Frequent phosphodiesterase 11A gene (PDE11A) defects in patients with Carney complex (CNC) caused by PRKAR1A mutations: PDE11A may contribute to adrenal and testicular tumors in CNC as a modifier of the phenotype.

Science.gov (United States)

Libé, Rossella; Horvath, Anelia; Vezzosi, Delphine; Fratticci, Amato; Coste, Joel; Perlemoine, Karine; Ragazzon, Bruno; Guillaud-Bataille, Marine; Groussin, Lionel; Clauser, Eric; Raffin-Sanson, Marie-Laure; Siegel, Jennifer; Moran, Jason; Drori-Herishanu, Limor; Faucz, Fabio Rueda; Lodish, Maya; Nesterova, Maria; Bertagna, Xavier; Bertherat, Jerome; Stratakis, Constantine A

2011-01-01

Carney complex (CNC) is an autosomal dominant multiple neoplasia, caused mostly by inactivating mutations of the regulatory subunit 1A of the protein kinase A (PRKAR1A). Primary pigmented nodular adrenocortical disease (PPNAD) is the most frequent endocrine manifestation of CNC with a great inter-individual variability. Germline, protein-truncating mutations of phosphodiesterase type 11A (PDE11A) have been described to predispose to a variety of endocrine tumors, including adrenal and testicular tumors. Our objective was to investigate the role of PDE11A as a possible gene modifier of the phenotype in a series of 150 patients with CNC. A higher frequency of PDE11A variants in patients with CNC compared with healthy controls was found (25.3 vs. 6.8%, P CNC patients, those with PPNAD were significantly more frequently carriers of PDE11A variants compared with patients without PPNAD (30.8 vs. 13%, P = 0.025). Furthermore, men with PPNAD were significantly more frequently carriers of PDE11A sequence variants (40.7%) than women with PPNAD (27.3%) (P CNC patients, a high frequency of PDE11A variants, suggesting that PDE11A is a genetic modifying factor for the development of testicular and adrenal tumors in patients with germline PRKAR1A mutation.

A Novel PRKAR1A Mutation Identified in a Patient with Isolated Primary Pigmented Nodular Adrenocortical Disease

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Sira Korpaisarn

2017-08-01

Full Text Available Primary pigmented nodular adrenocortical disease (PPNAD is a rare cause of Cushing syndrome, especially the isolated form without Carney complex, associated with germline mutations in PRKAR1A, the protein kinase A regulatory subunit type 1 alpha gene. We report a 31-year-old female who presented with secondary amenorrhea, cushingoid appearance, and hypertension without Carney complex. Biochemical laboratory examinations confirmed the ACTH-independent adrenal Cushing syndrome with negative Liddle test. A small right adrenal adenoma of 0.8 cm was shown on computed tomography while magnetic resonance imaging revealed nodularity of both adrenal glands. The histological report confirmed PPNAD using laparoscopic right adrenalectomy, and subsequent left adrenalectomy was performed 6 months later. She had inherited heterozygosity of a novel germline mutation of the PRKAR1A gene (g.114213T>G or c.709-5T>G. This splice site mutation results in exon 8 skipping. Her father carrying the same mutation had no clinical features of either PPNAD or Carney complex. This novel PRKAR1A gene mutation, c.709-5T>G, is reported here for the first time manifesting as an incomplete clinical expression of the isolated form of PPNAD and being inherited with low penetrance unlike other inherited mutations of the Carney complex which have a penetrance of almost 100%.

Occurrence of faecal pellet-filled simple and composite burrows in cold seep carbonates: A glimpse of a complex benthic ecosystem

Digital Repository Service at National Institute of Oceanography (India)

Mazumdar, A.; Joshi, R.K.; Peketi, A.; Kocherla, M.

of inorganic sulphur in sediments and shales. Chemical Geology 54, 149–155. Cordes, E. E., Carney, S. L., Hourdez, S., Carney, R. S., Brooks, J. M. & Fisher, C. R. 2007. Cold seeps of the deep Gulf of Mexico: Community structure and biogeographic comparisons..., Surficial hydrocarbon seep infauna from the Blake Ridge (Atlantic Ocean, 2150 m) and the Gulf of Mexico (690– 2240 m) PSZN. Marine Ecology 25, 313–336. Sahling, H., Rickert, D., Lee, R.W., Linke, P., Suess, E., 2002, Macrofaunal community structure...

Unplanned complex suicide: Two case reports

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Nikolić Slobodan

2010-01-01

Full Text Available Introduction The term complex suicide refers to suicides in which multiple suicidal methods are utilized, as opposed to simple suicide successfully done after one attempt. In planned complex suicides two or more methods are employed simultaneously in order to make sure that death will occur after failure of previous attempt. In unplanned complex suicides, several other methods of suicide tried after the first chosen method either failed or was too painful. Outline of Cases We report two cases of unplanned complex suicides. The first case was a female who first tried to commit suicide by cutting the wrists, and then hanged herself. In the other case, a male first tried to commit suicide by stubbing his chest with a knife, and then jumped into a well and drowned himself. In both reported cases the second, successful suicidal method was of higher lethality score. Conclusion From the forensic point of view, the presence of several injuries of different origin strongly suggests infliction by other person. The event could be reconstructed, based on autopsy findings and traces found at the scene. .

Familial gigantism

NARCIS (Netherlands)

W.W. de Herder (Wouter)

2012-01-01

textabstractFamilial GH-secreting tumors are seen in association with three separate hereditary clinical syndromes: multiple endocrine neoplasia type 1, Carney complex, and familial isolated pituitary adenomas.

Familial gigantism

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Wouter W. de Herder

2012-01-01

Full Text Available Familial GH-secreting tumors are seen in association with three separate hereditary clinical syndromes: multiple endocrine neoplasia type 1, Carney complex, and familial isolated pituitary adenomas.

Case report

African Journals Online (AJOL)

abp

25 août 2015 ... abdominal note une cicatrice de laparotomie médiane à cheval sur l'ombilic et la présence d'une masse allant de l'hypochondre droit à la fosse iliaque droite .... Les formes rétropéritonéales sont le plus souvent isolées [3,4]. Ils sont associés parfois à d'autres pathologies , notamment la triade de Carney [6] ...

Pigmented Epithelioid Melanocytoma (PEM)/Animal Type Melanoma (ATM): Quest for an Origin. Report of One Unusual Case Indicating Follicular Origin and Another Arising in an Intradermal Nevus.

Science.gov (United States)

Tarasen, Ashley; Carlson, J Andrew; Leonard, M Kathryn; Merlino, Glenn; Kaetzel, David; Slominski, Andrzej T

2017-08-15

Pigmented epithelioid melanocytoma (PEM) is a tumor encompassing epithelioid blue nevus of Carney complex (EBN of CNC) and was previously termed animal-type melanoma. Histologically PEMs are heavily pigmented spindled and epithelioid dermal melanocytic tumors with infiltrative borders, however, their origin remains unclear. Stem cells for the epidermis and hair follicle are located in the bulge area of the hair follicle with the potential to differentiate into multiple lineages. Multiple cutaneous carcinomas, including follicular cutaneous squamous cell carcinoma (FSCC), are thought to arise from stem cells in the follicular bulge. We present two cases of PEM/ATM in a 63 year-old male on the scalp with follicular origin and a 72 year-old female on the upper back arising in an intradermal nevus. Biopsy of both cases revealed a proliferation of heavily pigmented dermal nests of melanocytes with atypia. The Case 1 tumor was in continuation with the outer root sheath of the hair follicle in the bulge region. Case 2 arose in an intradermal melanocytic nevus. Rare mitotic figures, including atypical mitotic figures, were identified in both cases. We present two cases of PEM, with histologic evidence suggesting two origins: one from the follicular bulb and one from an intradermal nevus.

Primary pigmented nodular adrenocortical disease presenting with a unilateral adrenocortical nodule treated with bilateral laparoscopic adrenalectomy: a case report

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Kaltsas Gregory

2010-07-01

Full Text Available Abstract Introduction Primary pigmented nodular adrenocortical disease is a rare cause of adrenocorticotropic hormone-independent Cushing's syndrome. We report an uncommon primary pigmented nodular adrenocortical disease case presenting with a unilateral adrenocortical nodule and provide a brief overview of the existing literature. Case presentation A 27-year-old Caucasian woman was admitted to our Department with adrenocorticotropic hormone-independent Cushing's syndrome. Its cause was initially considered a left adrenocortical adenoma based on computer tomography imaging. The patient underwent left laparoscopic adrenalectomy and histological examination revealed pigmented micronodular adrenal hyperplasia. Evaluation for the presence of Carney complex was negative. Six months later recurrence of hypercortisolism was documented and a right laparoscopic adrenalectomy was performed further establishing the diagnosis of primary pigmented nodular adrenocortical disease. After a nine-year follow-up there is no evidence of residual disease. Conclusions Even though primary pigmented nodular adrenocortical disease is a rare cause of Cushing's syndrome, it should be included in the differential diagnosis of adrenocorticotropic hormone-independent Cushing's syndrome, especially because adrenal imaging can be misleading mimicking other adrenocortical diseases. Bilateral laparoscopic adrenalectomy is the preferred treatment in these subjects.

Measuring case-mix complexity of tertiary care hospitals using DRGs.

Science.gov (United States)

Park, Hayoung; Shin, Youngsoo

2004-02-01

The objectives of the study were to develop a model that measures and evaluates case-mix complexity of tertiary care hospitals, and to examine the characteristics of such a model. Physician panels defined three classes of case complexity and assigned disease categories represented by Adjacent Diagnosis Related Groups (ADRGs) to one of three case complexity classes. Three types of scores, indicating proportions of inpatients in each case complexity class standardized by the proportions at the national level, were defined to measure the case-mix complexity of a hospital. Discharge information for about 10% of inpatient episodes at 85 hospitals with bed size larger than 400 and their input structure and research and education activity were used to evaluate the case-mix complexity model. Results show its power to predict hospitals with the expected functions of tertiary care hospitals, i.e. resource intensive care, expensive input structure, and high levels of research and education activities.

Infected Complex Odontoma: A Case Report

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Shanthala Damodar

2015-06-01

Full Text Available Odontoma represent a hamartomatous malformation. They are usually asymptomatic and are diagnosed on routine radiological examination. Infection of an odontome is very uncommon. Few cases of infected odontoma are reported in the literature. We report a special case of infected complex odontoma and perforation of the cheeks with a tooth impacted upon along with computed tomographic (CT image. Thus, making the present case unusual. [Cukurova Med J 2015; 40(2.000: 379-383

Unusually large erupted complex odontoma: A rare case report

Energy Technology Data Exchange (ETDEWEB)

Bagewadi, Shivanand B.; Kukreja, Rahul; Suma, Gundareddy N.; Yadav, Bhawn; Sharma, Havi [Dept. of Oral Medicine and Radiology, ITS Centre for Dental Studies and Research, Murad Nagar (India)

2015-03-15

Odontomas are nonaggressive, hamartomatous developmental malformations composed of mature tooth substances and may be compound or complex depending on the extent of morphodifferentiation or on their resemblance to normal teeth. Among them, complex odontomas are relatively rare tumors. They are usually asymptomatic in nature. Occasionally, these tumors become large, causing bone expansion followed by facial asymmetry. Odontoma eruptions are uncommon, and thus far, very few cases of erupted complex odontomas have been reported in the literature. Here, we report the case of an unusually large, painless, complex odontoma located in the right posterior mandible.

Association of the M1V PRKAR1A mutation with primary pigmented nodular adrenocortical disease in two large families

NARCIS (Netherlands)

Pereira, Alberto M.; Hes, Frederik J.; Horvath, Anelia; Woortman, Sanne; Greene, Elizabeth; Bimpaki, Eirini; Alatsatianos, Anton; Boikos, Sosipatros; Smit, Johannes W.; Romijn, Johannes A.; Nesterova, Maria; Stratakis, Constantine A.

2010-01-01

Carney complex (CNC) is a familial multiple neoplasia syndrome frequently associated with primary pigmented nodular adrenocortical disease (PPNAD), a bilateral form of micronodular adrenal hyperplasia that leads to Cushing's syndrome (CS). Germline PRKAR1A mutations cause CNC and only rarely

Clinical decision-making by midwives: managing case complexity.

Science.gov (United States)

Cioffi, J; Markham, R

1997-02-01

In making clinical judgements, it is argued that midwives use 'shortcuts' or heuristics based on estimated probabilities to simplify the decision-making task. Midwives (n = 30) were given simulated patient assessment situations of high and low complexity and were required to think aloud. Analysis of verbal protocols showed that subjective probability judgements (heuristics) were used more frequently in the high than low complexity case and predominated in the last quarter of the assessment period for the high complexity case. 'Representativeness' was identified more frequently in the high than in the low case, but was the dominant heuristic in both. Reports completed after each simulation suggest that heuristics based on memory for particular conditions affect decisions. It is concluded that midwives use heuristics, derived mainly from their clinical experiences, in an attempt to save cognitive effort and to facilitate reasonably accurate decisions in the decision-making process.

Superior shoulder suspensory complex fracture dislocation case report

International Nuclear Information System (INIS)

Lidgett, T.; Bate, E.; Pittock, L.

2017-01-01

Background: Acromioclavicular joint dislocation can be more complex than it first appears. The presented case had an unusual combination of injuries to the superior shoulder suspensory complex, which yielded some interesting learning points. Case summary: The injuries were sustained after a fall from a push bike and included acromioclavicular dislocation with coracoid process, clavicle and acromion process fractures. These were identified on the initial X-ray examination, which was followed by computed tomography for surgical planning. The injuries were successfully treated by internal fixation. Conclusion: The unexpected complexity of the injuries could have led to subtle but important findings being overlooked. This case highlights the importance of a thorough search strategy, consideration of injury biomechanics and knowledge of associated injuries. - Highlights: • Search for associated fractures in acromioclavicular joint dislocation. • Assess the clavicle, acromion process and coracoid process in particular. • Do not end the shoulder X-ray examination after seeing one injury. • Both axial and cranially angulated anteroposterior projections are beneficial. • Acromioclavicular joint fracture dislocation treatment may require further research.

Basal cell carcinoma of the nipple-areola complex: a case report.

Science.gov (United States)

Huang, Ching-Wen; Pan, Ching-Kuen; Shih, Teng-Fu; Tsai, Cheng-Chien; Juan, Chung-Chou; Ker, Chen-Guo

2005-10-01

Basal cell carcinoma (BCC) of the nipple-areola complex is very rare. Only 24 cases were reported in the literature and 17 (70.8%) of these cases arose in men. Most of the cases were treated with simple excision. We report on a case of BCC of the nipple-areola complex in a 46-year-old woman, treated with partial mastectomy. Metastasis to the axillary lymph nodes had been noted in 3 (12.5%) of the 24 reported cases of BCC of the nipple-areola complex. Thus, we applied the concept of the sentinel lymph node to detect possible metastases of axillary lymph nodes, letting us avoid the unnecessary axillary lymph node dissection and possible future morbidity.

Tuberous sclerosis complex: A case report

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Soumyabrata Sarkar

2016-01-01

Full Text Available Tuberous sclerosis complex is an unusual autosomal dominant neurocutaneous syndrome characterized by the development of benign tumors affecting different body systems affecting the brain, skin, retina, and viscera. It is characterized by cutaneous changes, neurologic conditions, and the formation of hamartomas in multiple organs leading to morbidity and mortality. The most common oral manifestations are fibromas, gingival hyperplasia, and enamel hypoplasia. The management of these patients is often multidisciplinary involving specialists from various fields. Here, we present a case report of a 26-old-year male patient with characteristic clinical, radiological, and histological features of tuberous sclerosis complex.

A New Look at Worst Case Complexity: A Statistical Approach

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Niraj Kumar Singh

2014-01-01

Full Text Available We present a new and improved worst case complexity model for quick sort as yworst(n,td=b0+b1n2+g(n,td+ɛ, where the LHS gives the worst case time complexity, n is the input size, td is the frequency of sample elements, and g(n,td is a function of both the input size n and the parameter td. The rest of the terms arising due to linear regression have usual meanings. We claim this to be an improvement over the conventional model; namely, yworst(n=b0+b1n+b2n2+ɛ, which stems from the worst case O(n2 complexity for this algorithm.

Erupting complex odontoma: Report of a rare case

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Pinakapani Ramakrishna

2014-01-01

Full Text Available Odontomas are the most frequent hamartomatous lesions involving the oral cavity. The complex variant is an agglomerate of all dental tissues characterized by abnormal morphodifferentiation despite normal histodifferentiation. These are usually asymptomatic and are frequently associated with eruption disturbances. We report an unusual case of erupting complex odontoma associated with an impacted maxillary second molar.

Isolated familial somatotropinomas: clinical features and analysis of the MEN1 gene.

Science.gov (United States)

De Menis, Ernesto; Prezant, Toni R

2002-01-01

Isolated familial somatotropinomas (IFS) rarely occurs in the absence of multiple endocrine neoplasia type I (MEN1) or the Carney complex. In the present study we report two Italian siblings affected by GH-secreting adenomas. There was no history of parental consanguinity. The sister presented at 18 years of age with secondary amenorrhea and acromegalic features and one of her two brothers presented with gigantism at the same age. Endocrinological investigations confirmed GH hypersecretion in both cases. Although a pituitary microadenoma was detected in both patients, transsphenoidal surgery was not successful. The sister received conventional radiotherapy and acromegaly is now considered controlled; the brother is being treated with octreotide LAR 30 mg monthly and the disease is considered clinically active. Patients, their parents and the unaffected brother underwent extensive evaluation, and no features of MEN1 or Carney complex were found. Analysis of polymorphic microsatellite markers from chromosome 11q13 (D11S599, D11S4945, D11S4939, D11S4938 and D11S987) showed that the acromegalic siblings had inherited different maternal chromosomes and shared the paternal chromosome. No pathogenic MEN1 sequence changes were detected by sequencing or dideoxy fingerprinting of the coding sequence (exons 2-10) and exon/intron junctions. Although mutations in the promoter, introns or untranslated regions of the MEN1 gene cannot be excluded, germline mutations within the coding region of this gene do not appear responsible for IFS in this family.

[Patient-related complexity in nursing care - Collective case studies in the acute care hospital].

Science.gov (United States)

Gurtner, Caroline; Spirig, Rebecca; Staudacher, Diana; Huber, Evelyn

2018-06-04

Patient-related complexity in nursing care - Collective case studies in the acute care hospital Abstract. Patient-related complexity of nursing is defined by the three characteristics "instability", "uncertainty", and "variability". Complexity increased in the past years, due to reduced hospital length of stay and a growing number of patients with chronic and multiple diseases. We investigated the phenomenon of patient-related complexity from the point of view of nurses and clinical nurse specialists in an acute care hospital. In the context of a collective case study design, nurses and clinical nurse specialists assessed the complexity of nursing situations with a questionnaire. Subsequently, we interviewed nurses and clinical nurse specialists about their evaluation of patient-related complexity. In a within-case-analysis we summarized data inductively to create case narratives. By means of a cross-case-analysis we compared the cases with regard to deductively derived characteristics. The four cases exemplarily showed that the degree of complexity depends on the controllability and predictability of clinical problems. Additionally, complexity increases or decreases, according to patients' individual resources. Complex patient situations demand professional expertise, experience, communicative competencies and the ability for reflection. Beginner nurses would benefit from support and advice by experienced nurses to develop these skills.

Case Mix Complexity Differences between Teaching and Nonteaching Hospitals.

Science.gov (United States)

Ament, Richard P.; And Others

1981-01-01

The differences between teaching and nonteaching hospitals in complexity and variety of cases seen are described. The results show that teaching hospitals could be expected to cost somewhat more per patient even if case mix were the only factor. (Author/MLW)

Improving the Effectiveness of Professional Education: Learning Managerial Accounting via a Complex Case.

Science.gov (United States)

Carter, Melissa; And Others

To give students more experience with real situations, many professional schools use case studies in their courses. Creating complex cases, case experiences that immerse students in complex problems, rather than mere case studies that require armchair analysis should help students gain better and more integrated knowledge. Designing, implementing,…

First branchial complex anomalies: report of 3 cases

International Nuclear Information System (INIS)

Goten, A. van der; Hermans, R.; Hover, P. van; Crevits, I.; Baert, A.L.

1997-01-01

Three cases of first branchial cleft anomalies are presented. The embryology and pathology of first branchial complex anomalies, their imaging characteristics and differential diagnosis are discussed. (orig.). With 3 figs

First branchial complex anomalies: report of 3 cases

Energy Technology Data Exchange (ETDEWEB)

Goten, A. van der [Department of Radiology, University Hospitals, Catholic University of Leuven, Leuven (Belgium); Hermans, R. [Department of Radiology, University Hospitals, Catholic University of Leuven, Leuven (Belgium); Hover, P. van [Department of Radiology, University Hospitals, Catholic University of Leuven, Leuven (Belgium); Crevits, I. [Department of Radiology, University Hospitals, Catholic University of Leuven, Leuven (Belgium); Baert, A.L. [Department of Radiology, University Hospitals, Catholic University of Leuven, Leuven (Belgium)

1997-02-01

Three cases of first branchial cleft anomalies are presented. The embryology and pathology of first branchial complex anomalies, their imaging characteristics and differential diagnosis are discussed. (orig.). With 3 figs.

Ultrasonographic diagnosis of limb-body wall complex: a case report

Energy Technology Data Exchange (ETDEWEB)

Goo, Dong Erk; Yoo, Shi Joon; Cho, Kyoung Sik; Choi, Kee Young; Kim, Am [University of Ulsan College of Medicine, Asan Medical Center, Ulsan (Korea, Republic of)

1993-12-15

Limb-body wall complex (LBWC) is a rare congenital process believed to result from early rupture of the amnion, possibly as a consequence of vascular disruption. Characteristic fetal deformities include limb defects, scoliosis, thoracoschisis and/or abdominoschisis, and severe craniofacial anomalies. This complex should be distinguished from other body-wall defect including omphalocele and gastroschisis since the prognosis of LBWC is uniformly poor. We report a case of LBWC which was diagnosed by prenatal ultrasonography in 26 weeks of gestation. Prenatal ultrasonograms are correlated with the gross pathologic findings. The present case demonstrates the superb capability of modern ultrasonography in the diagnosis of complex fetal anomalies

Ultrasonographic diagnosis of limb-body wall complex: a case report

International Nuclear Information System (INIS)

Goo, Dong Erk; Yoo, Shi Joon; Cho, Kyoung Sik; Choi, Kee Young; Kim, Am

1993-01-01

Limb-body wall complex (LBWC) is a rare congenital process believed to result from early rupture of the amnion, possibly as a consequence of vascular disruption. Characteristic fetal deformities include limb defects, scoliosis, thoracoschisis and/or abdominoschisis, and severe craniofacial anomalies. This complex should be distinguished from other body-wall defect including omphalocele and gastroschisis since the prognosis of LBWC is uniformly poor. We report a case of LBWC which was diagnosed by prenatal ultrasonography in 26 weeks of gestation. Prenatal ultrasonograms are correlated with the gross pathologic findings. The present case demonstrates the superb capability of modern ultrasonography in the diagnosis of complex fetal anomalies

Tríada de Carney incompleta e hipertensión arterial en una mujer joven Incomplete Carney’s triad and arterial hypertension in a young woman

Directory of Open Access Journals (Sweden)

Alberto Allievi

2006-02-01

Full Text Available Se presenta una el caso de paciente joven, con tríada de Carney incompleta que cursa hipertensión arterial de dos años de evolución y anemia ferropénica grave por pérdida crónica de sangre por tubo digestivo, con tumores gástricos múltiples y paraganglioma pararrenal. No presenta aún desarrollo de condromas pulmonares visibles por tomografía axial computada. En nuestra paciente el paraganglioma no resultó funcionante. Resaltamos que la presencia de tumores gástricos múltiples en un adulto joven debe sugerir la posibilidad de tumores estromales (GIST, cuyo diagnóstico por biopsia endoscópica es difícil debido a su localización profunda, situada en las capas musculares de la pared gástrica. Asimismo queremos remarcar la importancia de las técnicas de marcación descriptas para el diagnóstico preciso. El seguimiento debe ser constante dado el pronóstico incierto de estos tumores. Los condromas pulmonares pueden aparecer años después de la resección del GIST y ser confundidos con metástasis del GIST.The case of young woman with arterial hypertension diagnosed two years before, is here presented; she had a ferropenic anemia caused by digestive loss of blood. Multiple gastric tumors and pararenal non functioning paraganglioma were found. No chondromas were detected. An incomplete Carney’s Triad was diagnosed. We remark that multiple gastric tumors in a young adult suggest the possibility of gastrointestinal stromal tumors (GIST Endoscopic biopsy frequently is not effective because these tumors are deep placed in the muscular gastric layers. The importance of specific techniques for a positive diagnosis are emphasized. Continuous follow up is needed because these tumors have uncertain prognosis. Lung chondromas may appear years later after the GIST was removed and might be confused with GIST metastases.

Experimental Demonstration of Photon Efficient Coherent Temporal Combining for Data Rate Scaling

Science.gov (United States)

2016-02-15

8610, Free-Space Laser Communication and Atmospheric Propagation XXV, 86100K, 2013. [9] N. W. Spellmeyer, C. A. Browne, D. O. Caplan , J. J. Carney, M...Communication and Atmospheric Propagation XXVI, 89710J, 2014, 10.1117/12.2057568. [10] D. O. Caplan , H. G. Rao, J. P. Wang, D. M. Boronson, J. J. Carney, A. S...CPDA8. [11] D. O. Caplan , J. J. Carney, and S. Constantine, "Parallel Direct Modulation Laser Transmitters for High-speed High-sensitivity Laser

Analysis and Perspective from the Complex Aerospace Systems Exchange (CASE) 2013

Science.gov (United States)

Jones, Kennie H.; Parker, Peter A.; Detweiler, Kurt N.; McGowan, Anna-Maria R.; Dress, David A.; Kimmel, William M.

2014-01-01

NASA Langley Research Center embedded four rapporteurs at the Complex Aerospace Systems Exchange (CASE) held in August 2013 with the objective to capture the essence of the conference presentations and discussions. CASE was established to provide a discussion forum among chief engineers, program managers, and systems engineers on challenges in the engineering of complex aerospace systems. The meeting consists of invited presentations and panels from industry, academia, and government followed by discussions among attendees. This report presents the major and reoccurring themes captured throughout the meeting and provides analysis and insights to further the CASE mission.

Multiple Dentogerous Cysts With a Complex Odontoma: An Unusual Case Report

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Sheikhi

2016-03-01

Full Text Available Introduction Multiple dentigerous cysts are rare and mostly associated with syndromes. Case Presentation The present case report is unique, as the dentigerous cysts enclosed the lateral incisor, canine, first and second premolars of the mandible and were accompanied by a complex odontoma, instead of first mandibular molar. Conclusions Multiple unilateral nosyndromic dentigerous cysts with complex odontoma are found only rarely. The periapical inflammation of non-vital deciduous teeth and trauma may be considered ethiological factors.

Erupted complex composite odontoma: Report of two atypical cases

Directory of Open Access Journals (Sweden)

Preeti Tomar Bhattacharya

2015-01-01

Full Text Available Odontomas are nonaggressive, hamartomatous developmental malformations of odontogenic origin. They are considered one of the most common odontogenic lesions composed by diverse dental tissues. They may interfere with the eruption of an associated tooth and are more prevalent in the posterior mandible. The eruption of a complex odontoma into the oral cavity is rare. Here, we report such two rare cases of gigantic erupted complex composite odontomas.

Perceptions of orthodontic case complexity among orthodontists, general practitioners, orthodontic residents, and dental students.

Science.gov (United States)

Heath, Elizabeth M; English, Jeryl D; Johnson, Cleverick D; Swearingen, Elizabeth B; Akyalcin, Sercan

2017-02-01

Our aims were to assess the perceptions of orthodontic case complexity among orthodontists, general dentists, orthodontic residents, and dental students and to compare their perceptions with the American Board of Orthodontics Discrepancy Index (DI). Orthodontists, general dentists, orthodontic residents, and dental students (n = 343) participated in a Web-based survey. Pretreatment orthodontic records of 29 cases with varying DI scores were obtained. Respondents were asked to evaluate case complexity on a 100-point visual analog scale. Additional information was collected on participants' orthodontic education and orthodontic treatment preferences. Pearson correlation coefficients were used to assess the relationship between the average complexity score and the DI score. Repeated measures analysis with linear mixed models was used to assess the association between the average complexity score and the DI score and whether the association between the 2 scores varied by level of difficulty or panel group. The level of significance for all analyses was set at P clear aligners. DI score was significantly associated with complexity perceptions (P = 0.0168). Associations between average complexity and DI score varied significantly by provider group (P = 0.0033), with orthodontists and residents showing the strongest associations. When the DI score was greater than 15, orthodontists and residents perceived cases as more complex than did the other provider groups. Orthodontists and orthodontic residents had better judgments for evaluating orthodontic case complexity. The high correlation between orthodontic professionals' perceptions and DI scores suggested that additional orthodontic education and training have an influence on the ability to recognize case complexity. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Clay is everything: archaeological analyses of colonial period inland swamp rice embankments

Science.gov (United States)

Andrew Agha

2016-01-01

Rice became the market export crop in the early eighteenth century that made South Carolina become an economic and agricultural powerhouse after many exotic tropical cultivars failed (Carney and Porcher 1993, Carney 1996, 2001, Littlefield 1981, Fields-Black 2008).

Procuring complex performance:case: public infrastructure projects

OpenAIRE

Leppänen, T. (Tero)

2015-01-01

Abstract This research studies procuring complex performance (PCP) in the case of public infrastructure projects. Focus of the research is on the interface between public clients and private sector contractors. Purpose of this research is to find out what are the main challenges of different project delivery methods according to literature (RQ1) and what are the practical challenges of public procurement (RQ2). As an end re...

An Unusual Erupted Complex Composite Odontoma: A Rare Case

Directory of Open Access Journals (Sweden)

Dawasaz Ali Azhar

2013-01-01

Full Text Available Odontomas are malformations of the dental tissues and may interfere with the eruption of the associated tooth. Complex composite odontoma (CO was described as a distinct entity for the first time by Broca in 1866. This lesion takes place due to the developmental disturbances where the dental components are laid down in a disorganized manner, due to failure of normal morphodifferentiation. Very few cases of erupted complex composite odontomas have been reported in the literature. The case reported here is of an odontoma found in the left mandibular body, associated with an impacted second molar of a 17-year-old Saudi male. Under local anesthesia the odontoma was surgically removed. Histopathological examination confirmed the diagnosis of CO. The impacted second molar which was left in the mandibular body erupted clinically after 6 months. Erupted CO is rarely seen in the mandibular left body. The early diagnosis, followed by a proper treatment at the right time, will result in a favorable prognosis.

Alternative Fuels Data Center: Saving Fuel in the Garden State with Truck

Science.gov (United States)

Center in Ridgefield, and another in southern New Jersey, at the Flying J Travel Plaza in Carneys Point major sites--one in the northern part of the state, at the New Jersey Turnpike's Vince Lombardi Travel . Since its opening in late 2011, the Carneys Point site alone has seen more than 23,000 billable hours of

Primary cardiac tumors associated with genetic syndromes. A comprehensive review

International Nuclear Information System (INIS)

Lee, Elizabeth; Agarwal, Prachi P.; Mahani, Maryam Ghadimi; Lu, Jimmy C.; Dorfman, Adam L.; Srinivasan, Ashok

2018-01-01

Various cardiac tumors occur in the setting of a genetic syndrome such as myxomas in Carney complex and rhabdomyomas in tuberous sclerosis. Tumor biology can be different in syndromic forms, and on imaging children sometimes demonstrate additional manifestations of the underlying syndrome. We discuss the imaging appearance of cardiac tumors occurring in the framework of a genetic syndrome, the findings that suggest an underlying syndrome, and the impact on management. (orig.)

Primary cardiac tumors associated with genetic syndromes. A comprehensive review

Energy Technology Data Exchange (ETDEWEB)

Lee, Elizabeth; Agarwal, Prachi P. [University of Michigan Health System, University Hospital Division of Cardiothoracic Radiology, Department of Radiology, Ann Arbor, MI (United States); Mahani, Maryam Ghadimi [University of Michigan Health System, University Hospital Division of Cardiothoracic Radiology, Department of Radiology, Ann Arbor, MI (United States); University of Michigan Health System, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Lu, Jimmy C.; Dorfman, Adam L. [University of Michigan Health System, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); C.S. Mott Children' s Hospital, University of Michigan Health System, Section of Pediatric Cardiology, Department of Pediatrics, Ann Arbor, MI (United States); Srinivasan, Ashok [University of Michigan Health System, Division of Neuroradiology, Department of Radiology, Ann Arbor, MI (United States)

2018-02-15

Various cardiac tumors occur in the setting of a genetic syndrome such as myxomas in Carney complex and rhabdomyomas in tuberous sclerosis. Tumor biology can be different in syndromic forms, and on imaging children sometimes demonstrate additional manifestations of the underlying syndrome. We discuss the imaging appearance of cardiac tumors occurring in the framework of a genetic syndrome, the findings that suggest an underlying syndrome, and the impact on management. (orig.)

Cushing's Syndrome caused by pigmented adrenocortical micro nodular dysplasia - A familial case

Energy Technology Data Exchange (ETDEWEB)

Gomez-Segovia, I; Gallowitsch, H J; Kresnik, E; Kumnig, G; Mikosch, P; Lind, P [Dept.of Nuclear Medicine and Endocrinology, LKH Klagenfurt (Austria)

2002-09-01

Introduction: We present a Case of Cushing's syndrome (CS) in a 16 year old male adolescent. Adrenocortical micro nodular dysplasia is a rare cause of CS. It mostly develops in the first two decades of life. In pathogenesis a stimulatory effect of circulating Immunoglobulins on adrenal steroidogenesis has been postulated. Familial cases have been reported in relation to Carney's Syndrome. We report the clinical case at first diagnosis and preoperative follow up of 1 year prior to treatment. The leading symptoms were severe bilateral (fibrotic) gynaecomastia, weight gain and growth retardation, without hypertension,but osteoporosis, secondary hypogonadism and glucose intolerance. Laboratory findings and the results of functional tests were diagnostic for CS. In addition LDH (I-131 Isotopes), CK, Lipoproteins, GPT, Androstendion, Prolactin were elevated. MRI abdomen revealed a slight enlargement of the adrenals, and suspected a bilateral micro nodular dysplasia. Iodo-cholesterol-scan under dexamethason suppression showed a diffuse bilateral Iodo-cholesterol uptake confirming the autonomous production of cortisol bilateral in the adrenals.Whole body bone scan showed a diffuse reduced diphosphonate uptake in the skeleton and the growth plates. The bone mineral density was significantly reduced.Radiologically osteoporosis was overt. The rapid increase of free urinary cortisol excretion/24h within one year of observation led to a total bilateral adrenalectomy. Postoperative 5 year follow up examinations. Documentation of the outcome and recovery of clinical signs,symptoms and laboratory findings, discussion about the most appropriate long-term substitution therapy. Familial anamnesis:affected family member was the father (micro nodular bilateral adrenocortical dysplasia), the aunt (pararenal incidentaloma, histologically lipoma) and a cousin (micro nodular adrenocortical dysplasia). Sequential analysis of the menin gene from the patient was negative.The detection of

Cushing's Syndrome caused by pigmented adrenocortical micro nodular dysplasia - A familial case

International Nuclear Information System (INIS)

Gomez-Segovia, I.; Gallowitsch, H.J.; Kresnik, E.; Kumnig, G.; Mikosch, P.; Lind, P.

2002-01-01

Introduction: We present a Case of Cushing's syndrome (CS) in a 16 year old male adolescent. Adrenocortical micro nodular dysplasia is a rare cause of CS. It mostly develops in the first two decades of life. In pathogenesis a stimulatory effect of circulating Immunoglobulins on adrenal steroidogenesis has been postulated. Familial cases have been reported in relation to Carney's Syndrome. We report the clinical case at first diagnosis and preoperative follow up of 1 year prior to treatment. The leading symptoms were severe bilateral (fibrotic) gynaecomastia, weight gain and growth retardation, without hypertension,but osteoporosis, secondary hypogonadism and glucose intolerance. Laboratory findings and the results of functional tests were diagnostic for CS. In addition LDH (I-131 Isotopes), CK, Lipoproteins, GPT, Androstendion, Prolactin were elevated. MRI abdomen revealed a slight enlargement of the adrenals, and suspected a bilateral micro nodular dysplasia. Iodo-cholesterol-scan under dexamethason suppression showed a diffuse bilateral Iodo-cholesterol uptake confirming the autonomous production of cortisol bilateral in the adrenals.Whole body bone scan showed a diffuse reduced diphosphonate uptake in the skeleton and the growth plates. The bone mineral density was significantly reduced.Radiologically osteoporosis was overt. The rapid increase of free urinary cortisol excretion/24h within one year of observation led to a total bilateral adrenalectomy. Postoperative 5 year follow up examinations. Documentation of the outcome and recovery of clinical signs,symptoms and laboratory findings, discussion about the most appropriate long-term substitution therapy. Familial anamnesis:affected family member was the father (micro nodular bilateral adrenocortical dysplasia), the aunt (pararenal incidentaloma, histologically lipoma) and a cousin (micro nodular adrenocortical dysplasia). Sequential analysis of the menin gene from the patient was negative.The detection of

Presence of voltage-gated potassium channel complex antibody in a case of genetic prion disease.

Science.gov (United States)

Jammoul, Adham; Lederman, Richard J; Tavee, Jinny; Li, Yuebing

2014-06-05

Voltage-gated potassium channel (VGKC) complex antibody-mediated encephalitis is a recently recognised entity which has been reported to mimic the clinical presentation of Creutzfeldt-Jakob disease (CJD). Testing for the presence of this neuronal surface autoantibody in patients presenting with subacute encephalopathy is therefore crucial as it may both revoke the bleak diagnosis of prion disease and allow institution of potentially life-saving immunotherapy. Tempering this optimistic view is the rare instance when a positive VGKC complex antibody titre occurs in a definite case of prion disease. We present a pathologically and genetically confirmed case of CJD with elevated serum VGKC complex antibody titres. This case highlights the importance of interpreting the result of a positive VGKC complex antibody with caution and in the context of the overall clinical manifestation. 2014 BMJ Publishing Group Ltd.

The evaluation of complex interventions in palliative care: an exploration of the potential of case study research strategies.

Science.gov (United States)

Walshe, Catherine

2011-12-01

Complex, incrementally changing, context dependent and variable palliative care services are difficult to evaluate. Case study research strategies may have potential to contribute to evaluating such complex interventions, and to develop this field of evaluation research. This paper explores definitions of case study (as a unit of study, a process, and a product) and examines the features of case study research strategies which are thought to confer benefits for the evaluation of complex interventions in palliative care settings. Ten features of case study that are thought to be beneficial in evaluating complex interventions in palliative care are discussed, drawing from exemplars of research in this field. Important features are related to a longitudinal approach, triangulation, purposive instance selection, comprehensive approach, multiple data sources, flexibility, concurrent data collection and analysis, search for proving-disproving evidence, pattern matching techniques and an engaging narrative. The limitations of case study approaches are discussed including the potential for subjectivity and their complex, time consuming and potentially expensive nature. Case study research strategies have great potential in evaluating complex interventions in palliative care settings. Three key features need to be exploited to develop this field: case selection, longitudinal designs, and the use of rival hypotheses. In particular, case study should be used in situations where there is interplay and interdependency between the intervention and its context, such that it is difficult to define or find relevant comparisons.

A Real-Life Case Study of Audit Interactions--Resolving Messy, Complex Problems

Science.gov (United States)

Beattie, Vivien; Fearnley, Stella; Hines, Tony

2012-01-01

Real-life accounting and auditing problems are often complex and messy, requiring the synthesis of technical knowledge in addition to the application of generic skills. To help students acquire the necessary skills to deal with these problems effectively, educators have called for the use of case-based methods. Cases based on real situations (such…

A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

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Yeliz Guven

2015-01-01

Full Text Available The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

Comparison of force fields and calculation methods for vibration intervals of isotopic H+3 molecules

International Nuclear Information System (INIS)

Carney, G.D.; Adler-Golden, S.M.; Lesseski, D.C.

1986-01-01

This paper reports (a) improved values for low-lying vibration intervals of H + 3 , H 2 D + , D 2 H + , and D + 3 calculated using the variational method and Simons--Parr--Finlan representations of the Carney--Porter and Dykstra--Swope ab initio H + 3 potential energy surfaces, (b) quartic normal coordinate force fields for isotopic H + 3 molecules, (c) comparisons of variational and second-order perturbation theory, and (d) convergence properties of the Lai--Hagstrom internal coordinate vibrational Hamiltonian. Standard deviations between experimental and ab initio fundamental vibration intervals of H + 3 , H 2 D + , D 2 H + , and D + 3 for these potential surfaces are 6.9 (Carney--Porter) and 1.2 cm -1 (Dykstra--Swope). The standard deviations between perturbation theory and exact variational fundamentals are 5 and 10 cm -1 for the respective surfaces. The internal coordinate Hamiltonian is found to be less efficient than the previously employed ''t'' coordinate Hamiltonian for these molecules, except in the case of H 2 D +

Complexities and dilemmas in the sharing economy : the Uber case

NARCIS (Netherlands)

Boshuijzen van Burken, C.; Haftor, D.M.

2017-01-01

By taking Uber as a case, we take a practice focus, in-depth analysis of the sharing economy. The business model that is typical for the sharing economy is based on using underutilized goods by private persons through digital technologies. In this paper, we bring together the complex reality of the

Dependent personality features in a complex case of borderline personality disorder.

Science.gov (United States)

Nirestean, Tudor; Lukacs, Emese; Nirestean, Aurel; Gabos Grecu, Iosif

2016-11-01

Borderline personality disorder is a complex disease model as it encompasses a diversity of pathological personality traits and psychopathological symptoms. It is not surprising, therefore, that it is often manifested by personality disorders across all three clusters and accompanied by other mental (Axis I) disorders. This melange makes both psychological treatment and pharmacotherapy especially challenging, and this paper describes the case of a particularly complex case of a 33-year-old Romanian patient, who has a history of severe deprivation in childhood, mood and substance use disorder in association with borderline pathology. In the course of treatment from many sources and interventions, it has become clear that dependence is a key component of the pathology and has been rewarded with a degree of success in management. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Economic Value Creation in Metro Complexes: Case Study on Sadr Station Complex in Tehran

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Nima Jafari

2017-04-01

Full Text Available The main objective of this research is economic value creation methods in metro station centers with the case study of Sadr Station complex in Tehran. The research implements a descriptive approach by benefiting from the data of a cross-sectional survey which was collected by the authors. The target population included all scholars of urban development and transport academics, capitalists and directors of the station complex with the total number of 1,100 people. By using a random sampling, 285 people were surveyed with a 25-item questionnaire developed by the researchers. The results suggest priority of value creation respectively in areas of collaborative, competitive, private, governmental, and personal. The test results also showed that among the components of economic value creation (corporate, individual, competitive, governmental and private, the observed correlation was significant. According to the obtained results, development of economic value creation in station centers seems necessary.

Organic complexation of radionuclides in cement pore water: a case study

International Nuclear Information System (INIS)

Hummel, W.

1993-01-01

The influence of the organic ligands EDTA (ethylenediaminetetraacetate), NTA (nitrilotriacetate), citrate and oxalate on the speciation of Cs, Sr, Ra, Ni, Pd, Tc, Sn, Zr, Th, U, Np, Pu, Am and Cm in cement pore waters is studied by means of chemical equilibria. Emphasis is laid on the development of a complete and consistent thermodynamic data base for the high pH range beyond pH 11. Missing data are estimated using free-energy relationships derived from a large number of experimentally determined stability constants compiled from the literature. In case where a sound estimation of stability constants is not possible due to the scarcity of quantitative information, at least upper limits are assessed for the stability of all possibly important species. Chemical equilibria were computed within the range of pH 11 to 13 and a range of Ca concentrations from 0.001 to 0.1 mol -1 (M). ETDA complexes predominate only in the case of Ni. In all other cases, the competition of Ca-organic or metal-hydroxo complexes successfully prevent any significant influence of EDTA, NTA, citrate or oxalate on the speciation of these radionuclides. (author) 10 figs., 9 refs

[A reflective case report applied to pain management in a complex care situation].

Science.gov (United States)

Kinsperger, Laura; Mayrhofer, Stefanie Maria; Pichler, Birgit; Qin, Hong; Rheinfrank, Iris; Schrems, Berta

2015-10-01

This case report deals with the unsatisfying pain management of a 44 year old patient with cardiac arrest and subsequent cardiopulmonary resuscitation. The patient has (1) a reduced consciousness, (2) is isolated due to an infection with multi-resistant germs, (3) has a tracheotomy and (4) contractures of the muscles in fingers and hands. During nursing care he shows facial expressions and body postures that indicate pain which is insufficiently addressed. The case was processed according to the model of reflexive case report by Johns (1995) and interpreted by theoretical expertise and the change of the perspective. Therefore the following questions were answered: Which factors made the nurse who brought the case to the case deliberation feeling dissatisfied with the pain management? Insufficient pain management due to a lack of knowledge, no assessment of the state of consciousness, pain and isolation probably led to unnecessary burden of the patient, next of kin and nurses. Training, systematic pain management and multi-disciplinary case conferences might facilitate dealing with comparable complex situations of caring in the future. The present case report shows that pain can only be treated successfully if pain-triggering factors are recognized, systematically assessed and treated. An adequate external assessment of the pain situation is especially important when dealing with patients who suffer from disorders of consciousness. In complex cases, in which multiple factors influence the pain situation, interdisciplinary case conferences may help to improve the quality of pain management.

Compound-complex odontoma: A case report of a rare variant

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Nishath Khanum

2014-01-01

Full Text Available The odontoma is a benign tumor containing all the various component tissues of the teeth. It is the most common odontogenic tumor representing 67% of all odontogenic tumors. Odontomas are considered to be developmental anomalies (hamartomas rather than true neoplasms. Based on the degree of morphodifferentiation or on the basis of their resemblance to normal teeth, they are divided into compound and complex odontomas. The compound odontoma is composed of multiple, small tooth-like structures. The complex odontoma consists of a conglomerate mass of enamel and dentin, which bears no anatomic resemblance to a tooth. They are usually diagnosed on routine radiological examinations in the second decade of life and are often slow growing and non-aggressive in nature. Here, we report a case of rare, unusually large, compound-complex odontoma, located in the left anterior maxilla of a 13-year-old male patient.

A possible new syndrome with growth-hormone secreting pituitary adenoma, colonic polyposis, lipomatosis, lentigines and renal carcinoma in association with familial testicular germ cell malignancy: A case report

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Mai Phuong L

2007-03-01

Full Text Available Abstract Background Germ-cell testicular cancer has not been definitively linked to any known hereditary cancer susceptibility disorder. Familial testicular cancer in the presence of other findings in affected and unaffected family members might indicate a previously-unidentified hereditary cancer syndrome. Case presentation The patient was diagnosed with a left testicular seminoma at age 28, and treated with left orchiectomy followed by adjuvant cobalt radiation. His family history is significant for testicular seminoma in his son, bladder cancer in his sister, and lipomatosis in his father. His evaluation as part of an etiologic study of familial testicular cancer revealed multiple colon polyps (adenomatous, hyperplastic, and hamartomatous first found in his 50 s, multiple lipomas, multiple hyperpigmented skin lesions, left kidney cancer diagnosed at age 64, and a growth-hormone producing pituitary adenoma with associated acromegaly diagnosed at age 64. The patient underwent genetic testing for Cowden syndrome (PTEN gene, Carney complex (PRKAR1A gene, and multiple endocrine neoplasia syndrome type 1 (MEN1 gene; no deleterious mutations were identified. Discussion The constellation of benign and malignant neoplasms in the context of this patient's familial testicular cancer raised the possibility that these might be manifestations of a known hereditary susceptibility cancer syndrome; however, genetic testing for the three syndromes that were most likely to explain these findings did not show any mutation. Alternatively, this family's phenotype might represent a novel neoplasm susceptibility disorder. This possibility cannot be evaluated definitively on the basis of a single case report; additional observations and studies are necessary to investigate this hypothesis further.

Peripheral ameloblastic fibro-odontoma or peripheral developing complex odontoma: report of a case

DEFF Research Database (Denmark)

Reibel, Jesper; Grønbæk, Anni Birgitte; Poulsen, Sven

2011-01-01

BACKGROUND. Peripheral (extraosseous) odontogenic tumors are rare. CASE REPORT. This report describes a case which illustrates the clinical and histopathological features of a lesion in an 8-year-old, healthy Caucasian girl that on purely morphological grounds would seem to be an ameloblastic fibro-odontoma......, but may represent a case of a peripheral developing complex odontoma. CONCLUSION. Conservative surgical enucleation of the lesion was followed by unbcomplicated healing and no recurrence was seen....

Severe calcified stylohyoid complex in twins: a case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Jo Eun; Min, Jung Hyun; Park, Hae Rang; Choi, Bo Ram; Huh, Kyung Hoe [School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Choi, Jin Woo [Dankook University College of Dentistry, Cheonan (Korea, Republic of)

2012-06-15

The styloid process is a cylindrical, long cartilaginous bone located on the temporal bone. The calcified stylohyoid ligament and elongated styloid process can be identified radiographically, and they are associated with a number of syndromes and symptoms. The exact cause of the styloid process elongation due to calcification and subsequent ossification of ligament is unclear. This report presents a case of severely calcified stylohyoid ligament complex occurred in twins who have the same pattern of calcification.

An Unusual Case of Heteropagus: Autosite With a Complex Cardiac Malformation

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Hulya Ozkan-Ulu

2011-12-01

Full Text Available Asymmetrical form of conjoined twinning (heteropagus is an extremely rare event with an incidence of 1–2 million live births. The incomplete component of heteropagus, namely, parasite, usually consists of rudimentary organs. Therefore, the autosite component of heteropagus can be separated successfully. A wide spectrum of associated congenital cardiac malformations, which are usually minor, has been described in autosites. However, a single-ventricle heart anomaly in the autosite has been reported in a very few cases. We report an unusual case of heteropagus with a complex cardiac malformation. To the best of our knowledge, this is the third heteropagus case in the literature with a single-ventricle heart in the autosite.

Apocrine carcinoma arising in a complex fibroadenoma: a case report.

Science.gov (United States)

Mele, Marco; Vahl, Pernille; Funder, Jonas Amstrup; Sorensen, Anne Schmidt; Jensen, Vibeke

2014-01-01

A carcinoma arising in a fibroadenoma is a rare event, which often entails a diagnostic challenge. The most common type is the lobular carcinoma and secondary a ductal carcinoma. We present an extremely rare case of malignant development of an invasive apocrine carcinoma in a complex fibroadenoma and underline the importance for clinicians to recognize the possibility of benign and malignant co-existence especially in older women.

Operationalization of biopsychosocial case complexity in general health care : the INTERMED project

NARCIS (Netherlands)

de Jonge, P; Huyse, FJ; Slaets, JPJ; Sollner, W; Stiefel, FC

Objective: Lack of operationalization of the biopsychosocial model hinders its effective application to the increasingly prevalent problems of comorbidities in clinical presentations. Here, we describe the INTERMED, an instrument to assess biopsychosocial case complexity in general health care, and

A suspected case of rocuronium-sugammadex complex-induced anaphylactic shock after cesarean section.

Science.gov (United States)

Yamaoka, Masakazu; Deguchi, Miki; Ninomiya, Kiichiro; Kurasako, Toshiaki; Matsumoto, Mutsuko

2017-02-01

An anaphylactic reaction during a cesarean section occurs rarely, and rocuronium is thought to be one of the common agents causing perioperative anaphylaxis. Here we report an anaphylactic shock after cesarean section that is suggested to be induced by the rocuronium-sugammadex complex. A 36-year-old primigravida underwent an elective cesarean section under general anesthesia due to placenta previa. While the operation was completed uneventfully, she developed anaphylactic shock following sugammadex administration. She was successfully managed with rapid treatments. Serum tryptase level was significantly elevated. Although sugammadex was first suspected to be the causative agent, the result of intradermal skin tests with sugammadex were negative. Surprisingly, a subsequent intradermal test with undiluted rocuronium caused the patient to fall into a state of shock. Furthermore, a later skin-prick test with pre-mixed rocuronium-sugammadex complex also revealed a strong positive reaction, and a test with only rocuronium showed negative. We finally concluded that the rocuronium-sugammadex complex is the causative agent in this case. To the best of our knowledge, this is the first report suggesting anaphylaxis caused by the rocuronium-sugammadex complex. This case highlights the importance of appropriate examinations to determinate the pathogenesis of anaphylaxis in order to establish risk reduction strategies.

Safety of gentamicin bladder irrigations in complex urological cases.

Science.gov (United States)

Defoor, William; Ferguson, Denise; Mashni, Susan; Creelman, Lisa; Reeves, Deborah; Minevich, Eugene; Reddy, Pramod; Sheldon, Curtis

2006-05-01

Recurrent urinary tract infections are common in complex pediatric urological cases, particularly those requiring clean intermittent catheterization. At our institution gentamicin bladder irrigations have been used for antimicrobial prophylaxis and to treat symptomatic bacteriuria, particularly when the infection does not involve the upper urinary tract. The purpose of this study was to assess the safety of this therapy. A retrospective study was performed of all children treated with gentamicin bladder irrigations from 1999 to 2004. The dose was 14 mg gentamicin in 30 ml saline instilled via catheter once or twice daily. Serum creatinine and random gentamicin levels were obtained according to a protocol based on risk of gentamicin toxicity. Patient demographics, laboratory results and outcomes were abstracted from the medical records. A total of 80 patients (38 males and 42 females) were identified. Median patient age was 10 years and median duration of treatment was 90 days. No patient had detectable serum gentamicin levels greater than 0.4 mg/dl. Small increases in serum creatinine were seen in 3 patients, all of whom had chronic renal insufficiency. A total of 21 patients (26%) had breakthrough UTIs, of which 5 (24%) were gentamicin resistant. No adverse events were documented. Gentamicin bladder irrigations are a helpful adjunct in the management of complex pediatric urological cases involving recurrent symptomatic bacteriuria. We no longer require intensive laboratory monitoring of low risk patients at our institution.

