.0004) and a 9-cm FOV (all stents: p < 0.0001), as compared with the other conditions, respectively. The luminal attenuation value was overestimated in each condition. For the luminal attenuation measurement, the use of prospective ECG-gated axial scans provided less measurement error compared with the retrospective ECG-gated helical scans (all stents: p < 0.0001), and the use of a 9-cm FOV tended to decrease the measurement error. The visualization of coronary stents is improved by the use of prospective ECG-gated axial scans and using a small FOV with reduced blooming artifacts and increased spatial resolution

  18. Noninvasive assessment of coronary artery disease by multislice spiral computed tomography using a new retrospectively ECG-gated image reconstruction technique. Comparison with angiographic results

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Yuichi; Matsumoto, Naoya; Kato, Masahiko [Nihon Univ., Tokyo (Japan). Surugadai Hospital] [and others

    2003-04-01

    The present study was designed to investigate the accuracy of multislice spiral computed tomography (MSCT) in detecting coronary artery disease, compared with coronary angiography (CAG), using a new retrospectively ECG-gated reconstruction method that reduced cardiac motion artifact. The study group comprised 54 consecutive patients undergoing MSCT and CAG. MSCT was performed using a SOMATOM Volume Zoom (4-detector-row, Siemens, Germany) with slice thickness 1.0 mm, pitch 1.5 (table feed: 1.5 mm per rotation) and gantry rotation time 500 ms. Metoprolol (20-60 mg) was administered orally prior to MSCT imaging. ECG-gated image reconstruction was performed with the reconstruction window (250 ms) positioned immediately before atrial contraction in order to reduce the cardiac motion artifact caused by the abrupt diastolic ventricular movement occurring during the rapid filling and atrial contraction periods. Following inspection of the volume rendering images, multiplanar reconstruction images and axial images of the left main coronary artery (LMCA), left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) were obtained and evaluated for luminal narrowing. The results were compared with those obtained by CAG. Of 216 coronary arteries, 206 (95.4%) were assessable; 10 arteries were excluded from the analysis because of severe calcification (n=4), stents (n=3) or insufficient contrast enhancement (n=3). The sensitivity to detect coronary stenoses {>=}50% was 93.5% and the specificity to define luminal narrowing <50% was 97.2%. The positive predictive value and the negative predictive value were 93.5% and 97.2%, respectively. The sensitivity was still satisfactory (80.6%) even when non-assessable arteries were included in the analysis. The new retrospectively ECG-gated reconstruction method for MSCT has excellent diagnostic accuracy in detecting significant coronary artery stenoses. (author)

  19. Particle therapy for mucosal melanoma of the head and neck. A single-institution retrospective comparison of proton and carbon ion therapy

    Energy Technology Data Exchange (ETDEWEB)

    Demizu, Y.; Fujii, O.; Terashima, K.; Mima, M.; Hashimoto, N.; Fuwa, N. [Hyogo Ion Beam Medical Center, Department of Radiology, Tatsuno, Hyogo (Japan); Niwa, Y. [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan); Akagi, T. [Hyogo Ion Beam Medical Center, Department of Radiation Physics, Tatsuno, Hyogo (Japan); Daimon, T. [Hyogo College of Medicine, Department of Biostatistics, Nishinomiya, Hyogo (Japan); Murakami, M. [Dokkyo Medical University, Center for Radiation Oncology, Shimotsuga-gun, Tochigi (Japan)

    2014-02-15

    To retrospectively analyze treatment outcomes after particle therapy using protons or carbon ions for mucosal melanoma of the head and neck (HNMM) at the Hyogo Ion Beam Medical Center, as well as to compare proton therapy (PT) and carbon ion therapy (CIT). Data from 62 HNMM patients without metastasis, treated with PT or CIT between October 2003 and April 2011 were analyzed. Median patient age was 70.5 years (range 33-89 years). Of the total patients, 33 (53 %) had received PT and 29 (47 %) had undergone CIT. Protocols for 65 or 70.2 GyE in 26 fractions were used for both ion types. Median follow-up was 18.0 months (range 5.2-82.7 months). The 1-/2-year overall survival (OS) and local control (LC) rates were 93 %/61 % and 93 %/78 % for all patients, 91 %/44 % and 92 %/71 % for the PT patients and 96 %/62 % and 95 %/59 % for the CIT patients, respectively. No significant differences were observed between PT and CIT. Local recurrence was observed in 8 patients (PT: 5, CIT: 3) and 29 (PT: 18, CIT: 11) experienced distant metastases. Acute reactions were acceptable and all patients completed the planned radiotherapy. Regarding late toxicity, grade 3 or greater events were observed in 5 patients (PT: 3, CIT: 2), but no significant difference was observed between PT and CIT. Our single-institution retrospective analysis demonstrated that particle therapy for HNMM achieved good LC, but OS was unsatisfactory. There were no significant differences between PT and CIT in terms of either efficacy or toxicity. (orig.)

  20. A retrospective comparison of the effects of propofol and etomidate on stimulus variables and efficacy of electroconvulsive therapy in depressed inpatients.

    Science.gov (United States)

    Graveland, Pieternella E; Wierdsma, André I; van den Broek, Walter W; Birkenhäger, Tom K

    2013-08-01

    To compare the effects of propofol and etomidate on the stimulus variables and efficacy of electroconvulsive therapy (ECT) in depressed inpatients. This retrospective study included 54 inpatients (aged 18-75 years) who met the DSM-IV criteria for major depression and were treated with bilateral ECT. For the first part of the study, the primary outcome was the mean stimulus charge per ECT session. For the second part, the main outcome measure was the proportion of patients achieving full remission. Propofol-treated patients showed a higher mean stimulus charge (etomidate = 227.58 ± 130.44, propofol = 544.91 ± 237.56, p<0.001) despite the lack of a significant difference in starting threshold doses. The propofol group had shorter mean electroencephalogram (etomidate = 69.41 ± 22.50, propofol = 42.95 ± 22.26, p<0.001) seizure duration and motor (etomidate = 46.11 ± 14.38, propofol = 22.89 ± 7.13, p<0.001) seizure duration and a higher mean number of inadequate seizures (etomidate = 0.12 ± 0.15, propofol = 0.47 ± 0.26, p<0.001). No significant differences were found between the groups for the effects of the anesthetics on the efficacy of ECT. Our study is limited by a retrospective design and the small number of patients treated with propofol restricted the sample size. Anesthesia with propofol has a significant reducing effect on seizure duration during the course of ECT which results in more inadequate seizures, despite the use of a higher mean stimulus charge. Regarding the possible effect of the anesthetics on ECT, randomized clinical trials with sufficient power to detect differences are warranted. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy

    Directory of Open Access Journals (Sweden)

    Arzu Antal Dönmez

    Full Text Available Abstract Objective: This study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications. Methods: This retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27ºC. Postoperative outcomes were evaluated. Results: Overall early mortality and stroke rate was 5.1% for both. There were 3 (4.3% deaths in group I, 2 (6.9% deaths in group II and 2 (5.4% deaths in group III. Stroke was observed in 5 (7.1% patients in group I and 2 (6.9% in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups. Conclusion: We identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique.

  2. A Comparison of Approach and Avoidance Sexual Goals in Couples With Vulvodynia and Community Controls.

    Science.gov (United States)

    Dubé, Justin P; Bergeron, Sophie; Muise, Amy; Impett, Emily A; Rosen, Natalie O

    2017-11-01

    couples coping with PVD. Dubé JP, Bergeron S, Muise A, et al. A Comparison of Approach and Avoidance Sexual Goals in Couples With Vulvodynia and Community Controls. J Sex Med 2017;14:1412-1420. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  3. Traction cytometry: regularization in the Fourier approach and comparisons with finite element method.

    Science.gov (United States)

    Kulkarni, Ankur H; Ghosh, Prasenjit; Seetharaman, Ashwin; Kondaiah, Paturu; Gundiah, Namrata

    2018-05-09

    Traction forces exerted by adherent cells are quantified using displacements of embedded markers on polyacrylamide substrates due to cell contractility. Fourier Transform Traction Cytometry (FTTC) is widely used to calculate tractions but has inherent limitations due to errors in the displacement fields; these are mitigated through a regularization parameter (γ) in the Reg-FTTC method. An alternate finite element (FE) approach computes tractions on a domain using known boundary conditions. Robust verification and recovery studies are lacking but essential in assessing the accuracy and noise sensitivity of the traction solutions from the different methods. We implemented the L2 regularization method and defined a maximum curvature point in the traction with γ plot as the optimal regularization parameter (γ*) in the Reg-FTTC approach. Traction reconstructions using γ* yield accurate values of low and maximum tractions (Tmax) in the presence of up to 5% noise. Reg-FTTC is hence a clear improvement over the FTTC method but is inadequate to reconstruct low stresses such as those at nascent focal adhesions. FE, implemented using a node-by-node comparison, showed an intermediate reconstruction compared to Reg-FTTC. We performed experiments using mouse embryonic fibroblast (MEF) and compared results between these approaches. Tractions from FTTC and FE showed differences of ∼92% and 22% as compared to Reg-FTTC. Selection of an optimum value of γ for each cell reduced variability in the computed tractions as compared to using a single value of γ for all the MEF cells in this study.

  4. A Bayesian approach to PET reconstruction using image-modeling Gibbs priors: Implementation and comparison

    International Nuclear Information System (INIS)

    Chan, M.T.; Herman, G.T.; Levitan, E.

    1996-01-01

    We demonstrate that (i) classical methods of image reconstruction from projections can be improved upon by considering the output of such a method as a distorted version of the original image and applying a Bayesian approach to estimate from it the original image (based on a model of distortion and on a Gibbs distribution as the prior) and (ii) by selecting an open-quotes image-modelingclose quotes prior distribution (i.e., one which is such that it is likely that a random sample from it shares important characteristics of the images of the application area) one can improve over another Gibbs prior formulated using only pairwise interactions. We illustrate our approach using simulated Positron Emission Tomography (PET) data from realistic brain phantoms. Since algorithm performance ultimately depends on the diagnostic task being performed. we examine a number of different medically relevant figures of merit to give a fair comparison. Based on a training-and-testing evaluation strategy, we demonstrate that statistically significant improvements can be obtained using the proposed approach

  5. Comparison of two-concentration with multi-concentration linear regressions: Retrospective data analysis of multiple regulated LC-MS bioanalytical projects.

    Science.gov (United States)

    Musuku, Adrien; Tan, Aimin; Awaiye, Kayode; Trabelsi, Fethi

    2013-09-01

    Linear calibration is usually performed using eight to ten calibration concentration levels in regulated LC-MS bioanalysis because a minimum of six are specified in regulatory guidelines. However, we have previously reported that two-concentration linear calibration is as reliable as or even better than using multiple concentrations. The purpose of this research is to compare two-concentration with multiple-concentration linear calibration through retrospective data analysis of multiple bioanalytical projects that were conducted in an independent regulated bioanalytical laboratory. A total of 12 bioanalytical projects were randomly selected: two validations and two studies for each of the three most commonly used types of sample extraction methods (protein precipitation, liquid-liquid extraction, solid-phase extraction). When the existing data were retrospectively linearly regressed using only the lowest and the highest concentration levels, no extra batch failure/QC rejection was observed and the differences in accuracy and precision between the original multi-concentration regression and the new two-concentration linear regression are negligible. Specifically, the differences in overall mean apparent bias (square root of mean individual bias squares) are within the ranges of -0.3% to 0.7% and 0.1-0.7% for the validations and studies, respectively. The differences in mean QC concentrations are within the ranges of -0.6% to 1.8% and -0.8% to 2.5% for the validations and studies, respectively. The differences in %CV are within the ranges of -0.7% to 0.9% and -0.3% to 0.6% for the validations and studies, respectively. The average differences in study sample concentrations are within the range of -0.8% to 2.3%. With two-concentration linear regression, an average of 13% of time and cost could have been saved for each batch together with 53% of saving in the lead-in for each project (the preparation of working standard solutions, spiking, and aliquoting). Furthermore

  6. Concentrations versus amounts of biomarkers in urine: a comparison of approaches to assess pyrethroid exposure

    Directory of Open Access Journals (Sweden)

    Bouchard Michèle

    2008-11-01

    Full Text Available Abstract Background Assessment of human exposure to non-persistent pesticides such as pyrethroids is often based on urinary biomarker measurements. Urinary metabolite levels of these pesticides are usually reported in volume-weighted concentrations or creatinine-adjusted concentrations measured in spot urine samples. It is known that these units are subject to intra- and inter-individual variations. This research aimed at studying the impact of these variations on the assessment of pyrethroid absorbed doses at individual and population levels. Methods Using data obtained from various adult and infantile populations, the intra and inter-individual variability in the urinary flow rate and creatinine excretion rate was first estimated. Individual absorbed doses were then calculated using volume-weighted or creatinine-adjusted concentrations according to published approaches and compared to those estimated from the amounts of biomarkers excreted in 15- or 24-h urine collections, the latter serving as a benchmark unit. The effect of the units of measurements (volume-weighted or creatinine adjusted concentrations or 24-h amounts on results of the comparison of pyrethroid biomarker levels between two populations was also evaluated. Results Estimation of daily absorbed doses of permethrin from volume-weighted or creatinine-adjusted concentrations of biomarkers was found to potentially lead to substantial under or overestimation when compared to doses reconstructed directly from amounts excreted in urine during a given period of time (-70 to +573% and -83 to +167%, respectively. It was also shown that the variability in creatinine excretion rate and urinary flow rate may introduce a bias in the case of between population comparisons. Conclusion The unit chosen to express biomonitoring data may influence the validity of estimated individual absorbed dose as well as the outcome of between population comparisons.

  7. Testing Process Predictions of Models of Risky Choice: A Quantitative Model Comparison Approach

    Directory of Open Access Journals (Sweden)

    Thorsten ePachur

    2013-09-01

    Full Text Available This article presents a quantitative model comparison contrasting the process predictions of two prominent views on risky choice. One view assumes a trade-off between probabilities and outcomes (or nonlinear functions thereof and the separate evaluation of risky options (expectation models. Another view assumes that risky choice is based on comparative evaluation, limited search, aspiration levels, and the forgoing of trade-offs (heuristic models. We derived quantitative process predictions for a generic expectation model and for a specific heuristic model, namely the priority heuristic (Brandstätter, Gigerenzer, & Hertwig, 2006, and tested them in two experiments. The focus was on two key features of the cognitive process: acquisition frequencies (i.e., how frequently individual reasons are looked up and direction of search (i.e., gamble-wise vs. reason-wise. In Experiment 1, the priority heuristic predicted direction of search better than the expectation model (although neither model predicted the acquisition process perfectly; acquisition frequencies, however, were inconsistent with both models. Additional analyses revealed that these frequencies were primarily a function of what Rubinstein (1988 called similarity. In Experiment 2, the quantitative model comparison approach showed that people seemed to rely more on the priority heuristic in difficult problems, but to make more trade-offs in easy problems. This finding suggests that risky choice may be based on a mental toolbox of strategies.

  8. Testing process predictions of models of risky choice: a quantitative model comparison approach

    Science.gov (United States)

    Pachur, Thorsten; Hertwig, Ralph; Gigerenzer, Gerd; Brandstätter, Eduard

    2013-01-01

    This article presents a quantitative model comparison contrasting the process predictions of two prominent views on risky choice. One view assumes a trade-off between probabilities and outcomes (or non-linear functions thereof) and the separate evaluation of risky options (expectation models). Another view assumes that risky choice is based on comparative evaluation, limited search, aspiration levels, and the forgoing of trade-offs (heuristic models). We derived quantitative process predictions for a generic expectation model and for a specific heuristic model, namely the priority heuristic (Brandstätter et al., 2006), and tested them in two experiments. The focus was on two key features of the cognitive process: acquisition frequencies (i.e., how frequently individual reasons are looked up) and direction of search (i.e., gamble-wise vs. reason-wise). In Experiment 1, the priority heuristic predicted direction of search better than the expectation model (although neither model predicted the acquisition process perfectly); acquisition frequencies, however, were inconsistent with both models. Additional analyses revealed that these frequencies were primarily a function of what Rubinstein (1988) called “similarity.” In Experiment 2, the quantitative model comparison approach showed that people seemed to rely more on the priority heuristic in difficult problems, but to make more trade-offs in easy problems. This finding suggests that risky choice may be based on a mental toolbox of strategies. PMID:24151472

  9. Comparison of different modeling approaches to simulate contaminant transport in a fractured limestone aquifer

    DEFF Research Database (Denmark)

    Mosthaf, Klaus; Rosenberg, L.; Balbarini, Nicola

    . Given available field data and model purpose, this paper therefore aims to develop, examine and compare modeling approaches for transport of contaminants in fractured limestone aquifers. The model comparison was conducted for a contaminated site in Denmark, where a plume of a dissolved contaminant (PCE...... was combined with an analysis of heterogeneities and fractures from a nearby excavation (analog site). Methods for translating the geological information and fracture mapping into each of the model concepts were examined. Each model was compared with available field data, considering both model fit...... of field data is the determination of relevant hydraulic properties and interpretation of aqueous and solid phase contaminant concentration sampling data. Traditional water sampling has a bias towards fracture sampling, however concentrations in the limestone matrix are needed for assessing contaminant...

  10. A Comparison of Proliferation Resistance Measures of Misuse Scenarios Using a Markov Approach

    International Nuclear Information System (INIS)

    Yue, M.; Cheng, L.-Y.; Bari, R.

    2008-01-01

    Misuse of declared nuclear facilities is one of the important proliferation threats. The robustness of a facility against these threats is characterized by a number of proliferation resistance (PR) measures. This paper evaluates and compares PR measures for several misuse scenarios using a Markov model approach to implement the pathway analysis methodology being developed by the PR and PP (Proliferation Resistance and Physical Protection) Expert Group. Different misue strategies can be adopted by a proliferator and each strategy is expected to have different impacts on the proliferator's success. Selected as the probabilistic measure to represent proliferation resistance, the probabilities of the proliferator's success of misusing a hypothetical ESFR (Example Sodium Fast Reactor) facility system are calculated using the Markov model based on the pathways constructed for individual misuse scenarios. Insights from a comparison of strategies that are likely to be adopted by the proliferator are discussed in this paper.

  11. The Innovative Approaches to Packaging – Comparison Analysis of Intelligent and Active Packaging Perceptions in Slovakia

    Directory of Open Access Journals (Sweden)

    Loucanova Erika

    2017-06-01

    Full Text Available Packaging has always served a practical function - to hold goods together and protect it when moving toward the customer through distribution channel. Today packaging is also a container for promoting the product and making it easier and safer to use. The sheer importance of packaging functions is still growing and consequently the interest of the company is to access to the packaging more innovative and creative. The paper deals with the innovative approaches to packaging resulting in the creation of packaging with interactive active features in the form of active and intelligent packaging. Using comparative analysis, we monitored the perception of the active packaging functions in comparison to intelligent packaging function among different age categories. We identified the age categories which are most interested in these functions.

  12. Rigorous approach to the comparison between experiment and theory in Casimir force measurements

    International Nuclear Information System (INIS)

    Klimchitskaya, G L; Chen, F; Decca, R S; Fischbach, E; Krause, D E; Lopez, D; Mohideen, U; Mostepanenko, V M

    2006-01-01

    In most experiments on the Casimir force the comparison between measurement data and theory was done using the concept of the root-mean-square deviation, a procedure that has been criticized in the literature. Here we propose a special statistical analysis which should be performed separately for the experimental data and for the results of the theoretical computations. In so doing, the random, systematic and total experimental errors are found as functions of separation, taking into account the distribution laws for each error at 95% confidence. Independently, all theoretical errors are combined to obtain the total theoretical error at the same confidence. Finally, the confidence interval for the differences between theoretical and experimental values is obtained as a function of separation. This rigorous approach is applied to two recent experiments on the Casimir effect

  13. The comparison of grey-scale ultrasonic and clinical features of hepatoblastoma and hepatocellular carcinoma in children: a retrospective study for ten years

    Directory of Open Access Journals (Sweden)

    Luo Yan

    2011-06-01

    Full Text Available Abstract Background Hepatoblastoma (HBL and hepatocellular carcinoma (HCC are respectively the first and the second most common pediatric malignant liver tumors. The purpose of this study was to evaluate the combined use of the ultrasound examination and the assessment of the patients' clinical features for differentiating HBL from HCC in children. Methods Thirty cases of the confirmed HBL and 12 cases of the confirmed HCC in children under the age of 15 years were enrolled into our study. They were divided into the HBL group and the HCC group according to the histological types of the tumors. The ultrasonic features and the clinical manifestations of the two groups were retrospectively analyzed, with an emphasis on the following parameters: onset age, gender (male/female ratio, positive epatitis-B-surface-antigen (HBV, alpha-fetoprotein increase, and echo features including septa, calcification and liquefaction within the tumors. Results Compared with the children with HCC, the children with HBL had a significantly younger onset age (8.2 years vs. 3.9 years, P Conclusion Ultrasonic features combined with clinical manifestations are valuable for differentiating HBL from HCC in children.

  14. Relevance of CT and MRI in retinoblastoma for the diagnosis of postlaminar invasion with normal-size optic nerve: a retrospective study of 150 patients with histological comparison

    International Nuclear Information System (INIS)

    Brisse, Herve J.; Guesmi, Myriam; Neuenschwander, Sylvia; Aerts, Isabelle; Sastre-Garau, Xavier; Savignoni, Alexia; Asselain, Bernard; Bours, Daniele; Lumbroso-Le Rouic, Livia; Desjardins, Laurence; Doz, Francois

    2007-01-01

    Detection of optic nerve invasion is mandatory in children primarily enucleated for retinoblastoma to ensure a free resection margin. To assess the accuracy of CT and MRI for the detection of postlaminar invasion in normal-size nerves. A total of 150 patients enucleated for retinoblastoma were included. Imaging data (119 CT and 46 MRI) were retrospectively reviewed and compared with histological findings. Abnormal contrast enhancement of the optic nerve was used as diagnostic criterion for invasion. The associations between postlaminar invasion and several indirect signs were also assessed. Statistical analysis was performed with the Kruskal-Wallis and Fisher exact tests. Postlaminar invasion on histology was observed in 8% (12/150). The sensitivity, specificity, accuracy and negative and positive predictive values were 60%, 95%, 91%, 95% and 60% for MRI, and 0%, 100%, 94% and 94% (PPV not assessable) for CT, respectively. Tumour diameter was the only indirect radiological sign significantly associated with postlaminar optic nerve invasion (P=0.002). Our results suggest that MRI is more relevant than CT for preoperative detection of optic nerve invasion in patients with retinoblastoma. Tumour diameter is the only indirect sign significantly associated with postlaminar invasion. (orig.)

  15. Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Hwa; Ko, Sung Min [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Radiology, Research Institute of Medical Science, Seoul (Korea, Republic of); Hwang, Hweung Kon [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiology, Seoul (Korea, Republic of); Song, Meong Gun; Shin, Je Kyoun [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Thoracic surgery, Seoul (Korea, Republic of); Kang, Woon Seok; Kim, Tae-Yop [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Anesthesiology, Seoul (Korea, Republic of)

    2013-11-15

    This retrospective study aims to assess the accuracy of two-phase computed tomography (CT) and transoesophageal echocardiography (TEE) for the detection of left atrial (LA) thrombus in patients with mitral stenosis (MS) and atrial fibrillation (AF), by using intraoperative findings as the reference standard. Preoperative two-phase CT and intraoperative TEE were performed in 106 patients with MS and AF. The ratio (LAA/AA{sub L}) of Hounsfield units (HU) in the LA appendage (LAA) to the ascending aorta (AA) was calculated on the late-phase CT image. LA echodense masses on TEE and LA filling defects on two-phase CT were observed in 29 and 39 patients, respectively. Thirty-five LA thrombi were identified at surgery in 27 patients. Compared with the intraoperative findings, per-patient sensitivity, specificity, positive and negative predictive values of two-phase CT were 100 %, 85 %, 69 % and 100 %, and those by using TEE were 93 %, 95 %, 86 % and 97 % in detecting LAA thrombus. After adopting the cut-off value of 0.5 for the LAA/AA{sub L} HU ratio, the specificity and positive predictive value of two-phase CT were increased to 96 % and 90 %, respectively. Two-phase CT with a cut-off value of LAA/AA{sub L} HU ratio of 0.5 provides high performance for the detection of LAA thrombus. (orig.)

  16. A comparison of antenatal classifications of 'overweight' and 'obesity' prevalence between white British, Indian, Pakistani and Bangladeshi pregnant women in England; analysis of retrospective data.

    Science.gov (United States)

    Garcia, Rebecca; Ali, Nasreen; Guppy, Andy; Griffiths, Malcolm; Randhawa, Gurch

    2017-04-11

    Maternal obesity increases women's risk of poor birth outcomes, and statistics show that Pakistani and Bangladeshi women (who are born or settled) in the UK experience higher rates of perinatal mortality and congenital anomalies than white British or white Other women. This study compares the prevalence of maternal obesity in Indian, Pakistani, Bangladeshi and white British women using standard and Asian-specific BMI metrics. Retrospective cross-sectional analysis using routinely recorded secondary data in Ciconia Maternity information System (CMiS), between 2008 and 2013. Mothers (n = 15,205) whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian. Adjusted standardised residuals and Pearson Chi-square. Percentage of mothers stratified by ethnicity (Indian, Pakistani, Bangladeshi and white British) who are classified as overweight or obese using standard and revised World Health Organisation BMI thresholds. Compared to standard BMI thresholds, using the revised BMI threshold resulted in a higher prevalence of obesity: 22.8% of Indian and 24.3% of Bangladeshi and 32.3% of Pakistani women. Pearson Chi-square confirmed that significantly more Pakistani women were classified as 'obese' compared with white British, Indian or Bangladeshi women (χ 2  = 499,88 df = 9, p women stratified by maternal ethnicity of white British, Indian, Pakistani and Bangladeshi. Using revised anthropometric measures in Indian, Pakistani and Bangladeshi women has clinical implications for identifying risks associated with obesity and increased complications in pregnancy.

  17. Relevance of CT and MRI in retinoblastoma for the diagnosis of postlaminar invasion with normal-size optic nerve: a retrospective study of 150 patients with histological comparison

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, Herve J.; Guesmi, Myriam; Neuenschwander, Sylvia [Institute Curie, Department of Radiology, Paris (France); Aerts, Isabelle [Institute Curie, Department of Paediatric Oncology, Paris (France); Sastre-Garau, Xavier [Institute Curie, Department of Pathology, Paris (France); Savignoni, Alexia; Asselain, Bernard; Bours, Daniele [Institute Curie, Department of Biostatistics, Paris (France); Lumbroso-Le Rouic, Livia; Desjardins, Laurence [Institute Curie, Department of Ocular Oncology, Paris (France); Doz, Francois [Institute Curie, Department of Paediatric Oncology, Paris (France); Faculty of Medicine, Department of Paediatrics, Paris (France)

    2007-07-15

    Detection of optic nerve invasion is mandatory in children primarily enucleated for retinoblastoma to ensure a free resection margin. To assess the accuracy of CT and MRI for the detection of postlaminar invasion in normal-size nerves. A total of 150 patients enucleated for retinoblastoma were included. Imaging data (119 CT and 46 MRI) were retrospectively reviewed and compared with histological findings. Abnormal contrast enhancement of the optic nerve was used as diagnostic criterion for invasion. The associations between postlaminar invasion and several indirect signs were also assessed. Statistical analysis was performed with the Kruskal-Wallis and Fisher exact tests. Postlaminar invasion on histology was observed in 8% (12/150). The sensitivity, specificity, accuracy and negative and positive predictive values were 60%, 95%, 91%, 95% and 60% for MRI, and 0%, 100%, 94% and 94% (PPV not assessable) for CT, respectively. Tumour diameter was the only indirect radiological sign significantly associated with postlaminar optic nerve invasion (P=0.002). Our results suggest that MRI is more relevant than CT for preoperative detection of optic nerve invasion in patients with retinoblastoma. Tumour diameter is the only indirect sign significantly associated with postlaminar invasion. (orig.)

  18. Comparison of intracytoplasmic sperm injection with testicular spermatozoa success in infertile men with obstructive and non-obstructive azoospermia; a retrospective analysis.

    Science.gov (United States)

    Yalcin, Ibrahim; Berker, Bulent; Sukur, Yavuz Emre; Kahraman, Korhan; Ates, Can

    2017-09-01

    The aim of this study was to compare the outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer between couples with infertility due to male non-obstructive azoospermia (NOA) and obstructive azoospermia (OA). A retrospective analysis of 234 couples with azoospermia who were treated by ICSI and embryo transfer between January 2007 and October 2010 was performed. There were 61 couples in NOA group and 173 couples in OA group. Fertilization rates, pregnancy and clinical pregnancy rates were the main outcome measures. The number of retrieved mature oocytes, injected oocytes, metaphase II (MII) oocytes, two distinct pronuclei oocytes, cleavage embryos and embryos transferred was not significantly different between the groups. The fertilization rate was significantly lower in NOA group when compared to OA group (56.2 vs. 66.7%, respectively; p = 0.013) and the pregnancy rate was significantly lower in NOA group than OA group (36.1 vs. 50.9%, respectively; p = 0.046). The clinical pregnancy rates were not statistically different between the patients with NOA and OA azoospermia groups (24.6 vs. 36.4%, respectively; p = 0.09). This study suggests that ICSI and embryo transfer together with testicular sperm extraction results in statistically significant lower fertilization and pregnancy rates in men with NOA when compared to men with OA.

  19. Intraoperative Right Ventricular Fractional Area Change Is a Good Indicator of Right Ventricular Contractility: A Retrospective Comparison Using Two- and Three-Dimensional Echocardiography.

    Science.gov (United States)

    Imada, Tatsuyuki; Kamibayashi, Takahiko; Ota, Chiho; Carl Shibata, Sho; Iritakenishi, Takeshi; Sawa, Yoshiki; Fujino, Yuji

    2015-08-01

    Intraoperative two-dimensional echocardiography is technically challenging, given the unique geometry of the right ventricle (RV). It was hypothesized that the RV fractional area change (RVFAC) could be used as a simple method to evaluate RV function during surgery. Therefore, the correlation between the intraoperative RVFAC and the true right ventricular ejection fraction (RVEF), as measured using newly developed three-dimensional (3D) analysis software, was evaluated. Retrospective study. University hospital. Patients who underwent cardiac surgery with transesophageal echocardiography monitoring between March 2014 and June 2014. None. Sixty-two patients were included in this study. After the exclusion of poor imaging data and patients with arrhythmias, 54 data sets were analyzed. RVFAC was measured by one anesthesiologist during surgery, and full-volume 3D echocardiographic data were recorded simultaneously. The 3D data were analyzed postoperatively using off-line 3D analysis software by a second anesthesiologist, who was blinded to the RVFAC results. The mean RVFAC was 38.8% ± 8.7%, the mean RVEF was 41.4% ± 8.3%, and there was a good correlation between the RVFAC and the RVEF (r(2) = 0.638; prights reserved.

  20. Retrospective comparison of surgical ligation and transarterial catheter occlusion for treatment of patent ductus arteriosus in two hundred and four dogs (1993-2003).

    Science.gov (United States)

    Goodrich, Kimberly R; Kyles, Andrew E; Kass, Phillip H; Campbell, Fiona

    2007-01-01

    To compare procedure time, complications, mortality, and short-term outcome in dogs with patent ductus arteriosus (PDA) treated by surgical ligation (SL) or transarterial coil occlusion (TCO). Retrospective study. Dogs with PDA (n=204). Medical records of dogs treated for PDA were reviewed. Dogs treated by SL when it was the primary method used for PDA treatment (1993-1998) were compared with dogs treated by TCO when it was the primary method used for PDA treatment (1999-2003). Dogs treated during the transition between techniques, dogs treated with SL (1999-2003) and dogs treated with TCO before 1999, as well as dogs with pulmonary hypertension, or bidirectional or reversed (right-to-left) flow through the PDA were excluded from analysis. Age, weight, gender distribution, and procedure times (P=.43) were similar for both groups. Major complications were more common with SL (12% versus 4.3%; P=.035) whereas minor complications were more common with TCO (12% versus 26%; P=.015). Initial success rate was higher for SL (94%) compared with TCO (84%; P=.027). There was no significant difference in mortality between SL (5.6%) and TCO (2.6%; P=.27). Both SL and TCO are acceptable PDA treatments with comparable mortality; however, SL was associated with a higher risk of major complications and TCO was associated with a lower initial success rate.

  1. Comparison between experiment and MCNP simulation for retrospective dosimetry according to the geometry of exposure using electronic components in a mobile phone

    International Nuclear Information System (INIS)

    Kim, Min Chae; Kim, Hyoungtaek; Lee, Seung Kyu; Chang, Insu; Lee, Jungil; Kim, Jang-Lyul; Kim, Bong-Hwan; Kim, Chan Hyeong

    2017-01-01

    Many efforts are carrying out for the use of thermoluminescence (TL) and optically stimulated luminescence (OSL) of personal electronic devices (such as mobile phone, USB memory chip etc.) as fortuitous dosimeters in the case of radiation emergency. A correction is required when evaluating the exposure dose to the body using the measured dose to the devices. As a starting point of this purpose, we have studied to evaluate the effects of the position of the electronic device on human body to measure the dose to the electronic device (mobile phone). We evaluated the doses to the mobile phone by using Monte Carlo N-Particle (MCNP) simulations and TL method with resistors and inductors in the mobile phone, and the results were then compared. We have studied to evaluate the effects of the position of mobile phone on human body to measure the dose to the phone with TL method and MCNP simulation method, and then compared. The results obtained by the TL experiments showed excellent agreement with the simulation results. With these results, it is expected that the retrospective estimation of the exposure dose to human body is possible by using the dose to mobile phone measured by TL analysis of resistors and inductors in phone.

  2. Comparison of Transverse Intraosseous Loop Technique and Pull Out Suture for Reinsertion of the Flexor Digitorum Profundus tendon. A Retrospective Study.

    Science.gov (United States)

    Rigó, István Zoltán; Røkkum, Magne

    2013-12-01

    We compared the results of two methods for reinsertion of flexor digitorum profundus tendons retrospectively. In 35 fingers of 29 patients pull-out suture and in 13 fingers of 11 patients transverse intraosseous loop technique was performed with a mean follow-up of 8 and 6 months, respectively. Eleven and nine fingers achieved "excellent" or "good" function according to Strickland and Glogovac at 8 weeks; 20 and ten at the last control in the pull-out and transverse intraosseous loop groups, respectively. The difference at 8 weeks was statistically significant in favour of the transverse intraosseous loop group. Ten patients underwent 12 complications in the pull-out group (four superficial infections; one rerupture, one PIP and one DIP joint contracture, one adhesion, two granulomas, one nail deformity and one carpal tunnel syndrome) and four of them were reoperated (one carpal tunnel release, one teno-arthrolysis and two resections of granuloma). There was no complication and no reoperation in the transverse intraosseous loop group, the difference being statistically significant for the former. In our study the transverse intraosseous loop technique seemed to be a safe alternative with possibly better functional results compared to the pull-out suture.

  3. Comparison of C-arm computed tomography and on-site quick cortisol assay for adrenal venous sampling: A retrospective study of 178 patients

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Chin-Chen; Lee, Bo-Ching; Chang, Yeun-Chung; Liu, Kao-Lang [National Taiwan University Hospital and National Taiwan University College of Medicine, Department of Medical Imaging, Taipei (China); Wu, Vin-Cent [National Taiwan University Hospital and National Taiwan University College of Medicine, Department of Internal Medicine, Taipei (China); Huang, Kuo-How [National Taiwan University Hospital and National Taiwan University College of Medicine, Department of Urology, Taipei (China); Collaboration: on behalf of the TAIPAI Study Group

    2017-12-15

    To compare the performance of on-site quick cortisol assay (QCA) and C-arm computed tomography (CT) assistance on adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. The institutional review board at our hospital approved this retrospective study, which included 178 consecutive patients with primary aldosteronism. During AVS, we used C-arm CT to confirm right adrenal cannulation between May 2012 and June 2015 (n = 100) and QCA for bilateral adrenal cannulation between July 2015 and September 2016 (n = 78). Successful AVS required a selectivity index (cortisol{sub adrenal} {sub vein}/cortisol{sub peripheral}) of ≥ 2.0 bilaterally. The overall success rate of C-arm CT-assisted AVS was 87%, which increased to 97.4% under QCA (P =.013). The procedure time (C-arm CT, 49.5 ± 21.3 min; QCA, 37.5 ± 15.6 min; P <.001) and radiation dose (C-arm CT, 673.9 ± 613.8 mGy; QCA, 346.4 ± 387.8 mGy; P <.001) were also improved. The resampling rate was 16% and 21.8% for C-arm CT and QCA, respectively. The initial success rate of the performing radiologist remained stable during the study period (C-arm CT 75%; QCA, 82.1%, P =.259). QCA might be superior to C-arm CT for improving the performance of AVS. (orig.)

  4. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Science.gov (United States)

    Myles, Puja R; Nguyen-Van-Tam, Jonathan S; Lim, Wei Shen; Nicholson, Karl G; Brett, Stephen J; Enstone, Joanne E; McMenamin, James; Openshaw, Peter J M; Read, Robert C; Taylor, Bruce L; Bannister, Barbara; Semple, Malcolm G

    2012-01-01

    Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs), the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS); to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3) and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children) with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC), sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI): CATs 0.77 (0.73, 0.80); CURB-65 0.68 (0.64, 0.72); PMEWS 0.68 (0.64, 0.73), ptools for predicting need for higher levels of care and/or mortality in patients of all ages.

  5. Comparison of C-arm computed tomography and on-site quick cortisol assay for adrenal venous sampling: A retrospective study of 178 patients.

    Science.gov (United States)

    Chang, Chin-Chen; Lee, Bo-Ching; Chang, Yeun-Chung; Wu, Vin-Cent; Huang, Kuo-How; Liu, Kao-Lang

    2017-12-01

    To compare the performance of on-site quick cortisol assay (QCA) and C-arm computed tomography (CT) assistance on adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. The institutional review board at our hospital approved this retrospective study, which included 178 consecutive patients with primary aldosteronism. During AVS, we used C-arm CT to confirm right adrenal cannulation between May 2012 and June 2015 (n = 100) and QCA for bilateral adrenal cannulation between July 2015 and September 2016 (n = 78). Successful AVS required a selectivity index (cortisol adrenal vein /cortisol peripheral ) of ≥ 2.0 bilaterally. The overall success rate of C-arm CT-assisted AVS was 87%, which increased to 97.4% under QCA (P = .013). The procedure time (C-arm CT, 49.5 ± 21.3 min; QCA, 37.5 ± 15.6 min; P AVS. • Adrenal venous sampling (AVS) is a technically challenging procedure. • C-arm CT and quick cortisol assay (QCA) are efficient for assisting AVS. • QCA might outperform C-arm CT in enhancing AVS performance.

  6. Support vector methods for survival analysis: a comparison between ranking and regression approaches.

    Science.gov (United States)

    Van Belle, Vanya; Pelckmans, Kristiaan; Van Huffel, Sabine; Suykens, Johan A K

    2011-10-01

    To compare and evaluate ranking, regression and combined machine learning approaches for the analysis of survival data. The literature describes two approaches based on support vector machines to deal with censored observations. In the first approach the key idea is to rephrase the task as a ranking problem via the concordance index, a problem which can be solved efficiently in a context of structural risk minimization and convex optimization techniques. In a second approach, one uses a regression approach, dealing with censoring by means of inequality constraints. The goal of this paper is then twofold: (i) introducing a new model combining the ranking and regression strategy, which retains the link with existing survival models such as the proportional hazards model via transformation models; and (ii) comparison of the three techniques on 6 clinical and 3 high-dimensional datasets and discussing the relevance of these techniques over classical approaches fur survival data. We compare svm-based survival models based on ranking constraints, based on regression constraints and models based on both ranking and regression constraints. The performance of the models is compared by means of three different measures: (i) the concordance index, measuring the model's discriminating ability; (ii) the logrank test statistic, indicating whether patients with a prognostic index lower than the median prognostic index have a significant different survival than patients with a prognostic index higher than the median; and (iii) the hazard ratio after normalization to restrict the prognostic index between 0 and 1. Our results indicate a significantly better performance for models including regression constraints above models only based on ranking constraints. This work gives empirical evidence that svm-based models using regression constraints perform significantly better than svm-based models based on ranking constraints. Our experiments show a comparable performance for methods

  7. Derringer desirability and kinetic plot LC-column comparison approach for MS-compatible lipopeptide analysis.

    Science.gov (United States)

    D'Hondt, Matthias; Verbeke, Frederick; Stalmans, Sofie; Gevaert, Bert; Wynendaele, Evelien; De Spiegeleer, Bart

    2014-06-01

    Lipopeptides are currently re-emerging as an interesting subgroup in the peptide research field, having historical applications as antibacterial and antifungal agents and new potential applications as antiviral, antitumor, immune-modulating and cell-penetrating compounds. However, due to their specific structure, chromatographic analysis often requires special buffer systems or the use of trifluoroacetic acid, limiting mass spectrometry detection. Therefore, we used a traditional aqueous/acetonitrile based gradient system, containing 0.1% (m/v) formic acid, to separate four pharmaceutically relevant lipopeptides (polymyxin B 1 , caspofungin, daptomycin and gramicidin A 1 ), which were selected based upon hierarchical cluster analysis (HCA) and principal component analysis (PCA). In total, the performance of four different C18 columns, including one UPLC column, were evaluated using two parallel approaches. First, a Derringer desirability function was used, whereby six single and multiple chromatographic response values were rescaled into one overall D -value per column. Using this approach, the YMC Pack Pro C18 column was ranked as the best column for general MS-compatible lipopeptide separation. Secondly, the kinetic plot approach was used to compare the different columns at different flow rate ranges. As the optimal kinetic column performance is obtained at its maximal pressure, the length elongation factor λ ( P max / P exp ) was used to transform the obtained experimental data (retention times and peak capacities) and construct kinetic performance limit (KPL) curves, allowing a direct visual and unbiased comparison of the selected columns, whereby the YMC Triart C18 UPLC and ACE C18 columns performed as best. Finally, differences in column performance and the (dis)advantages of both approaches are discussed.

