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Sample records for carney complex case

  1. Carney Complex

    Science.gov (United States)

    ... of Carney complex are Cushing’s syndrome and multiple thyroid nodules (tumors). Cushing’s syndrome features a combination of weight gain, ... with Carney complex include adrenocortical carcinoma , pituitary gland tumors , thyroid , colorectal , liver and pancreatic cancers . Ovarian cancer in ...

  2. [Familial cases of cutaneous myxomas and spotty pigmentation (Carney's complex)].

    Science.gov (United States)

    Koyano, T; Satoh, T; Ohtaki, N

    1990-09-01

    In 1985, Carney et al reported a complex of myxomas, spotty pigmentation, and endocrine overactivity and subsequently demonstrated dominant inheritance of the condition. The criteria for diagnosis of the complex is the presence of two or more of the following conditions: (1) cardiac myxoma, (2) cutaneous myxoma, (3) mammary myxoma, (4) spotty mucocutaneous pigmentation, (5) primary pigmented nodular adrenocortical disease (Cushing's syndrome), (6) testicular tumors (sexual precocity), (7) pituitary adenoma secreting growth hormone (acromegaly or gigantism). We encountered a family with an affected mother and daughter. Case 1 was a 43-year-old woman with multiple cutaneous myxomas, mammary myxomas and spotty mucocutaneous pigmentation. Case 2, the 19-year-old daughter of case 1 had multiple cutaneous myxomas and spotty cutaneous pigmentation. These two cases both met the criteria for the diagnosis of the complex. Our report is believed to be the first report on the complex in Japan. PMID:2266598

  3. Carney complex (CNC

    Directory of Open Access Journals (Sweden)

    Bertherat Jérôme

    2006-06-01

    Full Text Available Abstract The Carney complex (CNC is a dominantly inherited syndrome characterized by spotty skin pigmentation, endocrine overactivity and myxomas. Skin pigmentation anomalies include lentigines and blue naevi. The most common endocrine gland manifestations are acromegaly, thyroid and testicular tumors, and adrenocorticotropic hormone (ACTH-independent Cushing's syndrome due to primary pigmented nodular adrenocortical disease (PPNAD. PPNAD, a rare cause of Cushing's syndrome, is due to primary bilateral adrenal defect that can be also observed in some patients without other CNC manifestations or familial history of the disease. Myxomas can be observed in the heart, skin and breast. Cardiac myxomas can develop in any cardiac chamber and may be multiple. One of the putative CNC genes located on 17q22-24, (PRKAR1A, has been identified to encode the regulatory subunit (R1A of protein kinase A. Heterozygous inactivating mutations of PRKAR1A were reported initially in 45 to 65 % of CNC index cases, and may be present in about 80 % of the CNC families presenting mainly with Cushing's syndrome. PRKAR1A is a key component of the cAMP signaling pathway that has been implicated in endocrine tumorigenesis and could, at least partly, function as a tumor suppressor gene. Genetic analysis should be proposed to all CNC index cases. Patients with CNC or with a genetic predisposition to CNC should have regular screening for manifestations of the disease. Clinical work-up for all the manifestations of CNC should be performed at least once a year in all patients and should start in infancy. Cardiac myxomas require surgical removal. Treatment of the other manifestations of CNC should be discussed and may include follow-up, surgery, or medical treatment depending on the location of the tumor, its size, the existence of clinical signs of tumor mass or hormonal excess, and the suspicion of malignancy. Bilateral adrenalectomy is the most common treatment for Cushing

  4. Carney complex: Clinical and genetic 2010 update.

    Science.gov (United States)

    Vezzosi, D; Vignaux, O; Dupin, N; Bertherat, J

    2010-12-01

    First described in the mid 1980s, Carney complex is a rare dominantly heritable multiple endocrine neoplasia syndrome that affects endocrine glands as the adrenal cortex, the pituitary and the thyroid. It is associated with many other nonendocrine tumors, including cardiac myxomas, testicular tumors, melanotic schwannoma, breast myxomatosis, and abnormal pigmentation or myxomas of the skin. The Carney complex gene 1 was identified 10 years ago as the regulatory subunit 1A of protein kinase A (PRKAR1A) located at 17q22-24. An inactivating heterozygous germ line mutation of PRKAR1A is observed in about two-thirds of Carney complex patients. This last decade many progresses have been done in the knowledge of this rare disease and its genetics. This review outlines the current state of this knowledge on Carney complex. PMID:20850710

  5. Cryoglobulinemic vasculitis preceding diagnosis of Carney Complex

    DEFF Research Database (Denmark)

    Glerup, Mia; Stausbøl-Grøn, Brian; Heuck, Carsten;

    2014-01-01

    Carney complex (CNC) is a disorder characterized by skin pigmentary abnormalities and benign cardiac, endocrine, skin and neuronal tumors. We present a previously healthy 12-year-old boy with recurrent pain and swelling of the feet. One year later he presented with stiffness of the fingers...

  6. Carney complex--an unexpected finding during puerperium.

    Science.gov (United States)

    Schulz, S; Redlich, A; Köppe, I; Reschke, K; Weise, W

    2001-01-01

    Carney complex is an extremely rare, autosomal dominant, multi-system disorder characterized by multiple neoplasias and lentiginosis. The genetic defect responsible for this complex has been localized to the short arm of chromosome 2 (2p16). The most prevalent clinical manifestations in patients with Carney complex are spotty skin pigmentation, skin and cardiac myxomas, Cushing's syndrome and acromegaly. Here we report the case of a 31-year-old woman with a spontaneous pregnancy. At 32 weeks of gestation, she was admitted to our Department of Obstetrics with hypertension and severe back pain. In addition, she had unusual pigmentation and typical cushingoid features. One day after admission, the pregnancy was terminated by emergency cesarian section because of preeclampsia and pathological CTG. During the postoperative period the severe back pain persisted, and radiographic evaluation revealed a collapse of L(2)/L(3) with severe osteopenia. A CT scan showed a mass in the right suprarenal area. Histopathological examination revealed a primary pigmented nodular adrenocortical disease. After biochemical confirmation of the diagnosis of Cushing's syndrome, it was recognized that the patient met the diagnostic criteria for Carney complex. PMID:11306912

  7. Carney complex with right ventricular myxoma following second excision of left atrial myxoma.

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    Tamura, Yamato; Seki, Toshio

    2014-01-01

    We report a case of Carney complex with massive right ventricular myxoma after two-time excision of a left atrial myxoma. The patient was a 45-year-old woman with pyrexia. She temporarily lost consciousness during examination, and echocardiography and computed tomography (CT) showed a massive tumor in the right ventricle. Loss of consciousness was determined to be caused by intracardiac obstruction of blood flow due to the tumor, and corrective surgery was performed. Pathological findings indicated myxoma with no malignancy. Myxomas are benign, but there is frequent recurrence of tumors associated with Carney complex. Because her myxomas were accompanied by unusual skin pigmentation, she was diagnosed with Carney complex. Carney complex has a high rate of myxoma recurrence, and often runs in families. In all cases, it is necessary to observe the patient's course closely.

  8. Growth hormone and risk for cardiac tumors in Carney complex.

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    Bandettini, W Patricia; Karageorgiadis, Alexander S; Sinaii, Ninet; Rosing, Douglas R; Sachdev, Vandana; Schernthaner-Reiter, Marie Helene; Gourgari, Evgenia; Papadakis, Georgios Z; Keil, Meg F; Lyssikatos, Charalampos; Carney, J Aidan; Arai, Andrew E; Lodish, Maya; Stratakis, Constantine A

    2016-09-01

    Carney complex (CNC) is a multiple neoplasia syndrome that is caused mostly by PRKAR1A mutations. Cardiac myxomas are the leading cause of mortality in CNC patients who, in addition, often develop growth hormone (GH) excess. We studied patients with CNC, who were observed for over a period of 20 years (1995-2015) for the development of both GH excess and cardiac myxomas. GH secretion was evaluated by standard testing; dedicated cardiovascular imaging was used to detect cardiac abnormalities. Four excised cardiac myxomas were tested for the expression of insulin-like growth factor-1 (IGF-1). A total of 99 CNC patients (97 with a PRKAR1A mutation) were included in the study with a mean age of 25.8 ± 16.6 years at presentation. Over an observed mean follow-up of 25.8 years, 60% of patients with GH excess (n = 46) developed a cardiac myxoma compared with only 36% of those without GH excess (n = 54) (P = 0.016). Overall, patients with GH excess were also more likely to have a tumor vs those with normal GH secretion (OR: 2.78, 95% CI: 1.23-6.29; P = 0.014). IGF-1 mRNA and protein were higher in CNC myxomas than in normal heart tissue. We conclude that the development of cardiac myxomas in CNC may be associated with increased GH secretion, in a manner analogous to the association between fibrous dysplasia and GH excess in McCune-Albright syndrome, a condition similar to CNC. We speculate that treatment of GH excess in patients with CNC may reduce the likelihood of cardiac myxoma formation and/or recurrence of this tumor.

  9. Growth hormone and risk for cardiac tumors in Carney complex.

    Science.gov (United States)

    Bandettini, W Patricia; Karageorgiadis, Alexander S; Sinaii, Ninet; Rosing, Douglas R; Sachdev, Vandana; Schernthaner-Reiter, Marie Helene; Gourgari, Evgenia; Papadakis, Georgios Z; Keil, Meg F; Lyssikatos, Charalampos; Carney, J Aidan; Arai, Andrew E; Lodish, Maya; Stratakis, Constantine A

    2016-09-01

    Carney complex (CNC) is a multiple neoplasia syndrome that is caused mostly by PRKAR1A mutations. Cardiac myxomas are the leading cause of mortality in CNC patients who, in addition, often develop growth hormone (GH) excess. We studied patients with CNC, who were observed for over a period of 20 years (1995-2015) for the development of both GH excess and cardiac myxomas. GH secretion was evaluated by standard testing; dedicated cardiovascular imaging was used to detect cardiac abnormalities. Four excised cardiac myxomas were tested for the expression of insulin-like growth factor-1 (IGF-1). A total of 99 CNC patients (97 with a PRKAR1A mutation) were included in the study with a mean age of 25.8 ± 16.6 years at presentation. Over an observed mean follow-up of 25.8 years, 60% of patients with GH excess (n = 46) developed a cardiac myxoma compared with only 36% of those without GH excess (n = 54) (P = 0.016). Overall, patients with GH excess were also more likely to have a tumor vs those with normal GH secretion (OR: 2.78, 95% CI: 1.23-6.29; P = 0.014). IGF-1 mRNA and protein were higher in CNC myxomas than in normal heart tissue. We conclude that the development of cardiac myxomas in CNC may be associated with increased GH secretion, in a manner analogous to the association between fibrous dysplasia and GH excess in McCune-Albright syndrome, a condition similar to CNC. We speculate that treatment of GH excess in patients with CNC may reduce the likelihood of cardiac myxoma formation and/or recurrence of this tumor. PMID:27535175

  10. Pituitary adenoma in Carney complex: an immunohistochemical, ultrastructural, and immunoelectron microscopic study.

    Science.gov (United States)

    Kurtkaya-Yapicier, O; Scheithauer, B W; Carney, J A; Kovacs, K; Horvath, E; Stratakis, C A; Vidal, S; Vella, A; Young, W F; Atkinson, J L D; Lloyd, R V; Kontogeorgos, G

    2002-01-01

    First described in 1985, Carney complex is a rare, heritable disorder featuring abnormal skin pigmentation, cardiac and cutaneous myxoma, melanotic schwannoma of psammomatous type, and endocrine abnormalities, including pituitary adenomas. Patients with the latter present with elevated growth hormone (GH) levels and acromegaly or gigantism. Prolactin (PRL) elevation may also be seen. The authors have investigated 2 resected pituitary adenomas from patients with Carney complex. One, a 19-year-old female acromegalic with elevated GH, IgF-1, and PRL levels, had a mammosomatotroph adenoma immunoreactive for GH and PRL. Ultrastructurally, GH and PRL were present in the same secretory granules. The second patient, a 27-year-old acromegalic, had a sparsely granulated GH cell adenoma that by immuno-electron microscopy revealed GH immunoreactivity only. The lack of morphologic similarity between the 2 adenomas indicatesthat pituitary tumors in patients with Carney complex may not exhibit the same phenotype. PMID:12537759

  11. Carney complex: the complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas.

    Science.gov (United States)

    Carney, J A

    1995-06-01

    The complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas (the Carney complex) is a multisystem tumorous disorder that is transmitted as a mendelian autosomal dominant trait. Approximately 150 affected patients are known worldwide. The myxomas, which tend to be multiple in the involved organ, affect the heart, skin and breast. Typical sites for the skin myxomas are the eyelids, external ear canal, and nipples. The lesions commonly recur after excision. The spotty skin pigmentation includes lentigines and blue nevi, but ephelides and junctional and compound nevi also occur. The lentigines are widespread and typically involve the centrofacial area, including the vermilion border of the lips, and the conjunctiva, especially the lacrimal caruncle and the conjunctival semilunar fold. One or more intraoral pigmented spots are seen occasionally. The blue nevi occur on the face, trunk, and limbs, but not the hands and feet. Endocrine overactivity includes Cushing's syndrome (caused by primary pigmented nodular adrenocortical disease), acromegaly (caused by growth hormone-producing pituitary adenoma), and sexual precocity (caused by large-cell calcifying Sertoli cell tumor). The schwannomas are a special histological type, featuring psammoma bodies and melanin. Most commonly, they affect the upper gastrointestinal tract and sympathetic nerve chains, but a few have occurred in the skin. The most serious component of the Carney complex is cardiac myxoma. Patients suspected of having the syndrome (and their primary relatives) should be examined for this neoplasm.

  12. The complex of myxomas, spotty skin pigmentation and endocrine overactivity (Carney complex): imaging findings with clinical and pathological correlation

    OpenAIRE

    Courcoutsakis, Nikos A.; Tatsi, Christina; Patronas, Nicholas J.; Lee, Chiy-Chia Richard; Prassopoulos, Panos K.; Stratakis, Constantine A.

    2013-01-01

    The complex of myxomas, spotty skin pigmentation and endocrine overactivity, or Carney complex (CNC), is a familial multiple endocrine neoplasia and lentiginosis syndrome. CNC is inherited in an autosomal dominant manner and is genetically heterogeneous. Its features overlap those of McCune-Albright syndrome and other multiple endocrine neoplasia (MEN) syndromes. Spotty skin pigmentation is the major clinical manifestation of the syndrome, followed by multicentric heart myxomas, which occur a...

  13. Condroma pulmonar isolado: caso incompleto da tríade de Carney? Isolated pulmonary chondroma: a case of incomplete Carney triad?

    Directory of Open Access Journals (Sweden)

    Raul Lopes Ruiz Júnior

    2005-08-01

    Full Text Available Um homem, de 45 anos, com infecções pulmonares de repetição havia quatro anos apresentou-se com tosse, secreção amarelada, escarros hemópticos e dor torácica não pleural. A tomografia revelou nódulo calcificado ocluindo brônquio lobar inferior direito. Realizada bilobectomia inferior e média, o exame histopatológico revelou condroma endobrônquico, bem circunscrito. O condroma pulmonar é um tumor raro, em geral associado à tríade de Carney (condroma, leiomiossarcoma gástrico e paraganglioma extra-adrenal, sendo o menos freqüente dos três componentes. No presente caso, os outros dois componentes não foram observados. Podem, entretanto, se manifestar tardiamente, sendo, assim, necessário seguimento clínico em longo prazo do paciente.A 45-year-old man presented with recurrent pulmonary infection for four years, cough, bloody sputum, yellowish excretion and nonpleuritic chest pain. Tomography of the chest revealed a calcified nodule occluding the right lower lobe bronchus. A right lower and middle lobectomy was performed, and the histopathological examination of the bronchi revealed chondroma, a rare pulmonary tumor usually associated with the Carney triad (pulmonary chondroma, gastric leiomyosarcoma and extra-adrenal paraganglioma, being the less common of the three components. In the present case, the other two components of the triad were not observed. Since these components may appear years later, long-term follow-up care is necessary.

  14. An unusual case of Carney triad with high level catecholamine-secreting but no existence of extra-adrenal paraganglioma

    Institute of Scientific and Technical Information of China (English)

    QIAO Gui-bin; FANG Yi; ZENG Wei-sheng; PENG Li-jun; HUANG Wen-jie

    2010-01-01

    @@ In 1977, Carney originally described the association of gastric epithelioid leiomyosarcoma, pulmonary chondroma and extra-adrenal paraganglioma, and this unusual syndrome was subsequently called "Carney triad".

  15. The complex of myxomas, spotty skin pigmentation and endocrine overactivity (Carney complex): imaging findings with clinical and pathological correlation.

    Science.gov (United States)

    Courcoutsakis, Nikos A; Tatsi, Christina; Patronas, Nicholas J; Lee, Chiy-Chia Richard; Prassopoulos, Panos K; Stratakis, Constantine A

    2013-02-01

    The complex of myxomas, spotty skin pigmentation and endocrine overactivity, or Carney complex (CNC), is a familial multiple endocrine neoplasia and lentiginosis syndrome. CNC is inherited in an autosomal dominant manner and is genetically heterogeneous. Its features overlap those of McCune-Albright syndrome and other multiple endocrine neoplasia (MEN) syndromes. Spotty skin pigmentation is the major clinical manifestation of the syndrome, followed by multicentric heart myxomas, which occur at a young age and are the lethal component of the disease. Myxomas may also occur on the skin (eyelid, external ear canal and nipple) and the breast. Breast myxomas, when present, are multiple and bilateral among female CNC patients, an entity which is also described as "breast-myxomatosis" and is a characteristic feature of the syndrome. Affected CNC patients often have tumours of two or more endocrine glands, including primary pigmented nodular adrenocortical disease (PPNAD), an adrenocorticotropin hormone (ACTH)-independent cause of Cushing's syndrome, growth hormone (GH)-secreting and prolactin (PRL)-secreting pituitary adenomas, thyroid adenomas or carcinomas, testicular neoplasms (large-cell calcifying Sertoli cell tumours [LCCSCT]) and ovarian lesions (cysts and cancinomas). Additional infrequent but characteristic manifestations of CNC are psammomatous melanotic schwannomas (PMS), breast ductal adenomas (DAs) with tubular features, and osteochondromyxomas or "Carney bone tumour". Teaching Points • Almost 60 % of the known CNC kindreds have a germline inactivating mutations in the PRKAR1A gene. • Spotty skin pigmentation is the major clinical manifestation of CNC, followed by heart myxomas. • Indicative imaging signs of PPNAD are contour abnormality and hypodense spots within the gland. • Two breast tumours may present in CNC: myxoid fibroadenomas (breast myxomatosis) and ductal adenomas. • Additional findings of CNC are psammomatous melanotic schwannomas

  16. Use of mouse models to understand the molecular basis of tissue-specific tumorigenesis in the Carney complex.

    Science.gov (United States)

    Kirschner, L S

    2009-07-01

    Carney complex (CNC) is an autosomal dominant, multiple endocrine neoplasia syndrome comprised of spotty skin pigmentation, myxomatosis, endocrine tumours and schwannomas. The majority of cases are due to inactivating mutations in PRKAR1A, the gene encoding the type 1A regulatory subunit of the 3',5'-cyclic adenosine monophosphate (cAMP)-dependent protein kinase, PKA (protein kinase A). In order to understand the molecular basis for tumorigenesis associated with PRKAR1A mutations, we have developed conventional and conditional Prkar1a knockout (KO) mice as well as primary cell culture models corresponding to these genetic manipulations. At the biochemical level, removal of Prkar1a from cells causes enhanced PKA activity, the same effect which has been observed in tumours isolated from CNC patients. Mice heterozygous for Prkar1a mutations (the exact genetic model for CNC patients) are born at expected frequencies and are tumour prone, developing neoplasms in cAMP-responsive cell types such as Schwann cells, osteoblasts and thyrocytes. In order to understand the basis of tissue-specific tumour formation, we have created tissue-specific KOs of the gene from three different tissues: the neural crest (Schwann cells), the pituitary gland and the heart. In the neural crest and the pituitary, ablation of Prkar1a leads to excess proliferation and tumorigenesis, whereas the same manipulation in developing cardiomyocytes leads to reduced proliferation and embryonic demise. The KO hearts also exhibit myxomatous changes suggesting a connection between PKA activation and myxomagenesis, although the nature of this relationship has not yet been determined. This work confirms the role of Prkar1a as a tissue-specific tumour suppressor, and ongoing work is focused on identifying the key downstream signalling targets affected by dysregulation of PKA. PMID:19522826

  17. Case Report of a Left Atrial Myxoma Associated with Carney%u2019s Syndrome

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    Anil Ozen

    2016-05-01

    Full Text Available Primary cardiac neoplasms are very rare as compared to metastatic tumors. 70% to 80% of them are benign myxomas. Complications of myxomas include cyst and microabscess formation, embolization, syncope and sudden death. Rarely, cardiac myxomas are associated with primary nodular adrenal cortical disease, mammary fibroadenomas, testicular tumors or pitiutary adenomas with gigantism or acromegaly known as Carney%u2019s syndrome. We present a patient with a left atrial myxoma who underwent reoperation associated with Carney%u2019s syndrome.

  18. A mouse model for the Carney complex tumor syndrome develops neoplasia in cyclic AMP-responsive tissues.

    Science.gov (United States)

    Kirschner, Lawrence S; Kusewitt, Donna F; Matyakhina, Ludmila; Towns, William H; Carney, J Aidan; Westphal, Heiner; Stratakis, Constantine A

    2005-06-01

    Carney complex is an autosomal dominant neoplasia syndrome characterized by spotty skin pigmentation, myxomatosis, endocrine tumors, and schwannomas. This condition may be caused by inactivating mutations in PRKAR1A, the gene encoding the type 1A regulatory subunit of protein kinase A. To better understand the mechanism by which PRKAR1A mutations cause disease, we have developed conventional and conditional null alleles for Prkar1a in the mouse. Prkar1a(+/-) mice developed nonpigmented schwannomas and fibro-osseous bone lesions beginning at approximately 6 months of age. Although genotype-specific cardiac and adrenal lesions were not seen, benign and malignant thyroid neoplasias were observed in older mice. This spectrum of tumors overlaps that seen in Carney complex patients, confirming the validity of this mouse model. Genetic analysis indicated that allelic loss occurred in a subset of tumor cells, suggesting that complete loss of Prkar1a plays a key role in tumorigenesis. Similarly, tissue-specific ablation of Prkar1a from a subset of facial neural crest cells caused the formation of schwannomas with divergent differentiation. These observations confirm the identity of PRKAR1A as a tumor suppressor gene with specific importance to cyclic AMP-responsive tissues and suggest that these mice may be valuable tools not only for understanding endocrine tumorigenesis but also for understanding inherited predispositions for schwannoma formation. PMID:15930266

  19. A Simple Complex Case: Restoration of Circadian Cortisol Activity

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    Ragini C Bhake

    2015-08-01

    Full Text Available A 38-year-old librarian with confirmed Carney complex (PRKAR1a mutation was referred for further evaluation of ACTH-independent Cushing's syndrome. Previously, she was known to have schwannoma (excised, adenomyoepithelioma and normal annual echocardiograms. Over three years prior to current presentation, she had become aware of coarse hair on her chin and abdomen, as well as centripetal weight gain. She had noticed subtle but definite reduction in her girdle muscle strength. She had acquired some mood changes atypical of her personality, and had developed an interrupted sleep pattern. To our knowledge, this is the first published report of circadian RU486 therapy for PPNAD in a patient with Carney complex. It may have been possible to restore low levels surrounding the midnight hours using other agents, but the side-effect profile and lack of significantly elevated levels of cortisol made them less favorable options.

  20. Mabel Carney at Teachers College: From Home Missionary to White Ally

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    Weiler, Kathleen

    2005-01-01

    This article discusses the career of Mabel Carney, head of the Department of Rural Education at Teachers College from 1918 to 1941. Carney was deeply involved with African American and African education, traveling to Africa and the American South, teaching courses on "Negro education", and working closely with both African and African American…

  1. Melanosis of the uterine cervix: a case report and literature review

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    Daniel Chang

    2013-06-01

    Full Text Available Melanosis of the uterine cervix is an extremely rare melanocytic lesion and should be differentiated from melanoma. It is a melanocytic hyperpigmentation of basal layer cells from the squamous mucosa of the uterine cervix without an increase in the number of melanocytes. We present a typical case of this entity. Furthermore, we discuss the possible origins of melanocytes in this region and their association with Laugier-Hunziker syndrome and Carney complex.

  2. A novel germline SDHB mutation in a gastrointestinal stromal tumor patient without bona fide features of the Carney-Stratakis dyad.

    Science.gov (United States)

    Celestino, Ricardo; Lima, Jorge; Faustino, Alexandra; Máximo, Valdemar; Gouveia, António; Vinagre, João; Soares, Paula; Lopes, José Manuel

    2012-06-01

    Gastrointestinal stromal tumors (GISTs) are the most common mesenchyme neoplasms of the gastrointestinal tract. Gain-of-function somatic mutations of the KIT or PDGFRA genes represent the most prevalent molecular alterations in GISTs. In Carney-Stratakis dyad, patients portray germline mutations of the succinate dehydrogenase subunits B (SDHB), C (SDHC) and D (SDHD) and develop multifocal GISTs and multicentric paragangliomas (PGLs). We herein report a novel germline SDHB mutation (c.T282A--Ile44Asn) occurring in a 26 years-old patient diagnosed with a spindle cell intermediate risk GIST that did not present KIT/PDGFRA/BRAF gene mutations. Further analyses revealed loss of the wild-type SDHB allele and complete loss of SDHB expression in the tumor tissue. After genetic screening of other family members, we detected in the patient's mother a SDHB mutation without any clinical/laboratorial evidence of GIST or PGL. Altogether, our findings (germline SDHB mutation with absence of PGL in the index case and of GIST and/or PGL in his mother) raise the possibility that this familiar setting corresponds to an incomplete phenotype of the Carney-Stratakis dyad. PMID:22160509

  3. 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

  4. Familial acromegaly - case study of two sisters with acromegaly.

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    Malicka, Joanna; Świrska, Joanna; Nowakowski, Andrzej

    2011-01-01

    In the majority of cases, acromegaly is sporadic. However, it can also occur in a familial setting as a component of MEN-1, MEN-4, Carney complex (CNC) or as the extremely rare syndrome of isolated familial somatotropinoma (IFS), the latter belonging to familial isolated pituitary adenomas (FIPA). The diagnosis of IFS is based on the recognition of acromegaly/gigantism in at least two family members, given that the family is not affected by MEN-1, MEN-4 or CNC. The authors present a case study of two sisters: a 56 year-old patient (case no. 1) and a 61 year-old patient (case no. 2). In both sisters, acromegaly was recognised in the course of pituitary macroadenoma. Neither of the sisters showed features of MEN-1, MEN-4 or Carney complex. The authors suppose that the presented cases are manifestations of IFS. However, this diagnosis has not been confirmed yet because of the poor availability of genetic tests. PMID:22144223

  5. 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.

  6. Complex Pediatric Elbow Injury: An Uncommon Case

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    Taylor GR

    2005-03-01

    Full Text Available Abstract Background There is paucity of literature describing complex elbow trauma in the pediatric population. We described a case of an uncommon pediatric elbow injury comprised of lateral condyle fracture associated with posterolateral dislocation of elbow. Case presentation A 12-year-old boy sustained a direct elbow trauma and presented with Milch type II lateral condyle fracture associated with posterolateral dislocation of elbow. Elbow dislocation was managed by closed reduction. The elbow stability was assessed under general anaesthesia, followed by open K-wiring for the lateral condylar fracture fixation. The patient had an uneventful recovery with an excellent outcome at 39 months follow-up. Conclusion Complex pediatric elbow injuries are quite unusual to encounter, the management of such fractures can be technically demanding. Concomitant elbow dislocation should be managed by closed reduction followed by open reduction and internal fixation (K-wires or cannulated screws of the lateral condyle fracture.

  7. [Complex odontoma with dentigerous cyst: a case report].

    Science.gov (United States)

    Qizhang, Xu; Hongliang, Zhang; Xiaoyu, Wang; Zhanji, Wang; Qianqian, Xu; Qiong, Ma

    2014-12-01

    Complex odontoma is a relatively rare dental dysplasia. In particular, a complex odontoma with dentigerous cyst is seldom observed. A case of complex odontoma with dentigerous cyst is reported in this paper.

  8. Melanotic schwannoma arising in association with nevus of Ota: 2 cases suggesting a shared mechanism.

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    Trufant, Joshua W; Brenn, Thomas; Fletcher, Christopher D M; Virata, Andrew R; Cook, Deborah L; Bosenberg, Marcus W

    2009-12-01

    Melanotic schwannoma is a rare markedly pigmented peripheral nerve sheath tumor comprising cells with prominent melanization and schwannian features. The psammomatous variety is associated with Carney complex, a multiple neoplasia syndrome with spotty skin pigmentation. We present the first 2 reported cases of melanotic schwannoma arising in patients with a history of nevus of Ota, a rare dermal melanosis believed to represent a failure of melanocyte migration to the epidermis during embryogenesis. Case 1 involves a 40-year-old woman with a 1.8-cm, deeply pigmented, trigeminal nerve mass and pigmentation of the maxillary sinus mucosa and bone. Case 2 involves a 53-year-old woman with a 1.5-cm mass adjacent to the clavicle. Microscopically, both masses consist of partially encapsulated epithelioid and spindle cells with abundant melanin pigment, arising in association with peripheral nerves. Morphological, immunohistochemical, and ultrastructural features support a diagnosis of melanotic schwannoma. No psammoma bodies are noted, and neither patient exhibits any additional features of Carney complex. Melanotic schwannoma is most often benign but has been associated with malignant behavior in some cases. Distinguishing this nerve sheath tumor from malignant melanoma can be difficult but is of great clinical importance due to differences in prognosis and treatment.

  9. Complex problem solving: a case for complex cognition?

    OpenAIRE

    Funke, Joachim

    2010-01-01

    Complex problem solving (CPS) emerged in the last 30 years in Europe as a new part of the psychology of thinking and problem solving. This paper introduces into the field and provides a personal view. Also, related concepts like macrocognition or operative intelligence will be explained in this context. Two examples for the assessment of CPS, Tailorshop and MicroDYN, are presented to illustrate the concept by means of their measurement devices. Also, the relation of complex cognition and emot...

  10. A CASE OF REFERENCE ON COMPLEXITY

    Institute of Scientific and Technical Information of China (English)

    SONG Jian

    2003-01-01

    The author argues that the population system of human societies, the highest form of lives on the planet, may serve as standard paradigm for study of complex systems. it turned out to be a well investigable, nonlinearly controllable dynamic system, where census plays pivotal role. The theory has led China to succeed in checking the upsurge of population growth of 1970-80s and remains reliable basis for family-planning policy-making in all countries world-wide. It suggests that statistics could be a powerful tool in studying holistic properties of complex systems.

  11. BILATERAL OSSIFIED STYLOHYOID COMPLEX: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sarada Devi S

    2015-11-01

    Full Text Available : Mineralisation of all components of stylohyoid complex or chain, a 2nd branchial arch derivative is frequently reported. But bilateral occurrence of continuous bands of ossified tissue involving stylohyoid complex, are less commonly encountered. An adult skull specimen presented abnormally long osseous bands extending from base of skull in place of styloid process. On left side a band of 6.5cm long x1cm wide and 0.3cm in thickness, and on right side an irregularly rounded elongated structure of 7.5cm length were noticed. Lower end of the left process was fused to hyoid bone. Either abnormally long styloid process or this type of ossified stylohyoid complex may be a causative factor for severe pharyngeal pain, dysphagia, may be a cause for occasional swelling in submandibular region or may be associated with Eagle syndrome. Due to its close proximity to tonsillar bed, if elongated it may be felt during tonsillectomy in tonsillar fossa. In this backdrop reports of this type may be of interest to clinicians.

  12. Average-Case Analysis of Algorithms Using Kolmogorov Complexity

    Institute of Scientific and Technical Information of China (English)

    姜涛; 李明

    2000-01-01

    Analyzing the average-case complexity of algorithms is a very prac tical but very difficult problem in computer science. In the past few years, we have demonstrated that Kolmogorov complexity is an important tool for analyzing the average-case complexity of algorithms. We have developed the incompressibility method. In this paper, several simple examples are used to further demonstrate the power and simplicity of such method. We prove bounds on the average-case number of stacks (queues) required for sorting sequential or parallel Queuesort or Stacksort.

  13. Unusually large erupted complex odontoma: A rare case report

    International Nuclear Information System (INIS)

    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.

  14. Unusually large erupted complex odontoma: A rare case report.

    Science.gov (United States)

    Bagewadi, Shivanand B; Kukreja, Rahul; Suma, Gundareddy N; Yadav, Bhawna; Sharma, Havi

    2015-03-01

    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.

  15. 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.

  16. Sporadic cases are the norm for complex disease

    OpenAIRE

    Yang, Jian; Visscher, Peter M; Wray, Naomi R.

    2009-01-01

    The results of genome-wide association studies have revealed that most human complex diseases (for example, cancer, diabetes and psychiatric disorders) are affected by a large number of variants, each of which explains a small increase in disease risk, suggesting a pattern of polygenic inheritance. At the same time, it has been argued that most complex diseases are genetically heterogeneous because many sporadic cases are observed, as well as cases with a family history. In this study, under ...

  17. Complexity Thinking and Methodology: The Potential of "Complex Case Study" for Educational Research

    Science.gov (United States)

    Hetherington, Lindsay

    2013-01-01

    Complexity theories have in common perspectives that challenge linear methodologies and views of causality. In educational research, relatively little has been written explicitly exploring their implications for educational research methodology in general and case study in particular. In this paper, I offer a rationale for case study as a research…

  18. Complex odontoma associated to a primary maxillary canine: case report

    Directory of Open Access Journals (Sweden)

    Estela Maris LOSSO

    2009-06-01

    Full Text Available Introduction: Odontomas are malformations of the dental tissues and may interfere with the eruption of the associated tooth. The early diagnosis, followed by a proper treatment at the right time, will result in a favorable prognosis and a desirable occlusion development. Complex odontomas associated to primary teeth are rare. Case report and conclusion: This article describes a case of a complex odontoma in a four-year-old girl that prevented eruption of the left primary canine. The treatment choice was enucleation of the odontoma and the maintenance of the left primary canine.In this case, complete removal of the complex odontoma was successfully conducted, since after one year of follow-up the primary maxillary canine restarted its eruption process.

  19. Weakly bound systems in the case of complex potentials

    International Nuclear Information System (INIS)

    We consider weakly bound two-body systems. We study the behavior of the ground state mean square radius as the binding energy tends to zero in the case of complex potentials. We show that the asymptotic law, obtained with real potentials, is modified by the occurrence of a finite width in the case of finite-range potentials. The case of the PT-symmetric potentials is also discussed. We complete our study with few remarks concerning the same problem for three weakly bound particles. (author)

  20. Neurofibroma and lipoma in association with giant congenital melanocytic nevus coexisting in one nodule: a case report.

    Science.gov (United States)

    Shang, Zhiwei; Dai, Tao; Ren, Yongqiang

    2015-01-01

    Giant congenital melanocytic nevi (GCMN) are rare conditions that defined as melanocytic lesion recognized at birth, which will reach a diameter larger than 20 cm, and they occur in about 1 per 500,000 newborns. Despite its rarity, they may associate with severe abnormalities like spina bifida occulta, meningocele, club foot and hypertrophy or atrophy of deeper structures of a limb, Carney complex, premature aging syndromes, neurofibroma, vitiligo, lipoma and dysplasia of bilateral hip impact on the patient. In this case, we report a 3-years-old male child presenting a GCMN with large, blackish, and thick nevus covering over the entire neck, back, and lower to the waist level. We highlight the importance of proper histopathological examination of the biopsy taken from the single huge nodule which revealed features of both neurofibroma and lipoma coexisting. The objective of this paper is to report a rare case with the clinical and pathologic findings. PMID:26379904

  1. Complex transmission in a literate music tradition: a case study

    OpenAIRE

    De, Groot, N.

    2008-01-01

    How is it possible to arrive at musical sound from a written document? Is it possible by reading only? Usually a clear distinction is made between oral and written traditions in music. However, written music traditions cannot work by transmission through writing alone. Oral transmission is always part of it. In this article the complexity of transmission in a written music tradition is sounded out, using a case from late twentieth-century ‘new music’ as a starting point. Apart from written an...

  2. 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.

  3. Limb body wall complex or body stalk complex or cyllosomas: a case report

    Directory of Open Access Journals (Sweden)

    S. Saritha

    2013-04-01

    Full Text Available Limb body wall complex (LBWC is also called Body stalk complex and Cyllosomas. We present this rare congenital malformation complex highlighting the importance of early sonographic imaging findings in LBWC along with differentiation from other anterior abdominal wall defects. Limb body wall complex / Body stalk anomaly refers to a rare complicated polymalformative fetal malformation syndrome of uncertain etiology and results in head, heart, lung, diaphragm, kidney or gonadal abnormalities. LBWC was first described by Van Allen et al; in (1987. The two of the three following anomalies must be present to establish the diagnosis: 1. Exencephaly / Encephalocele with facial clefts, 2. Thoraco-Abdominoschisis / ventral body wall defects and 3. Limb defects. LBWC arises as a result of early amnion disruptions or error in embryonic development. If all components of the syndrome are present, the condition is lethal. LBWC is invariably fatal and incompatible with life. No case of postnatal survival is reported so far. Serum alpha-fetoprotein measurement and ultrasonography examination is the key to the prenatal diagnosis and followed by medical termination of pregnancy. It presents two distinct phenotypes described by Russo et al (1993 and later Cusi et al in (1996, according to the foetoplacental relationships: 1. Placento-cranial and 2.Placento-abdominal types. Among the 168 live births at S.V.S. Medical College & hospital Mahabubnagar (INDIA during the period of 2010-2011 we came across an aborted female fetus. It was weighing 1800gms, 30 weeks of gestation diagnosed by antenatal ultrasonography as ventral body wall defect. It was associated with ompholocele, severe scoliosis and limb defects. Its confirmation of the diagnosis of Limb body wall complex with Placento-abdominal type was done by postmortem fetography. [Int J Res Med Sci 2013; 1(2.000: 132-137

  4. Understanding Complex Human Ecosystems: The Case of Ecotourism on Bonaire

    Directory of Open Access Journals (Sweden)

    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.