Embodying complexity through movement sonification : case study on empowering the speed-skater

NARCIS (Netherlands)

Stienstra, J.T.; Overbeeke, C.J.; Wensveen, S.A.G.

2011-01-01

In this paper, we describe the Augmented Speed-skate Experience (ASE), a case of movement sonification in professional speed-skating. We designed and developed a system that provides feedback on technique to a professional speed-skater through an extra sense-modality, i.e. sound. Complexity is

A Case Report of Intra-articular Bee Venom Pharmacopuncture for Partial Tear of Triangular Fibrocartilage Complex

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Lee, Kwangho

2009-12-01

Full Text Available Objective: This case was to report a case of Partial Tear of Triangular Fibrocartilage Complex treated by Intra-articular bee venom Pharmacopuncture. Methods: The patient was treated by Intra-articular bee venom Pharmacopuncture. The Effect of Treatment was evaluated by Visual Analog Scale(VAS and Modified Mayo Wrist Score(Wrist Score. Results & Conclusions: After Treatment, Patient's VAS decreased and Wrist Score increased. For this results, Intra-articular Bee Venom Pharmacopuncture may be effective for Partial Tear of Triangular Fibrocartilage Complex.

Exploitation and Optimization of Reservoir Performance in Hunton Formation, Oklahoma

Energy Technology Data Exchange (ETDEWEB)

Kelkar, Mohan

2001-05-08

This report presents the work done so far on Hunton Formation in West Carney Field in Lincoln County, Oklahoma. West Carney Field produces oil and gas from the Hunton Formation. The field was developed starting in 1995. Some of the unique characteristics of the field include decreasing water oil and ratio over time, decreasing gas-oil ratio at the beginning of production, inability to calculate oil reserves in the field based on long data, and sustained oil rates over long periods of time.

The Influence of Time Pressure and Case Complexity on Physicians׳ Diagnostic Performance

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Dalal A. ALQahtani

2016-12-01

Conclusions: Time pressure did not impact the diagnostic performance, whereas the complexity of the clinical case negatively influenced the diagnostic accuracy. Further studies with the enhanced experimental manipulation of time pressure are needed to reveal the effect of time pressure, if any, on a physician׳s diagnostic performance.

The influence of vertical disparity gradient and cue conflict on EEG omega complexity in Panum's limiting case.

Science.gov (United States)

Li, Huayun; Jia, Huibin; Yu, Dongchuan

2018-03-01

Using behavioral measures and ERP technique, researchers discovered at least two factors could influence the final perception of depth in Panum's limiting case, which are the vertical disparity gradient and the degree of cue conflict between two- and three-dimensional shapes. Although certain event-related potential components have been proved to be sensitive to the different levels of these two factors, some methodological limitations existed in this technique. In this study, we proposed that the omega complexity of EEG signal may serve as an important supplement of the traditional event-related potential technique. We found that the trials with lower vertical gradient disparity have lower omega complexity (i.e., higher global functional connectivity) of the occipital region, especially that of the right-occipital hemisphere. Moreover, for occipital omega complexity, the trials with low-cue conflict have significantly larger omega complexity than those with medium- and high-cue conflict. It is also found that the electrodes located in the middle line of the occipital region (i.e., POz and Oz) are more crucial to the impact of different levels of cue conflict on omega complexity than the other electrodes located in the left- and right-occipital hemispheres. These evidences demonstrated that the EEG omega complexity could reflect distinct neural activities evoked by Panum's limiting case configurations, with different levels of vertical disparity gradient and cue conflict. Besides, the influence of vertical disparity gradient and cue conflict on omega complexity may be regional dependent. NEW & NOTEWORTHY The EEG omega complexity could reflect distinct neural activities evoked by Panum's limiting case configurations with different levels of vertical disparity gradient and cue conflict. The influence of vertical disparity gradient and cue conflict on omega complexity is regional dependent. The omega complexity of EEG signal can serve as an important supplement of the

Large Complex Odontoma of Mandible in a Young Boy: A Rare and Unusual Case Report

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G. Siva Prasad Reddy

2014-01-01

Full Text Available Odontomas are the most common odontogenic tumors. They are broadly classified in to Compound Odontoma and Complex Odontoma. Among them complex odontoma is a rare tumor. Occasionally this tumor becomes large, causing expansion of bone followed by facial asymmetry. Otherwise these tumors are asymptomatic and are generally diagnosed on radiographic examination. We report a rare case of complex odontoma of mandible in a young boy. The tumor was treated by surgical excision under general anesthesia.

A Burst-Mode Photon-Counting Receiver with Automatic Channel Estimation and Bit Rate Detection

Science.gov (United States)

2016-02-24

Grein, M.E., Elgin, L.E., Robinson, B.S., Kachelmyer, A.L., Caplan , D.O., Stevens, M.L., Carney, J.J., Hamilton, S.A., and Boroson, D.M., “Demonstration...Robinson, B.S., Kerman, A.J., Dauler, E.A., Barron, R.J., Caplan , D.O., Stevens, M.L., Carney, J.J., Hamilton, S.A., Yang, J.K.W., and Berggren, K.K., “781...Mbit/s photon-counting optical communications using a superconducting nanowire detector,” Optics Letters, v. 31 no. 4 444-446 (2006). [14] Caplan

Perioprosthetic and Implant-Supported Rehabilitation of Complex Cases: Clinical Management and Timing Strategy.

Science.gov (United States)

Landi, Luca; Piccinelli, Stefano; Raia, Roberto; Marinotti, Fabio; Manicone, Paolo Francesco

2016-01-01

Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy.

Managing a complex case of hypospadias cripple and chordee

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Costin Gingu

2017-11-01

Full Text Available Objectives. Hypospadias is a congenital affliction in which the urethral meatus is located on the underside of the penis. These cases are usually treated during childhood by pediatric surgeons, but more complex forms tend to reoccur, and after several failed attempts end up as hypospadias cripple in the care of urologists at an adult age. The aim of this paper is to present the management of a complex case of hypospadias cripple associated with penile curvature (chordee. Materials and Methods. A 24 year old patient presented in our clinic with hypospadias cripple and ventral penile curvature. At the physical examination we found a penoscrotal urethral meatus, heavy scaring of the distal ventral penis and a ventral chordee of approximately 90 degrees in erect state. A two stage “Bracka” repair technique with buccal mucosa graft was chosen. The first stage of the surgery consisted of removing the scarred and defective distal urethral plate and the fibrotic tissue responsible for the penile curvature, preparing the corpora cavernosa for the graft, clefting the glans, harvesting two buccal mucosa grafts from both inner cheeks, and finally quilting the grafts on the defect. The second stage of the repair was performed after a period of about six months, and consisted in the tubularization of the matured graft and glans plasty. Results and Conclusions. No immediate or late complications occurred after any of the two stages of the surgery; no significant ventral chordee was observed and no urethral fistula occurred till the one year follow-up. A two stage “Bracka” repair technique is best suited for treating these patients, correcting ventral chordee in the first session.

How Can We Explain Poverty? Case Study of Dee Reveals the Complexities

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Seccombe, Karen

2011-01-01

Many theories have been offered to explain why people are impoverished. This article by Karen Seccombe uses the case study of "Dee," a newly single mother, to explore four of the most common: individualism, social structuralism, the culture of poverty, and fatalism. She concludes that poverty is a highly complex phenomenon, and it is likely that…

Idealized tropical cyclone simulations of intermediate complexity: A test case for AGCMs

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Kevin Reed

2012-04-01

Full Text Available The paper introduces a moist, deterministic test case of intermediate complexity for Atmospheric General Circulation Models (AGCMs. We suggest pairing an AGCM dynamical core with simple physical parameterizations to test the evolution of a single, idealized, initially weak vortex into a tropical cyclone. The initial conditions are based on an initial vortex seed that is in gradient-wind and hydrostatic balance. The suggested ``simple-physics'' package consists of parameterizations of bulk aerodynamic surface fluxes for moisture, sensible heat and momentum, boundary layer diffusion, and large-scale condensation. Such a configuration includes the important driving mechanisms for tropical cyclones, and leads to a rapid intensification of the initial vortex over a forecast period of ten days. The simple-physics test paradigm is not limited to tropical cyclones, and can be universally applied to other flow fields. The physical parameterizations are described in detail to foster model intercomparisons.The characteristics of the intermediate-complexity test case are demonstrated with the help of four hydrostatic dynamical cores that are part of the Community Atmosphere Model version 5 (CAM 5 developed at the National Center for Atmospheric Research (NCAR. In particular, these are the Finite-Volume, Spectral Element, and spectral transform Eulerian and semi-Lagrangian dynamical cores that are coupled to the simple-physics suite. The simulations show that despite the simplicity of the physics forcings the models develop the tropical cyclone at horizontal grid spacings of about 55 km and finer. The simple-physics simulations reveal essential differences in the storm's structure and strength due to the choice of the dynamical core. Similar differences are also seen in complex full-physics aqua-planet experiments with CAM 5 which serve as a motivator for this work. The results suggest that differences in complex full-physics simulations can be, at least

AIC and the challenge of complexity: A case study from ecology.

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Moll, Remington J; Steel, Daniel; Montgomery, Robert A

2016-12-01

Philosophers and scientists alike have suggested Akaike's Information Criterion (AIC), and other similar model selection methods, show predictive accuracy justifies a preference for simplicity in model selection. This epistemic justification of simplicity is limited by an assumption of AIC which requires that the same probability distribution must generate the data used to fit the model and the data about which predictions are made. This limitation has been previously noted but appears to often go unnoticed by philosophers and scientists and has not been analyzed in relation to complexity. If predictions are about future observations, we argue that this assumption is unlikely to hold for models of complex phenomena. That in turn creates a practical limitation for simplicity's AIC-based justification because scientists modeling such phenomena are often interested in predicting the future. We support our argument with an ecological case study concerning the reintroduction of wolves into Yellowstone National Park, U.S.A. We suggest that AIC might still lend epistemic support for simplicity by leading to better explanations of complex phenomena. Copyright © 2016 Elsevier Ltd. All rights reserved.

COMPLEXITY OF ECOLOGICAL SYSTEMS (THE CASE OF MARINE CILIATE COMMUNITY

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I.V. Burkovsky

2016-03-01

Full Text Available The paper analyzes the seasonal and long-term dynamics of marine interstitial ciliates communities as a result of the processes of system self-organization (of increasing complexity in constantly fluctuating environment. The traits of simple structure of ciliate community include substantial variability in the composition (even in case of stable environment and the lack of sustainable combinations of species. The mechanism of the current state maintenance is the lack of energy supply in certain periods or in specific loci of space, as well as large amplitude and unpredictable fluctuations of environmental factors. An indication of the community’s complexity is availability of stable combinations of species in time and space. The mechanisms of formation of stable species combinations are a constant flow of external energy, optimal values and stability of environmental factors (including repeatability of seasonal cycles and the use of space resources by species according the principle of complementarity of ecological niches.

Familial isolated primary pigmented nodular adrenocortical disease associated with a novel low penetrance PRKAR1A gene splice site mutation

DEFF Research Database (Denmark)

Storr, Helen L; Metherell, Louise A; Dias, Renuka

2010-01-01

Primary pigmented nodular adrenocortical disease (PPNAD) is associated with inactivating germline protein kinase A regulatory subunit type 1-alpha (PRKAR1A) mutations and loss of heterozygosity at the 17q22-24 locus in approximately 50% patients. PRKAR1A mutations are observed in both isolated PP...... PPNAD (iPPNAD) and Carney complex (CNC). Most mutations result in a functionally null-allele and exhibit high penetrance. We genotyped members of an extended family for a novel PRKAR1A mutation and undertook detailed phenotyping for CNC in the affected individuals....

Perioprosthetic and Implant-Supported Rehabilitation of Complex Cases: Clinical Management and Timing Strategy

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Luca Landi

2016-01-01

Full Text Available Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy.

Papillary proliferation of the endometrium: a clinicopathologic study of 59 cases of simple and complex papillae without cytologic atypia.

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Ip, Philip P C; Irving, Julie A; McCluggage, W Glenn; Clement, Philip B; Young, Robert H

2013-02-01

Papillary proliferation of the endometrium (PPE) without cytologic atypia is uncommon and has only been studied in detail by Lehman and Hart in 2001. On histologic examination, PPE ranges from simple papillae with fibrovascular cores, often involving the surface of endometrial polyps, to complex intracystic proliferations; some consider the latter to be analogous to nonatypical complex hyperplasia. To further characterize PPE, with emphasis on the risk of and features associated with concurrent or subsequent neoplasia, the clinicopathologic features of 59 cases without cytologic atypia were studied. The cases were classified into 2 groups according to the degree of architectural complexity and extent of proliferation. Group 1 consisted of those with localized simple papillae. Simple papillae were defined as those with short, predominantly nonbranching stalks; those with occasional secondary branches and/or detached papillae were also included in this group. Localized proliferations were those with 1 or 2 foci involving the surface or the subjacent glands of polyps or nonpolypoid endometrium. Group 2 consisted of those with complex papillae and/or those with diffuse and crowded intracystic papillae. Complex papillae were those with either short or long stalks, with frequent secondary and complex branches. Diffuse proliferation was defined as presence of 3 or more foci within a specimen or involvement of >50% of the endometrial polyp by simple or complex PPE. Any coexistent or subsequent hyperplasia of conventional type (World Health Organization classification) or adenocarcinoma was recorded. The age of patients ranged from 23 to 82 years (median, 53 y); 36 (61%) were postmenopausal. The majority presented with abnormal vaginal bleeding. Sixteen patients (27%) were receiving hormonal preparations including 5 who were treated with a progestogen for preexisting endometrial hyperplasia or low-grade endometrioid adenocarcinoma. The histologic diagnosis of PPE was made

Does model performance improve with complexity? A case study with three hydrological models

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Orth, Rene; Staudinger, Maria; Seneviratne, Sonia I.; Seibert, Jan; Zappa, Massimiliano

2015-04-01

In recent decades considerable progress has been made in climate model development. Following the massive increase in computational power, models became more sophisticated. At the same time also simple conceptual models have advanced. In this study we validate and compare three hydrological models of different complexity to investigate whether their performance varies accordingly. For this purpose we use runoff and also soil moisture measurements, which allow a truly independent validation, from several sites across Switzerland. The models are calibrated in similar ways with the same runoff data. Our results show that the more complex models HBV and PREVAH outperform the simple water balance model (SWBM) in case of runoff but not for soil moisture. Furthermore the most sophisticated PREVAH model shows an added value compared to the HBV model only in case of soil moisture. Focusing on extreme events we find generally improved performance of the SWBM during drought conditions and degraded agreement with observations during wet extremes. For the more complex models we find the opposite behavior, probably because they were primarily developed for prediction of runoff extremes. As expected given their complexity, HBV and PREVAH have more problems with over-fitting. All models show a tendency towards better performance in lower altitudes as opposed to (pre-) alpine sites. The results vary considerably across the investigated sites. In contrast, the different metrics we consider to estimate the agreement between models and observations lead to similar conclusions, indicating that the performance of the considered models is similar at different time scales as well as for anomalies and long-term means. We conclude that added complexity does not necessarily lead to improved performance of hydrological models, and that performance can vary greatly depending on the considered hydrological variable (e.g. runoff vs. soil moisture) or hydrological conditions (floods vs. droughts).

Circle of Willis variation in a complex stroke presentation: a case report

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Young Carolyn A

2006-03-01

Full Text Available Abstract Background The impact of circle of Willis anatomical variation upon the presentation of stroke is probably underrecognised. Case presentation A 63-year-old right-handed woman developed a left hemiparesis and right leg weakness sequentially following a road traffic accident (RTA. Despite initial concern about the possibility of cervical spinal cord injury, the final diagnosis was bilateral artery-to-artery embolic cerebral infarction with dominant right internal carotid artery. Conclusion The case illustrates the complex presentation of stroke as a pseudo-cervical cord lesion and the impact of circle of Willis anatomical variation upon the expression of large vessel cerebrovascular disease.

Melanotic Schwannomas Are Rarely Seen Pigmented Tumors with Unpredictable Prognosis and Challenging Diagnosis.

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Keskin, Elif; Ekmekci, Sumeyye; Oztekin, Ozgur; Diniz, Gulden

2017-01-01

Melanotic Schwannoma (MS) is rarely seen and potentially malignant neoplasm that is categorized as a variant of Schwannoma. MS most frequently involves intracranial structures followed by posterior nerve roots in the spinal canal. Approximately 50% of the cases with MS have psammomatous calcifications and this type of MS is related to Carney complex with autosomal dominant inheritance. Most cases of MS are benign, though 10% of them are malignant with metastatic potential. MS mimics melanoma and the differential diagnosis should be made excluding other melanin producing neoplasms especially melanoma. Case 1 . A 42-year-old hypertensive male presented for checkup. He had a well-defined extraspinal oval lesion measuring 3.5 × 2.5 cm near right adrenal. Case 2 . A 22-year-old female presented with neurofibromatosis-2, bilateral acoustic schwannomas and café au lait lesions on sacrococcygeal region. She had an intradural extramedullary lesion measuring 6.1 × 2.0 cm at L1-2 level. MS is a rare neoplasm composed of Schwann cells and melanin pigment. These tumors are usually benign but they may become aggressive. The biologic behavior of MS is difficult to predict; the patients have to be followed up for a longer period due to its malignant potential.

APPLICATION OF AUGMENTED AND VIRTUAL REALITY IN RESIDENTIAL COMPLEX PRESENTATION, CASE STUDY: ENERGOPROJEKT SUNNYVILLE

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PEJIC Petar

2017-05-01

Full Text Available The traditional method of residential complex project presentations involves the use of a printed poster or elaborate on which the building is presented by using of two-dimensional drawings and images. The main traditional approach problem is the presentation of three-dimensional space on two-dimensional paper. The main focus of this paper is the development of contemporary, mobile systems for residential complex presentations which will be presented on a case study of “Energoprojekt Sunnyville” using a method of virtual and augmented reality. This approach enables easier and better understanding of all types of architectural objects and urban complex, allowing the user intuitive spatial overview of architectural work.

A case for Sandia investment in complex adaptive systems science and technology.

Energy Technology Data Exchange (ETDEWEB)

Colbaugh, Richard; Tsao, Jeffrey Yeenien; Johnson, Curtis Martin; Backus, George A.; Brown, Theresa Jean; Jones, Katherine A.

2012-05-01

This white paper makes a case for Sandia National Laboratories investments in complex adaptive systems science and technology (S&T) -- investments that could enable higher-value-added and more-robustly-engineered solutions to challenges of importance to Sandia's national security mission and to the nation. Complex adaptive systems are ubiquitous in Sandia's national security mission areas. We often ignore the adaptive complexity of these systems by narrowing our 'aperture of concern' to systems or subsystems with a limited range of function exposed to a limited range of environments over limited periods of time. But by widening our aperture of concern we could increase our impact considerably. To do so, the science and technology of complex adaptive systems must mature considerably. Despite an explosion of interest outside of Sandia, however, that science and technology is still in its youth. What has been missing is contact with real (rather than model) systems and real domain-area detail. With its center-of-gravity as an engineering laboratory, Sandia's has made considerable progress applying existing science and technology to real complex adaptive systems. It has focused much less, however, on advancing the science and technology itself. But its close contact with real systems and real domain-area detail represents a powerful strength with which to help complex adaptive systems science and technology mature. Sandia is thus both a prime beneficiary of, as well as potentially a prime contributor to, complex adaptive systems science and technology. Building a productive program in complex adaptive systems science and technology at Sandia will not be trivial, but a credible path can be envisioned: in the short run, continue to apply existing science and technology to real domain-area complex adaptive systems; in the medium run, jump-start the creation of new science and technology capability through Sandia's Laboratory Directed Research

[Arterial hypertension and RU-486: a complex case of secondary hypertension].

Science.gov (United States)

Leone, Alessandra; Pisaneschi, Silvia; Montereggi, Francesco; Canu, Letizia; Corsini, Elisa; Mannelli, Massimo; Montereggi, Alessio

2013-06-01

Secondary hypertension accounts for 10-15% of all cases of hypertension, and early diagnosis with identification of its etiology can be challenging. In this scenario, therapeutic management of affected patients may be difficult. Hypercortisolism is one of the possible causes of secondary hypertension, but its low prevalence and atypical clinical symptoms can lead to a delayed diagnosis. The complex clinical presentation and potential complications need a close collaboration among different clinicians in order to plan optimal or new treatment protocols.

Xanthogranulomatous Pyelonephritis Can Simulate a Complex Cyst: Case Description and Review of Literature

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Salvatore Butticè

2014-05-01

Full Text Available Xanthogranulomatous pyelonephritis is a rare and peculiar form of chronic pyelonephritis and is generally associated with renal lithiasis. Its incidence is higher in females. The peculiarity of this disease is that it requires a differential diagnosis, because it can often simulate dramatic pathologic conditions. In fact, in the literature are also described cases in association with squamous cell carcinoma of the kidney The radiologic clinical findings simulate renal masses, sometimes in association with caval thrombus. We describe a case of xanthogranulomatous pyelonephritis with radiologic aspects of a complex cyst of Bosniak class III in a man 40-year old.

Complex Regional Pain Syndrome (CRPS Type II After Carpal Tunnel Release Surgery: Case Report

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Hakan Tunç

2010-08-01

Full Text Available Summary Complex regional pain syndrome is a chronic syndrome characterised with dystrophic changes and neurovascular disordes of bone and skin of extremities. The most common etiological factors are trauma, ischemic heart disease, cerebral lesions, servical region disorders, infections, and surgical treatments. Carpal tunnel syndrome is the most common compressive neuropaty of the upper extremity. There are various surgical and conservative alternatives in the treatment of carpal tunnel syndrome. Complex regional pain syndrome has been reported as a complication of surgical carpal tunnel release in 2-5% of patients. In this case report clinical characteristics and rehabilitation outcomes of a patient with complex regional pain syndrome after carpal tunnel release surgery is presented. (Osteoporoz Dünyasından 2010;16:41-3

Adult congenital cardiopathy: percutaneous treatment of a complex case

International Nuclear Information System (INIS)

Suarez N, Alberto; Carvajal, Andres; Bustillo, Sabas

2008-01-01

Adult congenital cardiopathy is a clinical entity difficult to treat and diagnose. Since 1982 endovascular therapy changed its approach radically (1) and in the last years the design of new appliances and better balloon catheters facilitated the implementation of therapy to a greater number of patients (2). It is the election treatment for entities such as pulmonary valve stenosis (3), atrial septal defect (4) and persistent ductus arteriosus. We present the case of complex adult congenital cardiopathy that consisted of wide atrial septal defect,pulmonary valve stenosis with severe repercussion on the right ventricle, persistent PDA with severe calcification and pulmonary arterial hypertension and systemic essential arterial hypertension that were successfully treated through interventionist endovascular therapy in the Hospital Militar Central, in Bogota.

How Well Do Student Nurses Write Case Studies? A Cohesion-Centered Textual Complexity Analysis

NARCIS (Netherlands)

Dascalu, Mihai; Dessus, Philippe; Thuez, Laurent; Trausan-Matu, Stefan

2017-01-01

Starting from the presumption that writing style is proven to be a reliable predictor of comprehension, this paper investigates the extent to which textual complexity features of nurse students’ essays are related to the scores they were given. Thus, forty essays about case studies on infectious

Sporadic and genetic forms of paediatric somatotropinoma: a retrospective analysis of seven cases and a review of the literature

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Nozières Cécile

2011-10-01

Full Text Available Abstract Background Somatotropinoma, a pituitary adenoma characterised by excessive production of growth hormone (GH, is extremely rare in childhood. A genetic defect is evident in some cases; known genetic changes include: multiple endocrine neoplasia type 1 (MEN1; Carney complex; McCune-Albright syndrome; and, more recently identified, aryl hydrocarbon receptor-interacting protein (AIP. We describe seven children with somatotropinoma with a special focus on the differences between genetic and sporadic forms. Methods Seven children who presented in our regional network between 1992 and 2008 were included in this retrospective analysis. First-type therapy was somatostatin (SMS analogues or transsphenoidal surgery. Control was defined as when insulin-like growth factor-1 (IGF-1 levels were within the normal range for the patient's age at 6 months after therapy, associated with decreasing tumour volume. Results Patients were aged 5-17 years and the majority (n = 6 were male. Four patients had an identified genetic mutation (McCune-Albright syndrome: n = 1; MEN1: n = 1; AIP: n = 2; the remaining three cases were sporadic. Accelerated growth rate was reported as the first clinical sign in four patients. Five patients presented with macroadenoma; invasion was noted in four of them (sporadic: n = 1; genetic: n = 3. Six patients were treated with SMS analogues; normalisation of IGF-1 occurred in one patient who had a sporadic intrasellar macroadenoma. Multiple types of therapy were necessary in all patients with an identified genetic mutation (4 types: n = 1; 3 types: n = 2; 2 types: n = 1, whereas two of the three patients with sporadic somatotropinoma required only one type of therapy. Conclusions This is the first series that analyzes the therapeutic response of somatotropinoma in paediatric patients with identified genetic defects. We found that, in children, genetic somatotropinomas are more invasive than sporadic somatotropinomas. Furthermore

Three-stage management of complex pancreatic trauma with gastroduodenopancreatectomy: A case report

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Sergio Henrique Bastos Damous

Full Text Available Introduction: Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. Presentation of case: Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head. Gastroduodenopancreatectomy was performed with right hemicolectomy and the peritoneal cavity was temporarily closed by a vacuum peritoneostomy. Surgical reopening occurred on the fifth postoperative day, and the patient was subjected to single-loop reconstruction of the intestinal transit with telescoping pancreaticojejunal anastomosis, biliodigestive anastomosis with termino-lateral hepaticojejunal anastomosis with a Kehr drain and gastroenteroanastomosis in 2 planes. The terminal ileostomy was maintained. After 2 days, the patient was subjected to abdominal wall closure without complications, which required relaxing Gibson incisions and wound closure with polypropylene mesh placement in a pre-aponeurotic position closed with multiple stitches. Results: The patient was discharged on the 40th post-trauma day without drains, with a functioning ileostomy and with a scheduled reconstruction of intestinal transit. Conclusion: In the presence of multiple associated injuries, hemodynamic instability and the need for an extensive surgical procedure such as duodenopancreatectomy, damage control surgery performed in stages as reported here enables the clinical stabilization of the patient for definitive treatment, achieving better survival results. Keywords: Pancreatic trauma, Complex trauma, Damage control, Trauma, Gastroduodenopancreatectomy

CLINICAL CASE OF TREATMENT WITH RIBOSOMAL COMPLEX IN CHILD WITH COMPROMISED IMMUNITY

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A.A. Alekseeva

2011-01-01

Full Text Available The leading pathology in children is acute respiratory infections (ARI according to the expert data of WHO. The incidence of prolonged and recurrent types of ARI increases during recent years. Patients with these diseases subsequently form the group of children with compromised immunity. Immunogens and immunomodulators are the drugs of nonspecific prophylaxis which are used for the prevention of ARI. The group of bacterial immunomodulators is big but most well-studied systemic drug from this group is Ribomunyl. Ribosomal complex is effective and safe in pediatric practice. The article presents the clinical case of treatment with ribosomal complex in immunocompronised child with allergic pathology.Key words: children with compromised immunity, allergy, acute respiratory infections, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2: 211–215

Assessing health care needs and clinical outcome with Urological case complexity : A study using INTERMED

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Herms, AMRD; Pinggera, GM; De Jonge, P; Strasser, H; Sollner, W

2003-01-01

Urinary tract symptoms and, particularly, urinary incontinence are often chronic and complex conditions that cause diagnosis, treatment, and management problems. In many cases, psychosocial factors contribute to the development of a chronic condition. The authors investigated whether INTERMED, an

[Refusal of care faced by case manager from elderly persons in complex situation: cross perspectives].

Science.gov (United States)

Corvol, A; Balard, F; Moutel, G; Somme, D

2014-01-01

Case management is a new professional field in France. It is addressed to elderly persons living in community whose situation is regarded as particularly complex. Case managers have to assess needs and coordinate necessary services. One common criteria of complexity is refusal of care. The objective of this study is to compare the words of users with those of case managers about refusal of care, in order to understand its meaning, professionals' attitudes and ethical challenges. Two researchers have cooperated on this qualitative research: the first one, anthropologist, interviewed 19 individuals, and 11 of their caregivers. The second one, geriatrician and researcher in medical ethics, lead four focus groups gathering a total of 18 case managers. Refusal of care often is the result of the will of preserving one's identity, compromised by illness. Individuals seek control on their life. Facing this behaviour, case managers try to secure the individual, by establishing a personal relationship that respects their choices, even if care has to be delayed. Refusal of care may sometimes disclose a desire to vanish, in front of which professionals meet their own limits. To recognise an elderly person that refuses care as a unique individual who can make choices secure his identity, and allow him to change. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Syndromes that Link the Endocrine System and Genitourinary Tract.

Science.gov (United States)

Özlük, Yasemin; Kılıçaslan, Işın

2015-01-01

The endocrine system and genitourinary tract unite in various syndromes. Genitourinary malignancies may cause paraneoplastic endocrine syndromes by secreting hormonal substances. These entities include Cushing`s syndrome, hypercalcemia, hyperglycemia, polycythemia, hypertension, and inappropriate ADH or HCG production. The most important syndromic scenarios that links these two systems are hereditary renal cancer syndromes with specific genotype/phenotype correlation. There are also some very rare entities in which endocrine and genitourinary systems are involved such as Carney complex, congenital adrenal hyperplasia and Beckwith-Wiedemann syndrome. We will review all the syndromes regarding manifestations present in endocrine and genitourinary organs.

Nurse-led case management for ambulatory complex patients in general health care: A systematic review

NARCIS (Netherlands)

Latour-Delfgaauw, C.H.M.; van der Windt, D.A.W.M.; de Jonge, P.; Riphagen, II; Vos, R.; Huyse, F.J.; Stalman, W.A.B.

2007-01-01

Objective: The aim of this study was to summarize the available literature on the effectiveness of ambulatory nurse-led case management for complex patients in general health care. Method: We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and Cinahl. We included randomized

Succinate Dehydrogenase Subunit B (SDHB Is Expressed in Neurofibromatosis 1-Associated Gastrointestinal Stromal Tumors (Gists: Implications for the SDHB Expression Based Classification of Gists

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Jeanny H. Wang, Jerzy Lasota, Markku Miettinen

2011-01-01

Full Text Available Gastrointestinal Stromal Tumor (GIST is the most common mesenchymal tumor of the digestive tract. GISTs develop with relatively high incidence in patients with Neurofibromatosis-1 syndrome (NF1. Mutational activation of KIT or PDGFRA is believed to be a driving force in the pathogenesis of familial and sporadic GISTs. Unlike those tumors, NF1-associated GISTs do not have KIT or PGDFRA mutations. Similarly, no mutational activation of KIT or PDGFRA has been identified in pediatric GISTs and in GISTs associated with Carney Triad and Carney-Stratakis Syndrome. KIT and PDGFRA-wild type tumors are expected to have lesser response to imatinib treatment. Recently, Carney Triad and Carney-Stratakis Syndrome -associated GISTs and pediatric GISTs have been shown to have a loss of expression of succinate dehydrogenase subunit B (SDHB, a Krebs cycle/electron transport chain interface protein. It was proposed that GISTs can be divided into SDHB- positive (type 1, and SDHB-negative (type 2 tumors because of similarities in clinical features and response to imatinib treatment. In this study, SDHB expression was examined immunohistochemically in 22 well-characterized NF1-associated GISTs. All analyzed tumors expressed SDHB. Based on SDHB-expression status, NF1-associated GISTs belong to type 1 category; however, similarly to SDHB type 2 tumors, they do not respond well to imatinib treatment. Therefore, a simple categorization of GISTs into SDHB-positive and-negative seems to be incomplete. A classification based on both SDHB expression status and KIT and PDGFRA mutation status characterize GISTs more accurately and allow subdivision of SDHB-positive tumors into different clinico-genetic categories.

COMPLEX TREATMENT IN A PATIENT WITH SEVERE CHRONIC PERIODONTITIS (Case Report.

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Kamen Kotsilkov

2015-02-01

Full Text Available INTRODUCTION: Periodontitis is characterized by progressive destruction of periodontium, caused by relatively small group of microorganisms. The treatment aims to create proper environment which hampers the colonization of pathogens. The mechanical cleaning of the root surfaces combined with meticulous oral hygiene is the consensus treatment. In advanced cases the progression of the disease could lead to different problems - gingival recessions, insufficiency of attached gingiva, mobility and tooth loss which require complex treatment. OBJECTIVE: This presentation demonstrates the multidisciplinary treatment approach in a patient with a severe chronic periodontitis. METHODS: S.S. (42 with severe chronic periodontitis, insufficient mandibular vestibule depth, lack of keratinized gingiva, class III recessions and central incisors with grade III mobility. The #12 is missing and a crossbite is present on #32. The anti-infective therapy led to stable periodontal status. The corrective phase included the creation of vestibule depth with an autogenous gingival graft, dental implant placement with immediate provisional loading for #12, extraction of #31 and #41 due to attachment loss to the apex and immediate placement of provisionals with crossbite correction. RESULT: The reevaluation demonstrated good control of the gingival inflammation and stable periodontal status. The subsequent implant and prosthetic treatment led to the restoration of a functional dentition. CONCLUSION: The long term success of the treatment of the complex cases with severe chronic periodontitis depends significantly upon the proper control of the periodontal infection and the achievement of a stable periodontal status. These are the major prerequisites for successful further implant and prosthetic rehabilitation.

Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study.

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Tarocchi, Anna; Aschieri, Filippo; Fantini, Francesca; Smith, Justin D

2013-06-01

The cumulative effect of repeated traumatic experiences in early childhood incrementally increases the risk of adjustment problems later in life. Surviving traumatic environments can lead to the development of an interrelated constellation of emotional and interpersonal symptoms termed complex posttraumatic stress disorder (CPTSD). Effective treatment of trauma begins with a multimethod psychological assessment and requires the use of several evidence-based therapeutic processes, including establishing a safe therapeutic environment, reprocessing the trauma, constructing a new narrative, and managing emotional dysregulation. Therapeutic Assessment (TA) is a semistructured, brief intervention that uses psychological testing to promote positive change. The case study of Kelly, a middle-aged woman with a history of repeated interpersonal trauma, illustrates delivery of the TA model for CPTSD. Results of this single-case time-series experiment indicate statistically significant symptom improvement as a result of participating in TA. We discuss the implications of these findings for assessing and treating trauma-related concerns, such as CPTSD.

Rad50S alleles of the Mre11 complex: questions answered and questions raised.

Science.gov (United States)

Usui, Takehiko; Petrini, John H J; Morales, Monica

2006-08-15

We find that Rad50S mutations in yeast and mammals exhibit constitutive PIKK (PI3-kinase like kinase)-dependent signaling [T. Usui, H. Ogawa, J.H. Petrini, A DNA damage response pathway controlled by Tel1 and the Mre11 complex. Mol. Cell 7 (2001) 1255-1266.; M. Morales, J.W. Theunissen, C.F. Kim, R. Kitagawa, M.B. Kastan, J.H. Petrini, The Rad50S allele promotes ATM-dependent DNA damage responses and suppresses ATM deficiency: implications for the Mre11 complex as a DNA damage sensor. Genes Dev. 19 (2005) 3043-4354.]. The signaling depends on Mre11 complex functions, consistent with its role as a DNA damage sensor. Rad50S is distinct from hypomorphic mutations of Mre11 and Nbs1 in mammals [M. Morales, J.W. Theunissen, C.F. Kim, R. Kitagawa, M.B. Kastan, J.H. Petrini, The Rad50S allele promotes ATM-dependent DNA damage responses and suppresses ATM deficiency: implications for the Mre11 complex as a DNA damage sensor. Genes Dev. 19 (2005) 3043-3054.; J.P. Carney, R.S. Maser, H. Olivares, E.M. Davis, Le M. Beau, J.R. Yates, III, L. Hays, W.F. Morgan, J.H. Petrini, The hMre11/hRad50 protein complex and Nijmegen breakage syndrome: linkage of double-strand break repair to the cellular DNA damage response. Cell 93 (1998) 477-486.; G.S. Stewart, R.S. Maser, T. Stankovic, D.A. Bressan, M.I. Kaplan, N.G. Jaspers, A. Raams, P.J. Byrd, J.H. Petrini, A.M. Taylor, The DNA double-strand break repair gene hMRE11 is mutated in individuals with an ataxia-telangiectasia-like disorder. Cell 99 (1999) 577-587.; B.R. Williams, O.K. Mirzoeva, W.F. Morgan, J. Lin, W. Dunnick, J.H. Petrini, A murine model of nijmegen breakage syndrome. Curr. Biol. 12 (2002) 648-653.; J.W. Theunissen, M.I. Kaplan, P.A. Hunt, B.R. Williams, D.O. Ferguson, F.W. Alt, J.H. Petrini, Checkpoint failure and chromosomal instability without lymphomagenesis in Mre11(ATLD1/ATLD1) mice. Mol. Cell 12 (2003) 1511-1523.] and the Mre11 complex deficiency in yeast [T. Usui, H. Ogawa, J.H. Petrini, A DNA damage response

Creutzfeldt-Jakob Disease-Like Periodic Sharp Wave Complexes in Voltage-Gated Potassium Channel-Complex Antibodies Encephalitis: A Case Report.

Science.gov (United States)

Savard, Martin; Irani, Sarosh R; Guillemette, Annie; Gosselin-Lefebvre, Stéphanie; Geschwind, Michael; Jansen, Gerard H; Gould, Peter V; Laforce, Robert

2016-02-01

Voltage-gated potassium channel-complex antibodies (VGKC-cAbs) encephalitis, a treatable autoantibody encephalopathy, has been previously reported to clinically mimic sporadic Creutzfeldt-Jakob disease. Among available clinical clues to distinguish them, periodic sharp wave complexes, a typical finding in sporadic Creutzfeldt-Jakob disease, have never been reported in association with VGKC-cAbs encephalitis. A 76-year-old man was transferred to a tertiary neurology center with a clinical history of 6-month weight loss, cognitive disturbance, and nonspecific generalized weakness. He had two seizures the month before transfer and then evolved to severe encephalopathy, requiring mechanical ventilation. Periodic sharp wave complexes every 1 to 2 seconds over slowed background were found on EEG, and MRI showed cerebellar and bifrontal cortical T2/FLAIR/DWI hypersignal without restricted diffusion on ADC mapping. Pancorporal positron emission tomography scan was negative. An immunotherapy trial did not improve the patient condition. Therefore, he died after life support withdrawal. Brain autopsy revealed mononuclear neocortex infiltrate without significant spongiosis, and the anti-VGKC test showed a seropositivity of 336 pmol/L (normal, 0-31), 3 month after the patient deceased. This is the first reported case of VGKC-cAbs encephalitis associated with periodic sharp wave complexes on EEG, which further confuse the differential diagnosis with sporadic Creutzfeldt-Jakob disease. However, the cortical DWI hypersignal without restriction seems to remain a way to discriminate these two entities appropriately, when present. These clues are of paramount importance because VGKC-cAbs encephalitis is a treatable disease.

[Post-transplant recurrence of glomerulonephritis: a complex clinical case].

Science.gov (United States)

Bonucchi, Decenzio; Leonelli, Marco; Damiano, Francesca; Granito, Maria; Ghiandai, Giulia; De Amicis, Sara; Americo, Claudio; Ligabue, Giulia; Albertazzi, Vittorio; Cappelli, Gianni

2010-01-01

Lupus nephritis (LN) seldom recurs in a grafted kidney. By contrast, primary membranoproliferative glomerulonephritis (MPGN), which has been included, along with hemolytic uremic syndrome and age-related maculopathy, among the complement dysregulation diseases, has a high recurrence rate and is considered a contraindication to living-donor kidney transplant because of the poor prognosis. We report the case of a young girl with LN-related chronic renal failure who underwent a living donor transplant from her mother. After four months she had a recurrence that did not match the criteria for LN. Graft biopsies and revision of the clinical course pointed to type II MPGN on the basis of a lack of ARA criteria, persistent isolated low C3 levels, and response to plasma therapy. If confirmed by genetic analysis, the patient might benefit from treatment with the monoclonal antibody against the C5-C9 complex, eculizumab.

Analysis Thermal Comfort Condition in Complex Residential Building, Case Study: Chiangmai, Thailand

Science.gov (United States)

Juangjandee, Warangkana

2017-10-01

Due to the increasing need for complex residential buildings, it appears that people migrate into the high-density urban areas because the infrastructural facilities can be easily found in the modern metropolitan areas. Such rapid growth of urbanization creates congested residential buildings obstructing solar radiation and wind flow, whereas most urban residents spend 80-90% of their time indoor. Furthermore, the buildings were mostly built with average materials and construction detail. This causes high humidity condition for tenants that could promote mould growth. This study aims to analyse thermal comfort condition in complex residential building, Thailand for finding the passive solution to improve indoor air quality and respond to local conditions. The research methodology will be in two folds: 1) surveying on case study 2) analysis for finding the passive solution of reducing humidity indoor air The result of the survey indicated that the building need to find passive solution for solving humidity problem, that can be divided into two ways which raising ventilation and indoor temperature including increasing wind-flow ventilation and adjusting thermal temperature, for example; improving building design and stack driven ventilation. For raising indoor temperature or increasing mean radiant temperature, daylight can be passive solution for complex residential design for reducing humidity and enhance illumination indoor space simultaneous.

BCR translocation to derivative chromosome 2, a new case of chronic myeloid leukemia with complex variant translocation and Philadelphia chromosome

International Nuclear Information System (INIS)

Al-Achkar, W.; Wafa, A.; Al-Medani, S.

2011-01-01

The well-known typical fusion gene BCR/ABL can be observed in connection with a complex translocation event in only 5-8% of cases with chronic myeloid leukemia (CML). Herein we report an exceptional CML case with complex chromosomal aberrations not observed before, translocated BCR to the derivative chromosome 2 [der(2)], additional to involving a four chromosomes translocation implying chromosomal regions such as 1p32 and 2q21 besides 9q34 and 22q11.2. Which were characterized by molecular cytogenetics. (author)

Complex regional pain syndrome with associated chest wall dystonia: a case report

Directory of Open Access Journals (Sweden)

Schwartzman Robert J

2011-09-01

Full Text Available Abstract Patients with complex regional pain syndrome (CRPS often suffer from an array of associated movement disorders, including dystonia of an affected limb. We present a case of a patient with long standing CRPS after a brachial plexus injury, who after displaying several features of the movement disorder previously, developed painful dystonia of chest wall musculature. Detailed neurologic examination found palpable sustained contractions of the pectoral and intercostal muscles in addition to surface allodynia. Needle electromyography of the intercostal and paraspinal muscles supported the diagnosis of dystonia. In addition, pulmonary function testing showed both restrictive and obstructive features in the absence of a clear cardiopulmonary etiology. Treatment was initiated with intrathecal baclofen and the patient had symptomatic relief and improvement of dystonia. This case illustrates a novel form of the movement disorder associated with CRPS with response to intrathecal baclofen treatment.

Genetics of Gigantism and Acromegaly

Science.gov (United States)

Hannah-Shmouni, Fady; Trivellin, Giampaolo; Stratakis, Constantine A.

2016-01-01

Gigantism and acromegaly are rare disorders that are caused by excessive GH secretion and/or high levels of its mediator, IGF-1. Gigantism occurs when excess GH or IGF-1 lead to increased linear growth, before the end of puberty and epiphyseal closure. The majority of cases arise from a benign GH-secreting pituitary adenoma, with an incidence of pituitary gigantism and acromegaly of approximately 8 and 11 per million person-years, respectively. Over the past two decades, our increasing understanding of the molecular and genetic etiologies of pituitary gigantism and acromegaly yielded several genetic causes, including multiple endocrine neoplasia type 1 and 4, McCune-Albright syndrome, Carney complex, familial isolated pituitary adenoma, pituitary adenoma association due to defects in familial succinate dehydrogenase genes, and the recently identified X-linked acrogigantism. The early diagnosis of these conditions helps guide early intervention, screening, and genetic counseling of patients and their family members. In this review, we provide a concise and up-to-date discussion on the genetics of gigantism and acromegaly. PMID:27657986

Genetics of gigantism and acromegaly.

Science.gov (United States)

Hannah-Shmouni, Fady; Trivellin, Giampaolo; Stratakis, Constantine A

Gigantism and acromegaly are rare disorders that are caused by excessive GH secretion and/or high levels of its mediator, IGF-1. Gigantism occurs when excess GH or IGF-1 lead to increased linear growth, before the end of puberty and epiphyseal closure. The majority of cases arise from a benign GH-secreting pituitary adenoma, with an incidence of pituitary gigantism and acromegaly of approximately 8 and 11 per million person-years, respectively. Over the past two decades, our increasing understanding of the molecular and genetic etiologies of pituitary gigantism and acromegaly yielded several genetic causes, including multiple endocrine neoplasia type 1 and 4, McCune-Albright syndrome, Carney complex, familial isolated pituitary adenoma, pituitary adenoma association due to defects in familial succinate dehydrogenase genes, and the recently identified X-linked acrogigantism. The early diagnosis of these conditions helps guide early intervention, screening, and genetic counseling of patients and their family members. In this review, we provide a concise and up-to-date discussion on the genetics of gigantism and acromegaly. Published by Elsevier Ltd.

Knowledge to action for solving complex problems: insights from a review of nine international cases.

Science.gov (United States)

Riley, B L; Robinson, K L; Gamble, J; Finegood, D T; Sheppard, D; Penney, T L; Best, A

2015-05-01

Solving complex problems such as preventing chronic diseases introduces unique challenges for the creation and application of knowledge, or knowledge to action (KTA). KTA approaches that apply principles of systems thinking are thought to hold promise, but practical strategies for their application are not well understood. In this paper we report the results of a scan of systems approaches to KTA with a goal to identify how to optimize their implementation and impact. A 5-person advisory group purposefully selected 9 initiatives to achieve diversity on issues addressed and organizational forms. Information on each case was gathered from documents and through telephone interviews with primary contacts within each organization. Following verification of case descriptions, an inductive analysis was conducted within and across cases. The cases revealed 5 guidelines for moving from conceiving KTA systems to implementing them: (1) establish and nurture relationships, (2) co-produce and curate knowledge, (3) create feedback loops, (4) frame as systems interventions rather than projects, and (5) consider variations across time and place. Results from the environmental scan are a modest start to translating systems concepts for KTA into practice. Use of the strategies revealed in the scan may improve KTA for solving complex public health problems. The strategies themselves will benefit from the development of a science that aims to understand adaptation and ongoing learning from policy and practice interventions, strengthens enduring relationships, and fills system gaps in addition to evidence gaps. Systems approaches to KTA will also benefit from robust evaluations.

Fourth branchial complex anomalies: a case series.

Science.gov (United States)

Shrime, Mark; Kacker, Ashutosh; Bent, John; Ward, Robert F

2003-11-01

Anomalies of the fourth branchial arch complex are exceedingly rare, with approximately forty cases reported in the literature since 1972. The authors report experience with six fourth arch anomalies. Retrospective chart review of six consecutive patients presenting to the pediatric otolaryngology service at a tertiary care center with anomalies referable to the fourth branchial arch. All six patients presented within the first or second decade of life. All six had left-sided disease. Four patients presented with recurrent neck infection, one with asymptomatic cervical masses, and one with a neck mass and respiratory compromise. One patient had prior surgery presented with a recurrence. Diagnosis of fourth arch anomalies was suggested or confirmed by computed tomography and flexible laryngoscopy. Treatment was surgical in five patients; one patient is awaiting surgery. Surgical procedures included resection of the mass and endoscopic cauterization of the inner opening of the cyst. The presentation of a cervical mass, especially with recurrent infections and especially on the left side, in a child in the first or second decade of life heightens suspicion for an anomaly of the fourth branchial arch. Diagnosis can be difficult, but is aided by the use of flexible laryngoscopy, Computed tomography (CT) scanning and ultrasonography. Surgical resection of the cyst and cauterization of its pyriform sinus opening should be undertaken to minimize recurrence.

Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.

Science.gov (United States)

Wittmeier, Kristy D M; Restall, Gayle; Mulder, Kathy; Dufault, Brenden; Paterson, Marie; Thiessen, Matthew; Lix, Lisa M

2016-08-31

Children with complex needs can face barriers to system access and navigation related to their need for multiple services and healthcare providers. Central intake for pediatric rehabilitation was developed and implemented in 2008 in Winnipeg Manitoba Canada as a means to enhance service coordination and access for children and their families. This study evaluates the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. A mixed methods instrumental case study design was used. Interviews were completed with 9 individuals. Data was transcribed and analyzed for themes. Quantitative data (wait times, referral volume and caregiver satisfaction) was collected for children referred to physiotherapy with complex needs (n = 1399), and a comparison group of children referred for orthopedic concerns (n = 3901). Wait times were analyzed using the Kruskal-Wallis test, caregiver satisfaction was analyzed using Fisher exact test and change point modeling was applied to examine referral volume over the study period. Interview participants described central intake implementation as creating more streamlined processes. Factors that facilitated successful implementation included 1) agreement among stakeholders, 2) hiring of a central intake coordinator, 3) a financial commitment from the government and 4) leadership at the individual and organization level. Mean (sd) wait times improved for children with complex needs (12.3(13.1) to 8.0(6.9) days from referral to contact with family, p physiotherapy (i.e., decreasing wait times) for families of children with complex needs. Future research is needed to build on this single discipline case study approach to examine changes in wait times, therapy coordination and stakeholder satisfaction within the context of continuing improvements for pediatric therapy services within the province.

Operational Complexity of Supplier-Customer Systems Measured by Entropy—Case Studies

Directory of Open Access Journals (Sweden)

Ladislav Lukáš

2016-04-01

Full Text Available This paper discusses a unified entropy-based approach for the quantitative measurement of operational complexity of company supplier-customer relations. Classical Shannon entropy is utilized. Beside this quantification tool, we also explore the relations between Shannon entropy and (c,d-entropy in more details. An analytic description of so called iso-quant curves is given, too. We present five case studies, albeit in an anonymous setting, describing various details of general procedures for measuring the operational complexity of supplier-customer systems. In general, we assume a problem-oriented database exists, which contains detailed records of all product forecasts, orders and deliveries both in quantity and time, scheduled and realized, too. Data processing detects important flow variations both in volumes and times, e.g., order—forecast, delivery—order, and actual production—scheduled one. The unifying quantity used for entropy computation is the time gap between actual delivery time and order issue time, which is nothing else but a lead time in inventory control models. After data consistency checks, histograms and empirical distribution functions are constructed. Finally, the entropy, information-theoretic measure of supplier-customer operational complexity, is calculated. Basic steps of the algorithm are mentioned briefly, too. Results of supplier-customer system analysis from selected Czech small and medium-sized enterprises (SMEs are presented in various computational and managerial decision making details. An enterprise is ranked as SME one, if it has at most 250 employees and its turnover does not exceed 50 million USD per year, or its balance sheet total does not exceed 43 million USD per year, alternatively.

Complexity Management - A multiple case study analysis on control and reduction of complexity costs

DEFF Research Database (Denmark)

Myrodia, Anna

of products, with features more custom-made to cover individual needs, both regarding characteristics of products and support services. This necessity leads to a considerable increase of the complexity in the company, which affects the product portfolio, production and supply chain, market segments......, IT systems, and business processes. In order to identify and eliminate complexity, several approaches are used, both by researchers and practitioners. The purpose of this thesis is to contribute to the existing knowledge of complexity management theory. This research focuses on the relationship between......Complexity tends to be arguably the biggest challenge of manufacturing companies. The motivation of further studying complexity is a combination between the existing literature and the practical experiences from the industry. Based on the latest trend companies are trying to supply a growing mix...

Bringing content understanding into usability testing in complex application domains—a case study in eHealth

DEFF Research Database (Denmark)

Andersen, Simon Bruntse; Rasmussen, Claire Kirchert; Frøkjær, Erik

2017-01-01

A usability evaluation technique, Cooperative Usability Testing with Questions of Understanding (CUT with QU) intended to illuminate users’ ability to understand the content information of an application is proposed. In complex application domains as for instance the eHealth domain, this issue...... of users’ content understanding is sometimes crucial, and thus should be carefully evaluated. Unfortunately, conventional usability evaluation techniques do not address challenges of content understanding. In a case study within eHealth, specifically the setting of a rehabilitation clinic involving...... the participation of four physiotherapists and four clients in a period of 3.5 months, it was demonstrated how CUT with QU can complement conventional usability testing and provide insight into users’ challenges with understanding of a new complex eHealth application. More experiments in other complex application...

Pituitary gigantism: update on molecular biology and management.

Science.gov (United States)

Lodish, Maya B; Trivellin, Giampaolo; Stratakis, Constantine A

2016-02-01

To provide an update on the mechanisms leading to pituitary gigantism, as well as to familiarize the practitioner with the implication of these genetic findings on treatment decisions. Prior studies have identified gigantism as a feature of a number of monogenic disorders, including mutations in the aryl hydrocarbon receptor interacting protein gene, multiple endocrine neoplasia types 1 and 4, McCune Albright syndrome, Carney complex, and the paraganglioma, pheochromocytoma, and pituitary adenoma association because of succinate dehydrogenase defects. We recently described a previously uncharacterized form of early-onset pediatric gigantism caused by microduplications on chromosome Xq26.3 and we termed it X-LAG (X-linked acrogigantism). The age of onset of increased growth in X-LAG is significantly younger than other pituitary gigantism cases, and control of growth hormone excess is particularly challenging. Knowledge of the molecular defects that underlie pituitary tumorigenesis is crucial for patient care as they guide early intervention, screening for associated conditions, genetic counseling, surgical approach, and choice of medical management. Recently described microduplications of Xq26.3 account for more than 80% of the cases of early-onset pediatric gigantism. Early recognition of X-LAG may improve outcomes, as successful control of growth hormone excess requires extensive anterior pituitary resection and are difficult to manage with medical therapy alone.