  8. Comparison of Different Approaches to Predict the Performance of Pumps As Turbines (PATs

    Directory of Open Access Journals (Sweden)

    Mauro Venturini

    2018-04-01

    Full Text Available This paper deals with the comparison of different methods which can be used for the prediction of the performance curves of pumps as turbines (PATs. The considered approaches are four, i.e., one physics-based simulation model (“white box” model, two “gray box” models, which integrate theory on turbomachines with specific data correlations, and one “black box” model. More in detail, the modeling approaches are: (1 a physics-based simulation model developed by the same authors, which includes the equations for estimating head, power, and efficiency and uses loss coefficients and specific parameters; (2 a model developed by Derakhshan and Nourbakhsh, which first predicts the best efficiency point of a PAT and then reconstructs their complete characteristic curves by means of two ad hoc equations; (3 the prediction model developed by Singh and Nestmann, which predicts the complete turbine characteristics based on pump shape and size; (4 an Evolutionary Polynomial Regression model, which represents a data-driven hybrid scheme which can be used for identifying the explicit mathematical relationship between PAT and pump curves. All approaches are applied to literature data, relying on both pump and PAT performance curves of head, power, and efficiency over the entire range of operation. The experimental data were provided by Derakhshan and Nourbakhsh for four different turbomachines, working in both pump and PAT mode with specific speed values in the range 1.53–5.82. This paper provides a quantitative assessment of the predictions made by means of the considered approaches and also analyzes consistency from a physical point of view. Advantages and drawbacks of each method are also analyzed and discussed.

  9. LEGAL CERTAINTY OF INDUSTRIAL DESIGN REVENUE IN INDONESIA BASED ON INTELLECTUAL PROPERTY APPROACH AND LEGAL COMPARISON

    Directory of Open Access Journals (Sweden)

    Ranti Fauza Mayana

    2018-03-01

    Full Text Available [Legal Certainty Of Industrial Design Revenue  In Indonesia Based On Intellectual Property Approach And Legal Comparison]  Protection of Industrial Designs, as well as intellectual property, is based on the ability of human creativity through creativity, taste and intention. According to Article 25 paragraph (1 TRIPs Protected Industrial Design Agreement is a new or original Industrial Design, this provision holds the principle that the novelty of a design is obtained when the design is differ from the previous, the novelty includes novelty and originality, the principal basis for the grant of Industrial Design, whereas this principle is not fully adopted in the provisions of Industrial Design. The Industrial Design Decree in Indonesia only requires novelty without clarifying how to interpret the novelty requirement so that a large number of Industrial Design Rights are obtained based on the Minor Change approach where slight differences in form and configuration have essentially demonstrated novelty. The minor change approach is considered to exclude the aspect of originality and is less able to provide legal certainty to the holder of the registered Industrial Design Rights. This paper aims to explore minor change approach as the basis for the evaluation of the novelty of Industrial Design in the perspective of comparative law in several countries of the world, namely the United States, Japan, the European Union and Australia as a study and reference material in an effort to establish protection of Industrial Design Rights in Indonesia that can provide legal certainty. Keywords: Industrial Design Revenue, Comparative Law.

  10. A Retrospective Comparison of Ultrasound-Assisted Catheter-Directed Thrombolysis and Catheter-Directed Thrombolysis Alone for Treatment of Proximal Deep Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Tichelaar, Vladimir Y. I. G., E-mail: ynse.i.tichelaar@uit.no; Brodin, Ellen E.; Vik, Anders; Isaksen, Trond [UiT – The Arctic University of Norway, K. G. Jebsen – Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine (Norway); Skjeldestad, Finn Egil [UiT – The Arctic University of Norway, Research Group Epidemiology of Chronic Diseases, Department of Community Medicine (Norway); Kumar, Satish; Trasti, Nora C.; Singh, Kulbir [University Hospital of North Norway, Department of Radiology (Norway); Hansen, John-Bjarne [UiT – The Arctic University of Norway, K. G. Jebsen – Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine (Norway)

    2016-08-15

    BackgroundRecent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up.MethodsWe describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT. Scheduled follow-up visits took place between April 2013 and January 2014. Venography measured the degree of residual luminal obstruction of the affected veins. Each patient completed the Short Form 36-item health survey assessment and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaires. PTS was assessed using the Villalta scale.ResultsRisk factors of DVT were equally distributed between groups. In the USCDT group, we observed a significant decline in the duration of thrombolytic treatment (<48 h: 27 vs. 10 %), shortened hospital stay (median 6.0 days (IQR 5.0–9.0) vs. 8.0 (IQR 5.8–12.0)), and less implantation of (intravenous) stents (30 vs. 55 %). There was no difference in patency (76 vs. 79 % fully patent), prevalence of PTS (52 vs. 55 %), or quality of life between groups after long-term follow-up (median 65 months, range: 15–141).ConclusionsIn this observational study, USCDT was associated with shortened treatment duration, shorter hospital stay, and less intravenous stenting, compared to CDT alone without affecting the long-term prevalence of PTS or quality of life.

  11. Mitigating Latent Threats Identified through an Embedded In Situ Simulation Program and Their Comparison to Patient Safety Incidents: A Retrospective Review

    Directory of Open Access Journals (Sweden)

    Philip Knight

    2018-02-01

    Full Text Available ObjectiveTo assess the impact of service improvements implemented because of latent threats (LTs detected during in situ simulation.DesignRetrospective review from April 2008 to April 2015.SettingPaediatric Intensive Care Unit in a specialist tertiary hospital.InterventionService improvements from LTs detection during in situ simulation. Action plans from patient safety incidents (PSIs.Main outcome measuresThe quantity, category, and subsequent service improvements for LTs. The quantity, category, and subsequent action plans for PSIs. Similarities between PSIs and LTs before and after service improvements.Results201 Simulated inter-professional team training courses with 1,144 inter-professional participants. 44 LTs were identified (1 LT per 4.6 courses. Incident severity varied: 18 (41% with the potential to cause harm, 20 (46% that would have caused minimal harm, and 6 (13% that would have caused significant temporary harm. Category analysis revealed the majority of LTs were resources (36% and education and training (27%. The remainder consisted of equipment (11%, organizational and strategic (7%, work and environment (7%, medication (7%, and systems and protocols (5%. 43 service improvements were developed: 24 (55% resources/equipment; 9 (21% educational; 6 (14% organizational changes; 2 (5% staff communications; and 2 (5% guidelines. Four (9% service improvements were adopted trust wide. 32 (73% LTs did not recur after service improvements. 24 (1% of 1,946 PSIs were similar to LTs: 7 resource incidents, 7 catastrophic blood loss, 4 hyperkalaemia arrests, 3 emergency buzzer failures, and 3 difficulties contacting staff. 34 LTs (77% were never recorded as PSIs.ConclusionAn in situ simulation program can identify important LTs which traditional reporting systems miss. Subsequent improvements in workplace systems and resources can improve efficiency and remove error traps.

  12. Retrospective comparison of Traditional vs. LigaSure impact dissection during pancreatoduodenectomy: how to save money by using an expensive device.

    Science.gov (United States)

    Piccinni, Giuseppe; Pasculli, Alessandro; D'Ambrosio, Erasmina; Gurrado, Angela; Lissidini, Germana; Testini, Mario

    2013-09-01

    Pancreatoduodenectomy is an exceptional procedure that requires an extensive dissection of the supramesocolic region extended to the first jejunal limb. Lymphadenectomy, required for cancer, increases the dissection surface. The extensive preparation of the area is traditionally conducted with bipolar ormonopolar instruments, while clips, ligatures, and sutures are used for haemostasis. LigaSure™ vessel sealing(LSVS; Valleylab, Boulder, CO) is a technology that obtains vessel closure by using the body's own collagen and elastin to create a permanent fusion zone. This is obtained by a combination of forceps pressure and radio frequency. This effect has been improved by the introduction of the Force Triad™ (Valleylab, Boulder,CO) energy platform, controlled by TissueFect™ (Valleylab, Boulder, CO) sensing technology. With this device, the surgeon is able to fuse vessels up to 7 mm, lymphatics, tissue bundles, and pulmonary vasculature in a fast-seal cycle of almost 4 seconds. In our daily practice of open surgery we observe a rapid improvement of abdominal drainage output with a drastic reduction of protein loss. Its practical significance is, in our opinion, that we obtain a rapid recovery of normal serum protein levels with a low number of blood/plasmasac transfusions and a real improvement of anastomosis healing. Moreover, the efficacy and the speed of work of the device allow us to reduce the operating time significantly but safely. We performed a retrospective analysis of the data of 20 pancreatic resections conducted both with traditional dissection and with the Liga-Sure Impact device with Force Triad platform in order to verify whether observed data were real. Our clinical results show that the use of the LigaSure Impact device with Force Triad energy platform is really useful in open surgery to save operating time, number of postoperative days, and hemoderivate administration.

  13. A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review.

    Science.gov (United States)

    Özdin, Selçuk; Sarisoy, Gökhan; Böke, Ömer

    2017-10-01

    Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) have recently been used as indicators of inflammation. Higher MLR and PLR values have been determined in the euthymic and manic periods in patients with bipolar disorder compared to a control group. High NLR values were determined in the only study investigating this ratio in schizophrenia patients. The purpose of this study was to compare NLR, PLR and MLR values and complete blood count elements in patients receiving treatment and hospitalized due to schizophrenic psychotic episode and bipolar disorder manic episode. All patients meeting the inclusion criteria among subjects receiving treatment and hospitalized due to schizophrenia-psychotic episode and bipolar affective disorder-manic episode at the Ondokuz Mayıs University Medical Faculty Psychiatry Department, Turkey, in 2012-2016 were included in our study. A total of 157 healthy donors were included as a control group. White blood cell (WBC), neutrophil, lymphocyte, platelet and monocyte numbers were noted retrospectively from complete blood counts at time of admission, and NLR, PLR and MLR were calculated from these. NLR, PLR and MLR values and platelet numbers in this study were higher and lymphocyte numbers were lower in bipolar disorder patients compared to the controls. Elevation in NLR, MLR and PLR values and neutrophil numbers and lower lymphocyte numbers were determined in schizophrenia patients compared to the controls. Higher NLR and MLR values were found in schizophrenia patients compared to bipolar disorder. Findings of our study supported the inflammation hypothesis for schizophrenia and bipolar disorder.

  14. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Directory of Open Access Journals (Sweden)

    Puja R Myles

    Full Text Available Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs, the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS; to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3 and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC, sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI: CATs 0.77 (0.73, 0.80; CURB-65 0.68 (0.64, 0.72; PMEWS 0.68 (0.64, 0.73, p<0.001] and children [AUROC: CATs 0.74 (0.68, 0.80; CURB-65 0.52 (0.46, 0.59; PMEWS 0.69 (0.62, 0.75, p<0.001]. CURB-65 and CATs were similar in predicting death in adults with both performing better than PMEWS; and CATs best predicted death in children. CATs were the best predictor of Level 2/3 care and/or death for both adults and children. CATs are potentially useful triage tools for predicting need for higher levels of care and/or mortality in patients of all ages.

  15. Management of hip fractures in older people in Beijing: a retrospective audit and comparison with evidence-based guidelines and practice in the UK.

    Science.gov (United States)

    Tian, M; Gong, X; Rath, S; Wei, J; Yan, L L; Lamb, S E; Lindley, R I; Sherrington, C; Willett, K; Norton, R

    2016-02-01

    Despite the high burden of hip fracture in China, there is limited information on its management. This study investigated the management of hip fractures in a Beijing tertiary hospital and compared practice with that in 180 hospitals in the UK. The findings show a significant gap exists between the countries. The purpose of this study was to determine if the management of older people with hip fractures in a Beijing tertiary hospital is comparable with the UK best practice guidelines for hip fracture management and the UK National Hip Fracture Database 2012, obtained from 180 hospitals. A retrospective audit was undertaken in a large tertiary care hospital in Beijing. Data were compared with the National Hip Fracture Database 2012 collected in 180 hospitals in the UK on the proportion of patients managed according to the UK Blue Book standards. Sixty-six percent of patients were admitted to an orthopaedic ward within 24 h of fracture, while 100 % of patients in the UK were admitted to an orthopaedic ward within 24 h of arrival to an accident and emergency department. Only 8 % of patients received surgery within 48 h of admission compared with 83 % in the UK; 10 % received no surgery compared with 2.5 % in the UK; and 27 % received orthogeriatrician assessment compared with 70 % in the UK. New pressure ulcers developed in 2 % of patients compared with 3.7 % of those in the UK; whereas, 0.3 % of patients were assessed for osteoporosis treatment and 3.8 % received falls assessment, and comparable figures for the UK were 94 and 92 %, respectively. Significant gaps exist in hip fracture management in the Beijing hospital compared with the best practice achieved in 180 UK hospitals, highlighting the need to implement and evaluate proactive strategies to increase the uptake of best practice hip fracture care in China.

  16. The Impact of Smoking and Smoking Cessation on Wound Healing in Spinal Cord-Injured Patients With Pressure Injuries: A Retrospective Comparison Cohort Study.

    Science.gov (United States)

    Lane, Cheryl A; Selleck, Cynthia; Chen, Yuying; Tang, Ying

    2016-01-01

    The purpose of this study was to evaluate the impact of implementing evidence-based guidelines on smoking cessation in persons with spinal cord injuries and pressure injuries. We also evaluated the impact of smoking on pressure injury healing in this population. The sample population included 158 spinal cord-injured patients with pressure injuries (29 females and 129 males). There were 83 in the control group and 75 in the intervention group, with a mean age of 44 years in both groups. The research setting was an outpatient wound clinic located in a large medical center in the southeastern United States. A retrospective chart review was completed. Data were reviewed 6 months before and 6 months after implementation of the US Department of Health and Human Services Clinical Practice Guidelines for Treating Tobacco Use and Dependence. We evaluated the number and size of wounds, achievement of smoking cessation, and demographic information. Forty-eight percent of the control group participants and 57% of the intervention group participants smoked cigarettes at baseline. Smoking cessation doubled with the use of the clinical practice guidelines (P = .03). Smokers presented with a greater number of pressure injuries than nonsmokers. They experienced a mean increase rather than reduction in wound size. Nearly half (45.5%) of the intervention group participants who desired to have surgery had it performed, compared with only 34.9% of the control group participants (P = .35). Our findings demonstrate a positive influence with use of clinical practice guidelines to help individuals stop smoking. Results also confirm findings of previous studies supporting the negative impact of smoking on pressure injury healing in persons with spinal cord injuries.

  17. Comparison of positions of the trochlear groove line and the vertical midline of the pericondylar rectangle on axial computed tomography: a retrospective pilot study

    International Nuclear Information System (INIS)

    Nizic, Dinko

    2012-01-01

    To compare the positions of the trochlear groove (TG) line and the vertical midline of the pericondylar rectangle on axial computed tomography (CT). A retrospective pilot study was conducted in February and March 2011 comprising 14 knees in 9 consecutive patients with patellofemoral pain, a normal trochlear angle (124 -145 ), and no medical record of prior knee surgery. After the axial CT image displaying the center of the trochlear groove (''reference cut'') with a normal trochlear angle was identified, the pericondylar rectangle was drawn and located in the first quadrant of the Cartesian rectangular coordinate system. The x-coordinates of the vertical lines passing through the most posterior point of the trochlear groove (TG line) and the midpoints of the horizontal sides of the pericondylar rectangle (vertical midline) were obtained at 2-week intervals and statistically analyzed as matched pairs for differences (Wilcoxon signed rank test), agreements (Bland-Altman plot, intraclass correlation coefficient [ICC]) and relative variations (coefficient of variation [CV]). There were no statistically significant differences between matched pairs (2-tailed p from 0.583 to 0.641) whereas the agreements were substantial (bias = -0.37 and -0.45 respectively, ICC = 0.688 and 0.670 respectively) to almost perfect for duplicate measurements (bias = 0.11 and 0.04 respectively, ICC = 0.975 and 0.998 respectively), with much less relative variation with regard to the vertical midline (CV = 1.22% to CV = 0.34% respectively). The positions of the TG line and the vertical midline of the pericondylar rectangle on axial CT were identical. The latter was identified regardless of trochlear morphology. (orig.)

  18. Comparison of positions of the trochlear groove line and the vertical midline of the pericondylar rectangle on axial computed tomography: a retrospective pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Nizic, Dinko [Zagreb University Hospital Center, Clinical Institute of Diagnostic and Interventional Radiology, Zagreb (Croatia)

    2012-09-15

    To compare the positions of the trochlear groove (TG) line and the vertical midline of the pericondylar rectangle on axial computed tomography (CT). A retrospective pilot study was conducted in February and March 2011 comprising 14 knees in 9 consecutive patients with patellofemoral pain, a normal trochlear angle (124 -145 ), and no medical record of prior knee surgery. After the axial CT image displaying the center of the trochlear groove (''reference cut'') with a normal trochlear angle was identified, the pericondylar rectangle was drawn and located in the first quadrant of the Cartesian rectangular coordinate system. The x-coordinates of the vertical lines passing through the most posterior point of the trochlear groove (TG line) and the midpoints of the horizontal sides of the pericondylar rectangle (vertical midline) were obtained at 2-week intervals and statistically analyzed as matched pairs for differences (Wilcoxon signed rank test), agreements (Bland-Altman plot, intraclass correlation coefficient [ICC]) and relative variations (coefficient of variation [CV]). There were no statistically significant differences between matched pairs (2-tailed p from 0.583 to 0.641) whereas the agreements were substantial (bias = -0.37 and -0.45 respectively, ICC = 0.688 and 0.670 respectively) to almost perfect for duplicate measurements (bias = 0.11 and 0.04 respectively, ICC = 0.975 and 0.998 respectively), with much less relative variation with regard to the vertical midline (CV = 1.22% to CV = 0.34% respectively). The positions of the TG line and the vertical midline of the pericondylar rectangle on axial CT were identical. The latter was identified regardless of trochlear morphology. (orig.)

  19. A comparison of the intrasubject variation in drug exposure between generic and brand-name drugs: a retrospective analysis of replicate design trials.

    Science.gov (United States)

    Yu, Yang; Teerenstra, Steven; Neef, Cees; Burger, David; Maliepaard, Marc

    2016-04-01

    The aim of the present study was to investigate whether differences in total and peak drug exposure upon generic substitution are due to differences between formulations or to intrasubject pharmacokinetic variability of the active substance. The study was designed as a retrospective reanalysis of existing studies. Nine replicate design bioequivalence studies representing six drug classes - i.e. for alendronate, atorvastatin, cyclosporin, ebastine, exemestane, mycophenolate mofetil, and ropinirole - were retrieved from the Dutch Medicines Regulatory Authority. In most studies, the intrasubject variability in total and peak drug exposure was comparable for the brand-name [in the range 0.01-0.24 for area under the concentration-time curve (AUCt ) and 0.02-0.29 for peak plasma concentration (Cmax ) on a log scale] and generic (0.01-0.23 for AUCt and 0.08-0.33 for Cmax ) drugs, and was comparable with the intrasubject variability upon switching between those drugs (0.01-0.23 for AUCt and 0.06-0.33 for Cmax ). The variance related to subject-by-formulation interaction could be considered negligible (-0.069 to 0.047 for AUCt and -0.091 to 0.02 for Cmax ). In the investigated studies, the variation in total and peak exposure seen when a patient is switched from a brand-name to a generic drug is comparable with that seen following repeated administration of the brand-name drug in the patient. Only the intrasubject variability seems to play a crucial and decisive role in the variation in drug exposure seen; no additional formulation-dependent variation in exposure is observed upon switching. Thus, our data support that, for the medicines that were included in the present investigation, from a clinical pharmacological perspective, the benefit-risk balance of a generic drug is comparable with that of the brand-name drug. © 2015 The British Pharmacological Society.

  20. A comparison of survival outcomes and side effects of toremifene or tamoxifen therapy in premenopausal estrogen and progesterone receptor positive breast cancer patients: a retrospective cohort study

    International Nuclear Information System (INIS)

    Gu, Ran; Long, Meijun; Chen, Kai; Chen, Lili; Xiao, Qiaozhen; Wu, Mei; Song, Erwei; Su, Fengxi; Jia, Weijuan; Zeng, Yunjie; Rao, Nanyan; Hu, Yue; Li, Shunrong; Wu, Jiannan; Jin, Liang; Chen, Lijuan

    2012-01-01

    In premenopausal women, endocrine adjuvant therapy for breast cancer primarily consists of tamoxifen alone or with ovarian suppressive strategies. Toremifene is a chlorinated derivative of tamoxifen, but with a superior risk-benefit profile. In this retrospective study, we sought to establish the role of toremifene as an endocrine therapy for premenopausal patients with estrogen and/or progesterone receptor positive breast cancer besides tamoxifen. Patients with early invasive breast cancer were selected from the breast tumor registries at the Sun Yat-Sen Memorial Hospital (China). Premenopausal patients with endocrine responsive breast cancer who underwent standard therapy and adjuvant therapy with toremifene or tamoxifen were considered eligible. Patients with breast sarcoma, carcinosarcoma, concurrent contralateral primary breast cancer, or with distant metastases at diagnosis, or those who had not undergone surgery and endocrine therapy were ineligible. Overall survival and recurrence-free survival were the primary outcomes measured. Toxicity data was also collected and compared between the two groups. Of the 810 patients reviewed, 452 patients were analyzed in the study: 240 received tamoxifen and 212 received toremifene. The median and mean follow up times were 50.8 and 57.3 months, respectively. Toremifene and tamoxifen yielded similar overall survival values, with 5-year overall survival rates of 100% and 98.4%, respectively (p = 0.087). However, recurrence-free survival was significantly better in the toremifene group than in the tamoxifen group (p = 0.022). Multivariate analysis showed that recurrence-free survival improved independently with toremifene (HR = 0.385, 95% CI = 0.154-0.961; p = 0.041). Toxicity was similar in the two treatment groups with no women experiencing severe complications, other than hot flashes, which was more frequent in the toremifene patients (p = 0.049). No patients developed endometrial cancer. Toremifene may be a valid and

  1. A Retrospective Comparison of Ultrasound-Assisted Catheter-Directed Thrombolysis and Catheter-Directed Thrombolysis Alone for Treatment of Proximal Deep Vein Thrombosis

    International Nuclear Information System (INIS)

    Tichelaar, Vladimir Y. I. G.; Brodin, Ellen E.; Vik, Anders; Isaksen, Trond; Skjeldestad, Finn Egil; Kumar, Satish; Trasti, Nora C.; Singh, Kulbir; Hansen, John-Bjarne

    2016-01-01

    BackgroundRecent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up.MethodsWe describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT. Scheduled follow-up visits took place between April 2013 and January 2014. Venography measured the degree of residual luminal obstruction of the affected veins. Each patient completed the Short Form 36-item health survey assessment and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaires. PTS was assessed using the Villalta scale.ResultsRisk factors of DVT were equally distributed between groups. In the USCDT group, we observed a significant decline in the duration of thrombolytic treatment (<48 h: 27 vs. 10 %), shortened hospital stay (median 6.0 days (IQR 5.0–9.0) vs. 8.0 (IQR 5.8–12.0)), and less implantation of (intravenous) stents (30 vs. 55 %). There was no difference in patency (76 vs. 79 % fully patent), prevalence of PTS (52 vs. 55 %), or quality of life between groups after long-term follow-up (median 65 months, range: 15–141).ConclusionsIn this observational study, USCDT was associated with shortened treatment duration, shorter hospital stay, and less intravenous stenting, compared to CDT alone without affecting the long-term prevalence of PTS or quality of life.

  2. Minilaparotomy-Assisted Transmesenteric-Transjugular Intrahepatic Portosystemic Shunt: Comparison with Conventional Transjugular Approach

    Energy Technology Data Exchange (ETDEWEB)

    Jalaeian, Hamed, E-mail: hjalaeia@umn.edu; Talaie, Reza; D’Souza, Donna; Taleb, Shayandokht [University of Minnesota, Division of Interventional Radiology, Department of Radiology (United States); Noorbaloochi, Siamak [University of Minnesota, School of Medicine (United States); Flanagan, Siobhan; Hunter, David; Golzarian, Jafar [University of Minnesota, Division of Interventional Radiology, Department of Radiology (United States)

    2016-10-15

    PurposeThis study was performed to compare the intrahepatic shunt function outcome and procedural complications of minilaparotomy-assisted transmesenteric (MAT)-transjugular intrahepatic portosystemic shunt (TIPS) placement with the conventional transjugular method.MethodsThis is a retrospective review of all patients who had a MAT or conventional TIPS procedure over a 6-year period at our institute. The primary patency rate, fluoroscopy time, technical success, major procedure-related complications, and mortality data were compared between two treatment groups.ResultsWe included 49 patients with MAT-TIPS, and 63 with conventional TIPS, with an average follow-up of 21.43 months. The primary patency rates at 6 and 12 months were 82.9 and 66.7 % in the conventional TIPS group, and 81.0 and 76.5 % in the MAT-TIPS group (p = 1.000, and 0.529), respectively. There was no significant difference in technical success rate, post-procedure portosystemic pressure gradient, fluoroscopy time, and peri-procedural mortality rate between treatment groups. Major procedural-related complications were seen more frequently among MAT-TIPS patients (p = 0.012). In the MAT-TIPS group, 5 (10.2 %) patients developed post-procedure minilaparotomy, wound-related complications, and 5 (10.2 %) developed bacterial peritonitis; whereas, none of patients with conventional TIPS had either of these complications (p = 0.014).ConclusionWhile both MAT-TIPS and conventional TIPS had similar shunt primary patency rate and technical success rate, the MAT approach was associated with a significantly higher rate of minilaparotomy-related wound complications or infectious complications. These complications maybe prevented by a change in post-procedure monitoring and therapy.

  3. Next-Generation Mitogenomics: A Comparison of Approaches Applied to Caecilian Amphibian Phylogeny.

    Directory of Open Access Journals (Sweden)

    Simon T Maddock

    Full Text Available Mitochondrial genome (mitogenome sequences are being generated with increasing speed due to the advances of next-generation sequencing (NGS technology and associated analytical tools. However, detailed comparisons to explore the utility of alternative NGS approaches applied to the same taxa have not been undertaken. We compared a 'traditional' Sanger sequencing method with two NGS approaches (shotgun sequencing and non-indexed, multiplex amplicon sequencing on four different sequencing platforms (Illumina's HiSeq and MiSeq, Roche's 454 GS FLX, and Life Technologies' Ion Torrent to produce seven (near- complete mitogenomes from six species that form a small radiation of caecilian amphibians from the Seychelles. The fastest, most accurate method of obtaining mitogenome sequences that we tested was direct sequencing of genomic DNA (shotgun sequencing using the MiSeq platform. Bayesian inference and maximum likelihood analyses using seven different partitioning strategies were unable to resolve compellingly all phylogenetic relationships among the Seychelles caecilian species, indicating the need for additional data in this case.

  4. Next-Generation Mitogenomics: A Comparison of Approaches Applied to Caecilian Amphibian Phylogeny.

    Science.gov (United States)

    Maddock, Simon T; Briscoe, Andrew G; Wilkinson, Mark; Waeschenbach, Andrea; San Mauro, Diego; Day, Julia J; Littlewood, D Tim J; Foster, Peter G; Nussbaum, Ronald A; Gower, David J

    2016-01-01

    Mitochondrial genome (mitogenome) sequences are being generated with increasing speed due to the advances of next-generation sequencing (NGS) technology and associated analytical tools. However, detailed comparisons to explore the utility of alternative NGS approaches applied to the same taxa have not been undertaken. We compared a 'traditional' Sanger sequencing method with two NGS approaches (shotgun sequencing and non-indexed, multiplex amplicon sequencing) on four different sequencing platforms (Illumina's HiSeq and MiSeq, Roche's 454 GS FLX, and Life Technologies' Ion Torrent) to produce seven (near-) complete mitogenomes from six species that form a small radiation of caecilian amphibians from the Seychelles. The fastest, most accurate method of obtaining mitogenome sequences that we tested was direct sequencing of genomic DNA (shotgun sequencing) using the MiSeq platform. Bayesian inference and maximum likelihood analyses using seven different partitioning strategies were unable to resolve compellingly all phylogenetic relationships among the Seychelles caecilian species, indicating the need for additional data in this case.

  5. A direct comparison of remote sensing approaches for high-throughput phenotyping in plant breeding

    Directory of Open Access Journals (Sweden)

    Maria Tattaris

    2016-08-01

    Full Text Available Remote sensing (RS of plant canopies permits non-intrusive, high-throughput monitoring of plant physiological characteristics. This study compared three RS approaches using a low flying UAV (unmanned aerial vehicle, with that of proximal sensing, and satellite-based imagery. Two physiological traits were considered, canopy temperature (CT and a vegetation index (NDVI, to determine the most viable approaches for large scale crop genetic improvement. The UAV-based platform achieves plot-level resolution while measuring several hundred plots in one mission via high-resolution thermal and multispectral imagery measured at altitudes of 30-100 m. The satellite measures multispectral imagery from an altitude of 770 km. Information was compared with proximal measurements using IR thermometers and an NDVI sensor at a distance of 0.5-1m above plots. For robust comparisons, CT and NDVI were assessed on panels of elite cultivars under irrigated and drought conditions, in different thermal regimes, and on un-adapted genetic resources under water deficit. Correlations between airborne data and yield/biomass at maturity were generally higher than equivalent proximal correlations. NDVI was derived from high-resolution satellite imagery for only larger sized plots (8.5 x 2.4 m due to restricted pixel density. Results support use of UAV-based RS techniques for high-throughput phenotyping for both precision and efficiency.

  6. Applicability of the cost-effectiveness approach for comparison of waste management options

    International Nuclear Information System (INIS)

    Vuori, S.; Peltonen, E.; Vieno, T.; Vira, J.

    1984-01-01

    There is an obvious need to consider the achievable level of safety of waste management in view of the costs involved. The feasibility of the cost-effectiveness approach for this purpose is discussed in the framework of practical case studies. The analysis indicates that such an approach has clear benefits, but it also reveals several issues and ambiguities in its application. The waste management alternatives considered include various concepts for the disposal of low- and intermediate-level reactor wastes as well as of the unreprocessed spent fuel. The employed impact indicators describe both the individual and collective risks. In addition, indicators simultaneously giving a perspective into other risks in the society and a means to make a rank ordering of the alternative options are proposed. The cost-effectiveness ratios for collective risks vary in the range of ten to hundreds of millions US $ per man.Sv. The examples considered also indicate that increased costs do not necessarily improve safety. Furthermore, the comparison of the safety of different options requires more sophisticated and realistic models than those employed in the present analyses, because an unbalanced degree of conservatism could result in misleading conclusions. (author)

  7. Evaluation of users' satisfaction on pedestrian facilities using pair-wise comparison approach

    Science.gov (United States)

    Zainol, R.; Ahmad, F.; Nordin, N. A.; Aripin, A. W. M.

    2014-02-01

    Global climate change issues demand people of the world to change the way they live today. Thus, current cities need to be redeveloped towards less use of carbon in their day to day operations. Pedestrianized environment is one of the approaches used in reducing carbon foot print in cities. Heritage cities are the first to be looked into since they were built in the era in which motorized vehicles were minimal. Therefore, the research explores users' satisfaction on assessment of physical attributes of pedestrianization in Melaka Historical City, a UNESCO World Heritage Site. It aims to examine users' satisfaction on pedestrian facilities provided within the study area using pair wise questionnaire comparison approach. A survey of 200 respondents using random sampling was conducted in six different sites namely Jonker Street, Church Street, Kota Street, Goldsmith Street, Merdeka Street to Taming Sari Tower and Merdeka Street to River Cruise terminal. The survey consists of an assessment tool based on a nine-point scale of users' satisfaction level of pathway properties, zebra pedestrian crossing, street furniture, personal safety, adjacent to traffic flow, aesthetic and amenities. Analytical hierarchical process (AHP) was used to avoid any biasness in analyzing the data collected. Findings show that Merdeka Street to Taming Sari Tower as the street that scores the highest satisfaction level that fulfils all the required needs of a pedestrianized environment. Similar assessment elements can be used to evaluate existing streets in other cities and these criteria should also be used in planning for future cities.

  8. German nuclear codes revised: comparison with approaches used in other countries

    International Nuclear Information System (INIS)

    Raetzke, C.; Micklinghoff, M.

    2005-01-01

    The article deals with the plan of the German Federal Ministry for the Environment (BMU) to revise the German set of nuclear codes, and draws a comparison with approaches pursued in other countries in formulating and implementing new requirements imposed upon existing plants. A striking feature of the BMU project is the intention to have the codes reflect the state of the art in an entirely abstract way irrespective of existing plants. This implies new requirements imposed on plant design, among other things. However, the state authorities, which establish the licensing conditions for individual plants in concrete terms, will not be able to apply these new codes for legal reasons (protection of vested rights) to the extent in which they incorporate changes in safety philosophy. Also the procedure adopted has raised considerable concern. The processing time of two years is inordinately short, and participation of the public and of industry does not go beyond the strictly formal framework of general public participation. In the light of this absence of quality assurance, it would be surprising if this new set of codes did not suffer from considerable deficits in its contents. Other countries show that the BMU is embarking on an isolated approach in every respect. Elsewhere, backfitting requirements are developed carefully and over long periods of time; they are discussed in detail with the operators; costs and benefits are weighted, and the consequences are evaluated. These elements are in common to procedures in all countries, irrespective of very different steps in detail. (orig.)

  9. Comparison of Two Probabilistic Fatigue Damage Assessment Approaches Using Prognostic Performance Metrics

    Directory of Open Access Journals (Sweden)

    Xuefei Guan

    2011-01-01

    Full Text Available In this paper, two probabilistic prognosis updating schemes are compared. One is based on the classical Bayesian approach and the other is based on newly developed maximum relative entropy (MRE approach. The algorithm performance of the two models is evaluated using a set of recently developed prognostics-based metrics. Various uncertainties from measurements, modeling, and parameter estimations are integrated into the prognosis framework as random input variables for fatigue damage of materials. Measures of response variables are then used to update the statistical distributions of random variables and the prognosis results are updated using posterior distributions. Markov Chain Monte Carlo (MCMC technique is employed to provide the posterior samples for model updating in the framework. Experimental data are used to demonstrate the operation of the proposed probabilistic prognosis methodology. A set of prognostics-based metrics are employed to quantitatively evaluate the prognosis performance and compare the proposed entropy method with the classical Bayesian updating algorithm. In particular, model accuracy, precision, robustness and convergence are rigorously evaluated in addition to the qualitative visual comparison. Following this, potential development and improvement for the prognostics-based metrics are discussed in detail.

  10. Resective surgical approach shows a high performance in the management of advanced cases of bisphosphonate-related osteonecrosis of the jaws: a retrospective survey of 347 cases.

    Science.gov (United States)

    Graziani, Filippo; Vescovi, Paolo; Campisi, Giuseppina; Favia, Gianfranco; Gabriele, Mario; Gaeta, Giovanni Maria; Gennai, Stefano; Goia, Franco; Miccoli, Mario; Peluso, Franco; Scoletta, Matteo; Solazzo, Luigi; Colella, Giuseppe

    2012-11-01

    The aim of this study was to evaluate the results of the surgical treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a large cohort. A retrospective cohort multicenter study was designed. Patients were enrolled if they were diagnosed with BRONJ and received operative treatment. Data on demographic, health status, perioperative, and surgical factors were collected retrospectively. The primary outcome variable was a change in BRONJ staging (improvement, worsening, or no change). Interventions were grouped by local debridement and resective surgery. Data were collected for other variables as cofactors. Univariate analysis and logistic regressions were then performed. Of the 347 BRONJ-affected subjects, 59% showed improvement, 30% showed no change, and 11% showed worsening. Improvement was observed in 49% of cases treated with local debridement and 68% of cases treated with resective surgery. Multivariate analysis indicated that maxillary location, resective surgery, and no additional corticosteroid treatment were associated with a positive outcome. Surgical treatment of BRONJ appeared to be more effective when resective procedures were performed. Nonetheless, other factors, such as the absence of symptoms and the types of drug administration, should be taken into account before clinical decisions are made. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Factors associated with multidisciplinary case conference outcomes in children admitted to a regional hospital in Hong Kong with suspected child abuse: a retrospective case series with internal comparison.

    Science.gov (United States)

    Lo, W C; Fung, G Pg; Cheung, P Ch

    2017-10-01

    In all cases of suspected child abuse, accurate risk assessment is vital to guide further management. This study examined the relationship between risk factors in a risk assessment matrix and child abuse case conference outcomes. Records of all children hospitalised at United Christian Hospital in Hong Kong for suspected child abuse from January 2012 to December 2014 were reviewed. Outcomes of the hospital abuse work-up as concluded in the Multi-Disciplinary Case Conference were categorised as 'established', 'high risk', or 'not established'. All cases of 'established' and 'high risk' were included in the positive case conference outcome group and all cases of 'not established' formed the comparison group. On the other hand, using the Risk Assessment Matrix developed by the California State University, Fresno in 1990, each case was allotted a matrix score of low, intermediate, or high risk in each of 15 matrix domains, and an aggregate matrix score was derived. The effect of individual matrix domain on case conference outcome was analysed. Receiver operating characteristic curve analysis was used to examine the relationship between case conference outcome and aggregate matrix score. In this study, 265 children suspected of being abused were included, with 198 in the positive case conference outcome group and 67 in the comparison group. Three matrix domains (severity and frequency of abuse, location of injuries, and strength of family support systems) were significantly associated with case conference outcome. An aggregate cut-off score of 23 yielded a sensitivity of 91.4% and specificity of 38.2% in relation to outcome of abuse categorisation. Risk assessment should be performed when handling suspected child abuse cases. A high aggregate score should arouse suspicion in all disciplines managing child abuse cases.

  12. Detection and classification of focal liver lesions in patients with colorectal cancer: Retrospective comparison of diffusion-weighted MR imaging and multi-slice CT

    International Nuclear Information System (INIS)

    Eiber, Matthias; Fingerle, Alexander A.; Brügel, Melanie; Gaa, Jochen; Rummeny, Ernst J.; Holzapfel, Konstantin

    2012-01-01

    Objectives: To compare the diagnostic performance of diffusion-weighted MR imaging (DWI) with multi-slice CT (MS-CT) in the detection and classification of focal liver lesions in patients with colorectal cancer. Methods: In a retrospective study 68 patients who underwent DWI at 1.5 T (b-values of 50, 300 and 600 s/mm 2 ) and contrast-enhanced MS-CT were analysed by two radiologists blinded to the clinical results. Imaging results were correlated with intraoperative surgical and ultrasound findings (n = 24), imaging follow-up or PET (n = 44). Sensitivity of DWI and MS-CT in detection of focal liver lesions was compared on a per-lesion and a per-segment basis. Receiver operator-characteristic (ROC) curves to determine the diagnostic performance and the sensitivities of correctly identifying liver metastases on a segmental base were calculated. Results: For lesion detection, DWI was significantly superior to MS-CT both on a per-lesion (difference in sensitivities for reader 1 and 2 22.65% and 19.06%, p < 0.0001) and a per-segment basis (16.86% and 11.76%, p < 0.0001). Especially lesions smaller than 10 mm were better detected with DWI compared to MS-CT (difference 41.10% and 29.45%, p < 0.0001). ROC-analysis showed superiority for lesions classification (p < 0.0001) of DWI (AUC: 0.949 and 0.951) as compared to MS-CT (AUC: 0.879 and 0.892, p < 0.0001 and p = 0.005). DWI was able to filter out metastatic segments with a higher sensitivity (88.2 and 86.5%) compared to MS-CT (68.0 and 67.4%, p < 0.0001 and p = 0.005, respectively). Conclusion: Compared to MS-CT DWI is both more sensitive in the detection of liver lesions and more accurate in determining the extent of metastatic disease in patients with colorectal cancer and therefore might help to optimize therapeutic management in those patients.