  5. 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,…

  6. Genetic predisposition to peripheral nerve neoplasia: Diagnostic criteria and pathogenesis of neurofibromatoses, Carney complex, and related syndromes

    OpenAIRE

    Rodriguez, Fausto J.; Stratakis, Constantine A.; Evans, D Gareth

    2011-01-01

    Neoplasms of the peripheral nerve sheath represent essential clinical manifestations of the syndromes known as the neurofibromatoses. Although involvement of multiple organ systems, including skin, central nervous system and skeleton, may also be conspicuous, peripheral nerve neoplasia is often the most important and frequent cause of morbidity in these patients. Clinical characteristics of neurofibromatosis type 1 (NF1) and neurofibromatosis type 2 (NF2) have been extensively described and s...

  7. ESOPHAGEAL PEPTIC STENOSIS: MANAGEMENT OF A COMPLEX CASE

    Directory of Open Access Journals (Sweden)

    F. Fanti

    2012-01-01

    Full Text Available Introduction: esophageal stenosis is one of the most serious problems in patients with peptic esophagitis. It may require esophageal resection and replacement, if no other treatment is effective. Patients and methods: we report a successfully managed case of persistent esophageal stricture. The patient was a 10-year-old boy suffering from gastroesophageal reflux since birth. He has an esophageal peptic stricture which was treated with multiple dilatation at another hospital (about 24 times. The boy joined our Unit for gastroesophageal reflux and severe esophageal stricture confirmed with contrast X-ray. He could only eat liquid foods and had a growth retardation. He underwent endoscopy which shows severe esophagitis with mucosal bleeding. He also had a severe anemia, for which he underwent blood transfusion. We decided to submit the boy to Toupet laparoscopic fundoplication, endoscopic intraluminal dilatation with balloon and diathermic needle and therapy with PPI protonic pump inhibitors and corticostheroids. The little patient needed 7 endoscopic dilatations. Results: one month after the last dilatation he has grown, can eat all kind of foods, his blood count is normal and X-ray and endoscopy both show resolution of the stenosis and esophagitis. Conclusions: we report this case because we think that it’s a complex and interesting case. This patient was a candidate for esophageal replacement. We managed to save his native esophagus, treating gastroesophageal reflux and peptic stenosis with surgery and endoscopic dilatations, and reducing fibrosis and scarring with corticosteroid therapy. We thus think that this therapeutic procedure can be an optimal choice to contemplate before considering native esophagus replacement.

  8. Molecular alterations and expression of succinate dehydrogenase complex in wild-type KIT/PDGFRA/BRAF gastrointestinal stromal tumors.

    Science.gov (United States)

    Celestino, Ricardo; Lima, Jorge; Faustino, Alexandra; Vinagre, João; Máximo, Valdemar; Gouveia, António; Soares, Paula; Lopes, José Manuel

    2013-05-01

    Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, disclosing somatic KIT, PDGFRA and BRAF mutations. Loss of function of succinate dehydrogenase (SDH) complex is an alternative molecular mechanism in GISTs, namely in carriers of germline mutations of the SDH complex that develop Carney-Stratakis dyad characterized by multifocal GISTs and multicentric paragangliomas (PGLs). We studied a series of 25 apparently sporadic primary wild-type (WT) KIT/PDGFRA/BRAF GISTs occurring in patients without personal or familial history of PGLs, re-evaluated clinicopathological features and analyzed molecular alterations and immunohistochemistry expression of SDH complex. As control, we used a series of well characterized 49 KIT/PDGFRA/BRAF-mutated GISTs. SDHB expression was absent in 20% and SDHB germline mutations were detected in 12% of WT GISTs. Germline SDHB mutations were significantly associated to younger age at diagnosis. A significant reduction in SDHB expression in WT GISTs was found when compared with KIT/PDGFRA/BRAF-mutated GISTs. No significant differences were found when comparing DOG-1 and c-KIT expression in WT, SDHB-mutated and KIT/PDGFRA/BRAF-mutated GISTs. Our results confirm the occurrence of germline SDH genes mutations in isolated, apparently sporadic WT GISTs. WT KIT/PDGFRA/BRAF GISTs without SDHB or SDHA/SDHB expression may correspond to Carney-Stratakis dyad or Carney triad. Most importantly, the possibility of PGLs (Carney-Stratakis dyad) and/or pulmonary chondroma (Carney triad) should be addressed in these patients and their kindred. PMID:22948025

  9. Complexity of case mix in a regional allergy service

    Directory of Open Access Journals (Sweden)

    Kaminski Edward R

    2012-02-01

    Full Text Available Abstract Background Currently in the United Kingdom (UK, there is a mismatch between limited financial resources and the large proportion of patients with suspected allergies actually being referred to specialist allergy clinics. To better understand the case mix of patients being referred, we audited referrals to a regional allergy service over an 8 year period. The main source of data was consultant letters to General Practitioners (GP summarising the diagnosis of patients, archived from January 2002 to September 2009. Letters were reviewed, extracting the clinic date, doctor seen, gender, date of birth, postcode, GP, and diagnoses. Diagnoses were classified into seven groups and illustrative cases for each group noted. Findings Data from 2,028 new referrals with suspected allergy were analysed. The largest group of patients (43% were diagnosed with a type I hypersensitivity. The other diagnostic groups were chronic idiopathic (spontaneous urticaria (35%, suspected type I hypersensitivity but no allergen identified (8%, idiopathic (spontaneous angioedema (8%, physical urticaria (2.5%, non-allergic symptoms (1.6%, type IV hypersensitivity (0.8% and ACE inhibitor sensitivity (0.5%. Two thirds of patients seen were female with a higher percentage of female patients in the non type-I hypersensitivity group (71% than the type 1 hypersensitivity (66% (χ2 = 5.1, 1df, p = 0.024. The type 1 hypersensitivity patients were younger than other patients (38 Vs 46 years, t = -10.8, p Conclusions This study highlights the complexity of specialist allergy practice and the large proportion of patients referred with non-type I hypersensitivities, chronic idiopathic (spontaneous urticaria being by far the largest group. Such information is critical to inform commissioning decisions, define referral pathways and in primary care education.

  10. 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.

  11. Complexity, Representation and Practice: Case Study as Method and Methodology

    Science.gov (United States)

    Miles, Rebecca

    2015-01-01

    While case study is considered a common approach to examining specific and particular examples in research disciplines such as law, medicine and psychology, in the social sciences case study is often treated as a lesser, flawed or undemanding methodology which is less valid, reliable or theoretically rigorous than other methodologies. Building on…

  12. Erupted complex odontoma: a case report and literature review.

    Science.gov (United States)

    Litonjua, Luis A; Suresh, Lakshmanan; Valderrama, Lucia S; Neiders, Mirdza E

    2004-01-01

    A case involving a 17-year-old girl with a large erupted odontoma associated with a deeply impacted mandibular molar is reported. The molar, which previously had been displaced to the border of the mandible, erupted successfully three years after surgical removal of the odontoma. A review of the literature presents guidelines for treating similar cases.

  13. A practical approach to language complexity: a Wikipedia case study.

    Directory of Open Access Journals (Sweden)

    Taha Yasseri

    Full Text Available In this paper we present statistical analysis of English texts from Wikipedia. We try to address the issue of language complexity empirically by comparing the simple English Wikipedia (Simple to comparable samples of the main English Wikipedia (Main. Simple is supposed to use a more simplified language with a limited vocabulary, and editors are explicitly requested to follow this guideline, yet in practice the vocabulary richness of both samples are at the same level. Detailed analysis of longer units (n-grams of words and part of speech tags shows that the language of Simple is less complex than that of Main primarily due to the use of shorter sentences, as opposed to drastically simplified syntax or vocabulary. Comparing the two language varieties by the Gunning readability index supports this conclusion. We also report on the topical dependence of language complexity, that is, that the language is more advanced in conceptual articles compared to person-based (biographical and object-based articles. Finally, we investigate the relation between conflict and language complexity by analyzing the content of the talk pages associated to controversial and peacefully developing articles, concluding that controversy has the effect of reducing language complexity.

  14. Microcanonical Simulation of Complex Actions The Wess Zumino Witten Case

    CERN Document Server

    Baaquie, Belal E; Baaquie, Belal E.

    2000-01-01

    We present the main results of our microcanonical simulation of the Wess Zumino Witten action functional. This action, being highly non-trivial and capable of exhibiting many different phase transitions, is chosen to be representative of general complex actions. We verify the applicability of microcanonical simulation by successfully obtaining two of the many critical points of the Wess Zumino Witten action. The microcanonical algorithm has the additional advantage of exhibiting critical behaviour for a small $8\\times 8$ lattice. We also briefly discuss the subtleties that, in general, arise in simulating a complex action. Our algorithm for complex actions can be extended to the study of D-branes in the Wess Zumino Witten action.

  15. Case report of Plasmodium falciparum malaria presenting as wide complex tachycardia

    Institute of Scientific and Technical Information of China (English)

    Sunil Kumar; Diwan SK; Mahajan SN; Shilpa Bawankule; Chetan Mahure

    2011-01-01

    Malaria caused by Plasmodium falciparum is a multisystem disorder and may have diversity of clinical presentations. We are presenting a case report of patients of falciparum malaria who presented to us with palpitation and fever. On electrocardiogram he had wide complex tachycardia. This case reiterates the need to think of malaria in any case with symptoms of fever with chills, even with various unusual presentations like palpitation due to wide complex tachycardia, especially in endemic country like India.

  16. 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.

  17. Media framing of complex issues: The case of endangered languages.

    Science.gov (United States)

    Rivenburgh, Nancy K

    2013-08-01

    This study investigates how media frame a global trend that is complex in nature, emergent in terms of scientific understanding, and has public policy implications: the rapid disappearance of languages. It analyzes how English-language media from 15 western, industrialized countries frame the causes and implications of endangered languages over 35 years (1971-2006) - a time period notable for growing, interdisciplinary concerns over the potential negative impacts of losing the world's linguistic diversity. The results reveal a media discourse characterized by three complementary frames that are sympathetic to the plight of endangered languages, but that present the problem, its cause, and societal implications in a logical structure that would promote public complacency. PMID:23885053

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

    NARCIS (Netherlands)

    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 in

  19. Case for Deploying Complex Systems Utilizing Commodity Components

    Science.gov (United States)

    Bryant, Barry S.; Pitts, R. Lee

    2003-01-01

    When the International Space Station (ISS) finally reached an operational state, many of the Payload Operations and Integration Facility (POIF) hardware components were reaching end of life, COTS product costs were soaring, and the ISS budget was becoming severely constrained. However, most requirement development was complete. In addition, the ISS program is a fully functioning program with at least fifteen years of operational life remaining. Therefore it is critical that any upgrades, refurbishments, or enhancements be accomplished in realtime with minimal disruptions to service. For these and other reasons, it was necessary to ensure the viability of the POIF. Due to the to the breadth of capability of the POIF (a NASA ground station), it is believed that the lessons to be learned by other complex systems are applicable and any solutions garnered by the POIF are applicable to other complex systems as well. With that in mind, a number of new approaches have been investigated to increase the portability of the POIF and reduce the cost of refurbishment, operations, and maintenance. These new approaches were directed at the Total Cost of Ownership (TCO); not only the refurbishment but also current operational difficulties, licensing, and anticipation of the next refurbishment. Our basic premise is that technology had evolved dramatically since the concept of the POIF ground system and we should leverage our experience on this new technological landscape. Fortunately, Moore's law and market forces have changed the landscape considerably. These changes are manifest in five (5) ways that are particularly relevant to POIF: 1. Complex Instruction Set Computing (CISC) processors have advanced to unprecedented levels of compute capacity with a dramatic cost break, 2. Linux has become a major operating system supported by most vendors on a broad range of platforms, 3. Windows(TradeMark) based desktops are pervasive in the office environment, 4. Stable and affordable

  20. Complex Syntax Acquisition: A Longitudinal Case Study of a Child with Specific Language Impairment

    Science.gov (United States)

    Schuele, Melanie C.; Dykes, Julianna C.

    2005-01-01

    Although there is extensive documentation of the morphological limitations of children with specific language impairment (SLI), few studies have reported on complex syntax acquisition in children with SLI. This case study examined the development of complex syntax in a child with SLI between 3 and 7 years. Twelve conversational samples were…

  1. Lessons Learned from Designing a Comprehensive Case- Based Reasoning (CBR) Tool for Support of Complex Thinking

    OpenAIRE

    Richmond, Doug

    2007-01-01

    This research study focused on learning lessons from the experience of designing a comprehensive case-based reasoning (CBR) tool for support of complex thinking skills. Theorists have historically identified, analyzed, and classified different thinking processes and skills. Thinking skills have been increasingly emphasized in national standards, state testing, curricula, teaching and learning resources, and research agendas. Complex thinking is the core of higher-order thinking. Complex think...

  2. Large complex odontoma of mandible in a young boy: a rare and unusual case report.

    Science.gov (United States)

    Reddy, G Siva Prasad; Reddy, G V; Sidhartha, B; Sriharsha, K; Koshy, John; Sultana, Rehana

    2014-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. [Causation in the court: the complex case of malignant mesothelioma].

    Science.gov (United States)

    Lageard, Giovanni

    2011-01-01

    established some very clear legal principles of law. Essentially, when ascertaining the causation, a judge should verify whether or not there is a sufficiently well established scientific law covering the question and whether such a law is universal or probabilistic. Should the latter be the case, then it is necessary to establish if the accelerating effect has been determined in the case in question, on the basis of the factual acquisitions. We must now wait for the concrete application of these principles by juridical bodies. PMID:22073682

  5. Transforming Industrial Complexes to Innovative Clusters? A Korean Case Study

    Directory of Open Access Journals (Sweden)

    Sang-Chul Park

    2012-01-01

    Full Text Available Global economic environment based on globalization processes caused a severe competition between the nations, and these nations launched various strategic approaches to increase their market shares in the global markets. The economic globalization process stimulates changes of technology environment that is not favor for the technology advanced nations to transfer their strategic technology areas toward developing and newly industrialized nations. Moreover, due to the change of external economic and technological environment national development strategies in all nations are also changing. In order to generate economic growth and gain a better position in severe competition between nations, the advanced nations have already established strong national and regional innovation systems The nations participating in the globalization processes actively tend to close free trade agreements (FTA in order to intensify the movement of their production factors across the national borders as quick as possible. This new trend has cognized the importance of regions and regional competitiveness that are based on regional industries. In line with the new trend of global economies, building innovative local clusters has become one of the core strategies to develop the nations further. This frame shift has affected South Korea to a high extent because the nation cannot develop further without inventing its own core technology that costs a vast capital as well as takes a long time. This paper examines an attempt to restructure existing industrial complexes, turning them into innovative clusters at regional and local level. This contribution also tries to identify the tasks and strategies necessary to build locally embedded innovative clusters and how to best analyze these.

  6. 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…

  7. COMPUTATIONAL COMPLEXITY IN WORST, STOCHASTIC AND AVERAGE CASE SETTING ON FUNCTIONAL APPROXIMATION PROBLEM OF MULTIVARIATE

    Institute of Scientific and Technical Information of China (English)

    Fang Gensun; Ye Peixin

    2005-01-01

    The order of computational complexity of all bounded linear functional approximation problem is determined for the generalized Sobolev class Wp∧(Id), Nikolskii class Hk∞(Id) in the worst (deterministic), stochastic and average case setting, from which it is concluded that the bounded linear functional approximation problem for the classes stochastic and average case setting.

  8. 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.

  9. A Rare Presentation of Conjunctival Myxoma with Pain and Redness: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Yu-Po Chen

    2012-04-01

    Full Text Available Background: Conjunctival myxoma is a type of rare, benign tumor of mesenchymal cells, with fewer than 30 reported cases in the English literature. It is mostly an isolated occurrence but can sometimes be associated with systemic diseases such as Carney complex or Zollinger-Ellison syndrome. It is necessary in clinical practice to differentiate it from other similar lesions, such as amelanotic nevus, lymphangioma, myxoid liposarcoma, spindle-cell lipoma, myxoid neurofibroma, and rhabdomyosarcoma. Case Presentation: The usual presentation of conjunctival myxoma is a translucent, well-circumscribed, and painless conjunctival mass, but in this report we discuss an unusual case of conjunctival myxoma in a 47-year-old Taiwanese woman who presented initially with pain and redness. This atypical presentation complicated the diagnosis and the management at first. Surgical excision of the mass was performed. The mass was found to be a conjunctival myxoma. The patient subsequently underwent extensive evaluation but was found not to have any systemic diseases with known association with conjunctival myxoma. Conclusions: In summary, we present a case of conjunctival myxoma in a 47-year-old Taiwanese woman. The initial presentation with pain and redness was atypical for conjunctival myxoma. The lesion was successfully managed with complete excisional biopsy.

  10. 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....

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

    Science.gov (United States)

    Reibel, Jesper; Grønbaek, Anni B; Poulsen, Sven

    2011-11-01

    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.

  12. Review of 61 cases of odontoma. Presentation of an erupted complex odontoma.

    Science.gov (United States)

    Amado Cuesta, Susana; Gargallo Albiol, Jordi; Berini Aytés, Leonardo; Gay Escoda, Cosme

    2003-01-01

    Odontomas are benign tumors of odontogenic origin characterized by their slow growth. They consist of enamel, dentine, cementum and pulpal tissue and constitute 22% of all odontogenic tumors. Two types of odontoma are recognized: compound and complex. The first is approximately twice as common as complex odontomas. The purpose of this study is to value the prevalence of this kind of tumors in the ambulatory-surgical gambit and their clinical symptoms. We want to emphasize the exceptional spontaneous eruption of this tumors and we report a case of erupted complex odontoma. We made the revision of the cases of diagnosed odontomas between 1983 and 2001 in the Clínica Ntra. Sra. del Remei, in the Centro Médico Teknon and the Master de Cirugía e Implantología Bucal of the Odontologic Clínic (Barcelona University). We analyzed their prevalence, distribution in gender, age of the patients, anatomic location, adjacent structures affectation, symptoms, histologic classification and treatment. 52.4% of the cases were diagnosed in females. 37.7% of the tumors were complex odontomas and 62.3% were diagnosed as compound odontomas. 55.7% of all cases were in the maxilla and 44.3% in the mandible. The anterior portion of maxilla was the most common location (54% of cases). Only a case (1.6%) was erupted, in the molars area of the maxilla.

  13. 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.

  14. Case Report: Gollop-Wolfgang Complex in a 5 month old baby

    OpenAIRE

    Ihtesham A Qureshi; Gudepu, Rohit Kumar; Chava, Ravikanth; Emmani, Sravya; Asghar, Syed Husain; Mohtashim A. Qureshi; Arlappa, Nimmathota; Bastepe, Murat; He, Qing; Philip, Nicole; Robertson, Stephen; qureshi, aatif

    2015-01-01

    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 age...

  15. A case of hybrid closure of a muscular ventricular septal defect: anatomical complexity and surgical management.

    Science.gov (United States)

    Karimi, Mohsen; Hulsebus, Elise; Murdison, Kenneth; Wiles, Henry

    2012-06-01

    Complex muscular ventricular septal defect poses difficult surgical management and is associated with high morbidity and mortality despite advancements in surgical therapy. Device closure of muscular ventricular septal defect has been encouraging and has been used in hybrid approach at a few centres. However, device closure has some limitations in patients with complex muscular ventricular septal defect. We report a case of perventricular device closure of a complex muscular ventricular septal defect in a beating heart with entrapped right ventricular disc and its surgical management.

  16. Large Complex Odontome of Maxilla: Report of a case and Literature Review

    Directory of Open Access Journals (Sweden)

    Geeta Singh

    2015-01-01

    Full Text Available The pathologic al c onditions in which odontogenic differentiation is fully expressed are the odontomas. Odontomas are consi­ dered as hamartomas/developmental anomaly rather than a true neo plasm. These tumors are composed of enamel, dentin, cemen­tum and pulp tissue. They are basically classified into two types, compound and complex. Most compound odontoma are found in the anterior maxilla whereas complex odontomas are commonly found in posterior mandible. We present a rare case of complex odontome in anterior maxilla treated in our center.

  17. Foreign object ingestion in complex suicide: a case report and review of the literature.

    Science.gov (United States)

    Cascini, Fidelia; Longo, Francesca; Polacco, Matteo; Scafetta, Ilaria

    2012-06-10

    Foreign body ingestion frequently occurs accidentally in the paediatric population as well as intentionally in prisoners to achieve hospitalisation, but is relatively uncommon in forensic cases and extremely rare as a method of inducing death in complex suicide. The reasons for this infrequency are many, not least the slowness of action and the lack of effectiveness in terms of lethality, regardless of the object used. In this article, we show an unplanned complex suicide carried out by ingestion of four plastic knives before hanging. Other complex suicides involving foreign body ingestion reported in the forensic literature are reviewed. PMID:22169165

  18. Sequestrating giant complex odontoma: a case report and review of the literature.

    Science.gov (United States)

    Perumal, C J; Mohamed, A; Singh, A; Noffke, C E E

    2013-12-01

    Odontomas are the most common benign tumours of odontogenic origin. Due to their hamartomatous nature, they are usually asymptomatic but can cause impaction of one or more teeth. They consist microscopically of all the tissue types found in a developed tooth. We present a case of a large sequestrating complex odontoma resulting in facial asymmetry, cellulitis, pain and partial loss of function. This case has significance, as odontomas of this large size have rarely been reported.

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

    Science.gov (United States)

    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…

  20. 22q11 Deletion Syndrome and Multiple Complex Developmental Disorder: a case report

    NARCIS (Netherlands)

    V. Scandurra; M.R. Scordo; R. Canitano; E.I. de Bruin

    2013-01-01

    22q11.2 Deletion Syndrome (22q11 DS) is a multisystemic condition that may also include neuropsychiatric disorders. We present a case of a 15-year-old boy that was evaluated for social difficulties, and anxiety with the above genetic abnormality. Clinical features were rather complex as different ne

  1. Complexity

    CERN Document Server

    Gershenson, Carlos

    2011-01-01

    The term complexity derives etymologically from the Latin plexus, which means interwoven. Intuitively, this implies that something complex is composed by elements that are difficult to separate. This difficulty arises from the relevant interactions that take place between components. This lack of separability is at odds with the classical scientific method - which has been used since the times of Galileo, Newton, Descartes, and Laplace - and has also influenced philosophy and engineering. In recent decades, the scientific study of complexity and complex systems has proposed a paradigm shift in science and philosophy, proposing novel methods that take into account relevant interactions.

  2. Succinate dehydrogenase (SDHx) mutations in pituitary tumors: could this be a new role for mitochondrial complex II and/or Krebs cycle defects?

    Science.gov (United States)

    Xekouki, Paraskevi; Stratakis, Constantine A

    2012-12-01

    Succinate dehydrogenase (SDH) or mitochondrial complex II is a multimeric enzyme that is bound to the inner membrane of mitochondria and has a dual role as it serves both as a critical step of the tricarboxylic acid or Krebs cycle and as a member of the respiratory chain that transfers electrons directly to the ubiquinone pool. Mutations in SDH subunits have been implicated in the formation of familial paragangliomas (PGLs) and/or pheochromocytomas (PHEOs) and in Carney-Stratakis syndrome. More recently, SDH defects were associated with predisposition to a Cowden disease phenotype, renal, and thyroid cancer. We recently described a kindred with the coexistence of familial PGLs and an aggressive GH-secreting pituitary adenoma, harboring an SDHD mutation. The pituitary tumor showed loss of heterozygosity at the SDHD locus, indicating the possibility that SDHD's loss was causatively linked to the development of the neoplasm. In total, 29 cases of pituitary adenomas presenting in association with PHEOs and/or extra-adrenal PGLs have been reported in the literature since 1952. Although a number of other genetic defects are possible in these cases, we speculate that the association of PHEOs and/or PGLs with pituitary tumors is a new syndromic association and a novel phenotype for SDH defects.

  3. Case-Based Reasoning Topological Complexity Calculation of Design for Components

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Directly calculating the topological and geometric complexity from the STEP (standard for the exchange of product model data, ISO 10303) file is a huge task. So, a case-based reasoning approach is presented, which is based on the similarity between the new component and the old one, to calculate the topological and geometric complexity of new components. In order to index, retrieve in historical component database, a new way of component representation is brought forth. And then an algorithm is given to extract topological graph from its STEP files. A mathematical model, which describes how to compare the similarity, is discussed. Finally, an example is given to show the result.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Average-Case Complexity Versus Approximate Simulation of Commuting Quantum Computations

    Science.gov (United States)

    Bremner, Michael J.; Montanaro, Ashley; Shepherd, Dan J.

    2016-08-01

    We use the class of commuting quantum computations known as IQP (instantaneous quantum polynomial time) to strengthen the conjecture that quantum computers are hard to simulate classically. We show that, if either of two plausible average-case hardness conjectures holds, then IQP computations are hard to simulate classically up to constant additive error. One conjecture relates to the hardness of estimating the complex-temperature partition function for random instances of the Ising model; the other concerns approximating the number of zeroes of random low-degree polynomials. We observe that both conjectures can be shown to be valid in the setting of worst-case complexity. We arrive at these conjectures by deriving spin-based generalizations of the boson sampling problem that avoid the so-called permanent anticoncentration conjecture.

  7. Average-Case Complexity Versus Approximate Simulation of Commuting Quantum Computations.

    Science.gov (United States)

    Bremner, Michael J; Montanaro, Ashley; Shepherd, Dan J

    2016-08-19

    We use the class of commuting quantum computations known as IQP (instantaneous quantum polynomial time) to strengthen the conjecture that quantum computers are hard to simulate classically. We show that, if either of two plausible average-case hardness conjectures holds, then IQP computations are hard to simulate classically up to constant additive error. One conjecture relates to the hardness of estimating the complex-temperature partition function for random instances of the Ising model; the other concerns approximating the number of zeroes of random low-degree polynomials. We observe that both conjectures can be shown to be valid in the setting of worst-case complexity. We arrive at these conjectures by deriving spin-based generalizations of the boson sampling problem that avoid the so-called permanent anticoncentration conjecture. PMID:27588839

  8. Surgical treatment of extensive complex odontoma in the mandible by corticotomy. A case report.

    Science.gov (United States)

    Nogueira, A S; Gonçales, E S; Gonçales, A G B; Thiegui-Neto, V; Nogueira, C B P; Nogueira, A; Medeiros, R

    2013-09-01

    Odontomas represent the most prevalent odontogenic tumors in the jaw. The treatment of choice is surgical removal, usually performed by conventional techniques involving ostectomies to expose the tumor. In this paper, the authors describe, through the report of a case of complex odontoma located in the mandibular angle, a more conservative surgical technique called corticotomy, in which the bone removed for access to the tumor (buccal cortical) is repositioned and fixed by titanium plates of 1.5 mm. PMID:24126599

  9. The Stryker Mobile Gun System a case study on managing complexity

    OpenAIRE

    Christian Ayers

    2009-01-01

    Approved for public release, distribution unlimited This case study analyzes how the Stryker Mobile Gun System (MGS) program managed complexity. The MGS is one of the ten variants of the Stryker series of vehicles that equip the Army's Stryker Brigade Combat Teams. These brigades were created by the Army Chief of Staff from 1999-2003, General Eric Shinseki, to provide the Army with a highly deployable medium-force capability. Initially intended as a variant that required limited develo...

  10. Reconstruction of Complex Shoulder Defect in a Case of Subclavian Artery Thrombosis

    OpenAIRE

    Satish, Chetan

    2012-01-01

    We report a case of a 24-year-old man with complex shoulder defect on the right side following a road traffic accident. The patient was found to have a subclavian artery thrombosis in its second part with good collaterals ensuring limb viability. Free-flap reconstruction was not possible because of lack of recipient vascular pedicle nearby. Pedicled flaps routinely used for this area such as pectoralis major and latissimus dorsi myocutaneous flaps could not be used as their vascular pedicles ...

  11. Complex Evaluation of Light Sources in Case of Electric Power Cost Increase

    OpenAIRE

    Y. N. Kolesnik; A. V. Ivaneychik

    2008-01-01

    The paper gives complex evaluation of efficiency of incandescent lamps, luminescent and light-emitting-diode (LED) light sources in case of electric power price increase. On the basis of experimental table lamp electric power indices of light-emitting-diode (LED) light sources with equivalent luminous flux have been determined. Dependences of main indices of economic efficiency of various light sources on their operational regimes have been obtained and rate of influence on these indices of e...

  12. Surgical treatment of extensive complex odontoma in the mandible by corticotomy. A case report.

    Science.gov (United States)

    Nogueira, A S; Gonçales, E S; Gonçales, A G B; Thiegui-Neto, V; Nogueira, C B P; Nogueira, A; Medeiros, R

    2013-09-01

    Odontomas represent the most prevalent odontogenic tumors in the jaw. The treatment of choice is surgical removal, usually performed by conventional techniques involving ostectomies to expose the tumor. In this paper, the authors describe, through the report of a case of complex odontoma located in the mandibular angle, a more conservative surgical technique called corticotomy, in which the bone removed for access to the tumor (buccal cortical) is repositioned and fixed by titanium plates of 1.5 mm.

  13. Disaster preparedness in a complex urban system: the case of Kathmandu Valley, Nepal.

    Science.gov (United States)

    Carpenter, Samuel; Grünewald, François

    2016-07-01

    The city is a growing centre of humanitarian concern. Yet, aid agencies, governments and donors are only beginning to comprehend the scale and, importantly, the complexity of the humanitarian challenge in urban areas. Using the case study of the Kathmandu Valley, Nepal, this paper examines the analytical utility of recent research on complex urban systems in strengthening scholarly understanding of urban disaster risk management, and outlines its operational relevance to disaster preparedness. Drawing on a literature review and 26 interviews with actors from across the Government of Nepal, the International Red Cross and Red Crescent Movement, non-governmental organisations, United Nations agencies, and at-risk communities, the study argues that complexity can be seen as a defining feature of urban systems and the risks that confront them. To manage risk in these systems effectively, preparedness efforts must be based on adaptive and agile approaches, incorporating the use of network analysis, partnerships, and new technologies. PMID:26578230

  14. Disaster preparedness in a complex urban system: the case of Kathmandu Valley, Nepal.

    Science.gov (United States)

    Carpenter, Samuel; Grünewald, François

    2016-07-01

    The city is a growing centre of humanitarian concern. Yet, aid agencies, governments and donors are only beginning to comprehend the scale and, importantly, the complexity of the humanitarian challenge in urban areas. Using the case study of the Kathmandu Valley, Nepal, this paper examines the analytical utility of recent research on complex urban systems in strengthening scholarly understanding of urban disaster risk management, and outlines its operational relevance to disaster preparedness. Drawing on a literature review and 26 interviews with actors from across the Government of Nepal, the International Red Cross and Red Crescent Movement, non-governmental organisations, United Nations agencies, and at-risk communities, the study argues that complexity can be seen as a defining feature of urban systems and the risks that confront them. To manage risk in these systems effectively, preparedness efforts must be based on adaptive and agile approaches, incorporating the use of network analysis, partnerships, and new technologies.

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

    Directory of Open Access Journals (Sweden)

    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

  16. An unusual case of congenital melanocytic nevus presenting as neurocutaneous melanoma coexisting with Tuberous Sclerosis complex: A case report

    Directory of Open Access Journals (Sweden)

    Thacker Purujit J

    2011-07-01

    Full Text Available Abstract Introduction Congenital melanocytic nevi are among the several known risk factors for the development of melanoma. Neurocutaneous melanosis is a rare, congenital, non-hereditary disorder characterized by the presence of multiple and/or giant congenital melanocytic nevi. It is a rare condition, with fewer than 200 cases reported in the literature. Its association with tuberous sclerosis complex, a form of the neurocutaneous syndrome, is an unusual finding which, to the best of our knowledge, has not been documented in the English literature so far. Herein we present the first case documenting such an association in a 16-year-old post-pubertal Indian girl. Case presentation In this report, we describe the case of a 16-year-old Indian girl who presented to our hospital with swelling on the scalp which had progressed from the hairline to just above the left brow, causing mechanical ptosis. She was born with a black-pigmented triangular patch covered with hair over the scalp which had increased in size over a period of eight years after birth. An X-ray of her skull and ultrasonography revealed soft tissue swelling in the left temporofrontoparietal region. Magnetic resonance imaging of her brain showed the presence of 8.99 cm × 2.26 cm abnormal signal intensity involving the scalp, a few small tubers with cortical dysplasia in the left frontoparietal region with asymmetric dilatation, and the presence of calcified subependymal nodules within the left lateral ventricle. These findings were suggestive of tuberous sclerosis. A histopathological examination of the swelling was suggestive of congenital melanocytic nevi. The patient underwent surgery. Excision of the tumor with primary skin grafting was done, with the graft being taken from the medial aspect of the right thigh. Conclusion This case warrants further research to provide concrete evidence of an association of neurocutaneous melanoma with tuberous sclerosis complex. Research should be

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

    Directory of Open Access Journals (Sweden)

    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.

  18. MPO-ANCA associated crescentic glomerulonephritis with numerous immune complexes: case report

    Directory of Open Access Journals (Sweden)

    Morizane Ryuji

    2012-06-01

    Full Text Available Abstract Background Antineutrophil cytoplasmic antibody (ANCA-associated crescentic glomerulonephritis (CGN is a major cause of rapidly progressive glomerulonephritis (RPGN. ANCA-associated CGN is generally classified into pauci-immune RPGN, in which there are few or no immune complexes. Case Presentation A 78-year-old man presented with RPGN after a 7-year course of chronic proteinuria and hematuria with stable renal function. A blood examination showed a high titer of myeloperoxidase (MPO-ANCA. A renal biopsy showed crescentic glomerulonephritis with abundant subepithelial, intramenbranous and subendothelial deposits by electron microscopy, leading to the diagnosis of ANCA-associated CGN superimposed on type 3 membranoproliferative glomerulonephritis (MPGN. Conclusions This case is unique in that type 3 MPGN and MPO-ANCA-associated CGN coexisted, and no similar case has been reported to date. Because ANCA-associated CGN has a predilection for elderly individuals and primary type 3 MPGN is rarely seen in this age group, coincidental existence appears less likely. This case may confer valuable information regarding the link between immune complex and ANCA-associated CGN.

  19. 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

  20. 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...

  1. Transmission power in some particular cases of bi- or tri-dimensional complex systems

    Directory of Open Access Journals (Sweden)

    Eustache Megnigbeto

    2014-01-01

    Full Text Available In a complex system, mutual information measures the information common to the variables involved. In more than two dimensions, it indicates the level of synergy between variables or the level of self-organization or how central coordinated the system is. Mutual information has a lower and an upper bound that vary according to the system′s configuration. In this paper, we analyse the complex system of the Triple Helix of university-industry-government relationships from the information theory point of view. We find out general characteristics of bi- and tri-dimensional configurations where mutual information reaches its bounds; we compute efficiency, unused capacity and transmission power for such systems as well as for some particular cases.

  2. Shone's complex with dextrocardia and situs inversus totalis: a case report.

    Science.gov (United States)

    Ekici, Berkay; Erkan, Aycan Fahri; Sökmen, Yeliz; Tüfekçioğlu, Omaç

    2012-10-01

    Parachute mitral valve complex is an unusual congenital anomaly that has been described by Shone et al. It is characterized by a parachute deformity of the mitral valve associated with additional forms of left heart anomalies, such as aortic valvular stenosis and coarctation of the aorta. A 21-year-old female who was referred to our department because of progressive dyspnea on effort and at rest and minimal cyanosis is presented in this case report. On cardiac auscultation, the patient had a grade III/VI pansystolic murmur best heard at the lower left sternal border. The chest X-ray demonstrated dextrocardia and mild cardiomegaly. Echocardiographic evaluation revealed Shone's complex, including parachute mitral valve anomaly.

  3. Giant complex odontoma of the anterior mandible: report of case with long follow up.

    Science.gov (United States)

    Spini, Pedro Henrique Rezende; Spini, Túlio Humberto; Servato, João Paulo Silva; Faria, Paulo Rogério de; Cardoso, Sérgio Vitorino; Loyola, Adriano Mota

    2012-01-01

    This paper describes an exceptional case of an enormous complex odontoma affecting the mandibular symphysis of a 9-year-old boy. Because of its dimensions, the lesion produced cortical bone expansion, dental displacement and impactation, which are clinical signs very seldom described for odontomas. The lesion was surgically excised in a conservative way using an intraoral approach with local anesthesia. After 7 years of follow up, all teeth had erupted and the mandibular bone healed totally. Because of its radiographic mixed radiolucent and radiopaque appearance and its expansive growth, it is imperative to make the differential diagnosis of giant complex odontoma for other more aggressive mixed odontogenic tumors, such as ameloblastic fibro-odontoma, odotoameloblastoma and cystic calcified odontogenic tumor. Conservative approach appears to be indicated in the treatment of such lesions.