DIMENSIONS OF EXPERT REPORT COMPLEXITY IN INTELLECTUAL/INDUSTRIAL PROPERTY. CASE STUDY

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Raul Sorin Fântână

2016-11-01

Full Text Available The growing number of complex processes with the specific intellectual / industrial property demonstrated the need for highly qualified experts called in solving technical problems in the court files. The expertise in such field obliges to detailed knowledge of domestic and international law. However, those processes have as conjugate subjects: counterfeiting inventions, trademarks, industrial design; unfair competition; calculating damage that leads to highlighting the economic benefits, the latter requiring economic assessment of an intangible asset using in formula,in addition to economic data, micro - and macro-economic risk factors. Conflicts arise in a specific space. It is therefore necessary detailed knowledge of company law, competition law, that relating to interest, insolvency and bankruptcy in their developments. It should be considered domestic and European legal practice, as well as the rapid evolution of the meaning of legal terms and concepts. Experts have to understand solutions given in the prior complaints for correct interpretation of the provisions of the agreements, laws and regulations derived. The paper refersto one of the most complex expertise reports, which forced expert to integrated legislation acquaintances on patents, on insolvency and interest - in their evolution. But fundamentally, the expert had to understand the phenomenon of engineering and how to measure economic efficiency in the case of a divided invention.

Creating a Safe Space: A Case Study of Complex Trauma and a Call for Proactive Comprehensive Psychoeducational Assessments and Reviews

Science.gov (United States)

Mainwaring, Debra J.

2015-01-01

This article advocates for proactive, dynamic and comprehensive psycho-educational assessments for children and young people who have a history of complex trauma, because of its known effects on development and learning. A case study is shared of a young woman with a history of complex trauma because of exposure to parental neglect, multiple…

Complex Fuzzy Set-Valued Complex Fuzzy Measures and Their Properties

Science.gov (United States)

Ma, Shengquan; Li, Shenggang

2014-01-01

Let F*(K) be the set of all fuzzy complex numbers. In this paper some classical and measure-theoretical notions are extended to the case of complex fuzzy sets. They are fuzzy complex number-valued distance on F*(K), fuzzy complex number-valued measure on F*(K), and some related notions, such as null-additivity, pseudo-null-additivity, null-subtraction, pseudo-null-subtraction, autocontionuous from above, autocontionuous from below, and autocontinuity of the defined fuzzy complex number-valued measures. Properties of fuzzy complex number-valued measures are studied in detail. PMID:25093202

Bacterial flagella and Type III secretion: case studies in the evolution of complexity.

Science.gov (United States)

Pallen, M J; Gophna, U

2007-01-01

Bacterial flagella at first sight appear uniquely sophisticated in structure, so much so that they have even been considered 'irreducibly complex' by the intelligent design movement. However, a more detailed analysis reveals that these remarkable pieces of molecular machinery are the product of processes that are fully compatible with Darwinian evolution. In this chapter we present evidence for such processes, based on a review of experimental studies, molecular phylogeny and microbial genomics. Several processes have played important roles in flagellar evolution: self-assembly of simple repeating subunits, gene duplication with subsequent divergence, recruitment of elements from other systems ('molecular bricolage'), and recombination. We also discuss additional tentative new assignments of homology (FliG with MgtE, FliO with YscJ). In conclusion, rather than providing evidence of intelligent design, flagellar and non-flagellar Type III secretion systems instead provide excellent case studies in the evolution of complex systems from simpler components.

Rare association of anophthalmia, complex congenital heart disease and pulmonary hypertension: case report.

Science.gov (United States)

Ríos-Méndez, Raúl Enrique; Lozano Chinga, Michell Marola

2016-10-07

Clinical congenital anophthalmia is described as the uni- or bilateral absence of the eyeball that might occur in isolation or as part of a syndrome. It has a very low prevalence and its etiology is heterogeneous. Complex congenital cardiac malformations are also rare. The association of congenital anophthalmia and congenital heart disease is rarer still, and the etiology of those associations is not well understood yet. We report the case of a patient who had the very rare association of bilateral anophthalmia, multiple cardiac malformations and severe pulmonary hypertension.

[A complex case of diabetes due to LMNA mutation].

Science.gov (United States)

Ambonville, C; Bouldouyre, M-A; Laforêt, P; Richard, P; Benveniste, O; Vigouroux, C

2017-10-01

Laminopathies (diseases related to A/C mutations of lamines) are rare genetic diseases with an extensive phenotypic spectrum, including lipodystrophic syndromes-characterized by a selective loss of adipose tissue-of which the partial Dunnigan family type is the most frequent. We report on a 55-year-old woman with diabetes and long-term disabling myalgia. Her cushingoid morphotype, associated with cutaneous lipo-atrophy and muscle hypertrophy in addition to a genetic heritage, led us to the diagnosis of complex partial familial lipodystrophy heterozygous LMNA_c.82C>T, p.Arg28Trp mutation. Familial partial lipodystrophic syndromes may have varied phenotypes, mainly cardio-metabolic, which could mimic a particularly severe type 2 diabetes. The diagnostic work-up of this disease has to include a careful investigation of gait troubles and paroxysmal conduction that could lead to sudden death, as well as a genetic examination. In some cases, recombinant leptin can be proposed. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Dynamic Patterns in Development of Accuracy and Complexity : A Longitudinal Case Study in the Acquisition of Finnish

NARCIS (Netherlands)

Spoelman, Marianne; Verspoor, Marjolijn

Within a Dynamic System Theory (DST) approach, it is assumed that language is in a constant flux, but that differences in the degree of variability can give insight into the developmental process. This longitudinal case study focuses on intra-individual variability in accuracy rates and complexity

An Orchestrating Evaluation of Complex Educational Technologies: a Case Study of a CSCL System

Directory of Open Access Journals (Sweden)

Luis P. Prieto

2014-06-01

Full Text Available As digital technologies permeate every aspect of our lives, the complexity of the educational settings, and of the technological support we use within them, unceasingly rises. This increased complexity, along with the need for educational practitioners to apply such technologies within multi-constraint authentic settings, has given rise to the notion of technology-enhanced learning practice as “orchestration of learning”. However, at the same time, the complexity involved in evaluating the benefits of such educational technologies has also increased, prompting questions about the way evaluators can cope with the different places, technologies, informants and issues involved in their evaluation activity. By proposing the notion of “orchestrating evaluation”, this paper tries to reconcile the often disparate “front office accounts” of research publications and the “shop floor practice” of evaluation of educational technology, through the case study of evaluating a system to help teachers in coordinating computer-supported collaborative learning (CSCL scenarios. We reuse an internationally-evaluated conceptual framework of “orchestration aspects” (design, management, adaptation, pragmatism, etc. to structure the case‟s narrative, showing how the original evaluation questions and methods were modulated in the face of the multiple (authentic evaluation setting constraints.

Toxicological findings in two planned complex suicide cases: ingestion of petroleum distillates and subsequent hanging.

Science.gov (United States)

Martínez, María Antonia; Ballesteros, Salomé

2009-01-01

This paper describes two fatal cases of planned complex suicide by two male individuals, 86 and 51 years old, involving ingestion of petroleum distillates and hanging. Remarkable internal findings during autopsy of both cases included the intense odor of petroleum distillates that alerted authorities to the suspicion of ingestion. The initial toxicological screening and quantitation of these compounds were performed by gas chromatography with flame-ionization detection, and confirmation was performed using gas chromatography-mass spectrometry in total ion chromatogram mode after liquid-liquid extraction of biological samples following a previously published analytical method. In Case 1, diesel fuel No. 2 concentrations were distillates when there is a suspicion of ingestion of these products due to the odor observed at the scene of death and/or during autopsy. The results of these toxicological investigations can help to determine the manner of death and the medicolegal interpretation.

Cultural complexity and demography: the case of folktales

NARCIS (Netherlands)

Acerbi, A.; Kendal, J.; Tehrani, J.

2017-01-01

We investigate the relationship between cultural complexity and population size in a non-technological cultural domain for which we have suitable quantitative records: folktales. We define three levels of complexity for folk narratives: the number of tale types, the number of narrative motifs, and,

Report of a case of paroxysmal nocturnal hemoglobinuria (PNH) with complex evolution and liver transplant

OpenAIRE

Alencar,Railene Célia B.; Guimarães,Andréa M.; Brito Junior,Lacy C.

2016-01-01

ABSTRACT The paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disease, with thrombotic episodes and frequent pancytopenia. We report the case of a 32 year-old female PNH patient with bone marrow aplasia, which followed a complex course, diagnosed with aplastic anemia associated with PNH, evolving in three years with Budd-Chiari syndrome and liver transplantation. Post-transplant complications, hepatic arterial thrombosis, graft rejection, liver retransplantation and treatment of P...

Complex regional pain syndromes (CRPS type 1 validating case histories

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P. Berger

2003-01-01

Full Text Available The treatment of patients with complex regional pain syndrome (CRPS type 1 is challenging and unpredictable as the condition presents with vascular and neuropathic symptoms after nil or even minor injury to a peripheral nerve. The condition is one of a pain and motor dysfunction. The pathophysiology is not well understood and the relief of symptoms may change from being sympathetically mediated to sympathetically independent during  the course of the disease. At any stage physiotherapy has been advocated as the corner stone and most important aspect of treatment in the rehabilitation of these individuals but unfortunately it has been difficult to execute when pain is exacerbated due to allodynia (unbearable to touch or move and hyperalgesia. Best results have been obtained if the patients are recognised and treated in the early or acute phase and it has been found that through careful assessment and analysis these patients can be recognised by previous events that have occurred in their initial case history. The treatment in the acute stage with physiotherapy modalities such as electrical stimulation and acupuncture will produce an early cessation of the symptoms and prevention of the disease developing into the fully blown CRPS type 1 with irreversible and possibly atrophic consequences. Case histories have been presented that illustrate these important aspects and demonstrate  the value of early and the appropriate physiotherapy that may be more successful than other pharmacological and physical interventions in this disease.

Understanding Complex Human Ecosystems: The Case of Ecotourism on Bonaire

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Thomas Abel

2003-12-01

Full Text Available It is suggested that ecotourism development on the island of Bonaire can be productively understood as a perturbation of a complex human ecosystem. Inputs associated with ecotourism have fueled transformations of the island ecology and sociocultural system. The results of this study indicate that Bonaire's social and economic hierarchy is approaching a new, stable systems state following a 50-yr transition begun by government and industry that stabilized with the appearance of ecotourism development and population growth. Ecotourism can be understood to have "filled in" the middle of the production hierarchy of Bonaire. Interpreted from this perspective, population growth has completed the transformation by expanding into production niches at smaller scales in the production hierarchy. Both a consequence and a cause, ecotourism has transformed the island's social structure and demography. The theory and methods applied in this case study of interdisciplinary research in the field of human ecosystems are also presented.

Data science and complex networks real case studies with Python

CERN Document Server

Caldarelli, Guido

2016-01-01

This book provides a comprehensive yet short description of the basic concepts of complex network theory and the code to implement this theory. Differently from other books, we present these concepts starting from real cases of study. The application topics span from food webs, to the Internet, the World Wide Web, and social networks, passing through the international trade web and financial time series. The final part is devoted to definition and implementation of the most important network models. We provide information on the structure of the data and on the quality of available datasets. Furthermore, we provide a series of codes to implement instantly what is described theoretically in the book. People knowing the basis of network theory could learn the art of coding in Python by checking our codes and using the online material. In particular, the interactive Python notebook format is used so that the reader can immediately experiment by themselves with the codes present in the manuscript. To this purpose...

The application of method supplier’s complex evaluation. Case study

Directory of Open Access Journals (Sweden)

Ekaterina Chytilová

2012-01-01

Full Text Available The main goal of this article includes the illustration of selecting bidders evaluation with help Method of complex evaluation of suppliers (MCE. Nowadays the evaluation of suppliers has more importance is in the supply chain management. For SMEs with discontinuous custom manufacturing supplier evaluation at first stage becomes a priority to maintain and enhance the competitiveness of farm output and overall competitiveness. This article presents results of control MCE. The results of this article are results of suppliers’ evaluation conditions and eliminations of MCE application on the base of real enterprise data. MCE is oriented to small and medium-sized enterprises with discontinue manufacturing to order. Research is oriented to selecting procedure of existing suppliers at the first stage of supply chain. Nationality and geographic location haven’t importance to MCE application. Illustrative case study presents the evaluation process to the specific conditions and subsequently demonstrated viability of MCE.

Addressing the Complexities of Big Data Analytics in Healthcare: The Diabetes Screening Case

Directory of Open Access Journals (Sweden)

Daswin De Silva

2015-09-01

Full Text Available The healthcare industry generates a high throughput of medical, clinical and omics data of varying complexity and features. Clinical decision-support is gaining widespread attention as medical institutions and governing bodies turn towards better management of this data for effective and efficient healthcare delivery and quality assured outcomes. Amass of data across all stages, from disease diagnosis to palliative care, is further indication of the opportunities and challenges to effective data management, analysis, prediction and optimization techniques as parts of knowledge management in clinical environments. Big Data analytics (BDA presents the potential to advance this industry with reforms in clinical decision-support and translational research. However, adoption of big data analytics has been slow due to complexities posed by the nature of healthcare data. The success of these systems is hard to predict, so further research is needed to provide a robust framework to ensure investment in BDA is justified. In this paper we investigate these complexities from the perspective of updated Information Systems (IS participation theory. We present a case study on a large diabetes screening project to integrate, converge and derive expedient insights from such an accumulation of data and make recommendations for a successful BDA implementation grounded in a participatory framework and the specificities of big data in healthcare context.

Rapid spread of complex change: a case study in inpatient palliative care

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Filipski Marta I

2009-12-01

Full Text Available Abstract Background Based on positive findings from a randomized controlled trial, Kaiser Permanente's national executive leadership group set an expectation that all Kaiser Permanente and partner hospitals would implement a consultative model of interdisciplinary, inpatient-based palliative care (IPC. Within one year, the number of IPC consultations program-wide increased almost tenfold from baseline, and the number of teams nearly doubled. We report here results from a qualitative evaluation of the IPC initiative after a year of implementation; our purpose was to understand factors supporting or impeding the rapid and consistent spread of a complex program. Methods Quality improvement study using a case study design and qualitative analysis of in-depth semi-structured interviews with 36 national, regional, and local leaders. Results Compelling evidence of impacts on patient satisfaction and quality of care generated 'pull' among adopters, expressed as a remarkably high degree of conviction about the value of the model. Broad leadership agreement gave rise to sponsorship and support that permeated the organization. A robust social network promoted knowledge exchange and built on an existing network with a strong interest in palliative care. Resource constraints, pre-existing programs of a different model, and ambiguous accountability for implementation impeded spread. Conclusions A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull. The combination of push and pull may be especially important when the organizational context or the practice to be spread is complex.

Complex Variant t(9;22 Chromosome Translocations in Five Cases of Chronic Myeloid Leukemia

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Ana Valencia

2009-01-01

Full Text Available The Philadelphia (Ph1 chromosome arising from the reciprocal t(9;22 translocation is found in more than 90% of chronic myeloid leukemia (CML patients and results in the formation of the chimeric fusion gene BCR-ABL. However, a small proportion of patients with CML have simple or complex variants of this translocation, involving various breakpoints in addition to 9q34 and 22q11. We report five CML cases carrying variant Ph translocations involving both chromosomes 9 and 22 as well as chromosomes 3, 5, 7, 8, or 10. G-banding showed a reciprocal three-way translocation involving 3q21, 5q31, 7q32, 8q24, and 10q22 bands. BCR-ABL fusion signal on der(22 was found in all of the cases by FISH.

Large erupted complex odontoma

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Vijeev Vasudevan

2009-01-01

Full Text Available Odontomas are a heterogeneous group of jaw bone lesions, classified as odontogenic tumors which usually include well-diversified dental tissues. Odontoma is a term introduced to the literature by Broca in 1867. Trauma, infection and hereditary factors are the possible causes of forming this kind of lesions. Among odontogenic tumors, they constitute about 2/3 of cases. These lesions usually develop slowly and asymptomatically, and in most cases they do not cross the bone borders. Two types of odontoma are recognized: compound and complex. Complex odontomas are less common than the compound variety in the ratio 1:2.3. Eruption of an odontoma in the oral cavity is rare. We present a case of complex odontoma, in which apparent eruption has occurred in the area of the right maxillary second molar region.

Learning from simple ebooks, online cases or classroom teaching when acquiring complex knowledge. A randomized controlled trial in respiratory physiology and pulmonology.

Science.gov (United States)

Worm, Bjarne Skjødt

2013-01-01

E-learning is developing fast because of the rapid increased use of smartphones, tablets and portable computers. We might not think of it as e-learning, but today many new e-books are in fact very complex electronic teaching platforms. It is generally accepted that e-learning is as effective as classroom teaching methods, but little is known about its value in relaying contents of different levels of complexity to students. We set out to investigate e-learning effects on simple recall and complex problem-solving compared to classroom teaching. 63 nurses specializing in anesthesiology were evenly randomized into three groups. They were given internet-based knowledge tests before and after attending a teaching module about respiratory physiology and pulmonology. The three groups was either an e-learning group with eBook teaching material, an e-learning group with case-based teaching or a group with face-to-face case-based classroom teaching. After the module the students were required to answer a post-test. Time spent and the number of logged into the system was also measured. For simple recall, all methods were equally effective. For problem-solving, the eCase group achieved a comparable knowledge level to classroom teaching, while textbook learning was inferior to both (p<0.01). The textbook group also spent the least amount of time on acquiring knowledge (33 minutes, p<0.001), while the eCase group spent significantly more time on the subject (53 minutes, p<0.001) and logged into the system significantly more (2.8 vs 1.6, p<0.001). E-learning based cases are an effective tool for teaching complex knowledge and problem-solving ability, but future studies using higher-level e-learning are encouraged.Simple recall skills, however, do not require any particular learning method.

Learning from simple ebooks, online cases or classroom teaching when acquiring complex knowledge. A randomized controlled trial in respiratory physiology and pulmonology.

Directory of Open Access Journals (Sweden)

Bjarne Skjødt Worm

Full Text Available BACKGROUND AND AIMS: E-learning is developing fast because of the rapid increased use of smartphones, tablets and portable computers. We might not think of it as e-learning, but today many new e-books are in fact very complex electronic teaching platforms. It is generally accepted that e-learning is as effective as classroom teaching methods, but little is known about its value in relaying contents of different levels of complexity to students. We set out to investigate e-learning effects on simple recall and complex problem-solving compared to classroom teaching. METHODS: 63 nurses specializing in anesthesiology were evenly randomized into three groups. They were given internet-based knowledge tests before and after attending a teaching module about respiratory physiology and pulmonology. The three groups was either an e-learning group with eBook teaching material, an e-learning group with case-based teaching or a group with face-to-face case-based classroom teaching. After the module the students were required to answer a post-test. Time spent and the number of logged into the system was also measured. RESULTS: For simple recall, all methods were equally effective. For problem-solving, the eCase group achieved a comparable knowledge level to classroom teaching, while textbook learning was inferior to both (p<0.01. The textbook group also spent the least amount of time on acquiring knowledge (33 minutes, p<0.001, while the eCase group spent significantly more time on the subject (53 minutes, p<0.001 and logged into the system significantly more (2.8 vs 1.6, p<0.001. CONCLUSIONS: E-learning based cases are an effective tool for teaching complex knowledge and problem-solving ability, but future studies using higher-level e-learning are encouraged.Simple recall skills, however, do not require any particular learning method.

Binding abilities of a chiral calix[4]resorcinarene: a polarimetric investigation on a complex case of study

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Marco Russo

2017-12-01

Full Text Available Polarimetry was used to investigate the binding abilities of a chiral calix[4]resorcinarene derivative, bearing L-proline subunits, towards a set of suitably selected organic guests. The simultaneous formation of 1:1 and 2:1 host–guest inclusion complexes was observed in several cases, depending on both the charge status of the host and the structure of the guest. Thus, the use of the polarimetric method was thoroughly revisited, in order to keep into account the occurrence of multiple equilibria. Our data indicate that the stability of the host–guest complexes is affected by an interplay between Coulomb interactions, π–π interactions, desolvation effects and entropy-unfavorable conformational dynamic restraints. Polarimetry is confirmed as a very useful and versatile tool for the investigation of supramolecular interactions with chiral hosts, even in complex systems involving multiple equilibria.

Complexity in the new NHS: longitudinal case studies of CCGs in England.

Science.gov (United States)

Checkland, Katherine; McDermott, Imelda; Coleman, Anna; Perkins, Neil

2016-01-07

The reform in the English National Health Services (NHS) under the Health and Social Care Act 2012 is unlike previous NHS reorganisations. The establishment of clinical commissioning groups (CCGs) was intended to be 'bottom up' with no central blueprint. This paper sets out to offer evidence about how this process has played out in practice and examines the implications of the complexity and variation which emerged. Detailed case studies in CCGs across England, using interviews, observation and documentary analysis. Using realist framework, we unpacked the complexity of CCG structures. In phase 1 of the study (January 2011 to September 2012), we conducted 96 interviews, 439 h of observation in a wide variety of meetings, 2 online surveys and 38 follow-up telephone interviews. In phase 2 (April 2013 to March 2015), we conducted 42 interviews with general practitioners (GPs) and managers and observation of 48 different types of meetings. Our study has highlighted the complexity inherent in CCGs, arising out of the relatively permissive environment in which they developed. Not only are they very different from one another in size, but also in structure, functions between different bodies and the roles played by GPs. The complexity and lack of uniformity of CCGs is important as it makes it difficult for those who must engage with CCGs to know who to approach at what level. This is of increasing importance as CCGs are moving towards greater integration across health and social care. Our study also suggests that there is little consensus as to what being a 'membership' organisation means and how it should operate. The lack of uniformity in CCG structure and lack of clarity over the meaning of 'membership' raises questions over accountability, which becomes of greater importance as CCG is taking over responsibility for primary care co-commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

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Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

The Challenge of Integrating Care in Dual Diagnosis; Anti-NMDA-Receptor Encephalitis; Presentation And Outcome In 3 Cases Referred For Complex Specialist Rehabilitation Services

LENUS (Irish Health Repository)

Carroll, A

2018-03-01

The successful implementation of an integrated care pathway (ICP) for any given condition is a challenge. Even more challenging is successful ICP implementation for individuals who have multiple co-morbidities. This is further compounded when there are dual mental health and physical disabilities that require integrated working across multiple disciplines, specialties, institutions and organisations. Anti-NMDA-Receptor encephalitis (aNMDARe) is a relatively new diagnostic entity with patients typically presenting with significant psychiatric symptoms followed by progressive neurological deterioration. In this case series, we describe 3 cases of females with aNMDARe who were referred for complex specialist rehabilitation (CSR) to The National Rehabilitation Hospital. CSR is the total active care of patients with a disabling condition, and their families, by a multi-professional team who have undergone recognised specialist training in rehabilitation, led \\/supported by a consultant trained and accredited in rehabilitation medicine (RM). These services provide for patients with highly complex rehabilitation needs that are beyond the scope of local services. In these cases, referral to CSR resulted in the construction of a bespoke integrated care pathway (ICP) that transcended the barriers between primary, secondary and tertiary care and across the boundaries of physical and mental health. A care pathway is a complex intervention for the mutual decision-making and organisation of care processes Rehabilitation services acted as the coordinator of services in these cases to ensure implementation of the care plan and to ensure successful transitions of care and supported local specialist and general teams in the management of these complex cases.

Case study method and problem-based learning: utilizing the pedagogical model of progressive complexity in nursing education.

Science.gov (United States)

McMahon, Michelle A; Christopher, Kimberly A

2011-08-19

As the complexity of health care delivery continues to increase, educators are challenged to determine educational best practices to prepare BSN students for the ambiguous clinical practice setting. Integrative, active, and student-centered curricular methods are encouraged to foster student ability to use clinical judgment for problem solving and informed clinical decision making. The proposed pedagogical model of progressive complexity in nursing education suggests gradually introducing students to complex and multi-contextual clinical scenarios through the utilization of case studies and problem-based learning activities, with the intention to transition nursing students into autonomous learners and well-prepared practitioners at the culmination of a nursing program. Exemplar curricular activities are suggested to potentiate student development of a transferable problem solving skill set and a flexible knowledge base to better prepare students for practice in future novel clinical experiences, which is a mutual goal for both educators and students.

Complexity, Modeling, and Natural Resource Management

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Paul Cilliers

2013-09-01

Full Text Available This paper contends that natural resource management (NRM issues are, by their very nature, complex and that both scientists and managers in this broad field will benefit from a theoretical understanding of complex systems. It starts off by presenting the core features of a view of complexity that not only deals with the limits to our understanding, but also points toward a responsible and motivating position. Everything we do involves explicit or implicit modeling, and as we can never have comprehensive access to any complex system, we need to be aware both of what we leave out as we model and of the implications of the choice of our modeling framework. One vantage point is never sufficient, as complexity necessarily implies that multiple (independent conceptualizations are needed to engage the system adequately. We use two South African cases as examples of complex systems - restricting the case narratives mainly to the biophysical domain associated with NRM issues - that make the point that even the behavior of the biophysical subsystems themselves are already complex. From the insights into complex systems discussed in the first part of the paper and the lessons emerging from the way these cases have been dealt with in reality, we extract five interrelated generic principles for practicing science and management in complex NRM environments. These principles are then further elucidated using four further South African case studies - organized as two contrasting pairs - and now focusing on the more difficult organizational and social side, comparing the human organizational endeavors in managing such systems.

Utility of 3D printed temporal bones in pre-surgical planning for complex BoneBridge cases.

Science.gov (United States)

Mukherjee, Payal; Cheng, Kai; Flanagan, Sean; Greenberg, Simon

2017-08-01

With the advent of single-sided hearing loss increasingly being treated with cochlear implantation, bone conduction implants are reserved for cases of conductive and mixed hearing loss with greater complexity. The BoneBridge (BB, MED-EL, Innsbruck, Austria) is an active fully implantable device with no attenuation of sound energy through soft tissue. However, the floating mass transducer (FMT) part of the device is very bulky, which limits insertion in complicated ears. In this study, 3D printed temporal bones of patients were used to study its utility in preoperative planning on complicated cases. Computed tomography (CT) scans of 16 ears were used to 3D print their temporal bones. Three otologists graded the use of routine preoperative planning provided by MED-EL and that of operating on the 3D printed bone of the patient. Data were collated to assess the advantage and disadvantage of the technology. There was a statistically significant benefit in using 3D printed temporal bones to plan surgery for difficult cases of BoneBridge surgery compared to the current standard. Surgeons preferred to have the printed bones in theatre to plan their drill sites and make the transition of the planning to the patient's operation more precise. 3D printing is an innovative use of technology in the use of preoperative planning for complex ear surgery. Surgical planning can be done on the patient's own anatomy which may help to decrease operating time, reduce cost, increase surgical precision and thus reduce complications.

Navigating the complexities of qualitative comparative analysis: case numbers, necessity relations, and model ambiguities.

Science.gov (United States)

Thiem, Alrik

2014-12-01

In recent years, the method of Qualitative Comparative Analysis (QCA) has been enjoying increasing levels of popularity in evaluation and directly neighboring fields. Its holistic approach to causal data analysis resonates with researchers whose theories posit complex conjunctions of conditions and events. However, due to QCA's relative immaturity, some of its technicalities and objectives have not yet been well understood. In this article, I seek to raise awareness of six pitfalls of employing QCA with regard to the following three central aspects: case numbers, necessity relations, and model ambiguities. Most importantly, I argue that case numbers are irrelevant to the methodological choice of QCA or any of its variants, that necessity is not as simple a concept as it has been suggested by many methodologists, and that doubt must be cast on the determinacy of virtually all results presented in past QCA research. By means of empirical examples from published articles, I explain the background of these pitfalls and introduce appropriate procedures, partly with reference to current software, that help avoid them. QCA carries great potential for scholars in evaluation and directly neighboring areas interested in the analysis of complex dependencies in configurational data. If users beware of the pitfalls introduced in this article, and if they avoid mechanistic adherence to doubtful "standards of good practice" at this stage of development, then research with QCA will gain in quality, as a result of which a more solid foundation for cumulative knowledge generation and well-informed policy decisions will also be created. © The Author(s) 2014.

Inflammatory arthritis mimicking Complex Regional Pain Syndrome (CRPS) in a child: A case report.

Science.gov (United States)

Egilmez, Zeliha; Turgut, Selin Turan; Icagasioglu, Afitap; Bicakci, Irem

2016-01-01

Joint complaints in childhood are seen frequently and differential diagnosis can be difficult. Juvenile idiopathic arthritis (JIA) is the most common rheumatological disease of childhood. It involves peripheral joint arthritis, chronic synovitis, and extra-articular manifestations. Accurate diagnosis can take a long time and sometimes multiple diagnoses are used while following the patient until a final diagnosis can be reached. Arthritis may be triggered by trauma and confused with other diseases like complex regional pain syndrome (CRPS), in which trauma plays a role in the etiology. In the present case, ankle pain in an 8-year-old girl was misdiagnosed as CRPS.

On the impedance of galvanic cells XXVI. Application of the complex plane method in the case of mixed currents

NARCIS (Netherlands)

Dekker, B.G.; Sluyters-Rehbach, M.; Sluyters, J.H.

1969-01-01

The applicability of the complex plane method for the evaluation of the impedance parameters in the case of two simultaneously proceeding electrode reactions is discussed. It is shown that the possibility of the evaluation depends strongly on the values of the irreversibility quotients of both

Solid-state titania-based gas sensor for liquefied petroleum gas ...

Indian Academy of Sciences (India)

Administrator

the material is porous and has grapes-like morphology before exposure to the LPG. ... Variations in resistance with exposure of LPG to the sensing element were observed. ... and electrical properties (Carney et al 2005; Manera et al. 2007).

Complexity Plots

KAUST Repository

Thiyagalingam, Jeyarajan

2013-06-01

In this paper, we present a novel visualization technique for assisting the observation and analysis of algorithmic complexity. In comparison with conventional line graphs, this new technique is not sensitive to the units of measurement, allowing multivariate data series of different physical qualities (e.g., time, space and energy) to be juxtaposed together conveniently and consistently. It supports multivariate visualization as well as uncertainty visualization. It enables users to focus on algorithm categorization by complexity classes, while reducing visual impact caused by constants and algorithmic components that are insignificant to complexity analysis. It provides an effective means for observing the algorithmic complexity of programs with a mixture of algorithms and black-box software through visualization. Through two case studies, we demonstrate the effectiveness of complexity plots in complexity analysis in research, education and application. © 2013 The Author(s) Computer Graphics Forum © 2013 The Eurographics Association and Blackwell Publishing Ltd.

On Perturbative Cubic Nonlinear Schrodinger Equations under Complex Nonhomogeneities and Complex Initial Conditions

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Magdy A. El-Tawil

2009-01-01

Full Text Available A perturbing nonlinear Schrodinger equation is studied under general complex nonhomogeneities and complex initial conditions for zero boundary conditions. The perturbation method together with the eigenfunction expansion and variational parameters methods are used to introduce an approximate solution for the perturbative nonlinear case for which a power series solution is proved to exist. Using Mathematica, the symbolic solution algorithm is tested through computing the possible approximations under truncation procedures. The method of solution is illustrated through case studies and figures.

Current Opinion in Endocrinology, Diabetes, and Obesity “Pituitary gigantism: Update on Molecular Biology and Management”

Science.gov (United States)

Lodish, Maya B.; Trivellin, Giampaolo; Stratakis, Constantine A.

2016-01-01

Purpose of review To provide an update on the mechanisms leading to pituitary gigantism, as well as to familiarize the practitioner with the implication of these genetic findings on treatment decisions. Recent findings Prior studies have identified gigantism as a feature of a number of monogenic disorders, including mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene, multiple endocrine neoplasia types 1 and 4, McCune Albright Syndrome, Carney Complex, and the paraganglioma, pheochromocytoma and pituitary adenoma association (3PA) due to succinate dehydrogenase defects. We recently described a previously uncharacterized form of early-onset pediatric gigantism caused by microduplications on chromosome Xq26.3 and we termed it X-LAG (X-linked acrogigantism). The age of onset of increased growth in X-LAG is significantly younger than other pituitary gigantism cases, and control of growth hormone excess is particularly challenging. Summary Knowledge of the molecular defects that underlie pituitary tumorigenesis is crucial for patient care as they guide early intervention, screening for associated conditions, genetic counseling, surgical approach (partial or total hypophysectomy), and choice of medical management. Recently described microduplications of Xq26.3 account for more than 80% of the cases of early-onset pediatric gigantism. Early recognition of X-LAG may improve outcomes, as successful control of growth hormone excess requires extensive anterior pituitary resection and are difficult to manage with medical therapy alone. PMID:26574647

Cushing syndrome in a young woman due to primary pigmented nodular adrenal disease.

Science.gov (United States)

Hackman, Kathryn L; Davis, Anna L; Curnow, Paul A; Serpell, Jonathan W; McLean, Catriona A; Topliss, Duncan J

2010-01-01

To report a case of Cushing syndrome due to apparently sporadic primary pigmented nodular adrenal disease in a young woman. We describe the clinical, biochemical, radiologic, and histologic findings of Cushing syndrome due to the rare condition of primary pigmented nodular adrenal disease. A 30-year-old woman presented with a 2-year history of worsening itch without rash over her shoulders and arms and weight gain, particularly around the abdomen and face. Careful questioning did not elicit any history of exogenous glucocorticoid use (systemic or topical), including hydrocortisone. On examination, the patient had a slightly rounded and plethoric face, a small buffalo hump, central adiposity, and thin skin with a few small striae on her inner thighs. No features of the Carney complex were observed. Investigations showed hypercortisolism with suppressed corticotropin and normal adrenal imaging despite documentation of enlarged adrenal glands at removal. High-dose dexamethasone administration was followed by a decrease in urinary free cortisol excretion rather than a paradoxical rise as previously reported in primary pigmented nodular adrenal disease. No mutations were detected in the PRKAR1A gene. Primary pigmented nodular adrenal disease should be suspected in patients with corticotropin-independent Cushing syndrome who have normal adrenal imaging. The role of genetic testing in apparently sporadic cases is not established, but cumulative experience may be helpful in defining the frequency of PRKAR1A mutations.

Postural complexity influences development in infants born preterm with brain injury: relating perception-action theory to 3 cases.

Science.gov (United States)

Dusing, Stacey C; Izzo, Theresa; Thacker, Leroy R; Galloway, James Cole

2014-10-01

Perception-action theory suggests a cyclical relationship between movement and perceptual information. In this case series, changes in postural complexity were used to quantify an infant's action and perception during the development of early motor behaviors. Three infants born preterm with periventricular white matter injury were included. Longitudinal changes in postural complexity (approximate entropy of the center of pressure), head control, reaching, and global development, measured with the Test of Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, were assessed every 0.5 to 3 months during the first year of life. All 3 infants demonstrated altered postural complexity and developmental delays. However, the timing of the altered postural complexity and the type of delays varied among the infants. For infant 1, reduced postural complexity or limited action while learning to control her head in the midline position may have contributed to her motor delay. However, her ability to adapt her postural complexity eventually may have supported her ability to learn from her environment, as reflected in her relative cognitive strength. For infant 2, limited early postural complexity may have negatively affected his learning through action, resulting in cognitive delay. For infant 3, an increase in postural complexity above typical levels was associated with declining neurological status. Postural complexity is proposed as a measure of perception and action in the postural control system during the development of early behaviors. An optimal, intermediate level of postural complexity supports the use of a variety of postural control strategies and enhances the perception-action cycle. Either excessive or reduced postural complexity may contribute to developmental delays in infants born preterm with white matter injury. © 2014 American Physical Therapy Association.

[Application of hair analysis of selected psychoactive substances for medico-legal purposes. Part II. Cases of complex fatal poisonings: interactions of heroine - cocaine - amphetamines].

Science.gov (United States)

Rojek, Sebastian; Kłys, Małgorzata; Rzepecka-Woźniak, Ewa; Konopka, Tomasz

2010-01-01

The study represents an attempt at employing segmental hair analysis in complex poisonings with xenobiotic mixtures of heroine - cocaine - amphetamines in the context of the cause of death as a consequence of complex interaction mechanisms which occurred prior to death. Two cases of complex poisonings: heroine - cocaine and heroine - cocaine - amphetamines were analyzed and documented with macro- and microscopic examinations and complex toxicological examinations, including the analysis of classic biological material, i.e. samples of selective blood, and alternative material, i.e. hair samples. Determinations of opioids, cocaine and its metabolite and amphetamines in the hair biological matrix were performed using high performance liquid chromatography--atmospheric pressure chemical ionization--tandem mass spectrometry (HPLC-APCI-MS-MS). Segmental hair analysis of the investigated cases indicated a prolonged intake of similar psychoactive substances and a developed adaptation of the addicted to interaction mechanisms, which, however, led gradually to multiorgan anatomopathological changes, and in consequence to death.

Viability and resilience of complex systems concepts, methods and case studies from ecology and society

CERN Document Server

Deffuant, Guillaume

2011-01-01

One common characteristic of a complex system is its ability to withstand major disturbances and the capacity to rebuild itself. Understanding how such systems demonstrate resilience by absorbing or recovering from major external perturbations requires both quantitative foundations and a multidisciplinary view of the topic. This book demonstrates how new methods can be used to identify the actions favouring the recovery from perturbations on a variety of examples including the dynamics of bacterial biofilms, grassland savannahs, language competition and Internet social networking sites. The reader is taken through an introduction to the idea of resilience and viability and shown the mathematical basis of the techniques used to analyse systems. The idea of individual or agent-based modelling of complex systems is introduced and related to analytically tractable approximations of such models. A set of case studies illustrates the use of the techniques in real applications, and the final section describes how on...

Genetics of Endocrine and Neuroendocrine Neoplasias (PDQ®)—Health Professional Version

Science.gov (United States)

Genetics of Endocrine and Neuroendocrine Neoplasias discusses inherited syndromes multiple endocrine neoplasia types 1, 2, and 4 (MEN1, MEN2, MEN4), familial pheochromocytoma and paraganglioma, Carney-Stratakis syndrome, and familial nonmedullary thyroid cancer. Learn more in this clinician summary.

SDHA loss of function mutations in a subset of young adult wild-type gastrointestinal stromal tumors

International Nuclear Information System (INIS)

Italiano, Antoine; Chen, Chun-Liang; Sung, Yun-Shao; Singer, Samuel; DeMatteo, Ronald P; LaQuaglia, Michael P; Besmer, Peter; Socci, Nicholas; Antonescu, Cristina R

2012-01-01

A subset of KIT/PDGFRA wild-type gastrointestinal stromal tumors (WT GIST) have been associated with alteration of the succinate dehydrogenase (SDH) complex II function. A recent report identified four non-syndromic, KIT/PDGFRA WT GIST harboring compound heterozygous or homozygous mutations in SDHA encoding the main subunit of the SDH complex II. Next generation sequencing was applied on five pediatric and one young adult WT GIST, by whole exome capture and SOLiD 3-plus system sequencing. The putative mutations were first confirmed by Sanger sequencing and then screened on a larger panel of 11 pediatric and young adult WT GIST, including 5 in the context of Carney triad. A germline p.Arg31X nonsense SDHA mutation was identified in one of the six cases tested by SOLiD platform. An additional p.D38V missense mutation in SDHA exon 2 was identified by Sanger sequencing in the extended KIT/PDGFRA WT GIST patients cohort. Western blotting showed loss of SDHA expression in the two cases harboring SDHA mutations, while expression being retained in the other WT GIST tumors. Results were further confirmed by immunohistochemistry for both SDHA and SDHB, which showed a concurrent loss of expression of both proteins in SDHA-mutant lesions, while the remaining WT tumors showed only loss of SDHB expression. Germline and/or somatic aberrations of SDHA occur in a small subset of KIT/PDGFRA WT GISTs, outside the Carney’s triad and are associated with loss of both SDHA and SDHB protein expression. Mutations of the SDH complex II are more particularly associated with KIT/PDGFRA WT GIST occurring in young adults. Although pediatric GIST consistently display alterations of SDHB protein expression, further molecular studies are needed to identify the crucial genes involved in their tumorigenesis

Sequence complexity and work extraction

International Nuclear Information System (INIS)

Merhav, Neri

2015-01-01

We consider a simplified version of a solvable model by Mandal and Jarzynski, which constructively demonstrates the interplay between work extraction and the increase of the Shannon entropy of an information reservoir which is in contact with a physical system. We extend Mandal and Jarzynski’s main findings in several directions: first, we allow sequences of correlated bits rather than just independent bits. Secondly, at least for the case of binary information, we show that, in fact, the Shannon entropy is only one measure of complexity of the information that must increase in order for work to be extracted. The extracted work can also be upper bounded in terms of the increase in other quantities that measure complexity, like the predictability of future bits from past ones. Third, we provide an extension to the case of non-binary information (i.e. a larger alphabet), and finally, we extend the scope to the case where the incoming bits (before the interaction) form an individual sequence, rather than a random one. In this case, the entropy before the interaction can be replaced by the Lempel–Ziv (LZ) complexity of the incoming sequence, a fact that gives rise to an entropic meaning of the LZ complexity, not only in information theory, but also in physics. (paper)

Complex Odontoma: A Case Report with Micro-Computed Tomography Findings

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L. A. N. Santos

2016-01-01

Full Text Available Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research.

Modeling geophysical complexity: a case for geometric determinism

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C. E. Puente

2007-01-01

Full Text Available It has been customary in the last few decades to employ stochastic models to represent complex data sets encountered in geophysics, particularly in hydrology. This article reviews a deterministic geometric procedure to data modeling, one that represents whole data sets as derived distributions of simple multifractal measures via fractal functions. It is shown how such a procedure may lead to faithful holistic representations of existing geophysical data sets that, while complementing existing representations via stochastic methods, may also provide a compact language for geophysical complexity. The implications of these ideas, both scientific and philosophical, are stressed.

Elements of complexity in subsurface modeling, exemplified with three case studies

Energy Technology Data Exchange (ETDEWEB)

Freedman, Vicky L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rockhold, Mark [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bacon, Diana H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Freshley, Mark D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wellman, Dawn M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2017-04-03

There are complexity elements to consider when applying subsurface flow and transport models to support environmental analyses. Modelers balance the benefits and costs of modeling along the spectrum of complexity, taking into account the attributes of more simple models (e.g., lower cost, faster execution, easier to explain, less mechanistic) and the attributes of more complex models (higher cost, slower execution, harder to explain, more mechanistic and technically defensible). In this paper, modeling complexity is examined with respect to considering this balance. The discussion of modeling complexity is organized into three primary elements: 1) modeling approach, 2) description of process, and 3) description of heterogeneity. Three examples are used to examine these complexity elements. Two of the examples use simulations generated from a complex model to develop simpler models for efficient use in model applications. The first example is designed to support performance evaluation of soil vapor extraction remediation in terms of groundwater protection. The second example investigates the importance of simulating different categories of geochemical reactions for carbon sequestration and selecting appropriate simplifications for use in evaluating sequestration scenarios. In the third example, the modeling history for a uranium-contaminated site demonstrates that conservative parameter estimates were inadequate surrogates for complex, critical processes and there is discussion on the selection of more appropriate model complexity for this application. All three examples highlight how complexity considerations are essential to create scientifically defensible models that achieve a balance between model simplification and complexity.

New interpretation of Petty and Moran's ion-impact Ne--H+3 experiment

International Nuclear Information System (INIS)

Carney, G.D.

1979-01-01

The calculated energy intervals for breathing and bending vibrations of H + 3 given by Carney and Porter (2) agree with the observed ion-impact spectroscopy experiments of petty and Moran (1). The vibrational anharmonicity in H + 3 and rotational excitation processes are discussed

Monitoring centrálních bank - březen 2013

OpenAIRE

Česká národní banka

2013-01-01

Latest monetary policy developments at selected central banks and news. Spotlight: „Monetary policy in Japan“. Selected speech: „Guidance“ by Mark Carney (the Governor of the Bank of Canada, who will be replacing Mervyn King as head of the Bank of England).

Investigation of rare earth complexes with pyridoxalydenamino acids by optical methods. Structure of complexes on basis of hydrophobic amino acids

International Nuclear Information System (INIS)

Zolin, V.F.; Koreneva, L.G.; Serbinova, T.A.; Tsaryuk, V.I.

1975-01-01

The structure of pyridoxalidene amino acid complexes was studied by circular dichroism, magnetic circular dichroism and luminescence spectroscopy. It was shown that these are two-ligand complexes, whereby in the case of those based on valine, leucine and isoleucine the chromophores are almost perpendicular to one another. In the case of complexes based on glycine and alanine the co-ordination sphere is strongly deformed. (author)

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

Science.gov (United States)

Morales-Asencio, Jose M; Kaknani-Uttumchandani, Shakira; Cuevas-Fernández-Gallego, Magdalena; Palacios-Gómez, Leopoldo; Gutiérrez-Sequera, José L; Silvano-Arranz, Agustina; Batres-Sicilia, Juan Pedro; Delgado-Romero, Ascensión; Cejudo-Lopez, Ángela; Trabado-Herrera, Manuel; García-Lara, Esteban L; Martin-Santos, Francisco J; Morilla-Herrera, Juan C

2015-10-01

Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers and services used. The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry. A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web-based registry with modular and layered architecture was designed. The framework follows a pattern based on the model-view-controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one. The registry permits a complete and in-depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events. © 2015 John Wiley & Sons, Ltd.

Comparative Study of Elastic Network Model and Protein Contact Network for Protein Complexes: The Hemoglobin Case

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Guang Hu

2017-01-01

Full Text Available The overall topology and interfacial interactions play key roles in understanding structural and functional principles of protein complexes. Elastic Network Model (ENM and Protein Contact Network (PCN are two widely used methods for high throughput investigation of structures and interactions within protein complexes. In this work, the comparative analysis of ENM and PCN relative to hemoglobin (Hb was taken as case study. We examine four types of structural and dynamical paradigms, namely, conformational change between different states of Hbs, modular analysis, allosteric mechanisms studies, and interface characterization of an Hb. The comparative study shows that ENM has an advantage in studying dynamical properties and protein-protein interfaces, while PCN is better for describing protein structures quantitatively both from local and from global levels. We suggest that the integration of ENM and PCN would give a potential but powerful tool in structural systems biology.

EXPLOITATION AND OPTIMIZATION OF RESERVOIR PERFORMANCE IN HUNTON FORMATION, OKLAHOMA

Energy Technology Data Exchange (ETDEWEB)

Mohan Kelkar

2002-03-31

The West Carney Field in Lincoln County, Oklahoma is one of few newly discovered oil fields in Oklahoma. Although profitable, the field exhibits several unusual characteristics. These include decreasing water-oil ratios, decreasing gas-oil ratios, decreasing bottomhole pressures during shut-ins in some wells, and transient behavior for water production in many wells. This report explains the unusual characteristics of West Carney Field based on detailed geological and engineering analyses. We propose a geological history that explains the presence of mobile water and oil in the reservoir. The combination of matrix and fractures in the reservoir explains the reservoir's flow behavior. We confirm our hypothesis by matching observed performance with a simulated model and develop procedures for correlating core data to log data so that the analysis can be extended to other, similar fields where the core coverage may be limited.

Electroencephalographic evoked pain response is suppressed by spinal cord stimulation in complex regional pain syndrome: a case report.

Science.gov (United States)

Hylands-White, Nicholas; Duarte, Rui V; Beeson, Paul; Mayhew, Stephen D; Raphael, Jon H

2016-12-01

Pain is a subjective response that limits assessment. The purpose of this case report was to explore how the objectivity of the electroencephalographic response to thermal stimuli would be affected by concurrent spinal cord stimulation. A patient had been implanted with a spinal cord stimulator for the management of complex regional pain syndrome of both hands for 8 years. Following ethical approval and written informed consent we induced thermal stimuli using the Medoc PATHWAY Pain & Sensory Evaluation System on the right hand of the patient with the spinal cord stimulator switched off and with the spinal cord stimulator switched on. The patient reported a clinically significant reduction in thermal induced pain using the numerical rating scale (71.4 % reduction) with spinal cord stimulator switched on. Analysis of electroencephalogram recordings indicated the occurrence of contact heat evoked potentials (N2-P2) with spinal cord stimulator off, but not with spinal cord stimulator on. This case report suggests that thermal pain can be reduced in complex regional pain syndrome patients with the use of spinal cord stimulation and offers objective validation of the reported outcomes with this treatment.

An atypical case of postsurgical complex regional pain syndrome in a patient having nonhealing varicose venous ulcer treated by lumbar sympathectomy

Directory of Open Access Journals (Sweden)

Kailash Kothari

2017-01-01

Full Text Available Complex regional pain syndrome (CRPS of the lower limb is a relatively uncommon entity as compared to CRPS of the upper extremity. Literature search has revealed only 2 retrospective case series and a single case report of lower extremity CRPS type I from 1975 to 2014 on Pubmed, isolated cases of CRPS type I of lower extremity have also been reported following knee surgeries and arthroscopies. This report presents a case of lower limb CRPS type I, following surgery for varicose vein ulcer. Pain was not relieved with medications. Diagnostic lumbar sympathectomy was done and patient had tremendous relief of pain following that, proving sympathetic mediated pain of the involved limb.

Extending Life Concepts to Complex Systems

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Jean Le Fur

2013-01-01

Full Text Available There is still no consensus definition of complex systems. This article explores, as a heuristic approach, the possibility of using notions associated with life as transversal concepts for defining complex systems. This approach is developed within a general classification of systems, with complex systems considered as a general ‘living things’ category and living organisms as a specialised class within this category. Concepts associated with life are first explored in the context of complex systems: birth, death and lifetime, adaptation, ontogeny and growth, reproduction. Thereafter, a refutation approach is used to test the proposed classification against a set of diverse systems, including a reference case, edge cases and immaterial complex systems. The summary of this analysis is then used to generate a definition of complex systems, based on the proposal, and within the background of cybernetics, complex adaptive systems and biology. Using notions such as ‘birth’ or ‘lifespan’ as transversal concepts may be of heuristic value for the generic characterization of complex systems, opening up new lines of research for improving their definition.

Communication complexity and information complexity

Science.gov (United States)

Pankratov, Denis

Information complexity enables the use of information-theoretic tools in communication complexity theory. Prior to the results presented in this thesis, information complexity was mainly used for proving lower bounds and direct-sum theorems in the setting of communication complexity. We present three results that demonstrate new connections between information complexity and communication complexity. In the first contribution we thoroughly study the information complexity of the smallest nontrivial two-party function: the AND function. While computing the communication complexity of AND is trivial, computing its exact information complexity presents a major technical challenge. In overcoming this challenge, we reveal that information complexity gives rise to rich geometrical structures. Our analysis of information complexity relies on new analytic techniques and new characterizations of communication protocols. We also uncover a connection of information complexity to the theory of elliptic partial differential equations. Once we compute the exact information complexity of AND, we can compute exact communication complexity of several related functions on n-bit inputs with some additional technical work. Previous combinatorial and algebraic techniques could only prove bounds of the form theta( n). Interestingly, this level of precision is typical in the area of information theory, so our result demonstrates that this meta-property of precise bounds carries over to information complexity and in certain cases even to communication complexity. Our result does not only strengthen the lower bound on communication complexity of disjointness by making it more exact, but it also shows that information complexity provides the exact upper bound on communication complexity. In fact, this result is more general and applies to a whole class of communication problems. In the second contribution, we use self-reduction methods to prove strong lower bounds on the information

Critical analysis of the data on complexation of lanthanides and actinides by natural organic matter: particular case of humic substances

International Nuclear Information System (INIS)

Reiller, P.

2010-01-01

This document proposes a critical analysis of the models that describe the actinides and lanthanides complexation by natural organic matter in general and by humic substances in particular. In order to better delimit the particular properties of these substances the most influent physical and chemical properties on complexation are recalled as a preamble. Models as well as data that has been used are reviewed, compiled, and eventually compared to independent data in order to identify (i) their application domain, (ii) the possible simplifications which permit to obtain operational models, (iii) the conditions in which simplifications cannot be ascertained yet, and (iv) the data or fields of knowledge which are still too uncertain. A comparison between the different models is proposed in order to adapt parameters from one model to another minimising the experimental acquisitions, or at least to focus on missing data. Usually, data on the complexation of free ions M z+ are reliable; as soon as hydrolysis, or competition with another ligand in general, in at stake data are much less reliable. Predictions from models are much more uncertain: formation of mixed complexes with hydroxide or carbonate anions is not univocal whatever the modelling strategy. Hints for transfer functions between models which are believed to be incompatible could be explored in order to justify necessary simplifications for using operational modelling. Influence on the solubility of oxides could be quantified, but it is difficult to clearly separate it from colloidal particles stabilisation. The account of the competition between cations by the models has also been tested. In view of the small number of available experimental data there still lie some uncertainties especially for the media that are close to neutrality and in the case of competition with magnesium, but overall in the case of the competition with aluminium and iron. The influence of redox activity of humic substances is also

Coxeter-like complexes

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Eric Babson

2004-12-01

Full Text Available Motivated by the Coxeter complex associated to a Coxeter system (W,S, we introduce a simplicial regular cell complex Δ(G,S with a G-action associated to any pair (G,S where G is a group and S is a finite set of generators for G which is minimal with respect to inclusion. We examine the topology of Δ(G,S, and in particular the representations of G on its homology groups. We look closely at the case of the symmetric group S n minimally generated by (not necessarily adjacent transpositions, and their type-selected subcomplexes. These include not only the Coxeter complexes of type A, but also the well-studied chessboard complexes.