  13. Comparison of complication outcomes in acute pancreatitis following ERCP and conservative management at UKM medical centre: a six years retrospective study.

    Science.gov (United States)

    Zamri, Z; Razman, J

    2012-11-01

    Acute pancreatitis is one of the common reasons for surgical admission. It is a potentially lethal disease that is increasing in its incidence. The most common causes of acute pancreatitis is from gallstones and alcohol. Other causes of acute pancreatitis include hypertriglyceridaemia, hyperparathyroidism, pancreatic malignancy, Endoscopic retrograde cholangiopancreatography (ERCP), trauma, infectious agents, drugs, autoimmunity, and hereditary. The treatment of acute pancreatitis is mainly supportive. The complication of ERCP in acute pancreatitis can be divided into local complication (pancreatic abscess, pseudocyst), systemic complications (renal failure, respiratory failure, cardiogenic shock) and biliary sepsis (acute cholangitis and acute cholecystitis). However, early ERCP and possible sphincterotomy should be kept in mind for patients with severe disease and biliary obstruction who are not improving with medical therapy. This study is done to compare the complication rate of ERCP and conservative management in acute pancreatitis for past 6 years in Pusat Perubatan UKM. The study is conducted retrospectively and the study population was from January 2003 until December 2008. About 100 patients involving 51 males and 49 females were included in this study. All of them were diagnosed acute pancreatitis based on the serum amylase level of 4 times than normal value detected from Chemistry Pathology record, Pathology Department, PPUKM. Then, data were collected from the patient's file which include the demographic data and patient clinical presentation, ultrasound finding, either patient went for ERCP within 72 hours or not. If ERCP not done within 72 hours of admission then it will considered that the patient is under conservative management. From 100 patients that involved in this study about 44% was Malay, 36 % was Chinese, 18 % was Indian and the other 2 % was from other origin. There were 28 cases (28%) where ERCP was done within 72 hours, and the other 72

  14. Retrospective comparison of the effects of epidural anesthesia versus peripheral nerve block on postoperative outcomes in elderly Chinese patients with femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Jin JW

    2015-08-01

    Full Text Available Jianwen Jin,1 Gang Wang,2 Maowei Gong,3 Hong Zhang,3 Junle Liu21Department of Clinical Medicine, Fujian Health College, Fuzhou, 2Department of Anesthesiology, Chinese People’s Liberation Army 105 Hospital, Hefei, 3Anesthesia and Operation Center, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of ChinaBackground: Geriatric patients with femoral neck fracture (FNF have unacceptably high rates of postoperative complications and mortality. The purpose of this study was to compare the effects of epidural anesthesia versus peripheral nerve block (PNB on postoperative outcomes in elderly Chinese patients with FNF.Methods: This retrospective study explored mortality and postoperative complications in geriatric patients with FNF who underwent epidural anesthesia or PNB at the Chinese People’s Liberation Army General Hospital from January 2008 to December 2012. The electronic database at the Chinese People’s Liberation Army General Hospital includes discharge records for all patients treated in the hospital. Information on patient demographics, preoperative comorbidity, postoperative complications, type of anesthesia used, and in-hospital, 30-day, and 1-year mortality after surgery was obtained from this database.Results: Two hundred and fifty-eight patients were identified for analysis. The mean patient age was 79.7 years, and 71.7% of the patients were women. In-hospital, 30-day, and 1-year postoperative mortality was 4.3%, 12.4%, and 22.9%, respectively, and no differences in mortality or cardiovascular complications were found between patients who received epidural anesthesia and those who received PNB. More patients with dementia or delirium were given PNB. No statistically significant differences were found between groups for other comorbidities or intraoperative parameters. The most common complications were acute cardiovascular events (23.6%, electrolyte disturbances (20.9%, and hypoxemia (18.2%. Patients

  15. Nutrient deficiency and obstetrical outcomes in pregnant women following Roux-en-Y gastric bypass: A retrospective Danish cohort study with a matched comparison group.

    Science.gov (United States)

    Hammeken, Lianna Hede; Betsagoo, Ramsina; Jensen, Ann Nygaard; Sørensen, Anne Nødgaard; Overgaard, Charlotte

    2017-09-01

    Roux-en-Y gastric bypass surgery and small-for-gestational-age births are known to be associated although the etiology is not fully understood. This study aimed to investigate pregnancy outcomes and maternal nutritional status among pregnant women with a history of Roux-en-Y gastric bypass using maternal anemia and gestational weight gain as indicators of micronutrient and macronutrient deficiency in pregnancy. The study was designed as a retrospective matched cohort study. All Roux-en-Y-gastric-bypass-operated pregnant women (n=151) who were followed in the outpatient obstetric clinic at Aalborg University Hospital in Denmark and gave birth between 1 January 2010 and 31 December 2013 were included. Each Roux-en-Y-gastric-bypass-operated woman was closely matched with a non-Roux-en-Y-gastric-bypass-operated woman. Primary outcomes were small-for-gestational-age birth, maternal anemia and gestational weight gain. The two groups (matched 1:1) were compared by paired tests on all measures, conditional logistic regression for paired binary data and the paired t-test or Wilcoxon signed-rank test for paired continuous data. The risk of small-for-gestational-age birth (odds ratio (OR)=2.67, 95% confidence interval (CI); 1.04-6.82) and maternal anemia (OR=3.0, 95% CI; 1.09-8.25) were significantly increased for the Roux-en-Y gastric bypass group compared to the non-Roux-en-Y gastric bypass group. No significant difference was found in gestational weight gain (p=0.169) between women with a history of Roux-en-Y gastric bypass (11.51kg±8.97 standard deviation (SD)) and non- Roux-en-Y-gastric-bypass-operated women (12.18kg±6.28 SD). A history of Roux-en-Y gastric bypass surgery increases the risk of small-for-gestational-age birth and anemia, while a finding of differences in gestational weight gain is uncorroborated. Our findings suggest a role of micronutrient deficiency rather than reduced gestational weight gain in the etiology of small-for-gestational-age birth among

  16. An evaluation of Birmingham Own Health® telephone care management service among patients with poorly controlled diabetes. a retrospective comparison with the General Practice Research Database

    Directory of Open Access Journals (Sweden)

    Adab Peymané

    2011-09-01

    Full Text Available Abstract Background Telephone-based care management programmes have been shown to improve health outcomes in some chronic diseases. Birmingham Own Health® is a telephone-based care service (nurse-delivered motivational coaching and support for self-management and lifestyle change for patients with poorly controlled diabetes, delivered in Birmingham, UK. We used a novel method to evaluate its effectiveness in a real-life setting. Methods Retrospective cohort study in the UK. 473 patients aged ≥ 18 years with diabetes enrolled onto Birmingham Own Health® (intervention cohort and with > 90 days follow-up, were each matched by age and sex to up to 50 patients with diabetes registered with the General Practice Research Database (GPRD to create a pool of 21,052 controls (control cohort. Controls were further selected from the main control cohort, matching as close as possible to the cases for baseline test levels, followed by as close as possible length of follow-up (within +/-30 days limits and within +/-90 days baseline test date. The aim was to identify a control group with as similar distribution of prognostic factors to the cases as possible. Effect sizes were computed using linear regression analysis adjusting for age, sex, deprivation quintile, length of follow-up and baseline test levels. Results After adjusting for baseline values and other potential confounders, the intervention showed significant mean reductions among people with diabetes of 0.3% (95%CI 0.1, 0.4% in HbA1c; 3.5 mmHg (1.5, 5.5 in systolic blood pressure, 1.6 mmHg (0.4, 2.7 in diastolic blood pressure and 0.7 unit reduction (0.3, 1.0 in BMI, over a mean follow-up of around 10 months. Only small effects were seen on average on serum cholesterol levels (0.1 mmol/l reduction (0.1, 0.2. More marked effects were seen for each clinical outcome among patients with worse baseline levels. Conclusions Despite the limitations of the study design, the results are consistent with the

  17. Human tuberculosis caused by Mycobacterium bovis: a retrospective comparison with Mycobacterium tuberculosis in a Mexican tertiary care centre, 2000–2015

    Directory of Open Access Journals (Sweden)

    Pedro Torres-Gonzalez

    2016-11-01

    Full Text Available Abstract Background Human tuberculosis caused by Mycobacterium bovis is believed to be frequent in developing countries. Transmission is usually through ingestion of unpasteurized dairy products, although airborne contagion is possible. Disease caused by M. tuberculosis or M. bovis is clinically indistinguishable from each other. The aim of this study was to determine the factors associated with M. bovis disease. Methods Retrospective analysis of all culture-positive cases of M. bovis and M. tuberculosis from 2000 to 2015, in a Mexican tertiary-care centre. Sociodemographic, clinical, and radiographic data from medical records were compared. Disease site was classified as pulmonary, extrapulmonary, or pulmonary and extrapulmonary, based on cultures. Results We evaluated 533 cases, 372 (69.7 % of which were caused by M. tuberculosis and 161 (30.2 % by M. bovis. Characteristics associated with M. bovis disease were: younger age (aOR 0.97, 95 % CI 0.95–0.98, glucocorticoid use (aOR 2.27, 95 % CI 1.42–3.63, and extrapulmonary disease (aOR 1.80, 95 % CI 1.21–2.69. M. tuberculosis was associated with lower socioeconomic status (aOR 0.52, 95 % CI 0.28–0.97. When we analysed only pulmonary cases, younger age (aOR 0.97, 95 % CI 0.96–0.99, glucocorticoid use (aOR 2.41, 95 % CI 1.30–4.46, and smoking (aOR 1.94, CI 95 % 1.15–3.27 were associated with M. bovis. Both groups showed similar proportions of direct microscopy smear results (respiratory samples and chest X-ray cavitations. Conclusions Younger age, glucocorticoid use, and extrapulmonary disease were associated with M. bovis as the causative agent of tuberculosis in a group of patients from a tertiary care centre in a country where bovine tuberculosis is endemic. Further studies must be conducted in the general population to determine pathogen-specific associated factors and outcomes.

  18. Human tuberculosis caused by Mycobacterium bovis: a retrospective comparison with Mycobacterium tuberculosis in a Mexican tertiary care centre, 2000-2015.

    Science.gov (United States)

    Torres-Gonzalez, Pedro; Cervera-Hernandez, Miguel E; Martinez-Gamboa, Areli; Garcia-Garcia, Lourdes; Cruz-Hervert, Luis P; Bobadilla-Del Valle, Miriam; Ponce-de Leon, Alfredo; Sifuentes-Osornio, Jose

    2016-11-08

    Human tuberculosis caused by Mycobacterium bovis is believed to be frequent in developing countries. Transmission is usually through ingestion of unpasteurized dairy products, although airborne contagion is possible. Disease caused by M. tuberculosis or M. bovis is clinically indistinguishable from each other. The aim of this study was to determine the factors associated with M. bovis disease. Retrospective analysis of all culture-positive cases of M. bovis and M. tuberculosis from 2000 to 2015, in a Mexican tertiary-care centre. Sociodemographic, clinical, and radiographic data from medical records were compared. Disease site was classified as pulmonary, extrapulmonary, or pulmonary and extrapulmonary, based on cultures. We evaluated 533 cases, 372 (69.7 %) of which were caused by M. tuberculosis and 161 (30.2 %) by M. bovis. Characteristics associated with M. bovis disease were: younger age (aOR 0.97, 95 % CI 0.95-0.98), glucocorticoid use (aOR 2.27, 95 % CI 1.42-3.63), and extrapulmonary disease (aOR 1.80, 95 % CI 1.21-2.69). M. tuberculosis was associated with lower socioeconomic status (aOR 0.52, 95 % CI 0.28-0.97). When we analysed only pulmonary cases, younger age (aOR 0.97, 95 % CI 0.96-0.99), glucocorticoid use (aOR 2.41, 95 % CI 1.30-4.46), and smoking (aOR 1.94, CI 95 % 1.15-3.27) were associated with M. bovis. Both groups showed similar proportions of direct microscopy smear results (respiratory samples) and chest X-ray cavitations. Younger age, glucocorticoid use, and extrapulmonary disease were associated with M. bovis as the causative agent of tuberculosis in a group of patients from a tertiary care centre in a country where bovine tuberculosis is endemic. Further studies must be conducted in the general population to determine pathogen-specific associated factors and outcomes.

  19. Comparison of fixed low dose versus high dose radioactive iodine for the treatment of hyperthyroidism: retrospective multifactorial analysis impacting the outcome of therapy

    International Nuclear Information System (INIS)

    Suresh Kumar, A.C.; Malhotra, G.; Basu, S.; Asopa, R.V.

    2010-01-01

    Full text: Radioactive iodine ( 131 I) as a fixed dose protocol is widely used for treatment of hyperthyroidism. However, there is no consensus on the best optimum dose for an individual patient. The objectives of this study were to observe the outcome of 131 I therapy in patients of primary hyperthyroidism in relation to fixed low dose versus high dose regimen, impact of antithyroid drugs and influence of thyroid gland size on therapy outcome. Materials and Methods: Study design: Retrospective analysis. Study group included 287 diagnosed patients of primary hyperthyroidism who had undergone 131 I therapy for the first time (68 M, 219 F; Mean age ± S.D.: 43.84 ± 12.53). All patients with low RAIU, thyrocardiac disease were excluded. Details of antithyroid (ATD) drug treatment were recorded. Analysis was done from 2002 till patients became euthyroid/hypothyroid or until January 2010. Each patient's response was evaluated initially at 6 weeks and thereafter every three months. Appropriate statistical tests were applied to compare treatment response between the groups. A P value<0.05 was considered significant. Results: Of 287 patients, 209 patients had been administered low dose (Mean ± S.D.: 4.68 ± 0.62 mCi) while 78 patients had received high dose (Mean ± S.D.: 9.15 ± 1.05 mCi) of radioiodine. 57.9% (121/ 209) patients in the low dose group responded as compared to 75.6% (59/78) in high dose group after a follow up of more than 36 months. Similarly, among patients with and without antithyroid drug treatment, grade II and above goiters the response rates were significantly higher for high dose group as compared to low dose group. Conclusion: We suggest that high dose radioiodine treatment with 8 to 10 mCi is effective in treating hyperthyroidism in patients with a better success rate than the low dose treatment with 3 to 5 mCi. This is also likely to be helpful in patients who have not received antithyroid drugs. It appears that clinically relevant

  20. The comparison of various approach to evaluation erosion risks and design control erosion measures

    Science.gov (United States)

    Kapicka, Jiri

    2015-04-01

    In the present is in the Czech Republic one methodology how to compute and compare erosion risks. This methodology contain also method to design erosion control measures. The base of this methodology is Universal Soil Loss Equation (USLE) and their result long-term average annual rate of erosion (G). This methodology is used for landscape planners. Data and statistics from database of erosion events in the Czech Republic shows that many troubles and damages are from local episodes of erosion events. An extent of these events and theirs impact are conditional to local precipitation events, current plant phase and soil conditions. These erosion events can do troubles and damages on agriculture land, municipally property and hydro components and even in a location is from point of view long-term average annual rate of erosion in good conditions. Other way how to compute and compare erosion risks is episodes approach. In this paper is presented the compare of various approach to compute erosion risks. The comparison was computed to locality from database of erosion events on agricultural land in the Czech Republic where have been records two erosion events. The study area is a simple agriculture land without any barriers that can have high influence to water flow and soil sediment transport. The computation of erosion risks (for all methodology) was based on laboratory analysis of soil samples which was sampled on study area. Results of the methodology USLE, MUSLE and results from mathematical model Erosion 3D have been compared. Variances of the results in space distribution of the places with highest soil erosion where compared and discussed. Other part presents variances of design control erosion measures where their design was done on based different methodology. The results shows variance of computed erosion risks which was done by different methodology. These variances can start discussion about different approach how compute and evaluate erosion risks in areas

  1. [Comparison of ablation of left-sided accessory pathway by atrial septal and retrograde arterial approach].

    Science.gov (United States)

    Zhu, J G; Bao, Z Y; Gu, X

    2017-03-07

    Objective: To compare the advantages and disadvantages of radiofrequency ablation of left-sided accessory pathways by via atrial septal approach with retrograde through aortic approach. Methods: A total of 184 patients of left-side accessory pathways were treated in Taizhou People's Hospital and the Subei People's Hospital from March 2012 to August 2015.A total of 103 cases were treated by aortic retrograde approach as through arterial group, 81 cases were treated by punctured atrial septal to left atrial for mapping and ablation as through atrial septal group.Comparison of ablation procedure time, total and pathways of different parts(subgroup) at instant success and relapse rates, safety (serious complications), and statistics other complications in operation and postoperative. Results: Through arterial group and through atrial septal group were no significant difference ( P >0.05) in the ablation procedure time((25±18 ) vs (22±15)min ), instant success(98.1% vs 97.5%) and relapse rates(1.0% vs 1.2%), security(1 vs 0 case). There was no statistical difference in septal part subgroups (all P >0.05) in the ablation procedure time((22±18)vs (25±19)min), instant success(91.7% vs 89.9 %) and relapse rates(0 vs 11.1%); posterior wall subgroup had no statistical difference in the ablation procedure time((18±15)vs (16±12)min), instant success(100% vs 100 %) and relapse rates(0 vs 0)(all P >0.05); side wall subgroup had no statistical difference in the ablation procedure time((29±20)vs (21±18) min), instant success (98.3% vs 98.1%)and relapse rates(1.7% vs 0%)(all P >0.05). Conclusion: Ablation of left-sided accessory pathways by transseptal approach and transaortic approach has no statistical difference in the procedure time, instant success and relapse rates, security.In a particular case, there is a certain complementarity between the two methods.

  2. A preliminary comparison of hydrodynamic approaches for flood inundation modeling of urban areas in Jakarta Ciliwung river basin

    Science.gov (United States)

    Rojali, Aditia; Budiaji, Abdul Somat; Pribadi, Yudhistira Satya; Fatria, Dita; Hadi, Tri Wahyu

    2017-07-01

    This paper addresses on the numerical modeling approaches for flood inundation in urban areas. Decisive strategy to choose between 1D, 2D or even a hybrid 1D-2D model is more than important to optimize flood inundation analyses. To find cost effective yet robust and accurate model has been our priority and motivation in the absence of available High Performance Computing facilities. The application of 1D, 1D/2D and full 2D modeling approach to river flood study in Jakarta Ciliwung river basin, and a comparison of approaches benchmarked for the inundation study are presented. This study demonstrate the successful use of 1D/2D and 2D system to model Jakarta Ciliwung river basin in terms of inundation results and computational aspect. The findings of the study provide an interesting comparison between modeling approaches, HEC-RAS 1D, 1D-2D, 2D, and ANUGA when benchmarked to the Manggarai water level measurement.

  3. Retrospection-Simulation-Revision: Approach to the Analysis of the Composition and Characteristics of Medical Waste at a Disaster Relief Site.

    Science.gov (United States)

    Zhang, Li; Wu, Lihua; Tian, Feng; Wang, Zheng

    2016-01-01

    A large amount of medical waste is produced during disaster relief, posing a potential hazard to the habitat and the environment. A comprehensive understanding of the composition and characteristics of medical waste that requires management is one of the most basic steps in the development of a plan for medical waste management. Unfortunately, limited reliable information is available in the open literature on the characteristics of the medical waste that is generated at disaster relief sites. This paper discusses the analysis of the composition and characteristics of medical waste at a disaster relief site using the retrospection-simulation-revision method. For this study, we obtained 35 medical relief records of the Wenchuan Earthquake, Sichuan, May 2008 from a field cabin hospital. We first present a retrospective analysis of the relief medical records, and then, we simulate the medical waste generated in the affected areas. We ultimately determine the composition and characteristics of medical waste in the affected areas using untreated medical waste to revise the composition of the simulated medical waste. The results from 35 cases showed that the medical waste generated from disaster relief consists of the following: plastic (43.2%), biomass (26.3%), synthetic fiber (15.3%), rubber (6.6%), liquid (6.6%), inorganic salts (0.3%) and metals (1.7%). The bulk density of medical relief waste is 249 kg/m3, and the moisture content is 44.75%. The data should be provided to assist the collection, segregation, storage, transportation, disposal and contamination control of medical waste in affected areas. In this paper, we wish to introduce this research method of restoring the medical waste generated in disaster relief to readers and researchers. In addition, we hope more disaster relief agencies will become aware of the significance of medical case recording and storing. This may be very important for the environmental evaluation of medical waste in disaster areas, as

  4. Assessing fish predation on migrating juvenile steelhead and a retrospective comparison to steelhead survival through the Priest Rapids Hydroelectric Project, Columbia River, Washington, 2009-11

    Science.gov (United States)

    Hardiman, Jill M.; Counihan, Timothy D.; Burgess, Dave S.; Simmons, Katrina E.; Holmberg, Glen S.; Rogala, Josh; Polacek, Rochelle

    2012-01-01

    proportion was small. Predation index values in 2011 were highest in the Priest Rapids mid-reservoir reach for northern pikeminnow and smallmouth bass. Predation indices generally were high in the tailrace areas for northern pikeminnow, and high in the forebay areas for smallmouth bass. Steelhead survival in 2011 was consistently high throughout the study period and the PRP, although predation indices were relatively low, which suggests that fish predation did not significantly affect steelhead survival throughout the study area. Our efforts to correlate retrospective predation indices with survival estimates for 2009 and 2010 did provide some evidence for high predation occurring in some of the same reaches, which had low steelhead survival, such as the Priest Rapids tailrace in 2009. However, for 2010, our results indicated that the loss of salmonids to predation were more contradictory to the survival results, where predation indices were higher for reaches in the Priest Rapids Development than in the Wanapum Development. Establishing correlations between steelhead survival and observed predation indices for previous research years, in 2009 and 2010 was confounded by the lack of coordination of these two studies during the initial study design, implementation period for such an analysis. Future efforts to correlate steelhead survival with fish predation would benefit from efforts to better coordinate the studies with consistent study reaches, and better timing of concurrent efforts.

  5. Comparison of low and high dose rate brachytherapy in the treatment of uterine cervix cancer. Retrospective analysis of two sequential series

    International Nuclear Information System (INIS)

    Ferrigno, Robson; Nishimoto, Ines Nobuko; Ribeiro dos Santos Novaes, Paulo Eduardo; Pellizzon, Antonio Cassio Assis; Conte Maia, Maria Aparecida; Fogarolli, Ricardo Cesar; Salvajoli, Joao Victor

    2005-01-01

    Purpose: This retrospective analysis aims to report on the comparative outcome of cervical cancer patients treated with low dose rate (LDR) and high dose rate (HDR) brachytherapy. Methods and Materials: From 1989 to 1995, 190 patients were treated with low dose rate (LDR) brachytherapy (LDR group) and from 1994 to 2001, 118 patients were treated with high dose rate (HDR) brachytherapy (HDR group). FIGO stage distribution for the LDR group was Stage I: 6.3%; Stage II: 57.4%; and Stage III: 36.3% and for the HDR group Stage I: 9.3%; Stage II: 43.2%; and Stage III: 47.4%. All patients were treated with telecobalt external-beam radiotherapy (EBR). Median doses of LDR brachytherapy at Point A were 40 Gy and 50 Gy for patients treated with 1 and 2 implants, respectively. All patients from the HDR group were treated with 24 Gy in 4 fractions of 6 Gy to Point A. Survival, disease-free survival, local control, and late complications at 5 years, were endpoints compared for both groups. Results: Median follow-up time for LDR and HDR groups was 70 months (range, 8-127 months) and 33 months (range, 4-117 months), respectively. For all stages combined, overall survival, disease-free survival, and local control at 5 years were better in the LDR group (69% vs. 55%, p = 0.007; 73% vs. 56%, p = 0.002; and 74% vs. 65%; p = 0.04, respectively). For clinical Stages I and II, no differences was seen in overall survival, disease-free survival, and local control at 5 years between the two groups. For clinical Stage III, overall survival and disease-free survival at 5 years were better in the LDR group than in the HDR group (46% vs. 36%, p = 0.04 and 49% vs. 37%, p = 0.03, respectively), and local control was marginally higher in the LDR group than in the HDR group (58% vs. 50%, p = 0.19). The 5-year probability of rectal complications was higher in the LDR group than in the HDR group (16% vs. 8%, p = 0.03) and 5-year probability of small bowel and urinary complications was not

  6. Comparison of pregnancy outcomes between maternity waiting home users and non-users at hospitals with and without a maternity waiting home: retrospective cohort study.

    Science.gov (United States)

    Braat, Floris; Vermeiden, Tienke; Getnet, Gashaw; Schiffer, Rita; van den Akker, Thomas; Stekelenburg, Jelle

    2018-01-01

    To examine the impact of a maternity waiting home (MWH) by comparing pregnancy outcomes between users and non-users at hospitals with and without an MWH. We conducted a retrospective cohort study in Ethiopia comparing one hospital with an MWH (Attat) to a second hospital without one (Butajira). A structured questionnaire among sampled women in 2014 and hospital records from 2011 to 2014 were used to compare sociodemographic characteristics and pregnancy outcomes between Attat MWH users and non-MWH users, Attat MWH users and Butajira, and Attat non-MWH users and Butajira. χ2 or ORs with 95% CIs were calculated. Compared with Attat non-MWH users (n=306) and Butajira women (n=153), Attat MWH users (n=244) were more often multiparous (multipara vs primigravida: OR 4.43 [95% CI 2.94 to 6.68] and OR 3.58 [95% CI 2.24 to 5.73]), less educated (no schooling vs secondary school: OR 2.62 [95% CI 1.53 to 4.46] and OR 5.21 [95% CI 2.83 to 9.61], primary vs secondary school: OR 4.84 [95% CI 2.84 to 8.25] and OR 5.19 [95% CI 2.91 to 9.27]), poor (poor vs wealthy: OR 8.94 [95% CI 5.13 to 15.61] and OR 12.34 [95% CI 6.78 to 22.44] and further from the hospital (2 h 27 min vs 1 h 00 min and 1 h 12 min: OR 3.08 [95% CI 2.50 to 3.80] and OR 2.18 [95% CI 1.78 to 2.67]). Comparing hospital records of Attat MWH users (n=2784) with Attat non-users (n=5423) and Butajira women (n=9472), maternal deaths were 0 vs 20 (0.4%; p=0.001) and 31 (0.3%; p=0.003), stillbirths 38 (1.4%) vs 393 (7.2%) (OR 0.18 [95% CI 0.13 to 0.25]) and 717 (7.6%) (OR 0.17 [95% CI 0.12 to 0.24]) and uterine ruptures 2 (0.1%) vs 40 (1.1%) (OR 0.05 [95% CI 0.01 to 0.19]) and 122 (1.8%) (OR 0.04 (95% CI 0.01 to 0.16]). No significant differences were found regarding maternal deaths and stillbirths between Attat non-users and Butajira women. Attat MWH users had less favourable sociodemographic characteristics but better birth outcomes than Attat non-users and Butajira women. © The Author(s) 2018. Published by Oxford

  7. Comparison of risk of acute kidney injury after primary percutaneous coronary interventions with the transradial approach versus the transfemoral approach (from the PRIPITENA urban registry).

    Science.gov (United States)

    Cortese, Bernardo; Sciahbasi, Alessandro; Sebik, Rodrigo; Rigattieri, Stefano; Alonzo, Alessandro; Silva-Orrego, Pedro; Belloni, Flavia; Seregni, Romano G; Giovannelli, Francesca; Tespili, Maurizio; Ricci, Roberto; Berni, Andrea

    2014-09-15

    The risk of acute kidney injury (AKI) is a major issue after percutaneous coronary interventions (PCIs), especially in the setting of ST-elevation myocardial infarction. Preliminary data from large retrospective registries seem to show a reduction of AKI when a transradial (TR) approach for PCI is adopted. Little is known about the relation between vascular access and AKI after emergent PCI. We here report the results of the Primary PCI from Tevere to Navigli (PRIPITENA), a retrospective database of primary PCI performed at high-volume centers in the urban areas of Rome and Milan. Primary end point of this study was the occurrence of AKI in the TR and transfemoral (TF) access site groups. Secondary end points were major adverse cardiovascular events, stent thrombosis, and Thrombolysis in Myocardial Infarction major and minor bleedings. The database included 1,330 patients, 836 treated with a TR and 494 with a TF approach. After a propensity-matched analysis performed to exclude possible confounders, we identified 450 matched patients (225 TR and 225 TF). The incidence of AKI in the 2 matched groups was lower in patients treated with TR primary PCI (8.4% vs 16.9%, p = 0.007). Major adverse cardiovascular events and stent thrombosis were not different among study groups, whereas major bleedings were more often seen in the TF group. At multivariate analysis, femoral access was an independent predictor of AKI (odds ratio 1.654, 95% confidence interval 1.084 to 2.524, p = 0.042). In conclusion, in this database of primary PCI, the risk of AKI was lower with a TR approach, and the TF approach was an independent predictor for the occurrence of this complication. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Comparison of Exposure in the Kaplan Versus the Kocher Approach in the Treatment of Radial Head Fractures.

    Science.gov (United States)

    Barnes, Leslie Fink; Lombardi, Joseph; Gardner, Thomas R; Strauch, Robert J; Rosenwasser, Melvin P

    2018-01-01

    The aim of this study was to compare the complete visible surface area of the radial head, neck, and coronoid in the Kaplan and Kocher approaches to the lateral elbow. The hypothesis was that the Kaplan approach would afford greater visibility due to the differential anatomy of the intermuscular planes. Ten cadavers were dissected with the Kaplan and Kocher approaches, and the visible surface area was measured in situ using a 3-dimensional digitizer. Six measurements were taken for each approach by 2 surgeons, and the mean of these measurements were analyzed. The mean surface area visible with the lateral collateral ligament (LCL) preserved in the Kaplan approach was 616.6 mm 2 in comparison with the surface area of 136.2 mm 2 visible in the Kocher approach when the LCL was preserved. Using a 2-way analysis of variance, the difference between these 2 approaches was statistically significant. When the LCL complex was incised in the Kocher approach, the average visible surface area of the Kocher approach was 456.1 mm 2 and was statistically less than the Kaplan approach. The average surface area of the coronoid visible using a proximally extended Kaplan approach was 197.8 mm 2 . The Kaplan approach affords significantly greater visible surface area of the proximal radius than the Kocher approach.

  9. Effect of air turbulence on gas transport in soil; comparison of approaches

    Science.gov (United States)

    Pourbakhtiar, Alireza; Papadikis, Konstantinos; Poulsen, Tjalfe; Bridge, Jonathan; Wilkinson, Stephen

    2017-04-01

    Greenhouse gases are playing the key role in global warming. Soil is a source of greenhouse gases such as methane (CH4). Radon (Rn) which is a radioactive gas can emit form subsurface into the atmosphere and leads to health concerns in urban areas. Temperature, humidity, air pressure and vegetation of soil can affect gas emissions inside soil (Oertel et al., 2016). It's shown in many cases that wind induced fluctuations is an important factor in transport of gas through soil and other porous media. An example is: landfill gas emissions (Poulsen et al., 2001). We applied an experimental equipment for measuring controlled air turbulence on gas transport in soil in relation to the depth of sample. Two approaches for measurement of effect of wind turbulence on gas transport were applied and compared. Experiments were carried out with diffusion of CO2 and air as tracer gases with average vertical wind speeds of 0 to 0.83 m s-1. In approach A, Six different sample thicknesses from 5 to 30 cm were selected and total of 4 different wind conditions with different speed and fluctuations were applied. In approach B, a sample with constant depth was used. Five oxygen sensors were places inside sample at different depths. Total of 111 experiments were carried out. Gas transport is described by advection-dispersion equation. Gas transport is quantified as a dispersion coefficient. Oxygen breakthrough curves as a function of distance to the surface of the sample exposed to wind were derived numerically with an explicit forward time, central space finite-difference based model to evaluate gas transport. We showed that wind turbulence-induced fluctuations is an important factor in gas transport that can increase gas transport with average of 45 times more than molecular diffusion under zero wind condition. Comparison of two strategies for experiments, indicated that, constant deep samples (Approach B) are more reliable for measurement of gas transport under influence of wind

  10. Surgically induced astigmatism after phacoemulsification by temporal clear corneal and superior clear corneal approach: a comparison

    Directory of Open Access Journals (Sweden)

    Nikose AS

    2018-01-01

    Full Text Available Archana Sunil Nikose, Dhrubojyoti Saha, Pradnya Mukesh Laddha, Mayuri Patil Department of Ophthalmology, N.K.P. Salve Institute and LMH, Nagpur, Maharashtra, India Introduction: Cataract surgery has undergone various advances since it was evolved from ancient couching to the modern phacoemulsification cataract surgery. Surgically induced astigmatism (SIA remains one of the most common complications. The introduction of sutureless clear corneal incision has gained increasing popularity worldwide because it offers several advantages over the traditional sutured limbal incision and scleral tunnel. A clear corneal incision has the benefit of being bloodless and having an easy approach, but SIA is still a concern.Purpose: In this study, we evaluated the SIA in clear corneal incisions with temporal approach and superior approach phacoemulsification. Comparisons between the two incisions were done using keratometric readings of preoperative and postoperative refractive status.Methodology: It was a hospital-based prospective interventional comparative randomized control trial of 261 patients conducted in a rural-based tertiary care center from September 2012 to August 2014. The visual acuity and detailed anterior segment and posterior segment examinations were done and the cataract was graded according to Lens Opacification Classification System II. Patients were divided for phacoemulsification into two groups, group A and group B, who underwent temporal and superior clear corneal approach, respectively. The patients were followed up on day 1, 7, 30, and 90 postoperatively. The parameters recorded were uncorrected visual acuity, best-corrected visual acuity, slit lamp examination, and keratometry. The mean difference of SIA between 30th and 90th day was statistically evaluated using paired t-test, and all the analyses were performed using SPSS 18.0 (SPSS Inc. software.Results: The mean postoperative SIA in group A was 0.998 D on the 30th day, which

  11. Evaluating the effect of corridors and landscape heterogeneity on dispersal probability: a comparison of three spatially explicit modelling approaches

    DEFF Research Database (Denmark)

    Jepsen, J. U.; Baveco, J. M.; Topping, C. J.

    2004-01-01

    preferences of the modeller, rather than by a critical evaluation of model performance. We present a comparison of three common spatial simulation approaches (patch-based incidence-function model (IFM), individual-based movement model (IBMM), individual-based population model including detailed behaviour...

  12. Identifying functional reorganization of spelling networks: an individual peak probability comparison approach

    Science.gov (United States)

    Purcell, Jeremy J.; Rapp, Brenda

    2013-01-01

    Previous research has shown that damage to the neural substrates of orthographic processing can lead to functional reorganization during reading (Tsapkini et al., 2011); in this research we ask if the same is true for spelling. To examine the functional reorganization of spelling networks we present a novel three-stage Individual Peak Probability Comparison (IPPC) analysis approach for comparing the activation patterns obtained during fMRI of spelling in a single brain-damaged individual with dysgraphia to those obtained in a set of non-impaired control participants. The first analysis stage characterizes the convergence in activations across non-impaired control participants by applying a technique typically used for characterizing activations across studies: Activation Likelihood Estimate (ALE) (Turkeltaub et al., 2002). This method was used to identify locations that have a high likelihood of yielding activation peaks in the non-impaired participants. The second stage provides a characterization of the degree to which the brain-damaged individual's activations correspond to the group pattern identified in Stage 1. This involves performing a Mahalanobis distance statistics analysis (Tsapkini et al., 2011) that compares each of a control group's peak activation locations to the nearest peak generated by the brain-damaged individual. The third stage evaluates the extent to which the brain-damaged individual's peaks are atypical relative to the range of individual variation among the control participants. This IPPC analysis allows for a quantifiable, statistically sound method for comparing an individual's activation pattern to the patterns observed in a control group and, thus, provides a valuable tool for identifying functional reorganization in a brain-damaged individual with impaired spelling. Furthermore, this approach can be applied more generally to compare any individual's activation pattern with that of a set of other individuals. PMID:24399981

  13. Evaluation of users' satisfaction on pedestrian facilities using pair-wise comparison approach

    International Nuclear Information System (INIS)

    Zainol, R; Ahmad, F; Nordin, N A; Aripin, A W M

    2014-01-01

    Global climate change issues demand people of the world to change the way they live today. Thus, current cities need to be redeveloped towards less use of carbon in their day to day operations. Pedestrianized environment is one of the approaches used in reducing carbon foot print in cities. Heritage cities are the first to be looked into since they were built in the era in which motorized vehicles were minimal. Therefore, the research explores users' satisfaction on assessment of physical attributes of pedestrianization in Melaka Historical City, a UNESCO World Heritage Site. It aims to examine users' satisfaction on pedestrian facilities provided within the study area using pair wise questionnaire comparison approach. A survey of 200 respondents using random sampling was conducted in six different sites namely Jonker Street, Church Street, Kota Street, Goldsmith Street, Merdeka Street to Taming Sari Tower and Merdeka Street to River Cruise terminal. The survey consists of an assessment tool based on a nine-point scale of users' satisfaction level of pathway properties, zebra pedestrian crossing, street furniture, personal safety, adjacent to traffic flow, aesthetic and amenities. Analytical hierarchical process (AHP) was used to avoid any biasness in analyzing the data collected. Findings show that Merdeka Street to Taming Sari Tower as the street that scores the highest satisfaction level that fulfils all the required needs of a pedestrianized environment. Similar assessment elements can be used to evaluate existing streets in other cities and these criteria should also be used in planning for future cities

  14. A comparison and assessment of approaches for modelling flow over in-line tube banks

    International Nuclear Information System (INIS)

    Iacovides, Hector; Launder, Brian; West, Alastair

    2014-01-01

    Highlights: • We present wall-resolved LES and URANS simulations of periodic flow in heated in-line tube banks. • Simulations of flow in a confined in-line tube-bank are compared with experimental data. • When pitch-to-diameter (P/D) ratio becomes less than 1.6, the periodic flow becomes skewed. • URANS tested here unable to mimic the periodic flow at P/D = 1.6. • In confined tube banks URANS suggest alternate, in the axial direction, flow deflection. - Abstract: The paper reports experiences from applying alternative strategies for modelling turbulent flow and local heat-transfer coefficients around in-line tube banks. The motivation is the simulation of conditions in the closely packed cross-flow heat exchangers used in advanced gas-cooled nuclear reactors (AGRs). The main objective is the flow simulation in large-scale tube banks with confining walls. The suitability and accuracy of wall-resolved large-eddy simulation (LES) and Unsteady Reynolds-Averaged Navier–Stokes (URANS) approaches are examined for generic, square, in-line tube banks, where experimental data are limited but available. Within the latter approach, both eddy-viscosity and Reynolds-stress-transport models have been tested. The assumption of flow periodicity in all three directions is investigated by varying the domain size. It is found that the path taken by the fluid through the tube-bank configuration differs according to the treatment of turbulence and whether the flow is treated as two- or three-dimensional. Finally, the important effect of confining walls has been examined by making direct comparison with the experiments of the complete test rig of Aiba et al. (1982)

  15. Comparison of Outcomes before and after Ohio's Law Mandating Use of the FDA-Approved Protocol for Medication Abortion: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ushma D Upadhyay

    2016-08-01

    Full Text Available In February 2011, an Ohio law took effect mandating use of the United States Food and Drug Administration (FDA-approved protocol for mifepristone, which is used with misoprostol for medication abortion. Other state legislatures have passed or enacted similar laws requiring use of the FDA-approved protocol for medication abortion. The objective of this study is to examine the association of this legal change with medication abortion outcomes and utilization.We used a retrospective cohort design, comparing outcomes of medication abortion patients in the prelaw period to those in the postlaw period. Sociodemographic and clinical chart data were abstracted from all medication abortion patients from 1 y prior to the law's implementation (January 2010-January 2011 to 3 y post implementation (February 2011-October 2014 at four abortion-providing health care facilities in Ohio. Outcome data were analyzed for all women undergoing abortion at ≤49 d gestation during the study period. The main outcomes were as follows: need for additional intervention following medication abortion (such as aspiration, repeat misoprostol, and blood transfusion, frequency of continuing pregnancy, reports of side effects, and the proportion of abortions that were medication abortions (versus other abortion procedures. Among the 2,783 medication abortions ≤49 d gestation, 4.9% (95% CI: 3.7%-6.2% in the prelaw and 14.3% (95% CI: 12.6%-16.0% in the postlaw period required one or more additional interventions. Women obtaining a medication abortion in the postlaw period had three times the odds of requiring an additional intervention as women in the prelaw period (adjusted odds ratio [AOR] = 3.11, 95% CI: 2.27-4.27. In a mixed effects multivariable model that uses facility-months as the unit of analysis to account for lack of independence by site, we found that the law change was associated with a 9.4% (95% CI: 4.0%-18.4% absolute increase in the rate of requiring an additional

  16. Metal Mixture Modeling Evaluation project: 2. Comparison of four modeling approaches

    Science.gov (United States)

    Farley, Kevin J.; Meyer, Joe; Balistrieri, Laurie S.; DeSchamphelaere, Karl; Iwasaki, Yuichi; Janssen, Colin; Kamo, Masashi; Lofts, Steve; Mebane, Christopher A.; Naito, Wataru; Ryan, Adam C.; Santore, Robert C.; Tipping, Edward

    2015-01-01

    As part of the Metal Mixture Modeling Evaluation (MMME) project, models were developed by the National Institute of Advanced Industrial Science and Technology (Japan), the U.S. Geological Survey (USA), HDR⎪HydroQual, Inc. (USA), and the Centre for Ecology and Hydrology (UK) to address the effects of metal mixtures on biological responses of aquatic organisms. A comparison of the 4 models, as they were presented at the MMME Workshop in Brussels, Belgium (May 2012), is provided herein. Overall, the models were found to be similar in structure (free ion activities computed by WHAM; specific or non-specific binding of metals/cations in or on the organism; specification of metal potency factors and/or toxicity response functions to relate metal accumulation to biological response). Major differences in modeling approaches are attributed to various modeling assumptions (e.g., single versus multiple types of binding site on the organism) and specific calibration strategies that affected the selection of model parameters. The models provided a reasonable description of additive (or nearly additive) toxicity for a number of individual toxicity test results. Less-than-additive toxicity was more difficult to describe with the available models. Because of limitations in the available datasets and the strong inter-relationships among the model parameters (log KM values, potency factors, toxicity response parameters), further evaluation of specific model assumptions and calibration strategies is needed.