  4. Case Report: Gollop-Wolfgang Complex in a 5 month old baby.

    Science.gov (United States)

    Qureshi, Ihtesham A; Gudepu, Rohit Kumar; Chava, Ravikanth; Emmani, Sravya; Asghar, Syed Husain; Qureshi, Mohtashim A; Arlappa, Nimmathota

    2014-01-01

    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. PMID:26064472

  5. Epilepsy surgery for tuberous sclerosis complex: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    ZHAO Guo-guang; SHAN Yong-zhi; DU Jian-xin; LING Feng

    2008-01-01

    @@ Tuberous sclerosis complex (TSC) is a multisystem genetic disorder with variable phenotypic expression.Epilepsy is the most common neurological complication and up to 80%-90% of the individuals with TSC suffer from epilepsy at some point in their lifetime.Developmental delay, intellectual impairment, autism,behavioral problems, and neuropsychiatric disorders occur commonly in individuals with TSC and may be associated with poorly controlled epilepsy.1 In this paper we reported a case report of TSC, focusing on the patient's clinical symptom, surgical aspects and neuropathology through a comprehensive analysis.

  6. Epithelial and Fibrous Hyperplasia: An Oral Manifestation of Tuberous Sclerosis Complex. A Case Study.

    Science.gov (United States)

    Mbibi, Sandra U; Segelnick, Stuart L; Weinberg, Mea A

    2015-01-01

    The authors present a case study of a 13-year-old female with a past medical history of tuberous sclerosis complex (TSC), an autosomal dominant disorder. It usually presents with a triad of epilepsy, mental deficiency and facial angiofibromas that are often distributed around the nose, cheek and chin, and are frequently shaped like butterfly wings. In addition, oral manifestations include gingival enlargement and developmental enamel pitting on the facial aspect of the anterior permanent dentition in 50% to 100% of patients. The patient's chief complaint was gingival enlargement and gingival bleeding. The histology of the excised gingival tissue revealed epithelial and fibrous hyperplasia, consistent with TSC.

  7. 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.

  8. 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.

  9. SUPERFICIAL ANGIOMYXOMA OF THE NECK WITHOUT ASSOCIATED CARNEY’S COMPLEX: A RARE CASE REPORT

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    Suiyibangbe

    2015-05-01

    Full Text Available Superficial angiomyxomas are rare benign soft tissue tumour usually solitary and predominantly involving the dermis and subcutis. We report a case of 21 year s old male who presented with a history of swelling on the left upper anterolateral aspect of neck, measuring 3x2cm with irregular surface, non - tender, mobile and firm in consistency, fixed to the skin but not to the underlying structured. No lymph node was palpable. There was no evidence of any of the components of Carney’s complex at the time of presentation. Provisional diagnosis was made as Pleomorphic adenoma by FNAC. Wide local surgical excision was done. Histopathology examination revealed to be super ficial angiomyxoma. Here, we present a case of superficial angiomyxoma with a review to its rarity and difficulty in diagnosing and distinguishing from other soft tissue tumour of the skin.

  10. A Rare Cause of Prepubertal Gynecomastia: Sertoli Cell Tumor

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    Fatma Dursun

    2015-01-01

    Full Text Available Prepubertal gynecomastia due to testis tumors is a very rare condition. Nearly 5% of the patients with testicular mass present with gynecomastia. Sertoli cell tumors are sporadic in 60% of the reported cases, while the remaining is a component of multiple neoplasia syndromes such as Peutz-Jeghers syndrome and Carney complex. We present a 4-year-old boy with gynecomastia due to Sertoli cell tumor with no evidence of Peutz-Jeghers syndrome or Carney complex.

  11. A Rare Cause of Prepubertal Gynecomastia: Sertoli Cell Tumor

    Science.gov (United States)

    Dursun, Fatma; Su Dur, Şeyma Meliha; Şahin, Ceyhan; Kırmızıbekmez, Heves; Karabulut, Murat Hakan; Yörük, Asım

    2015-01-01

    Prepubertal gynecomastia due to testis tumors is a very rare condition. Nearly 5% of the patients with testicular mass present with gynecomastia. Sertoli cell tumors are sporadic in 60% of the reported cases, while the remaining is a component of multiple neoplasia syndromes such as Peutz-Jeghers syndrome and Carney complex. We present a 4-year-old boy with gynecomastia due to Sertoli cell tumor with no evidence of Peutz-Jeghers syndrome or Carney complex. PMID:26366315

  12. Reconstruction of complex shoulder defect in a case of subclavian artery thrombosis.

    Science.gov (United States)

    Satish, Chetan

    2013-06-01

    We report a case of a 24-year-old man with complex shoulder defect on the right side following a road traffic accident. The patient was found to have a subclavian artery thrombosis in its second part with good collaterals ensuring limb viability. Free-flap reconstruction was not possible because of lack of recipient vascular pedicle nearby. Pedicled flaps routinely used for this area such as pectoralis major and latissimus dorsi myocutaneous flaps could not be used as their vascular pedicles arise from the second and third parts of the axillary artery distal to the subclavian artery thrombosis. The best option we could think was the trapezius myocutaneous flap as its vascular pedicle arises from the first part of the subclavian artery proximal to the thrombosis. This article further establishes the importance of knowing the vascular supply of flaps before their clinical application. In this case the trapezius flap acts as a lifeboat for coverage of the complex shoulder defect as its vascular supply is proximal to the site of subclavian artery thrombosis.

  13. 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.

  14. Complex II deficiency--a case report and review of the literature.

    Science.gov (United States)

    Jain-Ghai, Shailly; Cameron, Jessie M; Al Maawali, Almundher; Blaser, Susan; MacKay, Nevena; Robinson, Brian; Raiman, Julian

    2013-02-01

    Complex II deficiency is a rare cause of mitochondrial respiratory chain defects with a prevalence of 2-23%. It is exclusively nuclear encoded and functions in the citric acid cycle by oxidizing succinate to fumarate and in the mitochondrial electron transport chain (ETC) by transferring electrons to ubiquinone. Of the four subunits, SDHA and SDHB are catalytic and SDHC and SDHD are anchoring. Mutations in SDHA and SDHAF1 (assembly factor) have been found in patients with CII deficiency and a mitochondrial phenotype. We present a patient with CII deficiency with a previously undescribed phenotype of dilated cardiomyopathy, left ventricular noncompaction, failure to thrive, hypotonia, and developmental delay. Also, a comprehensive review of 36 cases published in the literature was undertaken. The results show that CII deficiency has a variable phenotype with no correlation with residual complex activity in muscle although the phenotype and enzyme activities are comparable within a family. For some, the condition was fatal in infancy, others had multisystem involvement and some had onset in adulthood with mild symptoms and normal cognition. Neurological involvement is most commonly observed and brain imaging commonly shows leukoencephalopathy, Leigh syndrome, or cerebellar atrophy. Mutations in SDHAF1 are associated with leukoencephalopathy. Other organ systems like heart, muscle, and eyes are only involved in about 50% of the cases but cardiomyopathy is associated with high mortality and morbidity. In some patients, riboflavin has provided clinical improvement.

  15. 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

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

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    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.

  17. LIMB BODY WALL COMPLEX IN TWO HETEROZYGOTIC TWINS: A CASE REPORT

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    G. Giannotti

    2012-08-01

    Full Text Available Introdution. Limb-Body Wall Complex (LBWC is a congenital defect which includes at least two of the following characteristics: abdominal and/or thoracic body wall defects, exencephaly or encephalocoele with or without craniofacial defects (56% and spinal defects associated with marked vertebral or sacral defects (95%. Case Report. We present a case report of an infant with LBWC, borned by diamniotic twin pregnancy. A prenatal ultrasound reported an healthy fetus and a fetus with multiple malformations. At birth we found a big abdominal wall defect, absence of scrotal sac and testicles, asymmetric chest and no major deformities in craniofacial region. At 2 hours of life, we removed the amniotic sac, we put the stomach and the spleen in the abdominal cavity, which is virtual, and positioned a spring-loaded silo. At 15th day of life we had complete reduction of the intestinal loops and liver and we closed the wall defect with a prosthesis and a cryopreserved skin. The general conditions of the patient, very severe since birth, became progressively worse and he died in the 21st day of life. Discussion. Once the diagnosis is done the physician should offer the parents a therapeutic abortion, and above all, in case they want to carry the pregnancy to term, we need to prepare them to the severity of the malformation and the high probability of death.

  18. Complex papillary hyperplasia of the endometrium: an uncommon case report with cytopathological features and diagnostic implications.

    Science.gov (United States)

    Rekhi, Bharat; Menon, Santosh; Maheshwari, Amita

    2015-02-01

    Papillary proliferations of the endometrium, without atypia have been uncommonly documented, including on cytology specimens. Herein, we present an uncommon case of a 55-year-old obese lady, on antihypertensive medications, who presented with history of irregular perimenopausal bleeding. A year ago, she was diagnosed with simple cystic hyperplasia on dilation and curettage specimen. Presently, she underwent endometrial aspiration. Cytology smears were prepared from the collected tissue specimen that was further submitted for histopathological analysis. Although the smears were initially diagnosed as negative for malignancy, the tissue sections were reported as a uterine papillary serous carcinoma (UPSC). Review of the smears revealed prominent overlapping clusters and papillary arrangements of relatively banal endometrial cells exhibiting focal metaplasia. Histopathology sections confirmed diagnosis of complex papillary hyperplasia (CPH). Immunohistochemical (IHC) stains reinforced this impression with diffuse estrogen receptor positivity, low Ki-67/MIB1, and lack of diffuse p53 immunostaining. Subsequent hysterectomy, at the time of intraoperative consultation showed a small residual focus of CPH, restricted to endometrium with intramural leiomyomas and adenomyosis. This case is presented to highlight the fact that despite lack of significant atypia, cytological features like overlapping, clustering, and papillary formations are indicators of papillary lesions of the endometrium, including CPH, especially in postmenopausal women. On histopathology, in spite of conspicuous papillary formations, lack of significant nuclear pleomorphism, and tumor invasion are helpful features in avoiding an overdiagnosis of UPSC in such cases. IHC stains are supportive. Correct identification has significant therapeutic implications. PMID:24825243

  19. Average-Case Separation in Proof Complexity: Short Propositional Refutations for Random 3CNF Formulas

    CERN Document Server

    Müller, Sebastian

    2011-01-01

    Separating different propositional proof systems---that is, demonstrating that one proof system cannot efficiently simulate another proof system---is one of the main goals of proof complexity. Nevertheless, all known separation results between non-abstract proof systems are for specific families of hard tautologies: for what we know, in the average case all (non-abstract) propositional proof systems are no stronger than resolution. In this paper we show that this is not the case by demonstrating polynomial-size propositional refutations whose lines are $TC^0$ formulas (i.e., $TC^0$-Frege proofs) for random 3CNF formulas with $ n $ variables and $ \\Omega(n^{1.4}) $ clauses. By known lower bounds on resolution refutations, this implies an exponential separation of $TC^0$-Frege from resolution in the average case. The idea is based on demonstrating efficient propositional correctness proofs of the random 3CNF unsatisfiability witnesses given by Feige, Kim and Ofek [FOCS'06]. Since the soundness of these witnesse...

  20. Using cognitive behavioural therapy with complex cases: using the therapeutic relationship to change core beliefs.

    Science.gov (United States)

    Binnie, James

    2012-07-01

    Cognitive Behavioural Therapy (CBT) is often perceived as a manualised, symptom focused, surface level approach. This article aims to reflect on working with complex clinical presentations and explore how third wave CBT can be effectively integrated into standard cognitive behavioural interventions. To achieve these aims, a case study of a CBT assessment and treatment is presented. The interventions used are described in detail. The focus changes from the more traditional symptom-led interventions to third wave approaches based on the therapeutic relationship. When the focus was redirected towards the therapeutic relationship then real change occurred, quickly and powerfully. Reflections on the process are discussed and the overall approach used was evaluated with an action plan developed to enhance future clinical practice. It is hoped that this study can help CBT be viewed as a comprehensive form of psychotherapy.

  1. Complex pattern of colon cancer recurrence including a kidney metastasis: A case report

    Institute of Scientific and Technical Information of China (English)

    Helfried Waleczek; Moritz N Wente; Jürgen Kozianka

    2005-01-01

    We report a case of a 77-year-old female with a local recurrence of cancer after right hemicolectomy which infiltrated the pancreatic head affording pancreatoduodenectomy, who developed 3 years later recurrent tumor masses localized in the mesentery of the jejunum and in the lower pole of the left kidney. Partial nephrectomy and a segment resection of the small bowel were performed. Histological examination of both specimens revealed a necrotic metastasis of the primary carcinoma of the colon. Although intraluminal implantation of colon cancer cells in the renal pelvic mucosa from ureteric metastasis has been described, metastasis of a colorectal cancer in the kidney parenchyma is extremely rare and can be treated in an organ preserving manner. A complex pattern of colon cancer recurrence with unusual and rare sites of metastasis is reported.

  2. Coincidence of hepatocelluar carcinoma and hepatic angiomyolipomas in tuberous sclerosis complex:A case report

    Institute of Scientific and Technical Information of China (English)

    Bin Yang; Wen-Hui Chen; Pei-Zhi Shi; Jing-Jing Xiang; Ru-Jun Xu; Ji-Hong Liu

    2008-01-01

    Tuberous sclerosis complex (TSC) is a dominantly inherited disorder which characterized by the growth of harmatomatous in multiple organs.Unlike the common development of renal angiomyolipoma,hepatic angiomyolipoma rarely occur in patients with TSC.We report here a patient with hepatic angiomyolipomas and concurrent hepatocellular carcinoma in TSC.This represents the first reported case in English literature.In this patient,multiple hepatic angiomyolipomas were diagnosed with recognition of their fat components and typical clinical settings.Hepatocellular carcinoma in the left liver lobe was definitely diagnosed by US guided biopsy.In such clinical settings,fat containing lesions in liver can be reasonably treated as angiomyolipomas,but non fat containing lesions must be differentiated from hepatocellular carcinoma,imaging guided biopsy can be adopted to confirm the diagnosis.

  3. 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.

  4. Dental Treatment Considerations for Children with Complex Medical Histories: A Case of Townes-Brock Syndrome.

    Science.gov (United States)

    Elkaiali, Lujayn; Ratliff, Katelin; Oueis, Hassan

    2016-01-01

    It is common for oral health and dental care to be considered a lesser priority for children with complex medical histories than other aspects of their health care. Often, these patients are at a high risk for caries and infection due to poor oral health practices at home, special or restricted diets, and no early establishment of a dental home for routine dental care. Unfortunately, many of these patients present to their first dental visits with caries and require aggressive treatment, such as extractions instead of pulp therapy, or crowns instead of fillings, due to their high caries risk and the difficulty in safely managing them medically during treatment. A unique example of this occurred at the Children's Hospital of Michigan, where a patient with Townes-Brock syndrome (TBS) presented to the dental clinic with advanced caries. TBS is a rare autosomal dominant disorder characterized by major findings such as anomalies of the external ear, imperforate anus, renal malformations, and malformations of the hand. Like many medically complex cases, dental anomalies are not a direct consequence of TBS; however, due to the necessity of high calorie and high sugar feeding supplementation, many of these patients are at high risk for advanced dental caries. Due to this high caries risk, a more aggressive treatment plan is necessary to minimize the risk of recurrent decay and infection. It is critical to stress that even if the disease, syndrome, etc., of a patient does not have inherent dental consequences, it is imperative for regular dental care to be part of the comprehensive treatment plan for these patients. This includes the establishment of a dental home at a young age and proper oral health education of the patient's caregivers and their physicians. In the case of the patient with TBS, recommendations for daily brushing, especially after high sugar feedings was stressed, as well as the reduction of any other sweets within the diet. PMID:26882646

  5. Design for Reliability of Complex System: Case Study of Horizontal Drilling Equipment with Limited Failure Data

    Directory of Open Access Journals (Sweden)

    Morteza Soleimani

    2014-01-01

    Full Text Available Reliability is an important phase in durable system designs, specifically in the early phase of the product development. In this paper, a new methodology is proposed for complex systems’ design for reliability. Specific test and field failure data scarcity is evaluated here as a challenge to implement design for reliability of a new product. In the developed approach, modeling and simulation of the system are accomplished by using reliability block diagram (RBD method. The generic data are corrected to account for the design and environment effects on the application. The integral methodology evaluates reliability of the system and assesses the importance of each component. In addition, the availability of the system was evaluated using Monte Carlo simulation. Available design alternatives with different components are analyzed for reliability optimization. Evaluating reliability of complex systems in competitive design attempts is one of the applications of this method. The advantage of this method is that it is applicable in early design phase where there is only limited failure data available. As a case study, horizontal drilling equipment is used for assessment of the proposed method. Benchmarking of the results with a system with more available failure and maintenance data verifies the effectiveness and performance quality of presented method.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Phylloid pattern of pigmentary disturbance in a case of complex mosaicism.

    Science.gov (United States)

    Ribeiro Noce, T; de Pina-Neto, J M; Happle, R

    2001-01-15

    Among the various types of pigmentary disturbances associated with mosaicism, the phylloid pattern (Greek phyllon = leaf, eidos = form) is characterized by multiple leaf-like patches reminiscent of an art nouveau painting. The number of cases displaying this unusual pattern is so far limited. We describe a phylloid pattern of hypomelanosis in a 3-year-old girl with multiple congenital anomalies including microcephaly, midfacial hypoplasia, cleft lip, coloboma, posteriorly rotated ears, pectus carinatum, and pronounced mental and physical retardation. In addition, this child had oval or oblong patches of hyperpigmentation involving the trunk in a horizontal arrangement dissimilar from the phylloid hypomelanotic pattern. In peripheral blood lymphocytes a karyotype 46,XX,-13,+t(13q;13q) was consistently found, whereas cultured skin fibroblasts showed a complex form of mosaicism comprising three different abnormal cell lines (46,XX,-13,+t(13q;13q)/45,XX,-13/45,XX,-13,+frag). This case provides further evidence that the phylloid pattern represents a separate category of pigmentary disturbance to be distinguished from other types of cutaneous mosaicism such as the lines of Blaschko or the checkerboard arrangement.

  9. A New Method for Controlling Billet Temperature During Isothermal Die Forging of a Complex Superalloy Casing

    Science.gov (United States)

    Lin, Y. C.; Wu, Xian-Yang

    2015-09-01

    Isothermal die forging is one of near net-shape metal-forming technologies. Strict control of billet temperature during isothermal die forging is a guarantee for the excellent properties of final product. In this study, a new method is proposed to accurately control the billet temperature of complex superalloy casing, based on the finite element simulation and response surface methodology (RSM). The proposed method is accomplished by the following two steps. Firstly, the thermal compensation process is designed and optimized to overcome the inevitable heat loss of dies during hot forging. i.e., the layout and opening time of heaters assembled on die sleeves are optimized. Then, the effects of forging speed (the pressing velocity of hydraulic machine) and its changing time on the maximum billet temperature are discussed. Furthermore, the optimized forging speed and its changing time are obtained by RSM. Comparisons between the optimized and conventional die forging processes indicate that the proposed method can effectively control the billet temperature within the optimal forming temperature range. So, the optimized die forging processes can guarantee the high volume fraction of dynamic recrystallization, and restrict the rapid growth of grains in the forged superalloy casing.

  10. Tuberous sclerosis complex: Imaging characteristics in 11 cases and review of the literature.

    Science.gov (United States)

    Hu, Shan; Hu, Dao-Yu; Zhu, Wen-Zhen; Wang, Liang; Wang, Zi

    2016-08-01

    Tuberous sclerosis complex (TSC) is an uncommon multiorgan disorder that may present many and different manifestations on imaging. Radiology plays an important role in diagnosis and management, and can substantially improve the clinical outcome of TSC. Therefore, a comprehensive understanding of this disease is essential for the radiologist. The manifestations of TSC on computer tomography (CT) and magnetic resonance (MR) images were analyzed. Eleven patients with a clinical diagnosis of TSC were retrospectively reviewed. Central nervous system lesions included subependymal nodules (SENs) (11/11), subependymal giant cell astrocytomas (SEGAs) (2/11), cortical and subcortical tuber lesions (5/11), and white matter lesions (4/11). Of the 6 patients with abdominal scans, there were 6 cases of renal angiomyolipomas (AMLs), and one case of hepatic AMLs. Of the 4 patients undergoing chest CT, lung lymhangioleiomyomatosis (LAM) (2/4), and multiple small sclerotic bone lesions (2/4) were observed. Different modalities show different sensitivity to the lesion. Analysis of images should be integrated with patients' history in order to diagnose TSC. PMID:27465340

  11. Complex Bedforms and Complex Water Masses: A Case Study from the Tertiary to Present-day, Pelotas Basin, Offshore Uruguay

    Science.gov (United States)

    Thompson, P.; Badalini, G.; Wrigley, S.; Walker, R.; Argent, J.; Hernandez-Molina, J.; de Santa Ana, H.; Soto, M.; Tomasini, J.

    2015-12-01

    Contour currents are commonly associated with bedform development on modern seabeds yet there is a general paucity of published examples from the ancient record. Recently acquired 3D seismic data, covering over 13000km2 of the Pelotas Basin, offshore Uruguay, provides a unique opportunity to study the architecture and development of a variety of bedform. The data shows that, throughout the Tertiary, contour currents were the dominant control on sedimentation along the Uruguayan margin. The first evidence of contour current activity is during the Early Tertiary in the form of a major regional unconformity that, even though it was fully subaqueous, does not show any major features associated with downslope sedimentation. In the mid-slope region, the unconformity coincides with an extensive (1500km2) intra-slope scour-field orientated parallel to the slope. Individual scours are up to 40m deep, 500m wide and 3km long. Coeval with these scours are a group of coalesced basin floor scours, which run parallel to the base of slope and extend over 400km2. Individual scours exhibit an asymmetric shape - similar to giant flute marks - that are up to 150m deep, 20km wide and extend for at least 40km along slope. The development of these scoured areas shows clear evidence of two major north-flowing water masses. Directly above this regional unconformity are a series of ribbon-like bedforms that developed oblique to the slope. Individual bedforms are up to 40km in length with wavelengths of 5km and heights up to 100m. These bedforms are overlain by a set of barchan-like dunes, up to 30km in length with wavelengths of 10km. Individual dunes are in the order of 100m thick and stack to form an overall package up to 500m thick. These features show a clear change from erosion/bypass to deposition/reworking that is linked to a decrease in ocean current velocity and/ or sediment supply. The features observed suggest a complex oceanic regime was present throughout the Tertiary that

  12. Complex Variant of Philadelphia Translocation Involving Chromosomes 9, 12, and 22 in a Case with Chronic Myeloid Leukaemia

    Directory of Open Access Journals (Sweden)

    F. Malvestiti

    2014-01-01

    Full Text Available Chronic myeloid leukemia (CML is a hematopoietic stem cell disorder included in the broader diagnostic category of myeloproliferative neoplasms, associated with fusion by BCR gene at chromosome 22q11 to ABL1 gene at chromosome 9q34 with the formation of the Philadelphia (Ph chromosome. In 2–10% of CML cases, the fusion gene arises in connection with a variant translocation, involving chromosomes 9, 22, and one or more different chromosomes; consequently, the Ph chromosome could be masked within a complex chromosome rearrangement. In cases with variant Ph translocation a deletion on der(9 may be more frequently observed than in cases with the classical one. Herein we describe a novel case of CML with complex variant Ph translocation involving chromosomes 9, 12, and 22. We present the hematologic response and cytogenetic response after Imatinib treatment. We also speculated the mechanism which had originated the chromosome rearrangement.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Santos, L A N; Lopes, L J; Roque-Torres, G D; Oliveira, V F; Freitas, D Q

    2016-01-01

    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.

  15. Niche divergence builds the case for ecological speciation in skinks of the Plestiodon skiltonianus species complex

    Science.gov (United States)

    Wogan, Guinevere O.U.; Richmond, Jonathan Q.

    2015-01-01

    Adaptation to different thermal environments has the potential to cause evolutionary changes that are sufficient to drive ecological speciation. Here, we examine whether climate-based niche divergence in lizards of the Plestiodon skiltonianus species complex is consistent with the outcomes of such a process. Previous work on this group shows that a mechanical sexual barrier has evolved between species that differ mainly in body size and that the barrier may be a by-product of selection for increased body size in lineages that have invaded xeric environments; however, baseline information on niche divergence among members of the group is lacking. We quantified the climatic niche using mechanistic physiological and correlative niche models and then estimated niche differences among species using ordination techniques and tests of niche overlap and equivalency. Our results show that the thermal niches of size-divergent, reproductively isolated morphospecies are significantly differentiated and that precipitation may have been as important as temperature in causing increased shifts in body size in xeric habitats. While these findings alone do not demonstrate thermal adaptation or identify the cause of speciation, their integration with earlier genetic and behavioral studies provides a useful test of phenotype–environment associations that further support the case for ecological speciation in these lizards.

  16. 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.

  17. Primary leiomyosarcoma of the nipple-areola complex: Report of a case and review of literature

    Institute of Scientific and Technical Information of China (English)

    Lai-ching WONG; Po-chi HUANG; Shi-ping LUH; Chiun-sheng HUANG

    2008-01-01

    Primary leiomyosarcoma of the nipple-areola complex is extremely rare. Less than ten such cases have been reported in English literature so far. Herein we describe a 52-year-old female presenting with a 1.5 cm× 1.1 cm×0.7 cm nodular lesion over her left nipple, and leiomyosarcoma was proved by pathological examination of the excised specimen. Positron emitted tomogram (PET) revealed no abnormal signal other than the primary site. Microscopically, this poorly circumscribed tumor was composed of interlacing bundles of smooth muscle cells with bizarre and pleomorphic nuclei, as well as prominent nucleoli. Its mitotic count was up to 7 mitoses per 10 high power fields (HPF). Immunohistochemical study of tumor cells revealed positive stain for α-smooth muscle actin and vimentin; and negative for cytokeratin, CD34 and S-100. Left simple mastectomy was undertaken and no residual mass lesion was noted on the resected specimen. Related literatures about the diagnosis and treatment for breast leiomyosarcoma will be presented here.

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

    Spindle cell carcinoma of the breast is a rare tumor. hTis 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 ifne-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/m2, epirubicin 100 mg/m2, and cyclophosphamide 500 mg/m2) were administered. Radiotherapy was performed. hTis case is discussed with reference to the literature.

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

    Science.gov (United States)

    Santos, L. A. N.; Roque-Torres, G. D.; Oliveira, V. F.; Freitas, D. Q.

    2016-01-01

    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. PMID:27293913

  20. Neuroscience, neuropolitics and neuroethics: the complex case of crime, deception and FMRI.

    Science.gov (United States)

    Henry, Stuart; Plemmons, Dena

    2012-09-01

    Scientific developments take place in a socio-political context but scientists often ignore the ways their innovations will be both interpreted by the media and used by policy makers. In the rush to neuroscientific discovery important questions are overlooked, such as the ways: (1) the brain, environment and behavior are related; (2) biological changes are mediated by social organization; (3) institutional bias in the application of technical procedures ignores race, class and gender dimensions of society; (4) knowledge is used to the advantage of the powerful; and (5) its applications may reinforce existing structures of power that pose ethical questions about distributive justice. The case of crime, deception and functional Magnetic Resonance Imaging (fMRI) shows the complexity, and the political and ethical challenges that confront those who seek to use neuroscience to explain the etiology of crime, and who base policy on its findings. An ethically grounded neuroscience needs to take account of existing structures of power and difference, and to develop a public neuropolitical consciousness that ensures that those subject to risk by the application of science and technology are participants in the decision-making processes involving the implementation of policies that affect them.

  1. Case Study: Hidden Complexity of Medicines Use: Information Provided by a Person with Intellectual Disability and Diabetes to a Pharmacist

    Science.gov (United States)

    Flood, Bernadette; Henman, Martin C.

    2015-01-01

    People with intellectual disabilities may be "invisible" to pharmacists. They are a complex group of patients many of whom have diabetes. Pharmacists may have little experience of the challenges faced by this high risk group of patients who may be prescribed high risk medications. This case report details information supplied by Pat, a…

  2. Complex Childhood Trauma and School Responses: A Case Study of the Impact of Professional Development in One Elementary School

    Science.gov (United States)

    VanderWegen, Terrie A.

    2013-01-01

    The purpose of this qualitative case study was to examine one public elementary school in Spokane, Washington that has received significant complex trauma professional development training provided by Washington State University Area Health Education Center (WSU-AHEC). The study explored teachers', specialists', and the principal's perceptions of…

  3. 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 react

  4. From survey to high definition representations of a continuous architectonical space. The case study of the Pomposa Abbey complex

    Directory of Open Access Journals (Sweden)

    Anna Maria Manferdini

    2015-01-01

    Full Text Available The aim of this paper is to show the main results about high resolution 3D digital survey and representations of Santa Maria di Pomposa complex.The project has been developed in order to compare different methodologies, evaluating their effectiveness in the survey and representation of a huge architectural complex. This digitizationcampaign was planned for reproducing different multi-scalar representations, analyzing the digital replica of the site from different points of view and for different communication purposes. The paper presents some exemplifications of graphic representations extracted from a complex and multi-scalar 3D digital model. The adopted approach and the methodology has been developed and tested on field about a specific case study, but it can be extended to other examples which will present similar characteristics in critical and potential terms, common in several Cultural Heritage case studies.

  5. Understanding the lithosphere in complex tectonic scenarios by integrating geophysical data: The Pyrenees case study

    Science.gov (United States)

    Campanyà, Joan; Fullea, Javier; Ledo, Juanjo; Queralt, Pilar; Marcuello, Alex; Liesa, Montserrat; Muñoz, Josep Anton

    2016-04-01

    Tectonic processes dominate the development of the outermost layer of the Earth over a timescale of millions of years. The locations where these processes take place provide a great opportunity for Earth scientists to study and understand the dynamics and properties of the lithosphere. The Pyrenees are a particular case of continental collision formed as a result of the collision between the Iberian and European plates, which caused the subduction of the Iberian lower crust below the European crust. Large amounts of geophysical data have been acquired in the area providing spectacular images of lithospheric subduction beneath the Western and Central Pyrenees, confirming the occurrence of this generally well-understood process. The Eastern Pyrenees, however, are a most puzzling part of the orogen and the geodynamical evolution of this area cannot be understood without the influence of the Neogene Mediterranean rifting, following the continental collision. The complexity of this area and the controversy of the geophysical results set in debate concepts well recognized in the other parts of the Pyrenees such as the subduction of the Iberian lower crust and the depth of the lithosphere-asthenosphere boundary. The aims of this study are to characterise major tectonic and geophysical variations along the Pyrenean mountain range at a lithospheric-scale and constrain the causes of the observed lateral variations. A preliminary model of the lithospheric configuration and dynamics, based on magnetotelluric geophysical results, has been developed and constrained using independent and available geophysical, geological and geochemical data. Computational petrology methods, using Litmod, were used for integrated modelling of all data.

  6. Unusually large complex odontoma in maxillary sinus associated with unerupted tooth. Report of case and review of literature.

    Science.gov (United States)

    Singer, Steven R; Mupparapu, Muralidhar; Milles, Maano; Rinaggio, Joseph; Pisano, Dominic; Quaranta, Patrick

    2007-01-01

    An unusual case of a large complex odontoma with an associated impacted tooth is presented. Odontomas are hamartomatous growths of enamel, dentin, cementum and pulp tissue. Although they are usually tooth-sized or smaller, occasionally, the complex variant can exhibit considerable growth, as was seen in the case presented here. It occupied most of the maxillary sinus and displaced the floor of the orbit and the medial and posterior walls of the left maxillary sinus. Panoramic radiographs, as well as axial and coronal CT studies, showed the extent of the lesion in various dimensions. A differential diagnosis of various calcifying tumors was formulated on the basis of these findings. The lesion was surgically excised, and histologic analysis confirmed the radiographic impression. Although odontomas of this magnitude are rare, this case demonstrates the value of imaging, radiographic histopathologic diagnosis and surgical treatment planning prior to any definitive treatment.

  7. Co-managing complex social-ecological systems in Tanzania : the case of Lake Jipe wetland

    OpenAIRE

    Mahonge, C.P.I.

    2010-01-01

    It has been conventional among co-management scientists to view social-ecological systems and actors and institutions found in these systems monolithically. Such a view is simplistic and conceals the complex nature of social-ecological systems and associated institutions and actors. In essence, a social-ecological system is a complex system comprised of multiple, diverse and dynamic social-ecological units, players and rules. This thesis entitled Co-managing complex social-ecological systems ...

  8. Characteristics of Urban Sustainability in the Cases of Multi Commercial Complexes from the Perspective of the “Ground”

    Directory of Open Access Journals (Sweden)

    Soomi Kim

    2016-05-01

    Full Text Available In the diverse research on Multi Commercial Complexes, rather than a technical and statistical approach, it is now time to focus on the quality of urban sustainability based on the daily experience of urban residents. Therefore, this research proposes a mechanism for making a sophisticated adjustment to the “Ground”, defined as the empty space of a designated site under the existing urban conditions, towards planning the sustainability of a Multi-Commercial Complex. For the first step, the elements of urban sustainability were extracted from the Figure-Ground Theory and the urban theory of Aldo Rossi and Kevin Lynch, respectively. The relationship between the methodology, which deals with the concept of “Ground” and its sustainable urban status, is analyzed using five selected multi-commercial complex cases. We derived the characteristics of “Ground” represented in each case, including “Responding”, “Contextual”, “Historical”, “Co-existing”, and “Hybrid” sustainability. In each case, the “Ground” was treated as a crucial common issue. In this paper, we suggest that preferential consideration and sensitive design of the “Ground” are crucial for maintaining urban sustainability in the planning of Multi Commercial Complexes. This paper can thus contribute to the body of research on urban sustainability along with existing technical studies.

  9. Dynamic Development of Complexity and Accuracy: A Case Study in Second Language Academic Writing

    Science.gov (United States)

    Rosmawati

    2014-01-01

    This paper reports on the development of complexity and accuracy in English as a Second Language (ESL) academic writing. Although research into complexity and accuracy development in second language (L2) writing has been well established, few studies have assumed the multidimensionality of these two constructs (Norris & Ortega, 2009) or…

  10. 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…

  11. Time Series Analysis OF SAR Image Fractal Maps: The Somma-Vesuvio Volcanic Complex Case Study

    Science.gov (United States)

    Pepe, Antonio; De Luca, Claudio; Di Martino, Gerardo; Iodice, Antonio; Manzo, Mariarosaria; Pepe, Susi; Riccio, Daniele; Ruello, Giuseppe; Sansosti, Eugenio; Zinno, Ivana

    2016-04-01

    The fractal dimension is a significant geophysical parameter describing natural surfaces representing the distribution of the roughness over different spatial scale; in case of volcanic structures, it has been related to the specific nature of materials and to the effects of active geodynamic processes. In this work, we present the analysis of the temporal behavior of the fractal dimension estimates generated from multi-pass SAR images relevant to the Somma-Vesuvio volcanic complex (South Italy). To this aim, we consider a Cosmo-SkyMed data-set of 42 stripmap images acquired from ascending orbits between October 2009 and December 2012. Starting from these images, we generate a three-dimensional stack composed by the corresponding fractal maps (ordered according to the acquisition dates), after a proper co-registration. The time-series of the pixel-by-pixel estimated fractal dimension values show that, over invariant natural areas, the fractal dimension values do not reveal significant changes; on the contrary, over urban areas, it correctly assumes values outside the natural surfaces fractality range and show strong fluctuations. As a final result of our analysis, we generate a fractal map that includes only the areas where the fractal dimension is considered reliable and stable (i.e., whose standard deviation computed over the time series is reasonably small). The so-obtained fractal dimension map is then used to identify areas that are homogeneous from a fractal viewpoint. Indeed, the analysis of this map reveals the presence of two distinctive landscape units corresponding to the Mt. Vesuvio and Gran Cono. The comparison with the (simplified) geological map clearly shows the presence in these two areas of volcanic products of different age. The presented fractal dimension map analysis demonstrates the ability to get a figure about the evolution degree of the monitored volcanic edifice and can be profitably extended in the future to other volcanic systems with

  12. A case of complexity in the Latin American family. Tracing the Galleno Villafán history

    Directory of Open Access Journals (Sweden)

    Lucía Galleno

    2016-07-01

    Full Text Available The complexity and diversity of many Latin America families create a peculiar space of real as well as phantasmagoric presences. The Latin American history draws upon multicultural and multiethnic references that are at times untraceable. Latin American fa milies develop in this context often unaware of the constant transformation and amalgamation impacting the personal and communal consciousness. Yet memory anchors their evolutional reference and serves to create an identity. In this essay, I present a case study of family complexity and the relevance of memory in defining or forming family identity. This is the Galleno Villafán family, my family that evolved from Peruvians and immigrants.

  13. Money, case complexity, and wait lists: perspectives on problems and solutions at children's mental health centers in Ontario.

    Science.gov (United States)

    Reid, Graham J; Brown, Judith Belle

    2008-07-01

    Senior managers of children's mental health centers across Ontario, Canada were interviewed regarding the challenges and solutions of access and delivery of care. The central challenges--funding, case complexity, waitlists, staffing, and system integration--revealed a complex interplay between the policies and financing of children's mental health services and the provision of clinical services at the agency level and within the community. The desire for integration and collaboration was countered by competition for funding and service demands. A need for policies that allow for local solutions while providing leadership for sustained improvements in the ease and timeliness of access to care and effective clinical services emerged. PMID:18512157

  14. The Use of Best Practice in the Treatment of a Complex Diabetic Foot Ulcer: A Case Report

    OpenAIRE

    Melodie Blakely

    2016-01-01

    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 include...

  15. A Case of Follicular Bronchiolitis as the Histological Counterpart to Nodular Opacities in Bronchiectatic Mycobacterium avium Complex Disease

    Directory of Open Access Journals (Sweden)

    Kentaro Wakamatsu

    2012-01-01

    Full Text Available Here we report the case of a 72-year-old woman with nodular bronchiectatic Mycobacterium avium complex (MAC disease. Chest computed tomography on admission revealed multiple micronodular and branching opacities in both lobes with segmental distribution; bronchiectasis and bronchial wall thickening were observed in the middle lobe and lingula. The patient consented to and underwent thoracoscopic lung biopsy; epithelioid granulomas were occasionally observed, but follicular bronchiolitis was widespread. While bronchial lesions from nontuberculous mycobacterial infection generally present as epitheliod granulomas, the present case suggests that follicular bronchiolitis can also be a histological counterpart to nodular opacities in nodular bronchiectatic MAC disease.