3-Dimensional computed tomography imaging of the ring-sling complex with non-operative survival case in a 10-year-old female

OpenAIRE

Fukuda, Hironobu; Imataka, George; Drago, Fabrizio; Maeda, Kosaku; Yoshihara, Shigemi

2017-01-01

We report a case of a 10-year-old female patient who survived ring-sling complex without surgery. The patient had congenital wheezing from the neonatal period and was treated after a tentative diagnosis of infantile asthma. The patient suffered from allergy and was hospitalized several times due to severe wheezing, and when she was 22 months old, she was diagnosed with ring-sling complex. We used a segmental 4 mm internal diameter of the trachea for 3-dimensional computed tomography (3D-CT). ...

Case-crossover study of Burkholderia cepacia complex bloodstream infection associated with contaminated intravenous bromopride.

Science.gov (United States)

Martins, Ianick Souto; Pellegrino, Flávia Lúcia Piffano Costa; Freitas, Andrea d'Avila; Santos, Marisa da Silva; Ferraiuoli, Giovanna Ianini d'Alemeida; Vasques, Márcia Regina Guimarães; Amorim, Efigenia Lourdes Teixeira; Oliveira, Sandra; Nouér, Simone Aranha; Cardoso, Fernando Luiz Lopes; Mascarenhas, Luiz Affonso; Magalhães, Ana Cristina Gouveia; Cleinman, Isabella Barbosa; Figueiredo, Agnes Marie Sá; Moreira, Beatriz Meurer

2010-05-01

To investigate an outbreak of healthcare-associated Burkholderia cepacia complex (BCC) primary bloodstream infections (BCC-BSI). Case-crossover study in a public hospital, a university hospital and a private hospital in Rio de Janeiro, Brazil, from March 2006 to May 2006. Twenty-five patients with BCC-BSI. After determining the date BCC-BSI symptoms started for each patient, 3 time intervals of data collection were defined, each one with a duration of 3 days: the case period, starting just before BCC-BSI symptoms onset; the control period, starting 6 days before BCC-BSI symptoms onset; and the washout period, comprising the 3 days between the case period and the control period. Exposures evaluated were intravascular solutions and invasive devices and procedures. Potential risk factors were identified by using the McNemar chi(2) adjusted test. Cultures of samples of potentially contaminated solutions were performed. BCC strain typing was performed by pulsed-field gel electrophoresis using SpeI. The statistical analysis revealed that the use of bromopride and dipyrone was associated with BCC-BSI. A total of 21 clinical isolates from 17 (68%) of the 25 patients and an isolate obtained from the bromopride vial were available for strain typing. Six pulsotypes were detected. A predominant pulsotype (A) accounted for 11 isolates obtained from 11 patients (65%) in the 3 study hospitals. Our investigation, using a case-crossover design, of an outbreak of BCC-BSI infections concluded it was polyclonal but likely caused by infusion of contaminated bromopride. The epidemiological finding was validated by microbiological analysis. After recall of contaminated bromopride vials by the manufacturer, the outbreak was controlled.

Complex Systems and Dependability

CERN Document Server

Zamojski, Wojciech; Sugier, Jaroslaw

2012-01-01

Typical contemporary complex system is a multifaceted amalgamation of technical, information, organization, software and human (users, administrators and management) resources. Complexity of such a system comes not only from its involved technical and organizational structure but mainly from complexity of information processes that must be implemented in the operational environment (data processing, monitoring, management, etc.). In such case traditional methods of reliability analysis focused mainly on technical level are usually insufficient in performance evaluation and more innovative meth

Complex phonic tic and disinhibition in Tourette syndrome: case report

Directory of Open Access Journals (Sweden)

Maia Débora Palmini

2001-01-01

Full Text Available Tourette syndrome (TS is a neuropsychiatric disorder characterized by a combination of multiple motor tics and at least one phonic tic. TS patients often have associated behavioral abnormalities such as obsessive compulsive disorder, attention deficit and hyperactive disorder. Coprolalia, defined as emission of obscenities or swearing, is one type of complex vocal tic, present in 8% to 26% of patients. The pathophysiology of coprolalia and other complex phonic tics remains ill-defined. We report a patient whose complex phonic tic was characterized by repetitively saying "breast cancer" on seeing the son of aunt who suffered from this condition. The patient was unable to suppress the tic and did not meet criteria for obsessive compulsive disorder. The phenomenology herein described supports the theory that complex phonic tics result from disinhibition of the loop connecting the basal ganglia with the limbic cortex.

Three-stage management of complex pancreatic trauma with gastroduodenopancreatectomy: A case report.

Science.gov (United States)

Damous, Sergio Henrique Bastos; Darce, George Felipe Bezerra; Leal, Renato Silveira; Costa, Adilson Rodrigues; Ferreira, Pedro Henrique Alves; de Oliveira Bernini, Celso; Utiyama, Edivaldo Massazo

2018-01-01

Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head. Gastroduodenopancreatectomy was performed with right hemicolectomy and the peritoneal cavity was temporarily closed by a vacuum peritoneostomy. Surgical reopening occurred on the fifth postoperative day, and the patient was subjected to single-loop reconstruction of the intestinal transit with telescoping pancreaticojejunal anastomosis, biliodigestive anastomosis with termino-lateral hepaticojejunal anastomosis with a Kehr drain and gastroenteroanastomosis in 2 planes. The terminal ileostomy was maintained. After 2 days, the patient was subjected to abdominal wall closure without complications, which required relaxing Gibson incisions and wound closure with polypropylene mesh placement in a pre-aponeurotic position closed with multiple stitches. The patient was discharged on the 40th post-trauma day without drains, with a functioning ileostomy and with a scheduled reconstruction of intestinal transit. In the presence of multiple associated injuries, hemodynamic instability and the need for an extensive surgical procedure such as duodenopancreatectomy, damage control surgery performed in stages as reported here enables the clinical stabilization of the patient for definitive treatment, achieving better survival results. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

White matter abnormalities in tuberous sclerosis complex

Energy Technology Data Exchange (ETDEWEB)

Griffiths, P.D. [Sheffield Univ. (United Kingdom). Academic Dept. of Radiology; Bolton, P. [Cambridge Univ. (United Kingdom). Section of Developmental Psychiatry; Verity, C. [Addenbrooke`s NHS Trust, Cambridge (United Kingdom). Dept. of Paediatric Radiology

1998-09-01

The aim of this study was to investigate and describe the range of white matter abnormalities in children with tuberous sclerosis complex by means of MR imaging. Material and Methods: A retrospective cross-sectional study was performed on the basis of MR imaging findings in 20 cases of tuberous sclerosis complex in children aged 17 years or younger. Results: White matter abnormalities were present in 19/20 (95%) cases of tuberous sclerosis complex. These were most frequently (19/20 cases) found in relation to cortical tubers in the supratentorial compartment. White matter abnormalities related to tubers were found in the cerebellum in 3/20 (15%) cases. White matter abnormalities described as radial migration lines were found in relation to 5 tubers in 3 (15%) children. In 4/20 (20%) cases, white matter abnormalities were found that were not related to cortical tubers. These areas had the appearance of white matter cysts in 3 cases and infarction in the fourth. In the latter case there was a definable event in the clinical history, supporting the diagnosis of stroke. Conclusion: A range of white matter abnormalities were found by MR imaging in tuberous sclerosis complex, the commonest being gliosis and hypomyelination related to cortical tubers. Radial migration lines were seen infrequently in relation to cortical tubers and these are thought to represent heterotopic glia and neurons along the expected path of cortical migration. (orig.)

Cooperativity of complex salt bridges

OpenAIRE

Gvritishvili, Anzor G.; Gribenko, Alexey V.; Makhatadze, George I.

2008-01-01

The energetic contribution of complex salt bridges, in which one charged residue (anchor residue) forms salt bridges with two or more residues simultaneously, has been suggested to have importance for protein stability. Detailed analysis of the net energetics of complex salt bridge formation using double- and triple-mutant cycle analysis revealed conflicting results. In two cases, it was shown that complex salt bridge formation is cooperative, i.e., the net strength of the complex salt bridge...

Limb body wall complex: A rare anomaly

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Panduranga Chikkannaiah

2013-01-01

Full Text Available We present autopsy findings of a case of limb body wall complex (LBWC. The fetus had encephalocele, genitourinary agenesis, skeletal anomalies and body wall defects. The rare finding in our case is the occurrence of both cranial and urogenital anomalies. The presence of complex anomalies in this fetus, supports embryonal dysplasia theory of pathogenesis for LBWC.

Prenatal MRI evaluation of limb-body wall complex

Energy Technology Data Exchange (ETDEWEB)

Aguirre-Pascual, Elisa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Hospital Universitario Doce de Octubre, Department of Radiology, Madrid (Spain); Epelman, Monica [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Johnson, Ann M.; Chauvin, Nancy A.; Coleman, Beverly G.; Victoria, Teresa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States)

2014-11-15

The sonographic (US) features of limb-body wall complex have been well documented; however the literature regarding the findings on MRI in limb-body wall complex is scant. To characterize the prenatal MRI features of limb-body wall complex. We performed a retrospective review of all MRI scans of fetuses diagnosed with limb-body wall complex at our institution from 2001 to 2011. Fetuses without correlating US scans or follow-up information were excluded. Three pediatric radiologists blinded to the specific US findings reviewed the prenatal MRIs. Images were evaluated for the organ location and attachment, the body part affected, characterization of the body wall defect, and spinal, limb and umbilical cord abnormalities. Ten subjects met inclusion criteria. MRI was able to detect and characterize the body part affected and associated abnormalities. All fetuses had ventral wall defects, a small thorax and herniated liver and bowel. The kidneys were extracorporeal in three cases. The extruded organs were attached to the placenta or the uterine wall in all cases. Abnormal spinal curvatures of various degrees of severity were present in all cases. Eight cases had a short, uncoiled cord. Limb anomalies were present in 6 of the 10 cases. We illustrate the common fetal MRI findings of limb-body wall complex. The prenatal diagnosis of limb-body wall complex and the differentiation of this defect from treatable abdominal wall defects are crucial to providing appropriate guidance for patient counseling and management. (orig.)

Which is the best oxidant for complexed iron removal from groundwater: The Kogalym case

Energy Technology Data Exchange (ETDEWEB)

Munter, R.; Overbeck, P.; Sutt, J. [Tallinn University of Technology, Tallinn (Estonia). Dept. of Chemical Engineering

2008-07-01

A short overview of the significance of a preoxidation stage groundwater treatment is presented. As an example the case of complexed iron removal from Kogalym groundwater (Tjumen, Siberia, Russian Federation) using different preoxidants (ozone, oxygen, chlorine, hydrogen peroxide, and potassium permanganate) is discussed. The key problem is stable di- and trivalent iron-organic complexes in groundwater which after aeration tend to pass through the hydroanthracite-sand gravity filters. The total organic carbon (TOC) content in raw groundwater is in the range of 3.2-6.4 mg/L, total iron content 2.7-6.0 mg/L and divalent iron content 2.4-4.0 mg/L. Separation from Kogalym groundwater by XAD-16 adsorbent humic matter fraction was homogeneous, with only 1 peak on the chromatogram with maximum Rt = 10.75 min and corresponding molecular mass 1911 ({lt} 2000). The final developed treatment technology is based on the water oxidation/reduction potential (ORP) optimization according to the iron system pE-pH diagram and consists of intensive aeration of raw water in the Gas-Degas Treatment (GDT) unit with the following sequence: filtration through the hydroanthracite and special anthracite Everzit, with intermediate enrichment of water with pure oxygen between the filtration stages.

IN BRIEF: ADAPTATION AND INNOVATION

International Development Research Centre (IDRC) Digital Library (Canada)

voiced their passionate commitment and explored new ways of meeting the challenge. ... McCarney, President and CEO, Plan Canada and Nicolas Moyer, Executive ... “humanitarian actors are being called on to deal with the consequences of .... (OCCAH), highlighted the increasing imperative of tapping the expertise and.

Familial Investigations of Childhood Cancer Predisposition

Science.gov (United States)

2018-01-03

Acute Leukemia; Adenomatous Polyposis; Adrenocortical Carcinoma; AML; BAP1 Tumor Predisposition Syndrome; Carney Complex; Choroid Plexus Carcinoma; Constitutional Mismatch Repair Deficiency Syndrome; Diamond-Blackfan Anemia; DICER1 Syndrome; Dyskeratosis Congenita; Emberger Syndrome; Familial Acute Myeloid Leukemia; Familial Adenomatous Polyposis; Fanconi Anemia; Familial Cancer; Familial Wilms Tumor; Familial Neuroblastoma; GIST; Hereditary Breast and Ovarian Cancer; Hereditary Paraganglioma-Pheochromocytoma Syndrome; Hodgkin Lymphoma; Juvenile Polyposis; Li-Fraumeni Syndrome; Lynch Syndrome; MDS; Melanoma Syndrome; Multiple Endocrine Neoplasia Type 1; Multiple Endocrine Neoplasia Type 2; Neuroblastoma; Neurofibromatosis Type 1; Neurofibromatosis Type II; Nevoid Basal Cell Carcinoma Syndrome; Non Hodgkin Lymphoma; Noonan Syndrome and Other Rasopathy; Overgrowth Syndromes; Pancreatic Cancer; Peutz-Jeghers Syndrome; Pheochromocytoma/Paraganglioma; PTEN Hamartoma Tumor Syndrome; Retinoblastoma; Rhabdoid Tumor Predisposition Syndrome; Rhabdomyosarcoma; Rothmund-Thomson Syndrome; Tuberous Sclerosis; Von Hippel-Lindau Disease

Emergent nested systems a theory of understanding and influencing complex systems as well as case studies in urban systems

CERN Document Server

Walloth, Christian

2016-01-01

This book presents a theory as well as methods to understand and to purposively influence complex systems. It suggests a theory of complex systems as nested systems, i. e. systems that enclose other systems and that are simultaneously enclosed by even other systems. According to the theory presented, each enclosing system emerges through time from the generative activities of the systems they enclose. Systems are nested and often emerge unplanned, and every system of high dynamics is enclosed by a system of slower dynamics. An understanding of systems with faster dynamics, which are always guided by systems of slower dynamics, opens up not only new ways to understanding systems, but also to effectively influence them. The aim and subject of this book is to lay out these thoughts and explain their relevance to the purposive development of complex systems, which are exemplified in case studies from an urban system. The interested reader, who is not required to be familiar with system-theoretical concepts or wit...

How partnership accelerates Open Science: High Energy Physics and INSPIRE, a case study of a complex repository ecosystem

CERN Document Server

AUTHOR|(CDS)2079501; Hecker, Bernard Louis; Holtkamp, Annette; Mele, Salvatore; O'Connell, Heath; Sachs, Kirsten; Simko, Tibor; Schwander, Thorsten

2013-01-01

Public calls, agency mandates and scientist demand for Open Science are by now a reality with different nuances across diverse research communities. A complex “ecosystem” of services and tools, mostly communityDdriven, will underpin this revolution in science. Repositories stand to accelerate this process, as “openness” evolves beyond text, in lockstep with scholarly communication. We present a case study of a global discipline, HighDEnergy Physics (HEP), where most of these transitions have already taken place in a “social laboratory” of multiple global information services interlinked in a complex, but successful, ecosystem at the service of scientists. We discuss our firstDhand experience, at a technical and organizational level, of leveraging partnership across repositories and with the user community in support of Open Science, along threads relevant to the OR2013 community.

Noise problems in coal mining complex- a case discussion

International Nuclear Information System (INIS)

Mishra, Y.; Mitra, H.; Ghosh, S.; Pal, A.K.

1996-01-01

Noise monitoring study was conducted at Moonidih mining complex of Jharia coal-field. The study included monitoring and analysis of ambient as well as workplace noise levels. An attempt has been made to critically analyse the noise situation through octave band analysis, thereby identifying alarming noise frequencies for each noise generating equipment having Leq level more than 90 dBA. A noise model has also been developed to draw noise contours of the entire mining complex. Based on these studies, suitable control measures have been suggested. (author). 6 refs., 3 figs

Simple and complex hyperplastic papillary proliferations of the endometrium: a clinicopathologic study of nine cases of apparently localized papillary lesions with fibrovascular stromal cores and epithelial metaplasia.

Science.gov (United States)

Lehman, M B; Hart, W R

2001-11-01

The clinicopathologic features of nine cases of papillary proliferation of the endometrium devoid of malignant nuclear features were studied. The patients ranged in age from 33 to 71 years (median 57 years). All were postmenopausal, except the youngest. The most common symptom was postmenopausal bleeding. Two patients were receiving hormonal replacement therapy and two were taking megestrol acetate. Two lesions were incidental findings in a hysterectomy specimen. Seven were diagnosed in endometrial biopsy or curettage specimens. In six cases (67%) the lesion involved an endometrial polyp. In all cases the papillae had fibrovascular stromal cores and variable degrees of branching. Two architectural patterns were found. A simple papillary pattern with involvement of only a few glands and little epithelial proliferation occurred in five cases, including three that were entirely intracystic. A complex papillary pattern with more extensive involvement of endometrial glands, a greater degree of branching of the papillae, and cellular tufting occurred in four cases. One or more metaplastic epithelial changes occurred in all cases, including endocervical-type mucinous metaplasia in nine cases (90%), eosinophilic cell change in eight (89%), ciliated cell change in seven (70%), focal squamous metaplasia in two cases (22%), and hobnail cell change in two (22%). Mitotic figures were found in three cases. In four lesions (44%), all with a complex papillary pattern, the proliferating cells had mild nuclear atypia. Three of these patients underwent hysterectomy within 5 months. Simple nonpapillary hyperplasia and two endometrial polyps were found in one patient, complex nonpapillary hyperplasia in one, and atrophic endometrium in the other. Two patients had additional endometrial samplings within 4 months that contained small residual simple papillary lesions. One of these had another biopsy at 16 months that showed only atrophy. One patient had no subsequent diagnostic or

Ureterocystoneostomy in complex oncological cases with an "Uebelhoer" modified Boari bladder flap.

Science.gov (United States)

Radtke, Jan P; Korzeniewski, Nina; Huber, Johannes; Alt, Celine D; Pahernik, Sascha; Hadaschik, Boris A; Hohenfellner, Markus; Teber, Dogu

2017-12-01

The study aims to describe the technique and analyze the outcome of an arcuated bladder incision with building of a triangular flap, first described by Uebelhoer (UBBF), as a modification of the classical rectangular Boari bladder flap (BBF), that is often viable, but can present difficulties, such as reduced flap vascularization and mobility in pretreated patients. Twelve consecutive patients with distal or mid ureteral leakage or stenosis, that underwent UBBF, were retrospectively analyzed. We assessed postoperative morbidity using Clavien-Dindo classification. Short- and long-term functional outcomes were assessed using glomerular filtration rate (GFR), ultrasound, and renal scintigraphy. Patients underwent UBBF during initial oncological surgery in five cases and due to ureteral defects following oncological surgery or radiotherapy in seven cases. Median patient age was 57 (interquartile range (IQR) 46-72), defect length was 7.5 cm (IQR 5-8 cm), and median follow-up period was 41 (IQR 36-48) months. In short-term follow-up, 11/13 postoperative morbidities were Clavien-Dindo level I-II complications, mostly infections. Two level IIIa complications occurred. One anastomotic leakage was treated sufficiently with temporarily ureteral stenting and one voiding disorder needed intervention. In the long-term follow-up, 84% of patients had improved or constant GFR. In the one-year renal scintigraphy, no urodynamically relevant voiding disorder occurred. The UBBF is a reliable procedure to reconstruct ureteral trauma even in complex oncological, pretreated patients suffering from distal or mid ureteral defects. It can be performed easily by a modified arcuate incision and provides good long-term functional outcomes.

Complex band structure and electronic transmission eigenchannels

DEFF Research Database (Denmark)

Jensen, Anders; Strange, Mikkel; Smidstrup, Soren

2017-01-01

and complex band structure, in this case individual eigenchannel transmissions and different complex bands. We present calculations of decay constants for the two most conductive states as determined by complex band structure and standard DFT Landauer transport calculations for one semi-conductor and two...

[Custom-made implant for complex facial reconstruction: A case of total replacement of temporo-mandibular joint, zygomatic arch and malar bone].

Science.gov (United States)

Guillier, D; Moris, V; See, L-A; Girodon, M; Wajszczak, B-L; Zwetyenga, N

2017-02-01

Total prosthetic replacement of the temporo-mandibular joint (TMJ) has become a common procedure, but it is usually limited to the TMJ itself. We report about one case of complex prosthetic joint reconstruction extending to the neighbouring bony structures. A 57-year-old patient, operated several times for a cranio-facial fibrous dysplasia, presented with a recurring TMJ ankylosis and a complexe latero-facial bone loss on the right side. We performed a reconstruction procedure including the TMJ, the zygomatic arch and the malar bone by mean of custom made composite prosthesis (chrome-cobalt-molybdenum-titanium and polyethylene). Five years postoperatively, mouth opening, nutrition, pain and oral hygiene were significantly improved. Nowadays technical possibilities allow for complex facial alloplastic reconstructions with good medium term results. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Imaging Findings of Complex Fibroadenoma of the Breast: Correlation with Pathologic Findings

Energy Technology Data Exchange (ETDEWEB)

You, Sun Kyoung; Choi, Bo Bae; Kim, Kyung Hee [Chungnam National University Hospital College of Medicine, Seoul (Korea, Republic of)

2010-12-15

The imaging findings of complex fibroadenoma have been rarely reported even though the risk of developing breast carcinoma in a patient with complex fibroadenoma is higher than that for a patient with simple fibroadenoma. We reviewed the imaging features and pathologic findings of complex fibroadenomas. Between April 2003 and April 2010, the mammographic and sonographic findings of five patients with complex fibroadenomas were retrospectively reviewed according to the Breast Imaging Reporting and Data System (BIRADS). The pathologic findings were retrospectively reviewed for all 5 patients. The mammography findings showed masses (3 cases) and asymmetry (1 case). On ultrasonography, complex echo patterns were noted in all the patients, and all the lesions were assigned to BI-RADS category 4, suspicious for abnormality. The complex echoic patterns showed two types: 1) a mixture of a heterogeneous hypoechoic central portion and a fuzzy hyperechoic peripheral area in 2 cases, 2) a mixture of tiny anechoic and hypoehoic lesions in 3 cases. Multiple cystic changes were noted in all the cases on the pathologic analysis. Complex fibroadenomas showed different ultrasonographic findings from simple fibroadenomas such as two types of complex echo patterns, even though the other findings were similar to those of simple fibroadenoma. Cystic changes were noted in all the cases on the pathologic analysis. Awareness of these imaging findings will help us to properly diagnose complex fibroadenoma

Imaging Findings of Complex Fibroadenoma of the Breast: Correlation with Pathologic Findings

International Nuclear Information System (INIS)

You, Sun Kyoung; Choi, Bo Bae; Kim, Kyung Hee

2010-01-01

The imaging findings of complex fibroadenoma have been rarely reported even though the risk of developing breast carcinoma in a patient with complex fibroadenoma is higher than that for a patient with simple fibroadenoma. We reviewed the imaging features and pathologic findings of complex fibroadenomas. Between April 2003 and April 2010, the mammographic and sonographic findings of five patients with complex fibroadenomas were retrospectively reviewed according to the Breast Imaging Reporting and Data System (BIRADS). The pathologic findings were retrospectively reviewed for all 5 patients. The mammography findings showed masses (3 cases) and asymmetry (1 case). On ultrasonography, complex echo patterns were noted in all the patients, and all the lesions were assigned to BI-RADS category 4, suspicious for abnormality. The complex echoic patterns showed two types: 1) a mixture of a heterogeneous hypoechoic central portion and a fuzzy hyperechoic peripheral area in 2 cases, 2) a mixture of tiny anechoic and hypoehoic lesions in 3 cases. Multiple cystic changes were noted in all the cases on the pathologic analysis. Complex fibroadenomas showed different ultrasonographic findings from simple fibroadenomas such as two types of complex echo patterns, even though the other findings were similar to those of simple fibroadenoma. Cystic changes were noted in all the cases on the pathologic analysis. Awareness of these imaging findings will help us to properly diagnose complex fibroadenoma

The Coping Strategies of Nontraditional Female Students in Southwest Michigan and Northern Indiana

Science.gov (United States)

Davis, Desiree

2017-01-01

Problem: The purpose of this research study was to examine the coping strategies of nontraditional female students in a private university in Southwest Michigan, and a public university in Northern Indiana. According to Carney-Compton & Tan (2002), nontraditional female students characterize the leading emergent set of students beginning…

Evaluation of An Eating Disorder Lesson Plan.

Science.gov (United States)

Moriarty, Dick; And Others

This document reports on the quantitative and qualitative evaluation of "A Preventive Curriculum for Anorexia Nervosa and Bulimia" (Carney and Veilleux, 1986) which was published by the Bulimia Anorexia Nervosa Association-Canadian/American (BANA-Can/Am), an organization which was formed in 1983 by parents, professionals, and patients in…

The worst case complexity of maximum parsimony.

Science.gov (United States)

Carmel, Amir; Musa-Lempel, Noa; Tsur, Dekel; Ziv-Ukelson, Michal

2014-11-01

One of the core classical problems in computational biology is that of constructing the most parsimonious phylogenetic tree interpreting an input set of sequences from the genomes of evolutionarily related organisms. We reexamine the classical maximum parsimony (MP) optimization problem for the general (asymmetric) scoring matrix case, where rooted phylogenies are implied, and analyze the worst case bounds of three approaches to MP: The approach of Cavalli-Sforza and Edwards, the approach of Hendy and Penny, and a new agglomerative, "bottom-up" approach we present in this article. We show that the second and third approaches are faster than the first one by a factor of Θ(√n) and Θ(n), respectively, where n is the number of species.

Sutherland models for complex reflection groups

International Nuclear Information System (INIS)

Crampe, N.; Young, C.A.S.

2008-01-01

There are known to be integrable Sutherland models associated to every real root system, or, which is almost equivalent, to every real reflection group. Real reflection groups are special cases of complex reflection groups. In this paper we associate certain integrable Sutherland models to the classical family of complex reflection groups. Internal degrees of freedom are introduced, defining dynamical spin chains, and the freezing limit taken to obtain static chains of Haldane-Shastry type. By considering the relation of these models to the usual BC N case, we are led to systems with both real and complex reflection groups as symmetries. We demonstrate their integrability by means of new Dunkl operators, associated to wreath products of dihedral groups

Spectroscopy of plutonium-organic complexes

International Nuclear Information System (INIS)

Richmann, M.K.; Reed, D.T.

1995-01-01

Information on the spectroscopy of plutonium-organic complexes is needed to help establish the speciation of these complexes under environmentally relevant conditions. Laser photoacoustic spectroscopy (LPAS) and absorption spectrometry were used to characterize the Pu(IV)-citrate and Pu(IV)-nitrilotriacetic acid (NTA) complexes at concentrations of 10 -3 --10 -7 M in aqueous solution. Good agreement was observed between the band shape of the LPAS and absorption spectra for the Pu(IV)-NTA complex. Agreement for the Pu(IV)-citrate complex was not quite as good. In both cases, a linear dependence of the LPAS signal on laser power and total concentration of the complexes was noted. This work is part of an ongoing research effort to study key subsurface interactions of plutonium-organic complexes

Dynamics for the complex Ginzburg-Landau equation on non-cylindrical domains II: The monotone case

Science.gov (United States)

Zhou, Feng; Sun, Chunyou; Cheng, Jiaqi

2018-02-01

In this article, we continue the study of the dynamics of the following complex Ginzburg-Landau equation ∂tu - (λ + iα)Δu + (κ + iβ)|u|p-2u - γu = f(t) on non-cylindrical domains. We assume that the spatial domains are bounded and increase with time, which is different from the diffeomorphism case presented in Zhou and Sun [Discrete Contin. Dyn. Syst., Ser. B 21, 3767-3792 (2016)]. We develop a new penalty function to establish the existence and uniqueness of a variational solution satisfying energy equality as well as some energy inequalities and prove the existence of a D -pullback attractor for the non-autonomous dynamical system generated by this class of solutions.

[Operative treatment for complex tibial plateau fractures].

Science.gov (United States)

Song, Qi-Zhi; Li, Tao

2012-03-01

To explore the surgical methods and clinical evaluation of complex tibial plateau fractures resulted from high-energy injuries. From March 2006 to May 2009,48 cases with complex tibial plateau fractures were treated with open reduction and plate fixation, including 37 males and 11 females, with an average age of 37 years (ranged from 18 to 63 years). According to Schatzker classification, 16 cases were type IV, 20 cases type V and 12 cases type VI. All patients were examined by X-ray flim and CT scan. The function of knee joint were evaluated according to postoperative follow-up X-ray and Knee Merchant Rating. Forty-eight patients were followed up with a mean time of 14 months. According to Knee Merchant Rating, 24 cases got excellent results, 16 cases good, 6 cases fair and 2 cases poor. Appropriate operation time, anatomical reduction, suitable bone graft and reasonable rehabilitation exercises can maximally recovery the function of knee joint.

The case of value-based healthcare for people living with complex long-term conditions.

Science.gov (United States)

Elf, Marie; Flink, Maria; Nilsson, Marie; Tistad, Malin; von Koch, Lena; Ytterberg, Charlotte

2017-01-11

There is a trend towards value-based health service, striving to cut costs while generating value for the patient. The overall objective comprises higher-quality health services and improved patient safety and cost efficiency. The approach could align with patient-centred care, as it entails a focus on the patient's experience of her or his entire cycle of care, including the use of well-defined outcome measurements. Challenges arise when the approach is applied to health services for people living with long-term complex conditions that require support from various healthcare services. The aim of this work is to critically discuss the value-based approach and its implications for patients with long-term complex conditions. Two cases from clinical practice and research form the foundation for our reasoning, illustrating several challenges regarding value-based health services for people living with long-term complex conditions. Achieving value-based health services that provide the health outcomes that matter to patients and providing greater patient-centredness will place increased demands on the healthcare system. Patients and their informal caregivers must be included in the development and establishment of outcome measures. The outcome measures must be standardized to allow evaluation of specific conditions at an aggregated level, but they must also be sensitive enough to capture each patient's individual needs and goals. Healthcare systems that strive to establish value-based services must collaborate beyond the organizational boundaries to create clear patient trajectories in order to avoid fragmentation. The shift towards value-based health services has the potential to align healthcare-service delivery with patient-centred care if serious efforts to take the patient's perspective into account are made. This is especially challenging in fragmented healthcare systems and for patients with long-term- and multi-setting-care needs.

A curative treatment option for Complex Regional Pain Syndrome (CRPS) Type I: dorsal root entry zone operation (report of two cases).

Science.gov (United States)

Kanpolat, Yucel; Al-Beyati, Eyyub; Ugur, Hasan Caglar; Akpinar, Gokhan; Kahilogullari, Gokmen; Bozkurt, Melih

2014-01-01

Complex Regional Pain Syndrome Type I (CRPS-I) is a debated health problem concerning its pathophysiology and treatment strategies. A 12-year-old boy and a 35-year-old woman were diagnosed with CRPS-I at different times. They had previously undergone various types of interventions with no success. After one year of follow-up and observation, DREZ lesioning operation was performed. Afterwards, both cases had transient lower extremity ataxia. The first case was followed for 60 months with no recurrence and total cure. The second case was pain-free until the 6th month, when she required psychological support; she was followed for 33 months with partial satisfactory outcome. Although not a first-line option, DREZ lesioning procedure can be chosen and may be a curative option in selected cases of CRPS-I who are unresponsive to conventional therapies.

Complex organizations: the case of the Brazilian nuclear sector

International Nuclear Information System (INIS)

Xavier, Roberto Salles

2009-01-01

The resumption of the Brazilian Nuclear Program (BNP), in the proposed size and after 20 years of paralysis, requires profound changes in the current organizational modeling of the national nuclear industry. The effectiveness of any process of organizational change is limited to three factors. The theoretical bottleneck happens when you do not know enough about a phenomenon in order to effect the desired changes. The resource bottleneck occurs when knowledge may be available to change people's behavior but the funds necessary for implementation may be lacking. The organizational bottleneck emerges when there are knowledge and resources to solve a problem, but may not able to organize the resources in order to carry out the problem-solving effort. In the case of resumption of BNP seems clear that there is the knowledge of what is needed to make policy and the intention to allocate the necessary resources. But the question is the following: the current organizational model of the Brazilian nuclear sector is consistent with the goals laid down in the scenario of resumption of BNP? That is, is there organizational ability to leverage a program of the size proposed for the nuclear area? Find answers to these questions is crucial, because the organizational model of the Brazilian nuclear sector consists of elements involving a complex interorganizational system. Thus, this article is to examine the appropriateness of the current organizational modeling of the Brazilian nuclear sector to current demands of society. As a result, the article aims to propose recommendations for a remodeling of the nuclear sector, taking into account the current national and international scenarios of nuclear energy. (author)

Different Epidemic Models on Complex Networks

International Nuclear Information System (INIS)

Zhang Haifeng; Small, Michael; Fu Xinchu

2009-01-01

Models for diseases spreading are not just limited to SIS or SIR. For instance, for the spreading of AIDS/HIV, the susceptible individuals can be classified into different cases according to their immunity, and similarly, the infected individuals can be sorted into different classes according to their infectivity. Moreover, some diseases may develop through several stages. Many authors have shown that the individuals' relation can be viewed as a complex network. So in this paper, in order to better explain the dynamical behavior of epidemics, we consider different epidemic models on complex networks, and obtain the epidemic threshold for each case. Finally, we present numerical simulations for each case to verify our results.

Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers

Directory of Open Access Journals (Sweden)

Frédéric Balard

2016-11-01

Full Text Available Abstract Background In 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006–2010. People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users’ (old people and their informal caregivers and case managers’ first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation. Methods The study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19, their informal caregivers (11 and the case managers (5 who participated in the program during the first 6 months. Thematic analysis of the data was carried out. Results The analysis revealed that each group of people generated its own representations of the case manager’s role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager. Conclusion The innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual’s projected

Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers.

Science.gov (United States)

Balard, Frédéric; Gely-Nargeot, Marie-Christine; Corvol, Aline; Saint-Jean, Olivier; Somme, Dominique

2016-11-08

In 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006-2010). People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users' (old people and their informal caregivers) and case managers' first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation. The study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19), their informal caregivers (11) and the case managers (5) who participated in the program during the first 6 months. Thematic analysis of the data was carried out. The analysis revealed that each group of people generated its own representations of the case manager's role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager. The innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual's projected expectations of this social service. Analyzing the first representations

Spindle cell carcinoma of the breast as complex cystic lesion: a case report

International Nuclear Information System (INIS)

Kitada, Masahiro; Hayashi, Satoshi; Matsuda, Yoshinari; Ishibashi, Kei; Oikawa, Keisuke; Miyokawa, Naoyuki

2014-01-01

Spindle cell carcinoma of the breast is a rare tumor. This tumor can proliferate rapidly and cause cystic changes because of internal tissue necrosis. We evaluated a 54-year-old woman with right breast lump. Mammography showed a category four mass with a diameter of 2.5 cm. Ultrasonography (US) revealed a complex cystic lesion, and fine-needle aspiration (FNA) cytology demonstrated bloody fluid and malignant cells. Partial breast resection and sentinel lymph node biopsy were performed. Immunohistology revealed spindle cells with positive results for cytokeratin (AE1/AE3) and vimentin, partially positive results for s-100, and negative results for desmin and α-actin. The pathological stage was IIA, and biochemical characterization showed that the tumor was triple negative. Six courses of FEC-100 chemotherapy (5-fluorouracil 500 mg/m 2 , epirubicin 100 mg/m 2 , and cyclophosphamide 500 mg/m 2 ) were administered. Radiotherapy was performed. This case is discussed with reference to the literature

Multifaceted Modelling of Complex Business Enterprises.

Science.gov (United States)

Chakraborty, Subrata; Mengersen, Kerrie; Fidge, Colin; Ma, Lin; Lassen, David

2015-01-01

We formalise and present a new generic multifaceted complex system approach for modelling complex business enterprises. Our method has a strong focus on integrating the various data types available in an enterprise which represent the diverse perspectives of various stakeholders. We explain the challenges faced and define a novel approach to converting diverse data types into usable Bayesian probability forms. The data types that can be integrated include historic data, survey data, and management planning data, expert knowledge and incomplete data. The structural complexities of the complex system modelling process, based on various decision contexts, are also explained along with a solution. This new application of complex system models as a management tool for decision making is demonstrated using a railway transport case study. The case study demonstrates how the new approach can be utilised to develop a customised decision support model for a specific enterprise. Various decision scenarios are also provided to illustrate the versatility of the decision model at different phases of enterprise operations such as planning and control.

Multifaceted Modelling of Complex Business Enterprises

Science.gov (United States)

2015-01-01

We formalise and present a new generic multifaceted complex system approach for modelling complex business enterprises. Our method has a strong focus on integrating the various data types available in an enterprise which represent the diverse perspectives of various stakeholders. We explain the challenges faced and define a novel approach to converting diverse data types into usable Bayesian probability forms. The data types that can be integrated include historic data, survey data, and management planning data, expert knowledge and incomplete data. The structural complexities of the complex system modelling process, based on various decision contexts, are also explained along with a solution. This new application of complex system models as a management tool for decision making is demonstrated using a railway transport case study. The case study demonstrates how the new approach can be utilised to develop a customised decision support model for a specific enterprise. Various decision scenarios are also provided to illustrate the versatility of the decision model at different phases of enterprise operations such as planning and control. PMID:26247591

COULCC: A continued-fraction algorithm for Coulomb functions of complex order with complex arguments

International Nuclear Information System (INIS)

Thompson, I.J.; Barnett, A.R.

1985-01-01

The routine COULCC calculates both the oscillating and the exponentially varying Coulomb wave functions, and their radial derivations, for complex eta(Sommerfeld parameter), complex energies and complex angular momenta. The functions for uncharged scattering (spherical Bessels) and cylindrical Bessel functions are special cases which are more easily solved. Two linearly independent solutions are found, in general, to the differential equation f''(x)+g(x)f(x)=0, where g(x) has x 0 , x -1 and x -2 terms, with coefficients 1, -2eta and -lambda(lambda+1), respectively. (orig.)

Complexity of formation in holography

International Nuclear Information System (INIS)

Chapman, Shira; Marrochio, Hugo; Myers, Robert C.

2017-01-01

It was recently conjectured that the quantum complexity of a holographic boundary state can be computed by evaluating the gravitational action on a bulk region known as the Wheeler-DeWitt patch. We apply this complexity=action duality to evaluate the ‘complexity of formation’ (DOI: 10.1103/PhysRevLett.116.191301; 10.1103/PhysRevD.93.086006), i.e. the additional complexity arising in preparing the entangled thermofield double state with two copies of the boundary CFT compared to preparing the individual vacuum states of the two copies. We find that for boundary dimensions d>2, the difference in the complexities grows linearly with the thermal entropy at high temperatures. For the special case d=2, the complexity of formation is a fixed constant, independent of the temperature. We compare these results to those found using the complexity=volume duality.

Complexity of formation in holography

Energy Technology Data Exchange (ETDEWEB)

Chapman, Shira [Perimeter Institute for Theoretical Physics,Waterloo, ON N2L 2Y5 (Canada); Marrochio, Hugo [Perimeter Institute for Theoretical Physics,Waterloo, ON N2L 2Y5 (Canada); Department of Physics & Astronomy and Guelph-Waterloo Physics Institute,University of Waterloo, Waterloo, ON N2L 3G1 (Canada); Myers, Robert C. [Perimeter Institute for Theoretical Physics,Waterloo, ON N2L 2Y5 (Canada)

2017-01-16

It was recently conjectured that the quantum complexity of a holographic boundary state can be computed by evaluating the gravitational action on a bulk region known as the Wheeler-DeWitt patch. We apply this complexity=action duality to evaluate the ‘complexity of formation’ (DOI: 10.1103/PhysRevLett.116.191301; 10.1103/PhysRevD.93.086006), i.e. the additional complexity arising in preparing the entangled thermofield double state with two copies of the boundary CFT compared to preparing the individual vacuum states of the two copies. We find that for boundary dimensions d>2, the difference in the complexities grows linearly with the thermal entropy at high temperatures. For the special case d=2, the complexity of formation is a fixed constant, independent of the temperature. We compare these results to those found using the complexity=volume duality.

Matrix elements of the electric multiple transition and relativistic correction operators in the case of complex configurations

International Nuclear Information System (INIS)

Kanyauskas, Yu.M.; Rudzikas, Z.B.

1976-01-01

Operators and their submatrix elements are studied in the framework of the electric multipole transitions of complex atoms with account of relativistic corrections of the order of the square of the fine structure constant. The analysis is performed by means of irreducible tensor operators and genealogical coefficients. It has been assumed that angular momenta of individual shells are coupled with each other according to ls, lk, jk and jj coupling. Formulas are given for the operator which causes the relativistic corrections for the single-electron multipole transition and for its submatrix element in the case of configurations with two unfilled shells. A possibility is discussed of using the formulas suggested for calculation. As follows from analysis, the relativistic correction operators even with the pure ls coupling allow intercombination transitions with ΔS equals +-1. The expressions obtained may turn out to be useful for performing calculations in the case of the intermediate type of coupling

Beyond External Control: Internalization of Prosocial Values as Important in Preventing Bullying at School

Science.gov (United States)

Roth, Guy; Bibi, Uri

2009-01-01

Bullying in school is a social problem where peers repeatedly and systematically use power to dominate and harm others physically, socially, or emotionally (Frey et al., 2005; Olweus, 1993). A growing body of research has demonstrated that bullying leads to problematic outcomes for both bullies and their victims (Carney, 2000; Olweus, 1994).…

Impact of Business Interoperability on the Performance of Complex Cooperative Supply Chain Networks: A Case Study

Directory of Open Access Journals (Sweden)

Izunildo Cabral

2018-01-01

Full Text Available This paper proposes an agent-based model for evaluating the effect of business interoperability on the performance of cooperative supply chain networks. The model is based on insights from the Industrial Marketing and Purchasing network approach and the complex systems theory perspective. To demonstrate its applicability, an explanatory case study regarding a Portuguese reverse logistics cooperative supply chain network is presented. Face-to-face interviews and forms were used to collect data. The findings show that the establishment of appropriate levels of business interoperability has helped to reduce several non-value-added interaction processes and consequently improve the operational performance of the Valorpneu network. Regarding the research implications, this paper extends the current knowledge on business interoperability and an important problem in business: how business interoperability gaps in dyadic organizational relationships affect the network of companies that the two companies belong to—network effect. In terms of practical implications, managers can use the proposed model as a starting point to simulate complex interactions between supply chain network partners and understand better how the performance of their networks emerges from these interactions and from the adoption of different levels of business interoperability.

Remarks on the Schroedinger operator with singular complex potentials

International Nuclear Information System (INIS)

Brezis, Haim; Kato, Tosio

1979-01-01

To describe this method in a simple case Section 2 begin with real valued potentials. The main results in Section 2 are essentially known. In Section 3 the case of complex potentials is exposed. Schroedinger operators with complex potentials have been studied by Nelson. This results were extended. Here more general singularities are exposed

No evidence of somatic aryl hydrocarbon receptor interacting protein mutations in sporadic endocrine neoplasia

DEFF Research Database (Denmark)

Raitila, A; Georgitsi, M; Karhu, A

2007-01-01

. Here, we have analyzed 32 pituitary adenomas and 79 other tumors of the endocrine system for somatic AIP mutations by direct sequencing. No somatic mutations were identified. However, two out of nine patients with prolactin-producing adenoma were shown to harbor a Finnish founder mutation (Q14X...... as non-secreting pituitary adenomas have been reported, most mutation-positive patients have had growth hormone-producing adenomas diagnosed at relatively young age. Pituitary adenomas are also component tumors of some familial endocrine neoplasia syndromes such as multiple endocrine neoplasia type 1...... (MEN1) and Carney complex (CNC). Genes underlying MEN1 and CNC are rarely mutated in sporadic pituitary adenomas, but more often in other lesions contributing to these two syndromes. Thus far, the occurrence of somatic AIP mutations has not been studied in endocrine tumors other than pituitary adenomas...

Leading and Managing in Complexity: The Case of South African Deans

Science.gov (United States)

Seale, Oliver; Cross, Michael

2016-01-01

In recent years, deanship in universities has become more complex and challenging. Deans in South African universities take up their positions without appropriate training and prior executive experience, and with no clear understanding of the ambiguity and complexity of their roles. This paper calls for appropriate leadership development…

Distress Propagation in Complex Networks: The Case of Non-Linear DebtRank.

Directory of Open Access Journals (Sweden)

Marco Bardoscia

Full Text Available We consider a dynamical model of distress propagation on complex networks, which we apply to the study of financial contagion in networks of banks connected to each other by direct exposures. The model that we consider is an extension of the DebtRank algorithm, recently introduced in the literature. The mechanics of distress propagation is very simple: When a bank suffers a loss, distress propagates to its creditors, who in turn suffer losses, and so on. The original DebtRank assumes that losses are propagated linearly between connected banks. Here we relax this assumption and introduce a one-parameter family of non-linear propagation functions. As a case study, we apply this algorithm to a data-set of 183 European banks, and we study how the stability of the system depends on the non-linearity parameter under different stress-test scenarios. We find that the system is characterized by a transition between a regime where small shocks can be amplified and a regime where shocks do not propagate, and that the overall stability of the system increases between 2008 and 2013.

Complex aesthetic treatment on anterior maxillary teeth with malposition

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Febriastuti Febriastuti

2008-12-01

Full Text Available Background: Complex aesthetic treatment on anterior teeth involves more than one caries tooth with malformed shape and malposition. Purpose: The purpose of this paper is to find the alternative treatment for anterior maxillary teeth with malposition. Case: In this case, a 25 year-old man with a peg shaped teeth and caries on several teeth and malposition can be treated with complex aesthetic treatment. Case management: Endodontic pulpectomy treatment on anterior maxillary teeth and post construction with splint porcelain fused to metal crowns on 11, 12, and 21, 22 to correct the shape and position into normal position. Conclusion: Malformed and malpositioned teeth with caries can be treated with complex aesthetic treatment.

Embracing the complexity of educational programmes

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Elly Govers

2016-12-01

Full Text Available Systems of monitoring and control have left many educators and organisations in the field of post-compulsory education struggling to find ways to meet the needs of an increasingly diverse society. Education is complex. Many educators would agree that it is influenced by many, often contradictory, voices and power structures. Based on the findings of a case study involving multiple programmes in a post-compulsory education institution in Aotearoa/New Zealand, this paper aims to unravel this complexity for the case of educational programmes. It describes how programmes can be seen as complex systems, created by people and directed by discourses in society, some of which are more influential than others. If programmes are seen as complex systems, the experience of struggle as referred to above can be understood as a consequence of the attempt to control the complexity rather than work with it. This control limits the possibilities for development and innovation. Alternatively, as this paper will explain, acknowledging and embracing the complexity of programmes helps open up spaces for innovation that would otherwise remain hidden. It is argued that the ultimate space for change is educators’ personal and collective responsibility for the discourses in society they choose to follow.

Inpatient Complexity in Radiology-a Practical Application of the Case Mix Index Metric.

Science.gov (United States)

Mabotuwana, Thusitha; Hall, Christopher S; Flacke, Sebastian; Thomas, Shiby; Wald, Christoph

2017-06-01

With ongoing healthcare payment reforms in the USA, radiology is moving from its current state of a revenue generating department to a new reality of a cost-center. Under bundled payment methods, radiology does not get reimbursed for each and every inpatient procedure, but rather, the hospital gets reimbursed for the entire hospital stay under an applicable diagnosis-related group code. The hospital case mix index (CMI) metric, as defined by the Centers for Medicare and Medicaid Services, has a significant impact on how much hospitals get reimbursed for an inpatient stay. Oftentimes, patients with the highest disease acuity are treated in tertiary care radiology departments. Therefore, the average hospital CMI based on the entire inpatient population may not be adequate to determine department-level resource utilization, such as the number of technologists and nurses, as case length and staffing intensity gets quite high for sicker patients. In this study, we determine CMI for the overall radiology department in a tertiary care setting based on inpatients undergoing radiology procedures. Between April and September 2015, CMI for radiology was 1.93. With an average of 2.81, interventional neuroradiology had the highest CMI out of the ten radiology sections. CMI was consistently higher across seven of the radiology sections than the average hospital CMI of 1.81. Our results suggest that inpatients undergoing radiology procedures were on average more complex in this hospital setting during the time period considered. This finding is relevant for accurate calculation of labor analytics and other predictive resource utilization tools.

Quantum complex rotation and uniform semiclassical calculations of complex energy eigenvalues

International Nuclear Information System (INIS)

Connor, J.N.L.; Smith, A.D.

1983-01-01

Quantum and semiclassical calculations of complex energy eigenvalues have been carried out for an exponential potential of the form V 0 r 2 exp(-r) and Lennard-Jones (12,6) potential. A straightforward method, based on the complex coordinate rotation technique, is described for the quantum calculation of complex eigenenergies. For singular potentials, the method involves an inward and outward integration of the radial Schroedinger equation, followed by matching of the logarithmic derivatives of the wave functions at an intermediate point. For regular potentials, the method is simpler, as only an inward integration is required. Attention is drawn to the World War II researches of Hartree and co-workers who anticipated later quantum mechanical work on the complex rotation method. Complex eigenenergies are also calculated from a uniform semiclassical three turning point quantization formula, which allows for the proximity of the outer pair of complex turning points. Limiting cases of this formula, which are valid for very narrow or very broad widths, are also used in the calculations. We obtain good agreement between the semiclassical and quantum results. For the Lennard-Jones (12,6) potential, we compare resonance energies and widths from the complex energy definition of a resonance with those obtained from the time delay definition

Management of complex long bone nonunions using limb reconstruction system

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Hiranya Kumar Seenappa

2013-01-01

Full Text Available Background: Management of complex nonunions is difficult due to the presence of infection, deformities, shortening and multiple surgeries in the past. Complex nonunions are traditionally managed by Ilizarov fixation. The disadvantages of Ilizarov are poor patient compliance, inconvenience of the frame and difficult frame construction. We conducted a study on 30 long bone complex nonunions treated by the limb reconstruction system (LRS. Materials and Methods: Between April 2009 and September 2012, we treated 30 cases of complex nonunion of long bone with the LRS. 28 were male and 2 females. Average shortening was 5.06 cm and 14 cases presented with infected implants. Initially we managed with implant removal, radical debridement followed by fixation with the LRS. In 16 cases, corticotomy and lengthening was done. The average duration of treatment was 9.68 months. We compressed the fracture site at the rate of 0.25 mm per day for 1-2 weeks and distracted the corticotomy at the rate of 1 mm/day till lengthening was achieved. Result: The union occurred in 89.28% cases and eradication of infection in 91.66% cases. Average lengthening done was 4.57 cm. We had 79% excellent, 11% good and 10% poor bony result and fnctional result was excellent in 40% cases, good in 50% and failure in 10% cases using ASAMI scoring system. Conclusion: LRS is an alternative to the Ilizarov fixation in their management of complex nonunion of long bones. It is less cumbersome to the patient and more surgeon and patient friendly.

Substitution reactions of technetium complexes

International Nuclear Information System (INIS)

Omori, T.

1997-01-01

Substitution reactions of a series of technetium complexes are considered in comparison with corresponding reactions of rhenium. Rhenium and technetium complexes are rather inert in substitution reactions, the latter are characterized by greater rate constants when they proceed according to dissociative mechanism. In rare cases when k Tc /k Re id little it is assumed that the reaction proceeds according to the associative mechanism. (author)

Endeavor research into evolving paradigms around ophiolites: the case of the oceanic igneous complexes of Costa Rica

International Nuclear Information System (INIS)

Alvarado, Guillermo E.; Denyer, Perci; Gazel, Esteban

2009-01-01

, like Santa Elena Peninsula, Tortugal, Herradura and Quepos, the picture on these oceanic complexes are more or less clear. In the case of Osa-Golfito-Burica area, more studies are necessary. In general, the detailed field mapping is a powerful tool in combination with the modern techniques. The similarity in age, petrology, geochemistry and tectonic context for other oceanic complexes in Guatemala, Antilles and the northern part of South America, is more than a coincidence, they have a similar evolution. Therefore, a multidisciplinary study of the chrono- and bio-stratigraphic relations, together with modern petrology, geochemical and micropaleontology approach is necessary to provide a solid base for a robust plate tectonic reconstruction and geologic history. (author)

Treatment of complex regional pain syndrome type 1 in a pediatric patient using the lidocaine patch 5%: a case report

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Steven G Frost, MD

2003-09-01

Full Text Available Background: Successful treatment of complex regional pain syndrome type 1 (CRPS-1 requires a coordinated, multidisciplinary approach. Physical rehabilitation is an important component of long-term treatment. Unfortunately, patients with significant allodynia or hyperalgesia characteristic of CRPS-1 often have difficulty progressing through a physical therapy (PT regimen. In most adults with CRPS-1, the treatment of choice is PO opioids. Objective: This article presents a case report of the use of the lidocaine patch 5%, a targeted peripheral analgesic, in a pediatric patient and its effects on reducing pain, improving the patient's overall attitude, and facilitating compliance with ongoing PT. Results: A 10-year-old girl developed CRPS-1 after arthroscopic surgery for a sprained ankle. Attempts at PT were unsuccessful due to inadequate pain relief from various treatment modalities. Therapy with the lidocaine patch 5% was initiated and resulted in significant pain relief, improvements in the patient's attitude, and progress with PT. Conclusion: This case report of a child with CRPS-1 showed that therapy with lidocaine patch 5% may be efficacious in treating children with pain resulting from CRPS-1, thereby increasing the success of PT. Keywords: complex regional pain syndrome, lidocaine patch 5%, targeted peripheral analgesic, pediatrics

Promoting employee acceptance of a consumer bill of rights in a complex medical care organization: a case study.