  17. Perfluoroalkyl substances in aquatic environment-comparison of fish and passive sampling approaches.

    Science.gov (United States)

    Cerveny, Daniel; Grabic, Roman; Fedorova, Ganna; Grabicova, Katerina; Turek, Jan; Kodes, Vit; Golovko, Oksana; Zlabek, Vladimir; Randak, Tomas

    2016-01-01

    The concentrations of seven perfluoroalkyl substances (PFASs) were investigated in 36 European chub (Squalius cephalus) individuals from six localities in the Czech Republic. Chub muscle and liver tissue were analysed at all sampling sites. In addition, analyses of 16 target PFASs were performed in Polar Organic Chemical Integrative Samplers (POCISs) deployed in the water at the same sampling sites. We evaluated the possibility of using passive samplers as a standardized method for monitoring PFAS contamination in aquatic environments and the mutual relationships between determined concentrations. Only perfluorooctane sulphonate was above the LOQ in fish muscle samples and 52% of the analysed fish individuals exceeded the Environmental Quality Standard for water biota. Fish muscle concentration is also particularly important for risk assessment of fish consumers. The comparison of fish tissue results with published data showed the similarity of the Czech results with those found in Germany and France. However, fish liver analysis and the passive sampling approach resulted in different fish exposure scenarios. The total concentration of PFASs in fish liver tissue was strongly correlated with POCIS data, but pollutant patterns differed between these two matrices. The differences could be attributed to the metabolic activity of the living organism. In addition to providing a different view regarding the real PFAS cocktail to which the fish are exposed, POCISs fulfil the Three Rs strategy (replacement, reduction, and refinement) in animal testing. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. On Thermally Interacting Multiple Boreholes with Variable Heating Strength: Comparison between Analytical and Numerical Approaches

    Directory of Open Access Journals (Sweden)

    Marc A. Rosen

    2012-08-01

    Full Text Available The temperature response in the soil surrounding multiple boreholes is evaluated analytically and numerically. The assumption of constant heat flux along the borehole wall is examined by coupling the problem to the heat transfer problem inside the borehole and presenting a model with variable heat flux along the borehole length. In the analytical approach, a line source of heat with a finite length is used to model the conduction of heat in the soil surrounding the boreholes. In the numerical method, a finite volume method in a three dimensional meshed domain is used. In order to determine the heat flux boundary condition, the analytical quasi-three-dimensional solution to the heat transfer problem of the U-tube configuration inside the borehole is used. This solution takes into account the variation in heating strength along the borehole length due to the temperature variation of the fluid running in the U-tube. Thus, critical depths at which thermal interaction occurs can be determined. Finally, in order to examine the validity of the numerical method, a comparison is made with the results of line source method.

  19. Sales Comparison Approach Indicating Heterogeneity of Particular Type of Real Estate and Corresponding Valuation Accuracy

    Directory of Open Access Journals (Sweden)

    Martin Cupal

    2017-01-01

    Full Text Available The article focuses on heterogeneity of goods, namely real estate and consequently deals with market valuation accuracy. The heterogeneity of real estate property is, in particular, that every unit is unique in terms of its construction, condition, financing and mainly location and thus assessing the value must necessarily be difficult. This research also indicates the rate of efficiency of markets across the types based on their level of variability. The research is based on two databases consisting of various types of real estate with specific market parameters. These parameters determine the differences across the types and reveal heterogeneity. The first database has been set on valuations by sales comparison approach and the second one on data of real properties offered on the market. The methodology is based on univariate and multivariate statistics of key variables of those databases. The multivariate analysis is performed by Hotelling T2 control chart and statistics with appropriate numerical characteristics. The results of both databases were joint by weights with regard to the dependence criterion of the variables. The final results indicate potential valuation accuracy across the types. The main contribution of the research is that the evaluation was not only derived from the price deviation or distribution, but it also draws from causes of real property heterogeneity as a whole.

  20. Analyzing Information Systems Development: A Comparison and Analysis of Eight IS Development Approaches.

    Science.gov (United States)

    Iivari, Juhani; Hirschheim, Rudy

    1996-01-01

    Analyzes and compares eight information systems (IS) development approaches: Information Modelling, Decision Support Systems, the Socio-Technical approach, the Infological approach, the Interactionist approach, the Speech Act-based approach, Soft Systems Methodology, and the Scandinavian Trade Unionist approach. Discusses the organizational roles…

  1. Psychoeducation for hypochondriasis : A comparison of a cognitive-behavioural approach and a problem-solving approach

    NARCIS (Netherlands)

    Buwalda, Femke M.; Bouman, Theo. K.; van Duijn, Marijtje A. J.; Van der Duin, M.

    In this study, two 6-week psychoeducational courses for hypochondriasis are compared, one based on the cognitive-behavioural approach, and the other on the problem-solving approach. Effects of both courses on hypochondriacal complaints, depression, trait anxiety, and number of problems encountered

  2. Comparison of student's learning achievement through realistic mathematics education (RME) approach and problem solving approach on grade VII

    Science.gov (United States)

    Ilyas, Muhammad; Salwah

    2017-02-01

    The type of this research was experiment. The purpose of this study was to determine the difference and the quality of student's learning achievement between students who obtained learning through Realistic Mathematics Education (RME) approach and students who obtained learning through problem solving approach. This study was a quasi-experimental research with non-equivalent experiment group design. The population of this study was all students of grade VII in one of junior high school in Palopo, in the second semester of academic year 2015/2016. Two classes were selected purposively as sample of research that was: year VII-5 as many as 28 students were selected as experiment group I and VII-6 as many as 23 students were selected as experiment group II. Treatment that used in the experiment group I was learning by RME Approach, whereas in the experiment group II by problem solving approach. Technique of data collection in this study gave pretest and posttest to students. The analysis used in this research was an analysis of descriptive statistics and analysis of inferential statistics using t-test. Based on the analysis of descriptive statistics, it can be concluded that the average score of students' mathematics learning after taught using problem solving approach was similar to the average results of students' mathematics learning after taught using realistic mathematics education (RME) approach, which are both at the high category. In addition, It can also be concluded that; (1) there was no difference in the results of students' mathematics learning taught using realistic mathematics education (RME) approach and students who taught using problem solving approach, (2) quality of learning achievement of students who received RME approach and problem solving approach learning was same, which was at the high category.

  3. Regional citrate anticoagulation for continuous renal replacement therapy in severe burns-a retrospective analysis of a protocol-guided approach.

    Science.gov (United States)

    Gille, Jochen; Sablotzki, Armin; Malcharek, Michael; Raff, Thomas; Mogk, Martin; Parentin, Torsten

    2014-12-01

    For critically ill patients, the use of regional citrate anticoagulation as part of continuous renal replacement therapy (CRRT) has become increasingly common in recent years. However, there are scarce data on the use of this technique in patients with burns. The aim of this study was to examine the effectiveness, feasibility and complications of regional citrate anticoagulation for CRRT in burn patients, as well as the effects on coagulation and the electrolyte and acid-base balance. This retrospective study included all patients who received renal replacement therapy with citrate anticoagulation to treat acute kidney injury (AKI) between January 1, 2004 and December 31, 2009 at the burn unit of St. Georg Hospital GmbH in Leipzig. During the examination period, 18 patients were treated using CRRT with regional citrate anticoagulation (CVVHDF in the pre-dilution mode). The median patient age was 64 years (49.5; 71), with a median TBSA of 42.5% (33.25; 52.5) and a median ABSI score of 10 (9; 10). The CRRT was initiated on a median of 6 days (4; 8.75) after admission to the hospital and continued for a median duration of 7 days (5; 8). The median dialysis dose was 38.2mlkgBW(-1)h(-1) (31.8; 42.1). The median effective filter operation time was 67h (46; 72). No relevant disorders associated with acid-base balance, electrolytes or coagulation occurred, and there were no bleeding complications. In terms of bleeding risk and electrolyte and acid-base balance, regional citrate anticoagulation may be considered to be an effective, safe and user-friendly procedure for patients with severe burns and AKI. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  4. Statistical approaches in published ophthalmic clinical science papers: a comparison to statistical practice two decades ago.

    Science.gov (United States)

    Zhang, Harrison G; Ying, Gui-Shuang

    2018-02-09

    The aim of this study is to evaluate the current practice of statistical analysis of eye data in clinical science papers published in British Journal of Ophthalmology ( BJO ) and to determine whether the practice of statistical analysis has improved in the past two decades. All clinical science papers (n=125) published in BJO in January-June 2017 were reviewed for their statistical analysis approaches for analysing primary ocular measure. We compared our findings to the results from a previous paper that reviewed BJO papers in 1995. Of 112 papers eligible for analysis, half of the studies analysed the data at an individual level because of the nature of observation, 16 (14%) studies analysed data from one eye only, 36 (32%) studies analysed data from both eyes at ocular level, one study (1%) analysed the overall summary of ocular finding per individual and three (3%) studies used the paired comparison. Among studies with data available from both eyes, 50 (89%) of 56 papers in 2017 did not analyse data from both eyes or ignored the intereye correlation, as compared with in 60 (90%) of 67 papers in 1995 (P=0.96). Among studies that analysed data from both eyes at an ocular level, 33 (92%) of 36 studies completely ignored the intereye correlation in 2017, as compared with in 16 (89%) of 18 studies in 1995 (P=0.40). A majority of studies did not analyse the data properly when data from both eyes were available. The practice of statistical analysis did not improve in the past two decades. Collaborative efforts should be made in the vision research community to improve the practice of statistical analysis for ocular data. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. An empirical comparison of different approaches for combining multimodal neuroimaging data with Support Vector Machine

    Directory of Open Access Journals (Sweden)

    William ePettersson-Yeo

    2014-07-01

    Full Text Available In the pursuit of clinical utility, neuroimaging researchers of psychiatric and neurological illness are increasingly using analyses, such as support vector machine (SVM, that allow inference at the single-subject level. Recent studies employing single-modality data, however, suggest that classification accuracies must be improved for such utility to be realised. One possible solution is to integrate different data types to provide a single combined output classification; either by generating a single decision function based on an integrated kernel matrix, or, by creating an ensemble of multiple single modality classifiers and integrating their predictions. Here, we describe four integrative approaches: 1 an un-weighted sum of kernels, 2 multi-kernel learning, 3 prediction averaging, and 4 majority voting, and compare their ability to enhance classification accuracy relative to the best single-modality classification accuracy. We achieve this by integrating structural, functional and diffusion tensor magnetic resonance imaging data, in order to compare ultra-high risk (UHR; n=19, first episode psychosis (FEP; n=19 and healthy control subjects (HCs; n=19. Our results show that i whilst integration can enhance classification accuracy by up to 13%, the frequency of such instances may be limited, ii where classification can be enhanced, simple methods may yield greater increases relative to more computationally complex alternatives, and, iii the potential for classification enhancement is highly influenced by the specific diagnostic comparison under consideration. In conclusion, our findings suggest that for moderately sized clinical neuroimaging datasets, combining different imaging modalities in a data-driven manner is no magic bullet for increasing classification accuracy.

  6. Social Comparison and Body Image in Adolescence: A Grounded Theory Approach

    Science.gov (United States)

    Krayer, A.; Ingledew, D. K.; Iphofen, R.

    2008-01-01

    This study explored the use of social comparison appraisals in adolescents' lives with particular reference to enhancement appraisals which can be used to counter threats to the self. Social comparison theory has been increasingly used in quantitative research to understand the processes through which societal messages about appearance influence…

  7. The Pennsylvania Phosphorus Index and TopoSWAT: A comparison of transport components and approaches

    Science.gov (United States)

    The regional Chesapeake Bay Conservation Innovation Grant Initiative includes comparison of TopoSWAT results and Phosphorus Index (P Index) evaluations of eight study watersheds throughout the Chesapeake Bay watershed. While similarities exist between the P Index and TopoSWAT, further comparison of ...

  8. Distinguishing between forensic science and forensic pseudoscience: testing of validity and reliability, and approaches to forensic voice comparison.

    Science.gov (United States)

    Morrison, Geoffrey Stewart

    2014-05-01

    In this paper it is argued that one should not attempt to directly assess whether a forensic analysis technique is scientifically acceptable. Rather one should first specify what one considers to be appropriate principles governing acceptable practice, then consider any particular approach in light of those principles. This paper focuses on one principle: the validity and reliability of an approach should be empirically tested under conditions reflecting those of the case under investigation using test data drawn from the relevant population. Versions of this principle have been key elements in several reports on forensic science, including forensic voice comparison, published over the last four-and-a-half decades. The aural-spectrographic approach to forensic voice comparison (also known as "voiceprint" or "voicegram" examination) and the currently widely practiced auditory-acoustic-phonetic approach are considered in light of this principle (these two approaches do not appear to be mutually exclusive). Approaches based on data, quantitative measurements, and statistical models are also considered in light of this principle. © 2013.

  9. A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

    OpenAIRE

    Stefan Landgraeber; Henning Quitmann; Sebastian Güth; Marcel Haversath; Wojciech Kowalczyk; Andrés Kecskeméthy; Hansjörg Heep; Marcus Jäger

    2013-01-01

    There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and ...

  10. Complicated diverticular disease of the colon, do we need to change the classical approach, a retrospective study of 110 patients in southeast England

    Directory of Open Access Journals (Sweden)

    Subhas Gokulakkrishna

    2008-01-01

    Full Text Available Abstract Background Complicated diverticular disease of the colon imposes a serious risk to patient's life, challenge to surgeons and has cost implications for health authority. The aim of this study is to evaluate the management outcome of complicated colonic diverticular disease in a district hospital and to explore the current strategies of treatment. Methods This is a retrospective study of all patients who were admitted to the surgical ward between May 2002 and November 2006 with a diagnosis of complicated diverticular disease. A proforma of patients' details, admission date, ITU admission, management outcomes and the follow up were recorded from the patients case notes and analyzed. The mean follow-up was 34 months (range 6–60 months Results The mean age of patients was 72.7 years (range 39–87 years. Thirty-one men (28.18 % and Seventy-nine women (71.81% were included in this study. Male: female ratio was 1:2.5. Sixty-eight percent of patients had one or more co-morbidities. Forty-one patients (37.27% had two or more episodes of diverticulitis while 41.8% of them had no history of diverticular disease. Eighty-six percent of patients presented with acute abdominal pain while bleeding per rectum was the main presentation in 14%. Constipation and erratic bowel habit were the commonest chronic symptoms in patients with history of diverticular disease. Generalized tenderness was reported in 64.28% while 35.71% have left iliac fossa tenderness. Leukocytosis was reported in 58 patients (52.72%. The mean time from the admission until the start of operative intervention was 20.57 hours (range 4–96 hours. Perforation was confirmed in 59.52%. Mortality was 10.90%. Another 4 (3.63% died during follow up for other reasons. Conclusion Complicated diverticular disease carries significant morbidity and mortality. These influenced by patient-related factors. Because of high mortality and morbidities, we suggest the need to target a specific group of

  11. Correlations between biochemical testing, anthology findings and preoperative sestamibi scans: a retrospective study of the minimally invasive radioguided parathyroidectomy (MIRP) approach

    International Nuclear Information System (INIS)

    Stawicki, S.; El Chaar, M.; Baillie, D.; Jaik, N.; Estrada, F.

    2007-01-01

    Sestamibi imaging is the most widely used preoperative localization study for patients with hyperparathyroidism. Previous reports examine the relationship between the weight and volume of excised parathyroid glands and preoperative serum calcium and parathyroid hormone (PTH) levels.The aim of this study was to examine whether these variables correlate with the results of preoperative Sestamibi scans. A retrospective review of 150 consecutive patients who underwent preoperative sestamibi imaging for primary hyperparathyroidism between 1998 and 2007 was performed. Variables studied included patient demographics, diagnostic test (sestamibi) results, operative/pathology findings and surgical outcome (normocalcaemia vs. persistent hypercalcaemia). Sestamibi scans were designated as either 'negative' (NSS) or 'positive' (PSS), where PSS correctly localized abnormal gland(s) enabling a focused neck exploration. The results of sestamibi imaging were correlated with calcium/PTH levels, weight/volume of excised glands and patient outcomes and demographics. Total excised gland weight/volume and preoperative serum calcium levels were significantly higher with PSS (all, p ≤ 0.04). Higher preoperative serum calcium levels and greater total gland weight/volume were significantly associated with successful operative outcome (presence of postoperative normocalcaemia; all, p ≤ 0.01). Factors associated with operative failure included multi-gland disease (p <≤ 0.01) and NSS (p ≤0.01). Higher diagnostic PTH levels (≥ 150 pg/mL) were associated with greater excised gland mass (p ≤ 0.05) and volume (p ≤ 0.05). Male gender was associated with higher preoperative serum calcium levels (p < 0.02). Of interest, patients with single-gland disease had significantly higher preoperative PTH levels than patients with multi-gland disease (155 vs. 109 pg/mL, p ≤ 0.05). Positive sestamibi scans are associated with heavier/larger parathyroid glands and higher preoperative serum

  12. Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures.

    Science.gov (United States)

    Zhou, Hai-Chao; Yu, Tao; Ren, Hao-Yang; Li, Bing; Chen, Kai; Zhao, You-Guang; Yang, Yun-Feng

    2017-02-01

    To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra-articular calcaneal fractures. We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group. All patients were asked to return for a research visit that included radiography and clinical evaluation. The postoperative function was evaluated using the ankle and hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and the visual analogue scale (VAS). No significant difference was found in demographics between the two groups. The corrected value of the calcaneal varus angle between the two groups is statistically significant (P articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful for correcting the calcaneus varus deformity. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  13. The anterior sagittal transrectal approach (ASTRA) for cases associated with rectal implantation of the urethra: A retrospective review of six cases.

    Science.gov (United States)

    Macedo, A; Silva, M I S; Pompermaier, J A; Ottoni, S L; de Castro, R; Leal da Cruz, M

    2017-12-01

    Severe genital abnormalities such as urogenital sinus and urethral duplication with ectopic urethra in the rectum represent a major challenge in reconstructive urology. We aimed to review our cases presenting with functional ectopic urethra implanted in the rectum that were treated through an ASTRA approach. We reviewed the medical records of all patients who had undergone an ASTRA approach from 2005-2016. We collected data with interest to primary diagnosis, clinical presentation, additional procedure, immediate clinical outcome, complications, bowel habits after surgery, voiding and bladder emptying pattern and long term follow-up. Since 2005, we treated 6 cases using this method, consisting of 3 patients with congenital aphallia and 3 with Y-type urethral duplication. Two aphallia patients underwent De Castro's neophalloplasty with simultaneous anastomosis of proximal urethra to a tubed buccal mucosa neourethra and one had a neophalloplasty with transverse skin flaps and primary perineal urethrostomy. Two patients with Y-type urethral duplication had a complete urethroplasty performed (one end-to-end anastomosis and a two-stage repair). Last patient had a definitive perineal urethrostomy. At mean follow-up of 83.5 meses, only one patient voids through the urethra, four have a Mitrofanoff channel and two have a perineal urethrostomy. Immediate follow-up was uneventful and none of our patients had any bowel complications nor fecal incontinence. Domini et al. were the first proponents of the anterior sagittal transanorectal approach (ASTRA) as an alternative to classic Peña approach. Later, De Castro popularized specifically this technique as a relevant part of his neophalloplasty procedure to treat congenital aphallia. We did not find in this series any complications related to ASTRA technique in regards to bowel habits, fecal incontinence or infection but most of cases we tried to create a new anterior urethra and connect to the proximal stump failed. Moreover

  14. Self-regulatory Behaviors and Approaches to Learning of Arts Students: A Comparison Between Professional Training and English Learning.

    Science.gov (United States)

    Tseng, Min-Chen; Chen, Chia-Cheng

    2017-06-01

    This study investigated the self-regulatory behaviors of arts students, namely memory strategy, goal-setting, self-evaluation, seeking assistance, environmental structuring, learning responsibility, and planning and organizing. We also explored approaches to learning, including deep approach (DA) and surface approach (SA), in a comparison between students' professional training and English learning. The participants consisted of 344 arts majors. The Academic Self-Regulation Questionnaire and the Revised Learning Process Questionnaire were adopted to examine students' self-regulatory behaviors and their approaches to learning. The results show that a positive and significant correlation was found in students' self-regulatory behaviors between professional training and English learning. The results indicated that increases in using self-regulatory behaviors in professional training were associated with increases in applying self-regulatory behaviors in learning English. Seeking assistance, self-evaluation, and planning and organizing were significant predictors for learning English. In addition, arts students used the deep approach more often than the surface approach in both their professional training and English learning. A positive correlation was found in DA, whereas a negative correlation was shown in SA between students' self-regulatory behaviors and their approaches to learning. Students with high self-regulation adopted a deep approach, and they applied the surface approach less in professional training and English learning. In addition, a SEM model confirmed that DA had a positive influence; however, SA had a negative influence on self-regulatory behaviors.

  15. Comparison of the Masaoka-Koga and The IASLC/ITMIG Proposal for The TNM 
Staging Systems Based on the Chinese Alliance for Research in Thymomas (ChART
Retrospective Database

    Directory of Open Access Journals (Sweden)

    Guanghui LIANG

    2016-07-01

    Full Text Available Background and objective To compare the predictive effect of the Masaoka-Koga staging system and the International Association for the Study of Lung Cancer (IASLC/the International Thymic Malignancies Interest Group (ITMIG proposal for the new TNM staging on prognosis of thymic malignancies using the Chinese Alliance for Research in Thymomas (ChART retrospective database. Methods From 1992 to 2012, 2,370 patients in ChART database were retrospectively reviewed. Of these, 1,198 patients with complete information on TNM stage, Masaoka-Koga stage, and survival were used for analysis. Cumulative incidence of recurrence (CIR was assessed in R0 patients. Overall survival (OS was evaluated both in an R0 resected cohort, as well as in all patients (any R status. CIR and OS were first analyzed according to the Masaoka-Koga staging system. Then, they were compared using the new TNM staging proposal. Results Based on Masaoka-Koga staging system, significant difference was detected in CIR among all stages. However, No survival difference was revealed between stage I and II, or between stage II and III. Stage IV carried the highest risk of recurrence and worst survival. According to the new TNM staging proposal, CIR in T1a was significantly lower comparing to all other T categories (P<0.05 and there is a significant difference in OS between T1a and T1b (P=0.004. T4 had the worst OS comparing to all other T categories. CIR and OS were significantly worse in N(+ than in N0 patients. Significant difference in CIR and OS was detected between M0 and M1b, but not between M0 and M1a. OS was almost always statistically different when comparison was made between stages I-IIIa and stages IIIb-IVb. However, no statistical difference could be detected among stages IIIb to IVb. Conclusion Compared with Masaoka-Koga staging, the IASLC/ITMIG TNM staging proposal not only describes the extent of tumor invasion but also provides information on lymphatic involvement and tumor

  16. Post-closure biosphere assessment modelling: comparison of complex and more stylised approaches

    Energy Technology Data Exchange (ETDEWEB)

    Walke, Russell C. [Quintessa Limited, The Hub, 14 Station Road, Henley-on-Thames (United Kingdom); Kirchner, Gerald [University of Hamburg, ZNF, Beim Schlump 83, 20144 Hamburg (Germany); Xu, Shulan; Dverstorp, Bjoern [Swedish Radiation Safety Authority, SE-171 16 Stockholm (Sweden)

    2014-07-01

    to the biosphere. Some radionuclides do not reach equilibrium within the time frame that the biosphere evolves at the Forsmark site, making associated dose factors sensitive to time scales assumed for biosphere evolution. Comparison of the results generated by both types of model demonstrates that, for areas that evolve from marine, through lakes and mires to terrestrial systems with organic soils, the approach adopted in SKB's model is conservative. However, higher dose factors are possible when potential for long-term irrigation with shallow groundwater is considered. Surveys of groundwater wells in the Forsmark area today show that some shallow groundwater is used to water plants, which demonstrates that small scale irrigation from such sources cannot be ruled out for present-day or warmer climate states. Complex models use more of the available site-specific information and contribute to an understanding of complex process interactions and effects of system heterogeneity. The study shows, however, that simple 'reference' biosphere models enable processes that control potential radionuclide impacts to be identified, taking into account climate variability. They help to build understanding and confidence in more complex modelling approaches, quantify the conservatisms involved and remain a valuable tool for nuclear waste disposal licensing procedures. (authors)

  17. Within-culture variations of uniqueness: towards an integrative approach based on social status, gender, life contexts, and interpersonal comparison.

    Science.gov (United States)

    Causse, Elsa; Félonneau, Marie-Line

    2014-01-01

    Research on uniqueness is widely focused on cross-cultural comparisons and tends to postulate a certain form of within-culture homogeneity. Taking the opposite course of this classic posture, we aimed at testing an integrative approach enabling the study of within-culture variations of uniqueness. This approach considered different sources of variation: social status, gender, life contexts, and interpersonal comparison. Four hundred seventy-nine participants completed a measure based on descriptions of "self" and "other." Results showed important variations of uniqueness. An interaction between social status and life contexts revealed the expression of uniqueness in the low-status group. This study highlights the complexity of uniqueness that appears to be related to both cultural ideology and social hierarchy.

  18. Time-History Seismic Analysis of Masonry Buildings: A Comparison between Two Non-Linear Modelling Approaches

    Directory of Open Access Journals (Sweden)

    Michele Betti

    2015-05-01

    Full Text Available The paper presents a comparison between two numerical modelling approaches employed to investigate the seismic behavior of unreinforced masonry buildings with flexible diaphragms. The comparison is performed analyzing a two-story prototype tested on a shaking table at the CNR-ENEA research center of Casaccia (Italy. The first numerical model was built by using the finite element (FE technique, while the second one was built by a simplified macro-element (ME approach. Both models were employed to perform non-linear dynamic analyses, integrating the equations of motion by step-by-step procedures. The shaking table tests were simulated to analyze the behavior of the prototype from the initial elastic state until the development of extensive damage. The main results of the analyses are discussed and critically compared in terms of engineering parameters, such as accelerations, displacements and base shears. The effectiveness of both models within the investigated typology of buildings is then evaluated in depth.

  19. Marketing through Social Media : Case: Comparison of Social Media Marketing Approaches of B2C Companies for Company X

    OpenAIRE

    Rantapelkonen Ahlberg, Jaana

    2010-01-01

    Rantapelkonen Ahlberg, Jaana. 2010. Social Media Marketing. Case: Comparison of Social Media Marketing Approaches of B2C Companies for Company X. Master’s Thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 42 (74). The objective of this thesis is to provide insights on how Company X can use Social Media as a marketing and branding tool in consumer marketing in the Swedish market. More specifically, this study attempts to define what kinds of social media are u...

  20. Which percentile-based approach should be preferred for calculating normalized citation impact values? An empirical comparison of five approaches including a newly developed citation-rank approach (P100)

    NARCIS (Netherlands)

    Bornmann, L.; Leydesdorff, L.; Wang, J.

    2013-01-01

    For comparisons of citation impacts across fields and over time, bibliometricians normalize the observed citation counts with reference to an expected citation value. Percentile-based approaches have been proposed as a non-parametric alternative to parametric central-tendency statistics. Percentiles

  1. Treatment approach, delivery, and follow-up evaluation for cardiac rhythm disease management patients receiving radiation therapy: Retrospective physician surveys including chart reviews at numerous centers

    Energy Technology Data Exchange (ETDEWEB)

    Gossman, Michael S., E-mail: MGossman@TSRCC.com [Regulation Directive Medical Physics, Russell, KY (United States); Wilkinson, Jeffrey D. [Medtronic, Inc., Mounds View, MN (United States); Mallick, Avishek [Department of Mathematics, Marshall University, Huntington, WV (United States)

    2014-01-01

    In a 2-part study, we first examined the results of 71 surveyed physicians who provided responses on how they address the management of patients who maintained either a pacemaker or a defibrillator during radiation treatment. Second, a case review study is presented involving 112 medical records reviewed at 18 institutions to determine whether there was a change in the radiation prescription for the treatment of the target cancer, the method of radiation delivery, or the method of radiation image acquisition. Statistics are provided to illustrate the level of administrative policy; the level of communication between radiation oncologists and heart specialists; American Joint Committee on Cancer (AJCC) staging and classification; National Comprehensive Cancer Network (NCCN) guidelines; tumor site; patient's sex; patient's age; device type; manufacturer; live monitoring; and the reported decisions for planning, delivery, and imaging. This survey revealed that 37% of patient treatments were considered for some sort of change in this regard, whereas 59% of patients were treated without regard to these alternatives when available. Only 3% of all patients were identified with an observable change in the functionality of the device or patient status in comparison with 96% of patients with normal behavior and operating devices. Documented changes in the patient's medical record included 1 device exhibiting failure at 0.3-Gy dose, 1 device exhibiting increased sensor rate during dose delivery, 1 patient having an irregular heartbeat leading to device reprogramming, and 1 patient complained of twinging in the chest wall that resulted in a respiratory arrest. Although policies and procedures should directly involve the qualified medical physicist for technical supervision, their sufficient involvement was typically not requested by most respondents. No treatment options were denied to any patient based on AJCC staging, classification, or NCCN practice standards.

  2. Comparison of different statistical modelling approaches for deriving spatial air temperature patterns in an urban environment

    Science.gov (United States)

    Straub, Annette; Beck, Christoph; Breitner, Susanne; Cyrys, Josef; Geruschkat, Uta; Jacobeit, Jucundus; Kühlbach, Benjamin; Kusch, Thomas; Richter, Katja; Schneider, Alexandra; Umminger, Robin; Wolf, Kathrin

    2017-04-01

    Frequently spatial variations of air temperature of considerable magnitude occur within urban areas. They correspond to varying land use/land cover characteristics and vary with season, time of day and synoptic conditions. These temperature differences have an impact on human health and comfort directly by inducing thermal stress as well as indirectly by means of affecting air quality. Therefore, knowledge of the spatial patterns of air temperature in cities and the factors causing them is of great importance, e.g. for urban planners. A multitude of studies have shown statistical modelling to be a suitable tool for generating spatial air temperature patterns. This contribution presents a comparison of different statistical modelling approaches for deriving spatial air temperature patterns in the urban environment of Augsburg, Southern Germany. In Augsburg there exists a measurement network for air temperature and humidity currently comprising 48 stations in the city and its rural surroundings (corporately operated by the Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health and the Institute of Geography, University of Augsburg). Using different datasets for land surface characteristics (Open Street Map, Urban Atlas) area percentages of different types of land cover were calculated for quadratic buffer zones of different size (25, 50, 100, 250, 500 m) around the stations as well for source regions of advective air flow and used as predictors together with additional variables such as sky view factor, ground level and distance from the city centre. Multiple Linear Regression and Random Forest models for different situations taking into account season, time of day and weather condition were applied utilizing selected subsets of these predictors in order to model spatial distributions of mean hourly and daily air temperature deviations from a rural reference station. Furthermore, the different model setups were

  3. An empirical comparison of different approaches for combining multimodal neuroimaging data with support vector machine.

    Science.gov (United States)

    Pettersson-Yeo, William; Benetti, Stefania; Marquand, Andre F; Joules, Richard; Catani, Marco; Williams, Steve C R; Allen, Paul; McGuire, Philip; Mechelli, Andrea

    2014-01-01

    In the pursuit of clinical utility, neuroimaging researchers of psychiatric and neurological illness are increasingly using analyses, such as support vector machine, that allow inference at the single-subject level. Recent studies employing single-modality data, however, suggest that classification accuracies must be improved for such utility to be realized. One possible solution is to integrate different data types to provide a single combined output classification; either by generating a single decision function based on an integrated kernel matrix, or, by creating an ensemble of multiple single modality classifiers and integrating their predictions. Here, we describe four integrative approaches: (1) an un-weighted sum of kernels, (2) multi-kernel learning, (3) prediction averaging, and (4) majority voting, and compare their ability to enhance classification accuracy relative to the best single-modality classification accuracy. We achieve this by integrating structural, functional, and diffusion tensor magnetic resonance imaging data, in order to compare ultra-high risk (n = 19), first episode psychosis (n = 19) and healthy control subjects (n = 23). Our results show that (i) whilst integration can enhance classification accuracy by up to 13%, the frequency of such instances may be limited, (ii) where classification can be enhanced, simple methods may yield greater increases relative to more computationally complex alternatives, and, (iii) the potential for classification enhancement is highly influenced by the specific diagnostic comparison under consideration. In conclusion, our findings suggest that for moderately sized clinical neuroimaging datasets, combining different imaging modalities in a data-driven manner is no "magic bullet" for increasing classification accuracy. However, it remains possible that this conclusion is dependent on the use of neuroimaging modalities that had little, or no, complementary information to offer one another, and that the

  4. Comparison of transportation related injury mechanisms and outcome of young road users and adult road users, a retrospective analysis on 24,373 patients derived from the TraumaRegister DGU®.

    Science.gov (United States)

    Brockamp, Thomas; Schmucker, Uli; Lefering, Rolf; Mutschler, Manuel; Driessen, Arne; Probst, Christian; Bouillon, Bertil; Koenen, Paola

    2017-06-14

    Most young people killed in road crashes are known as vulnerable road users. A combination of physical and developmental immaturity as well as inexperience increases the risk of road traffic accidents with a high injury severity rate. Understanding injury mechanism and pattern in a group of young road users may reduce morbidity and mortality. This study analyzes injury patterns and outcomes of young road users compared to adult road users. The comparison takes into account different transportation related injury mechanisms. A retrospective analysis using data collected between 2002 and 2012 from the TraumaRegister DGU® was performed. Only patients with a transportation related injury mechanism (motor vehicle collision (MVC), motorbike, cyclist, and pedestrian) and an ISS ≥ 9 were included in our analysis. Four different groups of young road users were compared to adult trauma data depending on the transportation related injury mechanism. Twenty four thousand three hundred seventy three, datasets were retrieved to compare all subgroups. The mean ISS was 23.3 ± 13.1. The overall mortality rate was 8.61%. In the MVC, the motorbike and the cyclist group, we found young road users having more complex injury patterns with a higher AIS pelvis, AIS head, AIS abdomen and AIS of the extremities and also a lower GCS. Whereas in these three sub-groups the adult trauma group only had a higher AIS thorax. Only in the group of the adult pedestrians we found a higher AIS pelvis, AIS abdomen, AIS thorax, a higher AIS of the extremities and a lower GCS. This study reports on the most common injuries and injury patterns in young trauma patients in comparison to an adult trauma sample. Our analysis show that in contrast to more experienced road users our young collective refers to be a vulnerable trauma group with an increased risk of a high injury severity and high mortality rate. We indicate a striking difference in terms of the region of injury and the mechanism of

  5. A comparison of conventional local approach and the short crack approach to fatigue crack initiation at a notch

    Energy Technology Data Exchange (ETDEWEB)

    Ranganathan, Narayanaswami; Leroy, Rene; Tougui, Abdellah [Laboratoire de Mecanique et Rheologie, Universite Francois Rabelais de Tours, Polytech Tours, Departement Mecanique et Conception de Systemes, Tours (France)

    2009-09-15

    Methods to estimate fatigue crack initiation life at a notch tip are compared. The methods used determine the strain amplitudes at the notch tip using Neuber's or Glinka's approximation. In conventional approaches, equivalent-damage levels are determined, using appropriate strain-life relationships coupled with damage-summation models. In the short-crack approach, a crack-like defect is assumed to exist at the notch tip. It is shown that the short-crack concept can be successfully applied to predict crack-initiation behavior at a notch. Model predictions are compared with carefully designed experiments. It is shown that model predictions are very close to experimentally measured lives under an aircraft-wing loading spectrum. (Abstract Copyright [2009], Wiley Periodicals, Inc.)

  6. A Prospective Randomized Peri- and Post-Operative Comparison of the Minimally Invasive Anterolateral Approach Versus the Lateral Approach

    Science.gov (United States)

    Landgraeber, Stefan; Quitmann, Henning; Güth, Sebastian; Haversath, Marcel; Kowalczyk, Wojciech; Kecskeméthy, Andrés; Heep, Hansjörg; Jäger, Marcus

    2013-01-01

    There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study. PMID:24191179

  7. A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2013-07-01

    Full Text Available There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS or a conventional lateral approach (CON. We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36 or CON (n=39 approach. The Western Ontario\tand\tMcMaster\tUniversities Osteoarthritis Index and Harris Hip score (HHS were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045. But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study.

  8. Effects of a structured 20-session slow-cortical-potential-based neurofeedback program on attentional performance in children and adolescents with attention-deficit hyperactivity disorder: retrospective analysis of an open-label pilot-approach and 6-month follow-up.

    Science.gov (United States)

    Albrecht, Johanna S; Bubenzer-Busch, Sarah; Gallien, Anne; Knospe, Eva Lotte; Gaber, Tilman J; Zepf, Florian D

    2017-01-01

    The aim of this approach was to conduct a structured electroencephalography-based neurofeedback training program for children and adolescents with attention-deficit hyperactivity disorder (ADHD) using slow cortical potentials with an intensive first (almost daily sessions) and second phase of training (two sessions per week) and to assess aspects of attentional performance. A total of 24 young patients with ADHD participated in the 20-session training program. During phase I of training (2 weeks, 10 sessions), participants were trained on weekdays. During phase II, neurofeedback training occurred twice per week (5 weeks). The patients' inattention problems were measured at three assessment time points before (pre, T0) and after (post, T1) the training and at a 6-month follow-up (T2); the assessments included neuropsychological tests (Alertness and Divided Attention subtests of the Test for Attentional Performance; Sustained Attention Dots and Shifting Attentional Set subtests of the Amsterdam Neuropsychological Test) and questionnaire data (inattention subscales of the so-called Fremdbeurteilungsbogen für Hyperkinetische Störungen and Child Behavior Checklist/4-18 [CBCL/4-18]). All data were analyzed retrospectively. The mean auditive reaction time in a Divided Attention task decreased significantly from T0 to T1 (medium effect), which was persistent over time and also found for a T0-T2 comparison (larger effects). In the Sustained Attention Dots task, the mean reaction time was reduced from T0-T1 and T1-T2 (small effects), whereas in the Shifting Attentional Set task, patients were able to increase the number of trials from T1-T2 and significantly diminished the number of errors (T1-T2 & T0-T2, large effects). First positive but very small effects and preliminary results regarding different parameters of attentional performance were detected in young individuals with ADHD. The limitations of the obtained preliminary data are the rather small sample size, the

  9. Simulation-based comparison of two approaches frequently used for dynamic contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Zwick, Stefan; Brix, Gunnar; Tofts, Paul S.; Strecker, Ralph; Kopp-Schneider, Annette; Laue, Hendrik; Semmler, Wolfhard; Kiessling, Fabian

    2010-01-01

    The purpose was to compare two approaches for the acquisition and analysis of dynamic-contrast-enhanced MRI data with respect to differences in the modelling of the arterial input-function (AIF), the dependency of the model parameters on physiological parameters and their numerical stability. Eight hundred tissue concentration curves were simulated for different combinations of perfusion, permeability, interstitial volume and plasma volume based on two measured AIFs and analysed according to the two commonly used approaches. The transfer constants (Approach 1) K trans and (Approach 2) k ep were correlated with all tissue parameters. K trans showed a stronger dependency on perfusion, and k ep on permeability. The volume parameters (Approach 1) v e and (Approach 2) A were mainly influenced by the interstitial and plasma volume. Both approaches allow only rough characterisation of tissue microcirculation and microvasculature. Approach 2 seems to be somewhat more robust than 1, mainly due to the different methods of CA administration. (orig.)