  16. Making System Dynamics Cool II: New Hot Teaching and Testing Cases of Increasing Complexity

    OpenAIRE

    Pruyt, E.

    2010-01-01

    This follow-up paper presents several actual cases for testing and teaching System Dynamics. The cases were developed between April 2009 and January 2010 for the Introductory System Dynamics courses at Delft University of Technology in the Netherlands. They can be used for teaching and testing introductory System Dynamics courses at university level as well as for self study. The cases included here range from easy/short to difficult/long.

  17. Origin of plagiogranites in oceanic complexes: A case study of the Nicoya and Santa Elena terranes, Costa Rica

    Science.gov (United States)

    Whattam, Scott A.; Gazel, Esteban; Yi, Keewook; Denyer, Percy

    2016-10-01

    The origin of minor leucocratic intrusions known as "plagiogranites" in oceanic complexes dominated by basaltic compositions have been debated in the literature. Here we use well preserved plagiogranites within the contrasting Santa Elena Ophiolite and the Nicoya Complex, NW Costa Rica, to investigate the origin and age of these leucocratic intrusions. Magmatic zircons of plagiogranites of the Santa Elena ophiolite and the Nicoya Complex, yield weighted mean SHRIMP 206Pb/238U ages of 125.3 ± 2.0 Ma and 90.9 ± 2.0 Ma to 88.5 ± 2.0 Ma (n = 5), respectively. These ages record the main magmatic phases of formation of these intrusions preserved in each complex. Relatively flat, unfractionated chondrite-normalized REE patterns of plagiogranites from both complexes mimic signatures of related mafic rocks, which is consistent with formation via fractional crystallization from a mafic source as opposed to partial melting of a mafic (basalt, amphibolite) protolith. In the case of the Nicoya Complex, modelling suggests that the Nicoya plagiogranites are consistent as ~ 10-15% residual liquids after fractional crystallization from its mafic parental source. Trace element systematics of the plagiogranites are consistent with an oceanic arc origin for Santa Elena and a mostly mid-ocean ridge to oceanic-plateau origin for Nicoya.

  18. 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.

  19. Complexity as a cost driver in international call center management - Case: The Lufthansa Service Center Network

    OpenAIRE

    Heimo, Taina

    2010-01-01

    Objectives of the Study The purpose of this study was to examine the phenomenon of complexity and its effect on the cost of providing call center services. Furthermore, the goal was to analyze how call center management can influence these costs. The research is positioned in the field of call center management, while complexity – defined in this study as the variety of services, and the characteristics of and requirements set for the service delivery – formed the starting point and motiv...

  20. IT COMPLEX PROJECT MANAGEMENT: A CASE STUDY WITH FOCUS ON THE BUSINESS STRATEGY IN THE FINANCIAL SERVICES INDUSTRY

    Directory of Open Access Journals (Sweden)

    Ana Glória Slechticius

    2012-12-01

    Full Text Available This study aims to analyze what is the relationship between the concepts of complex project management and IT strategic planning in companies from the financial industry. To this end, from the literature review, we present four research assumptions that were analyzed empirically through the strategy of a single case study in a company in the financial sector with high representation in the Brazilian scenario. It was found that the strategic management of IT is related to the alignment between business and IT being the correct execution of complex projects in IT is naturally part of the strategic plans of the organizations due to the key role that IT plays in supporting the business. Additionally, it was found to be necessary alignment between strategic objectives and business of an organization that relies on IT to substantially that the implementation of a complex IT project has effective foundation to be properly implemented.

  1. The complexities in system building strategies — The case of personalized cancer medicines in England

    NARCIS (Netherlands)

    Kukk, P.; Moors, E.H.M.; Hekkert, M.P.

    2015-01-01

    Abstract Novel technologies often face difficulties in market uptake, especially when they differ significantly from already established technologies. In some cases, like personalized medicine, new technologies are composed of a number of parallel emerging technologies – in our case therapeutics and

  2. Role of Occupational Therapy in Case Management and Care Coordination for Clients With Complex Conditions.

    Science.gov (United States)

    Robinson, Monica; Fisher, Thomas F; Broussard, Kim

    2016-01-01

    Specific aspects of the profession of occupational therapy support a distinct value for its practitioners participating fully in the development of case management and care coordination systems. The expectation in the 21st century is that the U.S. health care system must be transformed from one that promotes volume of service to one that promotes value of care. Case management and care coordination will be critical components of that transformation. Occupational therapy's principles, education, practice, approach, and perspective offer much to benefit this increased attention to case management and care coordination. Occupational therapy practitioners should promote themselves and their profession as these system changes develop.

  3. Radiofrequency Ablation of Accessory Pathways in Chil- dren with Complex Congenital Cardiac Lesions: A Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Mohammad Dalili

    2015-10-01

    Full Text Available Catheter ablation is an accepted, highly effective modality of treatment for cardiac arrhythmias in children. The success rate depends on the operator’s experience, especially in cases involving complex anatomies. We hereby report our recent experience of successful ablation of accessory pathways in three children with complex congenital heart diseases.The first case was a 7-year-old girl with tricuspid atresia and a previous Glenn shunt, in whom a sub-epicardial overt accessory pathway was successfully ablated via the coronary sinus. The second case, a 9-year-old girl, received accessory pathway ablation via the fenestration of an extracardiac Fontan pathway. The third case was a 14-year-old boy with dextrocardia, common atrium, common ventricle, and a previous extracardiac Fontan operation, in whom ablation of a concealed accessory pathway was carried out retrogradely from the aorta. All the ablations were done in Rajaie Cardiovascular, Medical and Research Center, Tehran, and all the patients were discharged from the hospital without any complication.

  4. Prediction in complex systems: The case of the international trade network

    Science.gov (United States)

    Vidmer, Alexandre; Zeng, An; Medo, Matúš; Zhang, Yi-Cheng

    2015-10-01

    Predicting the future evolution of complex systems is one of the main challenges in complexity science. Based on a current snapshot of a network, link prediction algorithms aim to predict its future evolution. We apply here link prediction algorithms to data on the international trade between countries. This data can be represented as a complex network where links connect countries with the products that they export. Link prediction techniques based on heat and mass diffusion processes are employed to obtain predictions for products exported in the future. These baseline predictions are improved using a recent metric of country fitness and product similarity. The overall best results are achieved with a newly developed metric of product similarity which takes advantage of causality in the network evolution.

  5. Prediction in complex systems: the case of the international trade network

    CERN Document Server

    Vidmer, Alexandre; Medo, Matúš; Zhang, Yi-Cheng

    2015-01-01

    Predicting the future evolution of complex systems is one of the main challenges in complexity science. Based on a current snapshot of a network, link prediction algorithms aim to predict its future evolution. We apply here link prediction algorithms to data on the international trade between countries. This data can be represented as a complex network where links connect countries with the products that they export. Link prediction techniques based on heat and mass diffusion processes are employed to obtain predictions for products exported in the future. These baseline predictions are improved using a recent metric of country fitness and product similarity. The overall best results are achieved with a newly developed metric of product similarity which takes advantage of causality in the network evolution.

  6. 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.

  7. The Physics of Life and Quantum Complex Matter: A Case of Cross-Fertilization

    Directory of Open Access Journals (Sweden)

    Nicola Poccia

    2011-09-01

    Full Text Available Progress in the science of complexity, from the Big Bang to the coming of humankind, from chemistry and biology to geosciences and medicine, and from materials engineering to energy sciences, is leading to a shift of paradigm in the physical sciences. The focus is on the understanding of the non-equilibrium process in fine tuned systems. Quantum complex materials such as high temperature superconductors and living matter are both non-equilibrium and fine tuned systems. These topics have been subbjects of scientific discussion in the Rome Symposium on the “Quantum Physics of Living Matter”.

  8. Software efforts estimation using Use Case Point approach by increasing Technical Complexity and Experience Factors

    Directory of Open Access Journals (Sweden)

    Chetan Nagar

    2011-10-01

    Full Text Available An IT industry wants a simple and accurate method of efforts estimation. Estimation of efforts before starting of work is a prediction and prediction always not accurate. Intermediate COCOMOconsidered 17 factor that affecting the efforts, UCP considered 13 Technical Complexity Factors and 05 Experience factors. There is a lot factors that can affect efforts estimation .Most of the parameter are covered by COCOMO and UCP, but some parameters which are included in COCOMO left by UCP. UCP is one of the popular approaches of effort estimation. This paper is increasing the Technical complexity and Experience factors used in traditional UCP approach.

  9. Engineering hierarchical complex systems: an agent-based approach. The case of flexible manufacturing systems

    CERN Document Server

    Morvan, Gildas; Soyez, Jean-Baptiste; Merzouki, Rochdi; 10.1007/978-3-642-27449-7_4

    2012-01-01

    This article introduces a formal model to specify, model and validate hierarchical complex systems described at different levels of analysis. It relies on concepts that have been developed in the multi-agent-based simulation (MABS) literature: level, influence and reaction. One application of such model is the specification of hierarchical complex systems, in which decisional capacities are dynamically adapted at each level with respect to the emergences/constraints paradigm. In the conclusion, we discuss the main perspective of this work: the definition of a generic meta-model for holonic multi-agent systems (HMAS).

  10. 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

  11. L2 Grammatical Gender in a Complex Morphological System: The Case of German

    Science.gov (United States)

    Spinner, Patti; Juffs, Alan

    2008-01-01

    In order to determine the nature of naturalistic learners' difficulty with grammatical gender in a complex morphological system, the longitudinal production data of an early naturalistic L1-Italian and L1-Turkish learner who are acquiring German are examined in light of current theories of gender within Chomsky's (1995) Minimalist Program. After…

  12. Manifestation of Chaos in Real Complex Systems: Case of Parkinson's Disease

    CERN Document Server

    Yulmetyev, R M; Hänggi, P; Yulmetyev, Renat M.; Demin, Sergey A.; H\\"{a}nggi, Peter

    2006-01-01

    In this chapter we present a new approach to the study of manifestations of chaos in real complex system. Recently we have achieved the following result. In real complex systems the informational measure of chaotic chatacter (IMC) can serve as a reliable quantitative estimation of the state of a complex system and help to estimate the deviation of this state from its normal condition. As the IMC we suggest the statistical spectrum of the non-Markovity parameter (NMP) and its frequency behavior. Our preliminary studies of real complex systems in cardiology, neurophysiology and seismology have shown that the NMP has diverse frequency dependence. It testifies to the competition between Markovian and non-Markovian, random and regular processes and makes a crossover from one relaxation scenario to the other possible. On this basis we can formulate the new concept in the study of the manifestation of chaoticity. We suggest the statistical theory of discrete non-Markov stochastic processes to calculate the NMP and t...

  13. How Humans Solve Complex Problems: The Case of the Knapsack Problem

    Science.gov (United States)

    Murawski, Carsten; Bossaerts, Peter

    2016-01-01

    Life presents us with problems of varying complexity. Yet, complexity is not accounted for in theories of human decision-making. Here we study instances of the knapsack problem, a discrete optimisation problem commonly encountered at all levels of cognition, from attention gating to intellectual discovery. Complexity of this problem is well understood from the perspective of a mechanical device like a computer. We show experimentally that human performance too decreased with complexity as defined in computer science. Defying traditional economic principles, participants spent effort way beyond the point where marginal gain was positive, and economic performance increased with instance difficulty. Human attempts at solving the instances exhibited commonalities with algorithms developed for computers, although biological resource constraints–limited working and episodic memories–had noticeable impact. Consistent with the very nature of the knapsack problem, only a minority of participants found the solution–often quickly–but the ones who did appeared not to realise. Substantial heterogeneity emerged, suggesting why prizes and patents, schemes that incentivise intellectual discovery but discourage information sharing, have been found to be less effective than mechanisms that reveal private information, such as markets. PMID:27713516

  14. The inter-Korean economic cooperation: the case of Kaesong Industrial Complex

    OpenAIRE

    Ángel Licona Michel; Cintli Ayesa Cárdenas Barajas

    2012-01-01

    The inter-Korean economic cooperation materialized with the development of Kaesong Industrial Complex shows that the governments of South Korea and North Korea despite having unstable political relations need to agree to enhance trade and increase productivity of industries seeking thereby to have more competitive economies to detonate the creation of more infrastructure.

  15. Co-managing complex social-ecological systems in Tanzania : the case of Lake Jipe wetland

    NARCIS (Netherlands)

    Mahonge, C.P.I.

    2010-01-01

    It has been conventional among co-management scientists to view social-ecological systems and actors and institutions found in these systems monolithically. Such a view is simplistic and conceals the complex nature of social-ecological systems and associated institutions and actors. In essence, a so

  16. Tuberous sclerosis complex complicated with extraventricular cystic giant cell astrocytoma: case report

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu-zhu; DAI Jian-ping

    2007-01-01

    @@ Tuberous sclerosis complex (TSC) is one of the most commonly identified neurocutaneous disorders with a prevalence of 1/6000 to 1/9000 in general population1,2 In the patients with TSC, 10%-15% have subependymal giant cell astrocytoma (SGCA) .3

  17. The inter-Korean economic cooperation: the case of Kaesong Industrial Complex

    Directory of Open Access Journals (Sweden)

    Ángel Licona Michel

    2012-06-01

    Full Text Available The inter-Korean economic cooperation materialized with the development of Kaesong Industrial Complex shows that the governments of South Korea and North Korea despite having unstable political relations need to agree to enhance trade and increase productivity of industries seeking thereby to have more competitive economies to detonate the creation of more infrastructure.

  18. 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 buil

  19. Evolution of multi-enzyme complexes: the case of tryptophan synthase.

    Science.gov (United States)

    Leopoldseder, Sonja; Hettwer, Stefan; Sterner, Reinhard

    2006-11-28

    The prototypical tryptophan synthase is a stable heterotetrameric alpha-betabeta-alpha complex. The constituting TrpA and TrpB1 subunits, which are encoded by neighboring genes in the trp operon, activate each other in a bi-directional manner. Recently, a novel class of TrpB2 proteins has been identified, whose members contain additional amino acids that might sterically prevent complex formation with TrpA. To test this hypothesis, we characterized the TrpA and TrpB proteins from Sulfolobus solfataricus. This hyperthermophilic archaeon does not contain a TrpB1 protein but instead contains two TrpB2 homologues that are encoded within (TrpB2i) and outside (TrpB2o) the trp operon. We find that TrpB2i and TrpA form a weak and transient complex during catalysis, with a uni-directional activation of TrpA by TrpB2i. In contrast, TrpB2o and TrpA do not form a detectable complex. These results suggest a model for the evolution of the tryptophan synthase in which TrpB2o, TrpB2i, and TrpB1 reflect the stepwise increase of TrpB affinity for TrpA and the refinement of functional subunit interaction, concomitant with the co-localization of the encoding genes in the trp operon. PMID:17115706

  20. APLASIA CUTIS CONGENITAL WITH AMNIOTIC BAND DISRUPTION COMPLEX: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Pradipprava

    2015-09-01

    Full Text Available Aplasia cutis congenita (ACC is congenital absence of skin, most commonly affecting scalp. Etiology is multifactorial like intrauterine infection, teratogens, vascular causes, genetic syndromes etc. We here represent an infant with ACC involving extremities and associated with amniotic band disruption complex. He was treated conservatively and discharged.

  1. Colloids formation versus complexation in radionuclides natural organic matter interaction studies: the case of Boom clay

    International Nuclear Information System (INIS)

    Full text of publication follows: Complexation of radionuclides (RN) by Natural Organic Matter (NOM) present in the host rock may pose a negative impact on the safety of a radioactive waste repository. This is because the formed complexes may increase the solubility, decrease the sorption, and thus enhance the mobility of RN. For Boom Clay, the reference host formation in Belgium for methodological research, and the one with probably the most abundant NOM content among the studied sites in the world, such a negative impact has not been demonstrated. This paper illustrates that Boom Clay NOM plays only a negligible role in RN complexation, based on data produced by the EC project TRANCOM-II. Classic approaches use a conditional stability constant (CSC) to measure the extent of interaction between RN and NOM. Such approaches borrow the theories from aquatic chemistry and model NOM as a complexing ligand. At neutral to alkaline pH, the condition relevant for most of disposal sites, side reactions such as hydrolysis and carbonate complexation interfere with the formation of RN-NOM complexes so that a CSC is highly conditional. Most of the published CSC values are very large implying high stabilities of formed RN-NOM complexes. A large value of a CSC predicts an increase in solubility and, if the formed RN-NOM complex is not sorbed, a decrease in sorption. Such predictions should be tested, before applied in safety assessments, by solubility and sorption experiments under relevant disposal conditions. Solubilities of laboratory prepared, amorphous tetravalent uranium and thorium phases were determined under geochemical conditions of Boom Clay with varying concentrations of NOM, mainly humic acid. Experimental results showed that Boom Clay NOM did not have an observable impact on the solubility of U(IV) and Th. For both actinides, however, NOM facilitated the formation of U/Th bearing colloids resulting in an apparent increase of U(IV) and Th concentration 3 orders of

  2. A possibility to identify the vehicle driver through complex forensic and criminalistic expertise--case report.

    Science.gov (United States)

    Păduraru, G; Knieling, A; Scripcaru, C; Iliescu, Diana Bulgaru

    2014-01-01

    Traffic accidents can have more or less dramatic consequences that involve penal and civil responsibility with amplitude extending over long periods of time. In many cases, substitution of the driver with the passenger in order to avoid criminal responsibility is often remarked. The substitution takes place with the passenger's agreement or, in cases with dramatic consequences (coma or death), without his/her consent. These situations are encountered in civil cases regarding insurance fraud. In addition to forensic medical expertise, to aid the experts, mathematical modeling and computer simulation of the dynamics of vehicle passengers is a tool that completes the criminal expertise of traffic accidents. This paper presents the method of identification of the person driving the vehicle based on the computer simulation of vehicle occupants' dynamics.

  3. A possibility to identify the vehicle driver through complex forensic and criminalistic expertise--case report.

    Science.gov (United States)

    Păduraru, G; Knieling, A; Scripcaru, C; Iliescu, Diana Bulgaru

    2014-01-01

    Traffic accidents can have more or less dramatic consequences that involve penal and civil responsibility with amplitude extending over long periods of time. In many cases, substitution of the driver with the passenger in order to avoid criminal responsibility is often remarked. The substitution takes place with the passenger's agreement or, in cases with dramatic consequences (coma or death), without his/her consent. These situations are encountered in civil cases regarding insurance fraud. In addition to forensic medical expertise, to aid the experts, mathematical modeling and computer simulation of the dynamics of vehicle passengers is a tool that completes the criminal expertise of traffic accidents. This paper presents the method of identification of the person driving the vehicle based on the computer simulation of vehicle occupants' dynamics. PMID:25581977

  4. Governance of complex socio-environmental risks: the case of hazardous chemicals in the Baltic Sea.

    Science.gov (United States)

    Karlsson, Mikael; Gilek, Michael; Udovyk, Oksana

    2011-03-01

    Complex socio-environmental risks challenge society. In response to scientific uncertainty and sociopolitical controversies, environmental governance, precaution, and the ecosystem approach to management are held forward as complements to governmental risk-based sector-restricted regulation. We analyze this development for hazardous substances in the Baltic Sea. Based on interviews and policy analysis, we study informal governance and, in particular, four central EU and international policies, and investigate how present governance relates to risks and objectives at hand. While showing emergence of broader governance approaches, we conclude that central objectives will not likely be met. Furthermore, we question the quest for broad environmental governance and emphasize the value of command and control regulation, if it implements precaution. These findings contribute to the theorizing on environmental (risk) governance. Finally, we provide some ideas that could help development and implementation of risk policies for hazardous chemicals in the Baltic Sea as well as other complex risks.

  5. The complex chemistry of outflow cavity walls exposed: the case of low-mass protostars

    CERN Document Server

    Drozdovskaya, Maria N; Visser, Ruud; Harsono, Daniel; van Dishoeck, Ewine F

    2015-01-01

    Complex organic molecules are ubiquitous companions of young low-mass protostars. Recent observations suggest that their emission stems, not only from the traditional hot corino, but also from offset positions. In this work, 2D physicochemical modelling of an envelope-cavity system is carried out. Wavelength-dependent radiative transfer calculations are performed and a comprehensive gas-grain chemical network is used to simulate the physical and chemical structure. The morphology of the system delineates three distinct regions: the cavity wall layer with time-dependent and species-variant enhancements; a torus rich in complex organic ices, but not reflected in gas-phase abundances; and the remaining outer envelope abundant in simpler solid and gaseous molecules. Strongly irradiated regions, such as the cavity wall layer, are subject to frequent photodissociation in the solid phase. Subsequent recombination of the photoproducts leads to frequent reactive desorption, causing gas-phase enhancements of several or...

  6. Generalized friendship paradox in complex networks: the case of scientific collaboration.

    Science.gov (United States)

    Eom, Young-Ho; Jo, Hang-Hyun

    2014-04-08

    The friendship paradox states that your friends have on average more friends than you have. Does the paradox "hold" for other individual characteristics like income or happiness? To address this question, we generalize the friendship paradox for arbitrary node characteristics in complex networks. By analyzing two coauthorship networks of Physical Review journals and Google Scholar profiles, we find that the generalized friendship paradox (GFP) holds at the individual and network levels for various characteristics, including the number of coauthors, the number of citations, and the number of publications. The origin of the GFP is shown to be rooted in positive correlations between degree and characteristics. As a fruitful application of the GFP, we suggest effective and efficient sampling methods for identifying high characteristic nodes in large-scale networks. Our study on the GFP can shed lights on understanding the interplay between network structure and node characteristics in complex networks.

  7. Complex networks for data-driven medicine: the case of Class III dentoskeletal disharmony

    International Nuclear Information System (INIS)

    In the last decade, the availability of innovative algorithms derived from complexity theory has inspired the development of highly detailed models in various fields, including physics, biology, ecology, economy, and medicine. Due to the availability of novel and ever more sophisticated diagnostic procedures, all biomedical disciplines face the problem of using the increasing amount of information concerning each patient to improve diagnosis and prevention. In particular, in the discipline of orthodontics the current diagnostic approach based on clinical and radiographic data is problematic due to the complexity of craniofacial features and to the numerous interacting co-dependent skeletal and dentoalveolar components. In this study, we demonstrate the capability of computational methods such as network analysis and module detection to extract organizing principles in 70 patients with excessive mandibular skeletal protrusion with underbite, a condition known in orthodontics as Class III malocclusion. Our results could possibly constitute a template framework for organising the increasing amount of medical data available for patients’ diagnosis. (paper)

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

    OpenAIRE

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

    2014-01-01

    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...

  9. Uses of Complex Thinking in Higher Education Adaptive Leadership Practice: A Multiple-Case Study

    OpenAIRE

    Yeyinmen, Karen Coskren

    2016-01-01

    Research and theories of leadership development link the capacity for complex thinking to effectiveness at leading adaptive change. However, few empirical studies examine how this link operates in natural work settings, or explore its implications for practicing the kinds of leadership being called for in higher education today. In this study, I address this gap using post-positivist, ethnographic methods to examine how three higher education leaders, who are publicly recognized as effective ...

  10. Analyzing the Impact of Changes in Trade and Domestic Policies: The Case of the Soybean Complex

    OpenAIRE

    Costa, Rafael F.; Xia, Yan; Susanto, Dwi; Rosson, C. Parr, III; Adcock, Flynn J.

    2008-01-01

    This study analyzes the impacts of domestic and trade policy changes on the soybean complex using a Stochastic Equilibrium Displacement Model (SEDM). Three different policies, Loan Deficiency Payments (LDP), transportation costs and export taxes are considered in the analysis. The results indicate that Brazil benefits from a reduction in transportation costs and becomes more competitive in the global soybean market. Brazilian exports of soybeans increase due to relatively lower export prices....

  11. Spontaneous Partitioning of Californium from Curium: Curious Cases from the Crystallization of Curium Coordination Complexes

    Energy Technology Data Exchange (ETDEWEB)

    Cary, Samantha K.; Silver, Mark A.; Liu, Guokui; Wang, Jamie C.; Bogart, Justin A.; Stritzinger, Jared T.; Arico, Alexandra A.; Hanson, Kenneth; Schelter, Eric J.; Albrecht-Schmitt, Thomas E.

    2015-12-07

    The reaction of 248CmCl3 with excess 2,6-pyridinedicarboxylic acid (DPA) under mild solvothermal conditions results in crystallization of the tris-chelate complex Cm(HDPA)3·H2O. Approximately half of the curium remains in solution at the end of this process, and evaporation of the mother liquor results in crystallization of the bis-chelate complex [Cm(HDPA)- (H2DPA)(H2O)2Cl]Cl·2H2O. 248Cm is the daughter of the α decay of 252Cf and is extracted in high purity from this parent. However, trace amounts of 249,250,251Cf are still present in all samples of 248Cm. During the crystallization of Cm(HDPA)3·H2O and [Cm(HDPA)(H2DPA)(H2O)2Cl]Cl·2H2O, californium(III) spontaneously separates itself from the curium complexes and is found doped within crystals of DPA in the form of Cf(HDPA)3. These results add to the growing body of evidence that the chemistry of californium is fundamentally different from that of earlier actinides.

  12. Two cases of Axenfeld-Rieger syndrome, report of the complex pathology and treatment

    NARCIS (Netherlands)

    C.A. Bender; M.J. Koudstaal; J.F.A. van Elswijk; C. Prahl; E.B. Wolvius

    2014-01-01

    The purpose of this case report is to report the orthodontic surgical treatment and subsequent dental rehabilitation in two patients with Axenfeld-Rieger syndrome. Axenfeld-Rieger syndrome is a rare autosomal dominant condition characterized by ocular, dental, craniofacial, and periumbilical abnorma

  13. A case of horseshoe lung and complex congenital heart disease in a term newborn

    Energy Technology Data Exchange (ETDEWEB)

    Jeewa, Aamir [British Columbia Children' s Hospital and University of British Columbia, Department of Pediatrics, Division of Cardiology, Vancouver (Canada); Culham, J.A.G. [British Columbia Children' s Hospital, Department of Radiology, Vancouver (Canada); Human, Derek G. [British Columbia Children' s Hospital and University of British Columbia, Department of Pediatrics, Division of Cardiology, Vancouver (Canada); B.C. Children' s Hospital, Children' s Heart Centre, Vancouver (Canada)

    2010-02-15

    We describe and illustrate a rare association of hypoplastic left heart syndrome, absent hilar left pulmonary artery, and an unusual bronchopulmonary malformation. This case highlights the utility of combination imaging of echocardiography and CT angiography in diagnosing a cyanotic newborn with a chest radiograph that is suspicious for lung hypoplasia. (orig.)

  14. Containing Pedagogical Complexity through the Assignment of Photography: Two Case Presentations

    Science.gov (United States)

    Garrett, H. James; Matthews, Sara

    2014-01-01

    This article investigates the use of photography as a narrative approach to learning in the context of postsecondary education. Two cases are presented: a social studies methods course in a teacher education program in the South of the United States; and a senior undergraduate seminar on global violence at a university in southern Ontario, Canada.…

  15. 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

  16. Application of information and complexity theories to public opinion polls. The case of Greece (2004-2007)

    CERN Document Server

    Panos, C P

    2007-01-01

    A general methodology to study public opinion inspired from information and complexity theories is outlined. It is based on probabilistic data extracted from opinion polls. It gives a quantitative information-theoretic explanation of high job approval of Greek Prime Minister Mr. Constantinos Karamanlis (2004-2007), while the same time series of polls conducted by the company Metron Analysis showed that his party New Democracy (abbr. ND) was slightly higher than the opposition party of PASOK -party leader Mr. George Papandreou. It is seen that the same mathematical model applies to the case of the popularity of President Clinton between January 1998 and February 1999, according to a previous study, although the present work extends the investigation to concepts as complexity and Fisher information, quantifying the organization of public opinion data.

  17. Magnetically Regulated Star Formation in Three Dimensions: The Case of the Taurus Molecular Cloud Complex

    Science.gov (United States)

    Nakamura, Fumitaka; Li, Zhi-Yun

    2008-11-01

    We carry out three-dimensional MHD simulations of star formation in turbulent, magnetized clouds, including ambipolar diffusion and feedback from protostellar outflows. The calculations focus on relatively diffuse clouds threaded by a strong magnetic field capable of resisting severe tangling by turbulent motions and retarding global gravitational contraction in the cross field direction. They are motivated by observations of the Taurus molecular cloud complex (and, to a lesser extent, Pipe Nebula), which shows an ordered large-scale magnetic field, as well as elongated condensations that are generally perpendicular to the large-scale field. We find that stars form in earnest in such clouds when enough material has settled gravitationally along the field lines that the mass-to-flux ratios of the condensations approach the critical value. Only a small fraction (of order 1% or less) of the nearly magnetically critical, condensed material is turned into stars per local free-fall time, however. The slow star formation takes place in condensations that are moderately supersonic; it is regulated primarily by magnetic fields, rather than turbulence. The quiescent condensations are surrounded by diffuse halos that are much more turbulent, as observed in the Taurus complex. Strong support for magnetic regulation of star formation in this complex comes from the extremely slow conversion of the already condensed, relatively quiescent C18O gas into stars, at a rate 2 orders of magnitude below the maximum, free-fall value. We analyze the properties of dense cores, including their mass spectrum, which resembles the stellar initial mass function.

  18. Complexity analysis of blast-induced vibrations in underground mining:A case study

    Institute of Scientific and Technical Information of China (English)

    Cardu Marilena; Dompieri Mauricio; Seccatore Jacopo

    2012-01-01

    Blasting in geological bodies is an industrial process acting in an environment characterized by high uncertainties (natural joints,faults,voids,abrupt structural changes),which are transposed into the process parameters (e.g.energetic transfer to rock mass,hole deviations,misfires,vibrations,fly-rock,etc.).The approach to this problem searching for the "optimum" result can be ineffective.The geological environment is marked out by too many uncertainties,to have an "optimum" suitable to different applications.Researching for "Robustness" in a blast design gives rise to much more efficiency.Robustness is the capability of the system to behave constantly under varying conditions,without leading to unexpected results.Since the geology varies from site to site,setting a robust method can grant better results in varying environments,lowering the costs and increasing benefits and safety.Complexity Analysis (C.A.) is an innovative approach to systems.C.A.allows analyzing the Complexity of the Blast System and the criticality of each variable (drilling,charging and initiation parameters).The lower is the complexity,the more robust is the system,and the lower is the possibility of unexpected results.The paper presents the results obtained thanks to the C.A.approach in an underground gypsum quarry (Italy),exploited by conventional rooms and pillars method by drilling and blasting.The application of C.A.led to a reliable solution to reduce the charge per delay,hence reducing the impact of ground vibration on the surrounding structures.The analysis of the correlation degree between the variables allowed recognizing empirical laws as well.

  19. Pulsed Radiofrequency Treatment of Complex Regional Pain Syndrome: A Case Series

    Directory of Open Access Journals (Sweden)

    Vlad Djuric

    2014-01-01

    Full Text Available BACKGROUND: Various forms of sympathetic chain neurolysis (sympathectomy have, at one time or another, held promise as effective treatment options for complex regional pain syndrome (CRPS. Complications, such as worsening pain and the development of new pain syndromes, have prevented sympathectomy from emerging as a standard intervention. In an effort to avoid poor outcomes associated with neurolysis, pulsed radiofrequency (PRF has been proposed as a potential treatment alternative for a number of chronic neuropathic pain states, including some forms of CRPS.

  20. Complex networks and public funding: the case of the 2007-2013 Italian program

    CERN Document Server

    Nicotri, Stefano; Amoroso, Nicola; Garuccio, Elena; Bellotti, Roberto

    2015-01-01

    In this paper we apply techniques of complex network analysis to data sources representing public funding programs and discuss the importance of the considered indicators for program evaluation. Starting from the Open Data repository of the 2007-2013 Italian Program Programma Operativo Nazionale 'Ricerca e Competitivit\\`a' (PON R&C), we build a set of data models and perform network analysis over them. We discuss the obtained experimental results outlining interesting new perspectives that emerge from the application of the proposed methods to the socio-economical evaluation of funded programs.

  1. A Case Report of Renal Sympathetic Denervation for the Treatment of Polymorphic Ventricular Premature Complexes

    Science.gov (United States)

    Kiuchi, Márcio Galindo; Vitorio, Frederico Puppim; da Silva, Gustavo Ramalho; Paz, Luis Marcelo Rodrigues; Souto, Gladyston Luiz Lima

    2015-01-01

    Abstract Premature ventricular complexes are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Recently, Armaganijan et al reported the relevance of sympathetic activation in patients with ventricular arrhythmias and suggested a potential role for catheter-based renal sympathetic denervation in reducing the arrhythmic burden. In this report, we describe a 32-year-old hypertensive male patient presenting with a high incidence of polymorphic premature ventricular complexes on a 24 hour Holter monitor. Beginning 1 year prior, the patient experienced episodes of presyncope, syncope, and tachycardia palpitations. The patient was taking losartan 100 mg/day, which kept his blood pressure (BP) under control, and sotalol 160 mg twice daily. Bisoprolol 10 mg/day was used previously but was not successful for controlling the episodes. The 24 hour Holter performed after the onset of sotalol 160 mg twice daily showed a heart rate ranging between 48 (minimum)–78 (average)–119 (maximum) bpm; 14,286 polymorphic premature ventricular complexes; 3 episodes of nonsustained ventricular tachycardia, the largest composed of 4 beats at a rate of 197 bpm; and 14 isolated atrial ectopic beats. Cardiac magnetic resonance imaging with gadolinium perfusion performed at rest and under pharmacological stress with dipyridamole showed increased left atrial internal volume, preserved systolic global biventricular function, and an absence of infarcted or ischemic areas. The patient underwent bilateral renal sympathetic denervation. The only drug used postprocedure was losartan 25 mg/day. Three months after the patient underwent renal sympathetic denervation, the mean BP value dropped to 132/86 mmHg, the mean systolic/diastolic 24 hour ambulatory BP measurement was reduced to 128/83

  2. Extended Tower Number Field Sieve : A New Complexity for the Medium Prime Case

    OpenAIRE

    Kim, Taechan; Barbulescu, Razvan

    2016-01-01

    International audience We introduce a new variant of the number field sieve algorithm for discrete logarithms in Fpn called exTNFS. The most important modification is done in the polynomial selection step, which determines the cost of the whole algorithm: if one knows how to select good polynomi-als to tackle discrete logs in Fpκ , exTNFS allows to use this method when tackling Fpηκ whenever gcd(η, κ) = 1. This simple fact has consequences on the asymptotic complexity of NFS in the medium ...

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

    International Nuclear Information System (INIS)

    , 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)

  4. Long-term results of complex left ventricular reconstruction surgery: case report.

    Science.gov (United States)

    Letsou, George V; Forrester, Matthew; Frazier, O H

    2011-01-01

    Left ventricular reconstruction is advocated as a surgical option for patients with severe congestive heart failure. Despite initial enthusiasm for this procedure, reports of long-term results are sparse. Herein, we describe a particularly gratifying case of left ventricular reconstruction in a 43-year-old man, who continues to have excellent left ventricular function 10 years postoperatively. This approach may be a reasonable alternative to cardiac transplantation in patients who lack other treatment options.

  5. Educational models: A case study into transferability of pedagogical structure in a complex learning object

    OpenAIRE

    Poortman, Sybilla; Sloep, Peter

    2006-01-01

    research report The Dutch six-part series Leerobjecten in de praktijk (Learning objects in practice) is about six divergent and difficult problems that occur frequently in working with learning objects. Based on research into existing practice, guidelines are offered to policy makers, educational technology consultants, teachers, educational designers and developers of digital learning materials who are struggling with these problems in higher education. Educational models describes a case...

  6. A case of black hairy tongue responding to oral nystatin and vitamin B complex treatment

    Directory of Open Access Journals (Sweden)

    Ömer Kutlu

    2015-12-01

    Full Text Available Black hairy tongue, also known as lingua villosa nigra, is characterized by desquamation defects on the dorsal side of the tongue with reactive hypertrophy of the filiform papillae. Although the etiology of the disease is unknown, conditions such as smoking, alcohol and candidal infection are accused. In this study, a case of black hairy tongue which is considered to occur due to poor oral hygiene and candidal infection is presented.

  7. ORTHODONTIC-PROSTHETIC APPROACH IN THE TREATMENT OF COMPLEX CLINICAL CASES.

    OpenAIRE

    Desislava Konstantinova; Hristina Arnautska

    2014-01-01

    Modern dentistry demands an interdisciplinary approach in solving severe clinical cases. For a successful prosthetic treatment a number of prior manipulations are required. Rehabilitation of the oral cavity includes professional oral hygiene, repeated treatments of poorly filled root canals and removal of persistent teeth and roots. However, to achieve better conditions for prosthesis, special methods before the procedures are preferred. These methods include the more invasive periodontics an...

  8. Multiscale Enaction Model (MEM: The Case of Complexity and Context-Sensitivity in Vision

    Directory of Open Access Journals (Sweden)

    Éric eLAURENT

    2014-12-01

    Full Text Available I review the data on human visual perception that reveal the critical role played by non-visual contextual factors influencing visual activity. The global perspective that progressively emerges reveals that vision is sensitive to multiple couplings with other systems whose nature and levels of abstraction in science are highly variable. Contrary to some views where vision is immersed in modular hard-wired modules, rather independent from higher-level or other non-cognitive processes, converging data gathered in this article suggest that visual perception can be theorized in the larger context of biological, physical, and social systems with which it is coupled, and through which it is enacted. Therefore, any attempt to model complexity and multiscale couplings, or to develop a complex synthesis in the fields of mind, brain, and behavior, shall involve a systematic empirical study of both connectedness between systems or subsystems, and the embodied, multiscale and flexible teleology of subsystems. The conceptual model (MEM that is introduced in this paper finally relates empirical evidence gathered from psychology to biocomputational data concerning the human brain. Both psychological and biocomputational descriptions of MEM are proposed in order to help fill in the gap between scales of scientific analysis and to provide an account for both the autopoiesis-driven search for information, and emerging perception.