Science.gov (United States)

Mullen, P D; Leifer, B H

1982-01-01

To develop strong health education programs, health educators working in complex medical care organizations must often secure professional cooperation across disciplines, coordination of services, and orientation of policies, procedures, and personnel toward patient preferences and needs. Frequently, they undertake these tasks against the tide, within a problematic organizational structure. The present case study illustrates the difficulties posed by introducing change in medical care organizations in the context of an education program to acquaint employees of a large HMO with a consumer bill of rights mandated by the consumer Board of Trustees. The underlying assumption was that in a bureaucratic institution, an employee-centered and modest system reform strategy would be effective in bringing about client-centered outcomes-in this case, increased recognition of client rights. The case analysis and results of a post-intervention, cross-sectional survey suggest that in units where a threshold level of participation was reached, there were improvements in knowledge about the Bill and employee attitudes. The program was less successful with hospital nurses whose feelings about physicians were not taken into account fully, and with physicians whose relative lack of integration into the policy and managerial domains made them harder to reach.

Using action research for complex research initiatives

CSIR Research Space (South Africa)

Greeff, M

2009-12-01

Full Text Available the research process of such a complex research initiative. Action research is one research method that lends itself to these complex projects. The paper uses the Ability Based Technology Interventions (AbTi) research project as a case study to analyse...

Automatic Complexity Analysis

DEFF Research Database (Denmark)

Rosendahl, Mads

1989-01-01

One way to analyse programs is to to derive expressions for their computational behaviour. A time bound function (or worst-case complexity) gives an upper bound for the computation time as a function of the size of input. We describe a system to derive such time bounds automatically using abstract...

Optimization-based topology identification of complex networks

International Nuclear Information System (INIS)

Tang Sheng-Xue; Chen Li; He Yi-Gang

2011-01-01

In many cases, the topological structures of a complex network are unknown or uncertain, and it is of significance to identify the exact topological structure. An optimization-based method of identifying the topological structure of a complex network is proposed in this paper. Identification of the exact network topological structure is converted into a minimal optimization problem by using the estimated network. Then, an improved quantum-behaved particle swarm optimization algorithm is used to solve the optimization problem. Compared with the previous adaptive synchronization-based method, the proposed method is simple and effective and is particularly valid to identify the topological structure of synchronization complex networks. In some cases where the states of a complex network are only partially observable, the exact topological structure of a network can also be identified by using the proposed method. Finally, numerical simulations are provided to show the effectiveness of the proposed method. (general)

Developing a case mix classification for child and adolescent mental health services: the influence of presenting problems, complexity factors and service providers on number of appointments.

Science.gov (United States)

Martin, Peter; Davies, Roger; Macdougall, Amy; Ritchie, Benjamin; Vostanis, Panos; Whale, Andy; Wolpert, Miranda

2017-09-01

Case-mix classification is a focus of international attention in considering how best to manage and fund services, by providing a basis for fairer comparison of resource utilization. Yet there is little evidence of the best ways to establish case mix for child and adolescent mental health services (CAMHS). To develop a case mix classification for CAMHS that is clinically meaningful and predictive of number of appointments attended and to investigate the influence of presenting problems, context and complexity factors and provider variation. We analysed 4573 completed episodes of outpatient care from 11 English CAMHS. Cluster analysis, regression trees and a conceptual classification based on clinical best practice guidelines were compared regarding their ability to predict number of appointments, using mixed effects negative binomial regression. The conceptual classification is clinically meaningful and did as well as data-driven classifications in accounting for number of appointments. There was little evidence for effects of complexity or context factors, with the possible exception of school attendance problems. Substantial variation in resource provision between providers was not explained well by case mix. The conceptually-derived classification merits further testing and development in the context of collaborative decision making.

German Children's Use of Word Order and Case Marking to Interpret Simple and Complex Sentences: Testing Differences between Constructions and Lexical Items

Science.gov (United States)

Brandt, Silke; Lieven, Elena; Tomasello, Michael

2016-01-01

Children and adults follow cues such as case marking and word order in their assignment of semantic roles in simple transitives (e.g., "the dog chased the cat"). It has been suggested that the same cues are used for the interpretation of complex sentences, such as transitive relative clauses (RCs) (e.g., "that's the dog that chased…

Cytological features of complex type fibroadenoma in comparison with non-complex type fibroadenoma.

Science.gov (United States)

Ohashi, Ryuji; Matsubara, Miyuki; Watarai, Yasuhiko; Yanagihara, Keiko; Yamashita, Koji; Tsuchiya, Shin-Ichi; Takei, Hiroyuki; Naito, Zenya

2016-09-01

To determine the cytomorphological features of complex type fibroadenoma (CFA), we reviewed fine needle aspiration (FNA) cytology with correlation to its histopathology findings, and compared them with non-complex type fibroadenoma (NCFA). From excisional biopsy or resected specimens of fibroadenoma (FA) cases treated at our institution from 2004 to 2013, we chose 46 patients who underwent FNA before a diagnosis of FA was established. We histologically re-classified them into two groups: CFA and NCFA. FNA diagnosis was retrospectively re-evaluated from FNA reports. We further re-assessed detailed characteristics of each FNA smears to identify cytomorphological features of CFA. We found that 15 cases fulfilled the diagnostic criteria of CFA, in which 7 (46.7 %) had an FNA diagnosis of "suspicious for malignancy" or "indeterminate" while only 2 NCFA cases had that of "indeterminate" (p = 0.004). FNA smears from CFA cases showed discohesiveness, enlarged nuclei, prominent nucleoli, and fewer myoepithelial cells more often than NCFA. Although no significant difference was noted in patients' age and tumor size between CFA and NCFA, 5 CFA cases (33.3 %) were accompanied by the presence of carcinoma in the same breast or the contralateral breast while no NCFA cases had carcinoma in the breast. FNA of CFA can lead to erroneous or indeterminate interpretation, due to proliferative and/or hyperplastic changes of ductal epithelium with or without atypia. It is important to recognize the disease entity and characteristic cytomorphological findings of CFA to reach accurate FNA diagnosis of breast lesions.

Breast-axillary complex in HIV/AIDS patients.

Science.gov (United States)

Eni, U E; Naaya, H U; Yawe, K D T; Lawan, M A; Bakari, A A

2010-01-01

HIV/AIDS have not only increased the health care burden especially in developing countries, it equally complicates the presentation of many diseases. Some well known disease entities now occur in fulminant complexities not previously described or known as such. The objective of this article is to report an unusual presentation of HIV/AIDS patients to the surgeon with Axillary and ipsilateral breast swelling. This is a report of three cases seen and managed by the authors. Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known retroviral positive on Highly Active Anti-Retroviral Therapy (HAART). Examination revealed axillary abscess and ipsilateral breast oedema in two cases. The patient on HAART had a hard breast-axillary mass complex. Biopsy (FNAB) revealed inflammatory cells and no malignancy in all three cases. HIV screening was positive in all cases. One of the patients had excision of breast-axillary mass complex, and the histology showed features of chronic inflammation, with no malignant cells. The other two had incision and drainage of their axillary abscess. This shows the ubiquitous presentation of HIV/AIDS in our environment and surgeons should be aware of the breast axillary complex in HIV/AIDS. Medical practitioners should be careful to obtain accurate diagnosis before embarking on treatment especially mutilating surgical procedures.

Bilateral Giant Renal Angiomyolipoma in a Patient with Tuberous Sclerosis Complex: A Case Report

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Andika Afriansyah

2018-04-01

Full Text Available Tuberous sclerosis complex (TSC has several renal manifestations including angiomyolipomas (AML and renal epithelial neoplasms. A bilateral giant renal AML is extremely rare. We report a case of giant bilateral AML and discuss the diagnosis and treatment of it. The 22-year-old man was admitted due to bilateral flank pain, gross hematuria, and abdominal fullness. He had history of epilepsy, mental retardation, and delayed development during childhood. He had angiofibroma on his face since 10 years ago. Abdominal CT and MRI revealed large lobulated heterogeneous mass with fatty content. Based on those findings, we diagnosed the patient with bilateral giant renal AML. We gave conservative management for the patient and planned to total nephrectomy on the left kidney if the continued bleeding occurred. AML associated with TSC occur more frequently as multiple lesions and grows to larger size than idiopathic AML. Bilateral giant AML, which is very rare, could be treated with conservative management if no significant hemorrhage occurred.

-Heterocyclic Carbene Complexes of Mineral Acids

KAUST Repository

Brill, Marcel; Nahra, Fady; Gó mez-Herrera, Alberto; Zinser, Caroline; Cordes, David B.; Slawin, Alexandra M. Z.; Nolan, Steven P.

2016-01-01

We have synthesized and characterized new gold-N-heterocyclic carbene (NHC) complexes derived from the deprotonation of mineral acids. The use of sulfuric acid was a particularly interesting case. These complexes were tested in known gold-catalyzed reactions, such as the hydration of alkynes and the Meyer–Schuster rearrangement. They proved to be highly efficient in both reactions.

-Heterocyclic Carbene Complexes of Mineral Acids

KAUST Repository

Brill, Marcel

2016-11-08

We have synthesized and characterized new gold-N-heterocyclic carbene (NHC) complexes derived from the deprotonation of mineral acids. The use of sulfuric acid was a particularly interesting case. These complexes were tested in known gold-catalyzed reactions, such as the hydration of alkynes and the Meyer–Schuster rearrangement. They proved to be highly efficient in both reactions.

Integrating technology into complex intervention trial processes: a case study.

Science.gov (United States)

Drew, Cheney J G; Poile, Vincent; Trubey, Rob; Watson, Gareth; Kelson, Mark; Townson, Julia; Rosser, Anne; Hood, Kerenza; Quinn, Lori; Busse, Monica

2016-11-17

Trials of complex interventions are associated with high costs and burdens in terms of paperwork, management, data collection, validation, and intervention fidelity assessment occurring across multiple sites. Traditional data collection methods rely on paper-based forms, where processing can be time-consuming and error rates high. Electronic source data collection can potentially address many of these inefficiencies, but has not routinely been used in complex intervention trials. Here we present the use of an on-line system for managing all aspects of data handling and for the monitoring of trial processes in a multicentre trial of a complex intervention. We custom built a web-accessible software application for the delivery of ENGAGE-HD, a multicentre trial of a complex physical therapy intervention. The software incorporated functionality for participant randomisation, data collection and assessment of intervention fidelity. It was accessible to multiple users with differing levels of access depending on required usage or to maintain blinding. Each site was supplied with a 4G-enabled iPad for accessing the system. The impact of this system was quantified through review of data quality and collation of feedback from site coordinators and assessors through structured process interviews. The custom-built system was an efficient tool for collecting data and managing trial processes. Although the set-up time required was significant, using the system resulted in an overall data completion rate of 98.5% with a data query rate of 0.1%, the majority of which were resolved in under a week. Feedback from research staff indicated that the system was highly acceptable for use in a research environment. This was a reflection of the portability and accessibility of the system when using the iPad and its usefulness in aiding accurate data collection, intervention fidelity and general administration. A combination of commercially available hardware and a bespoke online database

Collet-Sicard Syndrome from Thrombosis of the Sigmoid-Jugular Complex: A Case Report and Review of the Literature

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Tom P. B. Handley

2010-01-01

Full Text Available Purpose. Collet-Sicard syndrome is a very rare condition characterised by unilateral palsy of the IX–XII cranial nerves. It is distinguished from Villaret syndrome by lack of presence of sympathetic involvement. Current literature contains only two cases of Collet-Sicard syndrome due to idiopathic internal jugular vein thrombosis. Method and Results. We report the case of Collet-Sicard syndrome in a 30-year-old man who presented with delayed development of XIth nerve dysfunction, due to internal jugular vein-sigmoid sinus thrombosis. A multidisciplinary team approach was employed in the management of this patient. At three-month followup, he had significantly improved swallowing, and repeat computed tomography neck scan showed partial recanalisation of the right internal jugular vein. Conclusion. In suspected Collet-Sicard syndrome, a focal primary lesion or metastasis to the temporal bone must be excluded, and sigmoid-jugular complex thrombosis should be considered in the differential diagnosis. Early recognition and treatment may result in significant functional recovery.

Collet-Sicard Syndrome from Thrombosis of the Sigmoid-Jugular Complex: A Case Report and Review of the Literature

Science.gov (United States)

Handley, Tom P. B.; Miah, Mohammed S.; Majumdar, Samit; Hussain, S. S. Musheer

2010-01-01

Purpose. Collet-Sicard syndrome is a very rare condition characterised by unilateral palsy of the IX–XII cranial nerves. It is distinguished from Villaret syndrome by lack of presence of sympathetic involvement. Current literature contains only two cases of Collet-Sicard syndrome due to idiopathic internal jugular vein thrombosis. Method and Results. We report the case of Collet-Sicard syndrome in a 30-year-old man who presented with delayed development of XIth nerve dysfunction, due to internal jugular vein-sigmoid sinus thrombosis. A multidisciplinary team approach was employed in the management of this patient. At three-month followup, he had significantly improved swallowing, and repeat computed tomography neck scan showed partial recanalisation of the right internal jugular vein. Conclusion. In suspected Collet-Sicard syndrome, a focal primary lesion or metastasis to the temporal bone must be excluded, and sigmoid-jugular complex thrombosis should be considered in the differential diagnosis. Early recognition and treatment may result in significant functional recovery. PMID:20706543

The BRST complex of homological Poisson reduction

Science.gov (United States)

Müller-Lennert, Martin

2017-02-01

BRST complexes are differential graded Poisson algebras. They are associated with a coisotropic ideal J of a Poisson algebra P and provide a description of the Poisson algebra (P/J)^J as their cohomology in degree zero. Using the notion of stable equivalence introduced in Felder and Kazhdan (Contemporary Mathematics 610, Perspectives in representation theory, 2014), we prove that any two BRST complexes associated with the same coisotropic ideal are quasi-isomorphic in the case P = R[V] where V is a finite-dimensional symplectic vector space and the bracket on P is induced by the symplectic structure on V. As a corollary, the cohomology of the BRST complexes is canonically associated with the coisotropic ideal J in the symplectic case. We do not require any regularity assumptions on the constraints generating the ideal J. We finally quantize the BRST complex rigorously in the presence of infinitely many ghost variables and discuss the uniqueness of the quantization procedure.

Vibrations and stability of complex beam systems

CERN Document Server

Stojanović, Vladimir

2015-01-01

 This book reports on solved problems concerning vibrations and stability of complex beam systems. The complexity of a system is considered from two points of view: the complexity originating from the nature of the structure, in the case of two or more elastically connected beams; and the complexity derived from the dynamic behavior of the system, in the case of a damaged single beam, resulting from the harm done to its simple structure. Furthermore, the book describes the analytical derivation of equations of two or more elastically connected beams, using four different theories (Euler, Rayleigh, Timoshenko and Reddy-Bickford). It also reports on a new, improved p-version of the finite element method for geometrically nonlinear vibrations. The new method provides more accurate approximations of solutions, while also allowing us to analyze geometrically nonlinear vibrations. The book describes the appearance of longitudinal vibrations of damaged clamped-clamped beams as a result of discontinuity (damage). It...

A case of complex regional pain syndrome with agnosia for object orientation.

Science.gov (United States)

Robinson, Gail; Cohen, Helen; Goebel, Andreas

2011-07-01

This systematic investigation of the neurocognitive correlates of complex regional pain syndrome (CRPS) in a single case also reports agnosia for object orientation in the context of persistent CRPS. We report a patient (JW) with severe long-standing CRPS who had no difficulty identifying and naming line drawings of objects presented in 1 of 4 cardinal orientations. In contrast, he was extremely poor at reorienting these objects into the correct upright orientation and in judging whether an object was upright or not. Moreover, JW made orientation errors when copying drawings of objects, and he also showed features of mirror reversal in writing single words and reading single letters. The findings are discussed in relation to accounts of visual processing. Agnosia for object orientation is the term for impaired knowledge of an object's orientation despite good recognition and naming of the same misoriented object. This defect has previously only been reported in patients with major structural brain lesions. The neuroanatomical correlates are discussed. The patient had no structural brain lesion, raising the possibility that nonstructural reorganisation of cortical networks may be responsible for his deficits. Other patients with CRPS may have related neurocognitive defects. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Polystochastic Models for Complexity

CERN Document Server

Iordache, Octavian

2010-01-01

This book is devoted to complexity understanding and management, considered as the main source of efficiency and prosperity for the next decades. Divided into six chapters, the book begins with a presentation of basic concepts as complexity, emergence and closure. The second chapter looks to methods and introduces polystochastic models, the wave equation, possibilities and entropy. The third chapter focusing on physical and chemical systems analyzes flow-sheet synthesis, cyclic operations of separation, drug delivery systems and entropy production. Biomimetic systems represent the main objective of the fourth chapter. Case studies refer to bio-inspired calculation methods, to the role of artificial genetic codes, neural networks and neural codes for evolutionary calculus and for evolvable circuits as biomimetic devices. The fifth chapter, taking its inspiration from systems sciences and cognitive sciences looks to engineering design, case base reasoning methods, failure analysis, and multi-agent manufacturing...

Comparing the Complexity of Two Network Architectures

Directory of Open Access Journals (Sweden)

Olivier Z. Zheng

2017-10-01

Full Text Available A Service Provider has different methods to provide a VPN service to its customers. But which method is the least complex to implement? In this paper, two architectures are described and analysed. Based on the analyses, two methods of complexity calculation are designed to evaluate the complexity of the architecture: the first method evaluates the resources consumed, the second evaluates the number of cases possible.

Complex ray analysis for plasmas

International Nuclear Information System (INIS)

Connor, K.A.

1980-01-01

An extension of ray tracing techniques is considered for a variety of cases in which the dispersion relation of the plasma medium is complex. The ray trajectories are permitted to begin and/or at least travel through complex space-time; the wave propagation process so characterized becomes significant only where the rays intersect real space-time. It is found that rules and guidelines can be established for limited application of this idea

COMPLEX TRAINING: A BRIEF REVIEW

Directory of Open Access Journals (Sweden)

William P. Ebben

2002-06-01

Full Text Available The effectiveness of plyometric training is well supported by research. Complex training has gained popularity as a training strategy combining weight training and plyometric training. Anecdotal reports recommend training in this fashion in order to improve muscular power and athletic performance. Recently, several studies have examined complex training. Despite the fact that questions remain about the potential effectiveness and implementation of this type of training, results of recent studies are useful in guiding practitioners in the development and implementation of complex training programs. In some cases, research suggests that complex training has an acute ergogenic effect on upper body power and the results of acute and chronic complex training include improved jumping performance. Improved performance may require three to four minutes rest between the weight training and plyometrics sets and the use of heavy weight training loads

Loss of heterozygosity on chromosome 11q13 in two families with acromegaly/gigantism is independent of mutations of the multiple endocrine neoplasia type I gene.

Science.gov (United States)

Gadelha, M R; Prezant, T R; Une, K N; Glick, R P; Moskal, S F; Vaisman, M; Melmed, S; Kineman, R D; Frohman, L A

1999-01-01

Familial acromegaly/gigantism occurring in the absence of multiple endocrine neoplasia type I (MEN-1) or the Carney complex has been reported in 18 families since the biochemical diagnosis of GH excess became available, and the genetic defect is unknown. In the present study we examined 2 unrelated families with isolated acromegaly/gigantism. In family A, 3 of 4 siblings were affected, with ages at diagnosis of 19, 21, and 23 yr. In family B, 5 of 13 siblings exhibited the phenotype and were diagnosed at 13, 15, 17, 17, and 24 yr of age. All 8 affected patients had elevated basal GH levels associated with high insulin-like growth factor I levels and/or nonsuppressible serum GH levels during an oral glucose tolerance test. GHRH levels were normal in affected members of family A. An invasive macroadenoma was found in 6 subjects, and a microadenoma was found in 1 subject from family B. The sequence of the GHRH receptor complementary DNA in 1 tumor from family A was normal. There was no history of consanguinity in either family, and the past medical history and laboratory results excluded MEN-1 and the Carney complex in all affected and unaffected screened subjects. Five of 8 subjects have undergone pituitary surgery to date, and paraffin-embedded pituitary blocks were available for analysis. Loss of heterozygosity on chromosome 11q13 was studied by comparing microsatellite polymorphisms of leukocyte and tumor DNA using PYGM (centromeric) and D11S527 (telomeric), markers closely linked to the MEN-1 tumor suppressor gene. All tumors exhibited a loss of heterozygosity at both markers. Sequencing of the MEN-1 gene revealed no germline mutations in either family, nor was a somatic mutation found in tumor DNA from one subject in family A. The integrity of the MEN-1 gene in this subject was further supported by demonstration of the presence of MEN-1 messenger ribonucleic acid, as assessed by RT-PCR. These data indicate that loss of heterozygosity in these affected family

Early AIDS dementia complex

International Nuclear Information System (INIS)

Mountz, J.M.; Speed, N.M.; Adams, K.; Schwartz, J.A.; Gross, M.D.; Ostrow, D.G.

1988-01-01

A frequent complication of the acquired immunodeficiency syndrome (AIDS) is AIDS dementia complex (ADC). The authors evaluated seven patients with AIDS (aged 28-55 years, all male) for ADC by psychiatric evaluation, neuropsychological testing, CT scanning, and IMP-SPECT. Six of seven patients exhibited cognitive or behavioral abnormalities. Neuropsychological testing showed general deficits but no cases of explicit dementia. SPECT showed marked abnormalities in two cases: posterior temporal-parietal diminution of tracer uptake in one case (posterior/anterior=0.81) and marked right/left subcortical asymmetry (1.17) in the other. In three additional cases there was asymmetric tracer uptake in the subcortical and parietal regions. CT findings were normal in all seven cases. The authors conclude that functional imaging with the use of IMP-SPECT may be a useful method to follow ADC progression and response to therapy

Residual Complexity Does Impact Organic Chemistry and Drug Discovery: The Case of Rufomyazine and Rufomycin.

Science.gov (United States)

Choules, Mary P; Klein, Larry L; Lankin, David C; McAlpine, James B; Cho, Sang-Hyun; Cheng, Jinhua; Lee, Hanki; Suh, Joo-Won; Jaki, Birgit U; Franzblau, Scott G; Pauli, Guido F

2018-05-24

Residual complexity (RC) involves the impact of subtle but critical structural and biological features on drug lead validation, including unexplained effects related to unidentified impurities. RC commonly plagues drug discovery efforts due to the inherent imperfections of chromatographic separation methods. The new diketopiperazine, rufomyazine (6), and the previously known antibiotic, rufomycin (7), represent a prototypical case of RC that (almost) resulted in the misassignment of biological activity. The case exemplifies that impurities well below the natural abundance of 13 C (1.1%) can be highly relevant and calls for advanced analytical characterization of drug leads with extended molar dynamic ranges of >1:1,000 using qNMR and LC-MS. Isolated from an actinomycete strain, 6 was originally found to be active against Mycobacterium tuberculosis with a minimum inhibitory concentration (MIC) of 2 μg/mL and high selectivity. As a part of lead validation, the dipeptide was synthesized and surprisingly found to be inactive. The initially observed activity was eventually attributed to a very minor contamination (0.24% [m/m]) with a highly active cyclic peptide (MIC ∼ 0.02 μM), subsequently identified as an analogue of 7. This study illustrates the serious implications RC can exert on organic chemistry and drug discovery, and what efforts are vital to improve lead validation and efficiency, especially in NP-related drug discovery programs.

Data Mining and Complex Problems: Case Study in Composite Materials

Science.gov (United States)

Rabelo, Luis; Marin, Mario

2009-01-01

Data mining is defined as the discovery of useful, possibly unexpected, patterns and relationships in data using statistical and non-statistical techniques in order to develop schemes for decision and policy making. Data mining can be used to discover the sources and causes of problems in complex systems. In addition, data mining can support simulation strategies by finding the different constants and parameters to be used in the development of simulation models. This paper introduces a framework for data mining and its application to complex problems. To further explain some of the concepts outlined in this paper, the potential application to the NASA Shuttle Reinforced Carbon-Carbon structures and genetic programming is used as an illustration.

Second Workshop on Supporting Complex Search Tasks

NARCIS (Netherlands)

Belkin, Nicholas J.; Bogers, Toine; Kamps, Jaap; Kelly, Diane; Koolen, Marijn; Yilmaz, Emine

2017-01-01

There is broad consensus in the field of IR that search is complex in many use cases and applications, both on the Web and in domain specific collections, and both professionally and in our daily life. Yet our understanding of complex search tasks, in comparison to simple look up tasks, is

Grammatical complexity for two-dimensional maps

International Nuclear Information System (INIS)

Hagiwara, Ryouichi; Shudo, Akira

2004-01-01

We calculate the grammatical complexity of the symbol sequences generated from the Henon map and the Lozi map using the recently developed methods to construct the pruning front. When the map is hyperbolic, the language of symbol sequences is regular in the sense of the Chomsky hierarchy and the corresponding grammatical complexity takes finite values. It is found that the complexity exhibits a self-similar structure as a function of the system parameter, and the similarity of the pruning fronts is discussed as an origin of such self-similarity. For non-hyperbolic cases, it is observed that the complexity monotonically increases as we increase the resolution of the pruning front

Grammatical complexity for two-dimensional maps

Energy Technology Data Exchange (ETDEWEB)

Hagiwara, Ryouichi; Shudo, Akira [Department of Physics, Tokyo Metropolitan University, Minami-Ohsawa, Hachioji, Tokyo 192-0397 (Japan)

2004-11-05

We calculate the grammatical complexity of the symbol sequences generated from the Henon map and the Lozi map using the recently developed methods to construct the pruning front. When the map is hyperbolic, the language of symbol sequences is regular in the sense of the Chomsky hierarchy and the corresponding grammatical complexity takes finite values. It is found that the complexity exhibits a self-similar structure as a function of the system parameter, and the similarity of the pruning fronts is discussed as an origin of such self-similarity. For non-hyperbolic cases, it is observed that the complexity monotonically increases as we increase the resolution of the pruning front.

Grammatical complexity for two-dimensional maps

Science.gov (United States)

Hagiwara, Ryouichi; Shudo, Akira

2004-11-01

We calculate the grammatical complexity of the symbol sequences generated from the Hénon map and the Lozi map using the recently developed methods to construct the pruning front. When the map is hyperbolic, the language of symbol sequences is regular in the sense of the Chomsky hierarchy and the corresponding grammatical complexity takes finite values. It is found that the complexity exhibits a self-similar structure as a function of the system parameter, and the similarity of the pruning fronts is discussed as an origin of such self-similarity. For non-hyperbolic cases, it is observed that the complexity monotonically increases as we increase the resolution of the pruning front.

A rare case of OEIS complex –newer approach to diagnosis of exstrophy bladder by color doppler and its differentiation from simple omphalocele

Directory of Open Access Journals (Sweden)

Kavita Aneja

2017-01-01

Full Text Available The objective of this article is to present a new approach to diagnose and differentiate similar ventral masses by color Doppler. Two cases of ventral masses, a rare case of OEIS complex (Omphalocele-exstrophy-imperforate anus-spinal defects with unusual presentation of exstrophy bladder and another of simple omphalocele, were studied by color Doppler for diagnosis and differentiation between the nature of similar masses. Ventral mass with absent bladder, normal kidneys, and normal amniotic fluid index raised the suspicion of exstrophy bladder. Color Doppler depicting altered intrafetal course of umbilical arteries and umbilical arteries coursing along the sides of ventral mass substantiated the diagnosis. The spatial relation between umbilical artery and aorta (which has no mention in the current literature in sagittal view has been identified as an acute angle in a normal fetus and coined as “K angle” arbitrarily by the author. Color Doppler reveals altered (widened “K angle” in exstrophy bladder compared to normal fetuses. Other combined anomalies pointed to the diagnosis of OEIS complex. The second case of simple omphalocele depicts normal intrafetal course of umbilical arteries and normal acute umbilical artery–aorta angle (K angle on color Doppler. Color Doppler aids the early diagnosis of ventral defects. New method by umbilical artery-aorta angle (K angle assessment on color Doppler helps differentiate exstrophy bladder from omphalocele.

Particle image velocimetry measurement of complex flow structures in the diffuser and spherical casing of a reactor coolant pump

Directory of Open Access Journals (Sweden)

Yongchao Zhang

2018-04-01

Full Text Available Understanding of turbulent flow in the reactor coolant pump (RCP is a premise of the optimal design of the RCP. Flow structures in the RCP, in view of the specially devised spherical casing, are more complicated than those associated with conventional pumps. Hitherto, knowledge of the flow characteristics of the RCP has been far from sufficient. Research into the nonintrusive measurement of the internal flow of the RCP has rarely been reported. In the present study, flow measurement using particle image velocimetry is implemented to reveal flow features of the RCP model. Velocity and vorticity distributions in the diffuser and spherical casing are obtained. The results illuminate the complexity of the flows in the RCP. Near the lower end of the discharge nozzle, three-dimensional swirling flows and flow separation are evident. In the diffuser, the imparity of the velocity profile with respect to different axial cross sections is verified, and the velocity increases gradually from the shroud to the hub. In the casing, velocity distribution is nonuniform over the circumferential direction. Vortices shed consistently from the diffuser blade trailing edge. The experimental results lend sound support for the optimal design of the RCP and provide validation of relevant numerical algorithms. Keywords: Diffuser, Flow Structures, Particle Image Velocimetry, Reactor Coolant Pump, Spherical Casing, Velocity Distribution

Innovation in a complex environment

Directory of Open Access Journals (Sweden)

René Pellissier

2012-11-01

Objectives: The study objectives were, firstly, to establish the determinants for complexity and how these can be addressed from a design point of view in order to ensure innovation success and, secondly, to determine how this changes innovation forms and applications. Method: Two approaches were offered to deal with a complex environment – one allowing for complexity for organisational innovation and the other introducing reductionism to minimise complexity. These approaches were examined in a qualitative study involving case studies, open-ended interviews and content analysis between seven developing economy (South African organisations and seven developed economy (US organisations. Results: This study presented a proposed framework for (organisational innovation in a complex environment versus a framework that minimises complexity. The comparative organisational analysis demonstrated the importance of initiating organisational innovation to address internal and external complexity, with the focus being on the leadership actions, their selected operating models and resultant organisational innovations designs, rather than on technological innovations. Conclusion: This study cautioned the preference for technological innovation within organisations and suggested alternative innovation forms (such as organisational and management innovation be used to remain competitive in a complex environment.

Synchronization in complex networks with switching topology

International Nuclear Information System (INIS)

Wang, Lei; Wang, Qing-guo

2011-01-01

This Letter investigates synchronization issues of complex dynamical networks with switching topology. By constructing a common Lyapunov function, we show that local and global synchronization for a linearly coupled network with switching topology can be evaluated by the time average of second smallest eigenvalues corresponding to the Laplacians of switching topology. This result is quite powerful and can be further used to explore various switching cases for complex dynamical networks. Numerical simulations illustrate the effectiveness of the obtained results in the end. -- Highlights: → Synchronization of complex networks with switching topology is investigated. → A common Lyapunov function is established for synchronization of switching network. → The common Lyapunov function is not necessary to monotonically decrease with time. → Synchronization is determined by the second smallest eigenvalue of its Laplacian. → Synchronization criterion can be used to investigate various switching cases.

Generation of fractals from complex logistic map

International Nuclear Information System (INIS)

Rani, Mamta; Agarwal, Rashi

2009-01-01

Remarkably benign looking logistic transformations x n+1 = r x n (1 - x n ) for choosing x 0 between 0 and 1 and 0 < r ≤ 4 have found a celebrated place in chaos, fractals and discrete dynamics. The strong physical meaning of Mandelbrot and Julia sets is broadly accepted and nicely connected by Christian Beck [Beck C. Physical meaning for Mandelbrot and Julia sets. Physica D 1999;125(3-4):171-182. Zbl0988.37060] to the complex logistic maps, in the former case, and to the inverse complex logistic map, in the latter case. The purpose of this paper is to study the bounded behavior of the complex logistic map using superior iterates and generate fractals from the same. The analysis in this paper shows that many beautiful properties of the logistic map are extendable for a larger value of r.

New definition of complexity for self-gravitating fluid distributions: The spherically symmetric, static case

Science.gov (United States)

Herrera, L.

2018-02-01

We put forward a new definition of complexity, for static and spherically symmetric self-gravitating systems, based on a quantity, hereafter referred to as complexity factor, that appears in the orthogonal splitting of the Riemann tensor, in the context of general relativity. We start by assuming that the homogeneous (in the energy density) fluid, with isotropic pressure is endowed with minimal complexity. For this kind of fluid distribution, the value of complexity factor is zero. So, the rationale behind our proposal for the definition of complexity factor stems from the fact that it measures the departure, in the value of the active gravitational mass (Tolman mass), with respect to its value for a zero complexity system. Such departure is produced by a specific combination of energy density inhomogeneity and pressure anisotropy. Thus, zero complexity factor may also be found in self-gravitating systems with inhomogeneous energy density and anisotropic pressure, provided the effects of these two factors, on the complexity factor, cancel each other. Some exact interior solutions to the Einstein equations satisfying the zero complexity criterium are found, and prospective applications of this newly defined concept, to the study of the structure and evolution of compact objects, are discussed.

An immunophenotypic comparison of metanephric metaplasia of Bowman capsular epithelium with metanephric adenoma, Wilms tumor, and renal development: a case report and review of the literature.

Science.gov (United States)

Fischer, Edgar G; Carney, J Aidan; Anderson, Scott R; Klatt, Edward C; Lager, Donna J

2004-06-01

Metanephric metaplasia of the parietal epithelium of the Bowman capsule is a rare pathologic finding of unknown pathogenesis that has occurred in patients with widespread malignant neoplasms of various types. We report this finding in a 25-year-old woman with partial expression of the Carney triad who died of a disseminated gastrointestinal stromal tumor, specifically a gastric stromal sarcoma. The metaplasia involved both kidneys diffusely. It originated in the parietal epithelium of the Bowman capsule, extended into the proximal tubules, and focally surrounded the glomeruli in a semicircular manner Immunohistochemical analysis revealed that the cells of metanephric metaplasia expressed the Wilms tumor gene product, bcl-2 protein, and CD57 and cytokeratin 7 and keratin AE1/AE3 focally, but not CD56. This immunophenotype parallels that of metanephric adenoma, Wilms tumor, and nephrogenic rests and overlaps with antigen expression in certain periods of renal development.

Complexes of salicylic acid and its derivatives

Energy Technology Data Exchange (ETDEWEB)

Tel' zhenskaya, P N; Shvarts, E M [AN Latvijskoj SSR, Riga. Inst. Neorganicheskoj Khimii

1977-01-01

A generalization and systematization have been made of literature data on complexing of various elements, including beryllium, cadmium, boron, indium, rare-earth elements, actinides, and transition elements with salicylic acid and it derivatives (amino-, nitro- and halosalicylic acids). The effect of the position and nature of the substitute, in the case of salicylic acid derivatives, on the complexing process is discussed. Certain physicochemical properties of the complexes under consideration are described along with data indicative of their stability.

The Design Features of Complex Vessels of Malyshev Neolithic Culture of Lower Priamurye (case study: Malyshevo 1 Settlement

Directory of Open Access Journals (Sweden)

Inga V. Filatova

2015-03-01

Full Text Available According to the author’s opinion, the solution for cultural genesis issues can be tackled through the analysis of structural peculiarities of hollow bodies of vessels of different ceramic complexes. The ceramics of the Malyshev Culture of the Lower Amur is no exception. The article traces the evolution of researchers’ views in regard to Neolithic culture in inner periodization of the region as well as cultural relevance of early complex ceramics by a well known Soviet archeologist academic A.P. Okladnykov – stage of Lower Amur Neolithic culture. Case study: visualization of ceramic collection of one-layer Neolithic settlement Malyshevo-1 (“At the craftsmen”. Here we identify two vessel groups, which differ through their morphological and decorative features. On the ground of technological assessments of manufacturing techniques by I. G. Glushkov (1996, including methodological developments by A. A. Bobrinsky (1978, the program of hollow body design is researched. The manufacturing techniques are identified (methods of fixing, build-up, straps oiling, types of molding, filling program, cutting and bottom fixing. The mixed programs of hollow body vessels are identified and locations of two pottery traditions are found. A competitive analysis for identifying the peculiarities of Malyshev ceramics and Neolithic materials of the Lower Amur and bordering seaside territories. There are similarities are drawn out between ceramic complexes of Osipov culture of early Neolithic (Lower Amur and Rudninsky culture (Rudninsky type, Sergeev type of early Neolithic (seaside territories.

Recurrent Factitious Subcutaneous Emphysema: Report of a Complex Case in a Young Woman and a Literature Review

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Yi-Pei Lee

2010-07-01

Full Text Available Subcutaneous emphysema (SE can be caused by antecedent trauma, surgery, rupture of visceral organs or serious infection from gas-forming microorganisms. Factitious SE is very rare; only about a dozen cases have been reported. Most patients had an underlying psychiatric condition or relevant history. The diagnosis and management of factitious SE are challenging. We report a new case of factitious SE with a very complex clinical course. A 29-year-old woman was seen at consultation for recurrent attacks of painful soft tissue swelling, affecting her chest wall, abdomen and neck over several months. Factitious disease was suspected because of the negative medical history of identifiable visceral perforations or gas-forming infections and the presence of multiple bizarre linear scars on the arm. This was supported by finding multiple recent puncture marks on the neck, chest and upper extremities on close inspection. The patient's history was remarkable for multiple stressful events in her life, frequent job changes, substance abuse and suicide attempts. Psychiatric evaluation revealed adjustment disorder with depression and anxiety, cluster B personality with bipolar II disorder and substance abuse. During the 1-year period, she had 20 visits to our ER for attacks of SE affecting various parts of her body. This case illustrates that self-infliction should be suspected in a patient presenting with medically unexplained recurrent SE and a hollow history, and one should search for puncture marks to support the diagnosis.

Design scenarios for renovation of sports complex: a case study

Science.gov (United States)

Nižetić, S.

2018-02-01

This paper elaborates design scenarios for a sports complex in Croatia from a technical and economic aspect. Different energy options are analysed and two are additionally addressed and discussed as the most viable ones. The possibilities of sports complex renovation are shown by properly choosing the appropriate energy concept and thus reducing the overall cost for produced thermal energy by around 33% and reducing the carbon dioxide emission by a factor of 1.8 in comparison with its present state. Finally, this study presents an example of good practice, where renewable energy solutions can be proposed and where it is possible to cover around 70-80% of overall yearly costs from achieved energy savings for the novel plant that is assumed to be financed through a bank loan.

T-cell acute lymphoblastic leukemia associated with complex karyotype and SET-NUP214 rearrangement: a case study and review of the literature.

Science.gov (United States)

Lee, Sang-Guk; Park, Tae Sung; Cho, Sun Young; Lim, Gayoung; Park, Gwang Jin; Oh, Seung Hwan; Cho, Eun Hae; Chong, So Young; Huh, Ji Young

2011-01-01

SET-NUP214 rearrangements have been rarely reported in T-cell acute lymphoblastic leukemia (T-ALL), acute undifferentiated leukemia, and acute myeloid leukemia, and most documented cases have been associated with normal karyotypes in conventional cytogenetic analyses. Here, we describe a novel case of T-ALL associated with a mediastinal mass and a SET-NUP214 rearrangement, which was masked by a complex karyotype at the time of initial diagnosis. Using multiplex reverse transcriptase-polymerase chain reaction analysis, we detected a cryptic SET-NUP214 rearrangement in our patient. As only 11 cases (including the present study) of T-ALL with SET-NUP214 rearrangement have been reported, the clinical features and treatment outcomes have not been fully determined. Further studies are necessary to evaluate the incidence of SET-NUP214 rearrangement in T-ALL patients and the treatment responses as well as prognosis of these patients.

Supporting complex search tasks

DEFF Research Database (Denmark)

Gäde, Maria; Hall, Mark; Huurdeman, Hugo

2015-01-01

, is fragmented at best. The workshop addressed the many open research questions: What are the obvious use cases and applications of complex search? What are essential features of work tasks and search tasks to take into account? And how do these evolve over time? With a multitude of information, varying from...

Case Report: Gollop-Wolfgang Complex in a 5 month old baby [v3; ref status: indexed, http://f1000r.es/53y

Directory of Open Access Journals (Sweden)

Ihtesham A. Qureshi

2015-02-01

Full Text Available Skeletal dysplasias are disorders associated with a generalized abnormality in the skeleton. The Gollop-Wolfgang complex (GWC is a limb deficiency disorder and an unusual limb malformation with highly variable manifestations. Here we report an interesting case of a 5-month old male baby from India with Gollop-Wolfgang Complex showing bifurcation of the right femur, ectrodactyly of both feet, ectrodactyly of left hand, syndactyly of right hand and unusual presentation of bilateral fibular agenesis and caudal (Sacrococcygeal agenesis. The etiology of GWC in this 5 month old male baby could possibly be attributed to spontaneous gene mutation. The clinical, radiographic findings and the unusual presentation are presented in detail.

Inter-organisational communication in civil-military cooperation during complex emergencies: a case study in Afghanistan.

Science.gov (United States)

Rietjens, Sebastiaan J H; Verlaan, Kirsten; Zaalberg, Thijs W Brocades; de Boer, Sirp J

2009-07-01

This paper seeks to contribute to an improved information management and exchange between humanitarian organisations and military agents in complex emergencies. To do so, a theoretical information management process model was developed and applied to the case of information management between International Security Assistance Force troops and humanitarian organisations such as Cordaid, DACAAR and the International Office for Migration in Kabul, Afghanistan. Based on this analysis the main shortcomings and problems in each stage of the information management process were identified. These include a lack of structured information databases, the absence of identification of information needs, and an over-classification of documents by the military. Using a logical framework analysis, six major improvement tactics were developed, including the creation of more overlap in rotations of personnel, the specification of aims and tasks regarding information management, the improvement of skills and competences of personnel involved, and the introduction of regular joint civil-military evaluations.

Dissolution of Fe(III) (hydr) oxides by metal-EDTA complexes

Science.gov (United States)

Ngwack, Bernd; Sigg, Laura

1997-03-01

The dissolution of Fe(III)(hydr)oxides (goethite and hydrous ferric oxide) by metal-EDTA complexes occurs by ligand-promoted dissolution. The process is initiated by the adsorption of metal-EDTA complexes to the surface and is followed by the dissociation of the complex at the surface and the release of Fe(III)EDTA into solution. The dissolution rate is decreased to a great extent if EDTA is complexed by metals in comparison to the uncomplexed EDTA. The rate decreases in the order EDTA CaEDTA ≫ PbEDTA > ZnEDTA > CuEDTA > Co(II)EDTA > NiEDTA. Two different rate-limiting steps determine the dissolution process: (1) detachment of Fe(III) from the oxide-structure and (2) dissociation of the metal-EDTA complexes. In the case of goethite, step 1 is slower than step 2 and the dissolution rates by various metals are similar. In the case of hydrous ferric oxide, step 2 is rate-limiting and the effect of the complexed metal is very pronounced.

Using virtual humans and computer animations to learn complex motor skills: a case study in karate

Directory of Open Access Journals (Sweden)

Spanlang Bernhard

2011-12-01

Full Text Available Learning motor skills is a complex task involving a lot of cognitive issues. One of the main issues consists in retrieving the relevant information from the learning environment. In a traditional learning situation, a teacher gives oral explanations and performs actions to provide the learner with visual examples. Using virtual reality (VR as a tool for learning motor tasks is promising. However, it raises questions about the type of information this kind of environments can offer. In this paper, we propose to analyze the impact of virtual humans on the perception of the learners. As a case study, we propose to apply this research problem to karate gestures. The results of this study show no significant difference on the after training performance of learners confronted to three different learning environments (traditional group, video and VR.

Generation of fractals from complex logistic map

Energy Technology Data Exchange (ETDEWEB)

Rani, Mamta [Galgotias College of Engg. and Technology, Greater Noida (India)], E-mail: mamtarsingh@rediffmail.com; Agarwal, Rashi [IEC College of Engg. and Tech., Greater Noida (India)], E-mail: agarwal_rashi@yahoo.com

2009-10-15

Remarkably benign looking logistic transformations x{sub n+1} = r x{sub n}(1 - x{sub n}) for choosing x{sub 0} between 0 and 1 and 0 < r {<=} 4 have found a celebrated place in chaos, fractals and discrete dynamics. The strong physical meaning of Mandelbrot and Julia sets is broadly accepted and nicely connected by Christian Beck [Beck C. Physical meaning for Mandelbrot and Julia sets. Physica D 1999;125(3-4):171-182. Zbl0988.37060] to the complex logistic maps, in the former case, and to the inverse complex logistic map, in the latter case. The purpose of this paper is to study the bounded behavior of the complex logistic map using superior iterates and generate fractals from the same. The analysis in this paper shows that many beautiful properties of the logistic map are extendable for a larger value of r.

Role of angiocardiography in the diagnosis and management of complex/complicated congenital heart disease

International Nuclear Information System (INIS)

Ling Jian; Liu Yuqing

2006-01-01

Objective: To evaluate the role of angiocadiography (ACG) in the diagnosis and management of complex/complicated congenital heart disease (CHD). Methods: A retrospective study of ACG findings in 360 cases with complex/complicated CHD was performed with a comparision to that of echocardiography (Echo) and related clinical examination. Results: The present series of CHD cases included pulmonary atresia with ventricular septal defect in 75 cases, double outlet of right ventricle in 62 cases, Fallot's tetralogy in 60 cases, single ventricle in 52 cases, transposition of the great arteries in 42 cases, tricuspid valve atresia in 15 cases, coronary abnormality in 6 eases, total abnormal pulmonary venous connection in 5 cases, total endocardial cushion defect in 5 cases, persistent truncus arteriosus in 4 cases, pulmonary atresia with normal ventricular septum in 3 cases, other disorders in 7 eases, and postsurgical operation in 24 cases. ACG was superior to that of Echo in demonstrating the abnormalities of systemic, pulmonary, and coronary arteries and their branches of complex/complicated CHD as well as measuring the pressure of pulmonary artery, vein, and systemic-pulmonary collateral vessels. Conclusion: In the diagnosis and differential diagnosis of knotty cases with complex and complicated CHD, particularly in the demonstration of full view of systemic, pulmonary, and coronary arterial branches and accurate measurement of' pulmonary arterial pressure/resistance, and atrial, ventricular, and systemic arterial pressure, ACG (including DSA) still plays an important and irreplaceable role. (authors)

Venipuncture-Induced Complex Regional Pain Syndrome: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Foad Elahi

2014-01-01

Full Text Available Venipuncture, the most frequently performed invasive medical procedure, is usually benign. Generally it produces only transitory mild discomfort. Venipuncture-induced neuropathic pain is hard to recognize at an early stage. Medical literature reviews show that there is not adequate medical knowledge about this important subject. The inciting incident in complex regional pain syndrome (CRPS can often seem far too trivial to result in a condition with such severe pathophysiologic effects. The practicing physician has little information available to enable early recognition of the condition, initiation of multidisciplinary treatment modalities, and proper referral to pain specialists. We encountered a unique case of venipuncture-induced complex regional pain syndrome (CRPS. The patient is a 52-year-old school teacher with no significant past medical history, who presented initially to the Center of Pain Medicine with left upper extremity pain. The pain started while phlebotomy was performed in the patient’s left antecubital area for routine blood check. The patient’s pain did not improve with multiple medications, physical therapy, or several nerve blocks. The patient demonstrated all the signs and symptoms of chronic neuropathic pain of CRPS in the upper extremity with minimal response to the continuous pain management. We decided to proceed with cervical spinal cord nerve stimulation along with continuing other modalities. The patient responded to this combination. During the follow-up, we noticed that the patient’s pain course was complicated by extension of the CRPS to her lower extremity. We will describe the course of treatment for the patient in this paper. In this paper we will discuss the electrical neuromodulation as an important modality in addition to the multidisciplinary pain management for a patient with venipuncture-induced chronic neuropathic pain.

Complexity is simple!

Science.gov (United States)

Cottrell, William; Montero, Miguel

2018-02-01

In this note we investigate the role of Lloyd's computational bound in holographic complexity. Our goal is to translate the assumptions behind Lloyd's proof into the bulk language. In particular, we discuss the distinction between orthogonalizing and `simple' gates and argue that these notions are useful for diagnosing holographic complexity. We show that large black holes constructed from series circuits necessarily employ simple gates, and thus do not satisfy Lloyd's assumptions. We also estimate the degree of parallel processing required in this case for elementary gates to orthogonalize. Finally, we show that for small black holes at fixed chemical potential, the orthogonalization condition is satisfied near the phase transition, supporting a possible argument for the Weak Gravity Conjecture first advocated in [1].

Complex arteriovenous malformation - a case report

International Nuclear Information System (INIS)

Sirakov, S.; Penkov, M.; Marinov, M.; Kamenov, B.

2014-01-01

AVMs are composed of a network of channels interposed between feeding arteries and draining veins, without any direct shunt. Two different anatomic types of nidus may be more or less differentiated: The most frequent clinical presentations of brain AVMs are hemorrhage, seizure, chronic headache, and focal deficits not related to hemorrhage. We show a case of 27 years old female came to the hospital in heavy condition with subarachnoid hemorrhage Fisher 4. She had a history of 4 surgical operation of brain AVM in the last 10 years, without significant reduction of the malformation. After discussion of multidisciplinary team, of neuroradiologist and neurosurgeon was decided to be perform endovascular embolization, because of the better outcome for the patient. We performed endovascular treatment of the AVM with achieving subtotal embolization of malformation (90%). The patient recovery completely after 22 days and went home. For the next 18 months follow up there is no data of accidents for the patient. Key words: Arteriovenous Malformation. Subarachnoid hemorrhage. Endovascular treatment. Embolization

Is Phenomenal Consciousness a Complex Structure?

OpenAIRE

Stieg, Chuck

2004-01-01

Evolutionary explanations of psychological phenomena have become widespread. This paper examines a recent attempt by Nichols and Grantham (2000) to circumvent the problem of epiphenomenalism in establishing the selective status of consciousness. Nichols and Grantham (2000) argue that a case can be made for the view that consciousness is an adaptation based on its complexity. I set out this argument and argue that it fails to establish that phenomenal consciousness is a complex system. It ...

Diffusion of Telecommunications Services in a Complex Socio-Economic Context

DEFF Research Database (Denmark)

Ismail, Abdullah

This research aims at creating a detailed account on the diffusion of telecommunications services in a complex socio-economic context, taking Pakistan as a case study. The core research question of this thesis is to investigate why the successful experience of the rapid and an effective diffusion...... of mobile communications services in case of Pakistan couldn’t be replicated in the cases of fixed telephony and internet services. The book investigates those major attributes which play a significant role in the diffusion of telecommunications services in a complex socio-economic and political context...... of telecom services within a complex unit of adoption. The empirical part of the research includes a significantly high number of interviews that were conducted from the key players of the local telecom market, and they essentially represented all the five major domains i.e. the supplier, policy, regulatory...

Understanding Complex Construction Systems Through Modularity

DEFF Research Database (Denmark)

Jensen, Tor Clarke; Bekdik, Baris; Thuesen, Christian

2014-01-01

This paper develops a framework for understanding complexity in construction projects by combining theories of complexity management and modularization. The framework incorporates three dimensions of product, process, and organizational modularity with the case of gypsum wall elements. The analysis...... system, rather than a modular, although the industry forces modular organizational structures. This creates a high complexity degree caused by the non-alignment of building parts and organizations and the frequent swapping of modules....... finds that the main driver of complexity is the fragmentation of the design and production, which causes the production modules to construct and install new product types and variants for each project as the designers are swapped for every project. The many interfaces are characteristics of an integral...

Self-Regulation in the Midst of Complexity: A Case Study of High School Physics Students Engaged in Ill-Structured Problem Solving

Science.gov (United States)

Milbourne, Jeffrey David

The purpose of this dissertation study was to explore the experiences of high school physics students who were solving complex, ill-structured problems, in an effort to better understand how self-regulatory behavior mediated the project experience. Consistent with Voss, Green, Post, and Penner's (1983) conception of an ill-structured problem in the natural sciences, the 'problems' consisted of scientific research projects that students completed under the supervision of a faculty mentor. Zimmerman and Campillo's (2003) self-regulatory framework of problem solving provided a holistic guide to data collection and analysis of this multi-case study, with five individual student cases. The study's results are explored in two manuscripts, each targeting a different audience. The first manuscript, intended for the Science Education Research community, presents a thick, rich description of the students' project experiences, consistent with a qualitative, case study analysis. Findings suggest that intrinsic interest was an important self-regulatory factor that helped motivate students throughout their project work, and that the self-regulatory cycle of forethought, performance monitoring, and self-reflection was an important component of the problem-solving process. Findings also support the application of Zimmerman and Campillo's framework to complex, ill-structured problems, particularly the cyclical nature of the framework. Finally, this study suggests that scientific research projects, with the appropriate support, can be a mechanism for improving students' selfregulatory behavior. The second manuscript, intended for Physics practitioners, combines the findings of the first manuscript with the perspectives of the primary, on-site research mentor, who has over a decade's worth of experience mentoring students doing physics research. His experience suggests that a successful research experience requires certain characteristics, including: a slow, 'on-ramp' to the research

Unplanned Complex Suicide-A Consideration of Multiple Methods.

Science.gov (United States)

Ateriya, Navneet; Kanchan, Tanuj; Shekhawat, Raghvendra Singh; Setia, Puneet; Saraf, Ashish

2018-05-01

Detailed death investigations are mandatory to find out the exact cause and manner in non-natural deaths. In this reference, use of multiple methods in suicide poses a challenge for the investigators especially when the choice of methods to cause death is unplanned. There is an increased likelihood that doubts of homicide are raised in cases of unplanned complex suicides. A case of complex suicide is reported where the victim resorted to multiple methods to end his life, and what appeared to be an unplanned variant based on the death scene investigations. A meticulous crime scene examination, interviews of the victim's relatives and other witnesses, and a thorough autopsy are warranted to conclude on the cause and manner of death in all such cases. © 2017 American Academy of Forensic Sciences.