  10. A comparison of two sampling approaches for assessing the urban forest canopy cover from aerial photography.

    Science.gov (United States)

    Ucar Zennure; Pete Bettinger; Krista Merry; Jacek Siry; J.M. Bowker

    2016-01-01

    Two different sampling approaches for estimating urban tree canopy cover were applied to two medium-sized cities in the United States, in conjunction with two freely available remotely sensed imagery products. A random point-based sampling approach, which involved 1000 sample points, was compared against a plot/grid sampling (cluster sampling) approach that involved a...

  11. A Comparison of Jungian, Person-Centered, and Gestalt Approaches to Personal Growth Groups.

    Science.gov (United States)

    Day, Bryon; Matthes, William

    1992-01-01

    Compares Jungian approach to personal growth groups to Person-centered and Gestalt approaches. Notes similarities, though Jungian approach adds dimension of "cognitive map" not found in other two. Notes that cognitive map uses constructs from Jung's theory of individuation process, hypothesizing that integration of these constructs into…

  12. A comparison of trans-cranial and trans-sphenoidal approaches for vision improvement due to pitutary adenomas

    Directory of Open Access Journals (Sweden)

    Fakhr Tabatabai SA

    1997-07-01

    Full Text Available To improve visual disturbance, optic nerve decompression can be performed via transcranial or tran-sphenoidal approaches. Although the surgical exposure in transcranial approach is favourable, yet the optic nerve's presence in the field may make it vulnerable to damage. Of fighty patients with different types of pituitary adenomas, 35 cases with medium-sized (1-3 cm tumors have been studied in a randomized clinical trial during a three year period, to compare the applicability of these approaches. While short hospital stay with better visual outcome was observed in fifteen trans-sphenoidal cases, in comparison to 20 trans-cranial cases, however the preoperative visual status and underlying disorders were similar in both groups. Decompressing the optic apparatus, trans-sphenoidally, seems beneficial, where there are no contraindications for the procedure in medium-sized pituitary adenomas

  13. Model-Assisted Estimation of Tropical Forest Biomass Change: A Comparison of Approaches

    Directory of Open Access Journals (Sweden)

    Nikolai Knapp

    2018-05-01

    Full Text Available Monitoring of changes in forest biomass requires accurate transfer functions between remote sensing-derived changes in canopy height (ΔH and the actual changes in aboveground biomass (ΔAGB. Different approaches can be used to accomplish this task: direct approaches link ΔH directly to ΔAGB, while indirect approaches are based on deriving AGB stock estimates for two points in time and calculating the difference. In some studies, direct approaches led to more accurate estimations, while, in others, indirect approaches led to more accurate estimations. It is unknown how each approach performs under different conditions and over the full range of possible changes. Here, we used a forest model (FORMIND to generate a large dataset (>28,000 ha of natural and disturbed forest stands over time. Remote sensing of forest height was simulated on these stands to derive canopy height models for each time step. Three approaches for estimating ΔAGB were compared: (i the direct approach; (ii the indirect approach and (iii an enhanced direct approach (dir+tex, using ΔH in combination with canopy texture. Total prediction accuracies of the three approaches measured as root mean squared errors (RMSE were RMSEdirect = 18.7 t ha−1, RMSEindirect = 12.6 t ha−1 and RMSEdir+tex = 12.4 t ha−1. Further analyses revealed height-dependent biases in the ΔAGB estimates of the direct approach, which did not occur with the other approaches. Finally, the three approaches were applied on radar-derived (TanDEM-X canopy height changes on Barro Colorado Island (Panama. The study demonstrates the potential of forest modeling for improving the interpretation of changes observed in remote sensing data and for comparing different methodologies.

  14. Comparison between bottom-up and top-down approaches in the estimation of measurement uncertainty.

    Science.gov (United States)

    Lee, Jun Hyung; Choi, Jee-Hye; Youn, Jae Saeng; Cha, Young Joo; Song, Woonheung; Park, Ae Ja

    2015-06-01

    Measurement uncertainty is a metrological concept to quantify the variability of measurement results. There are two approaches to estimate measurement uncertainty. In this study, we sought to provide practical and detailed examples of the two approaches and compare the bottom-up and top-down approaches to estimating measurement uncertainty. We estimated measurement uncertainty of the concentration of glucose according to CLSI EP29-A guideline. Two different approaches were used. First, we performed a bottom-up approach. We identified the sources of uncertainty and made an uncertainty budget and assessed the measurement functions. We determined the uncertainties of each element and combined them. Second, we performed a top-down approach using internal quality control (IQC) data for 6 months. Then, we estimated and corrected systematic bias using certified reference material of glucose (NIST SRM 965b). The expanded uncertainties at the low glucose concentration (5.57 mmol/L) by the bottom-up approach and top-down approaches were ±0.18 mmol/L and ±0.17 mmol/L, respectively (all k=2). Those at the high glucose concentration (12.77 mmol/L) by the bottom-up and top-down approaches were ±0.34 mmol/L and ±0.36 mmol/L, respectively (all k=2). We presented practical and detailed examples for estimating measurement uncertainty by the two approaches. The uncertainties by the bottom-up approach were quite similar to those by the top-down approach. Thus, we demonstrated that the two approaches were approximately equivalent and interchangeable and concluded that clinical laboratories could determine measurement uncertainty by the simpler top-down approach.

  15. Anatomic comparison of the endonasal and transpetrosal approaches for interpeduncular fossa access.

    Science.gov (United States)

    Oyama, Kenichi; Prevedello, Daniel M; Ditzel Filho, Leo F S; Muto, Jun; Gun, Ramazan; Kerr, Edward E; Otto, Bradley A; Carrau, Ricardo L

    2014-01-01

    The interpeduncular cistern, including the retrochiasmatic area, is one of the most challenging regions to approach surgically. Various conventional approaches to this region have been described; however, only the endoscopic endonasal approach via the dorsum sellae and the transpetrosal approach provide ideal exposure with a caudal-cranial view. The authors compared these 2 approaches to clarify their limitations and intrinsic advantages for access to the interpeduncular cistern. Four fresh cadaver heads were studied. An endoscopic endonasal approach via the dorsum sellae with pituitary transposition was performed to expose the interpeduncular cistern. A transpetrosal approach was performed bilaterally, combining a retrolabyrinthine presigmoid and a subtemporal transtentorium approach. Water balloons were used to simulate space-occupying lesions. "Water balloon tumors" (WBTs), inflated to 2 different volumes (0.5 and 1.0 ml), were placed in the interpeduncular cistern to compare visualization using the 2 approaches. The distances between cranial nerve (CN) III and the posterior communicating artery (PCoA) and between CN III and the edge of the tentorium were measured through a transpetrosal approach to determine the width of surgical corridors using 0- to 6-ml WBTs in the interpeduncular cistern (n = 8). Both approaches provided adequate exposure of the interpeduncular cistern. The endoscopic endonasal approach yielded a good visualization of both CN III and the PCoA when a WBT was in the interpeduncular cistern. Visualization of the contralateral anatomical structures was impaired in the transpetrosal approach. The surgical corridor to the interpeduncular cistern via the transpetrosal approach was narrow when the WBT volume was small, but its width increased as the WBT volume increased. There was a statistically significant increase in the maximum distance between CN III and the PCoA (p = 0.047) and between CN III and the tentorium (p = 0.029) when the WBT volume

  16. Comparisons of watershed sulfur budgets in southeast Canada and northeast US: New approaches and implications

    Science.gov (United States)

    Mitchell, M.J.; Lovett, G.; Bailey, S.; Beall, F.; Burns, D.; Buso, D.; Clair, T.A.; Courchesne, F.; Duchesne, L.; Eimers, C.; Fernandez, I.; Houle, D.; Jeffries, D.S.; Likens, G.E.; Moran, M.D.; Rogers, C.; Schwede, D.; Shanley, J.; Weathers, K.C.; Vet, R.

    2011-01-01

    concentrations and deposition predictions with the predictions of two continental-scale air quality models, the Community Multiscale Air Quality (CMAQ) model and A Unified Regional Air-quality Modeling System (AURAMS) that utilize complete inventories of emissions and chemical budgets. The results of this comparison indicated that the predictive relationship provides an accurate representation of SO2 concentrations and S deposition for the region that is generally consistent with these models, and thus provides confidence that our approach could be used to develop accurate watershed S budgets for these 15 sites. Most watersheds showed large net losses of SO42- on an annual basis, and the watershed mass balances were grouped into five categories based on the relative value of mean annual net losses or net gains. The net annual fluxes of SO42- showed a strong relationship with hydrology; the largest net annual negative fluxes were associated with years of greatest precipitation amount and highest discharge. The important role of catchment hydrology on S budgets suggests implications for future predicted climate change as it affects patterns of precipitation and drought. The sensitivity of S budgets is likely to be greatest in watersheds with the greatest wetland area, which are particularly sensitive to drying and wetting cycles. A small number of the watersheds in this analysis were shown to have substantial S sources from mineral weathering, but most showed evidence of an internal source of SO42-, which is likely from the mineralization of organic S stored from decades of increased S deposition. Mobilization of this internal S appears to contribute about 1-6 kg S ha-1 year-1 to stream fluxes at these sites and is affecting the rate and extent of recovery from acidification as S deposition rates have declined in recent years. This internal S source should be considered when developing critical deposition loads that will promote ecosystem recovery from acidification and the depl

  17. LESSONS FROM A RETROSPECTIVE ANALYSIS OF A 5-YR PERIOD OF PRESHIPMENT TESTING AT SAN DIEGO ZOO: A RISK-BASED APPROACH TO PRESHIPMENT TESTING MAY BENEFIT ANIMAL WELFARE.

    Science.gov (United States)

    Marinkovich, Matt; Wallace, Chelsea; Morris, Pat J; Rideout, Bruce; Pye, Geoffrey W

    2016-03-01

    The preshipment examination, with associated transmissible disease testing, has become standard practice in the movement of animals between zoos. An alternative disease risk-based approach, based on a comprehensive surveillance program including necropsy and preventive medicine examination testing and data, has been in practice since 2006 between the San Diego Zoo and San Diego Zoo Safari Park. A retrospective analysis, evaluating comprehensive necropsy data and preshipment testing over a 5-yr study period, was performed to determine the viability of this model for use with sending animals to other institutions. Animals (607 birds, 704 reptiles and amphibians, and 341 mammals) were shipped to 116 Association of Zoos and Aquariums (AZA)-accredited and 29 non-AZA-accredited institutions. The evaluation showed no evidence of the specific transmissible diseases tested for during the preshipment exam being present within the San Diego Zoo collection. We suggest that a risk-based animal and institution-specific approach to transmissible disease preshipment testing is more cost effective and is in the better interest of animal welfare than the current industry standard of dogmatic preshipment testing.

  18. Breast and prostate cancer productivity costs: a comparison of the human capital approach and the friction cost approach.

    Science.gov (United States)

    Hanly, Paul; Timmons, Aileen; Walsh, Paul M; Sharp, Linda

    2012-05-01

    Productivity costs constitute a substantial proportion of the total societal costs associated with cancer. We compared the results of applying two different analytical methods--the traditional human capital approach (HCA) and the emerging friction cost approach (FCA)--to estimate breast and prostate cancer productivity costs in Ireland in 2008. Data from a survey of breast and prostate cancer patients were combined with population-level survival estimates and a national wage data set to calculate costs of temporary disability (cancer-related work absence), permanent disability (workforce departure, reduced working hours), and premature mortality. For breast cancer, productivity costs per person using the HCA were € 193,425 and those per person using the FCA were € 8,103; for prostate cancer, the comparable estimates were € 109,154 and € 8,205, respectively. The HCA generated higher costs for younger patients (breast cancer) because of greater lifetime earning potential. In contrast, the FCA resulted in higher productivity costs for older male patients (prostate cancer) commensurate with higher earning capacity over a shorter time period. Reduced working hours postcancer was a key driver of total HCA productivity costs. HCA costs were sensitive to assumptions about discount and growth rates. FCA costs were sensitive to assumptions about the friction period. The magnitude of the estimates obtained in this study illustrates the importance of including productivity costs when considering the economic impact of illness. Vastly different results emerge from the application of the HCA and the FCA, and this finding emphasizes the importance of choosing the study perspective carefully and being explicit about assumptions that underpin the methods. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Multi-country comparisons of energy performance: The index decomposition analysis approach

    International Nuclear Information System (INIS)

    Ang, B.W.; Xu, X.Y.; Su, Bin

    2015-01-01

    Index decomposition analysis (IDA) is a popular tool for studying changes in energy consumption over time in a country or region. This specific application of IDA, which may be called temporal decomposition analysis, has been extended by researchers and analysts to study variations in energy consumption or energy efficiency between countries or regions, i.e. spatial decomposition analysis. In spatial decomposition analysis, the main objective is often to understand the relative contributions of overall activity level, activity structure, and energy intensity in explaining differences in total energy consumption between two countries or regions. We review the literature of spatial decomposition analysis, investigate the methodological issues, and propose a spatial decomposition analysis framework for multi-region comparisons. A key feature of the proposed framework is that it passes the circularity test and provides consistent results for multi-region comparisons. A case study in which 30 regions in China are compared and ranked based on their performance in energy consumption is presented. - Highlights: • We conducted cross-regional comparisons of energy consumption using IDA. • We proposed two criteria for IDA method selection in spatial decomposition analysis. • We proposed a new model for regional comparison that passes the circularity test. • Features of the new model are illustrated using the data of 30 regions in China

  20. Are Noncovalent Interactions an Achilles Heel in Chemistry Education? A Comparison of Instructional Approaches

    Science.gov (United States)

    Williams, Leah C.; Underwood, Sonia M.; Klymkowsky, Michael W.; Cooper, Melanie M.

    2015-01-01

    Intermolecular forces (IMFs), or more broadly, noncovalent interactions either within or between molecules, are central to an understanding of a wide range of chemical and biological phenomena. In this study, we present a multiyear, multi-institutional, longitudinal comparison of how students enrolled in traditional general chemistry courses and…

  1. An experimental detrending approach to attributing change of pan evaporation in comparison with the traditional partial differential method

    Science.gov (United States)

    Wang, Tingting; Sun, Fubao; Xia, Jun; Liu, Wenbin; Sang, Yanfang

    2017-04-01

    In predicting how droughts and hydrological cycles would change in a warming climate, change of atmospheric evaporative demand measured by pan evaporation (Epan) is one crucial element to be understood. Over the last decade, the derived partial differential (PD) form of the PenPan equation is a prevailing attribution approach to attributing changes to Epan worldwide. However, the independency among climatic variables required by the PD approach cannot be met using long term observations. Here we designed a series of numerical experiments to attribute changes of Epan over China by detrending each climatic variable, i.e., an experimental detrending approach, to address the inter-correlation among climate variables, and made comparison with the traditional PD method. The results show that the detrending approach is superior not only to a complicate system with multi-variables and mixing algorithm like aerodynamic component (Ep,A) and Epan, but also to a simple case like radiative component (Ep,R), when compared with traditional PD method. The major reason for this is the strong and significant inter-correlation of input meteorological forcing. Very similar and fine attributing results have been achieved based on detrending approach and PD method after eliminating the inter-correlation of input through a randomize approach. The contribution of Rh and Ta in net radiation and thus Ep,R, which has been overlooked based on the PD method but successfully detected by detrending approach, provides some explanation to the comparing results. We adopted the control run from the detrending approach and applied it to made adjustment of PD method. Much improvement has been made and thus proven this adjustment an effective way in attributing changes to Epan. Hence, the detrending approach and the adjusted PD method are well recommended in attributing changes in hydrological models to better understand and predict water and energy cycle.

  2. Comparison of complications in transtrochanteric and anterolateral approaches in primary total hip arthroplasty.

    LENUS (Irish Health Repository)

    Cashman, James P

    2008-11-01

    Three surgical approaches to primary total hip arthroplasty (THA) have been in use since Charnley popularized the transtrochanteric approach. This study was designed to examine the difference in morbidity between the transtrochanteric approach and the anterolateral approach in primary THA. Information on 891 patients who underwent primary THA performed by a single surgeon was collected prospectively between 1998 and 2003 using a modified SF-36 form, preoperatively, intraoperatively, and at 3 months postoperatively. The transtrochanteric group had higher morbidity and more patients who were dissatisfied with their THA. There was a greater range of motion in the anterolateral group.

  3. Comparison of three different surgical approaches for treatment of thoracolumbar burst fracture

    Directory of Open Access Journals (Sweden)

    WU Han

    2013-02-01

    Full Text Available 【Abstract】Objective: The main treatment method used for thoracolumbar fractures is open reduction and in-ternal fixation. Commonly there are three surgical approaches: anterior, posterior and paraspinal. We attempt to compare the three approaches based on our clinical data analysis. Methods: A group of 94 patients with Denis type A or B thoracolumbar burst fracture between March 2008 and September 2010 were recruited in this study. These patients were treated by anterior-, posterior- or paraspinal-approach reduction with or without decompression. The fracture was fixed with titanium mesh and Z-plate via anterior approach (24 patients, screw and rod system via posterior approach (38 patients or paraspinal approach (32 patients. Clinical evaluations included operation duration, blood loss, inci-sion length, preoperative and postoperative Oswestry dis-ability index (ODI. Results: The average operation duration (94.1 min±13.7 min, blood loss (86.7 ml±20.0 ml, length of incision (9.3 mm± 0.7 mm and postoperative ODI (6±0.5 were signifi-cantly lower (P<0.05 in paraspinal approach group than in traditional posterior approach group (operation duration 94.1 min±13.7 min, blood loss 143.3 ml±28.3 ml, length of incision 15.4 cm±2.1 cm and ODI 12±0.7 and anterior approach group (operation duration 176.3 min±20.7 min, blood loss 255.1 ml±38.4 ml, length of incision 18.6 cm±2.4 cm and ODI 13±2.4. There was not statistical difference in terms of Cobb angle on radiographs among the three approaches. Conclusion: The anterior approach surgery is conve-nient for resection of the vertebrae and reconstruction of vertebral height, but it is more complicated and traumatic. Hence it is mostly used for severe Denis type B fracture. The posterior approach is commonly applied to most thora-columbar fractures and has fewer complications compared with the anterior approach, but it has some shortcomings as well. The paraspinal approach has great advantages

  4. Rainfall Prediction of Indian Peninsula: Comparison of Time Series Based Approach and Predictor Based Approach using Machine Learning Techniques

    Science.gov (United States)

    Dash, Y.; Mishra, S. K.; Panigrahi, B. K.

    2017-12-01

    Prediction of northeast/post monsoon rainfall which occur during October, November and December (OND) over Indian peninsula is a challenging task due to the dynamic nature of uncertain chaotic climate. It is imperative to elucidate this issue by examining performance of different machine leaning (ML) approaches. The prime objective of this research is to compare between a) statistical prediction using historical rainfall observations and global atmosphere-ocean predictors like Sea Surface Temperature (SST) and Sea Level Pressure (SLP) and b) empirical prediction based on a time series analysis of past rainfall data without using any other predictors. Initially, ML techniques have been applied on SST and SLP data (1948-2014) obtained from NCEP/NCAR reanalysis monthly mean provided by the NOAA ESRL PSD. Later, this study investigated the applicability of ML methods using OND rainfall time series for 1948-2014 and forecasted up to 2018. The predicted values of aforementioned methods were verified using observed time series data collected from Indian Institute of Tropical Meteorology and the result revealed good performance of ML algorithms with minimal error scores. Thus, it is found that both statistical and empirical methods are useful for long range climatic projections.

  5. The Comparison of a Thematic versus Regional Approach to Teaching a World Geography Course

    Science.gov (United States)

    Korson, Cadey; Kusek, Weronika

    2016-01-01

    The benefits of a regional or thematic approach to the study and presentation of world geography have long been debated. The goal to not reimagine these debates or to promote one approach over another; the aim is to explore how world geography courses are currently being taught in American universities. By polling and sharing information about…

  6. Technical Note: A comparison of two empirical approaches to estimate in-stream net nutrient uptake

    Science.gov (United States)

    von Schiller, D.; Bernal, S.; Martí, E.

    2011-04-01

    To establish the relevance of in-stream processes on nutrient export at catchment scale it is important to accurately estimate whole-reach net nutrient uptake rates that consider both uptake and release processes. Two empirical approaches have been used in the literature to estimate these rates: (a) the mass balance approach, which considers changes in ambient nutrient loads corrected by groundwater inputs between two stream locations separated by a certain distance, and (b) the spiralling approach, which is based on the patterns of longitudinal variation in ambient nutrient concentrations along a reach following the nutrient spiralling concept. In this study, we compared the estimates of in-stream net nutrient uptake rates of nitrate (NO3) and ammonium (NH4) and the associated uncertainty obtained with these two approaches at different ambient conditions using a data set of monthly samplings in two contrasting stream reaches during two hydrological years. Overall, the rates calculated with the mass balance approach tended to be higher than those calculated with the spiralling approach only at high ambient nitrogen (N) concentrations. Uncertainty associated with these estimates also differed between both approaches, especially for NH4 due to the general lack of significant longitudinal patterns in concentration. The advantages and disadvantages of each of the approaches are discussed.

  7. Multidimensional Poverty Indices and First Order Dominance Techniques: An Empirical Comparison of Different Approaches

    DEFF Research Database (Denmark)

    Hussain, M. Azhar; Permanyer, Iñaki

    2018-01-01

    techniques (FOD). Our empirical findings suggest that the FOD approach might be a reasonable cost-effective alternative to the United Nations Development Program (UNDP)’s flagship poverty indicator: the Multidimensional Poverty Index (MPI). To the extent that the FOD approach is able to uncover the socio...

  8. Practical Skills Training in Agricultural Education--A Comparison between Traditional and Blended Approaches

    Science.gov (United States)

    Deegan, Donna; Wims, Padraig; Pettit, Tony

    2016-01-01

    Purpose: In this article the use of blended learning multimedia materials as an education tool was compared with the traditional approach for skills training. Design/Methodology/Approach: This study was conducted in Ireland using a pre-test, post-test experimental design. All students were instructed on how to complete two skills using either a…

  9. Comparison of a rational vs. high throughput approach for rapid salt screening and selection.

    Science.gov (United States)

    Collman, Benjamin M; Miller, Jonathan M; Seadeek, Christopher; Stambek, Julie A; Blackburn, Anthony C

    2013-01-01

    In recent years, high throughput (HT) screening has become the most widely used approach for early phase salt screening and selection in a drug discovery/development setting. The purpose of this study was to compare a rational approach for salt screening and selection to those results previously generated using a HT approach. The rational approach involved a much smaller number of initial trials (one salt synthesis attempt per counterion) that were selected based on a few strategic solubility determinations of the free form combined with a theoretical analysis of the ideal solvent solubility conditions for salt formation. Salt screening results for sertraline, tamoxifen, and trazodone using the rational approach were compared to those previously generated by HT screening. The rational approach produced similar results to HT screening, including identification of the commercially chosen salt forms, but with a fraction of the crystallization attempts. Moreover, the rational approach provided enough solid from the very initial crystallization of a salt for more thorough and reliable solid-state characterization and thus rapid decision-making. The crystallization techniques used in the rational approach mimic larger-scale process crystallization, allowing smoother technical transfer of the selected salt to the process chemist.

  10. Comparison of two approaches to the surgical management of cochlear implantation

    NARCIS (Netherlands)

    Postelmans, Job T. F.; Grolman, Wilko; Tange, Rinze A.; Stokroos, Robert J.

    2009-01-01

    OBJECTIVES/HYPOTHESIS: Our study was designed to compare two surgical approaches that are currently employed in cochlear implantation. METHODS: There were 315 patients who were divided into two groups according to the surgical technique used for implantation. The suprameatal approach (SMA) was

  11. Three approaches to deal with inconsistent decision tables - Comparison of decision tree complexity

    KAUST Repository

    Azad, Mohammad; Chikalov, Igor; Moshkov, Mikhail

    2013-01-01

    In inconsistent decision tables, there are groups of rows with equal values of conditional attributes and different decisions (values of the decision attribute). We study three approaches to deal with such tables. Instead of a group of equal rows, we consider one row given by values of conditional attributes and we attach to this row: (i) the set of all decisions for rows from the group (many-valued decision approach); (ii) the most common decision for rows from the group (most common decision approach); and (iii) the unique code of the set of all decisions for rows from the group (generalized decision approach). We present experimental results and compare the depth, average depth and number of nodes of decision trees constructed by a greedy algorithm in the framework of each of the three approaches. © 2013 Springer-Verlag.

  12. Comparison of candidate solar array maximum power utilization approaches. [for spacecraft propulsion

    Science.gov (United States)

    Costogue, E. N.; Lindena, S.

    1976-01-01

    A study was made of five potential approaches that can be utilized to detect the maximum power point of a solar array while sustaining operations at or near maximum power and without endangering stability or causing array voltage collapse. The approaches studied included: (1) dynamic impedance comparator, (2) reference array measurement, (3) onset of solar array voltage collapse detection, (4) parallel tracker, and (5) direct measurement. The study analyzed the feasibility and adaptability of these approaches to a future solar electric propulsion (SEP) mission, and, specifically, to a comet rendezvous mission. Such missions presented the most challenging requirements to a spacecraft power subsystem in terms of power management over large solar intensity ranges of 1.0 to 3.5 AU. The dynamic impedance approach was found to have the highest figure of merit, and the reference array approach followed closely behind. The results are applicable to terrestrial solar power systems as well as to other than SEP space missions.

  13. Comparison of methodological approaches to identify economic activity regularities in transition economy

    Directory of Open Access Journals (Sweden)

    Jitka Poměnková

    2011-01-01

    Full Text Available Presented paper focuses on consideration and evaluation of methodical approaches to analyze cyclical structure character of economic activity in transition economy. As a starting point, work in time domain is applied, which is followed in frequency domain approach. Both approaches are viewed from methodical as well as application point of view and their advantage and disadvantage are discussed. Consequently, time-frequency domain approach is added and applied on real data. On the basis of obtained results recommendation is formulated. All discussed methodical approaches are also considered from the perspective of capability to evaluate behaving of business cycle in time of global economic crisis before/after year 2008. The empirical part of the paper deals with data of gross domestic product in the Czech Republic in 1996/Q1–2010/Q2.

  14. Cervical interlaminar epidural steroid injection for unilateral cervical radiculopathy: Comparison of midline and paramedian approaches for efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ji Young; Kwon, Jong Won; Yoon, Young Cheol [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jong Seok [School of Business Administration, Hallym University, Chuncheon (Korea, Republic of)

    2015-06-15

    The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.

  15. Cervical interlaminar epidural steroid injection for unilateral cervical radiculopathy: Comparison of midline and paramedian approaches for efficacy

    International Nuclear Information System (INIS)

    Yoon, Ji Young; Kwon, Jong Won; Yoon, Young Cheol; Lee, Jong Seok

    2015-01-01

    The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.

  16. MR imaging of soft tissue alterations after total hip arthroplasty: comparison of classic surgical approaches

    Energy Technology Data Exchange (ETDEWEB)

    Agten, Christoph A.; Sutter, Reto; Pfirrmann, Christian W.A. [Balgrist University Hospital, Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Dora, Claudio [Balgrist University Hospital, Orthopedic Surgery, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

    2017-03-15

    To compare soft-tissue changes after total hip arthroplasty with posterior, direct-lateral, anterolateral, or anterior surgical approaches. MRI of 120 patients after primary total hip arthroplasty (30 per approach) were included. Each MRI was assessed by two readers regarding identification of surgical access, fatty muscle atrophy (Goutallier classification), tendon quality (0 = normal, 1 = tendinopathy, 2 = partial tear, 3 = avulsion), and fluid collections. Readers were blinded to the surgical approach. Surgical access was correctly identified in all cases. The direct lateral approach showed highest Goutallier grades and tendon damage for gluteus minimus muscle (2.07-2.67 and 2.00-2.77; p = 0.017 and p = 0.001 for readers 1 and 2, respectively) and tendon (2.30/1.67; p < 0.0005 for reader 1/2), and the lateral portion of the gluteus medius tendon (2.77/2.20; p < 0.0005 for reader 1/2). The posterior approach showed highest Goutallier grades and tendon damage for external rotator muscles (1.97-2.67 and 1.57-2.40; p < 0.0005-0.006 for reader 1/2) and tendons (1.41-2.45 and 1.93-2.76; p < 0.0005 for reader 1/2). The anterolateral and anterior approach showed less soft tissue damage. Fluid collections showed no differences between the approaches. MRI is well suited to identify surgical approaches after THA. The anterior and anterolateral approach showed less soft tissue damage compared to the posterior and direct lateral approach. (orig.)

  17. MR imaging of soft tissue alterations after total hip arthroplasty: comparison of classic surgical approaches

    International Nuclear Information System (INIS)

    Agten, Christoph A.; Sutter, Reto; Pfirrmann, Christian W.A.; Dora, Claudio

    2017-01-01

    To compare soft-tissue changes after total hip arthroplasty with posterior, direct-lateral, anterolateral, or anterior surgical approaches. MRI of 120 patients after primary total hip arthroplasty (30 per approach) were included. Each MRI was assessed by two readers regarding identification of surgical access, fatty muscle atrophy (Goutallier classification), tendon quality (0 = normal, 1 = tendinopathy, 2 = partial tear, 3 = avulsion), and fluid collections. Readers were blinded to the surgical approach. Surgical access was correctly identified in all cases. The direct lateral approach showed highest Goutallier grades and tendon damage for gluteus minimus muscle (2.07-2.67 and 2.00-2.77; p = 0.017 and p = 0.001 for readers 1 and 2, respectively) and tendon (2.30/1.67; p < 0.0005 for reader 1/2), and the lateral portion of the gluteus medius tendon (2.77/2.20; p < 0.0005 for reader 1/2). The posterior approach showed highest Goutallier grades and tendon damage for external rotator muscles (1.97-2.67 and 1.57-2.40; p < 0.0005-0.006 for reader 1/2) and tendons (1.41-2.45 and 1.93-2.76; p < 0.0005 for reader 1/2). The anterolateral and anterior approach showed less soft tissue damage. Fluid collections showed no differences between the approaches. MRI is well suited to identify surgical approaches after THA. The anterior and anterolateral approach showed less soft tissue damage compared to the posterior and direct lateral approach. (orig.)

  18. Comparison of approaches for mobile document image analysis using server supported smartphones

    Science.gov (United States)

    Ozarslan, Suleyman; Eren, P. Erhan

    2014-03-01

    With the recent advances in mobile technologies, new capabilities are emerging, such as mobile document image analysis. However, mobile phones are still less powerful than servers, and they have some resource limitations. One approach to overcome these limitations is performing resource-intensive processes of the application on remote servers. In mobile document image analysis, the most resource consuming process is the Optical Character Recognition (OCR) process, which is used to extract text in mobile phone captured images. In this study, our goal is to compare the in-phone and the remote server processing approaches for mobile document image analysis in order to explore their trade-offs. For the inphone approach, all processes required for mobile document image analysis run on the mobile phone. On the other hand, in the remote-server approach, core OCR process runs on the remote server and other processes run on the mobile phone. Results of the experiments show that the remote server approach is considerably faster than the in-phone approach in terms of OCR time, but adds extra delays such as network delay. Since compression and downscaling of images significantly reduce file sizes and extra delays, the remote server approach overall outperforms the in-phone approach in terms of selected speed and correct recognition metrics, if the gain in OCR time compensates for the extra delays. According to the results of the experiments, using the most preferable settings, the remote server approach performs better than the in-phone approach in terms of speed and acceptable correct recognition metrics.

  19. Comparison of rule induction, decision trees and formal concept analysis approaches for classification

    Science.gov (United States)

    Kotelnikov, E. V.; Milov, V. R.

    2018-05-01

    Rule-based learning algorithms have higher transparency and easiness to interpret in comparison with neural networks and deep learning algorithms. These properties make it possible to effectively use such algorithms to solve descriptive tasks of data mining. The choice of an algorithm depends also on its ability to solve predictive tasks. The article compares the quality of the solution of the problems with binary and multiclass classification based on the experiments with six datasets from the UCI Machine Learning Repository. The authors investigate three algorithms: Ripper (rule induction), C4.5 (decision trees), In-Close (formal concept analysis). The results of the experiments show that In-Close demonstrates the best quality of classification in comparison with Ripper and C4.5, however the latter two generate more compact rule sets.

  20. Effects Comparison of Different Resilience Enhancing Strategies for Municipal Water Distribution Network: A Multidimensional Approach

    Directory of Open Access Journals (Sweden)

    Xudong Zhao

    2015-01-01

    Full Text Available Water distribution network (WDN is critical to the city service, economic rehabilitation, public health, and safety. Reconstructing the WDN to improve its resilience in seismic disaster is an important and ongoing issue. Although a considerable body of research has examined the effects of different reconstruction strategies on seismic resistance, it is still hard for decision-makers to choose optimal resilience enhancing strategy. Taking the pipeline ductile retrofitting and network meshed expansion as demonstration, we proposed a feasible framework to contrast the resilience enhancing effects of two reconstruction strategies—units retrofitting strategy and network optimization strategy—in technical and organizational dimension. We also developed a new performance response function (PRF which is based on network equilibrium theory to conduct the effects comparison in integrated technical and organizational dimension. Through the case study of municipal WDN in Lianyungang, China, the comparison results were thoroughly shown and the holistic decision-making support was provided.

  1. Comparison of two anoxia models in rainbow trout cells by a 2-DE and MS/MS-based proteome approach

    DEFF Research Database (Denmark)

    Wulff, Tune; Hoffmann, E.K.; Roepstorff, P.

    2008-01-01

    In the literature, a variety of ways have been used to obtain anoxia, and most often results are compared between studies without taking into consideration how anoxia has been obtained. Here, we provide a comprehensive study of two types of anoxia, using a proteomics approach to compare changes...... and protein synthesis. It was also revealed that the level of a number of keratins was down-regulated. This study therefore provides a valuable comparison of two different anoxia models and shows that great care should be taken when comparing the effects of anoxia in studies that have used different types...

  2. Optimization of approximate decision rules relative to number of misclassifications: Comparison of greedy and dynamic programming approaches

    KAUST Repository

    Amin, Talha

    2013-01-01

    In the paper, we present a comparison of dynamic programming and greedy approaches for construction and optimization of approximate decision rules relative to the number of misclassifications. We use an uncertainty measure that is a difference between the number of rows in a decision table T and the number of rows with the most common decision for T. For a nonnegative real number γ, we consider γ-decision rules that localize rows in subtables of T with uncertainty at most γ. Experimental results with decision tables from the UCI Machine Learning Repository are also presented. © 2013 Springer-Verlag.

  3. An international comparison of models and approaches for the estimation of the radiological exposure of non-human biota

    International Nuclear Information System (INIS)

    Beresford, Nicholas A.; Balonov, Mikhail; Beaugelin-Seiller, Karine; Brown, Justin; Copplestone, David; Hingston, Joanne L.; Horyna, Jan; Hosseini, Ali; Howard, Brenda J.; Kamboj, Sunita; Nedveckaite, Tatjana; Olyslaegers, Geert; Sazykina, Tatiana; Vives i Batlle, Jordi; Yankovich, Tamara L.; Yu, Charley

    2008-01-01

    Over the last decade a number of models and approaches have been developed for the estimation of the exposure of non-human biota to ionising radiations. In some countries these are now being used in regulatory assessments. However, to date there has been no attempt to compare the outputs of the different models used. This paper presents the work of the International Atomic Energy Agency's EMRAS Biota Working Group which compares the predictions of a number of such models in model-model and model-data inter-comparisons

  4. An estimation of the transformation value by means of the estimation function. Market Comparison Approach with abridged data chart

    Directory of Open Access Journals (Sweden)

    Maurizio d’Amato

    2015-06-01

    Full Text Available This essay suggests a re-elaboration of the Marketing Comparison Approach in order to set the value of properties subject to transformation. The essay focuses on identifying the property valuation following a certain transformation and is aimed at determining the land value by means of the extraction method. The outcome, based on trading data and a study case in the province of Bari may also be applied to under construction properties valuation and to the identification of the value of properties under construction, (investment property under construction by means of the Future Value method.

  5. Space commerce in a global economy - Comparison of international approaches to commercial space

    Science.gov (United States)

    Stone, Barbara A.; Kleber, Peter

    1992-01-01

    A historical perspective, current status, and comparison of national government/commercial space industry relationships in the United States and Europe are presented. It is noted that space technology has been developed and used primarily to meet the needs of civil and military government initiatives. Two future trends of space technology development include new space enterprises, and the national drive to achieve a more competitive global economic position.

  6. A Study on Influencing Factors of Knowledge Management Systems Adoption: Models Comparison Approach

    OpenAIRE

    Mei-Chun Yeh; Ming-Shu Yuan

    2007-01-01

    Using Linear Structural Relation model (LISREL model) as analysis method and technology acceptance model and decomposed theory of planned behavior as research foundation, this study approachesmainly from the angle of behavioral intention to examine the influential factors of 421 employees adopting knowledge management systems and in the meantime to compare the two method models mentioned on the top. According to the research, there is no, in comparison with technology acceptance model anddeco...

  7. Comparison of umbilical cord blood allogeneic stem cell transplantation vs. auto-SCT for adult acute myeloid leukemia patients in second complete remission at transplant: a retrospective study on behalf of the SFGM-TC.

    Science.gov (United States)

    Chevallier, Patrice; Labopin, Myriam; Socie, Gerard; Rubio, Marie-There; Blaise, Didier; Vigouroux, Stephane; Huynh, Anne; Michallet, Mauricette; Bay, Jacques-Olivier; Maury, Sébastien; Yakoub-Agha, Ibrahim; Fegueux, Nathalie; Deconinck, Eric; Contentin, Nathalie; Maillard, Natacha; Bulabois, Claude-Eric; Francois, Sylvie; Oumedaly, Reman; Raus, Nicole; Mohty, Mohamad

    2015-05-01

    This retrospective study considered the outcomes of 181 patients with acute myeloid leukemia (AML) transplanted in second complete remission (CR2) between January 2005 and April 2012 and who received either a myeloablative autologous stem cell transplant (Auto-SCT; n = 82; median age: 48 years; median follow-up: 45 months) or an umbilical cord blood (UCB) allogeneic SCT (n = 99, median age: 46 years; median follow-up: 36 months; conditioning regimens: myeloablative n = 21, reduced n = 78; single unit n = 37, double units n = 62). Although the Auto group showed a significant better prognostic profile at transplant, with longer median interval between diagnosis and time of graft, higher incidence of good-risk cytogenetics and lower number of previously transplanted patients, 3-year OS and LFS were similar between both groups (Auto: 59 ± 6% vs. 50 ± 6%, P = 0.45; and 57 ± 6% vs. 46 ± 6%, P = 0.37). In multivariate analysis, UCB allo-SCT was associated with lower relapse incidence (HR: 0.3, 95% CI: 0.11-0.82, P = 0.02), but higher non-relapse mortality (NRM) (HR: 4.16; 95% CI: 1.46-11.9, P = 0.008). Results from this large study suggest that UCB allo-SCT provides better disease control than auto-SCT, which is especially important in the setting of high-risk disease. However, this disease control advantage is counterbalanced by higher toxicity, highlighting the need for novel approaches aiming to decrease NRM after UCB allo-SCT. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Comparing Diagnostic Accuracy of Cognitive Screening Instruments: A Weighted Comparison Approach

    Directory of Open Access Journals (Sweden)

    A.J. Larner

    2013-03-01

    Full Text Available Background/Aims: There are many cognitive screening instruments available to clinicians when assessing patients' cognitive function, but the best way to compare the diagnostic utility of these tests is uncertain. One method is to undertake a weighted comparison which takes into account the difference in sensitivity and specificity of two tests, the relative clinical misclassification costs of true- and false-positive diagnosis, and also disease prevalence. Methods: Data were examined from four pragmatic diagnostic accuracy studies from one clinic which compared the Mini-Mental State Examination (MMSE with the Addenbrooke's Cognitive Examination-Revised (ACE-R, the Montreal Cognitive Assessment (MoCA, the Test Your Memory (TYM test, and the Mini-Mental Parkinson (MMP, respectively. Results: Weighted comparison calculations suggested a net benefit for ACE-R, MoCA, and MMP compared to MMSE, but a net loss for TYM test compared to MMSE. Conclusion: Routine incorporation of weighted comparison or other similar net benefit measures into diagnostic accuracy studies merits consideration to better inform clinicians of the relative value of cognitive screening instruments.