  9. Spin state relaxation of iron complexes: The case for OPBE and S12g

    Directory of Open Access Journals (Sweden)

    Gruden Maja

    2015-01-01

    Full Text Available The structures of nine iron complexes that show a diversity of experimentally observed spin ground states are optimized and analyzed with Density Functional Theory (DFT. An extensive validation study of the new S12g functional is performed, with the discussion concerning the influence of the environment, geometry and its overall performance based on the comparison with the well proven OPBE functional. The OPBE and S12g functionals give the correct spin ground state for all investigated iron complexes. Since S12g performs remarkably well it can be considered a reliable tool for studying spin state energetics in complicated transition metal systems. [Ministerio de Ciencia e Innovación (MICINN, project CTQ2011-25086/BQU, the Ministerio de Economia y Competitividad (MINECO, project CTQ2014-59212/BQU and the DIUE of the Generalitat de Catalunya (project 2014SGR1202, and Xarxa de Referència en Química Teòrica i Computacional; MICINN and the FEDER fund (European Fund for Regional Development under grant UNGI10-4E-801, and the Serbian Ministry of Education and Science (Grant No. 172035. This work was performed in the framework of the COST action CM1305 "Explicit Control Over Spin-states in Technology and Biochemistry (ECOSTBio" (STSM reference: ECOST-STSM-CM1305-27360.

  10. Neuropsychiatric autoimmune encephalitis without VGKC-complex, NMDAR, and GAD autoantibodies: case report and literature review.

    Science.gov (United States)

    Najjar, Souhel; Pearlman, Daniel; Devinsky, Orrin; Najjar, Amanda; Nadkarni, Siddhartha; Butler, Tracy; Zagzag, David

    2013-03-01

    We report a patient with a seronegative autoimmune panencephalitis, adding a subtype to the emerging spectrum of seronegative autoimmune encephalitis, and we review the sparse literature on isolated psychiatric presentations of autoimmune encephalitis. (A PubMed search for "seronegative autoimmune encephalitis," "nonvasculitic autoimmune inflammatory meningoencephalitis," and related terms revealed VGKC)-complex, N-methyl-D-aspartate receptor (NMDAR), and glutamic acid decarboxylase (GAD) autoantibodies. We excluded genetic, metabolic, paraneoplastic, degenerative, and infectious etiologies. The patient's symptoms remitted fully with immune therapy, but recurred in association with widespread bihemispheric brain lesions. Brain biopsy revealed mild nonvasculitic inflammation and prominent vascular hyalinization. Immune therapy with plasma exchanges cleared the MRI abnormalities but, 10 years after onset, the patient still suffers neuropsychiatric sequelae. We conclude that autoimmune panencephalitis seronegative for VGKC-complex, NMDAR, and GAD autoantibodies is a subtype of autoimmune encephalitis that can present with pure neuropsychiatric features and a normal brain MRI. Immunologic mechanisms may account for psychiatric symptoms in a subset of patients now diagnosed with classical psychotic disorders. Delay in starting immune therapy can lead to permanent neuropsychiatric sequelae. We propose a standardized classification system for the autoimmune encephalitides, integrating earlier pathology-oriented terms with more recently defined serologic and clinical phenotypes.

  11. Multiscale Enaction Model (MEM): the case of complexity and “context-sensitivity” in vision

    Science.gov (United States)

    Laurent, Éric

    2014-01-01

    I review the data on human visual perception that reveal the critical role played by non-visual contextual factors influencing visual activity. The global perspective that progressively emerges reveals that vision is sensitive to multiple couplings with other systems whose nature and levels of abstraction in science are highly variable. Contrary to some views where vision is immersed in modular hard-wired modules, rather independent from higher-level or other non-cognitive processes, converging data gathered in this article suggest that visual perception can be theorized in the larger context of biological, physical, and social systems with which it is coupled, and through which it is enacted. Therefore, any attempt to model complexity and multiscale couplings, or to develop a complex synthesis in the fields of mind, brain, and behavior, shall involve a systematic empirical study of both connectedness between systems or subsystems, and the embodied, multiscale and flexible teleology of subsystems. The conceptual model (Multiscale Enaction Model [MEM]) that is introduced in this paper finally relates empirical evidence gathered from psychology to biocomputational data concerning the human brain. Both psychological and biocomputational descriptions of MEM are proposed in order to help fill in the gap between scales of scientific analysis and to provide an account for both the autopoiesis-driven search for information, and emerging perception. PMID:25566115

  12. Multiscale Enaction Model (MEM): the case of complexity and "context-sensitivity" in vision.

    Science.gov (United States)

    Laurent, Éric

    2014-01-01

    I review the data on human visual perception that reveal the critical role played by non-visual contextual factors influencing visual activity. The global perspective that progressively emerges reveals that vision is sensitive to multiple couplings with other systems whose nature and levels of abstraction in science are highly variable. Contrary to some views where vision is immersed in modular hard-wired modules, rather independent from higher-level or other non-cognitive processes, converging data gathered in this article suggest that visual perception can be theorized in the larger context of biological, physical, and social systems with which it is coupled, and through which it is enacted. Therefore, any attempt to model complexity and multiscale couplings, or to develop a complex synthesis in the fields of mind, brain, and behavior, shall involve a systematic empirical study of both connectedness between systems or subsystems, and the embodied, multiscale and flexible teleology of subsystems. The conceptual model (Multiscale Enaction Model [MEM]) that is introduced in this paper finally relates empirical evidence gathered from psychology to biocomputational data concerning the human brain. Both psychological and biocomputational descriptions of MEM are proposed in order to help fill in the gap between scales of scientific analysis and to provide an account for both the autopoiesis-driven search for information, and emerging perception. PMID:25566115

  13. Proteins with complex architecture as potential targets for drug design: a case study of Mycobacterium tuberculosis.

    Directory of Open Access Journals (Sweden)

    Bálint Mészáros

    2011-07-01

    Full Text Available Lengthy co-evolution of Homo sapiens and Mycobacterium tuberculosis, the main causative agent of tuberculosis, resulted in a dramatically successful pathogen species that presents considerable challenge for modern medicine. The continuous and ever increasing appearance of multi-drug resistant mycobacteria necessitates the identification of novel drug targets and drugs with new mechanisms of action. However, further insights are needed to establish automated protocols for target selection based on the available complete genome sequences. In the present study, we perform complete proteome level comparisons between M. tuberculosis, mycobacteria, other prokaryotes and available eukaryotes based on protein domains, local sequence similarities and protein disorder. We show that the enrichment of certain domains in the genome can indicate an important function specific to M. tuberculosis. We identified two families, termed pkn and PE/PPE that stand out in this respect. The common property of these two protein families is a complex domain organization that combines species-specific regions, commonly occurring domains and disordered segments. Besides highlighting promising novel drug target candidates in M. tuberculosis, the presented analysis can also be viewed as a general protocol to identify proteins involved in species-specific functions in a given organism. We conclude that target selection protocols should be extended to include proteins with complex domain architectures instead of focusing on sequentially unique and essential proteins only.

  14. Aquifer characteristics and its modeling around an industrial complex, Tuticorin, Tamil Nadu, India: A case study

    Indian Academy of Sciences (India)

    N C Mondal; V S Singh; R Rangarajan

    2009-06-01

    Anthropogenic pollution of shallow groundwater resources due to industrial activities is becoming a cause of concern in the east coastal belt of the state of Tamil Nadu,India.Integrated hydrogeological,geophysical and tracer studies were carried out in the coastal region encompassing an industrial complex.The objective has been to gain knowledge of aquifer characteristics,ascertaining groundwater movement and its flow direction,which would in turn reveal the possibility of contamination of groundwater regime and its better management.The results of multi-parameters and model study indicate that the velocity of groundwater flow ranges from 0.013 m/d to 0.22 m/d in and around the industrial complex in upstream western part of the catchment and 0.026 m/d to 0.054 m/d in the downstream eastern part,near the coast.These parameters are vital for the development of groundwater management scheme.

  15. Multiple dimensions of transitions in complex socio-ecological systems - A case from China

    Science.gov (United States)

    Liu, Wei; Yang, Wu; Vina, Andres; Schröter, Dagmar; Liu, Jianguo

    2013-04-01

    Transitions in complex socio-ecological systems are intermediate phases between two successive and more stable periods or states and involve various societal, ecological, and biophysical changes that are often non-linear and inter-related. Understanding transitions is challenging but important for managing socio-ecological systems for achieving environmental sustainability and improving human well-being. Long-term and intensive research is warranted to disclose common patterns and mechanisms of socio-ecological transitions and to develop ideas and methods for studying and planning sustainable transitions. Based on a long-term research on human-nature relationships in Wolong Nature Reserve in China, we studied multiple concurrent social, economic, and ecological transitions during the last 15 years. As a UNESCO biosphere reserve, Wolong lies within a global biodiversity hotspot and a World Heritage site. It contains the largest populations of the world-famous endangered giant pandas and several thousand other animal and plant species. Like most nature reserves in China and many other developing countries, Wolong is also home to many local residents who undertake a variety of activities that involve interaction with ecosystem. For the majority of the 20th century, local people in Wolong lived under poverty line in a closed subsistence-based agricultural economy. Their demands on for wood (as fuel and raw materials) from the natural forests were high and resulted in severe deforestation, habitat degradation, and landslides. Since late 1990s, a series of major economic (e.g., tourism development) and environmental (e.g., payment for ecosystem services programs) policies have been implemented in the reserve as adaptive strategies to cope with poverty and ecological degradation. Within a decade, we have observed major transitions in land use (i.e., from extractive use to non-consumptive use), economic structure (i.e., from a subsistence-based agricultural economy to an

  16. Stream computing for biomedical signal processing: A QRS complex detection case-study.

    Science.gov (United States)

    Murphy, B M; O'Driscoll, C; Boylan, G B; Lightbody, G; Marnane, W P

    2015-01-01

    Recent developments in "Big Data" have brought significant gains in the ability to process large amounts of data on commodity server hardware. Stream computing is a relatively new paradigm in this area, addressing the need to process data in real time with very low latency. While this approach has been developed for dealing with large scale data from the world of business, security and finance, there is a natural overlap with clinical needs for physiological signal processing. In this work we present a case study of streams processing applied to a typical physiological signal processing problem: QRS detection from ECG data.

  17. Stream computing for biomedical signal processing: A QRS complex detection case-study.

    Science.gov (United States)

    Murphy, B M; O'Driscoll, C; Boylan, G B; Lightbody, G; Marnane, W P

    2015-08-01

    Recent developments in "Big Data" have brought significant gains in the ability to process large amounts of data on commodity server hardware. Stream computing is a relatively new paradigm in this area, addressing the need to process data in real time with very low latency. While this approach has been developed for dealing with large scale data from the world of business, security and finance, there is a natural overlap with clinical needs for physiological signal processing. In this work we present a case study of streams processing applied to a typical physiological signal processing problem: QRS detection from ECG data. PMID:26737641

  18. Improved worst-case and liely accident definition in complex facilities for 40 CFR 68 compliance

    International Nuclear Information System (INIS)

    Many DOE facilities potentially subject to compliance with offsite consequence criteria under the 40 CFR 68 Risk Management Program house significant inventories of toxic and flammable chemicals. The accident progression event tree methodology is suggested as a useful technical basis to define Worst-Case and Alternative Release Scenarios in facilities performing operations beyond simple storage and/or having several barriers between the chemical hazard and the environment. For multiple chemical release scenarios, a chemical mixture methodology should be applied to conservatively define concentration isopleths. In some instances, the region requiring emergency response planning is larger under this approach than if chemicals are treated individually

  19. The complexity of maladaptation strategies to disasters: The case of Muzarabani, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Siduduziwe Ncube-Phiri

    2014-03-01

    Full Text Available Over the past decade disasters have increased both in complexity and multiplicity, worseningthe plight of vulnerable communities the world over. Many communities have devised copingmechanisms to mitigate the impact, but communities such as Muzarabani in Zimbabweremain susceptible to disasters. This article seeks to analyse whether the coping measuresapplied make the communities safe from or vulnerable to disasters. Information was obtainedthrough interviews, questionnaires and observations from four villages in Chadereka in theMuzarabani district. The results of this study indicated that households, government andnon-governmental organisations have come up with different mitigation strategies, suchas growing crops along river beds, livestock production, raised granaries and doorsteps,flood evacuation shelters and other emergency services. Research revealed that althoughviable, some of the strategies increased the community’s vulnerability. This article thereforerecommends sustainable utilisation of resources, and collaborative efforts to address the rootcauses, dynamic pressures and unsafe conditions in order to reduce the vulnerability of poorcommunities to natural disasters.

  20. [Diagnosis and treatment for 2 cases of tuberous sclerosis complex with pulmonary lymphangioleiomyomatosis].

    Science.gov (United States)

    Zong, Dandan; Liu, Caihong; Shi, Zhihui; Zhou, Li; Peng, Yating; Ouyang, Ruoyun

    2016-07-01

    To improve the diagnosis and treatment for tuberous sclerosis complex (TSC) with pulmonary lymphangioleiomyomatosis, a retrospective analysis was performed based on the clinical data of 2 patients with such disease. Both of them have typical thin-walled cystic lesion throughout the lung field, renal angioleiomyolipoma, and various degrees of skin lesions. Central nervous system is involved in one patient. Lesions in the lung and kidney in one patient were improved significantly after 5 months of rapamycin treatment. The clinical phenotypes were diverse in TSC patients. The CT imaging showed typical characteristics when the lung was invaded by the tumor. When a patient was diagnosed as pulmonary lymphangioleiomyomatosis, we should pay attention to the clinical screening of TSC. Rapamycin is an effective and safe treatment for this disease. PMID:27592585

  1. Magnetically Regulated Star Formation in 3D: The Case of Taurus Molecular Cloud Complex

    CERN Document Server

    Nakamura, Fumitaka

    2008-01-01

    We carry out three-dimensional MHD simulations of star formation in turbulent, magnetized clouds, including ambipolar diffusion and feedback from protostellar outflows. The calculations focus on relatively diffuse clouds threaded by a strong magnetic field capable of resisting severe tangling by turbulent motions and retarding global gravitational contraction in the cross-field direction. They are motivated by observations of the Taurus molecular cloud complex (and, to a lesser extent, Pipe Nebula), which shows an ordered large-scale magnetic field, as well as elongated condensations that are generally perpendicular to the large-scale field. We find that stars form in earnest in such clouds when enough material has settled gravitationally along the field lines that the mass-to-flux ratios of the condensations approach the critical value. Only a small fraction (of order 1% or less) of the nearly magnetically-critical, condensed material is turned into stars per local free-fall time, however. The slow star form...

  2. Integrated optimal allocation model for complex adaptive system of water resources management (II): Case study

    Science.gov (United States)

    Zhou, Yanlai; Guo, Shenglian; Xu, Chong-Yu; Liu, Dedi; Chen, Lu; Wang, Dong

    2015-12-01

    Climate change, rapid economic development and increase of the human population are considered as the major triggers of increasing challenges for water resources management. This proposed integrated optimal allocation model (IOAM) for complex adaptive system of water resources management is applied in Dongjiang River basin located in the Guangdong Province of China. The IOAM is calibrated and validated under baseline period 2010 year and future period 2011-2030 year, respectively. The simulation results indicate that the proposed model can make a trade-off between demand and supply for sustainable development of society, economy, ecology and environment and achieve adaptive management of water resources allocation. The optimal scheme derived by multi-objective evaluation is recommended for decision-makers in order to maximize the comprehensive benefits of water resources management.

  3. 3D Inversion of complex resistivity data: Case study on Mineral Exploration Site.

    Science.gov (United States)

    Son, Jeong-Sul; Kim, Jung-ho; Park, Sam-gyu; Park, My-Kyung

    2016-04-01

    Complex resistivity (CR) method is a frequency domain induced polarization (IP) method. It is also known as Spectral IP (SIP) method, if wider frequencies are used in data acquisition and interpretation. Although it takes more times than conventional time domain IP method, its data quality is more stable because its data acquisition which measures amplitude and phase is done when the source current is being injected. Our research group has been studying the modeling and inversion algorithms of complex resistivity (CR) method since several years ago and recently applied developed algorithms to various real field application. Due to tough terrain in our country, Profile survey and 2D interpretation were generally used. But to get more precise interpretation, three dimensional modeling and inversion algorithm is required. We developed three dimensional inversion algorithm for this purpose. In the inversion, we adopt the method of adaptive lagraingian multiplier which is automatically set based on the size of error misfit and model regularization norm. It was applied on the real data acquired for mineral exploration sites. CR data was acquired with the Zeta system, manufactured by Zonge Co. In the inversion, only the lower frequency data is used considering its quality and developed 3D inversion algorithm was applied to the acquired data set. Its results were compared to those of time domain IP data conducted at the same site. Resistivity image sections of CR and conventional resistivity method were almost identical. Phase anomalies were well matched with chargeability anomalies and the mining history of the test site. Each anomalies were well discriminated in 3D interpretation than those of 2D. From those experiments, we know that CR method was very effective for the mineral exploration.

  4. Complex karyotype in a case of cutaneous lymphangiosarcoma associated with chronic lymphedema of the lower limb.

    Science.gov (United States)

    Marando, Alessandro; Bernasconi, Barbara; Sabatino, Daniele; Militti, Lucia; Capella, Carlo

    2014-12-01

    Lymphangiosarcoma is a rare malignant neoplasm of endothelial cells. The term is used to describe an angiosarcoma associated with chronic lymphedema. The skin of the head and neck region is the most common site of origin. Rather few cytogenetic studies on lymphangiosarcoma are reported in the literature. We here describe a case of an 87-year-old woman, with a history of recurring lymphangitis and with an ulcerated nodular lesion of the leg. The histological diagnosis was a malignant neoplasm of vascular origin, with the morphological and immunohistochemical features of a lymphangiosarcoma. A series of antibodies (CD31, CD34, vimentin, podoplanin and HHV-8), conventional and molecular cytogenetic and Spectral Karyotyping (SKY-FISH) analyses were used to study this case. The immunohistochemical evaluation revealed that the neoplasm was positive for vimentin, CD31, CD34 and podoplanin and negative for HHV-8. The proliferation rate (Ki-67) was about 70%. Karyotype was defined using conventional cytogenetic and SKY-FISH. In addition, high-level of amplification was observed with MYC split signal probe. The morphological and immunohistochemical evaluations supported the diagnosis of lymphangiosarcoma. Moreover, the cytogenetic and molecular findings contributed towards accurately defining the karyotypic aberrations of this rare sarcoma. PMID:24947410

  5. Calcifying odontogenic cyst associated with complex odontoma: case report and review of the literature.

    Science.gov (United States)

    Gallana-Alvarez, Silvia; Mayorga-Jimenez, Francisco; Torres-Gómez, Francisco Javier; Avellá-Vecino, Francisco Javier; Salazar-Fernandez, Clara

    2005-01-01

    We report a calcifying odontogenic cyst associated with odontoma (COCaO) and an included permanent canine in the superior maxilla, in a 19 year-old-man. The calcifying odontogenic cyst (COC) was first described as a distinct entity by Gorlin et al in 1962. The lesion is a mixed odontogenic benign tumor, and although most of the cases present cystic characteristics, a few are of the solid type (15%), and its rare malignant transformation is well documented. The COC may occur in association with other odontogenic tumors, the most common is the odontoma, occurring in about 24% of the cases. For this association the term Odontocalcifying odontogenic cyst has been suggested. Radiographically is a well defined mixed lesion and histologically consists of a large cyst. In the central area of the cyst enamel and dentin deposits can be found, irregularly distributed in areas and in other parts it takes on a well defined organoid aspect. A thorough review of literature takes place and the pathogenesis is discussed.

  6. Nonadiabatic dynamics of floppy hydrogen bonded complexes: the case of the ionized ammonia dimer.

    Science.gov (United States)

    Chalabala, Jan; Slavíček, Petr

    2016-07-27

    In the case of the ammonia dimer, we address the following questions: how ultrafast ionization dynamics is controlled by hydrogen bonding and whether we can control the products via selective ionization of a specific electron. We use quantum chemical calculations and ab initio non-adiabatic molecular dynamics simulations to model the femtosecond dynamics of the ammonia dimer upon ionization. The role of nuclear quantum effects and thermal fluctuations in predicting the structure of the dimer is emphasized; it is shown that the minimum energy and vibrationally averaged structures are rather different. The ground state structure subsequently controls the ionization dynamics. We describe reaction pathways, electronic population transfers and reaction yields with respect to ionization from different molecular orbitals. The simulations showed that the ionized ammonia dimer is highly unstable and its decay rate is primarily driven by the position of the electron hole. In the case of ground state ionization (i.e. the HOMO electron is ionized), the decay is likely to be preceded by a proton transfer (PT) channel yielding NH4(+) and NH2˙ fragments. The PT is less intense and slower compared with the ionized water dimer. After ionizing deeper lying electrons, mainly NH3(+)˙ and NH3 fragments are formed. Overall, our results show that the ionization dynamics of the ammonia and water dimers differ due to the nature of the hydrogen bond in these systems. PMID:27402376

  7. 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)

    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 Mz+ 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

  8. 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.

  9. 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...

  10. Complex 3D Blood Flow Pathways in Two Cases of Aorta to Right Heart Fistulae: a 4D Flow MRI study

    OpenAIRE

    Thakrar, Darshit; Popescu, Andrada; Gupta, Suraj; de Freitas, Andrew; Russell, Hyde; Carr, James; Markl, Michael

    2013-01-01

    We present an analysis of 3D blood flow in two cases of Sinus of Valsalva to right heart fistulae based on 4D flow MRI. Despite similar underlying pathology, 3D visualization revealed intricate differences in flow patterns connecting the systemic and pulmonary circulation. The cases illustrates the potential of 4D flow MRI to complement the evaluation of complex structural heart disease by assessing complex flow dynamics and providing quantitative information of flow ratios and flow rates.

  11. Planning evaluation of radiotherapy for complex lung cancer cases using helical tomotherapy

    Science.gov (United States)

    Kron, Tomas; Grigorov, Grigor; Yu, Edward; Yartsev, Slav; Chen, Jeff Z.; Wong, Eugene; Rodrigues, George; Trenka, Kris; Coad, Terry; Bauman, Glenn; Van Dyk, Jake

    2004-08-01

    Lung cancer treatment is one of the most challenging fields in radiotherapy. The aim of the present study was to investigate what role helical tomotherapy (HT), a novel approach to the delivery of highly conformal dose distributions using intensity-modulated radiation fan beams, can play in difficult cases with large target volumes typical for many of these patients. Tomotherapy plans were developed for 15 patients with stage III inoperable non-small-cell lung cancer. While not necessarily clinically indicated, elective nodal irradiation was included for all cases to create the most challenging scenarios with large target volumes. A 2 cm margin was used around the gross tumour volume (GTV) to generate primary planning target volume (PTV2) and 1 cm margin around elective nodes for secondary planning target volume (PTV1) resulting in PTV1 volumes larger than 1000 cm3 in 13 of the 15 patients. Tomotherapy plans were created using an inverse treatment planning system (TomoTherapy Inc.) based on superposition/convolution dose calculation for a fan beam thickness of 25 mm and a pitch factor between 0.3 and 0.8. For comparison, plans were created using an intensity-modulated radiation therapy (IMRT) approach planned on a commercial treatment planning system (TheraplanPlus, Nucletron). Tomotherapy delivery times for the large target volumes were estimated to be between 4 and 19 min. Using a prescribed dose of 60 Gy to PTV2 and 46 Gy to PTV1, the mean lung dose was 23.8 ± 4.6 Gy. A 'dose quality factor' was introduced to correlate the plan outcome with patient specific parameters. A good correlation was found between the quality of the HT plans and the IMRT plans with HT being slightly better in most cases. The overlap between lung and PTV was found to be a good indicator of plan quality for HT. The mean lung dose was found to increase by approximately 0.9 Gy per percent overlap volume. Helical tomotherapy planning resulted in highly conformal dose distributions. It

  12. Management of Complex Knee Deformities in Asian Population: Our Experience of 11 Cases

    Directory of Open Access Journals (Sweden)

    Syed Shahid Noor

    2015-01-01

    Total Knee Arthroplasty (TKA is a life changing procedure for such patients. Great improvements in quality of life and outcome measure scores have been observed in patients undergone TKA. Our patients are challenging further as compared to western population because they present late for consultation when the disease and deformity is advanced. Their expectations are high, as they wish to resume their ground base activities such as kneeling for prayers. Furthermore with financial constraints present with most of the patients, one has to be careful in choosing the type of implant and keep in consideration other alternative available options. This case series encompasses our experience of TKA on patients with variety of challenging deformities, their short term outcome and a review of the literature.

  13. Analysis of complex seepage problems with the disposal of uranium tailings: selected case studies

    International Nuclear Information System (INIS)

    Evaluations of seepage effects from existing uranium tailings impoundments, as well as those planned for the future operations, form the subject matter of this paper. The method of evaluation is not restricted to uranium tailings alone, but may be applied to the disposal of other kinds of tailings and slurry wastes as well. The application of an integrated program involving field measurements, laboratory measurements, and mathematical modeling is reported. The paper deals with saturated and unsaturated fluid flows in subsurface media as well as with the associated geochemical interactions. The influence of impoundment liners, native soil, and rock types, as well as groundwater are discussed. Selected case studies of applications are reported and discussed

  14. [Complex metabolic disorders revealing a gastric ulcer of the bulb. A case report].

    Science.gov (United States)

    Neffati, F; Hellara, I; Jelizi, M A; Bahri, J; Douki, W; Amor, A Ben; Najjar, M F

    2009-01-01

    We report the case of a 54-year-old man, without particular pathological antecedents admitted to the emergency of the university hospital of Monastir, for right renal colic. Radiography of the urinary tract without preparation and renal echography showed bilateral renal lithiasis and a right ureteral lithiasis. The interrogation revealed concept of vomiting after which the patient felt relieved. The biological assessment objectified an hypochloremic metabolic alcalosis, an increase in the anion gap, a severe impaired renal function of obstructive origin and an hypokaliemia. The presence of the lithiasis did not explain on its own the metabolic disorders of this patient. The other investigations showed that initial pathology was an evolutionary bulb ulcer into pre-stenosis justifying treatment by omeprazole and explaining the biological disorders. PMID:19654086

  15. The Complexities of Implementing Cluster Supply Chain - Case Study of JCH

    Science.gov (United States)

    Xue, Xiao; Zhang, Jibiao; Wang, Yang

    As a new type of management pattern, "cluster supply chain" (CSC) can help SMEs to face the global challenges through all kinds of collaboration. However, a major challenge in implementing CSC is the gap between theory and practice in the field. In an effort to provide a better understanding of this emerging phenomenon, this paper presents the implementation process of CSC in the context of JingCheng Mechanical & Electrical Holding co., ltd.(JCH) as a case study. The cast study of JCH suggests that the key problems in the practice of cluster supply chain: How do small firms use cluster supply chain? Only after we clarify the problem, the actual construction and operation of cluster supply chain does show successful results as it should be.

  16. Complex fixed implant-supported restoration in a site compromised by periodontitis: a case report.

    Science.gov (United States)

    Happe, Arndt; Kunz, Andreas

    2016-01-01

    Periodontal disease presents a big challenge for clinicians placing dental implants. Besides the implant treatment, additional surgical procedures such as grafting or sinus floor elevation are often necessary to achieve a satisfactory result. Patient compliance is also important for achieving long-term treatment success. In the case presented here, digital planning and computer-aided surgery facilitated placement of the implants and fabrication of the prosthetic superstructures. The patient then wore INTERNAT IONAL metal-based provisional fixed partial dentures (FPDs) for about a year, while her compliance and oral hygiene were evaluated. During this period, the occlusal relations remained stable and the good condition of the hard and soft tissue was maintained. In the maxilla, the final restoration incorporated custom zirconia abutments and a zirconia framework fabricated using CAD/CAM technology. Titanium abutments and a cast non-precious metal framework were fabricated for the mandible. PMID:27092346

  17. A rare case of massive carpal osteoblastoma requiring complex reconstructive surgery.

    Science.gov (United States)

    Dunda, S E; Kauczok, J; Demir, E; Braunschweig, T; Pallua, N

    2013-07-01

    An osteoblastoma is a rare, commonly benign, osteoid-producing neoplasm of the bone with an incidence of 2% of all primary bone tumours. We present a case of a 54-year-old patient with persisting carpal pain and massive swelling of the hand for a period of 4 years. Incision biopsies revealed the histopathological finding of a carpal osteoblastoma. After complete tumour excision, including the carpal and, in parts, metacarpal bones, reconstructive surgery was performed with a free osteocutaneous iliac crest flap to obtain a natural hand contour and the best possible hand function. Follow-up revealed improvement of the hand function in terms of flexion, extension and strength without discomfort or further pain. Thus, ongoing carpal pain should lead to an intensive search with further diagnostic measures such as magnetic resonance imaging (MRI) scan as well as biopsies, if necessary, to obtain the correct diagnosis.

  18. The challenges of dysphagia management and rehabilitation after extensive thermal burn injury: a complex case.

    Science.gov (United States)

    Rumbach, Anna F; Ward, Elizabeth C; Cornwell, Petrea L; Bassett, Lynell V; Muller, Michael J

    2009-01-01

    The role of the speech pathologist in the burns population is still emerging, with detailed discussion of the assessment and management of dysphagia limited to date. This report describes the case of a 60-year-old man who developed severe contractures of the head and neck and oropharyngeal dysphagia after sustaining 53.5% deep partial- and full-thickness burns. Although some aspects of rehabilitation were confounded by a preexisting mild intellectual disability, the patient was able to participate in an intensive regimen of active and passive exercise to rehabilitate his oropharyngeal dysphagia. Significant oral contractures remained; however, the patient was discharged without tracheostomy and consuming a texture-modified diet with no signs of aspiration. To our knowledge, this is one of a small handful of reports that document speech pathology management of the burns population, and a first that identifies and outlines specific characteristics of, and rehabilitation strategies for, dysphagia in a burned individual.

  19. IS A SPOROPHILA LINEOLA/BOUVRONIDES/RESTRICTA (AVES: EMBERIZIDAE COMPLEX A SPECIES RING CASE?: ATHEORICALAPPROACH

    Directory of Open Access Journals (Sweden)

    Marín-Espinoza, Gedio

    2010-07-01

    Full Text Available Despite that no ring species have yet been convincingly demonstrated in the western hemisphere, Sporophila lineola/bouvronides/restricta complex may provide a plausible theoretical model in South America. There are at present three distinct forms, with varying proportions of sedentary and partially migratory “races”: S. lineola (L, S. bouvronides (B and S. restricta (R. Two characters are most obviously subject to variation: the extent (or absence of white on the crown, and the amount (or absence of dark mottling or barring on the white underparts. L and B populations occur sympatrically and seasonally, with one of them breeding (B and the other non-breeding (L and possessing subtly different song patterns. Interestingly, R is a stable “race” confined to the northwestern corner of South America (i.e., NE Colombia. In addition, there is a highly variable population exhibiting a combination of characters (hybrids? reported between breeding areas B (e.g., Venezuela and breeding areas L (e.g., SE Brazil. Moreover, the total extent of the breeding range of the L population is nearly unknown; similarly, where B populations spend the non-breeding season is not yet known. Likewise, we don't know if R populations migrate. If so, it may represent an incipient ring species pattern. Indeed, our hypothesis is consistent with southern american biogeographical history, involving isolation mechanisms. In the first phase, an ancestral species was split into two populations (due to andean uplift, one to the north (R and the other to the east; secondarily, Pliocene times would have subdivided L (subequatorial breeding and B (supraequatorial breeding. With the advent of pleistocenic and holocenic regressions and climatic fluctuations, the successive secondary contacts permitted L and B interconnections, involving both ethological (e.g., the cromo-vocalic gradual differentiation and seasonal isolating mechanisms (e.g., “turnover” of circannual rhythms

  20. Causes of Borehole Failure in Complex Basement Terrains: ABUAD Case Study, Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    1 Ogundana, A.K , 2 Aladesanmi A. O., 3 Okunade A., 4Olutomilola O.O

    2015-10-01

    Full Text Available A preliminary assessment of primary causes of borehole failure has being conducted using Afe Babalola University as a case study. A total of fourteen boreholes (namely borehole 1-14 were studied, vertical electrical soundings, depth sounding, flushing and pump testing were conducted on each of the boreholes to establish their status at the time of the study and possible evaluation of the groundwater potential of the wells. Four out of the fourteen boreholes (borehole 1-4 are productive and in-use, while the remaining ten (borehole 5-14 are out-of-use and abandoned for various. The productive holes were able to support continuous flow of water for over 3 hours without drop in volume of water flow. Seven of the holes (boreholes 5, 6, 8, 9, 11, 12 & 14 failed and were abandoned because of low yield (could not flow beyond 5 minutes, while the remaining three (boreholes 7, 10 & 13 failed and were abandoned due to wrong location and improper completion, caving/formation problems, and wrong installation/completion respectively. Proper well completion is essential in areas prone to caving and other formation related problems. Air drilling should be avoided in areas with thick and loose overburden. Right mixture of drilling mud should be applied to secure the hole wall while flushing should be continuous throughout drilling in such formation. Casing should be done immediately and such holes should be lined and grouted. Timers should be installed on low yield wells and regulated/programmed for 5 or 10 minutes flow depending on the recharge rate. Pump rating for installation should be strictly based on well recharge rate. Productive wells should be properly maintained and monitored for optimal performance.

  1. Lumbar Sympathetic Block with Botulinum Toxin Type B for Complex Regional Pain Syndrome: A Case Study.

    Science.gov (United States)

    Choi, Eunjoo; Cho, Chan Woo; Kim, Hye Young; Lee, Pyung Bok; Nahm, Francis Sahngun

    2015-01-01

    Lumbar sympathetic block (LSB) is an effective method for relief of sympathetically mediated pain in the lower extremities. To prolong the sympathetic blockade, sympathetic destruction with alcohol or radiofrequency has been used. The pre-ganglionic sympathetic nerves are cholinergic, and botulinum toxin (BTX) has been found to inhibit the release of acetylcholine at the cholinergic nerve terminals. Moreover, BTX type B (BTX-B) is more convenient to use than BTX type A. Based on these findings, we performed LSB on the 2 patients with complex regional pain syndrome (CRPS) in the lower extremity. Levobupivacaine 0.25% 5 mL mixed with BTX-B 5,000 IU was given under fluoroscopic guidance. Two months after LSB with BTX-B, pain intensity and the Leeds assessment of neuropathic symptoms and signs (LANSS) score were significantly reduced. Allodynia and coldness disappeared and skin color came back to normal. In conclusion, BTX-B can produce an efficacious and durable sympathetic blocking effect on patients with CRPS.

  2. Is the NIMBY syndrome real and remediable? A case of complex decision-making

    International Nuclear Information System (INIS)

    What is commonly termed the NIMBY syndrome is a complex psychological process. It is related to risk perception and anticipation; utility value judgment; and the approach-avoidance stimulus formation and the reward-punishment learning. The first section of the present paper briefly discusses these psychological aspects of the NIMBY reactions. The second section of this paper deals with the issues associated with risk perception and communication. Importance of factors relevant to risk-benefit trade-off is discussed. On the basis of both the theoretical model of communication and the result obtained from a number of empirical research, salient factors affecting the effectiveness of risk communication will be discussed. The last section presents a rational model of entire risk communication process. It is concluded that public acceptance of the siting of nuclear power plants is susceptible to a number of socio-psychological factors. Four most important factors in the risk communication process are the source (the sender), the message, the destination (the receiver) and the channel, which affect the effectiveness of communication. Dominant socio-political values, such as an equal opportunity to participate in decision-making, the openness and transparency of information, also seems to influence the process of enhancing public acceptance of nuclear energy. (author)

  3. Uncertainties and Complexities of the Geological Model in Slope Stability: a Case Study of Sabzkuh Tunnel

    Directory of Open Access Journals (Sweden)

    Abbas Eftekhari

    2014-06-01

    Full Text Available Slope stability analysis is a geotechnical engineering problem characterized by many sources ofuncertainty. In slope stability computations, some of these sources are encountered, such as geologicaldetails missed in the exploration program, estimation of soil properties that are difficult to quantifyand many other relevant factors. Therefore, accurate reproduction of the spatial variability in the fieldcould be essential to decrease uncertainty. The Sabzkuh-Choghakhor water conveyance tunnel iscurrently under construction using the NATM and TBM tunnelling methods in the Zagros Mountainsin south-western Iran. In the slope stability assessment of the Sabzkuh tunnel portal, despite adequategeotechnical investigations, field studies have not been performed with appropriate accuracy. Alandslide and collapse has occurred in a part of the portal due to tunnel excavation. In this paper, theimportance of having a precise and predetermined schedule for selecting site location, monitoring,complexities of the geological model, uncertainty and its effects on the stability of the trench wereinvestigated and the necessity of comprehensive slope management was emphasized.