Non-commutative cryptography and complexity of group-theoretic problems

CERN Document Server

Myasnikov, Alexei; Ushakov, Alexander

2011-01-01

This book is about relations between three different areas of mathematics and theoretical computer science: combinatorial group theory, cryptography, and complexity theory. It explores how non-commutative (infinite) groups, which are typically studied in combinatorial group theory, can be used in public-key cryptography. It also shows that there is remarkable feedback from cryptography to combinatorial group theory because some of the problems motivated by cryptography appear to be new to group theory, and they open many interesting research avenues within group theory. In particular, a lot of emphasis in the book is put on studying search problems, as compared to decision problems traditionally studied in combinatorial group theory. Then, complexity theory, notably generic-case complexity of algorithms, is employed for cryptanalysis of various cryptographic protocols based on infinite groups, and the ideas and machinery from the theory of generic-case complexity are used to study asymptotically dominant prop...

Complexity and demographic explanations of cumulative culture.

Science.gov (United States)

Querbes, Adrien; Vaesen, Krist; Houkes, Wybo

2014-01-01

Formal models have linked prehistoric and historical instances of technological change (e.g., the Upper Paleolithic transition, cultural loss in Holocene Tasmania, scientific progress since the late nineteenth century) to demographic change. According to these models, cumulation of technological complexity is inhibited by decreasing--while favoured by increasing--population levels. Here we show that these findings are contingent on how complexity is defined: demography plays a much more limited role in sustaining cumulative culture in case formal models deploy Herbert Simon's definition of complexity rather than the particular definitions of complexity hitherto assumed. Given that currently available empirical evidence doesn't afford discriminating proper from improper definitions of complexity, our robustness analyses put into question the force of recent demographic explanations of particular episodes of cultural change.

Symbolic complexity for nucleotide sequences: a sign of the genome structure

International Nuclear Information System (INIS)

Salgado-García, R; Ugalde, E

2016-01-01

We introduce a method for estimating the complexity function (which counts the number of observable words of a given length) of a finite symbolic sequence, which we use to estimate the complexity function of coding DNA sequences for several species of the Hominidae family. In all cases, the obtained symbolic complexities show the same characteristic behavior: exponential growth for small word lengths, followed by linear growth for larger word lengths. The symbolic complexities of the species we consider exhibit a systematic trend in correspondence with the phylogenetic tree. Using our method, we estimate the complexity function of sequences obtained by some known evolution models, and in some cases we observe the characteristic exponential-linear growth of the Hominidae coding DNA complexity. Analysis of the symbolic complexity of sequences obtained from a specific evolution model points to the following conclusion: linear growth arises from the random duplication of large segments during the evolution of the genome, while the decrease in the overall complexity from one species to another is due to a difference in the speed of accumulation of point mutations. (paper)

MECHANISMS OF THE COMPLEX FORMATION BY d-METALS ON POROUS SUPPORTS AND THE CATALYTIC ACTIVITY OF THE FORMED COMPLEXES IN REDOX REACTIONS

Directory of Open Access Journals (Sweden)

T. L. Rakitskaya

2015-11-01

Full Text Available The catalytic activity of supported complexes of d metals in redox reactions with participation of gaseous toxicants, PH3, CO, O3, and SO2, depends on their composition. Owing to the variety of physicochemical and structural-adsorption properties of available supports, their influence on complex formation processes, the composition and catalytic activity of metal complexes anchored on them varies over a wide range. The metal complex formation on sup-ports with weak ion-exchanging properties is similar to that in aqueous solutions. In this case, the support role mainly adds up to the ability to reduce the activity of water adsorbed on them. The interaction between a metal complex and a support surface occurs through adsorbed water molecules. Such supports can also affect complex formation processes owing to protolytic reactions on account of acidic properties of sorbents used as supports. The catalytic activity of metal complexes supported on polyphase natural sorbents considerably depends on their phase relationship. In the case of supports with the nonsimple structure and pronounced ion-exchanging properties, for instance, zeolites and laminar silicates, it is necessary to take into account the variety of places where metal ions can be located. Such location places determine distinctions in the coordination environment of the metal ions and the strength of their bonding with surface adsorption sites and, therefore, the catalytic activity of surface complexes formed by theses metal ions. Because of the energy surface inhomogeneity, it is important to determine a relationship between the strength of a metal complex bonding with a support surface and its catalytic activity. For example, bimetallic complexes are catalytically active in the reactions of oxidation of the above gaseous toxicants. In particular, in the case of carbon monoxide oxidation, the most catalytic activity is shown by palladium-copper complexes in which copper(II is strongly

(VI) ML6 Complexes

African Journals Online (AJOL)

A geometric analysis revealed that beta-(C-H) and alpha-(C-C) can occupy the seventh and eighth coordination sites in the title Fischer carbene complexes as agostic interactions, which allows classifying the carbene as a η3 ligand in these cases. This theory was supported by the relative energies of the conformers and an ...

On the structure of thorium and americium adenosine triphosphate complexes

International Nuclear Information System (INIS)

Mostapha, Sarah; Berton, Laurence; Boubals, Nathalie; Zorz, Nicole; Charbonnel, Marie-Christine; Fontaine-Vive, Fabien; Den Auwer, Christophe; Solari, Pier Lorenzo

2014-01-01

The actinides are chemical poisons and radiological hazards. One challenge to better appraise their toxicity and develop countermeasures in case of exposure of living organisms is to better assess pathways of contamination. Because of the high chemical affinity of those actinide elements for phosphate groups and the ubiquity of such chemical functions in biochemistry, nucleotides and in particular adenosine triphosphate nucleotide (ATP) may be considered critical target building blocks for actinides. Combinations of spectroscopic techniques (Fourier transformed Infra Red [FTIR], Electro-spray Ionization Mass Spectrometry [ESI-MS], and Extended X-ray Absorption Fine Structure [EXAFS]) with quantum chemical calculations have been implemented in order to assess the actinides coordination arrangement with ATP. We describe and compare herein the interaction of ATP with thorium and americium; thorium(IV) as a representative of actinide(IV) like plutonium(IV) and americium(III) as a representative of all heavier actinides. In the case of thorium, an insoluble complex is readily formed. In the case of americium, a behavior identical to that described previously for lutetium has been observed with insoluble and soluble complexes. The comparative study of ATP complexation with Th(IV) and Am(III) shows their ability to form insoluble complexes for which a structural model has been proposed by analogy with previously described Lu(III) complexes. (authors)

On the structure of thorium and americium adenosine triphosphate complexes.

Science.gov (United States)

Mostapha, Sarah; Fontaine-Vive, Fabien; Berthon, Laurence; Boubals, Nathalie; Zorz, Nicole; Solari, Pier Lorenzo; Charbonnel, Marie Christine; Den Auwer, Christophe

2014-11-01

The actinides are chemical poisons and radiological hazards. One challenge to better appraise their toxicity and develop countermeasures in case of exposure of living organisms is to better assess pathways of contamination. Because of the high chemical affinity of those actinide elements for phosphate groups and the ubiquity of such chemical functions in biochemistry, nucleotides and in particular adenosine triphosphate nucleotide (ATP) may be considered critical target building blocks for actinides. Combinations of spectroscopic techniques (Fourier transformed Infra Red [FTIR], Electrospray Ionization Mass Spectrometry [ESI-MS], and Extended X-ray Absorption Fine Structure [EXAFS]) with quantum chemical calculations have been implemented in order to assess the actinides coordination arrangement with ATP. We describe and compare herein the interaction of ATP with thorium and americium; thorium(IV) as a representative of actinide(IV) like plutonium(IV) and americium(III) as a representative of all heavier actinides. In the case of thorium, an insoluble complex is readily formed. In the case of americium, a behavior identical to that described previously for lutetium has been observed with insoluble and soluble complexes. The comparative study of ATP complexation with Th(IV) and Am(III) shows their ability to form insoluble complexes for which a structural model has been proposed by analogy with previously described Lu(III) complexes.

The Generalization Complexity Measure for Continuous Input Data

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Iván Gómez

2014-01-01

defined in Boolean space, quantifies the complexity of data in relationship to the prediction accuracy that can be expected when using a supervised classifier like a neural network, SVM, and so forth. We first extend the original measure for its use with continuous functions to later on, using an approach based on the use of the set of Walsh functions, consider the case of having a finite number of data points (inputs/outputs pairs, that is, usually the practical case. Using a set of trigonometric functions a model that gives a relationship between the size of the hidden layer of a neural network and the complexity is constructed. Finally, we demonstrate the application of the introduced complexity measure, by using the generated model, to the problem of estimating an adequate neural network architecture for real-world data sets.

Single photon emission computed tomography in AIDS dementia complex

International Nuclear Information System (INIS)

Pohl, P.; Vogl, G.; Fill, H.; Roessler, H.Z.; Zangerle, R.; Gerstenbrand, F.

1988-01-01

Single photon emission computed tomography (SPECT) studies were performed in AIDS dementia complex using IMP in 12 patients (and HM-PAO in four of these same patients). In all patients, SPECT revealed either multiple or focal uptake defects, the latter corresponding with focal signs or symptoms in all but one case. Computerized tomography showed a diffuse cerebral atrophy in eight of 12 patients, magnetic resonance imaging exhibited changes like atrophy and/or leukoencephalopathy in two of five cases. Our data indicate that both disturbance of cerebral amine metabolism and alteration of local perfusion share in the pathogenesis of AIDS dementia complex. SPECT is an important aid in the diagnosis of AIDS dementia complex and contributes to the understanding of the pathophysiological mechanisms of this disorder

Complex Composite Odontoma with Characteristic Histology

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Sujatha Govindrajan

2013-01-01

Full Text Available Odontomas are the most commonly occurring odontogenic tumors, which are considered by many to be hamartomas rather than neoplasms. These clinically asymptomatic tumors are classified into complex and compound odontomas. They are usually discovered in radiographs and rarely cause bony expansion or infection. This paper discusses a case report of a complex odontoma exhibiting all the structural features and defects of enamel, dentine, and cementum in succession, with an overview on its etiology.

Superrenormalizable quantum gravity with complex ghosts

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Leonardo Modesto

2016-04-01

Full Text Available We suggest and briefly review a new sort of superrenormalizable models of higher derivative quantum gravity. The higher derivative terms in the action can be introduced in such a way that all the unphysical massive states have complex poles. According to the literature on Lee–Wick quantization, in this case the theory can be formulated as unitary, since all massive ghosts-like degrees of freedom are unstable. Keywords: Quantum gravity, Higher derivatives, Complex poles

Heterolytic activation of dihydrogen by platinum and palladium complexes

NARCIS (Netherlands)

Almeida Leñero, K.Q.; Guari, Y.; Kramer, P.C.J.; van Leeuwen, P.W.N.M.; Donnadieu, B.; Sabo-Etienne, S.; Chaudret, B.; Lutz, M.; Spek, A.L.

2013-01-01

Wide bite angle diphosphine ligands were used to prepare [(diphosphine)M(2-(diphenylphosphino)pyridine)]2+ complexes (M = Pd, Pt). Except for the ligand with the largest bite angle, 2-(diphenylphosphino)pyridine coordinates in a bidentate mode leading to bis-chelate complexes. In the case of

Multimodality Renal Failure in a Patient with OEIS Complex

Directory of Open Access Journals (Sweden)

Jonathan D. Santoro

2015-10-01

Full Text Available Omphalocele-exstrophy of the bladder-imperforate anus-spinal defect (OEIS complex is a rare constellation of clinical abnormalities with wide phenotypic presentation. We describe a case of a preterm neonate with OEIS complex with acute renal failure, and the challenges in diagnosis and management of this patient as renal failure can be a multifactorial process when encountered with this rare complex.

High-resolution numerical simulation of summer wind field comparing WRF boundary-layer parametrizations over complex Arctic topography: case study from central Spitsbergen

Czech Academy of Sciences Publication Activity Database

Láska, K.; Chládová, Zuzana; Hošek, Jiří

2017-01-01

Roč. 26, č. 4 (2017), s. 391-408 ISSN 0941-2948 Institutional support: RVO:68378289 Keywords : surface wind field * model evaluation * topographic effect * circulation pattern * Svalbard Subject RIV: DG - Athmosphere Sciences, Meteorology OBOR OECD: Meteorology and atmospheric sciences Impact factor: 1.989, year: 2016 http://www.schweizerbart.de/papers/metz/detail/prepub/87659/High_resolution_numerical_simulation_of_summer_wind_field_comparing_WRF_boundary_layer_parametrizations_over_complex_Arctic_topography_case_study_from_central_Spitsbergen

The complexities of complex span: explaining individual differences in working memory in children and adults.

Science.gov (United States)

Bayliss, Donna M; Jarrold, Christopher; Gunn, Deborah M; Baddeley, Alan D

2003-03-01

Two studies are presented that investigated the constraints underlying working memory performance in children and adults. In each case, independent measures of processing efficiency and storage capacity are assessed to determine their relative importance in predicting performance on complex span tasks,which measure working memory capacity. Results show that complex span performance was independently constrained by individual differences in domain-general processing efficiency and domain-specific storage capacity. Residual variance, which may reflect the ability to coordinate storage and processing, also predicted academic achievement. These results challenge the view that complex span taps a limited-capacity resource pool shared between processing and storage operations. Rather, they are consistent with a multiple-component model in which separate resource pools support the processing and storage functions of working memory.

Complex Adaptive Schools: Educational Leadership and School Change

Science.gov (United States)

Kershner, Brad; McQuillan, Patrick

2016-01-01

This paper utilizes the theoretical framework of complexity theory to compare and contrast leadership and educational change in two urban schools. Drawing on the notion of a complex adaptive system--an interdependent network of interacting elements that learns and evolves in adapting to an ever-shifting context--our case studies seek to reveal the…

Complexity in White Noise Analysis

Science.gov (United States)

Hida, Takeyuki

We restrict our attention to random complex systems and discuss degree their degree of complexity based on a white noise. The white noise is realized as the time derivative of a Brownian motion B(t), and denoted by Ḃ(t). The collection {Ḃ(t)}, is a system of idealized elementary variables and at the same time the system is a stochastic representation of the time t, in other words it is time-oriented. Having expressed the given evolutional random phenomena in question in terms of the Ḃ(t), we introduce the notion of spectral multiplicity, which describes how much the phenomena are complex. The multiplicity is the number of cyclic subspaces that are spanned by the given random phenomena. Each cyclic subspace has further structure. Typical property is multiple Markov property, although this property appears only particular cases. As a related property, in fact as a characteristic of a complex system, one can speak of the time reversibility and irreversibility of certain random phenomena in terms of the white noise. We expect an irreversible random complex system may be decomposed into reversible systems.

Stories as case knowledge: case knowledge as stories.

Science.gov (United States)

Cox, K

2001-09-01

Every case contains a human story of illness and a medical story of disease, which together cover person management, case management, health system management and self-management. Much of that management can be learned via a thorough set of stories of typical and atypical core cases compiled by clinical teachers. Stories provide a highly flexible framework for illustrating the lessons of experience, the tips and traps for young players, and the dilemmas requiring careful judgement in the trade-offs between benefits and risks. Listening to real stories unfold is much more fun than being lectured (and better remembered). Stories illustrate 'what can happen' in a case as a guide to 'what to do'. A story begins with a real world situation with some predicament and a (causal) sequence of events or plot in which things are resolved one way or another. Patients tell their illness story; their clinician translates that into a disease story. Stories sort out what is important in such a predicament, consider the strategy and tactics of what to do, and speak about the outcomes. Each local situation provides relevance, context and circumstantial detail. Stories about case management can encapsulate practical knowledge, logical deduction, judgement and decision making, sharing with the student all the ingredients that develop expertise. Sometimes it is the plot that is important, sometimes the detail, sometimes it is the underlying message, the parable that resonates with the listener's experiences and feelings.1 Stories can also accommodate the complexity of multiple variables and the influence of other stakeholders, the uncertainties and dilemmas within the trade-offs, and the niceties of 'informed judgement'. This paper makes four points. First, clinical stories recount pointed examples of 'what happened' that expand our expertise in handling 'a case like that'. Second, cases are the unit of clinical work. Case stories expand the dimensions and details of case knowledge

Use of the nonsteady monotonic heating method for complex determination of thermophysical properties of chemically reacting mixture in the case of non-equilibrium proceeding of the chemical reaction

International Nuclear Information System (INIS)

Serebryanyj, G.Z.

1984-01-01

Theoretical analysis is made for the monotonic heating method as applied for complex determination of thermophysical properties of chemically reacting gases. The possibility is shown of simultaneous determination of frozen and equilibrium heat capacity, frozen and equilibrium heat conduction provided non-equilibrium occuring of the reaction in the wide range of temperatures and pressures. The monotonic heating method can be used for complex determination of thermophysical properties of chemically reacting systems in case of non-equilibrium proceeding of the chemical reaction

Evolution of DNA replication protein complexes in eukaryotes and Archaea.

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Nicholas Chia

Full Text Available BACKGROUND: The replication of DNA in Archaea and eukaryotes requires several ancillary complexes, including proliferating cell nuclear antigen (PCNA, replication factor C (RFC, and the minichromosome maintenance (MCM complex. Bacterial DNA replication utilizes comparable proteins, but these are distantly related phylogenetically to their archaeal and eukaryotic counterparts at best. METHODOLOGY/PRINCIPAL FINDINGS: While the structures of each of the complexes do not differ significantly between the archaeal and eukaryotic versions thereof, the evolutionary dynamic in the two cases does. The number of subunits in each complex is constant across all taxa. However, they vary subtly with regard to composition. In some taxa the subunits are all identical in sequence, while in others some are homologous rather than identical. In the case of eukaryotes, there is no phylogenetic variation in the makeup of each complex-all appear to derive from a common eukaryotic ancestor. This is not the case in Archaea, where the relationship between the subunits within each complex varies taxon-to-taxon. We have performed a detailed phylogenetic analysis of these relationships in order to better understand the gene duplications and divergences that gave rise to the homologous subunits in Archaea. CONCLUSION/SIGNIFICANCE: This domain level difference in evolution suggests that different forces have driven the evolution of DNA replication proteins in each of these two domains. In addition, the phylogenies of all three gene families support the distinctiveness of the proposed archaeal phylum Thaumarchaeota.

Preictal dynamics of EEG complexity in intracranially recorded epileptic seizure: a case report.

Science.gov (United States)

Bob, Petr; Roman, Robert; Svetlak, Miroslav; Kukleta, Miloslav; Chladek, Jan; Brazdil, Milan

2014-11-01

Recent findings suggest that neural complexity reflecting a number of independent processes in the brain may characterize typical changes during epileptic seizures and may enable to describe preictal dynamics. With respect to previously reported findings suggesting specific changes in neural complexity during preictal period, we have used measure of pointwise correlation dimension (PD2) as a sensitive indicator of nonstationary changes in complexity of the electroencephalogram (EEG) signal. Although this measure of complexity in epileptic patients was previously reported by Feucht et al (Applications of correlation dimension and pointwise dimension for non-linear topographical analysis of focal onset seizures. Med Biol Comput. 1999;37:208-217), it was not used to study changes in preictal dynamics. With this aim to study preictal changes of EEG complexity, we have examined signals from 11 multicontact depth (intracerebral) EEG electrodes located in 108 cortical and subcortical brain sites, and from 3 scalp EEG electrodes in a patient with intractable epilepsy, who underwent preoperative evaluation before epilepsy surgery. From those 108 EEG contacts, records related to 44 electrode contacts implanted into lesional structures and white matter were not included into the experimental analysis.The results show that in comparison to interictal period (at about 8-6 minutes before seizure onset), there was a statistically significant decrease in PD2 complexity in the preictal period at about 2 minutes before seizure onset in all 64 intracranial channels localized in various brain sites that were included into the analysis and in 3 scalp EEG channels as well. Presented results suggest that using PD2 in EEG analysis may have significant implications for research of preictal dynamics and prediction of epileptic seizures.

The complexity of language change: The case of Ancient Hebrew ...

African Journals Online (AJOL)

This article develops a theory of language change and diffusion in the light of new developments in contemporary linguistics on the themes of language evolution and the rise of linguistic complexity. The core assumptions of this article are, first, the fact that a language inevitably changes and diffuses over time and, second, ...

Complexity and demographic explanations of cumulative culture.

Directory of Open Access Journals (Sweden)

Adrien Querbes

Full Text Available Formal models have linked prehistoric and historical instances of technological change (e.g., the Upper Paleolithic transition, cultural loss in Holocene Tasmania, scientific progress since the late nineteenth century to demographic change. According to these models, cumulation of technological complexity is inhibited by decreasing--while favoured by increasing--population levels. Here we show that these findings are contingent on how complexity is defined: demography plays a much more limited role in sustaining cumulative culture in case formal models deploy Herbert Simon's definition of complexity rather than the particular definitions of complexity hitherto assumed. Given that currently available empirical evidence doesn't afford discriminating proper from improper definitions of complexity, our robustness analyses put into question the force of recent demographic explanations of particular episodes of cultural change.

Complex structure of Kerr geometry and rotating 'photon rocket' solutions

International Nuclear Information System (INIS)

Burinskii, Alexander

2003-01-01

In the frame of the Kerr-Schild approach, we obtain a generalization of the Kerr solution to a nonstationary case corresponding to a rotating source moving with arbitrary acceleration. Similar to the Kerr solution, the solutions obtained have geodesic and shearfree principal null congruence. The current parameters of the solutions are determined by a complex retarded-time construction via a given complex worldline of source. The real part of the complex worldline defines the values of the boost and acceleration while the imaginary part controls the rotation. The acceleration of the source is accompanied by lightlike radiation along the principal null congruence. The solutions obtained generalize to the rotating case the known Kinnersley class of the 'photon rocket' solutions

Average contraction and synchronization of complex switched networks

International Nuclear Information System (INIS)

Wang Lei; Wang Qingguo

2012-01-01

This paper introduces an average contraction analysis for nonlinear switched systems and applies it to investigating the synchronization of complex networks of coupled systems with switching topology. For a general nonlinear system with a time-dependent switching law, a basic convergence result is presented according to average contraction analysis, and a special case where trajectories of a distributed switched system converge to a linear subspace is then investigated. Synchronization is viewed as the special case with all trajectories approaching the synchronization manifold, and is thus studied for complex networks of coupled oscillators with switching topology. It is shown that the synchronization of a complex switched network can be evaluated by the dynamics of an isolated node, the coupling strength and the time average of the smallest eigenvalue associated with the Laplacians of switching topology and the coupling fashion. Finally, numerical simulations illustrate the effectiveness of the proposed methods. (paper)

Concept of Complex Environmental Monitoring Network - Vardzia Rock Cut City Case Study

Science.gov (United States)

Elashvili, Mikheil; Vacheishvili, Nikoloz; Margottini, Claudio; Basilaia, Giorgi; Chkhaidze, Davit; Kvavadze, Davit; Spizzichino, Daniele; Boscagli, Franceso; Kirkitadze, Giorgi; Adikashvili, Luka; Navrozashvili, Levan

2016-04-01

Vardzia represents an unique cultural heritage monument - rock cut city, which unites architectural monument and Natural-Geological complex. Such monuments are particularly vulnerable and their restoration and conservation requires complex approach. It is curved in various layers of volcanic tuffs and covers several hectares of area, with chronologically different segments of construction. This monument, as many similar monuments worldwide, is subjected to slow but permanent process of destruction, expressed in following factors: surface weathering of rock, active tectonics (aseismic displacement along the active faults and earthquakes), interaction between lithologically different rock layers, existence of major cracks and associated complex block structure, surface rainwater runoff and infiltrated ground water, temperature variations, etc. During its lifetime, Vardzia was heavily damaged by Historical Earthquake of 1283 and only partly restored afterwards. The technological progress together with the increased knowledge about ongoing environmental processes, established the common understanding that the complex monitoring of the environment represents the essential component for resolving such a principal issues, as: Proper management and prevention of natural disasters; Modeling of environmental processes, their short and long term prognosis; Monitoring of macro and micro climate; Safe functioning and preservation of important constructions. Research Center of Cultural Heritage and Environment of Ilia State University in cooperation with Experts from ISPRA, with the funding from the State agency of Cultural Heritage, has developed a concept of Vardzia complex monitoring network. Concept of the network includes: monitoring local meteorological conditions (meteorological station), monitoring microclimate in caves (temperature and humidity in the air and rock), monitoring microtremors and ambient seismic noise in Vardzia (local strong motion network), monitoring

Triangular fibrocartilage complex injury treated with prolotherapy

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Serdar Kesikburun

2016-06-01

Full Text Available Triangular fibrocartilage complex has a crucial role in stability and functionality of the wrist. Traumatic or degenerative injury of the triangular fibrocartilage complex is a common cause of ulnar side wrist pain. Arthroscopic treatment has been offered in chronic triangular fibrocartilage complex injury. A 19-year old male patient presented with pain at ulnar side of the wrist. He was diagnosed as having triangular fibrocartilage complex injury after assessment with MR imaging. The patients who did not benefit from drugs underwent prolotherapy three times. After treatment, he had pain relief and reported that he could use his wrist better. In this case, triangular fibrocartilage complex injury improved with prolotherapy and arthroscopic treatment was not required. Further clinical trials are needed to show better the role of prolotherapy in the treatment of triangular fibrocartilage complex injury. [Cukurova Med J 2016; 41(2.000: 403-405

Electrocardiogram artifact caused by rigors mimicking narrow complex tachycardia: a case report.

Science.gov (United States)

Matthias, Anne Thushara; Indrakumar, Jegarajah

2014-02-04

The electrocardiogram (ECG) is useful in the diagnosis of cardiac and non-cardiac conditions. Rigors due to shivering can cause electrocardiogram artifacts mimicking various cardiac rhythm abnormalities. We describe an 80-year-old Sri Lankan man with an abnormal electrocardiogram mimicking narrow complex tachycardia during the immediate post-operative period. Electrocardiogram changes caused by muscle tremor during rigors could mimic a narrow complex tachycardia. Identification of muscle tremor as a cause of electrocardiogram artifact can avoid unnecessary pharmacological and non-pharmacological intervention to prevent arrhythmias.

BAC-FISH assays delineate complex chromosomal rearrangements in a case of post-Chernobyl childhood thyroid cancer.

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Horst F Zitzelsberger

2009-12-01

Full Text Available Structural chromosome aberrations are known hallmarks of many solid tumors. In the papillary form of thyroid cancer (PTC, for example, activation of the receptor tyrosine kinase (RTK genes, RET and neurotrophic tyrosine kinase receptor type I (NTRK1 by intra- and interchromosomal rearrangements has been suggested as a cause of the disease. However, many phenotypically similar tumors do not carry an activated RET or NTRK-1 gene or express abnormal ret or NTRK-1 transcripts. Thus, we hypothesize that other cellular RTK-type genes are aberrantly expressed in these tumors. Using fluorescence in situ hybridization-based methods, we are studying karyotype changes in a relatively rare subgroup of PTCs, i.e., tumors that arose in children following the 1986 nuclear accident in Chernobyl, Ukraine. Here, we report our technical developments and progress in deciphering complex chromosome aberrations in case S48TK, an aggressively growing PTC cell line, which shows an unusual high number of unbalanced translocations.

BAC-FISH assays delineate complex chromosomal rearrangements in a case of post-Chernobyl childhood thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Kwan, Johnson; Baumgartner, Adolf; Lu, Chun-Mei; Wang, Mei; Weier, Jingly F.; Zitzelsberger, Horst F.; Weier, Heinz-Ulrich G.

2009-03-09

Structural chromosome aberrations are known hallmarks of many solid tumors. In the papillary form of thyroid cancer (PTC), for example, activation of the receptor tyrosine kinase (RTK) genes, RET and neurotrophic tyrosine kinase receptor type I (NTRK1) by intra- and interchromosomal rearrangements has been suggested as a cause of the disease. However, many phenotypically similar tumors do not carry an activated RET or NTRK-1 gene or express abnormal ret or NTRK-1 transcripts. Thus, we hypothesize that other cellular RTK-type genes are aberrantly expressed in these tumors. Using fluorescence in situ hybridization-based methods, we are studying karyotype changes in a relatively rare subgroup of PTCs, i.e., tumors that arose in children following the 1986 nuclear accident in Chernobyl, Ukraine. Here, we report our technical developments and progress in deciphering complex chromosome aberrations in case S48TK, an aggressively growing PTC cell line, which shows an unusual high number of unbalanced translocations.

Complexity management in the food industry

DEFF Research Database (Denmark)

Herbert-Hansen, Zaza Nadja Lee; Jacobsen, Peter

2017-01-01

The many stakeholders in the food industry with their diverse interests make this industry complex and interesting to work with. There are four main stakeholders; 1) The customers with their increased demand for customized products, quick delivery times and increased responsiveness, 2) The author......The many stakeholders in the food industry with their diverse interests make this industry complex and interesting to work with. There are four main stakeholders; 1) The customers with their increased demand for customized products, quick delivery times and increased responsiveness, 2...... this complexity and finding a method for using these complexity factors in economic calculations. The research question this paper seeks to address is therefore “Which complexity factors can be quantified in the food industry and how can they be used in economic calculations?” A case study of a SME Danish bread...... producer will address the research question due to the explorative nature of this study and the limited amount of previous research within this field....

Korean Conference on Several Complex Variables

CERN Document Server

Byun, Jisoo; Gaussier, Hervé; Hirachi, Kengo; Kim, Kang-Tae; Shcherbina, Nikolay

2015-01-01

This volume includes 28 chapters by authors who are leading researchers of the world describing many of the up-to-date aspects in the field of several complex variables (SCV). These contributions are based upon their presentations at the 10th Korean Conference on Several Complex Variables (KSCV10), held as a satellite conference to the International Congress of Mathematicians (ICM) 2014 in Seoul, Korea. SCV has been the term for multidimensional complex analysis, one of the central research areas in mathematics. Studies over time have revealed a variety of rich, intriguing, new knowledge in complex analysis and geometry of analytic spaces and holomorphic functions which were "hidden" in the case of complex dimension one. These new theories have significant intersections with algebraic geometry, differential geometry, partial differential equations, dynamics, functional analysis and operator theory, and sheaves and cohomology, as well as the traditional analysis of holomorphic functions in all dimensions. This...

Complex Regional Pain Syndrome Revived by Epileptic Seizure Then Disappeared Soon during Treatment with Regional Intravenous Nerve Blockade: A Case Report

Directory of Open Access Journals (Sweden)

Masahiko Sumitani

2011-01-01

Full Text Available We present a case of complex regional pain syndrome (CRPS, in which symptoms, including burning pain and severe allodynia, were alleviated by using a regional intravenous nerve blockade (Bier block combined with physiotherapy, but reappeared following an epileptic seizure. Symptoms disappeared again following control of epileptic discharges, as revealed by single-photon emission computed tomography (SPECT and electroencephalography (EEG results. Although systemic toxicity of a local anesthetic applied by Bier block was suspected as a cause of the first seizure, the patient did not present any other toxic symptoms, and seizures repeatedly occurred after Bier block cessation; the patient was then diagnosed as having temporal symptomatic epilepsy. This case suggests that symptoms of CRPS may be sustained by abnormal brain conditions, and our findings contribute to the understanding of how the central nervous system participates in maintaining pain and allodynia associated with CRPS.

Comparative study of binary and ternary complexes of some rare earths

International Nuclear Information System (INIS)

Makhijani, S.D.; Sangal, S.P.

1978-01-01

Modified form of Irving and Rossotti's pH titration technique has been used to evaluate and compare the stability constants of the binary and ternary complexes of Sc(III), Y(III), La(III), Pr(III), Nd(III) and Sm(III) at 30 0 at an ionic strength of 0.2M NaClO 4 . For the study of ternary complexes, nitrilotriacetic acid has been used as a primary ligand and polyhydroxy phenols i.e. pyrocatechol (PYC), pyrogallol (PYG) and gallic acid (GA) as secondary ligands. The stability constants of the binary complexes were found to be more than those of the corresponding ternary complexes which can reasonably be explained on the basis of electrostatic force between primary complex (metal in the case of binary complex) and secondary ligand, and space available to accommodate the secondary ligand. The stability decreases with the increase in ionic radii, i.e. Sc(III)>Y(III)>Sm(III)>Nd(III)>Pr(III)>La(III). In terms of secondary ligand, it follows the order PYC>GA>PYG. Rare earths form only 1:1 binary complex, and 1:1:1 mixed ligand complex in all the cases. (author)

Acid-base properties of complexes with three-dimensional polyligands. Complexes with three-dimensional polyphosphoric acids

International Nuclear Information System (INIS)

Kopylova, V.D.; Bojko, Eh.T.; Saldadze, K.M.

1985-01-01

By the method of potentiometric titration acid-base properties of uranyl (2) complexes with three-dimensional polyphosphoric acids, KRF-8p, KF-1, KF-7 prepared by phosphorylation of copolymer of styrene and divinylbenzene or saponification of the copolymers of di-2,2'-chloroethyl ester of vinylphosphonic acid with divinyl benzene are studied. It is shown that in case of formation in the phase of three-dimensional polyphosphoric acids of UO 2 2+ complexes with the growth of bond covalence of metal ion-phosphonic group the acidjty of the second hydroxyl of the phosphonic group increases

Conceptual design of a spent LWR fuel recycle complex

International Nuclear Information System (INIS)

Kirk, B.H.

1980-01-01

Purpose was to design a licensable facility, to make cost-benefit analyses of alternatives, and to aid in developing licensing criteria. The Savannah River Plant was taken to be the site for the recycle complex. The spent LWR fuel will be processed through the plant at the rate of 3000 metric tons of heavy metal per year. The following aspects of the complex are discussed: operation, maintenance, co-conversion (Coprecal), waste disposal, off-gas treatment, ventilation, safeguards, accounting, equipment and fuel fabrication. Differences between the co-processing case and the separated streams case are discussed. 44 figures

Scalar dark matter: real vs complex

Energy Technology Data Exchange (ETDEWEB)

Wu, Hongyan; Zheng, Sibo [Department of Physics, Chongqing University,Chongqing 401331 (China)

2017-03-27

We update the parameter spaces for both a real and complex scalar dark matter via the Higgs portal. In the light of constraints arising from the LUX 2016 data, the latest Higgs invisible decay and the gamma ray spectrum, the dark matter resonant mass region is further restricted to a narrow window between 54.9−62.3 GeV in both cases, and its large mass region is excluded until 834 GeV and 3473 GeV for the real and complex scalar, respectively.

Scalar dark matter: real vs complex

International Nuclear Information System (INIS)

Wu, Hongyan; Zheng, Sibo

2017-01-01

We update the parameter spaces for both a real and complex scalar dark matter via the Higgs portal. In the light of constraints arising from the LUX 2016 data, the latest Higgs invisible decay and the gamma ray spectrum, the dark matter resonant mass region is further restricted to a narrow window between 54.9−62.3 GeV in both cases, and its large mass region is excluded until 834 GeV and 3473 GeV for the real and complex scalar, respectively.

The relationship between automation complexity and operator error

International Nuclear Information System (INIS)

Ogle, Russell A.; Morrison, Delmar 'Trey'; Carpenter, Andrew R.

2008-01-01

One of the objectives of process automation is to improve the safety of plant operations. Manual operation, it is often argued, provides too many opportunities for operator error. By this argument, process automation should decrease the risk of accidents caused by operator error. However, some accident theorists have argued that while automation may eliminate some types of operator error, it may create new varieties of error. In this paper we present six case studies of explosions involving operator error in an automated process facility. Taken together, these accidents resulted in six fatalities, 30 injuries and hundreds of millions of dollars in property damage. The case studies are divided into two categories: low and high automation complexity (three case studies each). The nature of the operator error was dependent on the level of automation complexity. For each case study, we also consider the contribution of the existing engineering controls such as safety instrumented systems (SIS) or safety critical devices (SCD) and explore why they were insufficient to prevent, or mitigate, the severity of the explosion

Deregulation impacts AMR business cases

Energy Technology Data Exchange (ETDEWEB)

Wiebe, M.; Fauth, G.

2001-09-01

Meter reading strategy is being affected in fundamental ways by deregulation. For the utilities attempting to cope with meter reading unbundling, the processes, insights and general rules that had been developed prior to 2000 in the field of Automatic Meter Reading can no longer be relied upon to provide useful lessons. The fundamental impact on Automatic Meter Reading (AMR) business case drivers and the increasing complexity of building the business case model result from deregulation and unbundling. More and more, management has come to rely on rigorous business case analysis to compensate for the magnitude of AMR projects on the utility and the scarcity of financial resources. One can now expect the Chief Financial Officer and the Vice President Finance to become active players on AMR project teams in the fields of business case scrutiny and approval. Increasingly, the normal expertise of AMR personnel does not suffice to build a business case acceptable to finance. The financial and economic analysis skills required are ever more complex.

Benign renal complex cysts: MR imaging

International Nuclear Information System (INIS)

Levy, P.; Helenon, O.; Melki, P.; Paraf, F.; Chauveau, D.; Chretien, Y.; Moreau, J.F.

1994-01-01

The aim of this study was to assess the magnetic resonance imaging (MRI) characteristics of 13 benign complex renal cysts using T1 and T2-weighted images and contrast-enhanced images. The results have been compared to CT and ultrasonographic findings in all cases and correlated with histopathologic datas in 12 cases. Five groups have been defined according to the MR features. Group 1: homogeneous low signal intensity on T1-weighted images and homogeneous high signal intensity on T2-weighted images mimicking simple cyst (n = 2); group 2: homogeneous high signal intensity on both T1 and T2-weighted images mimicking hemorrhagic cyst (n = 1); group 3: characterized by high signal intensity on T1-weighted images and fluid-iron level on T2-weighted images (n = 3); group 4: characterized by fluid-iron level on both T1 and T2-weighted images (n = 3); group 5: pseudotumoral feature: heterogeneous signal intensity and/or wall contrast enhancement (n = 3). Among the 13 indeterminate lesions on ultrasonography and CT, MRI was of diagnostic value in 8 cases, whereas the 5 remaining cases remained indeterminate on MR images. Our results suggest that MRI can be useful in the diagnosis of benign complex cyst of the kidney presenting as indeterminate cystic lesion on other modalities. (authors). 40 refs., 7 figs., 2 tabs

The need for simulation in complex industrial systems

Directory of Open Access Journals (Sweden)

Aboura Khalid

2012-10-01

Full Text Available We discuss the concept of simulation and its application in the resolution of problems in complex industrial systems. Most problems of serious scale, be it an inventory problem, a production and distribution problem, a management of resources or process improvement, all real world problems require a mix of generic, data algorithmic and Ad-hoc solutions making the best of available information. We describe two projects in which analytical solutions were applied or contemplated. The first case study uses linear programming in the optimal allocation of advertising resources by a major internet service provider. The second study, in a series of projects, analyses options for the expansion of the production and distribution network of mining products, as part of a sensitive strategic business review. Using the examples, we make the case for the need of simulation in complex industrial problems where analytical solutions may be attempted but where the size and complexity of the problem forces a Monte Carlo approach.

River rating complexity

Science.gov (United States)

Holmes, Robert R.

2016-01-01

Accuracy of streamflow data depends on the veracity of the rating model used to derive a continuous time series of discharge from the surrogate variables that can readily be collected autonomously at a streamgage. Ratings are typically represented as a simple monotonic increasing function (simple rating), meaning the discharge is a function of stage alone, however this is never truly the case unless the flow is completely uniform at all stages and in transitions from one stage to the next. For example, at some streamflow-monitoring sites the discharge on the rising limb of the hydrograph is discernably larger than the discharge at the same stage on the falling limb of the hydrograph. This is the so-called “loop rating curve” (loop rating). In many cases, these loops are quite small and variation between rising- and falling-limb discharge measurements made at the same stage are well within the accuracy of the measurements. However, certain hydraulic conditions can produce a loop that is large enough to preclude use of a monotonic rating. A detailed data campaign for the Mississippi River at St. Louis, Missouri during a multi-peaked flood over a 56-day period in 2015 demonstrates the rating complexity at this location. The shifting-control method used to deal with complexity at this site matched all measurements within 8%.

A New Family of Low-Complexity STBCs for Four Transmit Antennas

KAUST Repository

Ismail, Amr

2012-12-29

Space-Time Block Codes (STBCs) suffer from a prohibitively high decoding complexity unless the low-complexity decodability property is taken into consideration in the STBC design. For this purpose, several families of STBCs that involve a reduced decoding complexity have been proposed, notably the multi-group decodable and the fast decodable (FD) codes. Recently, a new family of codes that combines both of these families namely the fast group decodable (FGD) codes was proposed. In this paper, we propose a new construction scheme for rate-1 FGD codes for 2^a transmit antennas. The proposed scheme is then applied to the case of four transmit antennas and we show that the new rate-1 FGD code has the lowest worst-case decoding complexity among existing comparable STBCs. The coding gain of the new rate-1 code is optimized through constellation stretching and proved to be constant irrespective of the underlying QAM constellation prior to normalization. Next, we propose a new rate-2 FD STBC by multiplexing two of our rate-1 codes by the means of a unitary matrix. Also a compromise between rate and complexity is obtained through puncturing our rate-2 FD code giving rise to a new rate-3/2 FD code. The proposed codes are compared to existing codes in the literature and simulation results show that our rate-3/2 code has a lower average decoding complexity while our rate-2 code maintains its lower average decoding complexity in the low SNR region. If a time-out sphere decoder is employed, our proposed codes outperform existing codes at high SNR region thanks to their lower worst-case decoding complexity.

COMBINATION OF APICALLY POSITIONED AND CORONALLY ADVANCED FLAP IN THE TREATMENT OF A COMPLEX MUCOGINGIVAL AND RESTORATIVE PROBLEM. A 3-YEAR FOLLOW-UP. (Case Report

Directory of Open Access Journals (Sweden)

Kamen Kotsilkov

2015-07-01

Full Text Available INTRODUCTION: The modern Periodontology has various approaches to achieve a complete functional and aesthetic rehabilitation of the mucogingival complex. These techniques include application of flaps with apical or coronal advancement in order to achieve different treatment objectives. Complex cases with different pathology on adjacent teeth require several surgeries thereby increasing treatment time and patient discomfort. New combined approaches are needed to meet the challenges of such cases. OBJECTIVE: This report presents a case with a simultaneous application of a resective and a mucogingival technique in one dental sextant. METHODS: I.C. (36 with a localized chronic periodontitis, Miller Class I gingival recessions (13,14 and subgingival caries lesions (15,16. A combined approach with simultaneous crown lengthening with apically positioned flap for 16,15 and root coverage with enamel matrix derivate and a coronally advanced flap for 14,13 was applied in order to avoid multiple surgical procedures. RESULTS: On the third month after the surgical procedure a complete root coverage (13,14 was achieved. The crown lengthening procedure enabled the restoration of the caries lesions and the placement of new crowns (15,16. The result at the third year demonstrates a stable gingival margin with no recurrence of the gingival recessions. CONCLUSION: The applied combined procedure led to a complete resolution of the existing problems with a single surgery. The simultaneous application of different procedures seems a promising approach aimed to reduce the treatment time and to diminish patient discomfort.

Innovation in a complex environment

Directory of Open Access Journals (Sweden)

René Pellissier

2012-02-01

Full Text Available Background: As our world becomes more global and competitive yet less predictable, the focus seems to be increasingly on looking to innovation activities to remain competitive. Although there is little doubt that a nation’s competitiveness is embedded in its innovativeness, the complex environment should not be ignored. Complexity is not accounted for in balance sheets or reported in reports; it becomes entrenched in every activity in the organisation. Innovation takes many forms and comes in different shapes.Objectives: The study objectives were, firstly, to establish the determinants for complexity and how these can be addressed from a design point of view in order to ensure innovation success and, secondly, to determine how this changes innovation forms and applications.Method: Two approaches were offered to deal with a complex environment – one allowing for complexity for organisational innovation and the other introducing reductionism to minimise complexity. These approaches were examined in a qualitative study involving case studies, open-ended interviews and content analysis between seven developing economy (South African organisations and seven developed economy (US organisations.Results: This study presented a proposed framework for (organisational innovation in a complex environment versus a framework that minimises complexity. The comparative organisational analysis demonstrated the importance of initiating organisational innovation to address internal and external complexity, with the focus being on the leadership actions, their selected operating models and resultant organisational innovations designs, rather than on technological innovations.Conclusion: This study cautioned the preference for technological innovation within organisations and suggested alternative innovation forms (such as organisational and management innovation be used to remain competitive in a complex environment. 

Assessment of the ARW-WRF model over complex terrain: the case of the Stellenbosch Wine of Origin district of South Africa

Science.gov (United States)

Soltanzadeh, Iman; Bonnardot, Valérie; Sturman, Andrew; Quénol, Hervé; Zawar-Reza, Peyman

2017-08-01

Global warming has implications for thermal stress for grapevines during ripening, so that wine producers need to adapt their viticultural practices to ensure optimum physiological response to environmental conditions in order to maintain wine quality. The aim of this paper is to assess the ability of the Weather Research and Forecasting (WRF) model to accurately represent atmospheric processes at high resolution (500 m) during two events during the grapevine ripening period in the Stellenbosch Wine of Origin district of South Africa. Two case studies were selected to identify areas of potentially high daytime heat stress when grapevine photosynthesis and grape composition were expected to be affected. The results of high-resolution atmospheric model simulations were compared to observations obtained from an automatic weather station (AWS) network in the vineyard region. Statistical analysis was performed to assess the ability of the WRF model to reproduce spatial and temporal variations of meteorological parameters at 500-m resolution. The model represented the spatial and temporal variation of meteorological variables very well, with an average model air temperature bias of 0.1 °C, while that for relative humidity was -5.0 % and that for wind speed 0.6 m s-1. Variation in model performance varied between AWS and with time of day, as WRF was not always able to accurately represent effects of nocturnal cooling within the complex terrain. Variations in performance between the two case studies resulted from effects of atmospheric boundary layer processes in complex terrain under the influence of the different synoptic conditions prevailing during the two periods.

Complex young lives: a collective qualitative case study analysis of young fatherhood and breastfeeding.

Science.gov (United States)

Ayton, Jennifer; Hansen, Emily

2016-01-01

Of all births in Australia, 10 % are to young fathers aged less than 24 years. How young fathers experience any breastfeeding and how this is shaped by their social context is poorly understood. Our aim is to increase understanding of the lived experience of young fathers (aged less than 24 years) and to explore the way they speak about breastfeeding in the context of their lives and parenting. This collective case study analysis uses qualitative data from interviews and focus groups with young fathers (aged less than 24 years) and community support staff. The research was undertaken in Tasmania, Australia, March to December 2013. Young fathers in our study had complex social and emotional circumstances that meant breastfeeding was not a high priority despite them valuing the health benefits of breastfeeding for their babies. If supported by peers and their community they appear to have a more positive parenting experience. Breastfeeding although understood by the young fathers in our study as healthy and desirable is not a priority in their lives. Learning to be a parent and support their partners to breastfeed may be more effectively gained through mentoring and father-to-father localized community based support services.

Complex solutions for generalised fitzhughnagumo equation

International Nuclear Information System (INIS)

Neirameh, A.

2014-01-01

During present investigation, a direct algebraic method on complex solutions of nonlinear partial differential equation is developed and tested in the case of generalized Burgers-Huxley equation. The proposed scheme can be used in a wide class of nonlinear reaction-diffusion equations. These calculations demonstrate that the accuracy of the direct algebraic solutions is quite high even in the case of a small number of grid points. This method is a very reliable, simple, small computation costs, flexible, and convenient alternative method. (author)

Some overdetermined systems of complex partial differential equations

International Nuclear Information System (INIS)

Le Hung Son.

1990-01-01

In this paper we extend some properties of analytic functions on several complex variables to solutions of overdetermined systems of complex partial differential equations. It is proved that many global properties of analytic functions are true for solutions of the Vekua system in special cases. The relation between analytic functions and solutions of quasi-linear systems is discussed in the paper. (author). 8 refs

A complex suicide by vehicle assisted ligature strangulation and wrist-cutting

Directory of Open Access Journals (Sweden)

Ramazan Akçan

2016-12-01

Conclusion: A complete forensic investigation revealed the case was an unusual complex suicide by vehicle assisted ligature strangulation and wrist-cutting. The case was interesting in terms of involving car assisted ligature strangulation.

Border detection in complex networks

International Nuclear Information System (INIS)

Travencolo, Bruno A N; Viana, Matheus Palhares; Costa, Luciano da Fontoura

2009-01-01

One important issue implied by the finite nature of real-world networks regards the identification of their more external (border) and internal nodes. The present work proposes a formal and objective definition of these properties, founded on the recently introduced concept of node diversity. It is shown that this feature does not exhibit any relevant correlation with several well-established complex networks measurements. A methodology for the identification of the borders of complex networks is described and illustrated with respect to theoretical (geographical and knitted networks) as well as real-world networks (urban and word association networks), yielding interesting results and insights in both cases.

Metric for Calculation of System Complexity based on its Connections

Directory of Open Access Journals (Sweden)

João Ricardo Braga de Paiva

2017-02-01

Full Text Available This paper proposes a methodology based on system connections to calculate its complexity. Two study cases are proposed: the dining Chinese philosophers’ problem and the distribution center. Both studies are modeled using the theory of Discrete Event Systems and simulations in different contexts were performed in order to measure their complexities. The obtained results present i the static complexity as a limiting factor for the dynamic complexity, ii the lowest cost in terms of complexity for each unit of measure of the system performance and iii the output sensitivity to the input parameters. The associated complexity and performance measures aggregate knowledge about the system.

Compact complex surfaces with geometric structures related to split quaternions

International Nuclear Information System (INIS)

Davidov, Johann; Grantcharov, Gueo; Mushkarov, Oleg; Yotov, Miroslav

2012-01-01

We study the problem of existence of geometric structures on compact complex surfaces that are related to split quaternions. These structures, called para-hypercomplex, para-hyperhermitian and para-hyperkähler, are analogs of the hypercomplex, hyperhermitian and hyperkähler structures in the definite case. We show that a compact 4-manifold carries a para-hyperkähler structure iff it has a metric of split signature together with two parallel, null, orthogonal, pointwise linearly independent vector fields. Every compact complex surface admitting a para-hyperhermitian structure has vanishing first Chern class and we show that, unlike the definite case, many of these surfaces carry infinite-dimensional families of such structures. We provide also compact examples of complex surfaces with para-hyperhermitian structures which are not locally conformally para-hyperkähler. Finally, we discuss the problem of non-existence of para-hyperhermitian structures on Inoue surfaces of type S 0 and provide a list of compact complex surfaces which could carry para-hypercomplex structures.

Complex Regional Pain Syndrome and Treatment Approaches

Directory of Open Access Journals (Sweden)

Neslihan Gokcen

2013-08-01

Full Text Available Complex Regional Pain Syndrome is a symptom complex including severe pain which is disproportioned by the initiating event. Formerly, it was known as reflex sympathetic dystropy, Sudeck’s atrophy and algoneurodystrophy. There are two types of complex regional pain syndrome (CPRS. CRPS type 1 (Reflex sympathetic dystropy occurs after a minor trauma of the extremities, CRPS type 2 (Causalgia occurs following peripheral nevre injury. Diagnosis is made according to the history, symptoms and physical findings of the patients. Patient education, physical therapy and medical treatment are the most common treatment approaches of complex regional pain syndrome. The aim of this review is to revise the treatment options ofcomplex regional pain syndrome, as well as to overview the new treatment approaches and options for the refractory complex regional pain syndrome cases. [Archives Medical Review Journal 2013; 22(4.000: 514-531

Complexities in building innovation systems : the case of radical medical technologies

NARCIS (Netherlands)

Kukk, P.

2016-01-01

The main goal of this thesis is to facilitate a further understanding of how firms behind innovative technologies deal with different complexities in system-building strategies and the co-dependencies among different technologies, actors and system-building activities, while contributing to the

Complex dynamics

CERN Document Server

Carleson, Lennart

1993-01-01

Complex dynamics is today very much a focus of interest. Though several fine expository articles were available, by P. Blanchard and by M. Yu. Lyubich in particular, until recently there was no single source where students could find the material with proofs. For anyone in our position, gathering and organizing the material required a great deal of work going through preprints and papers and in some cases even finding a proof. We hope that the results of our efforts will be of help to others who plan to learn about complex dynamics and perhaps even lecture. Meanwhile books in the field a. re beginning to appear. The Stony Brook course notes of J. Milnor were particularly welcome and useful. Still we hope that our special emphasis on the analytic side will satisfy a need. This book is a revised and expanded version of notes based on lectures of the first author at UCLA over several \\Vinter Quarters, particularly 1986 and 1990. We owe Chris Bishop a great deal of gratitude for supervising the production of cour...

Invasive Aspergillus niger complex infections in a Belgian tertiary care hospital.

Science.gov (United States)

Vermeulen, E; Maertens, J; Meersseman, P; Saegeman, V; Dupont, L; Lagrou, K

2014-05-01

The incidence of invasive infections caused by the Aspergillus niger species complex was 0.043 cases/10 000 patient-days in a Belgian university hospital (2005-2011). Molecular typing was performed on six available A. niger complex isolates involved in invasive disease from 2010 to 2011, revealing A. tubingensis, which has higher triazole minimal inhibitory concentrations, in five out of six cases. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Productivity? Domain Complexity vs. Tacit Knowledge

DEFF Research Database (Denmark)

Madsen, Erik Skov; Mikkelsen, Lars Lindegaard

This paper discusses productivity in relation to tacit knowledge (which in the paper is regarded as skills, experiences, competences and attitudes) and domain complexity. The study is based on five very different case studies; three studies are conducted in Den¬mark, China, and the Czech Republic...

Rhabdoid and Undifferentiated Phenotype in Renal Cell Carcinoma: Analysis of 32 Cases Indicating a Distinctive Common Pathway of Dedifferentiation Frequently Associated With SWI/SNF Complex Deficiency.