  9. Comparison between goal programming and cointegration approaches in enhanced index tracking

    Science.gov (United States)

    Lam, Weng Siew; Jamaan, Saiful Hafizah Hj.

    2013-04-01

    Index tracking is a popular form of passive fund management in stock market. Passive management is a buy-and-hold strategy that aims to achieve rate of return similar to the market return. Index tracking problem is a problem of reproducing the performance of a stock market index, without purchasing all of the stocks that make up the index. This can be done by establishing an optimal portfolio that minimizes risk or tracking error. An improved index tracking (enhanced index tracking) is a dual-objective optimization problem, a trade-off between maximizing the mean return and minimizing the tracking error. Enhanced index tracking aims to generate excess return over the return achieved by the index. The objective of this study is to compare the portfolio compositions and performances by using two different approaches in enhanced index tracking problem, which are goal programming and cointegration. The result of this study shows that the optimal portfolios for both approaches are able to outperform the Malaysia market index which is Kuala Lumpur Composite Index. Both approaches give different optimal portfolio compositions. Besides, the cointegration approach outperforms the goal programming approach because the cointegration approach gives higher mean return and lower risk or tracking error. Therefore, the cointegration approach is more appropriate for the investors in Malaysia.

  10. A comparison between neural response telemetry via cochleostomy or the round window approach in cochlear implantation.

    Science.gov (United States)

    Hamerschmidt, Rogério; Schuch, Luiz Henrique; Rezende, Rodrigo Kopp; Wiemes, Gislaine Richter Minhoto; Oliveira, Adriana Kosma Pires de; Mocellin, Marcos

    2012-01-01

    There are two techniques for cochlear implant (CI) electrode placement: cochleostomy and the round window (RW) approach. This study aims to compare neural response telemetry (NRT) results immediately after surgery to check for possible differences on auditory nerve stimulation between these two techniques. This is a prospective cross-sectional study. Twenty-three patients were enrolled. Six patients underwent surgery by cochleostomy and 17 had it through the RW approach. Mean charge units (MCU) for high frequency sounds: patients submitted to the RW approach had a mean value of 190.4 (± 29.2) while cochleostomy patients averaged 187.8 (± 32.7); p = 0.71. MCU for mid frequency sounds: patients submitted to the RW approach had a mean value of 192.5 (± 22) while cochleostomy patients averaged 178.5 (± 18.5); p = 0.23. MCU for low frequency sounds: patients submitted to the RW approach had a mean value of 183.3 (± 25) while cochleostomy patients averaged 163.8 (± 19.3); p = 0.19. This study showed no differences in the action potential of the distal portion of the auditory nerve in patients with multichannel cochlear implants submitted to surgery by cochleostomy or through the RW approach, using the implant itself to generate stimuli and record responses. Both techniques equally stimulate the cochlear nerve. Therefore, the choice of approach can be made based on the surgeon's own preference and experience.

  11. Comparison of statistical approaches dealing with time-dependent confounding in drug effectiveness studies.

    Science.gov (United States)

    Karim, Mohammad Ehsanul; Petkau, John; Gustafson, Paul; Platt, Robert W; Tremlett, Helen

    2018-06-01

    In longitudinal studies, if the time-dependent covariates are affected by the past treatment, time-dependent confounding may be present. For a time-to-event response, marginal structural Cox models are frequently used to deal with such confounding. To avoid some of the problems of fitting marginal structural Cox model, the sequential Cox approach has been suggested as an alternative. Although the estimation mechanisms are different, both approaches claim to estimate the causal effect of treatment by appropriately adjusting for time-dependent confounding. We carry out simulation studies to assess the suitability of the sequential Cox approach for analyzing time-to-event data in the presence of a time-dependent covariate that may or may not be a time-dependent confounder. Results from these simulations revealed that the sequential Cox approach is not as effective as marginal structural Cox model in addressing the time-dependent confounding. The sequential Cox approach was also found to be inadequate in the presence of a time-dependent covariate. We propose a modified version of the sequential Cox approach that correctly estimates the treatment effect in both of the above scenarios. All approaches are applied to investigate the impact of beta-interferon treatment in delaying disability progression in the British Columbia Multiple Sclerosis cohort (1995-2008).

  12. A systematic comparison of different approaches of density functional theory for the study of electrical double layers

    International Nuclear Information System (INIS)

    Yang, Guomin; Liu, Longcheng

    2015-01-01

    Based on the best available knowledge of density functional theory (DFT), the reference-fluid perturbation method is here extended to yield different approaches that well account for the cross correlations between the Columbic interaction and the hard-sphere exclusion in an inhomogeneous ionic hard-sphere fluid. In order to quantitatively evaluate the advantage and disadvantage of different approaches in describing the interfacial properties of electrical double layers, this study makes a systematic comparison against Monte Carlo simulations over a wide range of conditions. The results suggest that the accuracy of the DFT approaches is well correlated to a coupling parameter that describes the coupling strength of electrical double layers by accounting for the steric effect and that can be used to classify the systems into two regimes. In the weak-coupling regime, the approaches based on the bulk-fluid perturbation method are shown to be more accurate than the counterparts based on the reference-fluid perturbation method, whereas they exhibit the opposite behavior in the strong-coupling regime. More importantly, the analysis indicates that, with a suitable choice of the reference fluid, the weighted correlation approximation (WCA) to DFT gives the best account of the coupling effect of the electrostatic-excluded volume correlations. As a result, a piecewise WCA approach can be developed that is robust enough to describe the structural and thermodynamic properties of electrical double layers over both weak- and strong-coupling regimes

  13. Comparison of spatial association approaches for landscape mapping of soil organic carbon stocks

    Science.gov (United States)

    Miller, B. A.; Koszinski, S.; Wehrhan, M.; Sommer, M.

    2015-03-01

    The distribution of soil organic carbon (SOC) can be variable at small analysis scales, but consideration of its role in regional and global issues demands the mapping of large extents. There are many different strategies for mapping SOC, among which is to model the variables needed to calculate the SOC stock indirectly or to model the SOC stock directly. The purpose of this research is to compare direct and indirect approaches to mapping SOC stocks from rule-based, multiple linear regression models applied at the landscape scale via spatial association. The final products for both strategies are high-resolution maps of SOC stocks (kg m-2), covering an area of 122 km2, with accompanying maps of estimated error. For the direct modelling approach, the estimated error map was based on the internal error estimations from the model rules. For the indirect approach, the estimated error map was produced by spatially combining the error estimates of component models via standard error propagation equations. We compared these two strategies for mapping SOC stocks on the basis of the qualities of the resulting maps as well as the magnitude and distribution of the estimated error. The direct approach produced a map with less spatial variation than the map produced by the indirect approach. The increased spatial variation represented by the indirect approach improved R2 values for the topsoil and subsoil stocks. Although the indirect approach had a lower mean estimated error for the topsoil stock, the mean estimated error for the total SOC stock (topsoil + subsoil) was lower for the direct approach. For these reasons, we recommend the direct approach to modelling SOC stocks be considered a more conservative estimate of the SOC stocks' spatial distribution.

  14. Can intermuscular cleavage planes provide proper transverse screw angle? Comparison of two paraspinal approaches.

    Science.gov (United States)

    Cheng, Xiaofei; Ni, Bin; Liu, Qi; Chen, Jinshui; Guan, Huapeng

    2013-01-01

    The goal of this study was to determine which paraspinal approach provided a better transverse screw angle (TSA) for each vertebral level in lower lumbar surgery. Axial computed tomography (CT) images of 100 patients, from L3 to S1, were used to measure the angulation parameters, including transverse pedicle angle (TPA) and transverse cleavage plane angle (TCPA) of entry from the two approaches. The difference value between TCPA and TPA, defined as difference angle (DA), was calculated. Statistical differences of DA obtained by the two approaches and the angulation parameters between sexes, and the correlation between each angulation parameter and age or body mass index (BMI) were analyzed. TPA ranged from about 16° at L3 to 30° at S1. TCPA through the Wiltse's and Weaver's approach ranged from about -10° and 25° at L3 to 12° and 32° at S1, respectively. The absolute values of DA through the Weaver's approach were significantly lower than those through the Wiltse's approach at each level. The angulation parameters showed no significant difference with sex and no significant correlation with age or BMI. In the lower lumbar vertebrae (L3-L5) and S1, pedicle screw placement through the Weaver's approach may more easily yield the preferred TSA consistent with TPA than that through the Wiltse's approach. The reference values obtained in this paper may be applied regardless of sex, age or BMI and the descriptive statistical results may be used as references for applying the two paraspinal approaches.

  15. Comparisons of Multilevel Modeling and Structural Equation Modeling Approaches to Actor-Partner Interdependence Model.

    Science.gov (United States)

    Hong, Sehee; Kim, Soyoung

    2018-01-01

    There are basically two modeling approaches applicable to analyzing an actor-partner interdependence model: the multilevel modeling (hierarchical linear model) and the structural equation modeling. This article explains how to use these two models in analyzing an actor-partner interdependence model and how these two approaches work differently. As an empirical example, marital conflict data were used to analyze an actor-partner interdependence model. The multilevel modeling and the structural equation modeling produced virtually identical estimates for a basic model. However, the structural equation modeling approach allowed more realistic assumptions on measurement errors and factor loadings, rendering better model fit indices.

  16. Laying the Foundations for Democratic Behavior - A Comparison of Two Different Approaches to Democratic Education

    Directory of Open Access Journals (Sweden)

    Viola HUANG

    2014-07-01

    Full Text Available A democracy is a society in which everyone has equal rights and is able to participate in decision-making processes. Consequently, in a democratic society, democratic behavior is essential. This work investigates the question: In what ways and to what extent can alternative models of education support the development of democratic skills in children? To explore this question, the author analyzes and compares two different approaches to democratic education: The Sudbury approach and the democratic free school approach. The study is based on qualitative research participant observation and open-ended interviews conducted at different Sudbury and democratic free schools in the US.

  17. Retrospective dosimetry of populations exposed to reactor accident: Chernobyl example, lesson for Fukushima

    International Nuclear Information System (INIS)

    Chumak, Vadim V.

    2013-01-01

    Follow-up of the Chernobyl accident had included a good deal of retrospective dosimetry and dose reconstruction. Comparison of Chernobyl and Fukushima shows that despite some differences in course and scale of the two accidents, main elements are present in both situations and Chernobyl experience could be quite educative for better understanding and more optimal handling of Fukushima Dai-ichi accident consequences. This paper contains review of dose reconstruction efforts done to date and extensively published in scientific journals and reports. Specifically the following cases are considered: (i) evaluation of individual doses to evacuees; (ii) validation of ecological dosimetric models and ruling out unconfirmed dose rate measurements; dosimetric support of (iii) case–control study of leukemia among Chernobyl clean-up workers (liquidators), and (iv) cohort study of cataracts among liquidators. Due to limited size of this paper the given application cases are rather outlined while more detailed descriptions could be found in relevant publications. Each considered Chernobyl case is commented with respect to possible application to Fukushima Dai-ichi situation. The presented methodological findings and approaches could be used for retrospective assessment of human exposures in Fukushima. -- Highlights: ► Retrospective dosimetry in Chernobyl was applied for evaluation of individual doses to evacuees. ► Retrospective dosimetry in Chernobyl was applied for validation of ecological dosimetric models, rejection dubious dose rate records. ► Retrospective dosimetry in Chernobyl was applied for risk assessment of leukemia among Chernobyl clean-up workers (liquidators). ► Retrospective dosimetry in Chernobyl was applied for study of cataracts among liquidators. ► Experience of dose reconstruction in Chernobyl could be used for retrospective assessment of exposures in Fukushima

  18. Comparison of Two Probabilistic Fatigue Damage Assessment Approaches Using Prognostic Performance Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — A general framework for probabilistic prognosis using maximum entropy approach, MRE, is proposed in this paper to include all available information and uncertainties...

  19. A comparison of approaches for finding minimum identifying codes on graphs

    Science.gov (United States)

    Horan, Victoria; Adachi, Steve; Bak, Stanley

    2016-05-01

    In order to formulate mathematical conjectures likely to be true, a number of base cases must be determined. However, many combinatorial problems are NP-hard and the computational complexity makes this research approach difficult using a standard brute force approach on a typical computer. One sample problem explored is that of finding a minimum identifying code. To work around the computational issues, a variety of methods are explored and consist of a parallel computing approach using MATLAB, an adiabatic quantum optimization approach using a D-Wave quantum annealing processor, and lastly using satisfiability modulo theory (SMT) and corresponding SMT solvers. Each of these methods requires the problem to be formulated in a unique manner. In this paper, we address the challenges of computing solutions to this NP-hard problem with respect to each of these methods.

  20. Automatic Diagnosis of Fetal Heart Rate: Comparison of Different Methodological Approaches

    National Research Council Canada - National Science Library

    Magenes, G

    2001-01-01

    .... A Multilayer Perception (MLP) neural network and an Adaptive Neuro-Fuzzy Inference System (ANFIS) were compared with classical statistical methods. Both the neural and neuro-fuzzy approaches seem to give better results than any tested statistical classifier.

  1. A Comparison of Three Holistic Approaches to Health: One Health, EcoHealth, and Planetary Health

    Directory of Open Access Journals (Sweden)

    Henrik Lerner

    2017-09-01

    Full Text Available Several holistic and interdisciplinary approaches exist to safeguard health. Three of the most influential concepts at the moment, One Health, EcoHealth, and Planetary Health, are analyzed in this paper, revealing similarities and differences at the theoretical conceptual level. These approaches may appear synonymous, as they all promote the underlying assumption of humans and other animals sharing the same planet and the same environmental challenges, infections and infectious agents as well as other aspects of physical—and possibly mental—health. However, we would like to illuminate the differences between these three concepts or approaches, and how the choice of terms may, deliberately or involuntary, signal the focus, and underlying values of the approaches. In this paper, we have chosen some proposed and well-known suggestions of definitions. In our theoretical analysis, we will focus on at least two areas. These are (1 the value of the potential scientific areas which could be included and (2 core values present within the approach. In the first area, our main concern is whether the approaches are interdisciplinary and whether the core scientific areas are assigned equal importance. For the second area, which is rather wide, we analyze core values such as biodiversity, health, and how one values humans, animals, and ecosystems. One Health has been described as either a narrow approach combining public health and veterinary medicine or as a wide approach as in the wide-spread “umbrella” depiction including both scientific fields, core concepts, and interdisciplinary research areas. In both cases, however, safeguarding the health of vertebrates is usually in focus although ecosystems are also included in the model. The EcoHealth approach seems to have more of a biodiversity focus, with an emphasis on all living creatures, implying that parasites, unicellular organisms, and possibly also viruses have a value and should be protected

  2. A Comparison of Three Holistic Approaches to Health: One Health, EcoHealth, and Planetary Health.

    Science.gov (United States)

    Lerner, Henrik; Berg, Charlotte

    2017-01-01

    Several holistic and interdisciplinary approaches exist to safeguard health. Three of the most influential concepts at the moment, One Health, EcoHealth, and Planetary Health, are analyzed in this paper, revealing similarities and differences at the theoretical conceptual level. These approaches may appear synonymous, as they all promote the underlying assumption of humans and other animals sharing the same planet and the same environmental challenges, infections and infectious agents as well as other aspects of physical-and possibly mental-health. However, we would like to illuminate the differences between these three concepts or approaches, and how the choice of terms may, deliberately or involuntary, signal the focus, and underlying values of the approaches. In this paper, we have chosen some proposed and well-known suggestions of definitions. In our theoretical analysis, we will focus on at least two areas. These are (1) the value of the potential scientific areas which could be included and (2) core values present within the approach. In the first area, our main concern is whether the approaches are interdisciplinary and whether the core scientific areas are assigned equal importance. For the second area, which is rather wide, we analyze core values such as biodiversity, health, and how one values humans, animals, and ecosystems. One Health has been described as either a narrow approach combining public health and veterinary medicine or as a wide approach as in the wide-spread "umbrella" depiction including both scientific fields, core concepts, and interdisciplinary research areas. In both cases, however, safeguarding the health of vertebrates is usually in focus although ecosystems are also included in the model. The EcoHealth approach seems to have more of a biodiversity focus, with an emphasis on all living creatures, implying that parasites, unicellular organisms, and possibly also viruses have a value and should be protected. Planetary Health, on the

  3. A comparison of image restoration approaches applied to three-dimensional confocal and wide-field fluorescence microscopy.

    Science.gov (United States)

    Verveer, P. J; Gemkow, M. J; Jovin, T. M

    1999-01-01

    We have compared different image restoration approaches for fluorescence microscopy. The most widely used algorithms were classified with a Bayesian theory according to the assumed noise model and the type of regularization imposed. We considered both Gaussian and Poisson models for the noise in combination with Tikhonov regularization, entropy regularization, Good's roughness and without regularization (maximum likelihood estimation). Simulations of fluorescence confocal imaging were used to examine the different noise models and regularization approaches using the mean squared error criterion. The assumption of a Gaussian noise model yielded only slightly higher errors than the Poisson model. Good's roughness was the best choice for the regularization. Furthermore, we compared simulated confocal and wide-field data. In general, restored confocal data are superior to restored wide-field data, but given sufficient higher signal level for the wide-field data the restoration result may rival confocal data in quality. Finally, a visual comparison of experimental confocal and wide-field data is presented.

  4. Laying the Foundations for Democratic Behavior - A Comparison of Two Different Approaches to Democratic Education

    OpenAIRE

    Viola HUANG

    2014-01-01

    A democracy is a society in which everyone has equal rights and is able to participate in decision-making processes. Consequently, in a democratic society, democratic behavior is essential. This work investigates the question: In what ways and to what extent can alternative models of education support the development of democratic skills in children? To explore this question, the author analyzes and compares two different approaches to democratic education: The Sudbury approach and the democr...

  5. Reconsidering Cluster Bias in Multilevel Data: A Monte Carlo Comparison of Free and Constrained Baseline Approaches.

    Science.gov (United States)

    Guenole, Nigel

    2018-01-01

    The test for item level cluster bias examines the improvement in model fit that results from freeing an item's between level residual variance from a baseline model with equal within and between level factor loadings and between level residual variances fixed at zero. A potential problem is that this approach may include a misspecified unrestricted model if any non-invariance is present, but the log-likelihood difference test requires that the unrestricted model is correctly specified. A free baseline approach where the unrestricted model includes only the restrictions needed for model identification should lead to better decision accuracy, but no studies have examined this yet. We ran a Monte Carlo study to investigate this issue. When the referent item is unbiased, compared to the free baseline approach, the constrained baseline approach led to similar true positive (power) rates but much higher false positive (Type I error) rates. The free baseline approach should be preferred when the referent indicator is unbiased. When the referent assumption is violated, the false positive rate was unacceptably high for both free and constrained baseline approaches, and the true positive rate was poor regardless of whether the free or constrained baseline approach was used. Neither the free or constrained baseline approach can be recommended when the referent indicator is biased. We recommend paying close attention to ensuring the referent indicator is unbiased in tests of cluster bias. All Mplus input and output files, R, and short Python scripts used to execute this simulation study are uploaded to an open access repository.

  6. A Comparison of Approaches for Solving Hard Graph-Theoretic Problems

    Science.gov (United States)

    2015-04-29

    and Search”, in Discrete Mathematics and Its Applications, Book 7, CRC Press (1998): Boca Raton. [6] A. Lucas, “Ising Formulations of Many NP Problems...owner. 14. ABSTRACT In order to formulate mathematical conjectures likely to be true, a number of base cases must be determined. However, many... combinatorial problems are NP-hard and the computational complexity makes this research approach difficult using a standard brute force approach on a

  7. Comparison of various approaches for the treatment of fractures of the mandibular condylar process.

    Science.gov (United States)

    Handschel, Jörg; Rüggeberg, Tim; Depprich, Rita; Schwarz, Frank; Meyer, Ulrich; Kübler, Norbert R; Naujoks, Christian

    2012-12-01

    Fractures of the mandibular condyle process are the most common fractures of the lower jaw. Unfortunately, the type of treatment is still a matter of debate. The aim of this investigation was to compare the outcome of different treatment approaches regarding function and surgical side-effects. 111 fractures of the mandibular condyle representing all types according to the classification of Spiessl and Schroll were included. Both closed reduction (CR) and open reduction with internal fixation (ORIF) including the retromandibular/transparotid, submandibular, preauricular and intraoral approach were performed. The clinical examination included functional and aesthetic aspects at least 1 year after the fracture. The majority of fractures (45%) were classified into Type II and IV according to Spiessl and Schroll followed by fractures without any displacement or dislocation (29.7%). The submandibular approach showed the worst outcome regarding permanent palsy of the facial nerve and hypertrophic scarring. No significant differences between the various approaches were detected in the functional status in any diagnosis group. Inferior condylar neck fractures benefit from ORIF by an intraoral approach whereas in high condylar neck fractures the retromandibular/transparotid approach shows the best results. Fractures of the condylar head were almost all treated by CR and our results cannot contribute to the debate of CR vs. ORIF in this type of fracture. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. COMPARISONS BETWEEN AND COMBINATIONS OF DIFFERENT APPROACHES TO ACCELERATE ENGINEERING PROJECTS

    Directory of Open Access Journals (Sweden)

    H. Steyn

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: In this article, traditional project management methods such as PERT and CPM, as well as fast-tracking and systems approaches, viz. concurrent engineering and critical chain, are reviewed with specific reference to their contribution to reducing the duration of the execution phase of engineering projects. Each of these techniques has some role to play in the acceleration of project execution. Combinations of approaches are evaluated by considering the potential of sets consisting of two different approaches each. While PERT and CPM approaches have been combined for many years in a technique called PERT/CPM, new combinations of approaches are discussed. Certain assumptions inherent to PERT and often wrong are not made by the critical chain approach.

    AFRIKAANSE OPSOMMING: In hierdie artikel word tradisionele projekbestuurbenaderings soos PERT en CPM asook projekversnelling en stelselbenaderings, naamlik gelyktydige ingenieurswese, en kritiekeketting-ondersoek met betrekking tot die bydrae wat elk tot die versnelling van die uitvoeringsfase van ingenieursprojekte kan lewer. Elk van hierdie benaderings kan ‘n spesifieke bydrae tot die versnelling van projekte lewer. Kombinasies, elk bestaande uit twee verskillende benaderings, word geëvalueer. Terwyl PERT en CPM reeds baie jare lank in kombinasie gebruik word, word nuwe kombinasies ook hier bespreek. Sekere aannames inherent aan die PERT-benadering is dikwels foutief. Hierdie aannames word nie deur die kritieke-ketting-benadering gemaak nie.

  9. Retrospective dosimetry of Chernobyl liquidators

    International Nuclear Information System (INIS)

    Chumak, V.V.; Bakhanova, E.V.; Sholom, S.V.; Pasalskaya, L.F.; Bouville, A.; Krjuchkov, V.P.

    2000-01-01

    sets and, clearly, may lead to conclusion regarding the adequacy of the data set in general, not on individual basis. Another possibility to verify existing dose records is application of reliable retrospective dosimetric techniques, which may be used as a reference. Dosimetric screening of the study cohort requires a tool, which should meet two basic requirements: to be cheap and practical, and to be applicable to all subjects (desirably even post mortem). Till recent time such tool was missing and none of the known methods of retrospective dosimetry matched these criteria. Therefore in the novel method of Soft Expert Assessment Dosimetry (SEAD) was developed by the International Dosimetric Group operating under auspices of Ukraine-USA-France and CEC-Russia-Byelarus collaboration. This method is based on the analysis of information acquired from interviewing of liquidators and exploits regularities of dose distributions. The main advantage of this method is applicability to all subjects making it good for the screening of the cohort. Case-control study requires closer consideration of fewer subjects and in this regard high precision techniques (like EPR) make use. High cost of analyses is acceptable in this case. Practical implementation of this approach is illustrated by some on-going studies. Pros and contras of selected methods, as well as implementation considerations will be discussed as well. (author)

  10. Comparison of weighting approaches for genetic risk scores in gene-environment interaction studies.

    Science.gov (United States)

    Hüls, Anke; Krämer, Ursula; Carlsten, Christopher; Schikowski, Tamara; Ickstadt, Katja; Schwender, Holger

    2017-12-16

    Weighted genetic risk scores (GRS), defined as weighted sums of risk alleles of single nucleotide polymorphisms (SNPs), are statistically powerful for detection gene-environment (GxE) interactions. To assign weights, the gold standard is to use external weights from an independent study. However, appropriate external weights are not always available. In such situations and in the presence of predominant marginal genetic effects, we have shown in a previous study that GRS with internal weights from marginal genetic effects ("GRS-marginal-internal") are a powerful and reliable alternative to single SNP approaches or the use of unweighted GRS. However, this approach might not be appropriate for detecting predominant interactions, i.e. interactions showing an effect stronger than the marginal genetic effect. In this paper, we present a weighting approach for such predominant interactions ("GRS-interaction-training") in which parts of the data are used to estimate the weights from the interaction terms and the remaining data are used to determine the GRS. We conducted a simulation study for the detection of GxE interactions in which we evaluated power, type I error and sign-misspecification. We compared this new weighting approach to the GRS-marginal-internal approach and to GRS with external weights. Our simulation study showed that in the absence of external weights and with predominant interaction effects, the highest power was reached with the GRS-interaction-training approach. If marginal genetic effects were predominant, the GRS-marginal-internal approach was more appropriate. Furthermore, the power to detect interactions reached by the GRS-interaction-training approach was only slightly lower than the power achieved by GRS with external weights. The power of the GRS-interaction-training approach was confirmed in a real data application to the Traffic, Asthma and Genetics (TAG) Study (N = 4465 observations). When appropriate external weights are unavailable, we

  11. Comparison of the coracoid and retroclavicular approaches for ultrasound-guided infraclavicular brachial plexus block.

    Science.gov (United States)

    Kavrut Ozturk, Nilgun; Kavakli, Ali Sait

    2017-08-01

    This prospective randomized study compared the coracoid and retroclavicular approaches to ultrasound-guided infraclavicular brachial plexus block (IBPB) in terms of needle tip and shaft visibility and quality of block. We hypothesized that the retroclavicular approach would increase needle tip and shaft visibility and decrease the number of needle passes compared to the coracoid approach. A total of 100 adult patients who received IBPB block for upper limb surgery were randomized into two groups: a coracoid approach group (group C) and a retroclavicular approach group (group R). In group C, the needle was inserted 2 cm medial and 2 cm inferior to the coracoid process and directed from ventral to dorsal. In group R, the needle insertion point was posterior to the clavicle and the needle was advanced from cephalad to caudal. All ultrasound images were digitally stored for analysis. The primary aim of the present study was to compare needle tip and shaft visibility between the coracoid approach and retroclavicular approach in patients undergoing upper limb surgery. The secondary aim was to investigate differences between the two groups in the number of needle passes, sensory and motor block success rates, surgical success rate, block performance time, block performance-related pain, patient satisfaction, use of supplemental local anesthetic and analgesic, and complications. Needle tip visibility and needle shaft visibility were significantly better in group R (p = 0.040, p = 0.032, respectively). Block performance time and anesthesia-related time were significantly shorter in group R (p = 0.022, p = 0.038, respectively). Number of needle passes was significantly lower in group R (p = 0.044). Paresthesia during block performance was significantly higher in group C (p = 0.045). There were no statistically significant differences between the two groups in terms of sensory or motor block success, surgical success, block-related pain, and patient satisfaction

  12. Comparison of the different approaches to generate holograms from data acquired with a Kinect sensor

    Science.gov (United States)

    Kang, Ji-Hoon; Leportier, Thibault; Ju, Byeong-Kwon; Song, Jin Dong; Lee, Kwang-Hoon; Park, Min-Chul

    2017-05-01

    Data of real scenes acquired in real-time with a Kinect sensor can be processed with different approaches to generate a hologram. 3D models can be generated from a point cloud or a mesh representation. The advantage of the point cloud approach is that computation process is well established since it involves only diffraction and propagation of point sources between parallel planes. On the other hand, the mesh representation enables to reduce the number of elements necessary to represent the object. Then, even though the computation time for the contribution of a single element increases compared to a simple point, the total computation time can be reduced significantly. However, the algorithm is more complex since propagation of elemental polygons between non-parallel planes should be implemented. Finally, since a depth map of the scene is acquired at the same time than the intensity image, a depth layer approach can also be adopted. This technique is appropriate for a fast computation since propagation of an optical wavefront from one plane to another can be handled efficiently with the fast Fourier transform. Fast computation with depth layer approach is convenient for real time applications, but point cloud method is more appropriate when high resolution is needed. In this study, since Kinect can be used to obtain both point cloud and depth map, we examine the different approaches that can be adopted for hologram computation and compare their performance.

  13. A comparison of the stochastic and machine learning approaches in hydrologic time series forecasting

    Science.gov (United States)

    Kim, T.; Joo, K.; Seo, J.; Heo, J. H.

    2016-12-01

    Hydrologic time series forecasting is an essential task in water resources management and it becomes more difficult due to the complexity of runoff process. Traditional stochastic models such as ARIMA family has been used as a standard approach in time series modeling and forecasting of hydrological variables. Due to the nonlinearity in hydrologic time series data, machine learning approaches has been studied with the advantage of discovering relevant features in a nonlinear relation among variables. This study aims to compare the predictability between the traditional stochastic model and the machine learning approach. Seasonal ARIMA model was used as the traditional time series model, and Random Forest model which consists of decision tree and ensemble method using multiple predictor approach was applied as the machine learning approach. In the application, monthly inflow data from 1986 to 2015 of Chungju dam in South Korea were used for modeling and forecasting. In order to evaluate the performances of the used models, one step ahead and multi-step ahead forecasting was applied. Root mean squared error and mean absolute error of two models were compared.

  14. Delineating Individual Trees from Lidar Data: A Comparison of Vector- and Raster-based Segmentation Approaches

    Directory of Open Access Journals (Sweden)

    Maggi Kelly

    2013-08-01

    Full Text Available Light detection and ranging (lidar data is increasingly being used for ecosystem monitoring across geographic scales. This work concentrates on delineating individual trees in topographically-complex, mixed conifer forest across the California’s Sierra Nevada. We delineated individual trees using vector data and a 3D lidar point cloud segmentation algorithm, and using raster data with an object-based image analysis (OBIA of a canopy height model (CHM. The two approaches are compared to each other and to ground reference data. We used high density (9 pulses/m2, discreet lidar data and WorldView-2 imagery to delineate individual trees, and to classify them by species or species types. We also identified a new method to correct artifacts in a high-resolution CHM. Our main focus was to determine the difference between the two types of approaches and to identify the one that produces more realistic results. We compared the delineations via tree detection, tree heights, and the shape of the generated polygons. The tree height agreement was high between the two approaches and the ground data (r2: 0.93–0.96. Tree detection rates increased for more dominant trees (8–100 percent. The two approaches delineated tree boundaries that differed in shape: the lidar-approach produced fewer, more complex, and larger polygons that more closely resembled real forest structure.

  15. A viral metagenomic approach on a non-metagenomic experiment: Mining next generation sequencing datasets from pig DNA identified several porcine parvoviruses for a retrospective evaluation of viral infections.

    Directory of Open Access Journals (Sweden)

    Samuele Bovo

    Full Text Available Shot-gun next generation sequencing (NGS on whole DNA extracted from specimens collected from mammals often produces reads that are not mapped (i.e. unmapped reads on the host reference genome and that are usually discarded as by-products of the experiments. In this study, we mined Ion Torrent reads obtained by sequencing DNA isolated from archived blood samples collected from 100 performance tested Italian Large White pigs. Two reduced representation libraries were prepared from two DNA pools constructed each from 50 equimolar DNA samples. Bioinformatic analyses were carried out to mine unmapped reads on the reference pig genome that were obtained from the two NGS datasets. In silico analyses included read mapping and sequence assembly approaches for a viral metagenomic analysis using the NCBI Viral Genome Resource. Our approach identified sequences matching several viruses of the Parvoviridae family: porcine parvovirus 2 (PPV2, PPV4, PPV5 and PPV6 and porcine bocavirus 1-H18 isolate (PBoV1-H18. The presence of these viruses was confirmed by PCR and Sanger sequencing of individual DNA samples. PPV2, PPV4, PPV5, PPV6 and PBoV1-H18 were all identified in samples collected in 1998-2007, 1998-2000, 1997-2000, 1998-2004 and 2003, respectively. For most of these viruses (PPV4, PPV5, PPV6 and PBoV1-H18 previous studies reported their first occurrence much later (from 5 to more than 10 years than our identification period and in different geographic areas. Our study provided a retrospective evaluation of apparently asymptomatic parvovirus infected pigs providing information that could be important to define occurrence and prevalence of different parvoviruses in South Europe. This study demonstrated the potential of mining NGS datasets non-originally derived by metagenomics experiments for viral metagenomics analyses in a livestock species.

  16. Comparison of a Traditional Probabilistic Risk Assessment Approach with Advanced Safety Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Curtis L; Mandelli, Diego; Zhegang Ma

    2014-11-01

    As part of the Light Water Sustainability Program (LWRS) [1], the purpose of the Risk Informed Safety Margin Characterization (RISMC) [2] Pathway research and development (R&D) is to support plant decisions for risk-informed margin management with the aim to improve economics, reliability, and sustain safety of current NPPs. In this paper, we describe the RISMC analysis process illustrating how mechanistic and probabilistic approaches are combined in order to estimate a safety margin. We use the scenario of a “station blackout” (SBO) wherein offsite power and onsite power is lost, thereby causing a challenge to plant safety systems. We describe the RISMC approach, illustrate the station blackout modeling, and contrast this with traditional risk analysis modeling for this type of accident scenario. We also describe our approach we are using to represent advanced flooding analysis.

  17. Comparison of governance approaches for the control of antimicrobial resistance: Analysis of three European countries

    Directory of Open Access Journals (Sweden)

    Gabriel Birgand

    2018-02-01

    Full Text Available Abstract Policy makers and governments are calling for coordination to address the crisis emerging from the ineffectiveness of current antibiotics and stagnated pipe-line of new ones – antimicrobial resistance (AMR. Wider contextual drivers and mechanisms are contributing to shifts in governance strategies in health care, but are national health system approaches aligned with strategies required to tackle antimicrobial resistance? This article provides an analysis of governance approaches within healthcare systems including: priority setting, performance monitoring and accountability for AMR prevention in three European countries: England, France and Germany. Advantages and unresolved issues from these different experiences are reported, concluding that mechanisms are needed to support partnerships between healthcare professionals and patients with democratized decision-making and accountability via collaboration. But along with this multi-stakeholder approach to governance, a balance between regulation and persuasion is needed.

  18. A comparison of two closely-related approaches to aerodynamic design optimization

    Science.gov (United States)

    Shubin, G. R.; Frank, P. D.

    1991-01-01

    Two related methods for aerodynamic design optimization are compared. The methods, called the implicit gradient approach and the variational (or optimal control) approach, both attempt to obtain gradients necessary for numerical optimization at a cost significantly less than that of the usual black-box approach that employs finite difference gradients. While the two methods are seemingly quite different, they are shown to differ (essentially) in that the order of discretizing the continuous problem, and of applying calculus, is interchanged. Under certain circumstances, the two methods turn out to be identical. We explore the relationship between these methods by applying them to a model problem for duct flow that has many features in common with transonic flow over an airfoil. We find that the gradients computed by the variational method can sometimes be sufficiently inaccurate to cause the optimization to fail.

  19. Comparison between the basic least squares and the Bayesian approach for elastic constants identification

    Science.gov (United States)

    Gogu, C.; Haftka, R.; LeRiche, R.; Molimard, J.; Vautrin, A.; Sankar, B.

    2008-11-01

    The basic formulation of the least squares method, based on the L2 norm of the misfit, is still widely used today for identifying elastic material properties from experimental data. An alternative statistical approach is the Bayesian method. We seek here situations with significant difference between the material properties found by the two methods. For a simple three bar truss example we illustrate three such situations in which the Bayesian approach leads to more accurate results: different magnitude of the measurements, different uncertainty in the measurements and correlation among measurements. When all three effects add up, the Bayesian approach can have a large advantage. We then compared the two methods for identification of elastic constants from plate vibration natural frequencies.

  20. A Monte Carlo Study on Multiple Output Stochastic Frontiers: Comparison of Two Approaches

    DEFF Research Database (Denmark)

    Henningsen, Geraldine; Henningsen, Arne; Jensen, Uwe

    , dividing all other output quantities by the selected output quantity, and using these ratios as regressors (OD). Another approach is the stochastic ray production frontier (SR) which transforms the output quantities into their Euclidean distance as the dependent variable and their polar coordinates......In the estimation of multiple output technologies in a primal approach, the main question is how to handle the multiple outputs. Often an output distance function is used, where the classical approach is to exploit its homogeneity property by selecting one output quantity as the dependent variable...... of both specifications for the case of a Translog output distance function with respect to different common statistical problems as well as problems arising as a consequence of zero values in the output quantities. Although, our results partly show clear reactions to statistical misspecifications...

  1. Comparison of two approaches for differentiating full-field data in solid mechanics

    International Nuclear Information System (INIS)

    Avril, Stéphane; Feissel, Pierre; Villon, Pierre; Pierron, Fabrice

    2010-01-01

    In this study, the issue of reconstructing the gradients of noisy full-field data is addressed within the framework of solid mechanics. Two approaches are considered, a global one based on finite element approximation (FEA) and a local one based on diffuse approximation (DA). For both approaches, it is proposed to monitor locally the filtering effect in order to adapt the uncertainty to the local signal to noise ratio. Both approaches are applied to a case study which is commonly considered as difficult in solid mechanics (open-hole tensile test on a composite laminate). Both DA and FEA are successful for detecting local subsurface damage from the measured noisy displacement fields. Indications are also provided about the compared performances of DA and FEA. It is shown that DA is more robust, but the downside is that it is also more CPU time consuming

  2. Step-and-shoot prospectively ECG-gated versus retrospectively ECG-gated with tube current modulation coronary CT angiography using the 128-slice MDCT: comparison of image quality and radiation dose

    International Nuclear Information System (INIS)

    Jeong, Dong Wook; Choo, Ki Seok; Baik, Seung Kug; Kim, Yong Woo; Jeon, Ung Bae; Kim, Jeong Soo; Lim, Soo Jin

    2011-01-01

    Background: Little is known regarding image quality and the required radiation dose for step-and-shoot and retrospective coronary computed tomography angiography (CCTA) with tube current modulation (TCM) in 128-slice multidetector CT (MDCT) coronary angiography. Purpose: To compare image quality and radiation dose in patients who underwent 128-slice MDCT by the step-and- shoot method with those in patients who underwent 128-slice MDCT with retrospective CCTA with TCM. Material and Methods: CCTA obtained with 128-slice MDCT was retrospectively evaluated in 160 patients. Two independent reviewers separately scored the subjective image quality of the coronary artery segments (1, excellent; 4, poor) for step-and-shoot (68, mean heart rate [HR]: 59.3±6.8) and retrospective CCTA with TCM (77, mean HR: 59.1±9.8). Interobserver variability was calculated. Effective radiation doses of both scan techniques were calculated with dose-length product. Results: There was good agreement for quality scores of coronary artery segment images between the independent reviewers (k=0.72). The number of coronary artery segments that could not be evaluated was 2.85% (27 of 947) in the step-and-shoot and 1.87% (20 of 1071) in retrospective CCTA with TCM. Image quality scores were not significantly different (P>.05). Mean patient radiation dose was 63% lower for step-and-shoot (1.94±0.70 mSv) than for retrospective CCTA with TCM (4.51±1.18 mSv) (P<0.0001). For patients who underwent step-and-shoot or retrospective CCTA with TCM, an average HR of 63.5 beats per minute was identified as the threshold for the prediction of non-diagnostic image quality for both protocols. There were no significant differences in the image quality of both methods between obese (body mass index [BMI≥25) and non-obese patients (BMI<25), but radiation doses were higher in the obesity group than in the non-obesity group for both methods. Conclusion: Both step-and-shoot and retrospective CCTA with TCM using 128

  3. Comparison of modeling approaches to prioritize chemicals based on estimates of exposure and exposure potential.

    Science.gov (United States)

    Mitchell, Jade; Arnot, Jon A; Jolliet, Olivier; Georgopoulos, Panos G; Isukapalli, Sastry; Dasgupta, Surajit; Pandian, Muhilan; Wambaugh, John; Egeghy, Peter; Cohen Hubal, Elaine A; Vallero, Daniel A

    2013-08-01

    While only limited data are available to characterize the potential toxicity of over 8 million commercially available chemical substances, there is even less information available on the exposure and use-scenarios that are required to link potential toxicity to human and ecological health outcomes. Recent improvements and advances such as high throughput data gathering, high performance computational capabilities, and predictive chemical inherency methodology make this an opportune time to develop an exposure-based prioritization approach that can systematically utilize and link the asymmetrical bodies of knowledge for hazard and exposure. In response to the US EPA's need to develop novel approaches and tools for rapidly prioritizing chemicals, a "Challenge" was issued to several exposure model developers to aid the understanding of current systems in a broader sense and to assist the US EPA's effort to develop an approach comparable to other international efforts. A common set of chemicals were prioritized under each current approach. The results are presented herein along with a comparative analysis of the rankings of the chemicals based on metrics of exposure potential or actual exposure estimates. The analysis illustrates the similarities and differences across the domains of information incorporated in each modeling approach. The overall findings indicate a need to reconcile exposures from diffuse, indirect sources (far-field) with exposures from directly, applied chemicals in consumer products or resulting from the presence of a chemical in a microenvironment like a home or vehicle. Additionally, the exposure scenario, including the mode of entry into the environment (i.e. through air, water or sediment) appears to be an important determinant of the level of agreement between modeling approaches. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Comparison of modeling approaches to prioritize chemicals based on estimates of exposure and exposure potential

    Science.gov (United States)

    Mitchell, Jade; Arnot, Jon A.; Jolliet, Olivier; Georgopoulos, Panos G.; Isukapalli, Sastry; Dasgupta, Surajit; Pandian, Muhilan; Wambaugh, John; Egeghy, Peter; Cohen Hubal, Elaine A.; Vallero, Daniel A.