  4. Juridical complexity of some cases; La complexite de la situation juridique des mines arretees

    Energy Technology Data Exchange (ETDEWEB)

    Petit, D. [Conseil General des Mines, Lorraine (France)

    2001-06-01

    The recent closure of many mining operations led French authorities to reconsider the mining legislation dating back to the Napoleon's era in order to determine the way the damages occurring after the mine decommissioning should be dealt with. According to the former mining legislation, the landowner recovers the full proprietorship of the mine workings: it is obvious that he cannot assume the risks associated with these damages (subsidence, water rise and quality, etc.). According to their nature, these risks have to be assumed either by the State, or the local Authorities, or the former mining operator (when it has not disappeared). To illustrate the complexity of the problem, some examples are presented in the paper: - Water rise at the Messeix collieries closed in 1989: new springs of acidic and mineralized water have appeared and have necessitated the installation of a neutralizing station to be operated during around 10 years; all the costs are borne by the former operator; - Water rise and fire-damp emanations at the Nord-Pas-de-Calais Collieries: since these problems may last over a period of time of say fifty years and concern several local communities, the State assumes the responsibility of the corresponding works; - A similar problem exists in the closed Lorraine iron ore mines, where there are emanations of air containing traces of radon, necessitating permanent ventilation of buildings. (authors)

  5. Analysis of twenty pediatric cases of tuberous sclerosis complex: Are we doing enough?

    Directory of Open Access Journals (Sweden)

    Jyoti Nath

    2015-01-01

    Full Text Available Background: Tuberous sclerosis complex (TSC is a neuro-cutaneous disease characterized by hamartoma formation in various organs particularly the skin, brain, eye, kidney, heart and lungs. Patients usually have multisystem involvement and thus present to different medical specialties with varied complaints while the true nature of the disease and the hidden manifestations may remain unattended. A im: To assess the frequency and characteristics of various cutaneous and systemic manifestations in TSC and the total impact on different system in a cohort of pediatric patients. Methods: The study included 20 patients fulfilling the diagnostic criteria for TSC from dermatology, pediatrics, and neurology department. Detailed history, examination, and investigations such as chest X-ray, electrocardiography (ECG, ultrasonography (USG abdomen, echocardiography, fundoscopy, computed tomography (CT scan of brain and abdomen were done. Results: Dermatological manifestations included ash leaf macules, angiofibromas, shagreen patch, and fibrous plaque. Systemic findings observed were subependymal calcified nodules, subependymal giant cell astrocytoma, cortical tubers, renal cysts, angiomyolipomas, lung cyst, retinal hamartomas, mental deficits and epilepsy. Limitations: Wechsler′s Intelligence Scale for Children would have been more appropriate for assessing the intelligence. Dental check-up was not done in our group of patients. Conclusion: Our study highlights the wide variety of cutaneous and systemic manifestations of TSC. The study emphasizes the need for comprehensive multidisciplinary treatment and periodic follow-up which are necessary for appropriate management of this multisystem disorder. Counseling regarding education and rehabilitation of the patients and genetic counseling of parents are important.

  6. Impaired perception of harmonic complexity in congenital amusia: a case study.

    Science.gov (United States)

    Reed, Catherine L; Cahn, Steven J; Cory, Christopher; Szaflarski, Jerzy P

    2011-07-01

    This study investigates whether congenital amusia (an inability to perceive music from birth) also impairs the perception of musical qualities that do not rely on fine-grained pitch discrimination. We established that G.G. (64-year-old male, age-typical hearing) met the criteria of congenital amusia and demonstrated music-specific deficits (e.g., language processing, intonation, prosody, fine-grained pitch processing, pitch discrimination, identification of discrepant tones and direction of pitch for tones in a series, pitch discrimination within scale segments, predictability of tone sequences, recognition versus knowing memory for melodies, and short-term memory for melodies). Next, we conducted tests of tonal fusion, harmonic complexity, and affect perception: recognizing timbre, assessing consonance and dissonance, and recognizing musical affect from harmony. G.G. displayed relatively unimpaired perception and production of environmental sounds, prosody, and emotion conveyed by speech compared with impaired fine-grained pitch perception, tonal sequence discrimination, and melody recognition. Importantly, G.G. could not perform tests of tonal fusion that do not rely on pitch discrimination: He could not distinguish concurrent notes, timbre, consonance/dissonance, simultaneous notes, and musical affect. Results indicate at least three distinct problems-one with pitch discrimination, one with harmonic simultaneity, and one with musical affect-and each has distinct consequences for music perception.

  7. Safety culture of complex risky systems: the Nuclear Engineering Institute case study

    International Nuclear Information System (INIS)

    Analysis of industrial accidents have demonstrated that safe and reliable operation of complex industrial processes that use risky technology and/or hazard material depends not only on technical factors but on human and organizational factors as well. After the Chernobyl nuclear accident in 1986, the International Atomic Energy Agency established the safety culture concept and started a safety culture enhancement program within nuclear organizations worldwide. The Nuclear Engineering Institute, IEN, is a research and technological development unit of the Brazilian Nuclear Energy Commission, CNEN, characterized as a nuclear and radioactive installation where processes presenting risks to operators and to the environment are executed. In 1999, IEN started a management change program, aiming to achieve excellence of performance, based on the Model of Excellence of the National Quality Award. IEN's safety culture project is based on IAEA methodology and has been incorporated to the organizational management process. This work presents IEN's safety culture project; the results obtained on the initial safety culture assessment and the following project actions. (author)

  8. Lumbar Sympathetic Block with Botulinum Toxin Type B for Complex Regional Pain Syndrome: A Case Study.

    Science.gov (United States)

    Choi, Eunjoo; Cho, Chan Woo; Kim, Hye Young; Lee, Pyung Bok; Nahm, Francis Sahngun

    2015-01-01

    Lumbar sympathetic block (LSB) is an effective method for relief of sympathetically mediated pain in the lower extremities. To prolong the sympathetic blockade, sympathetic destruction with alcohol or radiofrequency has been used. The pre-ganglionic sympathetic nerves are cholinergic, and botulinum toxin (BTX) has been found to inhibit the release of acetylcholine at the cholinergic nerve terminals. Moreover, BTX type B (BTX-B) is more convenient to use than BTX type A. Based on these findings, we performed LSB on the 2 patients with complex regional pain syndrome (CRPS) in the lower extremity. Levobupivacaine 0.25% 5 mL mixed with BTX-B 5,000 IU was given under fluoroscopic guidance. Two months after LSB with BTX-B, pain intensity and the Leeds assessment of neuropathic symptoms and signs (LANSS) score were significantly reduced. Allodynia and coldness disappeared and skin color came back to normal. In conclusion, BTX-B can produce an efficacious and durable sympathetic blocking effect on patients with CRPS. PMID:26431145

  9. Complex Mixture-Associated Hormesis and Toxicity: The Case of Leather Tanning Industry

    Science.gov (United States)

    Pagano, Giovanni; Castello, Giuseppe; Gallo, Marialuisa; Borriello, Ilaria; Guida, Marco

    2008-01-01

    A series of studies investigated the toxicities of tannery-derived complex mixtures, i.e. vegetable tannin (VT) from Acacia sp. or phenol-based synthetic tannin (ST), and waste-water from tannin-based vs. chromium-based tanneries. Toxicity was evaluated by multiple bioassays including developmental defects and loss of fertilization rate in sea urchin embryos and sperm (Paracentrotus lividus and Sphaerechinus granularis), and algal growth inhibition (Dunaliella tertiolecta and Selenastrum capricornutum). Both VT and ST water extracts resulted in hormetic effects at concentrations ranging 0.1 to 0.3%, and toxicity at levels ≥1%, both in sea urchin embryo and sperm, and in algal growth bioassays. When comparing tannin-based tannery wastewater (TTW) vs. chromium-based tannery effluent (CTE), a hormesis to toxicity trend was observed for TTW both in terms of developmental and fertilization toxicity in sea urchins, and in algal growth inhibition, with hormetic effects at 0.1 to 0.2% TTW, and toxicity at TTW levels ≥1%. Unlike TTW, CTE showed a monotonic toxicity increase from the lowest tested level (0.1%) and CTE toxicity at higher levels was significantly more severe than TTW-induced toxicity. The results support the view that leather production utilizing tannins might be regarded as a more environmentally friendly procedure than chromium-based tanning process. PMID:19088903

  10. 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.

  11. Cases of limb-body wall complex: Early amnion rupture, vascular disruption, or abnormal splitting of the embryo?

    Science.gov (United States)

    Crespo, Frank; Pinar, Halit; Kostadinov, Stefan

    2012-12-01

    We report two cases of limb-body wall complex (LBWC), also known as body stalk anomaly, a rare form of body wall defect incompatible with life. The first case was identified during a level II ultrasound examination performed at 7 wk gestational age. The delivery was by breech extraction at 39 wk and 4 days. The second case was delivered by spontaneous vaginal delivery at 35 wk and 5 days. Karyotype analysis was normal in both fetuses. The phenotype of LBWC is variable, but commonly identified features include: exencephaly, limb defects, and either facial clefts or thoraco-abdominoschisis. The exact etiology remains uncertain, as the disorder has been regarded as sporadic with low recurrence. Vascular disruption during early embryogenesis, early amnion rupture, abnormal splitting of the embryo, and failure of amnion fusion have been implicated in the pathogenesis of LBWC. A role for possible gene mutation and maternal use of alcohol, tobacco, or illicit drugs has also been suggested. Detailed ultrasonography along with biochemical screening may allow for early detection.

  12. Connectivity among sinkholes and complex networks: The case of Ring of Cenotes in northwest Yucatan, Mexico

    Science.gov (United States)

    Gomez-Nicolas, Mariana; Rebolledo-Vieyra, Mario; Huerta-Quintanilla, Rodrigo; Canto-Lugo, Efrain

    2014-05-01

    A 180-km-diameter semicircular alignment of abundant karst sinkholes (locally known as cenotes) in northwestern Yucatán, México, coincides approximately with a concentric ring of the buried Chicxulub structure, a circular feature manifested in Cretaceous and older rocks, that has been identified as the product of the impact of a meteorite. The secondary permeability generated by the fracturing and faulting of the sedimentary sequence in the Chicxulub impact, has favored the karstification process and hence the development of genuine underground rivers that carry water from the continent to the sea. The study of the structure and morphology of the crater has allowed researchers to understand the key role of the crater in the Yucatán hydrogeology. It is generally accepted that the Ring of Cenotes, produced by the gravitational deformation of the Tertiary sedimentary sequence within the crater, controls the groundwater in northern Yucatán. However, today there is not solid evidence about the connectivity among cenotes, which is important because if established, public policies could be designed to manage sanitary infrastructure, septic control, regulation of agricultural and industrial activities and the protection of water that has not been compromised by anthropogenic pollution. All these directly affect more than half a million people whose main source of drinking water lies in the aquifer. In this contribution we investigated a set of 16 cenotes located in the vicinity of a gravimetric anomaly of Chicxulub crater ring, using complex networks to model the interconnectivity among them. Data from a geoelectrical tomography survey, collected with SuperSting R1/IP equipment, with multi-electrodes (72 electrodes), in a dipole-dipole configuration was used as input of our model. Since the total number of cenotes on the ring structure amounts to about 2000, the application of graph theoretic algorithms and Monte Carlo simulation to efficiently investigate network

  13. Biomonitoring of complex occupational exposures to carcinogens: The case of sewage workers in Paris

    International Nuclear Information System (INIS)

    Sewage workers provide an essential service in the protection of public and environmental health. However, they are exposed to varied mixtures of chemicals; some are known or suspected to be genotoxics or carcinogens. Thus, trying to relate adverse outcomes to single toxicant is inappropriate. We aim to investigate if sewage workers are at increased carcinogenic risk as evaluated by biomarkers of exposure and early biological effects. This cross sectional study will compare exposed sewage workers to non-exposed office workers. Both are voluntaries from Paris municipality, males, aged (20–60) years, non-smokers since at least six months, with no history of chronic or recent illness, and have similar socioeconomic status. After at least 3 days of consecutive work, blood sample and a 24-hour urine will be collected. A caffeine test will be performed, by administering coffee and collecting urines three hours after. Subjects will fill in self-administered questionnaires; one covering the professional and lifestyle habits while the a second one is alimentary. The blood sample will be used to assess DNA adducts in peripheral lymphocytes. The 24-hour urine to assess urinary 8-oxo-7, 8-dihydro-2'-deoxy-Guanosine (8-oxo-dG), and the in vitro genotoxicity tests (comet and micronucleus) using HeLa S3 or HepG2 cells. In parallel, occupational air sampling will be conducted for some Polycyclic Aromatic Hydrocarbons and Volatile Organic Compounds. A weekly sampling chronology at the offices of occupational medicine in Paris city during the regular medical visits will be followed. This protocol has been accepted by the French Est III Ethical Comitee with the number 2007-A00685-48. Biomarkers of exposure and of early biological effects may help overcome the limitations of environmental exposure assessment in very complex occupational or environmental settings

  14. Complex integrated method of dynamic meditation with Buddhists’ breathing in case of neurotic reactions

    Directory of Open Access Journals (Sweden)

    Omelyanenko V.I.

    2014-02-01

    Full Text Available Purpose: to elaborate complex integrated method of psychological influence upon sport dancers in time of training on base of Buddhists’ meditation “conscious breathing” for neurotic reactions elimination, professional skill improvement and psycho emotional stability advance. Material : twenty dancers at the age of 40-50 with neurotic reactions participated in the research. At the first stage of the research all the subjects’ ability to focus attention at breathing during sports dancing performance was examined. At the second stage training in method of dynamic meditation applied for martial arts of the experimental group of 10 subjects was conducted. Both individual and group training sessions were held. At the third stage the experimental group joined dynamic meditation and breathing at dance performance. At the fourth stage the experimental group’s results were compared with the control group’s results. Results : at the first stage of the research all the subjects noted difficulties in focusing attention on Buddhists’ nasal breathing and dance technique come-down. 3-5 sessions of training in method of dynamic meditation were necessary for the subjects of the experimental group at the second stage of the research. At the third stage of the research all the subjects of the experimental group could control their nasal breathing at dance performance without dance technique come-down. At the fourth stage the comparative evaluation of the results of the experimental and control groups revealed that it was necessary 3-7 sport dance practice sessions for elimination of the neurotic reactions. No such effect was observed in the control group. Conclusions : The results of the research prove that Buddhists’ meditation “conscious breathing” may be joined with dynamic meditation successfully. It’s impossible to focus attention continuously on breathing at time of sport dance performance. The elaborated technique of the integration of

  15. IMMUNOHISTOCHEMISTRY STUDIES IN A CASE OF DERMATITIS HERPETIFORMIS DEMONSTRATE COMPLEX PATTERNS OF REACTIVITY

    Directory of Open Access Journals (Sweden)

    Ana Maria Abreu Velez

    2013-11-01

    Full Text Available Introduction: Dermatitis herpetiformis (DH is an autoimmune, clinically pleomorphic, papulovesicular disorder sometimes associated with celiac disease and gluten sensitivity. DH is categorized by subepidermal vesicles and bullae on hematoxylin and eosin (H&E staining, and with immunoglobulin A deposits present along the dermal papillary tips on direct immunofluorescence (DIF. Case Report: We describe a 50 year old female that presented with sudden onset pruritus and clinical blisters, predominantly on extensor areas of the extremities. Biopsies for H&E examination, as well as immunohistochemistry (IHC and DIF analysis were performed. Results: H&E examination demonstrated subepidermal blistering; within the blister lumen, numerous neutrophils were present, with occasional eosinophils and lymphocytes also seen. DIF examination revealed linear deposits of IgA along the epidermal basement membrane zone, associated with other immunoglobulins and complement. IHC examination showed similar patterns of reactivity to IgA, and also to other immunoreactants. Cells positive for CD1a were present within the blisters, correlating with S-100 staining. Cells staining positive for CD8, CD45 and occasionally CD4 and Granzyme B were seen not only in the blister lumens, but also around neurovascular packages under the blisters. Finally, CD2 positive cells were found around the upper dermal blood vessels. Discussion: Focal DIF linear IgA deposition is the classic hallmark diagnostic finding in DH. However, it is possible that genetic susceptibility and environmental triggers also play a crucial role in the pathogenesis, often acting via cellular pathways exhibiting disease-associated polymorphisms. In tolerance breakthrough, the initiating antigen presenting cells likely lead to immune system cell differentiation, and activation of adaptive immunity.

  16. New Deep Dermal ADM Incorporates Well in Case Series of Complex Breast Reconstruction Patients.

    Science.gov (United States)

    Wilson, Henry Benjamin

    2015-05-01

    Breast cancer patients with significant comorbidities present reconstructive challenges due to a predictably high complication rate. During expander-based breast reconstruction, human acellular dermal matrix (ADM) is often used to prevent pectoralis muscle retraction, facilitate early expansion, and improve cosmetic outcome. Device infection and chronic seroma have been correlated to the addition of the graft by some large database reports but not others. This study describes the first reported experience with a new deep dermal ADM, FlexHD® Pliable™ (MTF, Edison, NJ). Sixteen breasts in 10 consecutive patients identified retrospectively and followed prospectively had immediate expander-based breast reconstruction utilizing the new ADM. Patient comorbidities were catalogued, complications were recorded, and overall reconstructive success was assessed. At implant exchange, the ADM was examined for tissue ingrowth and biopsied for histologic examination. All 16 breasts had successful reconstructions. Two breasts (12.5%) developed device infection, requiring removal and later replacement of the expander. One breast (6.7%) developed chronic seroma, also requiring expander removal and later replacement. All the complicated patients had significant comorbidities, including obesity in all 3. At expander removal, the FlexHD Pliable showed near-complete visual tissue incorporation in 14 of 16 breasts (88%). This case series demonstrates significant reconstructive success in challenging patients utilizing a novel ADM. Visual and histologic assessment of tissue ingrowth into the graft suggests the high rate of complication may be due to patient comorbidities rather than addition of ADM. Additional experience is needed to confirm and the study is ongoing. PMID:26020380

  17. 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.

  18. Tube-flap for management of complex recto-urinary fistula with York Mason technique: a case report.

    Science.gov (United States)

    Limkuansuwan, P

    2001-05-01

    Recto-urinary fistula results as a complication following trauma to the perinium and pelvis. These fistulas are difficult to treat and have a high recurrence rate due to the difficult surgical approach in repairing them. Both the transabdominal or transperineal approaches used in repairing these fistulas are difficult and provide only limited exposure to the fistula being repaired. In the case report, we present a patient with complex recto-urinary fistula due to trauma to the pelvis 20 years previously. In this patient we used the transphincteric York Mason approach to directly approach the fistula, followed by construction of a tube flap connecting the bladder and the urethra. The technique is simple, easy and the outcome has been excellent after 4 years of follow-up. PMID:11560228

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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. (authors)

  1. Primary pigmented nodular adrenocortical disease: report of 5 cases

    Institute of Scientific and Technical Information of China (English)

    ZHU Yu; WU Yu-xuan; RUI Wen-bin; LIU Ding-yi; ZHOU Wen-long; ZHANG Rong-ming; SUN Fu-kang; ZHANG Chong-yu; SHEN Zhou-jun

    2006-01-01

    @@ Primary pigmented nodular adrenocortical disease (PPNAD), found in the mid 1980s, is a rare type of ACTH-independent hypercortisolism,can be part of Carney complex (CNC), an autosomal dominant multiple neoplasia syndrome characterized by spotty skin pigmentation, cardiac myxomas and endocrine tumors. One of the putative CNC genes,located on 17q22-24, has been identified as the regulatory subunit R1A of protein kinase A (PRKAR1A). Patients with isolated PPNAD and no familial history of CNC can also present a germline de novo mutation of PRKAR1A. In China, five patients with PPNAD underwent surgical treatment in our department from 2001 to August 2004.1

  2. 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. Two cases of culture proven Mycobacterium tuberculosis presenting with a broad-complex tachycardia and non-caseating granulomas

    Directory of Open Access Journals (Sweden)

    Z. Farah

    2014-01-01

    Full Text Available Tuberculosis is a leading cause of death worldwide. It affects pulmonary and extra-pulmonary sites with a multitude of differing presentations. In this report, we describe two cases in which TB causes myopericarditis and presents with a broad-complex tachycardia that did not respond typically to standard anti-arrhythmic therapy; a very rare presentation with limited description in the literature. Both patients required extensive investigation culminating in identifying lymph nodes amenable to biopsy under endobronchial ultrasound guidance. It was not until both patients received anti-tuberculous chemotherapy alongside anti-arrhythmic management that any improvement to their condition was witnessed. Therefore, we recommend that the clinician should have a high index of suspicion for TB in any patient presenting with a broad-complex tachycardia that is not responding to standard first line management, especially if the patient is from a high risk background. We recommend an active diagnostic pursuit, and lymph node biopsy under endobronchial ultrasound guidance.

  4. PETROCHEMICAL SUPPLY CHAIN’S SHARE IN EMISSION OF GREEN HOUSE GASES, CASE STUDY: SHAZAND PETROCHEMICAL COMPLEX

    Directory of Open Access Journals (Sweden)

    Naser Moharamned

    2013-01-01

    Full Text Available In this study petrochemical supply chain shares in global warming is studied by monitoring carbon footprint during manufacturing and distribution phase. For identification and measurement of carbon emissions in petrochemical supply chain, at first step necessary data are collected. Then carbon footprint is calculated in manufacturing process. So GHG is measured during fossil fuel use for chemical productions and electricity production in exclusive power plant in production phase. Also carbon emissions are calculated during chemical process (non-energy use of fossil fuels. The other activity that has an impact on GHG emissions is transportation. In this study Intergovernmental Panel for Climate Change (IPCC methodology was employed. For conducting this research Shazand petrochemical complex in Iran is selected as a case study. The calculations and monitoring GHG will help to greening the petrochemical supply chain.The result shows GHG emissions in Shazad petrochemical complex supply chain is 6108960.35 tons per year. 6100434.9 tones CO2equ per year emit from manufacturing phase and 8525.4 tones CO2equ per year emit from distribution phase. Based on a comparison with statistics from United Nation Statistics division reports contribution of manufacturing phase of Shazand Petrochemical supply chain in global warming is about 0.020% and Based on a comparison with statistics from Iranian fuel Conservation Company and energy balance reports the contribution of distribution phase of Shazand Petrochemical supply chain in global warming is about 0.004%.

  5. The treatment of complex proximal humeral fractures: analysis of the results of 55 cases treated with PHILOS plate.

    Science.gov (United States)

    Fattoretto, D; Borgo, A; Iacobellis, C

    2016-08-01

    Complex proximal humerus fractures are often difficult to treat. Their frequency is high, especially in the elderly, and their treatment is still controversial. The aim of this study was to analyze the clinical and radiological results achieved by patients with complex proximal humerus fractures, treated with PHILOS plate only. A cohort of 55 patients was selected. The mean age was 63.4 (range 33-89), while the mean follow-up time was 21.5 months (range 6-75). Clinical outcome was evaluated with the "Constant-Murley shoulder score." All the informations about the presence of complications were gathered, and radiological images were used to calculate the head-shaft angle. The overall mean Constant score was 61.93 ± 18.59, the Individual CS was 70 ± 20 % and the Relative CS was 83 ± 23 %. No significant differences were found between fractures Neer 3 and Neer 4 and between the surgical approaches (delta-split vs. delto-pectoral). Six patients had a fracture with dislocation, seven patients (12.7 %) had complications while in four patients a head-shaft angle beyond the normal range was found. Osteosynthesis with PHILOS plate is stable in the greater part of the cases, and it allows an earlier rehabilitation and so a good functional result, which could be compromised by a prolonged immobilization. Therefore, PHILOS plate is a good option for the treatment of complex proximal humerus fractures. PMID:26833189

  6. The treatment of complex proximal humeral fractures: analysis of the results of 55 cases treated with PHILOS plate.

    Science.gov (United States)

    Fattoretto, D; Borgo, A; Iacobellis, C

    2016-08-01

    Complex proximal humerus fractures are often difficult to treat. Their frequency is high, especially in the elderly, and their treatment is still controversial. The aim of this study was to analyze the clinical and radiological results achieved by patients with complex proximal humerus fractures, treated with PHILOS plate only. A cohort of 55 patients was selected. The mean age was 63.4 (range 33-89), while the mean follow-up time was 21.5 months (range 6-75). Clinical outcome was evaluated with the "Constant-Murley shoulder score." All the informations about the presence of complications were gathered, and radiological images were used to calculate the head-shaft angle. The overall mean Constant score was 61.93 ± 18.59, the Individual CS was 70 ± 20 % and the Relative CS was 83 ± 23 %. No significant differences were found between fractures Neer 3 and Neer 4 and between the surgical approaches (delta-split vs. delto-pectoral). Six patients had a fracture with dislocation, seven patients (12.7 %) had complications while in four patients a head-shaft angle beyond the normal range was found. Osteosynthesis with PHILOS plate is stable in the greater part of the cases, and it allows an earlier rehabilitation and so a good functional result, which could be compromised by a prolonged immobilization. Therefore, PHILOS plate is a good option for the treatment of complex proximal humerus fractures.

  7. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

  10. [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.

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

    OpenAIRE

    Ihtesham A Qureshi; Rohit Kumar Gudepu; Ravikanth Chava; Sravya Emmani; Syed Husain Asghar; Mohtashim A. Qureshi; Nimmathota Arlappa

    2015-01-01

    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 age...

  12. A multi-disciplinary approach to study coastal complex landslides: the case of Torino di Sangro (Central Italy)

    Science.gov (United States)

    Sciarra, Marco; Carabba, Luigi; Urbano, Tullio; Calista, Monia

    2016-04-01

    This work illustrates the studies carried out on a complex landslide phenomenon between the Sangro and Osento River's mouths, near Torino di Sangro village in Southern Abruzzo Region (Italy). Historical activity of this landslide is well-documented since 1916; the activation/reactivation of the movements caused several interruptions of a national railway and the damage of few houses. The Torino di Sangro case study can be regarded as representative of many large landslides distributed along the central Adriatic coast (e.g., Ancona, Ortona, Vasto and Petacciato Landslides) that affect densely populated urban areas with a large amount of man-made infrastructure. The main controlling factors of these large and deep-seated landslides are still debated. From the geological and geomorphological viewpoint, the central Adriatic coast is characterized by a low-relief landscape (mesa) carved on clay-sandstone-conglomerate bedrock belonging to the Upper Pliocene - Lower Pleistocene marine deposits and locally to the Middle Pleistocene marine to continental transitional deposits. This high coast is widely affected by slope instability (rock falls, rotational, complex and shallow landslides) on both active and inactive sea cliffs, the first being mainly affected by wave-cut erosion and the latter influenced by heavy rainfall and changes of pore pressure. The main landslide has the typical characteristics of a deep-seated gravitation deformation. The landslide study was based on a multidisciplinary approach including: 1) definition and GIS mapping of geology and geomorphology factors (slope, aspect, topographic curvature, bedrock lithology, near-surface deposits, deposit thickness and land use), by means of DTM processing, multi-temporal analysis, and large-scale geomorphological field survey; 2) monitoring system in the landslide; 3) application of empiric models for the analysis of unstable sandstone-conglomerate escarpments; 4) slope stability analysis performed using a

  13. Vector control in a malaria epidemic occurring within a complex emergency situation in Burundi: a case study

    Directory of Open Access Journals (Sweden)

    D'Alessandro Umberto

    2007-07-01

    Full Text Available Abstract Background African highlands often suffer of devastating malaria epidemics, sometimes in conjunction with complex emergencies, making their control even more difficult. In 2000, Burundian highlands experienced a large malaria outbreak at a time of civil unrest, constant insecurity and nutritional emergency. Because of suspected high resistance to the first and second line treatments, the provincial health authority and Médecins Sans Frontières (Belgium decided to implement vector control activities in an attempt to curtail the epidemic. There are few reported interventions of this type to control malaria epidemics in complex emergency contexts. Here, decisions and actions taken to control this epidemic, their impact and the lessons learned from this experience are reported. Case description Twenty nine hills (administrative areas were selected in collaboration with the provincial health authorities for the vector control interventions combining indoor residual spraying with deltamethrin and insecticide-treated nets. Impact was evaluated by entomological and parasitological surveys. Almost all houses (99% were sprayed and nets use varied between 48% and 63%. Anopheles indoor resting density was significantly lower in treated as compared to untreated hills, the latter taken as controls. Despite this impact on the vector, malaria prevalence was not significantly lower in treated hills except for people sleeping under a net. Discussion Indoor spraying was feasible and resulted in high coverage despite being a logistically complex intervention in the Burundian context (scattered houses and emergency situation. However, it had little impact on the prevalence of malaria infection, possibly because it was implemented after the epidemic's peak. Nevertheless, after this outbreak the Ministry of Health improved the surveillance system, changed its policy with introduction of effective drugs and implementation of vector control to prevent new

  14. 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.

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

    OpenAIRE

    Al-Achkar, Walid; Wafa, Abdulsamad; ALMEDANI, SUHER

    2010-01-01

    The well-known typical fusion gene BCR/ABL is observed in connection with a complex translocation event in 5–8% of cases of chronic myeloid leukemia (CML). The present study described an exceptional CML case with complex chromosomal aberrations not previously observed. Aberrations included a translocated BCR to the derivative chromosome 2 [der(2)] that also involved a four-chromosome translocation, implying chromosomal regions 1p32 and 2q21, besides 9q34 and 22q11.2, which were characterized ...

  16. Complex odontoma with dentigerous cyst:a case report%混合性牙瘤合并含牙囊肿1例

    Institute of Scientific and Technical Information of China (English)

    徐其章; 张红亮; 王晓宇; 王占基; 徐倩倩; 马琼

    2014-01-01

    混合性牙瘤是一种比较少见的牙齿发育异常,混合性牙瘤合并含牙囊肿更是少见。本文报道1例混合性牙瘤合并含牙囊肿病例。%Complex odontoma is a relatively rare dental dysplasia. In particular, a complex odontoma with dentigerous cyst is seldom observed. A case of complex odontoma with dentigerous cyst is reported in this paper.

  17. Local development and globalization: the case of the formation of the agroindustrial complex of lemon in Colima, México

    Directory of Open Access Journals (Sweden)

    Saúl Martínez González

    2008-03-01

    Full Text Available The multinational company has been the main vehicle of internationalization of capital and trade integration between countries. The global expansion phase of the transnational corporation is associated with the hegemony of capitalism in the United States, whose influence has been decisive in the territories where it operates. This essay is a case of the influence of transnational company Coca Cola in the formation of the region of Tecoman, Colima, as providing an input to the company during the period dominated by Fordism. This region is formed from exogenous impulses of the needs of lemon essential oil by transnational companies which in turn have determined the stages of growth and expansion in the region that occur in phases of boom and bust. Dependence on oil exports Mexican lime by an American multinational company is determined, in turn, by the behavior of the economic cycle in the United States. This study highlights the stage of formation of the agroindustrial complex and does not attempt to analyze the current situation

  18. Function of Rural Settlement Complex Ecosystem in Mountain Area: A Case Study of Raosi Village of Zuogong County, Tibet

    Institute of Scientific and Technical Information of China (English)

    LIU Shaoquan; CHEN Guojie

    2006-01-01

    Using energy analysis,the quantifying evaluation and study method on production,living and ecology functions and their sustainability of rural settlement ecosystem in mountain area is established with these energy index such as export of labor and products,export of water resource,internal energy reserve,energy consumption for human living,net energy of ecosystem function and net internal reserve.Taking rural settlement Raosi Village in Hengduan Mountains as a case study,and on the basis of the synthetic research into the ecological process of the complex ecosystem,the study shows that energy costs of production,human living and ecology functions are separately taking 1.36%,13.59% and 85.05% of the gross ecosystem functions,and the exertions of production and human living functions are close to a high-point state on the present using level of energy in the settlement.The study also shows that the most important function of a rural settlement in mountain area is its ecological rather productive function.

  19. Steroid atrophy scarring treated with fat grafting in a patient with complex regional pain syndrome: A case report.

    Science.gov (United States)

    Strickland, Leah R; Collawn, Sherry S

    2016-06-01

    Subcutaneous atrophy is a known complication of steroid injections. Excellent results with fat grafting for the treatment of steroid atrophy have been documented. However, the benefit of treating steroid-induced subcutaneous atrophy in an extremity diagnosed with complex regional pain syndrome (CRPS) has not been described. CRPS, known formerly as reflex sympathetic dystrophy or RSD, causalgia, or reflex neurovascular dystrophy, is a severe, progressive musculoskeletal pain syndrome characterized by pain which is disproportionate to the severity of the inciting event, edema, or skin changes. Common treatment modalities include pharmacotherapy, physical therapy, and nerve blocks-each therapy producing varying results. We present a literature review of CRPS and the case of a 15-year-old female who developed CRPS of the left lower leg after arthroscopic debridement with retrograde drilling of an osteochondral lesion. Steroid atrophy of the involved area following a saphenous nerve block complicated the patient's treatment course. The area of atrophy was treated with autologous fat grafting. Following the adipose injection procedure, the patient experienced almost complete resolution of her CPRS-associated pain symptoms, along with improved cosmetic appearance of the area. PMID:26735938

  20. Identifying Complex Cultural Interactions in the Instructional Design Process: A Case Study of a Cross-Border, Cross-Sector Training for Innovation Program

    Science.gov (United States)

    Russell, L. Roxanne; Kinuthia, Wanjira L.; Lokey-Vega, Anissa; Tsang-Kosma, Winnie; Madathany, Reeny

    2013-01-01

    The purpose of this research is to identify complex cultural dynamics in the instructional design process of a cross-sector, cross-border training environment by applying Young's (2009) Culture-Based Model (CBM) as a theoretical framework and taxonomy for description of the instructional design process under the conditions of one case. This…

  1. 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…

  2. Coordination chemistry of a low-coordinate non-metal element: the case of electrophilic terminal phosphinidene complexes.

    Science.gov (United States)

    Villalba Franco, José Manuel; Schnakenburg, Gregor; Espinosa Ferao, Arturo; Streubel, Rainer

    2016-09-21

    3-Imino-azaphosphiridine complex 1 reacts with carbon monoxide to give 1,3-azaphosphetidinone complex 2, whereas with isocyanides 3a,b substitution occurred to yield complexes 4a,b. Oxidation of 1 using elemental sulfur afforded the first 1,3,2-thiazaphosphetidine-4-imine complex 5. DFT calculations provide insight into a manifold of pathways based on a common intermediate, a carbodiimide-to-phosphinidene complex, leading to P-N and P-C bond insertion products as well as ligand substitution products. PMID:27527532

  3. Complex Controls on Groundwater Quality in Growing Mid-sized Cities: A Case Study Focused on Nitrate and Emerging Contaminants

    Science.gov (United States)

    Ohr, C. A.; Godsey, S.; Welhan, J. A.; Larson, D. M.; Lohse, K. A.; Finney, B.; Derryberry, D.

    2015-12-01

    Many regions rely on quality groundwater to support urban growth. Groundwater quality often responds in a complex manner to stressors such as land use change, climate change, or policy decisions. Urban growth patterns in mid-sized cities, especially ones that are growing urban centers in water-limited regions in the western US, control and are controlled by water availability and its quality. We present a case study from southeastern Idaho where urban growth over the past 20 years has included significant ex-urban expansion of houses that rely on septic systems rather than city sewer lines for their wastewater treatment. Septic systems are designed to mitigate some contaminants, but not others. In particular, nitrates and emerging contaminants, such as pharmaceuticals, are not removed by most septic systems. Thus, even well-maintained septic systems at sufficiently high densities can impact down gradient water quality. Here we present patterns of nitrate concentrations over the period from 1985-2015 from the Lower Portneuf River Valley in southeastern Idaho. Concentrations vary from 0.03 to 27.09 nitrate-nitrogen mg/L, with average values increasing significantly over the 30 year time period from 3.15 +/- 0.065 to 3.57 +/- 0.43 mg/L. We examine temporal changes in locations of nitrate hotspots, and present pilot data on emerging contaminants of concern. Initial results suggest that high nitrate levels are generally associated with higher septic densities, but that this pattern is influenced by legacy agricultural uses and strongly controlled by underlying aquifer properties. Future work will include more detailed hydrological modeling to predict changes in hotspot locations under potential climate change scenarios.

  4. Universal plant DNA barcode loci may not work in complex groups: a case study with Indian berberis species.

    Directory of Open Access Journals (Sweden)

    Sribash Roy

    Full Text Available BACKGROUND: The concept of DNA barcoding for species identification has gained considerable momentum in animals because of fairly successful species identification using cytochrome oxidase I (COI. In plants, matK and rbcL have been proposed as standard barcodes. However, barcoding in complex genera is a challenging task. METHODOLOGY AND PRINCIPAL FINDINGS: We investigated the species discriminatory power of four reportedly most promising plant DNA barcoding loci (one from nuclear genome--ITS, and three from plastid genome--trnH-psbA, rbcL and matK in species of Indian Berberis L. (Berberidaceae and two other genera, Ficus L. (Moraceae and Gossypium L. (Malvaceae. Berberis species were delineated using morphological characters. These characters resulted in a well resolved species tree. Applying both nucleotide distance and nucleotide character-based approaches, we found that none of the loci, either singly or in combinations, could discriminate the species of Berberis. ITS resolved all the tested species of Ficus and Gossypium and trnH-psbA resolved 82% of the tested species in Ficus. The highly regarded matK and rbcL could not resolve all the species. Finally, we employed amplified fragment length polymorphism test in species of Berberis to determine their relationships. Using ten primer pair combinations in AFLP, the data demonstrated incomplete species resolution. Further, AFLP analysis showed that there was a tendency of the Berberis accessions to cluster according to their geographic origin rather than species affiliation. CONCLUSIONS/SIGNIFICANCE: We reconfirm the earlier reports that the concept of universal barcode in plants may not work in a number of genera. Our results also suggest that the matK and rbcL, recommended as universal barcode loci for plants, may not work in all the genera of land plants. Morphological, geographical and molecular data analyses of Indian species of Berberis suggest probable reticulate evolution and thus

  5. Switching industrial production processes from complex to defined media: method development and case study using the example of Penicillium chrysogenum

    Directory of Open Access Journals (Sweden)

    Posch Andreas E

    2012-06-01

    Full Text Available Abstract Background Filamentous fungi are versatile cell factories and widely used for the production of antibiotics, organic acids, enzymes and other industrially relevant compounds at large scale. As a fact, industrial production processes employing filamentous fungi are commonly based on complex raw materials. However, considerable lot-to-lot variability of complex media ingredients not only demands for exhaustive incoming components inspection and quality control, but unavoidably affects process stability and performance. Thus, switching bioprocesses from complex to defined media is highly desirable. Results This study presents a strategy for strain characterization of filamentous fungi on partly complex media using redundant mass balancing techniques. Applying the suggested method, interdependencies between specific biomass and side-product formation rates, production of fructooligosaccharides, specific complex media component uptake rates and fungal strains were revealed. A 2-fold increase of the overall penicillin space time yield and a 3-fold increase in the maximum specific penicillin formation rate were reached in defined media compared to complex media. Conclusions The newly developed methodology enabled fast characterization of two different industrial Penicillium chrysogenum candidate strains on complex media based on specific complex media component uptake kinetics and identification of the most promising strain for switching the process from complex to defined conditions. Characterization at different complex/defined media ratios using only a limited number of analytical methods allowed maximizing the overall industrial objectives of increasing both, method throughput and the generation of scientific process understanding.