Science.gov (United States)

Agaimy, Abbas; Cheng, Liang; Egevad, Lars; Feyerabend, Bernd; Hes, Ondřej; Keck, Bastian; Pizzolitto, Stefano; Sioletic, Stefano; Wullich, Bernd; Hartmann, Arndt

2017-02-01

Undifferentiated (anaplastic) and rhabdoid cell features are increasingly recognized as adverse prognostic findings in renal cell carcinoma (RCC), but their molecular pathogenesis has not been studied sufficiently. Recent studies identified alterations in the Switch Sucrose nonfermentable (SWI/SNF) chromatin remodeling complex as molecular mechanisms underlying dedifferentiation and rhabdoid features in carcinomas of different organs. We herein have analyzed 32 undifferentiated RCCs having in common an undifferentiated (anaplastic) phenotype, prominent rhabdoid features, or both, irrespective of the presence or absence of conventional RCC component. Cases were stained with 6 SWI/SNF pathway members (SMARCB1, SMARCA2, SMARCA4, ARID1A, SMARCC1, and SMARCC2) in addition to conventional RCC markers. Patients were 20 males and 12 females aged 32 to 85 years (mean, 59). A total of 22/27 patients with known stage presented with ≥pT3. A differentiated component varying from microscopic to major component was detected in 20/32 cases (16 clear cell and 2 cases each chromophobe and papillary RCC). The undifferentiated component varied from rhabdoid dyscohesive cells to large epithelioid to small monotonous anaplastic cells. Variable loss of at least 1 SWI/SNF complex subunit was noted in the undifferentiated/rhabdoid component of 21/32 cases (65%) compared with intact or reduced expression in the differentiated component. A total of 15/17 patients (88%) with follow-up died of metastatic disease (mostly within 1 y). Only 2 patients were disease free at last follow-up (1 and 6 y). No difference in survival, age distribution, or sex was observed between the SWI/SNF-deficient and the SWI/SNF-intact group. This is the first study exploring the role of SWI/SNF deficiency as a potential mechanism underlying undifferentiated and rhabdoid phenotype in RCC. Our results highlight the association between the aggressive rhabdoid phenotype and the SWI/SNF complex deficiency, consistent

Disseminated Mycobacterium avium complex in an immunocompetent host

Directory of Open Access Journals (Sweden)

Joseph M Yabes

2017-01-01

Full Text Available Disseminated Mycobacterium avium complex (DMAC has historically been described in the immunocompromised. The current epidemiologic research suggests that the incidence of nontuberculous mycobacterial infections is increasing. We present a case of DMAC infection manifesting as hepatic granulomas in a 35-year-old immunocompetent female. This case suggests DMAC infection in a patient without traditional epidemiological risk factors.

Quantum-information processing in disordered and complex quantum systems

International Nuclear Information System (INIS)

Sen, Aditi; Sen, Ujjwal; Ahufinger, Veronica; Briegel, Hans J.; Sanpera, Anna; Lewenstein, Maciej

2006-01-01

We study quantum information processing in complex disordered many body systems that can be implemented by using lattices of ultracold atomic gases and trapped ions. We demonstrate, first in the short range case, the generation of entanglement and the local realization of quantum gates in a disordered magnetic model describing a quantum spin glass. We show that in this case it is possible to achieve fidelities of quantum gates higher than in the classical case. Complex systems with long range interactions, such as ions chains or dipolar atomic gases, can be used to model neural network Hamiltonians. For such systems, where both long range interactions and disorder appear, it is possible to generate long range bipartite entanglement. We provide an efficient analytical method to calculate the time evolution of a given initial state, which in turn allows us to calculate its quantum correlations

Simulation of Wind Farms in Flat & Complex terrain using CFD

DEFF Research Database (Denmark)

Prospathopoulos, John; Cabezon, D.; Politis, E.S.

2010-01-01

, the combination of the induction factor method along with the turbulence correction provides satisfactory results. In the complex terrain case, there are some significant discrepancies with the measurements, which are discussed. In this case, the induction factor method does not provide satisfactory results....

Complex eigenvalues for neutron transport equation with quadratically anisotropic scattering

International Nuclear Information System (INIS)

Sjoestrand, N.G.

1981-01-01

Complex eigenvalues for the monoenergetic neutron transport equation in the buckling approximation have been calculated for various combinations of linearly and quadratically anisotropic scattering. The results are discussed in terms of the time-dependent case. Tables are given of complex bucklings for real decay constants and of complex decay constants for real bucklings. The results fit nicely into the pattern of real and purely imaginary eigenvalues obtained earlier. (author)

Terbium and dysprosium complexes luminescence at low temperatures

Energy Technology Data Exchange (ETDEWEB)

Meshkova, S B; Kravchenko, T B; Kononenko, L.I.; Poluehktov, N S [AN Ukrainskoj SSR, Odessa. Fiziko-Khimicheskij Inst.

1979-01-01

The variation is studied of the luminescence intensity of terbium and dysprosium complexes used in the analysis as solutions are cooled down to the liquid nitrogen temperature. Three groups of methods have been studied: observation of fluorescence of aqueous solutions, precipitate and extract suspensions in organic solvents. The brightest luminescence and greatest increase in luminescence intensity are observed at freezing of complex solvents with 1,2-dioxybenzene-3,5-disulfonic acid (DBSA) and iminodiacetic acid (IDA) and DBSA+EDTA, as well as in the case of benzene extracting of complexes with phenanthroline and salicylic acid. Otherwise the intensity increases 2-14-fold and for the complex of terbium with acetoacetic ester 36-fold.

Education research: a case-based bioethics curriculum for neurology residents.

Science.gov (United States)

Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth

2015-03-31

In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.

Acute Inflammatory Demyelinating Neuropathy : Immunoglobulin And Immune Complex Profile

Directory of Open Access Journals (Sweden)

Shripad A

2003-01-01

Full Text Available Serum immunoglobulins (IgG, IgA and IgM and immune complexes IgG (IcG were measured in 58 cases of acute inflammatory demyelinating neuropathy, popularly known as Guillian Barre′ syndrome, and in 30 healthy controls using single radial immunodiffusion assay. Immunoglobulin and immune complex levels were significantly elevated in patients as compared to controls. The increased levels of immunoglobulins and immune complexes may contribute to the pathogenesis of the disease and provide rationale for therapeutic plasmapheresis.

Presurgical EEG-fMRI in a complex clinical case with seizure recurrence after epilepsy surgery

Science.gov (United States)

Zhang, Jing; Liu, Qingzhu; Mei, Shanshan; Zhang, Xiaoming; Wang, Xiaofei; Liu, Weifang; Chen, Hui; Xia, Hong; Zhou, Zhen; Li, Yunlin

2013-01-01

Epilepsy surgery has improved over the last decade, but non-seizure-free outcome remains at 10%–40% in temporal lobe epilepsy (TLE) and 40%–60% in extratemporal lobe epilepsy (ETLE). This paper reports a complex multifocal case. With a normal magnetic resonance imaging (MRI) result and nonlocalizing electroencephalography (EEG) findings (bilateral TLE and ETLE, with more interictal epileptiform discharges [IEDs] in the right frontal and temporal regions), a presurgical EEG-functional MRI (fMRI) was performed before the intraoperative intracranial EEG (icEEG) monitoring (icEEG with right hemispheric coverage). Our previous EEG-fMRI analysis results (IEDs in the left hemisphere alone) were contradictory to the EEG and icEEG findings (IEDs in the right frontal and temporal regions). Thus, the EEG-fMRI data were reanalyzed with newly identified IED onsets and different fMRI model options. The reanalyzed EEG-fMRI findings were largely concordant with those of EEG and icEEG, and the failure of our previous EEG-fMRI analysis may lie in the inaccurate identification of IEDs and wrong usage of model options. The right frontal and temporal regions were resected in surgery, and dual pathology (hippocampus sclerosis and focal cortical dysplasia in the extrahippocampal region) was found. The patient became seizure-free for 3 months, but his seizures restarted after antiepileptic drugs (AEDs) were stopped. The seizures were not well controlled after resuming AEDs. Postsurgical EEGs indicated that ictal spikes in the right frontal and temporal regions reduced, while those in the left hemisphere became prominent. This case suggested that (1) EEG-fMRI is valuable in presurgical evaluation, but requires caution; and (2) the intact seizure focus in the remaining brain may cause the non-seizure-free outcome. PMID:23926432

PET/CT in the complex estimation of the patient after breast cancer therapy - case report

International Nuclear Information System (INIS)

Ziolkowska, E.; Lozynska-Podhrebelna, D.; Zarzycka, M.; Malkowski, B.

2007-01-01

The connection of positron emission tomography (PET) and computer tomography (CT) with the use of FDG is finding wider application to the diagnostics, monitoring and treatment of breast cancer. The use of PET/CT improves the effectiveness of recurrence, metastases to the bones and distant internal organs diagnostics, and in some patients outdistances the presence of lesions which in conventional diagnostic examinations are described considerably later. This work presents the case of a 50-year-old woman with diagnosed breast cancer, after surgery treatment and complementary chemotherapy and radiotherapy. There was a suspicion of local recurrence in postoperative scar (in 18 th month after finished radiotherapy) and the absence of oncocytes in cytological examination in this patient and PET/CT was performed. The recurrence in postoperative scar and signs of dissemination to the bones and the liver was shown in this examination despite the negative tumour marker profile. CT and scintigraphy were performed additionally and they confirmed only the existence of metastatic changes in S1 vertebra and VI rib on the left side. Thanks to PET/CT examination both palliative radiotherapy and chemotherapy were applied immediately. After 5 months the control PET/CT examination was performed which showed a partial response to the applied treatment. The result of the examination and further growth of CA 15-3 marker were reasons for the inclusion of the next two series of chemotherapy. Bone scintigraphy, which was performed after completion of chemotherapy, showed the progression of metastatic changes. The patient was referred for radioisotopic treatment. The introduced case confirms the suitability of PET/CT in the complex assessment of a patient with diagnosed breast cancer. The use of PET/CT is a valuable element of recurrence and dissemination in neoplasmic disease quick diagnostics and directs the ways of the optimum antineoplasmic treatment. (authors)

Association theories for complex thermodynamics

DEFF Research Database (Denmark)

Kontogeorgis, Georgios; Rafiqul Gani

2013-01-01

of this review is two-fold: first to illustrate some of the significant capabilities of these association theories and why indeed they have already been extensively used and are expected to find even more applications in the future. The second and most important aspect of this review is to outline many...... applications. While specialized models can handle different cases, even complex ones, with the advent of powerful theories and computers there is the hope that a single or a few models could be suitable for a general modeling of complex thermodynamics. After more than 100 years with active use of thermodynamic...... models, we have now come to the understanding that simple one-fluid theories like the cubic equations of state or the various forms of local composition models will never be able to model a wide range of complex systems with sufficient accuracy. While various modern approaches have appeared, one very...

Complexities in euthanasia or physician-assisted suicide as perceived by Dutch physicians and patients' relatives.

Science.gov (United States)

Snijdewind, Marianne C; van Tol, Donald G; Onwuteaka-Philipsen, Bregje D; Willems, Dick L

2014-12-01

The practice of euthanasia and physician-assisted suicide (EAS) is always complex, but some cases are more complex than others. The nature of these unusually complex cases is not known. To identify and categorize the characteristics of EAS requests that are more complex than others. We held in-depth interviews with 28 Dutch physicians about their perception of complex cases of EAS requests. We also interviewed 26 relatives of patients who had died by EAS. We used open coding and inductive analysis to identify various different aspects of the complexities described by the participants. Complexities can be categorized into relational difficulties-such as miscommunication, invisible suffering, and the absence of a process of growth toward EAS-and complexities that arise from unexpected situations, such as the capricious progress of a disease or the obligation to move the patient. The interviews showed that relatives of the patient influence the process toward EAS. First, the process toward EAS may be disrupted, causing a complex situation. Second, the course of the process toward EAS is influenced not only by the patient and his/her attending physician but also by the relatives who are involved. Communicating and clarifying expectations throughout the process may help to prevent the occurrence of unusually complex situations. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Thermodynamics of U(VI) and Eu(III) complexation by unsaturated carboxylates

Energy Technology Data Exchange (ETDEWEB)

Rawat, Neetika; Bhattacharyya, A. [Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400085 (India); Tomar, B.S., E-mail: bstomar@barc.gov.in [Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400085 (India); Ghanty, T.K. [Theoretical Chemistry Section, Bhabha Atomic Research Centre, Mumbai 400085 (India); Manchanda, V.K. [Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400085 (India)

2011-05-10

Highlights: {yields} {Delta}H and log K determined for U(VI) and Eu(III) complexes with maleate and fumarate. {yields} log K and coordination environment of Eu(III) complexes has been studied by TRFS. {yields} Higher log K of U(VI) complexes than Eu(III) complexes is due to higher entropy. {yields} Plot of log K vs log K{sub P} suggest charge polarization in fumarate complexes. {yields} Ab initio calculations support charge polarization in fumarate complexes. - Abstract: The thermodynamic parameters ({Delta}G, {Delta}H and {Delta}S) of complexation of U(VI) and Eu(III) by unsaturated dicarboxylic acids, namely, maleic and fumaric acid, has been determined by potentiometric and microcalorimetric titrations at fixed ionic strength (I = 1.0 M) and temperature (298 K). The results show formation of 1:1 complexes by both the ligands with Eu(III). In the case of U(VI), maleate forms both 1:1 and 1:2 complexes, while only 1:1 complex was formed with fumarate. The fluorescence emission spectra of Eu(III)-dicarboxylate solutions at varying ligand to metal ratio were also used to obtain their stability constants. In addition, the fluorescence lifetimes reveal higher dehydration of Eu(III)-maleate compared to Eu(III)-fumarate which corroborates the {Delta}S values. The thermodynamic quantities suggest charge polarization effects in the case of U(VI) and Eu(III) complexes of fumarate, which is further corroborated by theoretical calculations. For the same ligand, U(VI) complexes were found to be more stable which was mainly due to higher entropy term.

Finding optimal interaction interface alignments between biological complexes

KAUST Repository

Cui, Xuefeng

2015-06-13

Motivation: Biological molecules perform their functions through interactions with other molecules. Structure alignment of interaction interfaces between biological complexes is an indispensable step in detecting their structural similarities, which are keys to understanding their evolutionary histories and functions. Although various structure alignment methods have been developed to successfully access the similarities of protein structures or certain types of interaction interfaces, existing alignment tools cannot directly align arbitrary types of interfaces formed by protein, DNA or RNA molecules. Specifically, they require a \\'blackbox preprocessing\\' to standardize interface types and chain identifiers. Yet their performance is limited and sometimes unsatisfactory. Results: Here we introduce a novel method, PROSTA-inter, that automatically determines and aligns interaction interfaces between two arbitrary types of complex structures. Our method uses sequentially remote fragments to search for the optimal superimposition. The optimal residue matching problem is then formulated as a maximum weighted bipartite matching problem to detect the optimal sequence order-independent alignment. Benchmark evaluation on all non-redundant protein-DNA complexes in PDB shows significant performance improvement of our method over TM-align and iAlign (with the \\'blackbox preprocessing\\'). Two case studies where our method discovers, for the first time, structural similarities between two pairs of functionally related protein-DNA complexes are presented. We further demonstrate the power of our method on detecting structural similarities between a protein-protein complex and a protein-RNA complex, which is biologically known as a protein-RNA mimicry case. © The Author 2015. Published by Oxford University Press.

Coordination of a complex welfare system case: rehabilitation entity in Finland.

Science.gov (United States)

Miettinen, Sari; Ashorn, Ulla; Lehto, Juhani; Viitanen, Elina

2011-01-01

The main purpose of this article is to analyse the institutional and political structures of the Finnish rehabilitation entity and the governmental efforts to improve the governance of the rehabilitation policy. Rehabilitation in Finland is a complex welfare system which has undergone several coordination attempts during the last two decades. The centrality of the coordination of this welfare system is obvious. Based on the content analysis of three Government's rehabilitation reports from 1994 to 2002 and their background papers, this article provides two main findings. First, the rehabilitation entity seems to be based on different funding strategies, different governing and different coordination models between the rehabilitation subsystems. Second, the governance discourse in the reports seems to be unchanging with a predominantly hierarchical mode. The article concludes with a discussion on the challenges to coordinate this kind of a complex welfare system as an entity and also how to overcome those challenges. Copyright © 2010 John Wiley & Sons, Ltd.

German Children’s Use of Word Order and Case Marking to Interpret Simple and Complex Sentences: Testing Differences Between Constructions and Lexical Items

Science.gov (United States)

Brandt, Silke; Lieven, Elena; Tomasello, Michael

2016-01-01

ABSTRACT Children and adults follow cues such as case marking and word order in their assignment of semantic roles in simple transitives (e.g., the dog chased the cat). It has been suggested that the same cues are used for the interpretation of complex sentences, such as transitive relative clauses (RCs) (e.g., that’s the dog that chased the cat) (Bates, Devescovi, & D’Amico, 1999). We used a pointing paradigm to test German-speaking 3-, 4-, and 6-year-old children’s sensitivity to case marking and word order in their interpretation of simple transitives and transitive RCs. In Experiment 1, case marking was ambiguous. The only cue available was word order. In Experiment 2, case was marked on lexical NPs or demonstrative pronouns. In Experiment 3, case was marked on lexical NPs or personal pronouns. Whereas the younger children mainly followed word order, the older children were more likely to base their interpretations on the more reliable case-marking cue. In most cases, children from both age groups were more likely to use these cues in their interpretation of simple transitives than in their interpretation of transitive RCs. Finally, children paid more attention to nominative case when it was marked on first-person personal pronouns than when it was marked on third-person lexical NPs or demonstrative pronouns, such as der Löwe ‘the-NOM lion’ or der ‘he-NOM.’ They were able to successfully integrate this case-marking cue in their sentence processing even when it appeared late in the sentence. We discuss four potential reasons for these differences across development, constructions, and lexical items. (1) Older children are relatively more sensitive to cue reliability. (2) Word order is more reliable in simple transitives than in transitive RCs. (3) The processing of case marking might initially be item-specific. (4) The processing of case marking might depend on its saliency and position in the sentence. PMID:27019652

Treatment phases in management of a comprehensive restorative case. A case report

International Nuclear Information System (INIS)

AlSamh, Duaa Abo; Endo, Cert End

2008-01-01

The aim of this case report was to emphasize the value of preforming patient's treatment plan into phases of treatment and encouraging colleagues to apply such phases in the clinical practice for the management of complex restorative cases. Traditional approach to treatment planning has certain merits. However, new treatment approach should improve oral health rather than react to presenting problems and therefore, dentists should aim to convert their irregular attendee to a regular attendee with treatment plan directed to enhance oral health, prevent disease, improve esthetic and free the patient from pain and discomfort. In this report, a complex restorative case of a 16-year-old female patient was managed for comprehensive dental therapy in the form of treatment plan which was divided into phases by way of a ''staircase'' approach with one clinical step being dependent on the previous step. The whole treatment was completed in three months and the results were satisfactory and patient became a highly motivated person with more self-confidence. (author)

Analysis of complex networks using aggressive abstraction.

Energy Technology Data Exchange (ETDEWEB)

Colbaugh, Richard; Glass, Kristin.; Willard, Gerald

2008-10-01

This paper presents a new methodology for analyzing complex networks in which the network of interest is first abstracted to a much simpler (but equivalent) representation, the required analysis is performed using the abstraction, and analytic conclusions are then mapped back to the original network and interpreted there. We begin by identifying a broad and important class of complex networks which admit abstractions that are simultaneously dramatically simplifying and property preserving we call these aggressive abstractions -- and which can therefore be analyzed using the proposed approach. We then introduce and develop two forms of aggressive abstraction: 1.) finite state abstraction, in which dynamical networks with uncountable state spaces are modeled using finite state systems, and 2.) onedimensional abstraction, whereby high dimensional network dynamics are captured in a meaningful way using a single scalar variable. In each case, the property preserving nature of the abstraction process is rigorously established and efficient algorithms are presented for computing the abstraction. The considerable potential of the proposed approach to complex networks analysis is illustrated through case studies involving vulnerability analysis of technological networks and predictive analysis for social processes.

Holographic complexity and noncommutative gauge theory

Science.gov (United States)

Couch, Josiah; Eccles, Stefan; Fischler, Willy; Xiao, Ming-Lei

2018-03-01

We study the holographic complexity of noncommutative field theories. The four-dimensional N=4 noncommutative super Yang-Mills theory with Moyal algebra along two of the spatial directions has a well known holographic dual as a type IIB supergravity theory with a stack of D3 branes and non-trivial NS-NS B fields. We start from this example and find that the late time holographic complexity growth rate, based on the "complexity equals action" conjecture, experiences an enhancement when the non-commutativity is turned on. This enhancement saturates a new limit which is exactly 1/4 larger than the commutative value. We then attempt to give a quantum mechanics explanation of the enhancement. Finite time behavior of the complexity growth rate is also studied. Inspired by the non-trivial result, we move on to more general setup in string theory where we have a stack of D p branes and also turn on the B field. Multiple noncommutative directions are considered in higher p cases.

Preliminary MRI study in patients with congenital complex strabismus

International Nuclear Information System (INIS)

Man Fengyuan; Wang Zhenchang; Zhao Bo; Zhu Lei; Xian Junfang; Wang Shijun; Jiao Yonghong; Wu Xiao; Zhao Kanxing

2009-01-01

Objective: Although the ocular motility examination has been traditionally used in the diagnosis of complex strabismus resulting from cranial nerve (CN) and extraocular muscles (EOM) abnormalities, magnetic resonance imaging (MRI) now permits the direct imaging of lesions in CNs and EOMs. Methods: Twenty-six patients with complex strabismus underwent MRI examination on 1.5 T MR unit (Twinspeed, GE). Nerves to EOMs were imaged with T 1 weighted in orbits in all patients using phase array surface coils. Results: Patients with Duane syndrome (15 cases, 19 eyes) all exhibited absence or hypoplasia of abducens nerve (CN6), always with mild hypoplasia and apparent misdirection of oculomotor nerve (CN3) to the lateral rectus muscle in the orbit, and there were no hypoplasia of EOMs. Patients with congenital fibrosis of EOMs (9 cases, 16 eyes) exhibited severe hypoplasia of CN3 and CN6, and EOMs appeared hypoptasia to a different degree, particularly severe for the superior rectus and levated palpted muscles. Multiple nerves displayed aplasia in patients with Mobius syndrome (1 ease, 2 eyes) and there was abnormal branch from CN3 to lateral rectus. The tendons of bilateral superior oblique muscles were thin in the patients with Brown syndrome (1 case, 2 eyes). Conclusion: MRI can directly demonstrate absence or hypoplasia of CNs and corresponding EOM abnormalities in congenital complex strabismus, which suggests that the mechanism of congenital complex strabismus is perhaps abnormal innervation or displasia of the ocular motor nerves. (authors)

A note on the Lie symmetries of complex partial differential

Indian Academy of Sciences (India)

Folklore suggests that the split Lie-like operators of a complex partial differential equation are symmetries of the split system of real partial differential equations. However, this is not the case generally. We illustrate this by using the complex heat equation, wave equation with dissipation, the nonlinear Burgers equation and ...

Real and complex boson expansions in even-even deformed nuclei

International Nuclear Information System (INIS)

Silvestre-Brac, B.; Piepenbring, R.

1977-01-01

Analysis of real and complex boson expansions of the Kishimoto-Tamura type is performed in a deformed basis in order to allow a further study of the anharmonicities of vibrations in deformed nuclei. It is shown that complex solutions cannot be found in the cases where no real one exists. (Auth.)

Infection with the Mycobacterium avium complex in patients without predisposing conditons: a case report and literature review

Directory of Open Access Journals (Sweden)

Andrea Barral Martins

Full Text Available Nontuberculous Mycobacteria (NTM, especially Mycobacterium avium-intracellulare complex (MAC, has been considered responsible for human disease, especially in HIV patients. Nevertheless, it has been diagnosed in immunocompetent elderly men, frequently with previous pulmonary disease: chronic obstructive lung disease (COPD, complications of tuberculosis, pulmonary fibrosis and bronchiectasis. We relate the case of a female patient, 51 years old, with continuously acid fast bacilli (AFB smears and with three previous treatments, which were conducted at the multiresistant tuberculosis (MRTB service. MAC was identified in the sputum culture, and she received treatment for one year. The posterior sputum exams were negative. The cavity lesions observed in the high-resolution computed tomography (HRCT were reduced, and some of the nodule lesions became bronchiectasis, even after the end of treatment. We agree with the literature reports that indicate that MAC is the cause of bronchiectasis. It is necessary to identify the type of mycobacteria in immunocompetent individuals with positive AFB smears that do not become negative with tuberculosis treatment.

Management of Large Erupting Complex Odontoma in Maxilla

Directory of Open Access Journals (Sweden)

Colm Murphy

2014-01-01

Full Text Available We present the unusual case of a large complex odontoma erupting in the maxilla. Odontomas are benign developmental tumours of odontogenic origin. They are characterized by slow growth and nonaggressive behaviour. Complex odontomas, which erupt, are rare. They are usually asymptomatic and are identified on routine radiograph but may present with erosion into the oral cavity with subsequent cellulitis and facial asymmetry. This present paper describes the presentation and management of an erupting complex odontoma, occupying the maxillary sinus with extension to the infraorbital rim. We also discuss various surgical approaches used to access this anatomic area.

Complexation of thorium with pyridine monocarboxylates: A thermodynamic study by experiment and theory

International Nuclear Information System (INIS)

Rama Mohana Rao, D.; Rawat, Neetika; Manna, D.; Sawant, R.M.; Ghanty, T.K.; Tomar, B.S.

2013-01-01

Highlights: ► The thermodynamic parameters have been determined for the first time. ► The Th-picolinate complexation was exothermic in nature. ► The complexation of Th(IV) with the other two isomers was endothermic process. ► Isonicotinate forms stronger complexes than nicotinate with Th(IV). ► The theoretically calculated values are in line with the experimental results. -- Abstract: Complexation of thorium with pyridine monocarboxylates namely picolinic acid (pyridine-2-carboxylic acid), nicotinic acid (pyridine-3-carboxylic acid) and isonicotinic acid (pyridine-4-carboxylic acid) has been studied by potentiometry and calorimetry to determine the thermodynamic parameters (log K, ΔG, ΔH and ΔS) of complexation. All the studies were carried out at 1.0 M ionic strength adjusted by NaClO 4 and at a temperature of 298 K. The detailed analysis of potentiometric data by Hyperquad confirmed the formation of four complexes, ML i (i = 1–4) in case of picolinate but only one complex (ML) in case of nicotinate and isonicotinate. The stepwise formation constant for ML complex (log K ML ) of thorium-picolinate is higher than those of thorium-nicotinate and thorium-isonicotinate complexes. Further the changes in enthalpy during formation of thorium-picolinate complexes are negative whereas the same for the complexes of thorium with the other two isomers was positive. This difference in the complexation process is attributed to chelate formation in case of thorium-picolinate complexes in which the thorium ion is bound to the picolinate through both the nitrogen in the pyridyl ring and one of the carboxylate oxygen atoms. The complexation process of thorium-nicotinate and thorium-isonicotinate are found to be endothermic in nature and are entropy driven confirming the similar binding nature as in simple carboxylate complexes of thorium. The complexation energies, bond lengths and charges on each atom in the complexes of various possible geometries were calculated

Separation of calcium isotopes with cryptand complexes

International Nuclear Information System (INIS)

Heumann, K.G.; Schiefer, H.P.

1981-01-01

The calcium isotope separation in the liquid-liquid extraction system H 2 O/CHCl 3 is investigated using and cryptands for complex formation as well as without complexing agent. An extraction procedure is used which allows the transfer of larger amounts of calcium in the H 2 O phase. Without complexing agent in the extraction system, enrichment of the lighter calcium isotopes is already evident in the CHCl 3 phase which is just the same as when using cryptand. In the case of cryptand as a complexing agent, the isotope separation is higher. The separation factor is calculated to be a = 1 + epsilon = 1.011 for 40 Ca/ 48 Ca without complexing agent or with cryptand and a = 1.015 in the system with cryptand. For 40 Ca/ 44 Ca the epsilon-value is smaller by nearly a factor of two. These separation factors are the highest which are determined in chemical systems for calcium isotopes. (orig.)

Global Picture Archiving and Communication Systems (GPACS): An Overview

Science.gov (United States)

1994-04-01

depending on state law , hospital policies, and insurance coverage. The problems associated with a film library include lost film, damaged film, slow film...1991), (Jackson and Szasz ,1992), (Kajiwara,1992), (Kao et al.,1992), (Klien and Carney,1991), (Lin and Lu,1991), (Lynch,1985), (Manduca,1992,1992), (Moll...Biomedicine, v37 , 253-258, 1992 Jackson, S., Szasz , I. "The Use of Data Compression in Telecommunication of Nuclear Medicine Images", Proceedings of the

Software complex for geophysical data visualization

Science.gov (United States)

Kryukov, Ilya A.; Tyugin, Dmitry Y.; Kurkin, Andrey A.; Kurkina, Oxana E.

2013-04-01

The effectiveness of current research in geophysics is largely determined by the degree of implementation of the procedure of data processing and visualization with the use of modern information technology. Realistic and informative visualization of the results of three-dimensional modeling of geophysical processes contributes significantly into the naturalness of physical modeling and detailed view of the phenomena. The main difficulty in this case is to interpret the results of the calculations: it is necessary to be able to observe the various parameters of the three-dimensional models, build sections on different planes to evaluate certain characteristics and make a rapid assessment. Programs for interpretation and visualization of simulations are spread all over the world, for example, software systems such as ParaView, Golden Software Surfer, Voxler, Flow Vision and others. However, it is not always possible to solve the problem of visualization with the help of a single software package. Preprocessing, data transfer between the packages and setting up a uniform visualization style can turn into a long and routine work. In addition to this, sometimes special display modes for specific data are required and existing products tend to have more common features and are not always fully applicable to certain special cases. Rendering of dynamic data may require scripting languages that does not relieve the user from writing code. Therefore, the task was to develop a new and original software complex for the visualization of simulation results. Let us briefly list of the primary features that are developed. Software complex is a graphical application with a convenient and simple user interface that displays the results of the simulation. Complex is also able to interactively manage the image, resize the image without loss of quality, apply a two-dimensional and three-dimensional regular grid, set the coordinate axes with data labels and perform slice of data. The

Characterizing complexity in socio-technical systems: a case study of a SAMU Medical Regulation Center.

Science.gov (United States)

Righi, Angela Weber; Wachs, Priscila; Saurin, Tarcísio Abreu

2012-01-01

Complexity theory has been adopted by a number of studies as a benchmark to investigate the performance of socio-technical systems, especially those that are characterized by relevant cognitive work. However, there is little guidance on how to assess, systematically, the extent to which a system is complex. The main objective of this study is to carry out a systematic analysis of a SAMU (Mobile Emergency Medical Service) Medical Regulation Center in Brazil, based on the core characteristics of complex systems presented by previous studies. The assessment was based on direct observations and nine interviews: three of them with regulator of emergencies medical doctor, three with radio operators and three with telephone attendants. The results indicated that, to a great extent, the core characteristics of complexity are magnified) due to basic shortcomings in the design of the work system. Thus, some recommendations are put forward with a view to reducing unnecessary complexity that hinders the performance of the socio-technical system.

Post-prior equivalence for transfer reactions with complex potentials

Science.gov (United States)

Lei, Jin; Moro, Antonio M.

2018-01-01

In this paper, we address the problem of the post-prior equivalence in the calculation of inclusive breakup and transfer cross sections. For that, we employ the model proposed by Ichimura et al. [Phys. Rev. C 32, 431 (1985), 10.1103/PhysRevC.32.431], conveniently generalized to include the part of the cross section corresponding the transfer to bound states. We pay particular attention to the case in which the unobserved particle is left in a bound state of the residual nucleus, in which case the theory prescribes the use of a complex potential, responsible for the spreading width of the populated single-particle states. We see that the introduction of this complex potential gives rise to an additional term in the prior cross-section formula, not present in the usual case of real binding potentials. The equivalence is numerically tested for the 58Ni(d ,p X ) reaction.

Macro-institutional Complexity in Logistics

DEFF Research Database (Denmark)

Wessel, Frederic; Kinra, Aseem; Kotzab, Herbert

2016-01-01

structure and transactional costs, the concept of environmental complexity is applied to the logistics management perspective. Thereby, the impacts which a given framework on a macro-institutional level might have on the situation and leeway in decision-making at the firm (micro) or the supply chain (meso......In this paper, the interlink between the concept of macro-institutional complexity in logistics and the dynamics in the logistics practice of Eastern Europe will be examined. Referring to the importance of different authors having ascribed to the external environmental uncertainty on organizational......) levels will be analysed. Furthermore, a quantitative modelling approach will be presented and exemplified by using the case of logistics infrastructure in Eastern Europe....

Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India

Directory of Open Access Journals (Sweden)

A K Maurya

2012-01-01

Full Text Available Background: Drug-resistant tuberculosis is one of major current challenges to global public health. The transmission of resistant strains is increasing as a burden of multidrug-resistant tuberculosis (MDR-TB patients in extra pulmonary tuberculosis (EPTB cases in India. Aim and Objectives: The aim was to study trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of EPTB in referral hospitals in northern India. Study Design and Setting: A prospectively observational study and referral medical institutions in northern India. Materials and Methods: All EPTB specimens were processed for Ziehl Neelsen staining, BACTEC culture and BACTEC NAP test for Mycobacterium tuberculosis complex. All M. tuberculosis complex isolates were performed for radiometric-based drug susceptibility pattern against streptomycin, isoniazid, rifampicin and ethambutol using the 1% proportion method. Results: We found that 165/756 (20.5% isolates were identified as M. tuberculosis complex by the NAP test. We observed that 39.9% were resistant to first-line antitubercular drugs. The resistance rate was higher in previously treated patients: H (30.3%, R (16.3%, E (15.7% and S (16.3%. MDR-TB was observed in 13.4%, but, in new cases, this was 11.4% and 19.1% of the previously treated patients (P<0.05. Conclusion: MDR-TB is gradually increased in EPTB cases and predominant resistance to previous treated cases of EPTB. The molecular drug sensitivity test (DST method can be an early decision for chemotherapy in MDR-TB patients. The International Standards of TB Care need to be used by the RNTCP and professional medical associations as a tool to improve TB care in the country.

Complex suicide with black powder muzzle loading derringer.

Science.gov (United States)

Hejna, Petr; Šafr, Miroslav; Zátopková, Lenka; Straka, Luboš

2012-09-01

Planned complex suicide is defined as the combination of more than one method of suicide, previously planned by the victim, to prevent failure of the first method. Herein, we present a case of planned complex suicide, committed by a black powder muzzle loading handgun and hanging. A 39-year-old man was found dead in the bathroom of his flat, hanging by the neck with a huge atypical gunshot entrance in the right temporal region of his head with extensive backspatter. The skin defects, as well as soft tissues in the subcutaneous pocket undermining, were heavily burnt. Along the wound canal were multiple bone fragments, and at the end of the path at the left temple was an embedded lead ogival projectile with a cross shaped artificial incision at its tip. The hanging was incomplete. There were no fractures of the hyoid bone and laryngeal cartilages. Cervical muscles and vessels were intact. Simon's sign was negative. Signs of asphyxia were not present. This is the first reported case of complex suicide with a black powder derringer and manipulated projectile.

Report on the Second Workshop on Supporting Complex Search Tasks

DEFF Research Database (Denmark)

Koolen, Marijn; Kamps, Jaap; Bogers, Toine

2017-01-01

There is broad consensus in the field of IR that search is complex in many use cases and applications, both on the Web and in domain-specific collections, and both in our professional and in our daily life. Yet our understanding of complex search tasks, in comparison to simple look up tasks...

Herding Complex Networks

KAUST Repository

Ruf, Sebastian F.

2018-04-12

The problem of controlling complex networks is of interest to disciplines ranging from biology to swarm robotics. However, controllability can be too strict a condition, failing to capture a range of desirable behaviors. Herdability, which describes the ability to drive a system to a specific set in the state space, was recently introduced as an alternative network control notion. This paper considers the application of herdability to the study of complex networks. The herdability of a class of networked systems is investigated and two problems related to ensuring system herdability are explored. The first is the input addition problem, which investigates which nodes in a network should receive inputs to ensure that the system is herdable. The second is a related problem of selecting the best single node from which to herd the network, in the case that a single node is guaranteed to make the system is herdable. In order to select the best herding node, a novel control energy based herdability centrality measure is introduced.

Fast and accurate algorithm for the computation of complex linear canonical transforms.

Science.gov (United States)

Koç, Aykut; Ozaktas, Haldun M; Hesselink, Lambertus

2010-09-01

A fast and accurate algorithm is developed for the numerical computation of the family of complex linear canonical transforms (CLCTs), which represent the input-output relationship of complex quadratic-phase systems. Allowing the linear canonical transform parameters to be complex numbers makes it possible to represent paraxial optical systems that involve complex parameters. These include lossy systems such as Gaussian apertures, Gaussian ducts, or complex graded-index media, as well as lossless thin lenses and sections of free space and any arbitrary combinations of them. Complex-ordered fractional Fourier transforms (CFRTs) are a special case of CLCTs, and therefore a fast and accurate algorithm to compute CFRTs is included as a special case of the presented algorithm. The algorithm is based on decomposition of an arbitrary CLCT matrix into real and complex chirp multiplications and Fourier transforms. The samples of the output are obtained from the samples of the input in approximately N log N time, where N is the number of input samples. A space-bandwidth product tracking formalism is developed to ensure that the number of samples is information-theoretically sufficient to reconstruct the continuous transform, but not unnecessarily redundant.

Tetralogy of Fallot and Hypoplastic Left Heart Syndrome – Complex Clinical Phenotypes Meet Complex Genetic Networks

Science.gov (United States)

Lahm, Harald; Schön, Patric; Doppler, Stefanie; Dreßen, Martina; Cleuziou, Julie; Deutsch, Marcus-André; Ewert, Peter; Lange, Rüdiger; Krane, Markus

2015-01-01

In many cases congenital heart disease (CHD) is represented by a complex phenotype and an array of several functional and morphological cardiac disorders. These malformations will be briefly summarized in the first part focusing on two severe CHD phenotypes, hypoplastic left heart syndrome (HLHS) and tetralogy of Fallot (TOF). In most cases of CHD the genetic origin remains largely unknown, though the complexity of the clinical picture strongly argues against a dysregulation which can be attributed to a single candidate gene but rather suggests a multifaceted polygenetic origin with elaborate interactions. Consistent with this idea, genome-wide approaches using whole exome sequencing, comparative sequence analysis of multiplex families to identify de novo mutations and global technologies to identify single nucleotide polymorphisms, copy number variants, dysregulation of the transcriptome and epigenetic variations have been conducted to obtain information about genetic alterations and potential predispositions possibly linked to the occurrence of a CHD phenotype. In the second part of this review we will summarize and discuss the available literature on identified genetic alterations linked to TOF and HLHS. PMID:26069455

Procuring complex performance

DEFF Research Database (Denmark)

Hartmann, A.; Roehrich, J.; Frederiksen, Lars

2014-01-01

the transition process. Design/methodology/approach – A multiple, longitudinal case study method is used to examine the transition towards PCP. The study deploys rich qualitative data sets by combining semi-structured interviews, focus group meetings and organisational reports and documents. Findings...... and relational challenges they need to master when facing higher levels of performance and infrastructural complexity. Originality/value – The study adds to the limited empirical and conceptual understanding on the nature of long-term public-private interactions in PCP. It contributes through a rare focus...

Complex Strategic Choices

DEFF Research Database (Denmark)

Leleur, Steen

to strategic decision making, Complex Strategic Choices presents a methodology which is further illustrated by a number of case studies and example applications. Dr. Techn. Steen Leleur has adapted previously established research based on feedback and input from various conferences, journals and students...... resulting in new material stemming from and focusing on practical application of a systemic approach. The outcome is a coherent and flexible approach named systemic planning. The inclusion of both the theoretical and practical aspects of systemic planning makes this book a key resource for researchers...

Complex pelvic ring injuries associated with floating knee in a poly-trauma patient: A case report.

Science.gov (United States)

Zhou, Yuebin; Guo, Honggang; Cai, Zhiwei; Zhang, Yuan

2017-12-01

Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO). Our case involved a 45-year-old lady who was hit by a dilapidated building. The patient was anxious, pale and hemodynamically stable at the initial examination. The pelvis was unstable and there were obvious deformities in the left lower extremities. Significant degloved injuries in the left leg were noted. Her radiographs and physical examination verified the above signs. Unstable pelvic fractures, multiple fractures of bilateral lower limbs with floating knee injury, multiple pelvic and rib fractures and multiple degloving injuries and soft tissue contusion formed the characteristics of the multiple-injury. The algorithm of DCO was determined as the treatment. Early simplified procedures such as wound debridement, pelvis fixation, closed reduction and EF of the right shoulder joint, and chest wall fixation were conducted as soon as possible. After a period of time, internal fixations were applied to the fracture sites. The subsequent functional exercise was also conducted in accordance with this algorithm. This patient got recovery after the treatments which were guided by the criterion of DCO. The restoration of limb functional and the quality of life greatly improved. The DCO plays a decisive role in the first aid and follow-up treatment of this patient. The guidelines of management of complex pelvic ring injuries and floating knee should be established by authorities.

When should we test for voltage-gated potassium channel complex antibodies? A retrospective case control study.

Science.gov (United States)

O'Sullivan, B J; Steele, T; Ellul, M A; Kirby, E; Duale, A; Kier, G; Crooks, D; Jacob, A; Solomon, T; Michael, B D

2016-11-01

Patients with voltage-gated potassium channel (VGKC)-complex antibodies are increasingly recognized as having central, peripheral or combined phenotypes. With increasing awareness, more patients are tested and the clinical spectrum is expanding. Consequently, clinicians may be uncertain as to which patients should or should not be tested. Previous studies have identified common clinical features, but none has looked at the usefulness of these in predicting seropositive disease. We conducted a case-control study of patients tested for VGKC-complex antibodies over 10years at a regional tertiary neurology centre determining which clinical/biochemical features were associated with antibody-positive disease. We found a marked increase in the numbers tested, although the percentage positive remained low. Antibody titre was highest in central disease (pVGKC-disease (p=0.01). Seizures were present in 11 (69%) of those with VGKC-disease versus three (18%) without (odds ratio [OR] 10.3, 95% confidence interval [CI]: 2.0-52.7, p=0.005). There was an inverse correlation between the antibody titre and serum sodium. A multivariate model selected seizures and hyponatraemia as predictive of VGKC disease (sensitivity 75% and specificity 82%); faciobrachial dystonic movements were specific but insensitive. Interestingly serum alkaline phosphatase was higher in those with VGKC-disease (p=0.016) and highest in those with peripheral disease (p=0.015). An ALP>70u/L was strongly associated with antibody positivity (OR 4.11 95% CI: 1.43-11.8, p=0.007) with a sensitivity of 74.2%. The presence of seizures, faciobrachial movements, and hyponatraemia should raise suspicion of VGKC-disease; alkaline phosphatase may represent a novel biomarker, particularly in those with peripheral disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

Linking biomedical engineering ethics case study approach and policy.

Science.gov (United States)

Dibrell, William; Dobie, Elizabeth Ann

2007-01-01

In this paper we link bioengineering case study methods to the development of policy. The case study approach to ethics is an excellent way to show the complex nature of practical/moral reasoning. This approach can, however, lead to a kind of overwhelming complexity. The individual nature of each case makes it difficult to identify the most important information and difficult to see what moral considerations are most relevant. In order to make the overwhelming complexity less debilitating, we present a framework for moral decision making derived from suggestions made by W.D. Ross and Virginia Held. Ross articulates the multiple sources of morality and Held deepens the discussion by reminding us of the foundational importance of care and sympathy to our moral natures. We show how to use the notion of prima facie duty and discuss moral conflict. In doing this, we show how the framework, applied to cases, can be of assistance in helping us develop policies and codes of ethics with sufficient plasticity to be useful in the complex world of the bioengineer.

Branchial cleft anomaly, congenital heart disease, and biliary atresia: Goldenhar complex or Lambert syndrome?

Science.gov (United States)

Cohen, J; Schanen, N C

2000-01-01

The features of Goldenhar complex have been well-described and classically include branchial arch abnormalities, epibulbar dermoid and vertebral abnormalities. We have identified an infant with these features in association with complex congenital heart disease and intrahepatic biliary atresia. Although Lambert described an autosomal recessive disorder with an association of biliary atresia and branchial arch abnormalities, none of those cases had epibulbar dermoid. Diagnostic considerations in this case include inclusion of biliary atresia as a new feature in the expanding spectrum of the Goldenhar complex, versus Lambert syndrome with epibulbar dermoid.

Migraine and Complex Regional Pain Syndrome: A Case-Referent Clinical Study

OpenAIRE

Woldeamanuel, Yohannes W.; Cooley, Corinne; Foley-Saldena, Katharine; Cowan, Robert P.

2017-01-01

We studied clinical phenotype differences between migraineurs with CRPS (Mig + CRPS) and those without (Mig − CRPS). Mig + CRPS cases and Mig − CRPS referents aged ≥18 years were enrolled. Diagnosis was made in accordance with International Classification of Headache Disorders-3 beta (ICHD-3 beta) for migraine and Budapest Criteria for CRPS. Migraines both with and without aura were included. A total of 70 Mig + CRPS cases (13% males, mean age 48 years) and 80 Mig − CRPS referents (17% males,...

Descriptional complexity of non-unary self-verifying symmetric difference automata

CSIR Research Space (South Africa)

Marais, Laurette

2017-09-01

Full Text Available Previously, self-verifying symmetric difference automata were defined and a tight bound of 2^n-1-1 was shown for state complexity in the unary case. We now consider the non-unary case and show that, for every n at least 2, there is a regular...

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

Science.gov (United States)

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

Three-dimensional-printed cardiac prototypes aid surgical decision-making and preoperative planning in selected cases of complex congenital heart diseases: Early experience and proof of concept in a resource-limited environment.

Science.gov (United States)

Kappanayil, Mahesh; Koneti, Nageshwara Rao; Kannan, Rajesh R; Kottayil, Brijesh P; Kumar, Krishna

2017-01-01

Three-dimensional. (3D) printing is an innovative manufacturing process that allows computer-assisted conversion of 3D imaging data into physical "printouts" Healthcare applications are currently in evolution. The objective of this study was to explore the feasibility and impact of using patient-specific 3D-printed cardiac prototypes derived from high-resolution medical imaging data (cardiac magnetic resonance imaging/computed tomography [MRI/CT]) on surgical decision-making and preoperative planning in selected cases of complex congenital heart diseases (CHDs). Five patients with complex CHD with previously unresolved management decisions were chosen. These included two patients with complex double-outlet right ventricle, two patients with criss-cross atrioventricular connections, and one patient with congenitally corrected transposition of great arteries with pulmonary atresia. Cardiac MRI was done for all patients, cardiac CT for one; specific surgical challenges were identified. Volumetric data were used to generate patient-specific 3D models. All cases were reviewed along with their 3D models, and the impact on surgical decision-making and preoperative planning was assessed. Accurate life-sized 3D cardiac prototypes were successfully created for all patients. The models enabled radically improved 3D understanding of anatomy, identification of specific technical challenges, and precise surgical planning. Augmentation of existing clinical and imaging data by 3D prototypes allowed successful execution of complex surgeries for all five patients, in accordance with the preoperative planning. 3D-printed cardiac prototypes can radically assist decision-making, planning, and safe execution of complex congenital heart surgery by improving understanding of 3D anatomy and allowing anticipation of technical challenges.

Satisfying positivity requirement in the Beyond Complex Langevin approach

Directory of Open Access Journals (Sweden)

Wyrzykowski Adam

2018-01-01

Full Text Available The problem of finding a positive distribution, which corresponds to a given complex density, is studied. By the requirement that the moments of the positive distribution and of the complex density are equal, one can reduce the problem to solving the matching conditions. These conditions are a set of quadratic equations, thus Groebner basis method was used to find its solutions when it is restricted to a few lowest-order moments. For a Gaussian complex density, these approximate solutions are compared with the exact solution, that is known in this special case.

Satisfying positivity requirement in the Beyond Complex Langevin approach

Science.gov (United States)

Wyrzykowski, Adam; Ruba, Błażej Ruba

2018-03-01

The problem of finding a positive distribution, which corresponds to a given complex density, is studied. By the requirement that the moments of the positive distribution and of the complex density are equal, one can reduce the problem to solving the matching conditions. These conditions are a set of quadratic equations, thus Groebner basis method was used to find its solutions when it is restricted to a few lowest-order moments. For a Gaussian complex density, these approximate solutions are compared with the exact solution, that is known in this special case.

Spinor formalism and complex-vector formalism of general relativity

International Nuclear Information System (INIS)

Han-ying, G.; Yong-shi, W.; Gendao, L.

1974-01-01

In this paper, using E. Cartan's exterior calculus, we give the spinor form of the structure equations, which leads naturally to the Newman--Penrose equations. Furthermore, starting from the spinor spaces and the el (2C) algebra, we construct the general complex-vector formalism of general relativity. We find that both the Cahen--Debever--Defrise complex-vector formalism and that of Brans are its special cases. Thus, the spinor formalism and the complex-vector formalism of general relativity are unified on the basis of the uni-modular group SL(2C) and its Lie algebra

Observation-Driven Configuration of Complex Software Systems

Science.gov (United States)

Sage, Aled

2010-06-01

The ever-increasing complexity of software systems makes them hard to comprehend, predict and tune due to emergent properties and non-deterministic behaviour. Complexity arises from the size of software systems and the wide variety of possible operating environments: the increasing choice of platforms and communication policies leads to ever more complex performance characteristics. In addition, software systems exhibit different behaviour under different workloads. Many software systems are designed to be configurable so that policies can be chosen to meet the needs of various stakeholders. For complex software systems it can be difficult to accurately predict the effects of a change and to know which configuration is most appropriate. This thesis demonstrates that it is useful to run automated experiments that measure a selection of system configurations. Experiments can find configurations that meet the stakeholders' needs, find interesting behavioural characteristics, and help produce predictive models of the system's behaviour. The design and use of ACT (Automated Configuration Tool) for running such experiments is described, in combination a number of search strategies for deciding on the configurations to measure. Design Of Experiments (DOE) is discussed, with emphasis on Taguchi Methods. These statistical methods have been used extensively in manufacturing, but have not previously been used for configuring software systems. The novel contribution here is an industrial case study, applying the combination of ACT and Taguchi Methods to DC-Directory, a product from Data Connection Ltd (DCL). The case study investigated the applicability of Taguchi Methods for configuring complex software systems. Taguchi Methods were found to be useful for modelling and configuring DC- Directory, making them a valuable addition to the techniques available to system administrators and developers.

HEADROOM BEYOND THE QUALITY- ADJUSTED LIFE-YEAR: THE CASE OF COMPLEX PEDIATRIC NEUROLOGY.

Science.gov (United States)

van Nimwegen, Kirsten J M; Lilford, Richard J; van der Wilt, Gert J; Grutters, Janneke P C

2017-01-01

The headroom method was introduced for the very early evaluation of the potential value of new technologies. It allows for establishing a ceiling price for technologies to still be cost-effective by combining the maximum effect a technology might yield, the maximum willingness-to-pay (WTP) for this effect, and potential downstream expenses and savings. Although the headroom method is QALY-based, not all innovations are expected to result in QALY gain. This study explores the feasibility and usefulness of the headroom method in the evaluation of technologies that are unlikely to result in QALY gain. This will be illustrated with the diagnostic trajectory of complex pediatric neurology (CPN). Our headroom analysis showed a large room for improvement in the current diagnostic trajectory of CPN in terms of diagnostic yield. Combining this with a maximum WTP value for an additional diagnosis and the potential downstream expenses and savings, resulted in a total headroom of €15,028. This indicates that a new technology in this particular diagnostic trajectory, might be cost-effective as long as its costs do not exceed €15,028. The headroom method seems a useful tool in the very early evaluation of medical technologies, also in cases when immediate QALY gain is unlikely. It allows for allocating healthcare resources to those technologies that are most promising. It should be kept in mind, however, that the headroom assumes an optimistic scenario, and for that reason cannot guarantee future cost-effectiveness. It might be most useful for ruling out those technologies that are unlikely to be cost-effective.

Low-Complexity Full-Diversity Detection in Two-User MIMO X Channels

KAUST Repository

Ismail, Amr

2014-01-26

Several interference cancellation (IC) schemes have been recently proposed to suppress multi-user interference for various network configurations (e.g., multiple access and X channels). However, most of these schemes trade-off diversity for implementation complexity or vice-versa. In this paper, we propose a full-diversity interference cancellation scheme in a multiple-input multiple-output (MIMO) X channel with two sources and two destinations while maintaining low decoding complexity. We provide sufficient conditions for a wide range of space-time block codes (STBCs) to achieve full-diversity gain under the so-called partial interference cancellation group decoding (PICGD) in the configuration of interest. A systematic construction is then proposed to achieve full-diversity. The constructed scheme is compared to recently proposed IC scheme in terms of performance and decoding complexity. Our IC scheme outperforms the recently proposed scheme in the case it provides higher transmission rate, while it loses slightly in the case of equal rates. In terms of decoding complexity, both schemes are equivalent.

Low-Complexity Full-Diversity Detection in Two-User MIMO X Channels

KAUST Repository

Ismail, Amr; Abediseid, Walid; Alouini, Mohamed-Slim

2014-01-01

Several interference cancellation (IC) schemes have been recently proposed to suppress multi-user interference for various network configurations (e.g., multiple access and X channels). However, most of these schemes trade-off diversity for implementation complexity or vice-versa. In this paper, we propose a full-diversity interference cancellation scheme in a multiple-input multiple-output (MIMO) X channel with two sources and two destinations while maintaining low decoding complexity. We provide sufficient conditions for a wide range of space-time block codes (STBCs) to achieve full-diversity gain under the so-called partial interference cancellation group decoding (PICGD) in the configuration of interest. A systematic construction is then proposed to achieve full-diversity. The constructed scheme is compared to recently proposed IC scheme in terms of performance and decoding complexity. Our IC scheme outperforms the recently proposed scheme in the case it provides higher transmission rate, while it loses slightly in the case of equal rates. In terms of decoding complexity, both schemes are equivalent.