    2014-01-01

    While only limited data are available to characterize the potential toxicity of over 8 million commercially available chemical substances, there is even less information available on the exposure and use-scenarios that are required to link potential toxicity to human and ecological health outcomes. Recent improvements and advances such as high throughput data gathering, high performance computational capabilities, and predictive chemical inherency methodology make this an opportune time to develop an exposure-based prioritization approach that can systematically utilize and link the asymmetrical bodies of knowledge for hazard and exposure. In response to the US EPA’s need to develop novel approaches and tools for rapidly prioritizing chemicals, a “Challenge” was issued to several exposure model developers to aid the understanding of current systems in a broader sense and to assist the US EPA’s effort to develop an approach comparable to other international efforts. A common set of chemicals were prioritized under each current approach. The results are presented herein along with a comparative analysis of the rankings of the chemicals based on metrics of exposure potential or actual exposure estimates. The analysis illustrates the similarities and differences across the domains of information incorporated in each modeling approach. The overall findings indicate a need to reconcile exposures from diffuse, indirect sources (far-field) with exposures from directly, applied chemicals in consumer products or resulting from the presence of a chemical in a microenvironment like a home or vehicle. Additionally, the exposure scenario, including the mode of entry into the environment (i.e. through air, water or sediment) appears to be an important determinant of the level of agreement between modeling approaches. PMID:23707726

  5. Comparison of ensemble post-processing approaches, based on empirical and dynamical error modelisation of rainfall-runoff model forecasts

    Science.gov (United States)

    Chardon, J.; Mathevet, T.; Le Lay, M.; Gailhard, J.

    2012-04-01

    In the context of a national energy company (EDF : Electricité de France), hydro-meteorological forecasts are necessary to ensure safety and security of installations, meet environmental standards and improve water ressources management and decision making. Hydrological ensemble forecasts allow a better representation of meteorological and hydrological forecasts uncertainties and improve human expertise of hydrological forecasts, which is essential to synthesize available informations, coming from different meteorological and hydrological models and human experience. An operational hydrological ensemble forecasting chain has been developed at EDF since 2008 and is being used since 2010 on more than 30 watersheds in France. This ensemble forecasting chain is characterized ensemble pre-processing (rainfall and temperature) and post-processing (streamflow), where a large human expertise is solicited. The aim of this paper is to compare 2 hydrological ensemble post-processing methods developed at EDF in order improve ensemble forecasts reliability (similar to Monatanari &Brath, 2004; Schaefli et al., 2007). The aim of the post-processing methods is to dress hydrological ensemble forecasts with hydrological model uncertainties, based on perfect forecasts. The first method (called empirical approach) is based on a statistical modelisation of empirical error of perfect forecasts, by streamflow sub-samples of quantile class and lead-time. The second method (called dynamical approach) is based on streamflow sub-samples of quantile class and streamflow variation, and lead-time. On a set of 20 watersheds used for operational forecasts, results show that both approaches are necessary to ensure a good post-processing of hydrological ensemble, allowing a good improvement of reliability, skill and sharpness of ensemble forecasts. The comparison of the empirical and dynamical approaches shows the limits of the empirical approach which is not able to take into account hydrological

  6. A comparison of labeling and label-free mass spectrometry-based proteomics approaches.

    Science.gov (United States)

    Patel, Vibhuti J; Thalassinos, Konstantinos; Slade, Susan E; Connolly, Joanne B; Crombie, Andrew; Murrell, J Colin; Scrivens, James H

    2009-07-01

    The proteome of the recently discovered bacterium Methylocella silvestris has been characterized using three profiling and comparative proteomics approaches. The organism has been grown on two different substrates enabling variations in protein expression to be identified. The results obtained using the experimental approaches have been compared with respect to number of proteins identified, confidence in identification, sequence coverage and agreement of regulated proteins. The sample preparation, instrumental time and sample loading requirements of the differing experiments are compared and discussed. A preliminary screen of the protein regulation results for biological significance has also been performed.

  7. Avian fatalities at wind energy facilities in North America: A comparison of recent approaches

    Science.gov (United States)

    Johnson, Douglas H.; Loss, Scott R.; Smallwood, K. Shawn; Erickson, Wallace P.

    2016-01-01

    Three recent publications have estimated the number of birds killed each year by wind energy facilities at 2012 build-out levels in the United States. The 3 publications differ in scope, methodology, and resulting estimates. We compare and contrast characteristics of the approaches used in the publications. In addition, we describe decisions made in obtaining the estimates that were produced. Despite variation in the 3 approaches, resulting estimates were reasonably similar; about a quarter- to a half-million birds are killed per year by colliding with wind turbines.

  8. Prospective electrocardiogram-gated axial 64-detector computed tomographic angiography vs retrospective gated helical technique to assess coronary artery bypass graft anastomosis. Comparison of image quality and patient radiation dose

    International Nuclear Information System (INIS)

    Machida, Haruhiko; Masukawa, Ai; Tanaka, Isao; Fukui, Rika; Suzuki, Kazufumi; Ueno, Eiko; Kodera, Kojiro; Nakano, Kiyoharu; Shen, Y.

    2010-01-01

    In the present study the effective dose and image quality at distal anastomoses were retrospectively compared between prospective electrocardiogram (ECG)-gated axial and retrospective ECG-gated helical techniques on 64-detector computed tomographic (CT) angiography following coronary artery bypass graft surgery. Following bypass surgery, 52 patients with a heart rate <65 beats/min underwent CT angiography: 26 patients each with prospective and retrospective ECG gating techniques. The effective dose was compared between the 2 groups using a 4-point scale (4, excellent; 1, poor) to grade the quality of curved multiplanar reformation images at distal anastomoses. Patient characteristics of the 2 groups were well matched, and the same CT scan parameters were used for both, except for the interval between surgery and CT examination, tube current, and image noise index. Image quality scores did not differ significantly (3.26±0.95 vs 3.35±0.87; P=0.63), but the effective dose was significantly lower in the prospective (7.3±1.8 mSv) than in the retrospective gating group (23.6±4.5 mSv) (P<0.0001). Following bypass surgery, 64-detector CT angiography using prospective ECG gating is superior to retrospective gating in limiting the radiation dose and maintaining the image quality of distal anastomoses. (author)

  9. Myocardial Protection in Mitral Valve Surgery: Comparison Between Minimally Invasive Approach and Standard Sternotomy.

    Science.gov (United States)

    Lebon, Jean-Sébastien; Couture, Pierre; Fortier, Annik; Rochon, Antoine G; Ayoub, Christian; Viens, Claudia; Laliberté, Éric; Bouchard, Denis; Pellerin, Michel; Deschamps, Alain

    2018-04-01

    To compare antegrade and retrograde cardioplegia administration in minimally invasive mitral valve surgery (MIMS) and open mitral valve surgery (OMS) for myocardial protection. Retrospective study. Tertiary care university hospital. The study comprised 118 patients undergoing MIMS and 118 patients undergoing OMS. The data of patients admitted for MIMS from 2006 to 2010 were reviewed. Patients undergoing isolated elective OMS from 2004 to 2006 were used as a control group. Cardioplegia in the MIMS group was delivered via the distal port of the endoaortic clamp and an endovascular coronary sinus catheter positioned using echographic and fluoroscopic guidance. Antegrade and retrograde cardioplegia were used in OMS. Data regarding myocardial infarction (MI) (creatine kinase [CK]-MB, troponin T, electrocardiography); myocardial function; and hemodynamic stability were collected. There was no difference in the perioperative MI incidence between both groups (1 in each group, p = 0.96). No statistically significant difference was found for maximal CK-MB (35.9 µg/L [25.1-50.1] v 37.9 µg/L [28.6-50.9]; p = 0.31) or the number of patients with CK-MB levels >50 µg/L (29 v 33; p = 0.55) or CK-MB >100 µg/L (3 v 4; p = 0.70) between the OMS and MIMS groups. However, maximum troponin T levels in the MIMS group were significantly lower (0.47 µg/L [0.32-0.79] v 0.65 µg/L [0.45-0.94]; p = 0.0007). No difference in the incidence of difficult weaning from bypass and intra-aortic balloon pump use between the MIMS and OMS groups was found. Antegrade and retrograde cardioplegia administration during MIMS and OMS provided comparable myocardial protection. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  10. Comparison of liver volumetry on contrast‐enhanced CT images: one semiautomatic and two automatic approaches

    Science.gov (United States)

    Cai, Wei; He, Baochun; Fang, Chihua

    2016-01-01

    This study was to evaluate the accuracy, consistency, and efficiency of three liver volumetry methods— one interactive method, an in‐house‐developed 3D medical Image Analysis (3DMIA) system, one automatic active shape model (ASM)‐based segmentation, and one automatic probabilistic atlas (PA)‐guided segmentation method on clinical contrast‐enhanced CT images. Forty‐two datasets, including 27 normal liver and 15 space‐occupying liver lesion patients, were retrospectively included in this study. The three methods — one semiautomatic 3DMIA, one automatic ASM‐based, and one automatic PA‐based liver volumetry — achieved an accuracy with VD (volume difference) of −1.69%,−2.75%, and 3.06% in the normal group, respectively, and with VD of −3.20%,−3.35%, and 4.14% in the space‐occupying lesion group, respectively. However, the three methods achieved an efficiency of 27.63 mins, 1.26 mins, 1.18 mins on average, respectively, compared with the manual volumetry, which took 43.98 mins. The high intraclass correlation coefficient between the three methods and the manual method indicated an excellent agreement on liver volumetry. Significant differences in segmentation time were observed between the three methods (3DMIA, ASM, and PA) and the manual volumetry (pvolumetries (ASM and PA) and the semiautomatic volumetry (3DMIA) (pvolumetry agreed well with manual gold standard in both the normal liver group and the space‐occupying lesion group. The ASM‐ and PA‐based automatic segmentation have better efficiency in clinical use. PACS number(s): 87.55.‐x PMID:27929487

  11. Comparison of liver volumetry on contrast-enhanced CT images: one semiautomatic and two automatic approaches.

    Science.gov (United States)

    Cai, Wei; He, Baochun; Fan, Yingfang; Fang, Chihua; Jia, Fucang

    2016-11-08

    This study was to evaluate the accuracy, consistency, and efficiency of three liver volumetry methods- one interactive method, an in-house-developed 3D medical Image Analysis (3DMIA) system, one automatic active shape model (ASM)-based segmentation, and one automatic probabilistic atlas (PA)-guided segmentation method on clinical contrast-enhanced CT images. Forty-two datasets, including 27 normal liver and 15 space-occupying liver lesion patients, were retrospectively included in this study. The three methods - one semiautomatic 3DMIA, one automatic ASM-based, and one automatic PA-based liver volumetry - achieved an accuracy with VD (volume difference) of -1.69%, -2.75%, and 3.06% in the normal group, respectively, and with VD of -3.20%, -3.35%, and 4.14% in the space-occupying lesion group, respectively. However, the three methods achieved an efficiency of 27.63 mins, 1.26 mins, 1.18 mins on average, respectively, compared with the manual volumetry, which took 43.98 mins. The high intraclass correlation coefficient between the three methods and the manual method indicated an excel-lent agreement on liver volumetry. Significant differences in segmentation time were observed between the three methods (3DMIA, ASM, and PA) and the manual volumetry (p volumetries (ASM and PA) and the semiautomatic volumetry (3DMIA) (p < 0.001). The semiautomatic interactive 3DMIA, automatic ASM-based, and automatic PA-based liver volum-etry agreed well with manual gold standard in both the normal liver group and the space-occupying lesion group. The ASM- and PA-based automatic segmentation have better efficiency in clinical use. © 2016 The Authors.

  12. Performance comparisons between PCA-EA-LBG and PCA-LBG-EA approaches in VQ codebook generation for image compression

    Science.gov (United States)

    Tsai, Jinn-Tsong; Chou, Ping-Yi; Chou, Jyh-Horng

    2015-11-01

    The aim of this study is to generate vector quantisation (VQ) codebooks by integrating principle component analysis (PCA) algorithm, Linde-Buzo-Gray (LBG) algorithm, and evolutionary algorithms (EAs). The EAs include genetic algorithm (GA), particle swarm optimisation (PSO), honey bee mating optimisation (HBMO), and firefly algorithm (FF). The study is to provide performance comparisons between PCA-EA-LBG and PCA-LBG-EA approaches. The PCA-EA-LBG approaches contain PCA-GA-LBG, PCA-PSO-LBG, PCA-HBMO-LBG, and PCA-FF-LBG, while the PCA-LBG-EA approaches contain PCA-LBG, PCA-LBG-GA, PCA-LBG-PSO, PCA-LBG-HBMO, and PCA-LBG-FF. All training vectors of test images are grouped according to PCA. The PCA-EA-LBG used the vectors grouped by PCA as initial individuals, and the best solution gained by the EAs was given for LBG to discover a codebook. The PCA-LBG approach is to use the PCA to select vectors as initial individuals for LBG to find a codebook. The PCA-LBG-EA used the final result of PCA-LBG as an initial individual for EAs to find a codebook. The search schemes in PCA-EA-LBG first used global search and then applied local search skill, while in PCA-LBG-EA first used local search and then employed global search skill. The results verify that the PCA-EA-LBG indeed gain superior results compared to the PCA-LBG-EA, because the PCA-EA-LBG explores a global area to find a solution, and then exploits a better one from the local area of the solution. Furthermore the proposed PCA-EA-LBG approaches in designing VQ codebooks outperform existing approaches shown in the literature.

  13. Performance scores in general practice: a comparison between the clinical versus medication-based approach to identify target populations.

    Directory of Open Access Journals (Sweden)

    Olivier Saint-Lary

    Full Text Available CONTEXT: From one country to another, the pay-for-performance mechanisms differ on one significant point: the identification of target populations, that is, populations which serve as a basis for calculating the indicators. The aim of this study was to compare clinical versus medication-based identification of populations of patients with diabetes and hypertension over the age of 50 (for men or 60 (for women, and any consequences this may have on the calculation of P4P indicators. METHODS: A comparative, retrospective, observational study was carried out with clinical and prescription data from a panel of general practitioners (GPs, the Observatory of General Medicine (OMG for the year 2007. Two indicators regarding the prescription for statins and aspirin in these populations were calculated. RESULTS: We analyzed data from 21.690 patients collected by 61 GPs via electronic medical files. Following the clinical-based approach, 2.278 patients were diabetic, 8,271 had hypertension and 1.539 had both against respectively 1.730, 8.511 and 1.304 following the medication-based approach (% agreement = 96%, kappa = 0.69. The main reasons for these differences were: forgetting to code the morbidities in the clinical approach, not taking into account the population of patients who were given life style and diet rules only or taking into account patients for whom morbidities other than hypertension could justify the use of antihypertensive drugs in the medication-based approach. The mean (confidence interval per doctor was 33.7% (31.5-35.9 for statin indicator and 38.4% (35.4-41.4 for aspirin indicator when the target populations were identified on the basis of clinical criteria whereas they were 37.9% (36.3-39.4 and 43.8% (41.4-46.3 on the basis of treatment criteria. CONCLUSION: The two approaches yield very "similar" scores but these scores cover different realities and offer food for thought on the possible usage of these indicators in the

  14. Comparison of the Modeling Approach between Membrane Bioreactor and Conventional Activated Sludge Processes

    DEFF Research Database (Denmark)

    Jiang, Tao; Sin, Gürkan; Spanjers, Henri

    2009-01-01

    Activated sludge models (ASM) have been developed and largely applied in conventional activated sludge (CAS) systems. The applicability of ASM to model membrane bioreactors (MBR) and the differences in modeling approaches have not been studied in detail. A laboratory-scale MBR was modeled using ASM...

  15. Continuous Training and Wages: An Empirical Analysis Using a Comparison-Group Approach

    Science.gov (United States)

    Gorlitz, Katja

    2011-01-01

    Using German linked employer-employee data, this paper investigates the short-term impact of on-the-job training on wages. The applied estimation approach was first introduced by Leuven and Oosterbeek (2008). Wages of employees who intended to participate in training but did not do so because of a random event are compared to wages of training…

  16. Risk-based microbiological criteria for Campylobacter in broiler meat: A comparison of two approaches

    DEFF Research Database (Denmark)

    Nauta, Maarten; Andersen, Jens Kirk; Tuominen, Pirkko

    2015-01-01

    Risk-based microbiological criteria can offer a tool to control Campylobacter in the broiler meat production chain. Recently two approaches have been applied to derive such criteria and to analyse their potential impact in terms of human health risk reduction: the risk-based version...

  17. A Comparison of Online and Face-to-Face Approaches to Teaching Introduction to American Government

    Science.gov (United States)

    Bolsen, Toby; Evans, Michael; Fleming, Anna McCaghren

    2016-01-01

    This article reports results from a large study comparing four different approaches to teaching Introduction to American Government: (1) traditional, a paper textbook with 100% face-to-face lecture-style teaching; (2) breakout, a paper textbook with 50% face-to-face lecture-style teaching and 50% face-to-face small-group breakout discussion…

  18. Distinguishing Continuous and Discrete Approaches to Multilevel Mixture IRT Models: A Model Comparison Perspective

    Science.gov (United States)

    Zhu, Xiaoshu

    2013-01-01

    The current study introduced a general modeling framework, multilevel mixture IRT (MMIRT) which detects and describes characteristics of population heterogeneity, while accommodating the hierarchical data structure. In addition to introducing both continuous and discrete approaches to MMIRT, the main focus of the current study was to distinguish…

  19. Learning Biology through Innovative Curricula: A Comparison of Game- and Nongame-Based Approaches

    Science.gov (United States)

    Sadler, Troy D.; Romine, William L.; Menon, Deepika; Ferdig, Richard E.; Annetta, Leonard

    2015-01-01

    This study explored student learning in the context of innovative biotechnology curricula and the effects of gaming as a central element of the learning experience. The quasi-experimentally designed study compared learning outcomes between two curricular approaches: One built around a computer-based game, and the other built around a narrative…

  20. Psychiatric Cultures Compared : Psychiatry and Mental Health Care in the Twentieth Century: Comparisons and Approaches

    NARCIS (Netherlands)

    Gijswijt-Hofstra, Marijke; Oosterhuis, Harry; Vijselaar, Joost; Freeman, Hugh

    2005-01-01

    The history of mental health care in the twentieth century is a relatively uncharted territory. Exemplifying a new emphasis on the comparative approach, this volume offers overviews of various national psychiatric cultures and explores new research subjects. By confronting Dutch psychiatry with

  1. Detecting autologous blood transfusions: a comparison of three passport approaches and four blood markers

    DEFF Research Database (Denmark)

    Mørkeberg, J; Sharpe, K; Belhage, B

    2011-01-01

    Blood passport has been suggested as an indirect tool to detect various kinds of blood manipulations. Autologous blood transfusions are currently undetectable, and the objective of this study was to examine the sensitivities of different blood markers and blood passport approaches in order to det...

  2. A Critical Comparison of Transformation and Deep Approach Theories of Learning

    Science.gov (United States)

    Howie, Peter; Bagnall, Richard

    2015-01-01

    This paper reports a critical comparative analysis of two popular and significant theories of adult learning: the transformation and the deep approach theories of learning. These theories are operative in different educational sectors, are significant, respectively, in each, and they may be seen as both touching on similar concerns with learning…

  3. Comparison of Two Music Training Approaches on Music and Speech Perception in Cochlear Implant Users

    NARCIS (Netherlands)

    Fuller, Christina D; Galvin, John J; Maat, Bert; Başkent, Deniz; Free, Rolien H

    2018-01-01

    In normal-hearing (NH) adults, long-term music training may benefit music and speech perception, even when listening to spectro-temporally degraded signals as experienced by cochlear implant (CI) users. In this study, we compared two different music training approaches in CI users and their effects

  4. A comparison between prescriptive- and performance-based approaches in fire safety design of structures

    DEFF Research Database (Denmark)

    Budny, Iwona; Giuliani, Luisa

    2010-01-01

    methodology of the performance-based fire design approach is considered, with the avail of computer-aided simulations of the main frame of the car-park. Nonlinear analyses, with respect to thermally induced effects and emphasis laid to the collapse modality, are carried out on a frame of the considered...

  5. Comparison between AGC and a tuningless LFC approach based on direct observation of DERs

    DEFF Research Database (Denmark)

    Prostejovsky, Alexander Maria; Marinelli, Mattia

    2017-01-01

    , and the resulting reduction of available inertia. In this paper, we propose a tuningless Load-Frequency Control (LFC) approach able to cope with the changing dynamics of electric power grids. Harnessing the possibilities of modern monitoring and communication means, the so-called Direct Load-Frequency Control (DLFC...

  6. International Students' Motivation and Learning Approach: A Comparison with Local Students

    Science.gov (United States)

    Chue, Kah Loong; Nie, Youyan

    2016-01-01

    Psychological factors contribute to motivation and learning for international students as much as teaching strategies. 254 international students and 144 local students enrolled in a private education institute were surveyed regarding their perception of psychological needs support, their motivation and learning approach. The results from this…

  7. A comparison of two different approaches for mapping potential ozone damage to vegetation. A model study

    International Nuclear Information System (INIS)

    Simpson, D.; Ashmore, M.R.; Emberson, L.; Tuovinen, J.-P.

    2007-01-01

    Two very different types of approaches are currently in use today for indicating risk of ozone damage to vegetation in Europe. One approach is the so-called AOTX (accumulated exposure over threshold of X ppb) index, which is based upon ozone concentrations only. The second type of approach entails an estimate of the amount of ozone entering via the stomates of vegetation, the AFstY approach (accumulated stomatal flux over threshold of Y nmol m -2 s -1 ). The EMEP chemical transport model is used to map these different indicators of ozone damage across Europe, for two illustrative vegetation types, wheat and beech forests. The results show that exceedences of critical levels for either type of indicator are widespread, but that the indicators give very different spatial patterns across Europe. Model simulations for year 2020 scenarios suggest reductions in risks of vegetation damage whichever indicator is used, but suggest that AOT40 is much more sensitive to emission control than AFstY values. - Model calculations of AOT40 and AFstY show very different spatial variations in the risks of ozone damage to vegetation

  8. A Comparison of Three Approaches to Correct for Direct and Indirect Range Restrictions: A Simulation Study

    Science.gov (United States)

    Pfaffel, Andreas; Schober, Barbara; Spiel, Christiane

    2016-01-01

    A common methodological problem in the evaluation of the predictive validity of selection methods, e.g. in educational and employment selection, is that the correlation between predictor and criterion is biased. Thorndike's (1949) formulas are commonly used to correct for this biased correlation. An alternative approach is to view the selection…

  9. Post-closure biosphere assessment modelling: comparison of complex and more stylised approaches.

    Science.gov (United States)

    Walke, Russell C; Kirchner, Gerald; Xu, Shulan; Dverstorp, Björn

    2015-10-01

    Geological disposal facilities are the preferred option for high-level radioactive waste, due to their potential to provide isolation from the surface environment (biosphere) on very long timescales. Assessments need to strike a balance between stylised models and more complex approaches that draw more extensively on site-specific information. This paper explores the relative merits of complex versus more stylised biosphere models in the context of a site-specific assessment. The more complex biosphere modelling approach was developed by the Swedish Nuclear Fuel and Waste Management Co (SKB) for the Formark candidate site for a spent nuclear fuel repository in Sweden. SKB's approach is built on a landscape development model, whereby radionuclide releases to distinct hydrological basins/sub-catchments (termed 'objects') are represented as they evolve through land rise and climate change. Each of seventeen of these objects is represented with more than 80 site specific parameters, with about 22 that are time-dependent and result in over 5000 input values per object. The more stylised biosphere models developed for this study represent releases to individual ecosystems without environmental change and include the most plausible transport processes. In the context of regulatory review of the landscape modelling approach adopted in the SR-Site assessment in Sweden, the more stylised representation has helped to build understanding in the more complex modelling approaches by providing bounding results, checking the reasonableness of the more complex modelling, highlighting uncertainties introduced through conceptual assumptions and helping to quantify the conservatisms involved. The more stylised biosphere models are also shown capable of reproducing the results of more complex approaches. A major recommendation is that biosphere assessments need to justify the degree of complexity in modelling approaches as well as simplifying and conservative assumptions. In light of

  10. Comparison of Two Music Training Approaches on Music and Speech Perception in Cochlear Implant Users.

    Science.gov (United States)

    Fuller, Christina D; Galvin, John J; Maat, Bert; Başkent, Deniz; Free, Rolien H

    2018-01-01

    In normal-hearing (NH) adults, long-term music training may benefit music and speech perception, even when listening to spectro-temporally degraded signals as experienced by cochlear implant (CI) users. In this study, we compared two different music training approaches in CI users and their effects on speech and music perception, as it remains unclear which approach to music training might be best. The approaches differed in terms of music exercises and social interaction. For the pitch/timbre group, melodic contour identification (MCI) training was performed using computer software. For the music therapy group, training involved face-to-face group exercises (rhythm perception, musical speech perception, music perception, singing, vocal emotion identification, and music improvisation). For the control group, training involved group nonmusic activities (e.g., writing, cooking, and woodworking). Training consisted of weekly 2-hr sessions over a 6-week period. Speech intelligibility in quiet and noise, vocal emotion identification, MCI, and quality of life (QoL) were measured before and after training. The different training approaches appeared to offer different benefits for music and speech perception. Training effects were observed within-domain (better MCI performance for the pitch/timbre group), with little cross-domain transfer of music training (emotion identification significantly improved for the music therapy group). While training had no significant effect on QoL, the music therapy group reported better perceptual skills across training sessions. These results suggest that more extensive and intensive training approaches that combine pitch training with the social aspects of music therapy may further benefit CI users.

  11. A comparison of direct aspiration versus stent retriever as a first approach ('COMPASS'): protocol.

    Science.gov (United States)

    Turk, Aquilla S; Siddiqui, Adnan H; Mocco, J

    2018-02-20

    Acute ischemic stroke is a potentially devastating condition and leading cause of morbidity and mortality, affecting an estimated 800 000 people per year in the USA. The natural history of untreated or unrevascularized large vessel occlusions in acute stroke patients results in mortality rates approaching 30%, with only 25% achieving good neurologic outcomes at 90 days. Recently, data have demonstrated that early endovascular recanalization of large vessel occlusions results in better outcomes than medical therapy alone. However, the majority of patients in these studies were treated with a stent retriever based approach. The purpose of COMPASS is to evaluate whether patients treated with a direct aspiration first pass (ADAPT) approach have non-inferior functional outcomes to those treated with a stent retriever as the firstline (SRFL) approach. All patients who meet the inclusion and exclusion criteria and consent to participate will be enrolled at participating centers. Treatment will be randomly assigned by a central web based system in a 1:1 manner to treatment with either ADAPT or SRFL thrombectomy. Statistical methodology is prespecified with details available in the statistical analysis plan. The trial recently completed enrollment, and data collection/verification is ongoing. The final results will be made available on completion of enrollment and follow-up. This paper details the design of the COMPASS trial, a randomized, blinded adjudicator, concurrent, controlled trial of patients treated with either ADAPT or SRFL approaches in order to evaluate whether ADAPT results in non-inferior functional outcome. NCT02466893, Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. A comparison of regional flood frequency analysis approaches in a simulation framework

    Science.gov (United States)

    Ganora, D.; Laio, F.

    2016-07-01

    Regional frequency analysis (RFA) is a well-established methodology to provide an estimate of the flood frequency curve at ungauged (or scarcely gauged) sites. Different RFA approaches exist, depending on the way the information is transferred to the site of interest, but it is not clear in the literature if a specific method systematically outperforms the others. The aim of this study is to provide a framework wherein carrying out the intercomparison by building up a virtual environment based on synthetically generated data. The considered regional approaches include: (i) a unique regional curve for the whole region; (ii) a multiple-region model where homogeneous subregions are determined through cluster analysis; (iii) a Region-of-Influence model which defines a homogeneous subregion for each site; (iv) a spatially smooth estimation procedure where the parameters of the regional model vary continuously along the space. Virtual environments are generated considering different patterns of heterogeneity, including step change and smooth variations. If the region is heterogeneous, with the parent distribution changing continuously within the region, the spatially smooth regional approach outperforms the others, with overall errors 10-50% lower than the other methods. In the case of a step-change, the spatially smooth and clustering procedures perform similarly if the heterogeneity is moderate, while clustering procedures work better when the step-change is severe. To extend our findings, an extensive sensitivity analysis has been performed to investigate the effect of sample length, number of virtual stations, return period of the predicted quantile, variability of the scale parameter of the parent distribution, number of predictor variables and different parent distribution. Overall, the spatially smooth approach appears as the most robust approach as its performances are more stable across different patterns of heterogeneity, especially when short records are

  13. Performance comparison of novel WNN approach with RBFNN in navigation of autonomous mobile robotic agent

    Directory of Open Access Journals (Sweden)

    Ghosh Saradindu

    2016-01-01

    Full Text Available This paper addresses the performance comparison of Radial Basis Function Neural Network (RBFNN with novel Wavelet Neural Network (WNN of designing intelligent controllers for path planning of mobile robot in an unknown environment. In the proposed WNN, different types of activation functions such as Mexican Hat, Gaussian and Morlet wavelet functions are used in the hidden nodes. The neural networks are trained by an intelligent supervised learning technique so that the robot makes a collision-free path in the unknown environment during navigation from different starting points to targets/goals. The efficiency of two algorithms is compared using some MATLAB simulations and experimental setup with Arduino Mega 2560 microcontroller in terms of path length and time taken to reach the target as an indicator for the accuracy of the network models.

  14. Comparison of Functional and Radiological Outcomes Between Two Posterior Approaches in the Treatment of Multilevel Cervical Spondylotic Myelopathy

    Directory of Open Access Journals (Sweden)

    Da-Jiang Ren

    2015-01-01

    Full Text Available Background: Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy (CSM. Each posterior technique has its own advantages and disadvantages. In the present study, we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM. Methods: Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery, Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study. Patients were divided into two groups by surgical procedure: Laminoplasty (Group L and hemilaminectomy (Group H. Perioperative parameters including age, sex, duration of symptoms, operative duration, and intraoperative blood loss were recorded and compared. Spinal canal area, calculated using AutoCAD ® software(Autodesk Inc., San Rafael, CA, USA, and neurological improvement, evaluated with Japanese Orthopedic Association score, were also compared. Results: Neurological improvement did not differ significantly between groups. Group H had a significantly shorter operative duration and significantly less blood loss. Mean expansion ratio was significantly greater in Group L (77.83 ± 6.41% than in Group H (62.72 ± 3.86% (P < 0.01. Conclusions: Both surgical approaches are safe and effective in treating multilevel CSM. Laminoplasty provides a greater degree of enlargement of the spinal canal, whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.

  15. Comparison of Functional and Radiological Outcomes Between Two Posterior Approaches in the Treatment of Multilevel Cervical Spondylotic Myelopathy.

    Science.gov (United States)

    Ren, Da-Jiang; Li, Fang; Zhang, Zhi-Cheng; Kai, Guan; Shan, Jian-Lin; Zhao, Guang-Min; Sun, Tian-Sheng

    2015-08-05

    Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy (CSM). Each posterior technique has its own advantages and disadvantages. In the present study, we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM. Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery, Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study. Patients were divided into two groups by surgical procedure: Laminoplasty (Group L) and hemilaminectomy (Group H). Perioperative parameters including age, sex, duration of symptoms, operative duration, and intraoperative blood loss were recorded and compared. Spinal canal area, calculated using AutoCAD ® software(Autodesk Inc., San Rafael, CA, USA), and neurological improvement, evaluated with Japanese Orthopedic Association score, were also compared. Neurological improvement did not differ significantly between groups. Group H had a significantly shorter operative duration and significantly less blood loss. Mean expansion ratio was significantly greater in Group L (77.83 ± 6.41%) than in Group H (62.72 ± 3.86%) (P < 0.01). Both surgical approaches are safe and effective in treating multilevel CSM. Laminoplasty provides a greater degree of enlargement of the spinal canal, whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.

  16. A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches.

    Science.gov (United States)

    Martino, Martin A; Berger, Elizabeth A; McFetridge, Jeffrey T; Shubella, Jocelyn; Gosciniak, Gabrielle; Wejkszner, Taylor; Kainz, Gregory F; Patriarco, Jeremy; Thomas, M Bijoy; Boulay, Richard

    2014-01-01

    To measure procedure-related hospital readmissions within 30 days after discharge for patients who have a hysterectomy for benign disease. Secondary outcome quality measures evaluated were cost, estimated blood loss, length of stay and sum of costs associated with readmissions. Retrospective cohort study (Canadian Task Force classification II-2). Academic community hospital. Patients who underwent hysterectomy to treat benign disease from January 2008 to December 2012. Patients were grouped according to route of hysterectomy: robotic-assisted laparoscopic hysterectomy (robotic), laparoscopic hysterectomy (laparoscopic), abdominal hysterectomy (open via laparotomy), and vaginal hysterectomy (vaginal). Inclusion criteria were met by 2554 patients: 601 in the robotic group, 427 in the laparoscopic group, 1194 in the abdominal group, and 332 in the vaginal group. Readmission rates in the robotic cohort were significantly less (probotic cohorts: Robotic (1%), laparoscopic (2.5%), open (3.5%), vaginal (2.4%). Estimated blood loss, length of stay, and sum of readmission costs were also significantly less in the robotic cohort (probotic-assisted laparoscopic hysterectomy have a significantly lower chance of readmission robotics cohort also experienced a shorter length of stay, less estimated blood loss, and a cost savings associated with readmissions when compared to non-robotic approaches. Prospective registries describing quality outcomes, total sum of costs including 30 days follow-up, as well as patient-related quality of life benefits are recommended to confirm these findings and determine which surgical route offers the highest patient and societal value. Copyright © 2014. Published by Elsevier Inc.

  17. A comparison of two approaches to managing acute primary angle closure in Asian eyes

    Directory of Open Access Journals (Sweden)

    Ho H

    2013-06-01

    Full Text Available Henrietta Ho,1 Paul T Chew,2 Chelvin Sng,1,2 Huiqi Huang,1 Tin Aung,1,2 Shamira A Perera1,21Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; 2Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, SingaporePurpose: To review the management regimes of acute primary angle closure (APAC in two hospitals in Singapore, and to identify the incidence of and risk factors for progression to glaucomatous optic neuropathy.Methods: We conducted a retrospective review of 40 patients from National University Hospital (NUH and 52 patients from Singapore National Eye Centre (SNEC who were diagnosed with APAC. Patients were treated with similar protocols of intensive medical therapy until laser peripheral iridotomy could be performed. In the event of failed medical treatment, patients at NUH only underwent laser iridoplasty. The 1-year outcomes were reviewed.Results: The demographic features of patients and presenting intraocular pressures (IOP were similar in both centers. More patients from NUH presented within 3 days of symptom onset, compared to those from SNEC (90.0% versus 71.2%, respectively (P = 0.037. The mean ± standard deviation time to break the attack was 18.2 ± 32.9 hours at SNEC and 9.80 ± 10.6 hours at NUH (P = 0.11. The mean follow up duration was 18.8 ± 14.0 months. Nineteen patients (36.5% from SNEC and six patients (22.5% from NUH developed raised IOP (P = 0.032 within 1-year of the attack. Of these, glaucomatous optic neuropathy developed in thirteen patients (68.4% from SNEC and all six patients (100% from NUH. At final review, the mean IOP of the APAC eye was 14.8 ± 4.3 mmHg from SNEC and 13.4 ± 3.0 mmHg from NUH. There was no significant difference in final visual acuity or IOP between both groups.Conclusion: Treatment strategies in both centers were effective in aborting an APAC attack. The development of raised IOP appears to be associated with a longer

  18. Predictive Utility of Personality Disorder in Depression: Comparison of Outcomes and Taxonomic Approach.

    Science.gov (United States)

    Newton-Howes, Giles; Mulder, Roger; Ellis, Pete M; Boden, Joseph M; Joyce, Peter

    2017-09-19

    There is debate around the best model for diagnosing personality disorder, both in terms of its relationship to the empirical data and clinical utility. Four randomized controlled trials examining various treatments for depression were analyzed at an individual patient level. Three different approaches to the diagnosis of personality disorder were analyzed in these patients. A total of 578 depressed patients were included in the analysis. Personality disorder, however measured, was of little predictive utility in the short term but added significantly to predictive modelling of medium-term outcomes, accounting for more than twice as much of the variance in social functioning outcome as depression psychopathology. Personality disorder assessment is of predictive utility with longer timeframes and when considering social outcomes as opposed to symptom counts. This utility is sufficiently great that there appears to be value in assessing personality; however, no particular approach outperforms any other.

  19. Comparison of different Kalman filter approaches in deriving time varying connectivity from EEG data.

    Science.gov (United States)

    Ghumare, Eshwar; Schrooten, Maarten; Vandenberghe, Rik; Dupont, Patrick

    2015-08-01

    Kalman filter approaches are widely applied to derive time varying effective connectivity from electroencephalographic (EEG) data. For multi-trial data, a classical Kalman filter (CKF) designed for the estimation of single trial data, can be implemented by trial-averaging the data or by averaging single trial estimates. A general linear Kalman filter (GLKF) provides an extension for multi-trial data. In this work, we studied the performance of the different Kalman filtering approaches for different values of signal-to-noise ratio (SNR), number of trials and number of EEG channels. We used a simulated model from which we calculated scalp recordings. From these recordings, we estimated cortical sources. Multivariate autoregressive model parameters and partial directed coherence was calculated for these estimated sources and compared with the ground-truth. The results showed an overall superior performance of GLKF except for low levels of SNR and number of trials.

  20. Alcohol intake and colorectal cancer: a comparison of approaches for including repeated measures of alcohol consumption

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Wu, Kana; Grønbaek, Morten

    2008-01-01

    BACKGROUND: In numerous studies, alcohol intake has been found to be positively associated with colorectal cancer risk. However, the majority of studies included only one exposure measurement, which may bias the results if long-term intake is relevant.METHODS: We compared different approaches...... for including repeated measures of alcohol intake among 47,432 US men enrolled in the Health Professionals Follow-up Study. Questionnaires including questions on alcohol intake had been completed in 1986, 1990, 1994, and 1998. The outcome was incident colorectal cancer during follow-up from 1986 to 2002.RESULTS......: During follow-up, 868 members of the cohort experienced colorectal cancer. Baseline, updated, and cumulative average alcohol intakes were positively associated with colorectal cancer, with only minor differences among the approaches. These results support moderately increased risk for intake >30 g...

  1. Neurobiological studies of risk assessment: A comparison of expected utility and mean-variance approaches

    OpenAIRE

    d'Acremont, M.; Bossaerts, Peter

    2008-01-01

    When modeling valuation under uncertainty, economists generally prefer expected utility because it has an axiomatic foundation, meaning that the resulting choices will satisfy a number of rationality requirements. In expected utility theory, values are computed by multiplying probabilities of each possible state of nature by the payoff in that state and summing the results. The drawback of this approach is that all state probabilities need to be dealt with separately, which becomes extremely ...

  2. Sample preparation with solid phase microextraction and exhaustive extraction approaches: Comparison for challenging cases.