  6. Variable coordinating activity of sulfur in silver(I) complexes with thiophene based N¹ -substituted thiosemicarbazones: First case of thiopheneyl-thione sulfur bridging in a dinuclear complex

    Indian Academy of Sciences (India)

    REKHA SHARMA; TARLOK S LOBANA; MANVIR KAUR; NEERAJ THATHAI; GEETA HUNDAL; JERRY P JASINSKI; RAY J BUTCHER

    2016-07-01

    Thiophene-2-carbaldehyde / acetaldehyde-N¹-substituted thiosemicarbazones {R¹R²C² = N³ - N(H)- C¹(=S)N¹HR; R¹, R², R : C₄H₃S, H, Me, Httsc- NMe; C₄H₃S, H, Et, Httsc-NEt; C₄H₃S, H, Ph, Httsc-NPh; C₄H₃S, Me, Et, Hattsc-NEt} and furan-2-carbaldehyde-N-ethyl thiosemicarbazone (C₄H₃O, H, Et, Hftsc-NEt) were reacted with silver(I) halides/silver(I) acetate in presence of triphenylphosphine in organic solvents. These reactions yielded a series of dinuclear [Ag₂(μ-Br)₂ (κ-S-Httsc-NEt)2(PPh3)2]·2MeOH 1, [Ag2Cl2(κ1-SHttsc-NPh)2(μ-S,S-Httsc-NPh)2] 2, [Ag2Cl2(μ-S-Hftsc-NEt)2(κ1-S-Hftsc-NEt)2] 4, [Ag2(μ3-N3,S-ttsc-NMe)2 (Ph3P)2]·2(CH3)2CO 5, [Ag2 (μ3-N3,S-attsc-NEt)2(Ph3P)2]·0.5(CH3)2CO 6 and mononuclear [AgBr(κ1-SHttsc-NPh)(PPh3)2]· MeCN 3 complexes, all of which have been characterized using analytical techniques, IRand NMR spectroscopy, and X-ray crystallography. Thio-ligands bind in neutral form in complexes 1-4 and in anionic form in complexes 5-6. Further, the sulfur donor atoms have shown variable coordination modes incomplexes, namely, κ1-S in 1 and 3; κ1-S, μ-S in 4; κ1-S, μ-S,S (thiopheneyl-thione) in 2 and μ3- N3, S in 5 and 6. Tertiary-phosphine (PPh3) showed dual function of ligation/de-ligation towards silver(I) chloride during the synthesis of complexes 2 and 4. The bridge bonding of Httsc-NPh in 2 through thiopheneyl ring sulfur andthione sulfur is unprecedented in metal-thiosemicarbazone chemistry.

  7. Diacritical Seismic Signatures for Complex Geological Structures: Case Studies from Shushan Basin (Egypt) and Arkoma Basin (USA)

    OpenAIRE

    Abdel-Fattah, Mohamed I.; Hamed A. Alrefaee

    2014-01-01

    Seismic reflection techniques show an imperative role in imaging complex geological structures and are becoming more acceptable as data interpreting tools in 2D/3D view. These subsurface geological structures provide complex seismic signature due to their geometrical behavior. Consequently, it is extremely difficult to interpret these seismic sections in terms of subsurface configuration. The main goal of this paper is to introduce seismic attributes as a powerful tool to interpret complex ge...

  8. Mycobacterium avium complex olecranon bursitis resolves without antimicrobials or surgical intervention: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Selene Working

    2015-01-01

    Conclusion: This case raises an important clinical question of whether close observation off antimicrobials is appropriate in select cases of immunocompetent patients with localized atypical mycobacterial disease of soft tissue and skeletal structures.

  9. Multicolor-FISH applied to resolve complex chromosomal changes in a case of T-ALL (FAB L2)

    NARCIS (Netherlands)

    Mkrtchyan, H.; Glaser, M.; Gross, M.; Wedding, U.; Hoeffken, K.; Liehr, T.; Aroutiounian, R.

    2006-01-01

    We report on a patient with a clinically diagnosed acute lymphoblastic leukemia (ALL) with partial unrecorded complex translocation events especially involving chromosomes 5,9 and 18. At the GTG-band level the karyotype was abnormal in 20% of the analyzed cells. The complex karyotype was studied in

  10. Decomposition as a Complex-Skill Acquisition Strategy in Management Education: A Case Study in Business Forecasting

    Science.gov (United States)

    Adya, Monica; Lusk, Edward J.; Balhadjali, Moncef

    2009-01-01

    Graduate business education has been criticized for utilizing simplistic teaching strategies that compromise the presentation of real-world complex skills in the classroom. In this article, we propose that complex management functions can be effectively taught using decomposition strategies. We demonstrate the usefulness of this strategy in the…

  11. Complexity in Decision Making: The Case of the Rotterdam Harbour Expansion : Connecting Decisions, Arenas and Actors in Spatial Decision Making

    NARCIS (Netherlands)

    E-H. Klijn (Erik-Hans); M.K.A. van Gils (Marcel)

    2007-01-01

    textabstractDecision making about spatial projects is very complex. Decisions to develop the Rotterdam harbour are taken in the context of a network of local, regional, national, European and international actors, both public and private. These decision-making processes exhibit a lot of complexity a

  12. COMPLEX EVALUATION OF THE NUMBER DYNAMICS OF COLONIAL WATERBIRD COMMUNITIES (THE CASE OF SOME ISLANDS OF SIVASH REGION

    Directory of Open Access Journals (Sweden)

    Matsyura A.V.

    2011-12-01

    Full Text Available The problem of the mathematical analysis of the number dynamics of the nesting waterbirds for the islands of the south of Ukraine is examined. The algorithm of the evaluation of changes in the number of island birds is proposed. Data of the long-term monitoring of the number of birds were analyzed according to this algorithm. The necessity of the implementation of the statistical indices together with the graphic representation of island birds’ turnover is proved. The trends of population dynamics are determined for the key species. The discussed procedure of the complex evaluation is proposed for the management planning of the island bird species and their habitats. The performed analysis of the number dynamics of the key-stone breeding island birds showed that, with the exception of little tern, the population status and the prognosis of number are sufficiently favorable. From the data of long-term monitoring we came up with the conclusion about the existence of island habitats with carrying capacity to maintain the additional number of breeding birds. In the case of unfavorable conditions like strengthening of anthropogenic press, concurrent interrelations, deficiency of feed resources or drastic reduction of breeding biotopes, the birds due to turnover are capable to successfully react even without reducing their number and breeding success. The extinction rate of the breeding bird species from the island sites directly correlates with the number of breeding species. For the species with equal abundance, the extinction probability is higher for birds, whose numbers are unstable and characterized by significant fluctuations. This testifies the urgency of the constant monitoring and analysis of the number dynamics of breeding bird species in region. The suggested procedure of analysis is recommended for drawing up of management plans and performing of prognoses of number of breeding island bird species. More detail analysis with use of

  13. Modeling and hazard mapping of complex cascading mass movement processes: the case of glacier lake 513, Carhuaz, Peru

    Science.gov (United States)

    Schneider, Demian; Huggel, Christian; García, Javier; Ludeña, Sebastian; Cochachin, Alejo

    2013-04-01

    that complex cascades of mass movement processes can realistically be modeled using different models and model parameters. The method to semi-automatically produce hazard maps is promising and should be applied in other case studies. Verification of model based results in the field remains an important requirement. Results from this study are important for the GLOF early warning system that is currently in an implementation phase, and for risk reduction efforts in general.

  14. Topical Treatment With Liposomal Sodium Copper Chlorophyllin Complex in Subjects With Facial Redness and Erythematotelangiectatic Rosacea: Case Studies.

    Science.gov (United States)

    Vasily, David B

    2015-10-01

    Physicians are often presented with patients complaining of facial redness and difficult to control rosacea. The water soluble sodium copper chlorophyllin complex has been shown to have anti-oxidant, anti-inflammatory, and anti-bacterial activities in vitro and anti-redness, pore reduction, and anti-acne activities in pilot clinical studies. In these case studies, the safety and efficacy of a topical gel containing a liposomal suspension of sodium copper chlorophyllin complex was assessed in subjects with facial redness and erythematotelangiectatic rosacea. PMID:26461829

  15. Rare case of impalement of two occupants of a vehicle by the same object: insights into the management of complex thoracic impalements

    Institute of Scientific and Technical Information of China (English)

    Maneesh Singhal; Madduri Vijay Kumar; Prem Prakash; Amit Gupta; Subodh Kumar; Sushma Sagar

    2012-01-01

    Thoracic impalement injuries are very rare and the majority of patients do not survive to reach a medical care facility.In this case report,we describe the successful outcome of a case of double thoracic impalement by two steed tors,of which one steel tor had impaled two patients simultaneously.The case report highlights all aspects of managing such rare and complex cases right from prehospital care; extrication process which happened under controlled environment at the trauma centre itself,till the definitive management of the impaled thoracic objects.Thoracic impalement injuries are dramatic and appear very challenging.However presence of mind of the managing team,coordinated team effort and availability of adequate facilities can lead to a successful outcome.

  16. Glacial recession in the Tropical Andes from the Little Ice Age: the case of Ampato Volcanic Complex (Southern Peru

    Science.gov (United States)

    Alcalá, J.; Palacios, D.; Zamorano, J. J.

    2010-03-01

    the Ampato volcanic complex (15º24´- 15º 51´ S, 71º 51´ - 73º W; 6.288 masl), one of the most important complexes of the northern sector of the CVZ. Photointerpretation of aerial photographs and teledetection through satellite images of Huayuray Valley (15º 41´ 14´´ S - 71º 51´ 53´´ W), located to the north of the complex, aided in accurately reconstructing the area occupied by the ice mass at different times (LIA, 1955, 2000 and 2008). Also the paleo-ELA (Equilibrium Line Altitude) and the ELA were calculated using the Accumulation Area (AA) method (Kaser and Osmaston, 2002; Osmaston, 2005) in a GIS. The ELA shows the relationship between climate and glacier mass balance (González Trueba, 2005). The data from Huayuray Valley show that the glaciers reached a minimum altitude of 5400 masl and covered an area of ~2.81 Km2 during the LIA. The paleo-ELA was located at ~5780 masl, ~120 m below the current ELA (~5900 m). Based on a vertical thermal gradient of 0.65ºC/100 m, the temperature during this event would have been about 0.7º C colder than present temperature in the Ampato volcanic complex. In 1955, Huayuray glacier covered ~2.45 km2, 12.8% less than in the LIA. In the same year, the glaciers in the Huayuray valley reached a minimum elevation of ~5660 masl and the ELA rose ~20 m, to 5800 masl. In only 45 years (1955 - 2000) the surface area of the ice was significantly reduced (~1 km2), i.e. 40.8%. The ELA continued to rise, until it reached 5890 masl in 2000. From 2000 - 2008, the Huayuray glacier was reduced to ~0.78 km2 and the ELA rised ~10 m to reach the 5900 masl These results from the CVZ confirm the dramatic recession of the glaciers in the tropical Andes during recent decades. They also suggest that if the rate of recession associated with the period 2000-2008 continues, glaciers in the Ampato volcanic complex will disappear in 10 years approximately. References González Trueba, J.J. (2005): La Pequeña Edad del Hielo en los Picos de

  17. The TOM Complex of Amoebozoans: the Cases of the Amoeba Acanthamoeba castellanii and the Slime Mold Dictyostelium discoideum.

    Science.gov (United States)

    Wojtkowska, Małgorzata; Buczek, Dorota; Stobienia, Olgierd; Karachitos, Andonis; Antoniewicz, Monika; Slocinska, Małgorzata; Makałowski, Wojciech; Kmita, Hanna

    2015-07-01

    Protein import into mitochondria requires a wide variety of proteins, forming complexes in both mitochondrial membranes. The TOM complex (translocase of the outer membrane) is responsible for decoding of targeting signals, translocation of imported proteins across or into the outer membrane, and their subsequent sorting. Thus the TOM complex is regarded as the main gate into mitochondria for imported proteins. Available data indicate that mitochondria of representative organisms from across the major phylogenetic lineages of eukaryotes differ in subunit organization of the TOM complex. The subunit organization of the TOM complex in the Amoebozoa is still elusive, so we decided to investigate its organization in the soil amoeba Acanthamoeba castellanii and the slime mold Dictyostelium discoideum. They represent two major subclades of the Amoebozoa: the Lobosa and Conosa, respectively. Our results confirm the presence of Tom70, Tom40 and Tom7 in the A. castellanii and D. discoideum TOM complex, while the presence of Tom22 and Tom20 is less supported. Interestingly, the Tom proteins display the highest similarity to Opisthokonta cognate proteins, with the exception of Tom40. Thus representatives of two major subclades of the Amoebozoa appear to be similar in organization of the TOM complex, despite differences in their lifestyle. PMID:26074248

  18. 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.

  19. Complex morphological and molecular genetic examination of amelogenesis imperfecta: a case presentation of two Czech siblings with a non-syndrome form of the disease.

    Science.gov (United States)

    Kripnerova, Tereza; Krulisova, Veronika; Ptakova, Nikola; Macek, Milan; Dostalova, Tatjana

    2014-01-01

    Amelogenesis imperfecta (AI) is an overarching term for a group of rare inherited disorders of hard tooth tissues. It is characterized by various defects in proper enamel formation. AI is a severe disorder that affects both the aesthetics and function of the dentition, with affected teeth increasingly suffering from dental caries. Therefore, early diagnosis and lifelong stomatological interventions are important. Due to the complex nature of AI family history, stomatological, radiographic, and molecular genetic examinations should be part of the diagnostic portfolio. Additionally, we utilized new visualization methods for the assessment of teeth demineralization. We present a case report of two affected Czech sisters (6 and 8 years old) with clinically defined AI. These are the first Czech cases in which comprehensive clinical and genetic analysis had been carried out and reflect the complex clinical nature, positive treatment options, and limitations of candidate-gene molecular genetic testing.

  20. The complexities of managing forest resources in post-decentralization Indonesia: a case study from Sintang District, West Kalimantan

    NARCIS (Netherlands)

    Yasmi, Y.; Anshari, Gusti Z.; Alqadrie, S.; Budiarto, T.; Ngusmanto,; Abidin, E.; Komarudin, H.; McGrath, S.; Zulkifli,; Afifudin,

    2005-01-01

    The study attempted to understand the dynamics and complexities of forest resources management following decentralization, the interactions among stakeholders in forest resources management, and the impacts of the new legislation on local community livelihoods in Sintang District, West Kalimantan. F

  1. [Case of anti VGKC-complex antibody associated disorder presenting with severe pain and fasciculations predominant in unilateral upper extremity].

    Science.gov (United States)

    Hara, Kenju; Watanabe, Osamu; Shibano, Ken; Ishiguro, Hideaki

    2012-01-01

    A 21-year-old man complained of severe pain and muscle twitching localized in his right arm. Neurological examination showed muscle fasciculations in his right forearm but no myokymia or myotonia. Needle electromyography revealed fibrillation potentials in his biceps brachii muscle and extensor carpi radialis muscle at rest but no myokymic discharges. His serum anti-voltage-gated potassium channel (VGKC)-complex antibody level was significantly high (194.2pM; controls VGKC-complex antibody associated disorder.

  2. Switching industrial production processes from complex to defined media: method development and case study using the example of Penicillium chrysogenum

    OpenAIRE

    Posch Andreas E; Spadiut Oliver; Herwig Christoph

    2012-01-01

    Abstract Background Filamentous fungi are versatile cell factories and widely used for the production of antibiotics, organic acids, enzymes and other industrially relevant compounds at large scale. As a fact, industrial production processes employing filamentous fungi are commonly based on complex raw materials. However, considerable lot-to-lot variability of complex media ingredients not only demands for exhaustive incoming components inspection and quality control, but unavoidably affects ...

  3. Complex Care Management to Decrease Emergency Department Utilization: A Case Study of the Homeless Patient Aligned Care Team Demonstration Project at VA Greater Los Angeles Healthcare System

    OpenAIRE

    Patel, Beena Ishwar

    2013-01-01

    This quality improvement (QI) dissertation is a case study of the homeless-oriented Patient Centered Medical Home demonstration program, referred to as the Homeless Patient Aligned Care Team (HPACT) at West Los Angeles VA Medical Center (WLA). The WLA HPACT program was implemented to address the complex needs of the homeless and at-risk for homelessness population using the Patient Centered Medical Home model (PCMH) - a multi-disciplinary, team-based approach to primary care. Unlike tradition...

  4. Vacuum assisted closure for the treatment of complex wounds and enterocutaneous fistulas in full term and premature neonates: a case report

    OpenAIRE

    Paradiso, Filomena Valentina; Nanni, Lorenzo; Merli, Laura; De Marco, Erika Adalgisa; Catania, Vincenzo Davide; Taddei, Alessandra; Manzoni, Carlo; Conti, Giorgio

    2016-01-01

    Background The Vacuum Assisted Closure (VAC) system has become an effective treatment for acute and chronic wound defects. Although its use has been reported in wound care of children and premature infants, the management of the device in this population has not been well established. Case presentation We report the satisfactory results in two neonates (one full-term and one preterm) with complex wounds secondary to major abdominal surgery. In the premature baby an enterocutaneous fistula was...

  5. Diacritical Seismic Signatures for Complex Geological Structures: Case Studies from Shushan Basin (Egypt and Arkoma Basin (USA

    Directory of Open Access Journals (Sweden)

    Mohamed I. Abdel-Fattah

    2014-01-01

    Full Text Available Seismic reflection techniques show an imperative role in imaging complex geological structures and are becoming more acceptable as data interpreting tools in 2D/3D view. These subsurface geological structures provide complex seismic signature due to their geometrical behavior. Consequently, it is extremely difficult to interpret these seismic sections in terms of subsurface configuration. The main goal of this paper is to introduce seismic attributes as a powerful tool to interpret complex geological structures in different geological settings. In order to image these complex geological features, multiple seismic attributes such as coherence and curvature have been applied to the seismic data generated over the Shushan Basin (Egypt and Arkoma Basin (USA. Each type of geological structure event usually generates a unique seismic “signature” that we can recognize and identify by using these seismic attributes. In Shushan Basin (Egypt, they provide a framework and constraint during the interpretation and can help prevent mistakes during a 3D structural modeling. In Arkoma Basin (USA, the seismic attributes results provide useful information for broader analyses of the complex structural relations in the region where the Ouachita orogenic belt intersects with the southern Oklahoma aulacogen. Finally, complex geological structures provide dramatically diacritical seismic signatures that can be easily interpreted by collaborating conventional seismic interpretation techniques with multiple seismic attributes.

  6. Tangled Narratives and Wicked Problems: A Complex Case of Positioning and Politics in a Diverse School Community

    Science.gov (United States)

    Nguyen, Thu Suong Thi; Scribner, Samantha M. Paredes; Crow, Gary M.

    2012-01-01

    The case of Allen Elementary School presents tangled narratives and wicked problems describing the multidimensionality of school community work. Using multiple converging and diverging vignettes, the case points to the distinctiveness of individual experience in schools; the ways institutionalized organizational narratives become cultural…

  7. Complex odontoma of unusual size involving the maxillary sinus: report of a case and review of CT and histopathologic features.

    Science.gov (United States)

    Mupparapu, Muralidhar; Singer, Steven R; Rinaggio, Joseph

    2004-09-01

    An unusually large complex odontoma of the maxilla, occupying the entire maxillary sinus with expansion into the floor of the orbit and left nasal fossa, is reported. Although occurrences of complex odontomas are not considered rare, odontomas attaining extremely large sizes, especially involving the entire maxillary sinus with extension to the orbital floor and nasal fossae, are indeed, rare. In this article, the literature is reviewed to identify the common clinical, radiographic, and histologic characteristics of such lesions, and the outcome of treatment is discussed. Complex odontomas occasionally have significant growth potential, especially in the first two decades of life. Early recognition and consideration for surgical excision are key to successful management of this common odontogenic lesion. When odontomas extend beyond the alveolar process into the fascial planes, nasal fossae, paranasal sinuses, and orbits, computed tomography can readily demonstrate the extent and boundaries of the lesion.

  8. Cavernous hemangioma of the internal auditory canal encasing the VII and VIII cranial nerve complex: case report and review of the literature.

    Science.gov (United States)

    Mastronardi, Luciano; Carpineta, Ettore; Cacciotti, Guglielmo; Di Scipio, Ettore; Roperto, Raffaelino

    2016-04-01

    Cavernous angiomas originating in the internal auditory canal are very rare. In the available literature, only 65 cases of cavernomas in this location have been previously reported. We describe the case of a 22-year-old woman surgically treated for a cavernous hemangioma in the left internal auditory canal, mimicking on preoperative magnetic resonance imaging MRI an acoustic neuroma. Neurological symptoms were hypoacusia and dizziness. The cavernous angioma encased the seventh and, partially, the eighth cranial nerve complex. A "nearly total" removal was performed, leaving a thin residual of malformation adherent to the facial nerve. Postoperative period was uneventful; hearing was unchanged, but the patient had a moderate inferior left facial palsy (House-Brackmann grade II) slightly improved during the following weeks. On the basis of the observation of this uncommon case, we propose a revision of the literature and discuss clinical features, differential diagnosis, and treatment. PMID:26876892

  9. ETHICS, POLITICAL CONJUCTURES AND SOCIALIZATION: A CASE STUDY OF POLICY ENTREPRENEURSHIP ON THE CONVERSATION OF MAU FOREST COMPLEX IN KENYA

    OpenAIRE

    Mmbali, Oscar Siema

    2016-01-01

    This is a case where the government risked public support to save the environment. The government broke the law by disobeying human rights law in order to enforce the environmental policy. Implementers also disobeyed court orders in order to enforce executive decrees. Taking this event as a case study, the purpose of this study was to analyze what politicians tell the public during major political crisis and its implications on environmental ethics and political socialization. Document Analys...

  10. Carbohydrate Content in the GDM Diet: Two Views: View 1: Nutrition Therapy in Gestational Diabetes: The Case for Complex Carbohydrates.

    Science.gov (United States)

    Hernandez, Teri L

    2016-05-01

    IN BRIEF Restriction of dietary carbohydrate has been the cornerstone for treatment of gestational diabetes mellitus (GDM). However, there is evidence that a balanced liberalization of complex carbohydrate as part of an overall eating plan in GDM meets treatment goals and may mitigate maternal adipose tissue insulin resistance, both of which may promote optimal metabolic outcomes for mother and offspring.

  11. Computer tomography navigation for the transoral anterior release of a complex craniovertebral junction deformity: A report of two cases

    Directory of Open Access Journals (Sweden)

    Junya Miyahara

    2016-01-01

    Conclusion: Transoral anterior release using CT navigation is an effective treatment option for rigid complex CVJ deformities. The accurate identification of the patients' anatomical features such as occipitoatlantal assimilation, is crucial for the conducting accurate preoperative CT-based navigation during transoral surgery.

  12. Exploring Innovation Processes from a Complexity Perspective. Part II. Experiences from the Subsea Increased Oil Recovery Case

    Science.gov (United States)

    Aasen, Tone Merethe Berg; Johannessen, Stig

    2007-01-01

    In this second part of the papers, exploring innovation processes from a complexity perspective, we present an empirical example to strengthen further the relevance of the approach. The example draws on a longitudinal research initiative conducted in cooperation with the Norwegian petroleum company Statoil ASA. We conducted our research into the…

  13. Prenatal diagnosis of cerebral lesions in Tuberous sclerosis complex (TSC). Case report and review of the literature.

    NARCIS (Netherlands)

    Wortmann, S.B.; Reimer, A.G.; Creemers, J.W.; Mullaart, R.A.

    2008-01-01

    Tuberous sclerosis complex (TSC) is an autosomal-dominant neurocutaneous disorder with multi-organ involvement. The diagnosis is suspected at fetal ultrasound on the discovery of multiple cardiac rhabdomyomas (CRs). They typically develop in utero and undergo spontaneous regression during the first

  14. Adaptive Capacity Within a Mega Project : A Case Study on Planning and Decision-Making in the Face of Complexity

    NARCIS (Netherlands)

    Giezen, Mendel; Bertolini, Luca; Salet, Willem

    2015-01-01

    There is a tendency in policy to reduce the complexity of planning and decision-making by simplifying both the process and the scope of projects. However, by framing a planning project's scope or process in a narrow way at an early stage, the possibility of adapting to changes in the context, and th

  15. Advances in Multi-Sensor Scanning and Visualization of Complex Plants: the Utmost Case of a Reactor Building

    Science.gov (United States)

    Hullo, J.-F.; Thibault, G.; Boucheny, C.

    2015-02-01

    In a context of increased maintenance operations and workers generational renewal, a nuclear owner and operator like Electricité de France (EDF) is interested in the scaling up of tools and methods of "as-built virtual reality" for larger buildings and wider audiences. However, acquisition and sharing of as-built data on a large scale (large and complex multi-floored buildings) challenge current scientific and technical capacities. In this paper, we first present a state of the art of scanning tools and methods for industrial plants with very complex architecture. Then, we introduce the inner characteristics of the multi-sensor scanning and visualization of the interior of the most complex building of a power plant: a nuclear reactor building. We introduce several developments that made possible a first complete survey of such a large building, from acquisition, processing and fusion of multiple data sources (3D laser scans, total-station survey, RGB panoramic, 2D floor plans, 3D CAD as-built models). In addition, we present the concepts of a smart application developed for the painless exploration of the whole dataset. The goal of this application is to help professionals, unfamiliar with the manipulation of such datasets, to take into account spatial constraints induced by the building complexity while preparing maintenance operations. Finally, we discuss the main feedbacks of this large experiment, the remaining issues for the generalization of such large scale surveys and the future technical and scientific challenges in the field of industrial "virtual reality".

  16. 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.

  17. The drive for muscle leanness: a complex case with features of muscle dysmorphia and eating disorder not otherwise specified.

    Science.gov (United States)

    Cafri, G; Blevins, N; Thompson, J K

    2006-12-01

    Muscle dysmorphia has been described as a subtype of body dysmorphic disorder in which an individual experiences severe body image disturbance related to muscularity. The current case is of a 20-year-old man who describes a history of muscle dysmorphia in which the nature of the body image concern is related to leanness (i.e., muscularity in the absence of body fat), as opposed to increasing muscle mass, which is how muscle dysmorphia has typically been characterized in the literature. The case illustrates the need to consider this additional facet of body image when diagnosing muscle dysmorphia. PMID:17272941

  18. Emergence of complex networks from diffusion on fractal lattices. A special case of the Sierpinski gasket and tetrahedron

    Energy Technology Data Exchange (ETDEWEB)

    Chełminiak, Przemysław, E-mail: geronimo@amu.edu.pl [Faculty of Physics, A. Mickiewicz University, Umultowska 85, 61-614 Poznań (Poland)

    2012-10-01

    A new approach to the assemblage of complex networks displaying the scale-free architecture is proposed. While the growth and the preferential attachment of incoming nodes assure an emergence of such networks according to the Barabási–Albert model, it is argued here that the preferential linking condition needs not to be a principal rule. To assert this statement a simple computer model based on random walks on fractal lattices is introduced. It is shown that the model successfully reproduces the degree distributions, the ultra-small-worldness and the high clustering arising from the topology of scale-free networks. -- Highlights: ► A new mechanism of evolution for scale-free complex networks is proposed. ► The preferential attachment rule is not necessary to construct such networks. ► It is shown that they reveal some basic properties of classical scale-free nets.

  19. 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.

  20. A case-study of complex gas–water–rock–pollutants interactions in shallow groundwater: Šalek Valley (Slovenia)

    OpenAIRE

    Giammanco, S.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Catania, Catania, Italia; Justin, B.; ERICo Velenje, Environmental Research & Industrial Co-operation Institute, Koroška 58, SI-3320 Velenje, Slovenia; Speh, N.; ERICo Velenje, Environmental Research and Industrial Co-operation Institute, Velenje, Slovenia; Veder, M.; Kardeljev trg 2, SI-3320 Velenje, Slovenia

    2008-01-01

    The complex geochemical interactions in the groundwater of the industrial area of S ˇ alek Valley (Slovenia) between natural and anthropogenic fluids were studied by means of major (Ca, Mg, Na, K, HCO3 -, Cl- and SO4 2-) and trace elements’ (As , Cd, Cu, Pb, Zn, Hg, Se and V) abundances, geochemical classification and statistical analysis of data. Cation abundances indicate mixing between a dolomitic end-member and an evaporitic or geothermal end-member. Anion ab...

  1. Use of synthesized data to support complex ad-hoc queries in an enterprise information warehouse: a diabetes use case.

    Science.gov (United States)

    Rogers, Patrick; Erdal, Selnur; Santangelo, Jennifer; Liu, Jianhua; Schuster, Dara; Kamal, Jyoti

    2008-11-06

    The Ohio State University Medical Center (OSUMC) Information Warehouse (IW) is a comprehensive data warehousing facility incorporating operational, clinical, and biological data sets from multiple enterprise system. It is common for users of the IW to request complex ad-hoc queries that often require significant intervention by data analyst. In response to this challenge, we have designed a workflow that leverages synthesized data elements to support such queries in an more timely, efficient manner.

  2. ADVANCES IN MULTI-SENSOR SCANNING AND VISUALIZATION OF COMPLEX PLANTS: THE UTMOST CASE OF A REACTOR BUILDING

    OpenAIRE

    Hullo, J.-F.; Thibault, G.; Boucheny, C.

    2015-01-01

    In a context of increased maintenance operations and workers generational renewal, a nuclear owner and operator like Electricité de France (EDF) is interested in the scaling up of tools and methods of “as-built virtual reality” for larger buildings and wider audiences. However, acquisition and sharing of as-built data on a large scale (large and complex multi-floored buildings) challenge current scientific and technical capacities. In this paper, we first present a state of th...

  3. Universal Plant DNA Barcode Loci May Not Work in Complex Groups: A Case Study with Indian Berberis Species

    OpenAIRE

    Sribash Roy; Antariksh Tyagi; Virendra Shukla; Anil Kumar; Singh, Uma M.; Lal Babu Chaudhary; Bhaskar Datt; Bag, Sumit K.; Singh, Pradhyumna K.; Nair, Narayanan K.; Tariq Husain; Rakesh Tuli

    2010-01-01

    BACKGROUND: The concept of DNA barcoding for species identification has gained considerable momentum in animals because of fairly successful species identification using cytochrome oxidase I (COI). In plants, matK and rbcL have been proposed as standard barcodes. However, barcoding in complex genera is a challenging task. METHODOLOGY AND PRINCIPAL FINDINGS: We investigated the species discriminatory power of four reportedly most promising plant DNA barcoding loci (one from nuclear genome--ITS...

  4. 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

  5. Ambiguity in the Manifestation of Adult Separation Anxiety Disorder Occurring in Complex Anxiety Presentations: Two Clinical Case Reports

    Science.gov (United States)

    Dudaee-Faass, Sigal; Marnane, Claire; Wagner, Renate

    2009-01-01

    Two case reports are described in which patients presented for the treatment of multiple comorbid anxiety disorders, all of which appeared to derive from prolonged separation anxiety disorder. In particular, these adults had effectively altered their lifestyles to avoid separation, thereby displaying only ambiguous separation anxiety symptoms that…

  6. Alignment of Configuration and Documentation for Highly Engineered Complex Product Configuration Systems: a Demonstration from a Case Study

    DEFF Research Database (Denmark)

    Shafiee, Sara; Kristjansdottir, Katrin; Hvam, Lars

    2015-01-01

    activities: (1) iterative testing of the system during the development, (2) communication with domain experts, (3) documentation and maintenance, and finally (4) updates without spending a lot of time and resources. This article is supplemented with a case study from an ETO company where the method for the...

  7. Keeping it simple? A case study into the advantages and disadvantages of reducing complexity in mega project planning

    NARCIS (Netherlands)

    Giezen, M.

    2012-01-01

    There are many articles discussing time and cost overruns in mega projects. This research, however, looks at a case that was successful in managing these aspects: a metro extension in the Rotterdam Region in the Netherlands. The literature identifies several causes for overruns and the question thus

  8. 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.

  9. Ecohydrodynamics of cold-water coral reefs: a case study of the Mingulay Reef Complex (western Scotland.

    Directory of Open Access Journals (Sweden)

    Juan Moreno Navas

    Full Text Available Ecohydrodynamics investigates the hydrodynamic constraints on ecosystems across different temporal and spatial scales. Ecohydrodynamics play a pivotal role in the structure and functioning of marine ecosystems, however the lack of integrated complex flow models for deep-water ecosystems beyond the coastal zone prevents further synthesis in these settings. We present a hydrodynamic model for one of Earth's most biologically diverse deep-water ecosystems, cold-water coral reefs. The Mingulay Reef Complex (western Scotland is an inshore seascape of cold-water coral reefs formed by the scleractinian coral Lophelia pertusa. We applied single-image edge detection and composite front maps using satellite remote sensing, to detect oceanographic fronts and peaks of chlorophyll a values that likely affect food supply to corals and other suspension-feeding fauna. We also present a high resolution 3D ocean model to incorporate salient aspects of the regional and local oceanography. Model validation using in situ current speed, direction and sea elevation data confirmed the model's realistic representation of spatial and temporal aspects of circulation at the reef complex including a tidally driven current regime, eddies, and downwelling phenomena. This novel combination of 3D hydrodynamic modelling and remote sensing in deep-water ecosystems improves our understanding of the temporal and spatial scales of ecological processes occurring in marine systems. The modelled information has been integrated into a 3D GIS, providing a user interface for visualization and interrogation of results that allows wider ecological application of the model and that can provide valuable input for marine biodiversity and conservation applications.

  10. Case histories : implementation of new liner hanger technology in south central Venezuela significantly improves operations in complex wells

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez, C.; Soto, S.; Leon, A. [PDVSA Petroleos de Venezuela SA, Caracas (Venezuela, Bolivarian Republic of); Marval, P.; Schoener-Scott, M. [Halliburton, Houston, TX (United States)

    2009-07-01

    Liner hangers are used in deep drilling operations to eliminate the need for full casing strings. However, conventional liner-hanger system do not always permit tool rotation, and liner-hanger failures can result in the complete loss of the wellbore. This study discussed an expandable liner hanger designed to withstand aggressive reaming as well as drilling to depths. Three case histories of wells located in southern Venezuela were used to compare the use of traditional and expandable liner hanger systems. The studies considered liner weight, and the pressure differentials caused by the use of positive seals. The study showed that conventional liner systems are not suited to the extreme environments of the Venezuelan heavy oil reserves. Multiple leak paths were observed. The expandable liner system provided a gas-tight seal, improved flow paths, and reduced the need for remedial cement jobs. It was concluded that use of the expandable systems also increased worker safety. 6 refs., 13 figs.

  11. Complex Regional Pain Syndrome (CRPS type-1) in an Adolescent Following Extravasation of Dextrose Containing Fluid-an Underdiagnosed Case

    OpenAIRE

    Subedi, Asish; Bhattarai, Balkrishna; Biswas, Binay K; Khatiwada, Sindhu

    2011-01-01

    Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked...

  12. Linguistic and Cross-Cultural Complexities of A Specialized Legal Item: The ‘True And Fair’ Case

    Directory of Open Access Journals (Sweden)

    Annalisa Zanola

    2014-01-01

    The aim of our contribution is that of analysing the possible linguistic and cross-cultural contexts where the hendiadys true and fair was born, and exploring the meaning implications of the same ‘formula’ during the centuries. We start from the hypothesis that true and fair is a hendiadys, to show that the two terms take strength and completeness one from the other, so as to generate an only complex meaning, whose original usage was, last but not least,  a literary and poetical one. The analysis of the hendiadys moves from the non-legal to the legal context, following steps of the etymological and lexical research methodology.

  13. Natural and Anthropogenic Source of Heavy Metals Pollution in the Soil Samples of an Industrial Complex; a Case Study

    OpenAIRE

    Maryam Mohammadi Roozbahani; Soheil Sobhanardakani; Hoda Karimi; Rezvan Sorooshnia

    2015-01-01

    Background: Soil serves as a major reservoir for contaminants as it can bind to various chemicals. The aim of this study was to evaluate the levels of some metals (Cd, Cu, Fe and V) in soil samples collected from different stations of Ahvaz Industrial Complex II to determine the natural and anthropogenic contribution of metal in the soil. Methods: This was an experimental study that carried out in 2013. Soil samples were obtained from 9 stations and were subjected to bulk digestion and che...

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

    OpenAIRE

    Alberto Colombo; Giuseppe Maccari; Terenzio Congiu; Petra Basso; Andreina Baj; Antonio Toniolo

    2013-01-01

    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-d...

  15. ‘Patient-Centered Care’ for Complex Patients with Type 2 Diabetes Mellitus—Analysis of Two Cases

    OpenAIRE

    Hackel, Jennifer M.

    2013-01-01

    Purpose This paper serves to apply and compare aspects of person centered care and recent consensus guidelines to two cases of older adults with poorly controlled diabetes in the context of relatively similar multimorbidity. Methods After review of the literature regarding the shift from guidelines promoting tight control in diabetes management to individualized person centered care, as well as newer treatment approaches emerging in diabetes care, the newer guidelines and potential treatment ...