On Complex Nuclei Energetics in LENR

Science.gov (United States)

Miley, George H.; Hora, Heinz

2005-03-01

Swimming Electron Layer (SEL) theory plus fission of ``complex nuclei'' were proposed earlier to explain reaction products observed in electrolysis with multi-layer thin-film metallic electrodesootnotetext1.G.H. Miley, and J.A. Patterson, J. New Energy, Vol. 1, pp.11-15, (1996).. SEL was then extended to treat gas-diffusion driven transmutation experimentsootnotetextG. H. Miley and H. Hora, ``Nuclear Reactions in Solids,'' APS DNP Mtg., East Lansing, MI, Oct (2002).. It is also consistent with measured charged-particle emission during thin-film electrolysis and x-ray emission during plasma bombardment experimentsootnotetextA. Karabut, ``X-ray emission in high-current glow discharge,'' Proc., ICCF-9, Beijing China, May (2002).. The binding energy per complex nucleon can be estimated by an energy balance combined with identification of products for each complex e.g. complexes of A 39 have ˜ 0.05 MeV/Nucleon, etc, in thin film electrolysis. Energies in gas diffusion experiments are lower due to the reduced trap site potential at the multi-atom surface. In the case of x-ray emission, complexes involve subsurface defect center traps, giving only a few keV/Nucleon, consistent with experiments^3.

Collaboration, communication and categorical complexity: A case study in collaboratory evaluation

DEFF Research Database (Denmark)

Cleal, B.R.; Andersen, H.H.K.; Albrechtsen, H.

2004-01-01

This article presents findings from an empirical evaluation of a collaboratory supporting film research. Few collaboratories have been formally evaluated. The article makes a case for looking at wider work-based contexts users engage in. Focussing on key features of the prototype system, it is sh......This article presents findings from an empirical evaluation of a collaboratory supporting film research. Few collaboratories have been formally evaluated. The article makes a case for looking at wider work-based contexts users engage in. Focussing on key features of the prototype system...

INVESTIGATION OF INFLUENCE OF ENCODING FUNCTION COMPLEXITY ON DISTRIBUTION OF ERROR MASKING PROBABILITY

Directory of Open Access Journals (Sweden)

A. B. Levina

2016-03-01

Full Text Available Error detection codes are mechanisms that enable robust delivery of data in unreliable communication channels and devices. Unreliable channels and devices are error-prone objects. Respectively, error detection codes allow detecting such errors. There are two classes of error detecting codes - classical codes and security-oriented codes. The classical codes have high percentage of detected errors; however, they have a high probability to miss an error in algebraic manipulation. In order, security-oriented codes are codes with a small Hamming distance and high protection to algebraic manipulation. The probability of error masking is a fundamental parameter of security-oriented codes. A detailed study of this parameter allows analyzing the behavior of the error-correcting code in the case of error injection in the encoding device. In order, the complexity of the encoding function plays an important role in the security-oriented codes. Encoding functions with less computational complexity and a low probability of masking are the best protection of encoding device against malicious acts. This paper investigates the influence of encoding function complexity on the error masking probability distribution. It will be shownthat the more complex encoding function reduces the maximum of error masking probability. It is also shown in the paper that increasing of the function complexity changes the error masking probability distribution. In particular, increasing of computational complexity decreases the difference between the maximum and average value of the error masking probability. Our resultshave shown that functions with greater complexity have smoothed maximums of error masking probability, which significantly complicates the analysis of error-correcting code by attacker. As a result, in case of complex encoding function the probability of the algebraic manipulation is reduced. The paper discusses an approach how to measure the error masking

Formation, clearance, deposition, pathogenicity, and identification of biopharmaceutical-related immune complexes: review and case studies.

Science.gov (United States)

Rojko, Jennifer L; Evans, Mark G; Price, Shari A; Han, Bora; Waine, Gary; DeWitte, Mark; Haynes, Jill; Freimark, Bruce; Martin, Pauline; Raymond, James T; Evering, Winston; Rebelatto, Marlon C; Schenck, Emanuel; Horvath, Christopher

2014-06-01

Vascular inflammation, infusion reactions, glomerulopathies, and other potentially adverse effects may be observed in laboratory animals, including monkeys, on toxicity studies of therapeutic monoclonal antibodies and recombinant human protein drugs. Histopathologic and immunohistochemical (IHC) evaluation suggests these effects may be mediated by deposition of immune complexes (ICs) containing the drug, endogenous immunoglobulin, and/or complement components in the affected tissues. ICs may be observed in glomerulus, blood vessels, synovium, lung, liver, skin, eye, choroid plexus, or other tissues or bound to neutrophils, monocytes/macrophages, or platelets. IC deposition may activate complement, kinin, and/or coagulation/fibrinolytic pathways and result in a systemic proinflammatory response. IC clearance is biphasic in humans and monkeys (first from plasma to liver and/or spleen, second from liver or spleen). IC deposition/clearance is affected by IC composition, immunomodulation, and/or complement activation. Case studies are presented from toxicity study monkeys or rats and indicate IHC-IC deposition patterns similar to those predicted by experimental studies of IC-mediated reactions to heterologous protein administration to monkeys and other species. The IHC-staining patterns are consistent with findings associated with generalized and localized IC-associated pathology in humans. However, manifestations of immunogenicity in preclinical species are generally not considered predictive to humans. © 2014 by The Author(s).

Wilm′s tumour with WAGR complex.

OpenAIRE

Mathur P; Khamesera H; Pendse A; Chittora R; Porewal K

1996-01-01

WAGR Syndrome is an acronym for a rare constellation of congenital abnormalities which include Wilms′ tumor, Aniridia, Genito-urinary malformations and mental Retardation. Fewer than fifty patients of this complex have been described in the literature. We report a case of WAGR syndrome, with Stage-IV Wilms′ tumor and intracaval extension, treated by multimodal therapy.

Complex and compound odontomas: Analysis of 69 cases and a ...

African Journals Online (AJOL)

2015-02-26

Feb 26, 2015 ... The treatment of choice is surgical removal of the odontoma. In the case of odontomas associated to impacted teeth, the teeth should be preserved in wait of spontaneous ... listed by the World Health Organization in 1992.

Spectrochemical study on different ligand neodymium complexes

International Nuclear Information System (INIS)

Khomenko, V.S.; Lozinskij, M.O.; Fialkov, Yu.A.; Krasovskaya, L.I.; Rasshinina, T.A.; AN Ukrainskoj SSR, Kiev. Inst. Organicheskoj Khimii)

1986-01-01

A series of new adducts of neodymium complexes with 1, 1, 1, 5, 5, 5-hexafluoropentadione - 2, 4 and 2-heptafluoropropoxy-1, 1, 1, 2-tetrafluoro-5-phenylpentadione-3, 5: Nd(HFPTFPhPD) 3 x2H 2 O, Nd(HFPTFPhPD) 3 xDipy, Nd(HFPTFPhPD) 3 xPhen, Nd(HFPTFPhPD) 3 xDphen, Nd(HFA) 3 x2H 2 O, Nd(HFA) 3 xDipy, Nd(HFA) 3 xPhen, Nd(HFA) 3 xDphen, have been synthesized. Ways of their fragmentation under electron impact are established. Bond strength of additional ligands with central atom in the complexes studied is evaluated. Data on decomposition mechanisms of bicharged ions have been obtained for the first time. Addition of bis-heterocycles to neodymium three-ligand complexes changes the properties of the complexes - their thermal stability and photochemical stability increase, in certain cases their volatility increases

Colonization of a Central Venous Catheter by the Hyaline Fungus Fusarium solani Species Complex: A Case Report and SEM Imaging

Directory of Open Access Journals (Sweden)

Alberto Colombo

2013-01-01

Full Text Available The incidence of opportunistic infections by filamentous fungi is increasing partly due to the widespread use of central venous catheters (CVC, indwelling medical devices, and antineoplastic/immunosuppressive drugs. The case of a 13-year-old boy under treatment for acute lymphoblastic leukemia is presented. The boy was readmitted to the Pediatric Ward for intermittent fever of unknown origin. Results of blood cultures drawn from peripheral venous sites or through the CVC were compared. CVC-derived bottles (but not those from peripheral veins yielded hyaline fungi that, based on morphology, were identified as belonging to the Fusarium solani species complex. Gene amplification and direct sequencing of the fungal ITS1 rRNA region and the EF-1alpha gene confirmed the isolate as belonging to the Fusarium solani species complex. Portions of the CVC were analyzed by scanning electron microscopy. Fungi mycelia with long protruding hyphae were seen into the lumen. The firm adhesion of the fungal formation to the inner surface of the catheter was evident. In the absence of systemic infection, catheter removal and prophylactic voriconazole therapy were followed by disappearance of febrile events and recovery. Thus, indwelling catheters are prone to contamination by environmental fungi.

3-Dimensional computed tomography imaging of the ring-sling complex with non-operative survival case in a 10-year-old female.

Science.gov (United States)

Fukuda, Hironobu; Imataka, George; Drago, Fabrizio; Maeda, Kosaku; Yoshihara, Shigemi

2017-09-01

We report a case of a 10-year-old female patient who survived ring-sling complex without surgery. The patient had congenital wheezing from the neonatal period and was treated after a tentative diagnosis of infantile asthma. The patient suffered from allergy and was hospitalized several times due to severe wheezing, and when she was 22 months old, she was diagnosed with ring-sling complex. We used a segmental 4 mm internal diameter of the trachea for 3-dimensional computed tomography (3D-CT). Bronchial asthma is considered an exacerbating factor in infantile period and frequently required treatment with bronchodilator. After the age of 10, the patient had recurrent breathing difficulties during physical activity and during night time, and this condition was assessed to be related to the pressure from the blood vessel on the ring. We repeated the 3D-CT evaluation later and discovered that the internal diameter of the trachea had grown to 5 mm. Eventually, patient's breathing difficulties disappeared after the treatment of bronchial asthma and restriction of physical activities. Our patient remained in stable condition without undergoing any surgical procedures even after she passed the age of 10.

Pulsed Radiofrequency of Dorsal Root Ganglia for the Treatment of Complex Regional Pain Syndrome in an Adolescent with Poliomyelitis Sequel: A Case Report.

Science.gov (United States)

Apiliogullari, Seza; Aydin, Bahattin Kerem; Onal, Ozkan; Kirac, Yunus; Celik, Jale Bengi

2015-07-01

Complex regional pain syndrome (CRPS) is a painful and disabling syndrome in which the patient presents with neuropathic pain, edema, or vasomotor or pseudomotor abnormalities that are often refractory to treatment. Polio paralysis is caused by the damage or destruction of motor neurons in the spine, which lead to corresponding muscle paralysis. This report is a case report on the application of a pulsed radiofrequency (PRF) current to dorsal root ganglia (DRG) for the treatment of CRPS type 1 in an adolescent patient. Single case report. Selcuk University Hospital. A 16-year-old girl who suffered from CRPS type 1 secondary to surgeries for the sequelae of poliomyelitis. PRF current application to the lumbar 4 and lumbar 5 DRG. Pain reduction. The patient had complete resolution of her symptoms, which was maintained at a 6-month follow-up. This case illustrates that PRF applied to lumbar 4 and lumbar 5 DRG may play a significant role in CRPS type 1 management after the surgical treatment of poliomyelitis sequelae in adolescent patients. Further randomized, controlled studies are needed to support this argument. Wiley Periodicals, Inc.

Assisted reproductive techniques and risk of exstrophy-epispadias complex: a German case-control study.

Science.gov (United States)

Zwink, Nadine; Jenetzky, Ekkehart; Hirsch, Karin; Reifferscheid, Peter; Schmiedeke, Eberhard; Schmidt, Dominik; Reckin, Sabrina; Obermayr, Florian; Boemers, Thomas M; Stein, Raimund; Reutter, Heiko; Rösch, Wolfgang H; Brenner, Hermann; Ebert, Anne-Karoline

2013-04-01

We assessed the risk of exstrophy-epispadias complex in children conceived by in vitro fertilization or intracytoplasmic sperm injection. Data from the German Network for Congenital Uro-REctal malformations were compared to nationwide data from the German In Vitro Fertilization Register and the German Federal Statistical Office. Odds ratios (95% CI) were determined to quantify associations using logistic regression. A total of 123 patients with exstrophy-epispadias complex born in Germany between 1997 and 2011 were recruited through participating departments of pediatric urology and pediatric surgery throughout the country as well as the German self-help organizations Blasenekstrophie/Epispadie e.V. and Kloakenekstrophie. All German live births (10,069,986) between 1997 and 2010 comprised the controls. Overall, 12 subjects (10%) and 129,982 controls (1%) were conceived by in vitro fertilization or intracytoplasmic sperm injection. Conception by assisted reproductive technique was associated with a more than eightfold increased risk of exstrophy-epispadias complex compared to spontaneous conception (OR 8.3, 95% CI 4.6-15.0, p risk of exstrophy-epispadias complex in children conceived by in vitro fertilization (OR 14.0, 95% CI 6.5-30.0, p study provides evidence that assisted reproductive techniques such as in vitro fertilization and intracytoplasmic sperm injection are associated with a markedly increased risk of having a child born with exstrophy-epispadias complex. However, it remains unclear whether this finding may be due to assisted reproduction per se and/or underlying infertility/subfertility etiology or parent characteristics. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The Hidden Complexity of Mendelian Traits across Natural Yeast Populations

Directory of Open Access Journals (Sweden)

Jing Hou

2016-07-01

Full Text Available Mendelian traits are considered to be at the lower end of the complexity spectrum of heritable phenotypes. However, more than a century after the rediscovery of Mendel’s law, the global landscape of monogenic variants, as well as their effects and inheritance patterns within natural populations, is still not well understood. Using the yeast Saccharomyces cerevisiae, we performed a species-wide survey of Mendelian traits across a large population of isolates. We generated offspring from 41 unique parental pairs and analyzed 1,105 cross/trait combinations. We found that 8.9% of the cases were Mendelian. Further tracing of causal variants revealed background-specific expressivity and modified inheritances, gradually transitioning from Mendelian to complex traits in 30% of the cases. In fact, when taking into account the natural population diversity, the hidden complexity of traits could be substantial, confounding phenotypic predictability even for simple Mendelian traits.

The Use of Best Practice in the Treatment of a Complex Diabetic Foot Ulcer: A Case Report

Directory of Open Access Journals (Sweden)

Melodie Blakely

2016-03-01

Full Text Available Background and Purpose: Published guidelines for effective management of diabetic foot ulcers (DFU include total contact casting (TCC. The purpose of this case study is to describe the application of best practice guidelines for the treatment of a diabetic foot ulcer (DFU in a complex patient where TCC offloading could not be utilized. Case Description: The patient was a 47 year-old female with a five-plus year history of a full-thickness DFU on the left plantar mid-foot. Treatment included sharp and ultrasound debridement, the use of a silver hydrofiber dressing, edema management via compression therapy, negative pressure wound therapy, offloading via customized 1/4 inch adhesive-backed felt applied to the plantar foot in addition to an offloading boot and use of a wheelchair, patient education regarding diabetes management, and the application of a bilayered living skin-equivalent biologic dressing. Outcomes: At 15 weeks the wound was closed and the patient was transitioned into diabetic footwear. Discussion: The felt offloading was a beneficial alternative to TCC. The patient’s longer than average healing rate may have been complicated by the duration of her wound, her 41 year history of diabetes, and the fact that gold standard offloading (TCC was not able to be used. Further research is needed regarding the use of felt for offloading, such as application technique for wounds on different areas of the foot, comparison of different types of felt, and the use of felt in conjunction with various offloading devices.

Environmental management on the basis of Complex Regional Indicators Concept: case of the Murmansk region

Science.gov (United States)

Kozlov, A.; Gutman, S.; Zaychenko, I.; Rytova, E.; Nijinskaya, P.

2015-09-01

The article presents an approach to sustainable environmental development of the Murmansk region of the Russian Federation based on the complex regional indicators as a transformation of a balance scorecard method. The peculiarities of Murmansk region connected with sustainable environmental development are described. The complex regional indicators approach allows to elaborate the general concept of complex regional development taking into consideration economic and non-economic factors with the focus on environmental aspects, accumulated environmental damage in particular. General strategic chart of sustainable environmental development of the Murmansk region worked out on the basis of complex regional indicators concept is composed. The key target indicators of sustainable ecological development of the Murmansk region are presented for the following strategic chart components: regional finance; society and market; industry and entrepreneurship; training, development and innovations. These charts are to be integrated with international environmental monitoring systems.

Multilevel Complex Networks and Systems

Science.gov (United States)

Caldarelli, Guido

2014-03-01

Network theory has been a powerful tool to model isolated complex systems. However, the classical approach does not take into account the interactions often present among different systems. Hence, the scientific community is nowadays concentrating the efforts on the foundations of new mathematical tools for understanding what happens when multiple networks interact. The case of economic and financial networks represents a paramount example of multilevel networks. In the case of trade, trade among countries the different levels can be described by the different granularity of the trading relations. Indeed, we have now data from the scale of consumers to that of the country level. In the case of financial institutions, we have a variety of levels at the same scale. For example one bank can appear in the interbank networks, ownership network and cds networks in which the same institution can take place. In both cases the systemically important vertices need to be determined by different procedures of centrality definition and community detection. In this talk I will present some specific cases of study related to these topics and present the regularities found. Acknowledged support from EU FET Project ``Multiplex'' 317532.

Noether charge, black hole volume, and complexity

Energy Technology Data Exchange (ETDEWEB)

Couch, Josiah; Fischler, Willy; Nguyen, Phuc H. [Theory Group, Department of Physics and Texas Cosmology Center,University of Texas at Austin, 2515 Speedway, C1600, Austin, TX 78712-1192 (United States)

2017-03-23

In this paper, we study the physical significance of the thermodynamic volumes of AdS black holes using the Noether charge formalism of Iyer and Wald. After applying this formalism to study the extended thermodynamics of a few examples, we discuss how the extended thermodynamics interacts with the recent complexity = action proposal of Brown et al. (CA-duality). We, in particular, discover that their proposal for the late time rate of change of complexity has a nice decomposition in terms of thermodynamic quantities reminiscent of the Smarr relation. This decomposition strongly suggests a geometric, and via CA-duality holographic, interpretation for the thermodynamic volume of an AdS black hole. We go on to discuss the role of thermodynamics in complexity = action for a number of black hole solutions, and then point out the possibility of an alternate proposal, which we dub “complexity = volume 2.0'. In this alternate proposal the complexity would be thought of as the spacetime volume of the Wheeler-DeWitt patch. Finally, we provide evidence that, in certain cases, our proposal for complexity is consistent with the Lloyd bound whereas CA-duality is not.

Reliability Standards of Complex Engineering Systems

Science.gov (United States)

Galperin, E. M.; Zayko, V. A.; Gorshkalev, P. A.

2017-11-01

Production and manufacture play an important role in today’s modern society. Industrial production is nowadays characterized by increased and complex communications between its parts. The problem of preventing accidents in a large industrial enterprise becomes especially relevant. In these circumstances, the reliability of enterprise functioning is of particular importance. Potential damage caused by an accident at such enterprise may lead to substantial material losses and, in some cases, can even cause a loss of human lives. That is why industrial enterprise functioning reliability is immensely important. In terms of their reliability, industrial facilities (objects) are divided into simple and complex. Simple objects are characterized by only two conditions: operable and non-operable. A complex object exists in more than two conditions. The main characteristic here is the stability of its operation. This paper develops the reliability indicator combining the set theory methodology and a state space method. Both are widely used to analyze dynamically developing probability processes. The research also introduces a set of reliability indicators for complex technical systems.

Development and evaluation of the process for final placement application: a review of the new student led allocation system

OpenAIRE

Mason, Rachael; Brackenbury, Debra; Broady, Sophie

2016-01-01

Background A process to facilitate nursing students to have more ownership of their final placement was introduced for this academic year by inviting them to apply for a specific placement they felt most appropriate. Whilst there has been significant research into preparing students for practice (Woods et al, 2015) and to explore the transition from student to graduate nurse (Kumaran and Carney, 2014), there is little to explore the effect of gaining preference for their final placement or...

Complex Toda theories and twisted reality conditions

International Nuclear Information System (INIS)

Evans, J.M.

1993-01-01

The Toda equations (based on a finite-dimensional or affine Lie algebra of superalgebra) are discussed as integrable non-linear differential equations for a set of complex scalar fields. We show that such complex Toda fields can either be restricted to take real values in the standard way or else they can be subjected to a 'twisted' reality condition associated to any Z 2 symmetry of the Cartan matrix or Dynkin diagram of the underlying algebra. Different reality conditions give rise to different lagrangian field theories. In the conformal case, however, these theories have the same central charge, while in the affine case they have the same mass spectrum. The construction of N=2 superconformal theories based on the superalgebras A(n, n-1) is clarified, and a new class of conformal field theories with positive kinetic energy based on the superalgebras C(n) is presented. The ideas developed are also relevant to understanding solition solutions in affine Toda theories with imaginary coupling constant. (orig.)

Use of Aromatase Inhibitors in Large Cell Calcifying Sertoli Cell Tumors: Effects on Gynecomastia, Growth Velocity, and Bone Age

Science.gov (United States)

Crocker, Melissa K.; Gourgari, Evgenia; Stratakis, Constantine A.

2014-01-01

Context: Large cell calcifying Sertoli cell tumors (LCCSCT) present in isolation or, especially in children, in association with Carney Complex (CNC) or Peutz-Jeghers Syndrome (PJS). These tumors overexpress aromatase (CYP19A1), which leads to increased conversion of delta-4-androstenedione to estrone and testosterone to estradiol. Prepubertal boys may present with growth acceleration, advanced bone age, and gynecomastia. Objective: To investigate the outcomes of aromatase inhibitor therapy (AIT) in prepubertal boys with LCCSCTs. Design: Case series of a very rare tumor and chart review of cases treated at other institutions. Setting: Tertiary care and referral center. Patients: Six boys, five with PJS and one with CNC, were referred to the National Institutes of Health for treatment of LCCSCT. All patients had gynecomastia, testicular enlargement, and advanced bone ages, and were being treated by their referring physicians with AIT. Interventions: Patients were treated for a total of 6–60 months on AIT. Main Outcome Measures: Height, breast tissue mass, and testicular size were all followed; physical examination, scrotal ultrasounds, and bone ages were obtained, and hormonal concentrations and tumor markers were measured. Results: Tumor markers were negative. All patients had decreases in breast tissue while on therapy. Height percentiles declined, and predicted adult height moved closer to midparental height as bone age advancement slowed. Testicular enlargement stabilized until entry into central puberty. Only one patient required unilateral orchiectomy. Conclusions: Patients with LCCSCT benefit from AIT with reduction and/or elimination of gynecomastia and slowing of linear growth and bone age advancement. Further study of long-term outcomes and safety monitoring are needed but these preliminary data suggest that mammoplasty and/or orchiectomy may be foregone in light of the availability of medical therapy. PMID:25226294

Case Study of High-Dose Ketamine for Treatment of Complex Regional Pain Syndrome in the Pediatric Intensive Care Unit.

Science.gov (United States)

Pasek, Tracy Ann; Crowley, Kelli; Campese, Catherine; Lauer, Rachel; Yang, Charles

2017-06-01

Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient. The expertise of advanced practice nurses blended exquisitely to ensure patient and family-centered care and the coordination of care across the illness trajectory. The patient experienced positive outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

arXiv Spin models in complex magnetic fields: a hard sign problem

CERN Document Server

de Forcrand, Philippe

2018-01-01

Coupling spin models to complex external fields can give rise to interesting phenomena like zeroes of the partition function (Lee-Yang zeroes, edge singularities) or oscillating propagators. Unfortunately, it usually also leads to a severe sign problem that can be overcome only in special cases; if the partition function has zeroes, the sign problem is even representation-independent at these points. In this study, we couple the N-state Potts model in different ways to a complex external magnetic field and discuss the above mentioned phenomena and their relations based on analytic calculations (1D) and results obtained using a modified cluster algorithm (general D) that in many cases either cures or at least drastically reduces the sign-problem induced by the complex external field.

Electrolytic formation of technetium complexes with π-acceptor ligands

International Nuclear Information System (INIS)

Cerda, F.; Kremer, C.; Gambino, D.; Kremer, E.

1994-01-01

Electrolytic reduction of pertechnetate was performed in aqueous solution containing π-acceptor ligands. Cyanide and 1,10-phenanthroline were the selected ligands. In both cases, electrolyses produced a cathodic TcO 2 deposit and soluble Tc complexes. When cyanide was the ligand, the complexes formed were [Tc(CN) 6 ] 5- and [TcO 2 (CN) 4 ] 3- . When working with the amine, [Tc(phen) 3 ] 2+ and another positively charged species were found after reaction. Results are compared with previous studies with amines, and the usefulness of the electrolytic route to obtain Tc complexes is evaluated. (author) 11 refs.; 2 figs.; 1 tab

Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study

OpenAIRE

Tarocchi, Anna; Aschieri, Filippo; Fantini, Francesca; Smith, Justin D.

2013-01-01

The cumulative effect of repeated traumatic experiences in early childhood incrementally increases the risk of adjustment problems later in life. Surviving traumatic environments can lead to the development of an interrelated constellation of emotional and interpersonal symptoms termed complex posttraumatic stress disorder (CPTSD). Effective treatment of trauma begins with a multimethod psychological assessment and requires the use of several evidence-based therapeutic processes, including es...

Complex tibial fracture outcomes following treatment with low-intensity pulsed ultrasound.

Science.gov (United States)

Leung, Kwok-Sui; Lee, Wing-Sze; Tsui, Hon-For; Liu, Paul Po-Lung; Cheung, Wing-Hoi

2004-03-01

A clinical study was conducted to investigate the effect of low-intensity pulsed ultrasound (US) stimulation (LIPUS) on the healing of complex tibial fractures. Thirty complex tibial fractures were randomly assigned to the treatment with LIPUS (n = 16) or by a dummy machine (sham-exposed: n = 14). The fractures were immobilized by either internal or external fixations according to the clinical indications. LIPUS was given 20 min/day for 90 days. Fracture healing was monitored by clinical, radiological, densitometric and biochemical assessments. The LIPUS-treated group showed statistically significantly better healing, as demonstrated by all assessments. Complications were minimal in the LIPUS group. There were two cases of delayed union, with one in each group. There were two cases of infection in the control group. The delayed-union cases were subsequently treated by LIPUS and the infection cases were treated with standard protocol. Fracture healing in these patients was again treated by LIPUS.

Spontaneous onset of Complex Regional Pain Syndrome

NARCIS (Netherlands)

de Rooij, A.M.; Perez, R.S.G.M.; Huygen, F.J.; van Eijs, F.; van Kleef, M.; Bauer, M.C.R.; van Hilten, J.J.; Marinus, J.

2010-01-01

Complex Regional Pain Syndrome (CRPS) usually develops after a noxious event, but spontaneous onsets have been described in 3-11% of the cases. The existence of spontaneous-onset CRPS is highly debated and the aim of the present study was therefore to compare the phenotypic characteristics of CRPS

Coexistence of Autism Spectrum Disorders Among Three Children with Tuberous Sclerosis Complex; Case reports and review of literature

Directory of Open Access Journals (Sweden)

Amna Al-Futaisi

2016-11-01

Full Text Available Tuberous sclerosis complex (TSC is a multisystem neurocutaneous disorder inherited in an autosomal dominant manner and characterised by benign tumours in the brain and other vital organs such as the heart, eyes, kidneys, skin and lungs. Links between autism spectrum disorder (ASD and TSC have been postulated for many decades, with TSC considered to be one of the main syndromic causes of ASD; however, precise confirmation of a relationship between these two disorders required validated diagnostic tools. Fortunately, accurate evaluation of this relationship is now possible with standardised criteria for ASD diagnosis. We report three children who presented to the Sultan Qaboos University Hospital, Muscat, Oman, between 2014 and 2015 with ASD and TSC. These cases demonstrate the spectrum of neuropsychiatric involvement in TSC and highlight the importance of screening children with TSC for ASD features in order to encourage the early enrolment of these children in educational and rehabilitation programmes.

Hand-assisted Approach as a Model to Teach Complex Laparoscopic Hepatectomies: Preliminary Results.

Science.gov (United States)

Makdissi, Fabio F; Jeismann, Vagner B; Kruger, Jaime A P; Coelho, Fabricio F; Ribeiro-Junior, Ulysses; Cecconello, Ivan; Herman, Paulo

2017-08-01

Currently, there are limited and scarce models to teach complex liver resections by laparoscopy. The aim of this study is to present a hand-assisted technique to teach complex laparoscopic hepatectomies for fellows in liver surgery. Laparoscopic hand-assisted approach for resections of liver lesions located in posterosuperior segments (7, 6/7, 7/8, 8) was performed by the trainees with guidance and intermittent intervention of a senior surgeon. Data as: (1) percentage of time that the senior surgeon takes the surgery as main surgeon, (2) need for the senior surgeon to finish the procedure, (3) necessity of conversion, (4) bleeding with hemodynamic instability, (5) need for transfusion, (6) oncological surgical margins, were evaluated. In total, 12 cases of complex laparoscopic liver resections were performed by the trainee. All cases included deep lesions situated on liver segments 7 or 8. The senior surgeon intervention occurred in a mean of 20% of the total surgical time (range, 0% to 50%). A senior intervention >20% was necessary in 2 cases. There was no need for conversion or reoperation. Neither major bleeding nor complications resulted from the teaching program. All surgical margins were clear. This preliminary report shows that hand-assistance is a safe way to teach complex liver resections without compromising patient safety or oncological results. More cases are still necessary to draw definitive conclusions about this teaching method.

Bipartite quantum states and random complex networks

International Nuclear Information System (INIS)

Garnerone, Silvano; Zanardi, Paolo; Giorda, Paolo

2012-01-01

We introduce a mapping between graphs and pure quantum bipartite states and show that the associated entanglement entropy conveys non-trivial information about the structure of the graph. Our primary goal is to investigate the family of random graphs known as complex networks. In the case of classical random graphs, we derive an analytic expression for the averaged entanglement entropy S-bar while for general complex networks we rely on numerics. For a large number of nodes n we find a scaling S-bar ∼c log n +g e where both the prefactor c and the sub-leading O(1) term g e are characteristic of the different classes of complex networks. In particular, g e encodes topological features of the graphs and is named network topological entropy. Our results suggest that quantum entanglement may provide a powerful tool for the analysis of large complex networks with non-trivial topological properties. (paper)

A Multiscale Model of Morphological Complexity in Cities

DEFF Research Database (Denmark)

Heinrich, Mary Katherine; Ayres, Phil; Bar-Yam, Yaneer

2017-01-01

Approaches from complex systems science can support design decision-making by extracting important information about key dependencies from large, unstructured data sources. This paper presents an initial case study applying such approaches to city structure, by characterising low-level features a...

Design of complex architectures using a three dimension approach : the crosswork case

NARCIS (Netherlands)

Seguel Pérez, R.E.; Grefen, P.W.P.J.; Eshuis, H.

2010-01-01

In this paper, we present a three dimensional design approach of complex information systems architectures. Key element of this approach is the model transformation cube, which consists of three dimensions along which architecture models can be positioned. Industry architecture frameworks to guide

Tuberous schlerosis complex and astrocytoma: a case report, Hiroshima

Energy Technology Data Exchange (ETDEWEB)

Rudnick, P A; Hoshino, N; Kitaoka, T; Miura, M

1961-02-10

This case report concerned a young woman with cutaneous, osseous, and retinal changes of tuberous sclerosis, referred to ABCC for evaluation of blindness and increased intracranial pressure. A right lateral ventricle astrocytoma was successfully removed, but the patient's sight was not restored. The development of cerebral neoplasms in these patients is discussed. A careful search for resectable brain lesions should be made in all patients with tuberous sclerosis who have signs and symptoms of increased intracranial pressure. 14 references, 6 figures.

Tuberous schlerosis complex and astrocytoma: a case report, Hiroshima

Energy Technology Data Exchange (ETDEWEB)

Rudnick, P.A.; Hoshino, N.; Kitaoka, T.; Miura, M.

1961-02-10

This case report concerned a young woman with cutaneous, osseous, and retinal changes of tuberous sclerosis, referred to ABCC for evaluation of blindness and increased intracranial pressure. A right lateral ventricle astrocytoma was successfully removed, but the patient's sight was not restored. The development of cerebral neoplasms in these patients is discussed. A careful search for resectable brain lesions should be made in all patients with tuberous sclerosis who have signs and symptoms of increased intracranial pressure. 14 references, 6 figures.

Case definition for Ebola and Marburg haemorrhagic fevers: a complex challenge for epidemiologists and clinicians.

Science.gov (United States)

Pittalis, Silvia; Fusco, Francesco Maria; Lanini, Simone; Nisii, Carla; Puro, Vincenzo; Lauria, Francesco Nicola; Ippolito, Giuseppe

2009-10-01

Viral haemorrhagic fevers (VHFs) represent a challenge for public health because of their epidemic potential, and their possible use as bioterrorism agents poses particular concern. In 1999 the World Health Organization (WHO) proposed a case definition for VHFs, subsequently adopted by other international institutions with the aim of early detection of initial cases/outbreaks in western countries. We applied this case definition to reports of Ebola and Marburg virus infections to estimate its sensitivity to detect cases of the disease. We analyzed clinical descriptions of 795 reported cases of Ebola haemorrhagic fever: only 58.5% of patients met the proposed case definition. A similar figure was obtained reviewing 169 cases of Marburg diseases, of which only 64.5% were in accordance with the case definition. In conclusion, the WHO case definition for hemorrhagic fevers is too specific and has poor sensitivity both for case finding during Ebola or Marburg outbreaks, and for early detection of suspected cases in western countries. It can lead to a hazardous number of false negatives and its use should be discouraged for early detection of cases.

Ecological significance and complexity of N-source preference in plants.

Science.gov (United States)

Britto, Dev T; Kronzucker, Herbert J

2013-10-01

Plants can utilize two major forms of inorganic N: NO3(-) (nitrate) and NH4(+) (ammonium). In some cases, the preference of one form over another (denoted as β) can appear to be quite pronounced for a plant species, and can be an important determinant and predictor of its distribution and interactions with other species. In many other cases, however, assignment of preference is not so straightforward and must take into account a wide array of complex physiological and environmental features, which interact in ways that are still not well understood. This Viewpoint presents a discussion of the key, and often co-occurring, factors that join to produce the complex phenotypic composite referred to by the deceptively simple term 'N-source preference'. N-source preference is much more complex a biological phenomenon than is often assumed, and general models predicting how it will influence ecological processes will need to be much more sophisticated than those that have been so far developed.

Symplectic geometry on moduli spaces of holomorphic bundles over complex surfaces

OpenAIRE

Khesin, Boris; Rosly, Alexei

2000-01-01

We give a comparative description of the Poisson structures on the moduli spaces of flat connections on real surfaces and holomorphic Poisson structures on the moduli spaces of holomorphic bundles on complex surfaces. The symplectic leaves of the latter are classified by restrictions of the bundles to certain divisors. This can be regarded as fixing a "complex analogue of the holonomy" of a connection along a "complex analogue of the boundary" in analogy with the real case.

Lability of Nanoparticulate Metal Complexes at a Macroscopic Metal Responsive (Bio)interface

NARCIS (Netherlands)

Duval, Jérôme F.L.; Town, Raewyn M.; Leeuwen, Van Herman P.

2018-01-01

The lability of metal complexes expresses the extent of the dissociative contribution of the complex species to the flux of metal ions toward a macroscopic metal-responsive (bio)interface, for example, an electrodic sensor or an organism. While the case of molecular ligands is well-established, it

Sickle cell disease and complex congenital cardiac surgery: a case report and review of the pathophysiology and perioperative management.

Science.gov (United States)

Sanders, D B; Smith, B P; Sowell, S R; Nguyen, D H; Derby, C; Eshun, F; Nigro, J J

2014-03-01

Sickle cell anemia and thalassemia are hemoglobinopathies rarely encountered in the United States. Compounded with congenital heart disease, patients with sickle cell disease (SCD) requiring cardiopulmonary bypass and open-heart surgery represent the proverbial "needle in the haystack". As such, there is some trepidation on the part of clinicians when these patients present for complex cardiac surgery. SCD is an autosomal, recessive condition that results from a single nucleotide polymorphism in the β-globin gene. Hemoglobin SS molecules (HgbSS) with this point mutation can polymerize under the right conditions, stiffening the erythrocyte membrane and distorting the cellular structure to the characteristic sickle shape. This shape change alters cellular transit through the microvasculature. As a result, circumstances such as hypoxia, hypothermia, acidosis or diminished blood flow can lead to aggregation, vascular occlusion and thrombosis. Chronically, SCD can give rise to multiorgan damage secondary to hemolysis and vascular obstruction. This review and case study details an 11-year-old African-American male with known SCD who presented to the cardiothoracic surgical service with congenital heart disease consisting of an anomalous, intramural right coronary artery arising from the left coronary sinus for surgical consultation and subsequent surgical correction. This case report will include a review of the pathophysiology and current literature regarding preoperative, intraoperative and postoperative management of SCD patients.

Complex linear Goldstino superfield and supergravity

Energy Technology Data Exchange (ETDEWEB)

Kuzenko, Sergei M. [School of Physics M013, The University of Western Australia,35 Stirling Highway, Crawley W.A. 6009 (Australia)

2015-10-01

The complex linear Goldstino superfield was proposed in http://arxiv.org/abs/1102.3042 for the cases of global and local four-dimensional N=1 supersymmetry. Here we make use of this superfield to construct a supergravity action which is invariant under spontaneously broken local N=1 supersymmetry and has a positive cosmological constant for certain values of the parameters.

Complex Systems Education for natural Hazards and from down to up Pushing of Government and Officials: A Case Study

Science.gov (United States)

Zvelebil, J.

2009-04-01

interplays of highly organized entities. Of course, such efforts mainly fail due to existence of qualitative differences between description of the same phenomena on different time-space scales or functional levels. Main features of a basic course "Application of nonlinear dynamics and Theory of Complex Systems for Physical Geographers" are described. They also partially follow the course reader's opinion about necessity of new reunion of modern philosophy and methodology of natural and human sciences Dangerous distortion of reflections of reality by the frequently proposed substitution of human science methodology by the natural science one is stressed. On the contrary, examples from philosophy (Bergson 1919, Wittgenstein 1953), which had anticipated and even defined some profound themes of Complex Systems (e.g. Kauffman 1993), as e.g. self-organizing, entropy decreasing behavior, or existence of discontinuities between description of the same phenomena on different time-space scales or functional levels. The second priority has information dissemination for decisions makers of natural Hazards management. Any successful Case history is better then ten popular lectures for those decision makers. A case history of highly computerized Integrated Information System (IIS) for unstable rock slope monitoring, on-line rock fall precursors diagnostics of time series and automated early warning launching, the both with the use of predominantly nonlinear tools is outlined. It stands to support author's opinion that pushing of officials is effective only if it is provided from down to up. That means it is based on satisfactory solution of specific community needs, instead of from up to down flowing more or less general directives of some far away sitting clerks. The third tactical item is rather long-distance run. Change of paradigm cannot be ordered, it is matter of generation change, as on scientific, as well as on decision makers (hopefully recruited from students already aware of

Numerical Modeling of Fluid-Structure Interaction with Rheologically Complex Fluids

OpenAIRE

Chen, Xingyuan

2014-01-01

In the present work the interaction between rheologically complex fluids and elastic solids is studied by means of numerical modeling. The investigated complex fluids are non-Newtonian viscoelastic fluids. The fluid-structure interaction (FSI) of this kind is frequently encountered in injection molding, food processing, pharmaceutical engineering and biomedicine. The investigation via experiments is costly, difficult or in some cases, even impossible. Therefore, research is increasingly aided...

Holocene glacier variability: three case studies using an intermediate-complexity climate model

NARCIS (Netherlands)

Weber, S.L.; Oerlemans, J.

2003-01-01

Synthetic glacier length records are generated for the Holocene epoch using a process-based glacier model coupled to the intermediate-complexity climate model ECBilt. The glacier model consists of a massbalance component and an ice-flow component. The climate model is forced by the insolation change

Adaptation and complexity in repeated games

DEFF Research Database (Denmark)

Maenner, Eliot Alexander

2008-01-01

The paper presents a learning model for two-player infinitely repeated games. In an inference step players construct minimally complex inferences of strategies based on observed play, and in an adaptation step players choose minimally complex best responses to an inference. When players randomly...... select an inference from a probability distribution with full support the set of steady states is a subset of the set of Nash equilibria in which only stage game Nash equilibria are played. When players make ‘cautious' inferences the set of steady states is the subset of self-confirming equilibria...... with Nash outcome paths. When players use different inference rules, the set of steady states can lie between the previous two cases...

Whole exome sequencing in 342 congenital cardiac left sided lesion cases reveals extensive genetic heterogeneity and complex inheritance patterns

Directory of Open Access Journals (Sweden)

Alexander H. Li

2017-10-01

Full Text Available Abstract Background Left-sided lesions (LSLs account for an important fraction of severe congenital cardiovascular malformations (CVMs. The genetic contributions to LSLs are complex, and the mutations that cause these malformations span several diverse biological signaling pathways: TGFB, NOTCH, SHH, and more. Here, we use whole exome sequence data generated in 342 LSL cases to identify likely damaging variants in putative candidate CVM genes. Methods Using a series of bioinformatics filters, we focused on genes harboring population-rare, putative loss-of-function (LOF, and predicted damaging variants in 1760 CVM candidate genes constructed a priori from the literature and model organism databases. Gene variants that were not observed in a comparably sequenced control dataset of 5492 samples without severe CVM were then subjected to targeted validation in cases and parents. Whole exome sequencing data from 4593 individuals referred for clinical sequencing were used to bolster evidence for the role of candidate genes in CVMs and LSLs. Results Our analyses revealed 28 candidate variants in 27 genes, including 17 genes not previously associated with a human CVM disorder, and revealed diverse patterns of inheritance among LOF carriers, including 9 confirmed de novo variants in both novel and newly described human CVM candidate genes (ACVR1, JARID2, NR2F2, PLRG1, SMURF1 as well as established syndromic CVM genes (KMT2D, NF1, TBX20, ZEB2. We also identified two genes (DNAH5, OFD1 with evidence of recessive and hemizygous inheritance patterns, respectively. Within our clinical cohort, we also observed heterozygous LOF variants in JARID2 and SMAD1 in individuals with cardiac phenotypes, and collectively, carriers of LOF variants in our candidate genes had a four times higher odds of having CVM (odds ratio = 4.0, 95% confidence interval 2.5–6.5. Conclusions Our analytical strategy highlights the utility of bioinformatic resources, including human

Improving complex kinship analyses with additional STR loci.

Science.gov (United States)

Carboni, Ilaria; Iozzi, Sara; Nutini, Anna Lucia; Torricelli, Francesca; Ricci, Ugo

2014-11-01

In a standard paternity testing, mother, child, and alleged father are analyzed with STR markers using commercially available kits. Since Italian civil legislation does not have thresholds to confirm a paternity, paternity is practically proven when likelihood ratio increases prior probability of paternity to posterior, accepted by court as sufficient. However, in some cases the number of markers included in a commercial kit may be insufficient to conclusively prove or disprove a relationship between individuals, especially when complex family scenarios are suspected or indirect analyses are required. Additional genetic information can increase the values of the likelihood ratio regarding the detection of true parental relationships in a pedigree, while reducing the chances of false attributions (e.g. false paternities). In these cases the introduction of a 26Plex amplification system allows to examine 23-26 additional markers depending on the commercial kit used, thus increasing the statistical power of the kinship analysis. The PCR conditions were optimized for a multiplex amplification system and a new generation CE instrument. In order to demonstrate the utility of additional STRs markers, four complex kinship cases are presented. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Iterative methods for the solution of very large complex symmetric linear systems of equations in electrodynamics

Energy Technology Data Exchange (ETDEWEB)

Clemens, M.; Weiland, T. [Technische Hochschule Darmstadt (Germany)

1996-12-31

In the field of computational electrodynamics the discretization of Maxwell`s equations using the Finite Integration Theory (FIT) yields very large, sparse, complex symmetric linear systems of equations. For this class of complex non-Hermitian systems a number of conjugate gradient-type algorithms is considered. The complex version of the biconjugate gradient (BiCG) method by Jacobs can be extended to a whole class of methods for complex-symmetric algorithms SCBiCG(T, n), which only require one matrix vector multiplication per iteration step. In this class the well-known conjugate orthogonal conjugate gradient (COCG) method for complex-symmetric systems corresponds to the case n = 0. The case n = 1 yields the BiCGCR method which corresponds to the conjugate residual algorithm for the real-valued case. These methods in combination with a minimal residual smoothing process are applied separately to practical 3D electro-quasistatical and eddy-current problems in electrodynamics. The practical performance of the SCBiCG methods is compared with other methods such as QMR and TFQMR.

Winners and losers in the complex web of global supply chains.

Science.gov (United States)

Glendon, Lee

2013-01-01

This paper discusses how supply chain, risk and business continuity professionals can collaboratively address the consequences of increasing supply chain complexity in order to deliver both resilient and sustainable supply chains. The paper identifies the key drivers of complexity supported by recent case examples, including the equine DNA scandal and the Rana Plaza tragedy in Bangladesh.

Metal–organic complexation in the marine environment

Directory of Open Access Journals (Sweden)

Witter Amy

2001-09-01

Full Text Available We discuss the voltammetric methods that are used to assess metal–organic complexation in seawater. These consist of titration methods using anodic stripping voltammetry (ASV and cathodic stripping voltammetry competitive ligand experiments (CSV-CLE. These approaches and a kinetic approach using CSV-CLE give similar information on the amount of excess ligand to metal in a sample and the conditional metal ligand stability constant for the excess ligand bound to the metal. CSV-CLE data using different ligands to measure Fe(III organic complexes are similar. All these methods give conditional stability constants for which the side reaction coefficient for the metal can be corrected but not that for the ligand. Another approach, pseudovoltammetry, provides information on the actual metal–ligand complex(es in a sample by doing ASV experiments where the deposition potential is varied more negatively in order to destroy the metal–ligand complex. This latter approach gives concentration information on each actual ligand bound to the metal as well as the thermodynamic stability constant of each complex in solution when compared to known metal–ligand complexes. In this case the side reaction coefficients for the metal and ligand are corrected. Thus, this method may not give identical information to the titration methods because the excess ligand in the sample may not be identical to some of the actual ligands binding the metal in the sample.

A complex-network perspective on Alexander's wholeness

Science.gov (United States)

Jiang, Bin

2016-12-01

The wholeness, conceived and developed by Christopher Alexander, is what exists to some degree or other in space and matter, and can be described by precise mathematical language. However, it remains somehow mysterious and elusive, and therefore hard to grasp. This paper develops a complex network perspective on the wholeness to better understand the nature of order or beauty for sustainable design. I bring together a set of complexity-science subjects such as complex networks, fractal geometry, and in particular underlying scaling hierarchy derived by head/tail breaks - a classification scheme and a visualization tool for data with a heavy-tailed distribution, in order to make Alexander's profound thoughts more accessible to design practitioners and complexity-science researchers. Through several case studies (some of which Alexander studied), I demonstrate that the complex-network perspective helps reduce the mystery of wholeness and brings new insights to Alexander's thoughts on the concept of wholeness or objective beauty that exists in fine and deep structure. The complex-network perspective enables us to see things in their wholeness, and to better understand how the kind of structural beauty emerges from local actions guided by the 15 fundamental properties, and in particular by differentiation and adaptation processes. The wholeness goes beyond current complex network theory towards design or creation of living structures.

Solving structures of protein complexes by molecular replacement with Phaser

International Nuclear Information System (INIS)

McCoy, Airlie J.

2006-01-01

Four case studies in using maximum-likelihood molecular replacement, as implemented in the program Phaser, to solve structures of protein complexes are described. Molecular replacement (MR) generally becomes more difficult as the number of components in the asymmetric unit requiring separate MR models (i.e. the dimensionality of the search) increases. When the proportion of the total scattering contributed by each search component is small, the signal in the search for each component in isolation is weak or non-existent. Maximum-likelihood MR functions enable complex asymmetric units to be built up from individual components with a ‘tree search with pruning’ approach. This method, as implemented in the automated search procedure of the program Phaser, has been very successful in solving many previously intractable MR problems. However, there are a number of cases in which the automated search procedure of Phaser is suboptimal or encounters difficulties. These include cases where there are a large number of copies of the same component in the asymmetric unit or where the components of the asymmetric unit have greatly varying B factors. Two case studies are presented to illustrate how Phaser can be used to best advantage in the standard ‘automated MR’ mode and two case studies are used to show how to modify the automated search strategy for problematic cases

Positioning matrix of economic efficiency and complexity: a case study in a university hospital.

Science.gov (United States)

Ippolito, Adelaide; Viggiani, Vincenzo

2014-01-01

At the end of 2010, the Federico II University Hospital in Naples, Italy, initiated a series of discussions aimed at designing and applying a positioning matrix to its departments. This analysis was developed to create a tool able to extract meaningful information both to increase knowledge about individual departments and to inform the choices of general management during strategic planning. The name given to this tool was the positioning matrix of economic efficiency and complexity. In the matrix, the x-axis measures the ratio between revenues and costs, whereas the y-axis measures the index of complexity, thus showing "profitability" while bearing in mind the complexity of activities. By using the positioning matrix, it was possible to conduct a critical analysis of the characteristics of the Federico II University Hospital and to extract useful information for general management to use during strategic planning at the end of 2010 when defining medium-term objectives. Copyright © 2013 John Wiley & Sons, Ltd.

Metastasis to the penis. Case reports and review of the literature

DEFF Research Database (Denmark)

Osther, P J; Løntoft, E

1991-01-01

Metastasis to the penis is rare, despite rich vascularization and complex circulation. Less than 200 cases have been reported. Three new cases of penis metastasis from primary tumours in the bladder and prostate, respectively, are described. The most common symptoms are penile induration and swel......Metastasis to the penis is rare, despite rich vascularization and complex circulation. Less than 200 cases have been reported. Three new cases of penis metastasis from primary tumours in the bladder and prostate, respectively, are described. The most common symptoms are penile induration...

Pulmonary choriostoma in a case of tuberous sclerosis complex

Directory of Open Access Journals (Sweden)

S Spalgais

2015-01-01

Full Text Available A 52 years old lady was diagnosed to have Tuberous Sclerosis Complex (TSC on the basis of 2 major and one minor criterion. She had family history of similar complaints in her sister and two sons. There was involvement of kidney in the form of angiomyolipoma, skin in the form of facial angiofibroma and teeth with a dental pit. She had an unusual lung involvement in the form of multiple small choristomas. Choristoma was diagnosed on transbronchial lung biopsy and was present in the form of disorganised striated muscles. The reported pulmonary manifestations of TCS i.e. lymphangioleiomyomatosis (LAM and multifocal micronodular pneumocyte hyperplasia (MMPH are types of hamartomas. Hamartomas and choristomas are both types of disorganized tissue. ′Choristoma′of lung in TSC however is not reported. Clinopathological correlation of pulmonary hamartoma and choristoma, and treatment in TSC has been discussed.

Structure, magnetic behavior, and anisotropy of homoleptic trinuclear lanthanoid 8-quinolinolate complexes.

Science.gov (United States)

Chilton, Nicholas F; Deacon, Glen B; Gazukin, Olga; Junk, Peter C; Kersting, Berthold; Langley, Stuart K; Moubaraki, Boujemaa; Murray, Keith S; Schleife, Frederik; Shome, Mahasish; Turner, David R; Walker, Julia A

2014-03-03

Three complexes of the form [Ln(III)3(OQ)9] (Ln = Gd, Tb, Dy; OQ = 8-quinolinolate) have been synthesized and their magnetic properties studied. The trinuclear complexes adopt V-shaped geometries with three bridging 8-quinolinolate oxygen atoms between the central and peripheral eight-coordinate metal atoms. The magnetic properties of these three complexes differ greatly. Variable-temperature direct-current (dc) magnetic susceptibility measurements reveal that the gadolinium and terbium complexes display weak antiferromagnetic nearest-neighbor magnetic exchange interactions. This was quantified in the isotropic gadolinium case with an exchangecoupling parameter of J = -0.068(2) cm(-1). The dysprosium compound displays weak ferromagnetic exchange. Variable-frequency and -temperature alternating-current magnetic susceptibility measurements on the anisotropic cases reveal that the dysprosium complex displays single-molecule-magnet behavior, in zero dc field, with two distinct relaxation modes of differing time scales within the same molecule. Analysis of the data revealed anisotropy barriers of Ueff = 92 and 48 K for the two processes. The terbium complex, on the other hand, displays no such behavior in zero dc field, but upon application of a static dc field, slow magnetic relaxation can be observed. Ab initio and electrostatic calculations were used in an attempt to explain the origin of the experimentally observed slow relaxation of the magnetization for the dysprosium complex.

A complex-like calculus for spherical vectorfields

NARCIS (Netherlands)

Graaf, de J.

2011-01-01

First, R^{1+d}, d in N, is turned into an algebra by mimicing the usual complex multiplication. Indeed the special case d = 1 reproduces C. For d > 1 the considered algebra is commutative, but non-associative and even non-alternative. Next, the Dijkhuis class of mappings (’vectorfields’) R^{1+d} ¿

Political Challenges in Complex Place-Based Health Promotion Partnerships: Lessons From an Exploratory Case Study in a Disadvantaged Area of Queensland, Australia.