    Science.gov (United States)

    Boyacı, Ezel; Rodríguez-Lafuente, Ángel; Gorynski, Krzysztof; Mirnaghi, Fatemeh; Souza-Silva, Érica A; Hein, Dietmar; Pawliszyn, Janusz

    2015-05-11

    In chemical analysis, sample preparation is frequently considered the bottleneck of the entire analytical method. The success of the final method strongly depends on understanding the entire process of analysis of a particular type of analyte in a sample, namely: the physicochemical properties of the analytes (solubility, volatility, polarity etc.), the environmental conditions, and the matrix components of the sample. Various sample preparation strategies have been developed based on exhaustive or non-exhaustive extraction of analytes from matrices. Undoubtedly, amongst all sample preparation approaches, liquid extraction, including liquid-liquid (LLE) and solid phase extraction (SPE), are the most well-known, widely used, and commonly accepted methods by many international organizations and accredited laboratories. Both methods are well documented and there are many well defined procedures, which make them, at first sight, the methods of choice. However, many challenging tasks, such as complex matrix applications, on-site and in vivo applications, and determination of matrix-bound and free concentrations of analytes, are not easily attainable with these classical approaches for sample preparation. In the last two decades, the introduction of solid phase microextraction (SPME) has brought significant progress in the sample preparation area by facilitating on-site and in vivo applications, time weighted average (TWA) and instantaneous concentration determinations. Recently introduced matrix compatible coatings for SPME facilitate direct extraction from complex matrices and fill the gap in direct sampling from challenging matrices. Following introduction of SPME, numerous other microextraction approaches evolved to address limitations of the above mentioned techniques. There is not a single method that can be considered as a universal solution for sample preparation. This review aims to show the main advantages and limitations of the above mentioned sample

  3. A Comparison of Organizational Structure and Pedagogical Approach: Online versus Face-to-face

    OpenAIRE

    Donovan A. McFarlane

    2011-01-01

    This paper examines online versus face-to-face organizational structure and pedagogy in terms of education and the teaching and learning process. The author distinguishes several important terms related to distance/online/e-learning, virtual learning and brick-and-mortar learning interactions and concepts such as asynchronous and synchronous interactions, etc, before deliberating on perceived differences in organizational structure and pedagogical approaches of virtual and brick-and-mortar sc...

  4. Comparison between endoscopic and microscopic approaches for surgery of pituitary tumours.

    Science.gov (United States)

    Khan, Inamullah; Shamim, Muhammad Shahzad

    2017-11-01

    Surgical techniques for resection of pituitary tumours have come a long way since it was first introduced in late 18th century. Nowadays, most pituitary surgeries are performed through trans-nasal trans-sphenoidal approach either using a microscope, or an endoscope. Herein the authors review the literature and compare these two instruments with regards to their outcomes when used for resection of pituitary tumours. .

  5. Optimal PID settings for first and second-order processes - Comparison with different controller tuning approaches

    OpenAIRE

    Pappas, Iosif

    2016-01-01

    PID controllers are extensively used in industry. Although many tuning methodologies exist, finding good controller settings is not an easy task and frequently optimization-based design is preferred to satisfy more complex criteria. In this thesis, the focus was to find which tuning approaches, if any, present close to optimal behavior. Pareto-optimal controllers were found for different first and second-order processes with time delay. Performance was quantified in terms of the integrat...

  6. Comparison of numerical approaches to solve a Poincare-covariant Faddeev equation

    International Nuclear Information System (INIS)

    Alkofer, R.; Eichmann, G.; Krassnigg, A.; Schwinzerl, M.

    2006-01-01

    Full text: The quark core of Baryons can be described with the help of the numerical solution of the Poincare-Faddeev equation. Hereby the used elements, as e.g. the quark propagator are taken from non-perturbative studies of Landau gauge QCD. Different numerical approaches to solve in this way the relativistic three quark problem are compared and benchmarked results for the efficiency of different algorithms are presented. (author)

  7. Comparisons of single-stage and two-stage approaches to genomic selection.

    Science.gov (United States)

    Schulz-Streeck, Torben; Ogutu, Joseph O; Piepho, Hans-Peter

    2013-01-01

    Genomic selection (GS) is a method for predicting breeding values of plants or animals using many molecular markers that is commonly implemented in two stages. In plant breeding the first stage usually involves computation of adjusted means for genotypes which are then used to predict genomic breeding values in the second stage. We compared two classical stage-wise approaches, which either ignore or approximate correlations among the means by a diagonal matrix, and a new method, to a single-stage analysis for GS using ridge regression best linear unbiased prediction (RR-BLUP). The new stage-wise method rotates (orthogonalizes) the adjusted means from the first stage before submitting them to the second stage. This makes the errors approximately independently and identically normally distributed, which is a prerequisite for many procedures that are potentially useful for GS such as machine learning methods (e.g. boosting) and regularized regression methods (e.g. lasso). This is illustrated in this paper using componentwise boosting. The componentwise boosting method minimizes squared error loss using least squares and iteratively and automatically selects markers that are most predictive of genomic breeding values. Results are compared with those of RR-BLUP using fivefold cross-validation. The new stage-wise approach with rotated means was slightly more similar to the single-stage analysis than the classical two-stage approaches based on non-rotated means for two unbalanced datasets. This suggests that rotation is a worthwhile pre-processing step in GS for the two-stage approaches for unbalanced datasets. Moreover, the predictive accuracy of stage-wise RR-BLUP was higher (5.0-6.1%) than that of componentwise boosting.

  8. Comparison of approaches for the characterization of contamination at rural megasites

    DEFF Research Database (Denmark)

    Rein, Arno; Popp, Steffen; Zacharias, Steffen

    2011-01-01

    the complete area. The DP investigation provided information on the contamination distribution and yielded also important information on hydraulic conditions. Statistical analysis of the results applying indicator kriging revealed that the conventional approach is markedly risky when decision-making relies...... consideration into account, DP-based groundwater screening is recommended to obtain either first or complementary information on the entire site. Based on these data, also locations for a long-term monitoring could be selected if temporal variability is assumed relevant....

  9. Accounting for context in studies of health inequalities: a review and comparison of analytic approaches.

    Science.gov (United States)

    Schempf, Ashley H; Kaufman, Jay S

    2012-10-01

    A common epidemiologic objective is to evaluate the contribution of residential context to individual-level disparities by race or socioeconomic position. We reviewed analytic strategies to account for the total (observed and unobserved factors) contribution of environmental context to health inequalities, including conventional fixed effects (FE) and hybrid FE implemented within a random effects (RE) or a marginal model. To illustrate results and limitations of the various analytic approaches of accounting for the total contextual component of health disparities, we used data on births nested within neighborhoods as an applied example of evaluating neighborhood confounding of racial disparities in gestational age at birth, including both a continuous and a binary outcome. Ordinary and RE models provided disparity estimates that can be substantially biased in the presence of neighborhood confounding. Both FE and hybrid FE models can account for cluster level confounding and provide disparity estimates unconfounded by neighborhood, with the latter having greater flexibility in allowing estimation of neighborhood-level effects and intercept/slope variability when implemented in a RE specification. Given the range of models that can be implemented in a hybrid approach and the frequent goal of accounting for contextual confounding, this approach should be used more often. Published by Elsevier Inc.

  10. Comparison of scientific and engineering approaches to the treatment of mixed wastes

    International Nuclear Information System (INIS)

    Gilbert, K.V.; Bowers, J.S.

    1993-12-01

    This paper discusses two approaches to the treatment of mixed waste. (Mixed waste, defined as radioactive waste that is co-contaminated with hazardous waste as defined in the Resource Conservation and Conservation Act, is presently stored throughout the United States awaiting the establishment of treatment capability.)The first approach employs conventional engineering that focuses on low risk technology which has been proven in other industries in similar applications and is adaptable for waste treatment use. The term ''low risk'' means that implementation success is relatively certain, and the major uncertainty is the degree of success. Technologies under consideration include centrifugation, evaporation, microfiltration and stabilization. Process offgases are treated with traditional scrubbers and carbon absorption units.For the scientific approach, Lawrence Livermore National Laboratory is in the conceptual design phase of a project to demonstrate incinerator alternatives to destroy organic contaminants in radioactive waste streams without the use of incineration. This Mixed Waste Management Facility will use approximately 15000 square feet of an existing facility to demonstrate an integrated waste management system. Robotic and telerobotic systems will be employed for waste segregation, characterization and feed preparation. Waste feeds will be treated using molten salt oxidation, mediated electrochemical oxidation and wet oxidation. Residues, which can be managed as radioactive-only waste, will be immobilized in an organic matrix prior to shipment to an authorized disposal site

  11. A comparison of bilingual education and generalist teachers' approaches to scientific biliteracy

    Science.gov (United States)

    Garza, Esther

    The purpose of this study was to determine if educators were capitalizing on bilingual learners' use of their biliterate abilities to acquire scientific meaning and discourse that would formulate a scientific biliterate identity. Mixed methods were used to explore teachers' use of biliteracy and Funds of Knowledge (Moll, L., Amanti, C., Neff, D., & Gonzalez, N., 1992; Gonzales, Moll, & Amanti, 2005) from the students' Latino heritage while conducting science inquiry. The research study explored four constructs that conceptualized scientific biliteracy. The four constructs include science literacy, science biliteracy, reading comprehension strategies and students' cultural backgrounds. There were 156 4th-5th grade bilingual and general education teachers in South Texas that were surveyed using the Teacher Scientific Biliteracy Inventory (TSBI) and five teachers' science lessons were observed. Qualitative findings revealed that a variety of scientific biliteracy instructional strategies were frequently used in both bilingual and general education classrooms. The language used to deliver this instruction varied. A General Linear Model revealed that classroom assignment, bilingual or general education, had a significant effect on a teacher's instructional approach to employ scientific biliteracy. A simple linear regression found that the TSBI accounted for 17% of the variance on 4th grade reading benchmarks. Mixed methods results indicated that teachers were utilizing scientific biliteracy strategies in English, Spanish and/or both languages. Household items and science experimentation at home were encouraged by teachers to incorporate the students' cultural backgrounds. Finally, science inquiry was conducted through a universal approach to science learning versus a multicultural approach to science learning.

  12. A comparison of two surgical approaches to the scapulohumeral joint in dogs.

    Science.gov (United States)

    McLaughlin, R; Roush, J K

    1995-01-01

    Two scapulohumeral arthrotomy techniques were evaluated and compared in 10 normal, young adult greyhounds. A caudolateral approach with craniodorsal retraction of the teres minor muscle (no-tenotomy) and a craniolateral approach with tenotomy of the infraspinatus tendon were each performed unilaterally in 5 dogs. The dogs were evaluated using force plate gait analysis, lameness evaluation, radiography, and goniometry for 5 weeks and then euthanatized. Tenotomy sites and sections of the humeral articular cartilage were collected from shoulder joints that had been operated on and examined microscopically. The same surgical approach has then performed on the contralateral shoulder in the cadavers and exposure of the humeral articular cartilage was measured using planimetry. Peak vertical force applied to the operated limbs in the tenotomy group was significantly less than preoperative leads on day 3 and significantly less than the no-tenotomy group on days 21 and 28. The peak vertical force applied to the operated limbs in the no-tenotomy group was not significantly different from preoperative levels during the study. Scapulohumeral arthrotomy by tenotomy of the infraspinatus resulted in decreased range-of-motion and joint extension compared with joints operated on without tenotomies, but provided significantly greater exposure to the articular surface. Scapulohumeral arthrotomy with craniodorsal retraction of the teres minor muscle did not significantly alter goniometric measurements compared with unoperated joints. Both techniques resulted in similar subjective lameness scores and caused no gross microscopic or radiographic evidence of articular cartilage damage.

  13. Comparison of Australian and American orthodontic clinical approaches towards root resorption.

    Science.gov (United States)

    Lim, Elaine; Sameshima, Glenn; Petocz, Peter; Darendeliler, Ali

    2012-11-01

    As part of The Rocky Mountain Travelling Fellowship, a pilot survey was conducted to assess current diagnostic and clinical approaches to the management of orthodontic patients in relation to root resorption. Groups comprising Australians (Sydney, New South Wales) and North Americans (Los Angeles, California), in two stages of their orthodontic careers (post-graduate orthodontic students from the University of Sydney and University of Southern California and qualified practising orthodontists) were asked to complete a questionnaire. The questions examined diagnosis and management approaches related to root resorption used in their clinical practice. Replies demonstrated that there were differences in management depending on operator experience and the country of clinical practice. However, a summarised common approach to orthodontic root resorption comprised (1) the use of an orthopantomogram as a screening diagnostic tool, followed by periapical radiographs for those perceived as 'higher risk' patients, particularly individuals with a history of root resorption; (2) a six monthly radiographic review during treatment; (3) the use of light forces and/or rest periods (discontinuous forces) every two to three months; (4) the extraction of deciduous teeth if permanent successors were erupting ectopically and causing damage to adjacent root structures; and (5) the use of fixed retention after treatment. This project was intended to initiate discussion and form a basis for further investigation into the clinical management of orthodontic root resorption.

  14. Neurobiological studies of risk assessment: a comparison of expected utility and mean-variance approaches.

    Science.gov (United States)

    D'Acremont, Mathieu; Bossaerts, Peter

    2008-12-01

    When modeling valuation under uncertainty, economists generally prefer expected utility because it has an axiomatic foundation, meaning that the resulting choices will satisfy a number of rationality requirements. In expected utility theory, values are computed by multiplying probabilities of each possible state of nature by the payoff in that state and summing the results. The drawback of this approach is that all state probabilities need to be dealt with separately, which becomes extremely cumbersome when it comes to learning. Finance academics and professionals, however, prefer to value risky prospects in terms of a trade-off between expected reward and risk, where the latter is usually measured in terms of reward variance. This mean-variance approach is fast and simple and greatly facilitates learning, but it impedes assigning values to new gambles on the basis of those of known ones. To date, it is unclear whether the human brain computes values in accordance with expected utility theory or with mean-variance analysis. In this article, we discuss the theoretical and empirical arguments that favor one or the other theory. We also propose a new experimental paradigm that could determine whether the human brain follows the expected utility or the mean-variance approach. Behavioral results of implementation of the paradigm are discussed.

  15. Basic echocardiography for undergraduate students: a comparison of different peer-teaching approaches.

    Science.gov (United States)

    Gradl-Dietsch, G; Menon, A K; Gürsel, A; Götzenich, A; Hatam, N; Aljalloud, A; Schrading, S; Hölzl, F; Knobe, M

    2018-02-01

    The aim of this study was to assess the impact of different teaching interventions in a peer-teaching environment on basic echocardiography skills and to examine the influence of gender on learning outcomes. We randomly assigned 79 s year medical students (55 women, 24 men) to one of four groups: peer teaching (PT), peer teaching using Peyton's four-step approach (PPT), team based learning (TBL) and video-based learning (VBL). All groups received theoretical and practical hands-on training according to the different approaches. Using a pre-post-design we assessed differences in theoretical knowledge [multiple choice (MC) exam], practical skills (Objective Structured Practical Examination, OSPE) and evaluation results with respect to gender. There was a significant gain in theoretical knowledge for all students. There were no relevant differences between the four groups regarding the MC exam and OSPE results. The majority of students achieved good or very good results. Acceptance of the peer-teaching concept was moderate and all students preferred medical experts to peer tutors even though the overall rating of the instructors was fairly good. Students in the Video group would have preferred a different training method. There was no significant effect of gender on evaluation results. Using different peer-teaching concepts proved to be effective in teaching basic echocardiography. Gender does not seem to have an impact on effectiveness of the instructional approach. Qualitative analysis revealed limited acceptance of peer teaching and especially of video-based instruction.

  16. Optimising MR perfusion imaging: comparison of different software-based approaches in acute ischaemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Schaafs, Lars-Arne [Charite-Universitaetsmedizin, Department of Radiology, Berlin (Germany); Charite-Universitaetsmedizin, Academic Neuroradiology, Department of Neurology and Center for Stroke Research, Berlin (Germany); Porter, David [Fraunhofer Institute for Medical Image Computing MEVIS, Bremen (Germany); Audebert, Heinrich J. [Charite-Universitaetsmedizin, Department of Neurology with Experimental Neurology, Berlin (Germany); Fiebach, Jochen B.; Villringer, Kersten [Charite-Universitaetsmedizin, Academic Neuroradiology, Department of Neurology and Center for Stroke Research, Berlin (Germany)

    2016-11-15

    Perfusion imaging (PI) is susceptible to confounding factors such as motion artefacts as well as delay and dispersion (D/D). We evaluate the influence of different post-processing algorithms on hypoperfusion assessment in PI analysis software packages to improve the clinical accuracy of stroke PI. Fifty patients with acute ischaemic stroke underwent MRI imaging in the first 24 h after onset. Diverging approaches to motion and D/D correction were applied. The calculated MTT and CBF perfusion maps were assessed by volumetry of lesions and tested for agreement with a standard approach and with the final lesion volume (FLV) on day 6 in patients with persisting vessel occlusion. MTT map lesion volumes were significantly smaller throughout the software packages with correction of motion and D/D when compared to the commonly used approach with no correction (p = 0.001-0.022). Volumes on CBF maps did not differ significantly (p = 0.207-0.925). All packages with advanced post-processing algorithms showed a high level of agreement with FLV (ICC = 0.704-0.879). Correction of D/D had a significant influence on estimated lesion volumes and leads to significantly smaller lesion volumes on MTT maps. This may improve patient selection. (orig.)

  17. Optimising MR perfusion imaging: comparison of different software-based approaches in acute ischaemic stroke

    International Nuclear Information System (INIS)

    Schaafs, Lars-Arne; Porter, David; Audebert, Heinrich J.; Fiebach, Jochen B.; Villringer, Kersten

    2016-01-01

    Perfusion imaging (PI) is susceptible to confounding factors such as motion artefacts as well as delay and dispersion (D/D). We evaluate the influence of different post-processing algorithms on hypoperfusion assessment in PI analysis software packages to improve the clinical accuracy of stroke PI. Fifty patients with acute ischaemic stroke underwent MRI imaging in the first 24 h after onset. Diverging approaches to motion and D/D correction were applied. The calculated MTT and CBF perfusion maps were assessed by volumetry of lesions and tested for agreement with a standard approach and with the final lesion volume (FLV) on day 6 in patients with persisting vessel occlusion. MTT map lesion volumes were significantly smaller throughout the software packages with correction of motion and D/D when compared to the commonly used approach with no correction (p = 0.001-0.022). Volumes on CBF maps did not differ significantly (p = 0.207-0.925). All packages with advanced post-processing algorithms showed a high level of agreement with FLV (ICC = 0.704-0.879). Correction of D/D had a significant influence on estimated lesion volumes and leads to significantly smaller lesion volumes on MTT maps. This may improve patient selection. (orig.)

  18. Indicators for assessment of rural electrification-An approach for the comparison of apples and pears

    International Nuclear Information System (INIS)

    Ilskog, Elisabeth

    2008-01-01

    Despite a large number of rural electrification projects being implemented in developing countries, there are few published in-depth evaluations of the effects of these projects on sustainable development. There is also no generally accepted method for the assessment of such effects that includes all relevant aspects of sustainability. An issue of growing importance is whether rural electrification implemented by private entrepreneurs or other non-governmental organisations contribute more effectively to sustainable development than the conventional approach where rural electrification is the responsibility of a government utility. This paper presents a method for sustainability evaluation based on the use of 39 indicators. The proposed indicators cover the five dimensions of sustainability: technical, economical, social/ethical, environmental and institutional sustainability. The paper presents the indicators and gives a detailed example of the procedure to calculate an indicator based on information that can realistically be collected in field studies. It is suggested that this interdisciplinary approach will lead to an improved basis for evaluation of projects than previous, more limited approaches. Projects promoted on the basis of information only about prioritised dimensions of sustainability, such as environment, may fail as a result of weaknesses in other dimensions. The proposed method may reduce this risk

  19. Link removal for the control of stochastically evolving epidemics over networks: a comparison of approaches.

    Science.gov (United States)

    Enns, Eva A; Brandeau, Margaret L

    2015-04-21

    For many communicable diseases, knowledge of the underlying contact network through which the disease spreads is essential to determining appropriate control measures. When behavior change is the primary intervention for disease prevention, it is important to understand how to best modify network connectivity using the limited resources available to control disease spread. We describe and compare four algorithms for selecting a limited number of links to remove from a network: two "preventive" approaches (edge centrality, R0 minimization), where the decision of which links to remove is made prior to any disease outbreak and depends only on the network structure; and two "reactive" approaches (S-I edge centrality, optimal quarantining), where information about the initial disease states of the nodes is incorporated into the decision of which links to remove. We evaluate the performance of these algorithms in minimizing the total number of infections that occur over the course of an acute outbreak of disease. We consider different network structures, including both static and dynamic Erdös-Rényi random networks with varying levels of connectivity, a real-world network of residential hotels connected through injection drug use, and a network exhibiting community structure. We show that reactive approaches outperform preventive approaches in averting infections. Among reactive approaches, removing links in order of S-I edge centrality is favored when the link removal budget is small, while optimal quarantining performs best when the link removal budget is sufficiently large. The budget threshold above which optimal quarantining outperforms the S-I edge centrality algorithm is a function of both network structure (higher for unstructured Erdös-Rényi random networks compared to networks with community structure or the real-world network) and disease infectiousness (lower for highly infectious diseases). We conduct a value-of-information analysis of knowing which

  20. Quantitative Comparison of Ternary Eutectic Phase-Field Simulations with Analytical 3D Jackson-Hunt Approaches

    Science.gov (United States)

    Steinmetz, Philipp; Kellner, Michael; Hötzer, Johannes; Nestler, Britta

    2018-02-01

    For the analytical description of the relationship between undercoolings, lamellar spacings and growth velocities during the directional solidification of ternary eutectics in 2D and 3D, different extensions based on the theory of Jackson and Hunt are reported in the literature. Besides analytical approaches, the phase-field method has been established to study the spatially complex microstructure evolution during the solidification of eutectic alloys. The understanding of the fundamental mechanisms controlling the morphology development in multiphase, multicomponent systems is of high interest. For this purpose, a comparison is made between the analytical extensions and three-dimensional phase-field simulations of directional solidification in an ideal ternary eutectic system. Based on the observed accordance in two-dimensional validation cases, the experimentally reported, inherently three-dimensional chain-like pattern is investigated in extensive simulation studies. The results are quantitatively compared with the analytical results reported in the literature, and with a newly derived approach which uses equal undercoolings. A good accordance of the undercooling-spacing characteristics between simulations and the analytical Jackson-Hunt apporaches are found. The results show that the applied phase-field model, which is based on the Grand potential approach, is able to describe the analytically predicted relationship between the undercooling and the lamellar arrangements during the directional solidification of a ternary eutectic system in 3D.

  1. A Cross-Disciplinary Successful Aging Intervention and Evaluation: Comparison of Person-to-Person and Digital-Assisted Approaches

    Directory of Open Access Journals (Sweden)

    Hui-Chuan Hsu

    2018-05-01

    Full Text Available Background: Successful aging has been the paradigm of old-age life. The purpose of this study was to implement and evaluate a cross-disciplinary intervention program using two approaches for community-based older adults in Taichung, Taiwan. Methods: The content of the intervention included successful aging concepts and preparation, physical activity, chronic disease and health management, dietary and nutrition information, cognitive training, emotional awareness and coping skills, family relationship and resilience, legal concepts regarding financial protection, and Internet use. The traditional person-to-person (P2P intervention approach was implemented among participants at urban centers, and the personal-and-digital (P&D intervention approach was implemented among participants at rural centers; before the P&D group received the intervention, participants were assessed as the control group for comparison. Results: Healthy behavior and nutrition improved for the P2P group, although not significantly. Strategies for adapting to old age and reducing ineffective coping were significantly improved in the P2P group. The ability to search for health information improved in the P&D group, and knowledge of finance-related law increased in the P2P group. Conclusion: A continuous, well-designed and evidence-based intervention program is beneficial for improving the health of older adults, or at least delaying its decline.

  2. Monitoring the training intensity and recovery with a psychometrics approach: a gender comparison with young athletes

    Directory of Open Access Journals (Sweden)

    Ramon Cruz

    2017-12-01

    Full Text Available Abstract AIMS The purpose of present study was verify if the RPE-training session differs between females and males during the track and field training and if biological maturity (BM has interference on this response. METHODS Seventy-five athletes (13-15 years old have participated of study, with 38 male 37 female. Five training sessions of track and field were prescribe and monitoring by RPE-training session (intensity and Total Quality Recovery (TQR (recovery. RESULTS There was no statistical difference between males and females on 75-meters run, long jump and shot put. Otherwise, for training of 250 and 1000-meters females related higher RPE-values than males 3.68 ± 0.79, 3.26 ± 0.56, p < 0.01 and 4.14 ± 0.94, 3.72 ± 0.89, p < 0.05; respectively. Even when controlling the effect of biological maturity the same results were observed to 250-meters F1,73 = 2.060; p = 0.002 and 1000-meters F1,73 = 0.997; p = 0.036. There was no difference for TQR between genders. CONCLUSION The comparison the RPE-training session of females and males indicated there were difference to 250 and 1000-m training sessions, females have more RPE-training sessions than males. Additionally, there were no differences between genders for recovery parameters, even controlling BM.

  3. MR-guided stereotactic neurosurgery-comparison of fiducial-based and anatomical landmark transformation approaches

    International Nuclear Information System (INIS)

    Hunsche, S; Sauner, D; Maarouf, M; Hoevels, M; Luyken, K; Schulte, O; Lackner, K; Sturm, V; Treuer, H

    2004-01-01

    For application in magnetic resonance (MR) guided stereotactic neurosurgery, two methods for transformation of MR-image coordinates in stereotactic, frame-based coordinates exist: the direct stereotactic fiducial-based transformation method and the indirect anatomical landmark method. In contrast to direct stereotactic MR transformation, indirect transformation is based on anatomical landmark coregistration of stereotactic computerized tomography and non-stereotactic MR images. In a patient study, both transformation methods have been investigated with visual inspection and mutual information analysis. Comparison was done for our standard imaging protocol, including t2-weighted spin-echo as well as contrast enhanced t1-weighted gradient-echo imaging. For t2-weighted spin-echo imaging, both methods showed almost similar and satisfying performance with a small, but significant advantage for fiducial-based transformation. In contrast, for t1-weighted gradient-echo imaging with more geometric distortions due to field inhomogenities and gradient nonlinearity than t2-weighted spin-echo imaging, mainly caused by a reduced bandwidth per pixel, anatomical landmark transformation delivered markedly better results. Here, fiducial-based transformation yielded results which are intolerable for stereotactic neurosurgery. Mean Euclidian distances between both transformation methods were 0.96 mm for t2-weighted spin-echo and 1.67 mm for t1-weighted gradient-echo imaging. Maximum deviations were 1.72 mm and 3.06 mm, respectively

  4. Comparison of Computational Approaches for Rapid Aerodynamic Assessment of Small UAVs

    Science.gov (United States)

    Shafer, Theresa C.; Lynch, C. Eric; Viken, Sally A.; Favaregh, Noah; Zeune, Cale; Williams, Nathan; Dansie, Jonathan

    2014-01-01

    Computational Fluid Dynamic (CFD) methods were used to determine the basic aerodynamic, performance, and stability and control characteristics of the unmanned air vehicle (UAV), Kahu. Accurate and timely prediction of the aerodynamic characteristics of small UAVs is an essential part of military system acquisition and air-worthiness evaluations. The forces and moments of the UAV were predicted using a variety of analytical methods for a range of configurations and conditions. The methods included Navier Stokes (N-S) flow solvers (USM3D, Kestrel and Cobalt) that take days to set up and hours to converge on a single solution; potential flow methods (PMARC, LSAERO, and XFLR5) that take hours to set up and minutes to compute; empirical methods (Datcom) that involve table lookups and produce a solution quickly; and handbook calculations. A preliminary aerodynamic database can be developed very efficiently by using a combination of computational tools. The database can be generated with low-order and empirical methods in linear regions, then replacing or adjusting the data as predictions from higher order methods are obtained. A comparison of results from all the data sources as well as experimental data obtained from a wind-tunnel test will be shown and the methods will be evaluated on their utility during each portion of the flight envelope.

  5. Comparison of NDE standards in the frame of fracture mechanics approach

    International Nuclear Information System (INIS)

    Reale, S.; Capurro, E.; Corvi, A.

    1991-01-01

    The Design and Construction Codes are a set of rules which were set together because they were the best ones when the Codes were issued. A permanent objective must be to complete and improve these rules. This objective can be attained as the result of industrial experiences and by means of research and development activities. Until recently, high risk plants like nuclear plants were designed and built on the basis of the codes and standards of the country where the plant was to be built and operated, and this caused many disadvantages. On the contrary, the use of common codes and standards offers many advantages. A general objective is to compare codes in order to identify the differences in national rules and standards. The acceptance criteria based on nondestructive testing to reject dangerous defects are discussed. In this paper, the standards adopted in France, Germany, Italy and the United Kingdom are taken in consideration, and ultrasonic and radiographic inspections are selected. The methodology of this activity and the results of comparison are reported. (K.I.)

  6. Audio Classification in Speech and Music: A Comparison between a Statistical and a Neural Approach

    Directory of Open Access Journals (Sweden)

    Alessandro Bugatti

    2002-04-01

    Full Text Available We focus the attention on the problem of audio classification in speech and music for multimedia applications. In particular, we present a comparison between two different techniques for speech/music discrimination. The first method is based on Zero crossing rate and Bayesian classification. It is very simple from a computational point of view, and gives good results in case of pure music or speech. The simulation results show that some performance degradation arises when the music segment contains also some speech superimposed on music, or strong rhythmic components. To overcome these problems, we propose a second method, that uses more features, and is based on neural networks (specifically a multi-layer Perceptron. In this case we obtain better performance, at the expense of a limited growth in the computational complexity. In practice, the proposed neural network is simple to be implemented if a suitable polynomial is used as the activation function, and a real-time implementation is possible even if low-cost embedded systems are used.

  7. A novel model approach for esophageal burns in rats: A comparison of three methods.

    Science.gov (United States)

    Kalkan, Yildiray; Tumkaya, Levent; Akdogan, Remzi Adnan; Yucel, Ahmet Fikret; Tomak, Yakup; Sehitoglu, İbrahim; Pergel, Ahmet; Kurt, Aysel

    2015-07-01

    Corrosive esophageal injury causes serious clinical problems. We aimed to create a new experimental esophageal burn model using a single catheter without a surgical procedure. We conducted the study with two groups of 12 male rats that fasted for 12 h before application. A modified Foley balloon catheter was inserted into the esophageal lumen. The control group was given 0.9% sodium chloride, while the experimental group was given 37.5% sodium hydroxide with the other part of the catheter. After 60s, esophagus was washed with distilled water. The killed rats were examined using histopathological methods after 28 days. In comparison with the histopathological changes experienced by the study groups, the control groups were observed to have no pathological changes. Basal cell degeneration, dermal edema, and a slight increase in the keratin layer and collagen density of submucosa due to stenosis were all observed in the group subjected to esophageal corrosion. A new burn model can thus, we believe, be created without the involvement of invasive laparoscopic surgery and general anesthesia. The burn in our experiment was formed in both the distal and proximal esophagus, as in other models; it can also be formed optionally in the entire esophagus. © The Author(s) 2013.

  8. MR-guided stereotactic neurosurgery-comparison of fiducial-based and anatomical landmark transformation approaches

    Energy Technology Data Exchange (ETDEWEB)

    Hunsche, S [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Sauner, D [Institute for Diagnostic and Interventional Radiology, Friedrich-Schiller-University of Jena, Jena (Germany); Maarouf, M [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Hoevels, M [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Luyken, K [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Schulte, O [Department of Radiology, University of Cologne, Cologne (Germany); Lackner, K [Department of Radiology, University of Cologne, Cologne (Germany); Sturm, V [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Treuer, H [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany)

    2004-06-21

    For application in magnetic resonance (MR) guided stereotactic neurosurgery, two methods for transformation of MR-image coordinates in stereotactic, frame-based coordinates exist: the direct stereotactic fiducial-based transformation method and the indirect anatomical landmark method. In contrast to direct stereotactic MR transformation, indirect transformation is based on anatomical landmark coregistration of stereotactic computerized tomography and non-stereotactic MR images. In a patient study, both transformation methods have been investigated with visual inspection and mutual information analysis. Comparison was done for our standard imaging protocol, including t2-weighted spin-echo as well as contrast enhanced t1-weighted gradient-echo imaging. For t2-weighted spin-echo imaging, both methods showed almost similar and satisfying performance with a small, but significant advantage for fiducial-based transformation. In contrast, for t1-weighted gradient-echo imaging with more geometric distortions due to field inhomogenities and gradient nonlinearity than t2-weighted spin-echo imaging, mainly caused by a reduced bandwidth per pixel, anatomical landmark transformation delivered markedly better results. Here, fiducial-based transformation yielded results which are intolerable for stereotactic neurosurgery. Mean Euclidian distances between both transformation methods were 0.96 mm for t2-weighted spin-echo and 1.67 mm for t1-weighted gradient-echo imaging. Maximum deviations were 1.72 mm and 3.06 mm, respectively.

  9. Estimating amplitude ratios in boundary layer stability theory: a comparison between two approaches

    Science.gov (United States)

    Govindarajan, Rama; Narasimha, R.

    2001-07-01

    We first demonstrate that, if the contributions of higher-order mean flow are ignored, the parabolized stability equations (Bertolotti et al. 1992) and the ‘full’ non-parallel equation of Govindarajan & Narasimha (1995, hereafter GN95) are both equivalent to order R[minus sign]1 in the local Reynolds number R to Gaster's (1974) equation for the stability of spatially developing boundary layers. It is therefore of some concern that a detailed comparison between Gaster (1974) and GN95 reveals a small difference in the computed amplitude ratios. Although this difference is not significant in practical terms in Blasius flow, it is traced here to the approximation, in Gaster's method, of neglecting the change in eigenfunction shape due to flow non-parallelism. This approximation is not justified in the critical and the wall layers, where the neglected term is respectively O(R[minus sign]2/3) and O(R[minus sign]1) compared to the largest term. The excellent agreement of GN95 with exact numerical simulations, on the other hand, suggests that the effect of change in eigenfunction is accurately taken into account in that paper.

  10. A Comparison of Hybrid Approaches for Turbofan Engine Gas Path Fault Diagnosis

    Science.gov (United States)

    Lu, Feng; Wang, Yafan; Huang, Jinquan; Wang, Qihang

    2016-09-01

    A hybrid diagnostic method utilizing Extended Kalman Filter (EKF) and Adaptive Genetic Algorithm (AGA) is presented for performance degradation estimation and sensor anomaly detection of turbofan engine. The EKF is used to estimate engine component performance degradation for gas path fault diagnosis. The AGA is introduced in the integrated architecture and applied for sensor bias detection. The contributions of this work are the comparisons of Kalman Filters (KF)-AGA algorithms and Neural Networks (NN)-AGA algorithms with a unified framework for gas path fault diagnosis. The NN needs to be trained off-line with a large number of prior fault mode data. When new fault mode occurs, estimation accuracy by the NN evidently decreases. However, the application of the Linearized Kalman Filter (LKF) and EKF will not be restricted in such case. The crossover factor and the mutation factor are adapted to the fitness function at each generation in the AGA, and it consumes less time to search for the optimal sensor bias value compared to the Genetic Algorithm (GA). In a word, we conclude that the hybrid EKF-AGA algorithm is the best choice for gas path fault diagnosis of turbofan engine among the algorithms discussed.

  11. A comparison of rule-based and machine learning approaches for classifying patient portal messages.

    Science.gov (United States)

    Cronin, Robert M; Fabbri, Daniel; Denny, Joshua C; Rosenbloom, S Trent; Jackson, Gretchen Purcell

    2017-09-01

    Secure messaging through patient portals is an increasingly popular way that consumers interact with healthcare providers. The increasing burden of secure messaging can affect clinic staffing and workflows. Manual management of portal messages is costly and time consuming. Automated classification of portal messages could potentially expedite message triage and delivery of care. We developed automated patient portal message classifiers with rule-based and machine learning techniques using bag of words and natural language processing (NLP) approaches. To evaluate classifier performance, we used a gold standard of 3253 portal messages manually categorized using a taxonomy of communication types (i.e., main categories of informational, medical, logistical, social, and other communications, and subcategories including prescriptions, appointments, problems, tests, follow-up, contact information, and acknowledgement). We evaluated our classifiers' accuracies in identifying individual communication types within portal messages with area under the receiver-operator curve (AUC). Portal messages often contain more than one type of communication. To predict all communication types within single messages, we used the Jaccard Index. We extracted the variables of importance for the random forest classifiers. The best performing approaches to classification for the major communication types were: logistic regression for medical communications (AUC: 0.899); basic (rule-based) for informational communications (AUC: 0.842); and random forests for social communications and logistical communications (AUCs: 0.875 and 0.925, respectively). The best performing classification approach of classifiers for individual communication subtypes was random forests for Logistical-Contact Information (AUC: 0.963). The Jaccard Indices by approach were: basic classifier, Jaccard Index: 0.674; Naïve Bayes, Jaccard Index: 0.799; random forests, Jaccard Index: 0.859; and logistic regression, Jaccard

  12. Comparison of marine spatial planning methods in Madagascar demonstrates value of alternative approaches.

    Directory of Open Access Journals (Sweden)

    Thomas F Allnutt

    Full Text Available The Government of Madagascar plans to increase marine protected area coverage by over one million hectares. To assist this process, we compare four methods for marine spatial planning of Madagascar's west coast. Input data for each method was drawn from the same variables: fishing pressure, exposure to climate change, and biodiversity (habitats, species distributions, biological richness, and biodiversity value. The first method compares visual color classifications of primary variables, the second uses binary combinations of these variables to produce a categorical classification of management actions, the third is a target-based optimization using Marxan, and the fourth is conservation ranking with Zonation. We present results from each method, and compare the latter three approaches for spatial coverage, biodiversity representation, fishing cost and persistence probability. All results included large areas in the north, central, and southern parts of western Madagascar. Achieving 30% representation targets with Marxan required twice the fish catch loss than the categorical method. The categorical classification and Zonation do not consider targets for conservation features. However, when we reduced Marxan targets to 16.3%, matching the representation level of the "strict protection" class of the categorical result, the methods show similar catch losses. The management category portfolio has complete coverage, and presents several management recommendations including strict protection. Zonation produces rapid conservation rankings across large, diverse datasets. Marxan is useful for identifying strict protected areas that meet representation targets, and minimize exposure probabilities for conservation features at low economic cost. We show that methods based on Zonation and a simple combination of variables can produce results comparable to Marxan for species representation and catch losses, demonstrating the value of comparing alternative

  13. Quantifying Neural Oscillatory Synchronization: A Comparison between Spectral Coherence and Phase-Locking Value Approaches

    Science.gov (United States)

    Lowet, Eric; Roberts, Mark J.; Bonizzi, Pietro; Karel, Joël; De Weerd, Peter

    2016-01-01

    Synchronization or phase-locking between oscillating neuronal groups is considered to be important for coordination of information among cortical networks. Spectral coherence is a commonly used approach to quantify phase locking between neural signals. We systematically explored the validity of spectral coherence measures for quantifying synchronization among neural oscillators. To that aim, we simulated coupled oscillatory signals that exhibited synchronization dynamics using an abstract phase-oscillator model as well as interacting gamma-generating spiking neural networks. We found that, within a large parameter range, the spectral coherence measure deviated substantially from the expected phase-locking. Moreover, spectral coherence did not converge to the expected value with increasing signal-to-noise ratio. We found that spectral coherence particularly failed when oscillators were in the partially (intermittent) synchronized state, which we expect to be the most likely state for neural synchronization. The failure was due to the fast frequency and amplitude changes induced by synchronization forces. We then investigated whether spectral coherence reflected the information flow among networks measured by transfer entropy (TE) of spike trains. We found that spectral coherence failed to robustly reflect changes in synchrony-mediated information flow between neural networks in many instances. As an alternative approach we explored a phase-locking value (PLV) method based on the reconstruction of the instantaneous phase. As one approach for reconstructing instantaneous phase, we used the Hilbert Transform (HT) preceded by Singular Spectrum Decomposition (SSD) of the signal. PLV estimates have broad applicability as they do not rely on stationarity, and, unlike spectral coherence, they enable more accurate estimations of oscillatory synchronization across a wide range of different synchronization regimes, and better tracking of synchronization-mediated information

  14. Comparison of Standard and Novel Signal Analysis Approaches to Obstructive Sleep Apnoea Classification

    Directory of Open Access Journals (Sweden)

    Aoife eRoebuck

    2015-08-01

    Full Text Available Obstructive sleep apnoea (OSA is a disorder characterised by repeated pauses in breathing during sleep, which leads to deoxygenation and voiced chokes at the end of each episode. OSA is associated by daytime sleepiness and an increased risk of serious conditions such as cardiovascular disease, diabetes and stroke. Between 2-7% of the adult population globally has OSA, but it is estimate