  16. 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.

  17. Hyperspectral Sensor Data Capability for Retrieving Complex Urban Land Cover in Comparison with Multispectral Data: Venice City Case Study (Italy

    Directory of Open Access Journals (Sweden)

    Federico Santini

    2008-05-01

    Full Text Available This study aims at comparing the capability of different sensors to detect land cover materials within an historical urban center. The main objective is to evaluate the added value of hyperspectral sensors in mapping a complex urban context. In this study we used: (a the ALI and Hyperion satellite data, (b the LANDSAT ETM+ satellite data, (c MIVIS airborne data and (d the high spatial resolution IKONOS imagery as reference. The Venice city center shows a complex urban land cover and therefore was chosen for testing the spectral and spatial characteristics of different sensors in mapping the urban tissue. For this purpose, an object-oriented approach and different common classification methods were used. Moreover, spectra of the main anthropogenic surfaces (i.e. roofing and paving materials were collected during the field campaigns conducted on the study area. They were exploited for applying band-depth and sub-pixel analyses to subsets of Hyperion and MIVIS hyperspectral imagery. The results show that satellite data with a 30m spatial resolution (ALI, LANDSAT ETM+ and HYPERION are able to identify only the main urban land cover materials.

  18. The complexity of crime network data: a case study of its consequences for crime control and the study of networks.

    Science.gov (United States)

    Rostami, Amir; Mondani, Hernan

    2015-01-01

    The field of social network analysis has received increasing attention during the past decades and has been used to tackle a variety of research questions, from prevention of sexually transmitted diseases to humanitarian relief operations. In particular, social network analyses are becoming an important component in studies of criminal networks and in criminal intelligence analysis. At the same time, intelligence analyses and assessments have become a vital component of modern approaches in policing, with policy implications for crime prevention, especially in the fight against organized crime. In this study, we have a unique opportunity to examine one specific Swedish street gang with three different datasets. These datasets are the most common information sources in studies of criminal networks: intelligence, surveillance and co-offending data. We use the data sources to build networks, and compare them by computing distance, centrality, and clustering measures. This study shows the complexity factor by which different data sources about the same object of study have a fundamental impact on the results. The same individuals have different importance ranking depending on the dataset and measure. Consequently, the data source plays a vital role in grasping the complexity of the phenomenon under study. Researchers, policy makers, and practitioners should therefore pay greater attention to the biases affecting the sources of the analysis, and be cautious when drawing conclusions based on intelligence assessments and limited network data. This study contributes to strengthening social network analysis as a reliable tool for understanding and analyzing criminality and criminal networks. PMID:25775130

  19. The complexity of crime network data: a case study of its consequences for crime control and the study of networks.

    Directory of Open Access Journals (Sweden)

    Amir Rostami

    Full Text Available The field of social network analysis has received increasing attention during the past decades and has been used to tackle a variety of research questions, from prevention of sexually transmitted diseases to humanitarian relief operations. In particular, social network analyses are becoming an important component in studies of criminal networks and in criminal intelligence analysis. At the same time, intelligence analyses and assessments have become a vital component of modern approaches in policing, with policy implications for crime prevention, especially in the fight against organized crime. In this study, we have a unique opportunity to examine one specific Swedish street gang with three different datasets. These datasets are the most common information sources in studies of criminal networks: intelligence, surveillance and co-offending data. We use the data sources to build networks, and compare them by computing distance, centrality, and clustering measures. This study shows the complexity factor by which different data sources about the same object of study have a fundamental impact on the results. The same individuals have different importance ranking depending on the dataset and measure. Consequently, the data source plays a vital role in grasping the complexity of the phenomenon under study. Researchers, policy makers, and practitioners should therefore pay greater attention to the biases affecting the sources of the analysis, and be cautious when drawing conclusions based on intelligence assessments and limited network data. This study contributes to strengthening social network analysis as a reliable tool for understanding and analyzing criminality and criminal networks.

  20. SURFACE AREA AND MICRO-ROUGHNESS OF VOLCANIC ASH PARTICLES: A case study, Acigol Volcanic Complex, Cappadocia, Central Turkiye

    Science.gov (United States)

    Ersoy, O.; Aydar, E.; Sen, E.; Atici, G.

    2009-04-01

    Every single ash particle may convey information about its own formation environment and conditions. Certain features on particles may give a hint about the fragmentation regime, the intensity of fragmentation and quantity of water that partakes in the fragmentation process, etc. On this account, this study majored in the analysis on finer pyroclastic material, namely volcanic ash particles. Here, we used volcanic ash particles from Quaternary Acigol Volcanic complex (West of Nevsehir, Cappadocia, Central Turkiye). Quaternary Acigol Volcanic complex lies between the towns of Nevsehir and Acigol. It consists of a shallow caldera, a thick pyroclastic apron, seven obsidian dome clusters, and scattered cinder cones and associated lavas (Druitt et al., 1995). The products of explosive volcanism of the region were distinguished as two main Quaternary tuffs by a recent study (Druitt et al., 1995). Samples are from ashfall beds in a sequence of intercalated pumice fall, ashfall, and ignimbrite beds. In this study in order to achieve surface properties of volcanic ash particles, surface areas and micro-roughness of ash particles were measured on digital elevation models (DEM) reconstructed from stereoscopic images acquired on Scanning Electron Microscope (SEM) at varying specimen tilt angles. Correlation between surface texture of volcanic ash particles and eruption characteristics was determined.

  1. Natural and Anthropogenic Source of Heavy Metals Pollution in the Soil Samples of an Industrial Complex; a Case Study

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    Maryam Mohammadi Roozbahani

    2015-06-01

    Full Text Available Background: Soil serves as a major reservoir for contaminants as it can bind to various chemicals. The aim of this study was to evaluate the levels of some metals (Cd, Cu, Fe and V in soil samples collected from different stations of Ahvaz Industrial Complex II to determine the natural and anthropogenic contribution of metal in the soil. Methods: This was an experimental study that carried out in 2013. Soil samples were obtained from 9 stations and were subjected to bulk digestion and chemical partitioning. Concentrations of Cd, Cu, Fe and V in soil were determined by ICP-OES. Contaminant factor (CF and geo-accumulation index (I-geo were used to evaluate the soil pollution in the samples. ANOVA, Duncan Multiple Range and Pearson correlation coefficient matrix tests was used to analyze the data. Results: According to I-geo results, the soil samples of the Ahvaz Industrial Complex II could be classified as strongly to very strongly pollute for Cd and it was unpolluted to moderately pollute for Cu, Fe and V. The amount of anthropogenic pollution was more than that of natural sources and the anthropogenic order of metals pollution was Fe (88%> Cu (83%> Cd (75%> V (61%. Conclusion: Metals concentrations are the highest at a distance of 300m from the pollution source. V, Cu and Cd pollutants are probably originated from oil industries.

  2. [Health and work: the case of the gas emissions at the Industrial Complex of Mayagüez].

    Science.gov (United States)

    Cruz Chaulissant, M

    1990-04-01

    This article describes the effects of gas emissions on the health of the workers (mostly women) of garment Industry at the Guanajibo Industrial Complex in Mayagüez. The persons affected show the following diseases and conditions: peripherial neuropathy, alteration of time and space orientation, damage to the pulmonary system and the respiratory tract, allergies, degenerative diseases, and even death. The agencies concerned have been negligent alleging that the problem is caused by stress of mass hysteria, this without performing the necessary studies. Having evaluated the problem, the Committee concludes that its roots are in the establishment in Puerto Rico of industries without considering the negative effects over health due to the contamination they generate, and which they do not control properly, all to maintain jobs that in the long run will not solve our problems, but will surely affect the health of the people.

  3. POTENTIAL BENEFITS AND COMPLEXITIES OF BLENDED LEARNING IN HIGHER EDUCATION: The case of the University of Botswana

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    Regina K. MASALELA

    2009-01-01

    Full Text Available Blended/hybrid learning is dominating news in higher education as a training and educational delivery method of choice. It is seen as a link between instructors, learners and classrooms located in different places to enhance learning. Based on the interviews with 15 faculty members and one administrator that had direct experience with this form of delivery at the University of Botswana (UB the findings suggested two major themes that dominated faculty members ’accounts: potential benefits and challenges of blended learning. The study was guided by the Diffusion of Innovation theory. The potential benefits of blended learning included improved pedagogy; engagement in learning; and added flexibility in the teaching and learning to mention a few. Faculty members perceived complexities such as lack of students’ readiness to use the course management system, slow network and breakdowns; lack of computers for students and lack of time. The article concludes by suggesting future directions for blended learning (BL at the UB.

  4. Thermodynamics of complexes formation by ITC in methanol/water = 9/1 (v/v) solution: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Fisicaro, Emilia, E-mail: emilia.fisicaro@unipr.it [University of Parma, Department of Pharmacy, Parco Area delle Scienze, 27/A, 43124 Parma (Italy); Compari, Carlotta; Bacciottini, Franco; Contardi, Laura [University of Parma, Department of Pharmacy, Parco Area delle Scienze, 27/A, 43124 Parma (Italy); Carcelli, Mauro; Rispoli, Gabriele; Rogolino, Dominga [University of Parma, Department of Chemistry, Parco Area delle Scienze, 17/A, 43124 Parma (Italy)

    2014-06-01

    Graphical abstract: Integrase strand transfert inhibitors chelate the metal ions in the active site of HIV integrase. - Highlights: • Development of inhibitors acting against those viral enzymes operating via a cooperative two-metal ion mechanism, such as HIV integrase (IN), requires optimizing the binding affinity to the target. • We have defined an experimental procedure for obtaining reliable thermodynamic data by ITC in methanol/water = 9/1 (v/v) as solvent. • Formation heats in mixed solvent of the complexes formed by a ligand, model of Raltegravir, with Mg(II), Mn(II), Co(II) and Zn(II) are here reported. - Abstract: Most enzymes that participate in the biochemistry of nucleic acids require divalent metal ion cofactors to promote activity. Development of potent inhibitors, acting against those viral enzymes operating via a cooperative two-metal ion mechanism, such as HIV integrase (IN) and RNase H, hepatitis C virus polymerase and influenza endonuclease, requires optimizing the binding affinity to the target, which is dictated by the binding free energy composed of both enthalpic and entropic contributions. They can be obtained by using isothermal titration microcalorimetry. We have defined an experimental procedure for obtaining reliable thermodynamic data in methanol/water = 9/1 0.1 M KCl as solvent, used to overcome solubility problems. In this way we have measured the heats of formation of the complexes formed by N-(4-fluorobenzyl)-5-hydroxy-2-isopropyl-1-methyl-6-oxo-1, 6-dihydroxypyrimidine-4-carboxylate (HL, a model of Raltegravir, the antiretroviral drug produced by Merck and Co.), and a series of divalent metal ions of biological interest (Mg(II), Mn(II), Co(II) and Zn(II)), whose speciation was previously determined by potentiometry.

  5. A Complex Systems Approach to Energy Poverty in sub-Saharan Africa: Nigeria as a Case Study

    Science.gov (United States)

    Chidebell Emordi, Chukwunonso

    Energy poverty is pervasive in sub-Saharan Africa. Nigeria, located in sub-Saharan West Africa, is the world's seventh largest oil exporting country and is a resource-rich nation. It however experiences the same levels of energy poverty as most of its neighboring countries. Attributing this paradox only to corruption or the "Dutch Disease", where one sector booms at the expense of other sectors of the economy, is simplistic and enervates attempts at reform. In addition, data on energy consumption is aggregated at the national level via estimates, disaggregated data is virtually non-existent. Finally, the wave of decentralization of vertically integrated national utilities sweeping the developing world has caught on in sub-Saharan Africa. However, little is known of the economic and social implications of these transitions within the unique socio-technical system of the region's electricity sector, especially as it applies to energy poverty. This dissertation proposes a complex systems approach to measuring and mitigating energy poverty in Nigeria due to its multi-dimensional nature. This is done via a three-fold approach: the first section of the study delves into causation by examining the governance institutions that create and perpetuate energy poverty; the next section proposes a context-specific minimum energy poverty line based on field data collected on energy consumption; and the paper concludes with an indicator-based transition management framework encompassing institutional, economic, social, and environmental themes of sustainable transition within the electricity sector. This work contributes to intellectual discourse on systems-based mitigation strategies for energy poverty that are widely applicable within the sub-Saharan region, as well as adds to the knowledge-base of decision-support tools for addressing energy poverty in its complexity.

  6. Submandibular cellulitis (Ludwig's angina) associated to a complex odontoma erupted into the oral cavity. Case report and literature review.

    Science.gov (United States)

    Bertolai, R; Acocella, A; Sacco, R; Agostini, T

    2007-01-01

    The clinical presentation of Ludwig's angina consists in a severe expanding cellulitis causing swelling of the floor of the mouth, tongue and submandibular region, thus resulting in a possible obstruction of the airway and in a rapid progress in deep neck soft tissue infection and mediastinitis with potentially fatal consequences. Frequently, submandibular cellulitis develops from an acute infection spreading from the lower molar teeth. Mandibular fractures, traumatic laceration of the floor of the mouth, and peritonsillar abscesses are other concomitant clinical features. A case of Ludwig's angina associated with a large erupted odontoma and with a deeply impacted third molar displaced to the border of the mandible is described. The patient was affected by enlargement of submandibular space, marked face swelling causing an evident face deformity, tenderness and redness of the neck and limited movement of the neck and mouth. In the past, Ludwig's angina was frequently fatal, however aggressive surgical and medical therapy have significantly reduced the mortality rate. The reported case can be considered as important, not only because of the rarity of the odontoma eruption in the oral cavity, but mainly for the extent of the clinical manifestation of a lesion usually described in literature as asymptomatic.

  7. Applying genetic algorithms in a parallel computing environment for optimising parameters of complex cellular automata models: the case of SCIDDICA S3hex

    Science.gov (United States)

    D'Ambrosio, D.; Iovine, G.

    2003-04-01

    Cellular Automata (CA) offer a valid alternative to the classic approach, based on partial differential equation, in order to simulate complex phenomena, when these latter can be described in terms of local interactions among their constituent parts. SCIDDICA S3hex is a two-dimensional hexagonal CA model developed for simulating debris flows: it has recently been applied to several real cases of landslides occurred in Campania (Southern Italy). The release S3hex has been derived by progressively improving an initial simplified CA model, originally derived for simulating simple cases of flow-type landslides. The model requires information related to topography, thickness of erodable regolith overlying the bedrock, and location and extension of landslide sources. Performances depend on a set of global parameters which are utilised in the transition function of the model: their value affect the elementary processes of the transition function and thus the overall results. A fine calibration is therefore an essential phase, in order to evaluate the reliability of the model for successive applications to debris-flow susceptibility zonation. The complexity of both the model and the phenomena to be simulated suggested to employ an automated technique of evaluation, for the determination of the best set of global parameters. Genetic Algorithms (GA) are a powerful optimization tool inspired to natural selection. In the last decades, in spite of their intrinsic simplicity, they have largely been successfully applied on a wide number of highly complex problems. The calibration of the model could therefore be performed through such technique of optimisation, by considering several real cases of study. Owing to the large number of simulations generally needed for performing GA experiments on complex phenomena, which imply long lasting tests on sequential computational architectures, the adoption of a parallel computational environment seemed appropriate: the original source code

  8. Acute unstable complex radial head and neck fractures fixed with a mini T-shaped plate in a 20-year-old man: a case report.

    Science.gov (United States)

    Yu, Weiguang; Hu, Jun; Zhang, Xinchao; Zhu, Xingfei; Xu, Yinfeng; Yi, Jianhua; Liu, Yunjiang

    2016-01-01

    Acute unstable complex radial head and neck fractures in adults are seldom reported in the literature. Early recognition and appropriate management are essential to prevent long-term consequences of the loss of elbow function, forearm rotation, and chronic pain. Here, we describe an unusual case of a 20-year-old man who exhibited acute unstable complex fractures of the head and neck of the right radius without other injuries or comorbidity. An open reduction and mini T-shaped plate fixation were performed within 3 hours after injury, and the results were satisfactory. A long plaster fixation was continued for 3 weeks. A gradual mobilization was started after the removal of the plaster under the supervision of a physiotherapist. At the 12-month follow-up, no complications associated with the use of the mini T-shaped plate were noted, and the Mayo Elbow Performance Score was 97 (excellent). To our knowledge, acute unstable complex radial head and neck fractures in adults can be successfully treated with a mini T-shaped plate reconstruction technique. PMID:27307743

  9. Joint impact of rainfall and tidal level on flood risk in a coastal city with a complex river network: a case study for Fuzhou city, China

    Directory of Open Access Journals (Sweden)

    J. J. Lian

    2012-06-01

    Full Text Available Coastal cities are particularly vulnerable to flood under the combined effect of multivariable variables, such as heavy rainfall, high sea level and large waves. For better assessment and management of flood risk the combined effect and joint probability should be considered. This paper aims to study the joint impact of rainfall and tidal level on flood risk by estimating the combined risk degree of flood and the joint flood probability. The area of case study is a typical coastal city in China, which has a complex river system. The flood in this city is mainly caused by inundation of river system. In this paper, the combined risk degree of flood is assessed by analyzing the behavior of the complex river network of the city under the combined effect of rainfall and tidal level with diverse return periods. The hydraulic model of the complex drainage network is established using HEC-RAS and verified by comparing the simulation results with the observed data during Typhoon "Longwang". The joint distribution and combined risk probability of rainfall and tidal level are estimated using the optimal copula function. The work carried out in this paper would facilitate assessment of flood risk significantly, which can be referred for the similar cities.

  10. Thermographic mapping of a complex vernacular settlement: the case study of Casalnuovo District within the Sassi of Matera (Italy)

    Science.gov (United States)

    Cardinale, Tiziana; Balestra, Alessandro; Cardinale, Nicola

    2015-04-01

    Never as in the Sassi of Matera (Italy), the parties have a volumetric material identity and a special construction condition for which, first of all, you need to know the whole to which they give life, and then the individual components and their connections. The distribution of these building artifacts in symbiotic connection with the connective calcareous texture that hosts them, resulted in a spontaneously harmonious figurative balance that characterizes the constructive expedients employed and the distributive and morphological solutions. This is the reason why the Sassi, and the overlooking Park of Rupestrian Churches of Matera Murgia have been entered in 1993 in the UNESCO World Heritage List. Our research focuses on a largely abandoned area within the Casalnuovo District, situated in the extreme south of the city, probably the place of the future Demoethnoanthropological Museum. It is known today that the particular shape of the area is made up of settlements mainly in cave; during the time architectures above ground, in a very limited number, filled almost completely the limited building space. Here there are the most archaic types and forms of building and wine cellars within the Sassi, essentially derive from the natural cave only slightly structured by man. The exterior construction complete the elementary cave and it is called lamione. The complexity of a built space like this one determines the need for a non-traditional approach, so you have to combine last generation tools and canonical ones for survey and energy diagnosis within a dialectic between memory, tradition and innovation, in order to identify solutions for an environment friendly recover of a cultural heritage such this one. Since the evaluation of the historical buildings conservation state using destructive techniques should be avoided to prevent the integrity of the cultural heritage, the development of non-destructive and non-contact techniques is very important. For this reason, an

  11. Geostatistical analysis to identify hydrogeochemical processes in complex aquifers: a case study (Aguadulce unit, Almeria, SE Spain).

    Science.gov (United States)

    Daniele, Linda; Pulido Bosch, Antonio; Vallejos, Angela; Molina, Luis

    2008-06-01

    The Aguadulce aquifer unit in southeastern Spain is a complex hydrogeological system because of the varied lithology of the aquifer strata and the variability of the processes that can take place within the unit. Factorial analysis of the data allowed the number of variables to be reduced to 3 factors, which were found to be related to such physico-chemical processes as marine intrusion and leaching of saline deposits. Variographic analysis was applied to these factors, culminating in a study of spatial distribution using ordinary kriging. Mapping of the factors allowed rapid differentiation of some of the processes that affect the waters of the Gador carbonate aquifer within the Aguadulce unit, without the need to recur to purely hydrogeochemical techniques. The results indicate the existence of several factors related to salinity: marine intrusion, paleowaters, and/or leaching of marls and evaporitic deposits. The techniques employed are effective, and the results conform to those obtained using hydrogeochemical methods (vertical records of conductivity and temperature, ion ratios, and others). The findings of this study confirm that the application of such analytical methods can provide a useful assessment of factors affecting groundwater composition. PMID:18686503

  12. Physician density planning in a public healthcare system: Complexities, threats and opportunities-The case of the Israeli healthcare system.

    Science.gov (United States)

    Gamzu, Ronni; Kaidar, Nir; Afek, Arnon; Horev, Tuvia

    2016-08-01

    Human-resource planning in healthcare is one of the most significant challenges that healthcare systems worldwide face. Among all healthcare professions, the planning of physician supply is the most complex of all due to physicians' lengthy training and many specialties. Forecasts showing a disturbing downward trend in the ratio of physicians to population in Israel prompted the Israeli Government in 2010 to establish a committee mandated to predict demand for physicians and recommend steps to adjust supply to it. The committee analyzed numerous variables that affect physician supply and demand and recommended measures that in greater part were implemented. The article discusses the methodology of the committee, its recommendations, and their implementation such as a 52% increase in the number of first-year medical students between 2010 and 2012. Its analysis of the current situation shows that the implementation of the recommendations successfully stemmed the decrease in physician density and attained the committee's other long-term objectives: physician density of 2.9 per 1000 of population and an increase (32.5%) in the number of physicians who began training in targeted specialties. PMID:27496154

  13. Skills based constraints and complexities affecting small-scale-entrepreneurship: A case of communal cattle farmers in Vhembe District

    Directory of Open Access Journals (Sweden)

    Mavhungu Abel Mafukata

    2015-09-01

    Full Text Available This paper investigates constraints and complexities affecting entrepreneurial and Agri-business small-scale farming success and sustainability in the Vhembe District of Limpopo Province, South Africa. The respondent entrepreneur farmers were purposively selected (n=55 amongst 183 other farmers in the district for primary data collection through a semi-structured cross-language (Tshivenda questionnaire. Key Informant Interviews (KIIs and Focus Group Discussions (FGDs also formed part of data collection instruments. The results of this paper revealed that the entrepreneur farmers’ formal school educational levels and basic literacy skills in addition; subtraction; multiplication and division were reasonably higher while technological skills in farm risk management and production, and managerial competence in business financial skills; budgeting and marketing were low. Government sponsored extension service could be employed to improve some of these deficient skills through skills training amongst the entrepreneur farmers. Since the study area is in the proximity of the University of Venda and Madzivhandila Agricultural Colleges, these institutions could be enlisted to provide skills training to the entrepreneur farmers.

  14. Airborne verification of CALIPSO products over the Amazon: a case study of daytime observations in a complex atmospheric scene

    Directory of Open Access Journals (Sweden)

    F. Marenco

    2014-04-01

    Full Text Available A daytime underflight of CALIPSO with the Facility for Airborne Atmospheric Measurements has been performed on 20 September 2012 in the Amazon region, during the biomass burning season. The scene is dominated by a thin elevated layer (aerosol optical depth 0.03 at 532 nm and a moderately turbid boundary layer (aerosol extinction coefficient ∼110 Mm−1. The boundary layer is topped with small broken stratocumulus clouds. In this complex scene, a comparison of observations from the airborne and spaceborne lidars reveals a few discrepancies. The CALIPSO detection scheme tends to miss the elevated thin layer, and also shows several gaps (∼30% in the boundary layer. The small clouds are not correctly detected in the atmospheric volume description flags, and are therefore not removed from the signals; this causes the CALIPSO aerosol subtype to oscillate between smoke and polluted dust and may introduce distorsion in the aerosol retrieval scheme. The magnitude of the average extinction coefficient estimated from CALIPSO level 2 data in the boundary layer is as expected, when compared to the aircraft lidar and accounting for wavelength scaling. However, when the gaps in aerosol detection mentioned above are accounted for, we are left with an overall estimate of aerosol extinction for this particular scene that is of the order of two thirds of that determined with the airborne lidar.

  15. A case-study of complex gas-water-rock-pollutants interactions in shallow groundwater: Šalek Valley (Slovenia)

    Science.gov (United States)

    Giammanco, Salvatore; Justin, Barbara; Speh, Natalija; Veder, Marta

    2009-03-01

    The complex geochemical interactions in the groundwater of the industrial area of Šalek Valley (Slovenia) between natural and anthropogenic fluids were studied by means of major (Ca, Mg, Na, K, HCO3 -, Cl- and SO4 2-) and trace elements’ (As , Cd, Cu, Pb, Zn, Hg, Se and V) abundances, geochemical classification and statistical analysis of data. Cation abundances indicate mixing between a dolomitic end-member and an evaporitic or geothermal end-member. Anion abundances indicate mixing between bicarbonate waters and either sulphate-enriched waters (suggesting hydrothermalism) or chlorine-rich waters. Principal component analysis (PCA) allowed the extraction of seven factors, which describe, respectively: water-rock interaction mainly on dolomitic rocks; redox conditions of water; Cd-Zn enrichment in chlorine-rich waters (probably from industrial wastes); hydrothermal conditions in waters close to major faults; Pb and Cu pollution; V and K enrichments, indicating their common organic source; the role of partial pressure of CO2 dissolved in water, which is highest in three wells with bubbling gases. Average underground discharge rates of solutes from the Valley range between 0.09 t/a (V) and 1.8 × 104 t/a (HCO3 -) and indicate how natural fluids can significantly contribute to the levels of elements in the environment, in addition to the amount of elements released by human activities.

  16. Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care

    Directory of Open Access Journals (Sweden)

    Hasson Henna

    2012-03-01

    Full Text Available Abstract Background Prior studies measuring fidelity of complex interventions have mainly evaluated adherence, and not taken factors affecting adherence into consideration. A need for studies that clarify the concept of fidelity and the function of factors moderating fidelity has been emphasized. The aim of the study was to systematically evaluate implementation fidelity and possible factors influencing fidelity of a complex care continuum intervention for frail elderly people. Methods The intervention was a systematization of the collaboration between a nurse with geriatric expertise situated at the emergency department, the hospital ward staff, and a multi-professional team with a case manager in the municipal care services for older people. Implementation was evaluated between September 2008 and May 2010 with observations of work practices, stakeholder interviews, and document analysis according to a modified version of The Conceptual Framework for Implementation Fidelity. Results A total of 16 of the 18 intervention components were to a great extent delivered as planned, while some new components were added to the model. No changes in the frequency or duration of the 18 components were observed, but the dose of the added components varied over time. Changes in fidelity were caused in a complex, interrelated fashion by all the moderating factors in the framework, i.e., context, staff and participant responsiveness, facilitation, recruitment, and complexity. Discussion The Conceptual Framework for Implementation Fidelity was empirically useful and included comprehensive measures of factors affecting fidelity. Future studies should focus on developing the framework with regard to how to investigate relationships between the moderating factors and fidelity over time. Trial registration ClinicalTrials.gov, NCT01260493.

  17. Prioritization methodology for the decommissioning of nuclear facilities: a study case on the Iraq former nuclear complex.

    Science.gov (United States)

    Jarjies, Adnan; Abbas, Mohammed; Monken Fernandes, Horst; Wong, Melanie; Coates, Roger

    2013-05-01

    There are a number of sites in Iraq which have been used for nuclear activities and which contain potentially significant amounts of radioactive waste. The principal nuclear site being Al-Tuwaitha. Many of these sites suffered substantial physical damage during the Gulf Wars and have been subjected to subsequent looting. All require decommissioning in order to ensure both radiological and non-radiological safety. However, it is not possible to undertake the decommissioning of all sites and facilities at the same time. Therefore, a prioritization methodology has been developed in order to aid the decision-making process. The methodology comprises three principal stages of assessment: i) a quantitative surrogate risk assessment ii) a range of sensitivity analyses and iii) the inclusion of qualitative modifying factors. A group of Tuwaitha facilities presented the highest risk among the evaluated ones, followed by a middle ranking grouping of Tuwaitha facilities and some other sites, and a relatively large group of lower risk facilities and sites. The initial order of priority is changed when modifying factors are taken into account. It has to be considered the Iraq's isolation from the international nuclear community over the last two decades and the lack of experienced personnel. Therefore it is appropriate to initiate decommissioning operations on selected low risk facilities at Tuwaitha in order to build capacity and prepare for work to be carried out in more complex and potentially high hazard facilities. In addition it is appropriate to initiate some prudent precautionary actions relating to some of the higher risk facilities. PMID:22321251

  18. A Retrospective Study of Causes of Low Vision in Saud Arabia, A Case of Eye World Medical Complex in Riyadh.

    Science.gov (United States)

    Z Alotaibi, Abdullah

    2016-01-01

    Vision is the ability of seeing with a definite understanding of features, color and contrast, and to distinguish between objects visually. In the year 1999, the World Health Organization (WHO) and the International Agency for the Prevention of Blindness formulated a worldwide project for the eradication of preventable loss of sight with the subject of "Vision 2020: the Right to Sight". This global program aims to eradicate preventable loss of sight by the year 2020. This study was conducted to determine the main causes of low vision in Saudi Arabia and also to assess their visual improvement after using low vision aids (LVD).The study is a retrospective study and was conducted in low vision clinic at Eye World Medical Complex in Riyadh, Saudi Arabia. The file medical record of 280 patients attending low vision clinics from February 2008 to June 2010 was included. A data sheet was filled which include: age, gender, cause of low vision, unassisted visual acuity for long distances and short distances, low vision devices needed for long distances and short distances that provides best visual acuity. The result shows that the main cause of low vision was Optic atrophy (28.9%). Retinitis pigmentosa was the second cause of low vision, accounting for 73 patients (26%) followed by Diabetic retinopathy and Macular degeneration with 44 patients (15.7%) and 16 patients (5.7%) respectively. Inter family marriage could be one of the main causes of low vision. Public awareness should be embarked on for enlightenment on ocular diseases result in consanguineous marriage. Also, it is an important issue to start establishing low vision clinics in order to improve the situation.

  19. ITS polymorphisms shed light on hybrid evolution in apomictic plants: a case study on the Ranunculus auricomus complex.

    Science.gov (United States)

    Hodač, Ladislav; Scheben, Armin Patrick; Hojsgaard, Diego; Paun, Ovidiu; Hörandl, Elvira

    2014-01-01

    The reconstruction of reticulate evolutionary histories in plants is still a major methodological challenge. Sequences of the ITS nrDNA are a popular marker to analyze hybrid relationships, but variation of this multicopy spacer region is affected by concerted evolution, high intraindividual polymorphism, and shifts in mode of reproduction. The relevance of changes in secondary structure is still under dispute. We aim to shed light on the extent of polymorphism within and between sexual species and their putative natural as well as synthetic hybrid derivatives in the Ranunculus auricomus complex to test morphology-based hypotheses of hybrid origin and parentage of taxa. We employed direct sequencing of ITS nrDNA from 68 individuals representing three sexuals, their synthetic hybrids and one sympatric natural apomict, as well as cloning of ITS copies in four representative individuals, RNA secondary structure analysis, and landmark geometric morphometric analysis on leaves. Phylogenetic network analyses indicate additivity of parental ITS variants in both synthetic and natural hybrids. The triploid synthetic hybrids are genetically much closer to their maternal progenitors, probably due to ploidy dosage effects, although exhibiting a paternal-like leaf morphology. The natural hybrids are genetically and morphologically closer to the putative paternal progenitor species. Secondary structures of ITS1-5.8S-ITS2 were rather conserved in all taxa. The observed similarities in ITS polymorphisms suggest that the natural apomict R. variabilis is an ancient hybrid of the diploid sexual species R. notabilis and the sexual species R. cassubicifolius. The additivity pattern shared by R. variabilis and the synthetic hybrids supports an evolutionary and biogeographical scenario that R. variabilis originated from ancient hybridization. Concerted evolution of ITS copies in R. variabilis is incomplete, probably due to a shift to asexual reproduction. Under the condition of

  20. ITS polymorphisms shed light on hybrid evolution in apomictic plants: a case study on the Ranunculus auricomus complex.

    Directory of Open Access Journals (Sweden)

    Ladislav Hodač

    Full Text Available The reconstruction of reticulate evolutionary histories in plants is still a major methodological challenge. Sequences of the ITS nrDNA are a popular marker to analyze hybrid relationships, but variation of this multicopy spacer region is affected by concerted evolution, high intraindividual polymorphism, and shifts in mode of reproduction. The relevance of changes in secondary structure is still under dispute. We aim to shed light on the extent of polymorphism within and between sexual species and their putative natural as well as synthetic hybrid derivatives in the Ranunculus auricomus complex to test morphology-based hypotheses of hybrid origin and parentage of taxa. We employed direct sequencing of ITS nrDNA from 68 individuals representing three sexuals, their synthetic hybrids and one sympatric natural apomict, as well as cloning of ITS copies in four representative individuals, RNA secondary structure analysis, and landmark geometric morphometric analysis on leaves. Phylogenetic network analyses indicate additivity of parental ITS variants in both synthetic and natural hybrids. The triploid synthetic hybrids are genetically much closer to their maternal progenitors, probably due to ploidy dosage effects, although exhibiting a paternal-like leaf morphology. The natural hybrids are genetically and morphologically closer to the putative paternal progenitor species. Secondary structures of ITS1-5.8S-ITS2 were rather conserved in all taxa. The observed similarities in ITS polymorphisms suggest that the natural apomict R. variabilis is an ancient hybrid of the diploid sexual species R. notabilis and the sexual species R. cassubicifolius. The additivity pattern shared by R. variabilis and the synthetic hybrids supports an evolutionary and biogeographical scenario that R. variabilis originated from ancient hybridization. Concerted evolution of ITS copies in R. variabilis is incomplete, probably due to a shift to asexual reproduction. Under the

  1. Using mitochondrial and nuclear sequence data for disentangling population structure in complex pest species: a case study with Dermanyssus gallinae.

    Directory of Open Access Journals (Sweden)

    Lise Roy

    Full Text Available Among global changes induced by human activities, association of breakdown of geographical barriers and impoverishered biodiversity of agroecosystems may have a strong evolutionary impact on pest species. As a consequence of trade networks' expansion, secondary contacts between incipient species, if hybrid incompatibility is not yet reached, may result in hybrid swarms, even more when empty niches are available as usual in crop fields and farms. By providing important sources of genetic novelty for organisms to adapt in changing environments, hybridization may be strongly involved in the emergence of invasive populations. Because national and international trade networks offered multiple hybridization opportunities during the previous and current centuries, population structure of many pest species is expected to be the most intricate and its inference often blurred when using fast-evolving markers. Here we show that mito-nuclear sequence datasets may be the most helpful in disentangling successive layers of admixture in the composition of pest populations. As a model we used D. gallinae s. l., a mesostigmatid mite complex of two species primarily parasitizing birds, namely D. gallinae L1 and D. gallinae s. str. The latter is a pest species, considered invading layer farms in Brazil. The structure of the pest as represented by isolates from both wild and domestic birds, from European (with a focus on France, Australian and Brazilian farms, revealed past hybridization events and very recent contact between deeply divergent lineages. The role of wild birds in the dissemination of mites appears to be null in European and Australian farms, but not in Brazilian ones. In French farms, some recent secondary contact is obviously consecutive to trade flows. Scenarios of populations' history were established, showing five different combinations of more or less dramatic bottlenecks and founder events, nearly interspecific hybridizations and recent

  2. A Retrospective Study of Causes of Low Vision in Saud Arabia, A Case of Eye World Medical Complex in Riyadh.

    Science.gov (United States)

    Z Alotaibi, Abdullah

    2016-01-01

    Vision is the ability of seeing with a definite understanding of features, color and contrast, and to distinguish between objects visually. In the year 1999, the World Health Organization (WHO) and the International Agency for the Prevention of Blindness formulated a worldwide project for the eradication of preventable loss of sight with the subject of "Vision 2020: the Right to Sight". This global program aims to eradicate preventable loss of sight by the year 2020. This study was conducted to determine the main causes of low vision in Saudi Arabia and also to assess their visual improvement after using low vision aids (LVD).The study is a retrospective study and was conducted in low vision clinic at Eye World Medical Complex in Riyadh, Saudi Arabia. The file medical record of 280 patients attending low vision clinics from February 2008 to June 2010 was included. A data sheet was filled which include: age, gender, cause of low vision, unassisted visual acuity for long distances and short distances, low vision devices needed for long distances and short distances that provides best visual acuity. The result shows that the main cause of low vision was Optic atrophy (28.9%). Retinitis pigmentosa was the second cause of low vision, accounting for 73 patients (26%) followed by Diabetic retinopathy and Macular degeneration with 44 patients (15.7%) and 16 patients (5.7%) respectively. Inter family marriage could be one of the main causes of low vision. Public awareness should be embarked on for enlightenment on ocular diseases result in consanguineous marriage. Also, it is an important issue to start establishing low vision clinics in order to improve the situation. PMID:26652071

  3. 40Ar- 39Ar dating of detrital muscovite in provenance investigations: a case study from the Adelaide Rift Complex, South Australia

    Science.gov (United States)

    Haines, Peter W.; Turner, Simon P.; Kelley, Simon P.; Wartho, Jo-Anne; Sherlock, Sarah C.

    2004-11-01

    Detrital zircon ages are commonly used to investigate sediment provenance and supply routes. Here, we explore the advantages of employing multiple, complimentary techniques via a case study of the Neoproterozoic and Cambrian of the Adelaide Rift Complex, South Australia. Detrital muscovite Ar-Ar ages are presented from stratigraphic units, or equivalents, that have previously been the subject of U-Pb detrital zircon dating, and, in some cases, whole-rock Sm-Nd isotope studies. The zircon age ranges and whole-rock Sm-Nd isotope data suggest that early Neoproterozoic sediments from near the base of the Adelaide Rift Complex comprise a mixture of detritus derived from the adjacent Gawler Craton (Palaeoproterozoic to earliest Mesoproterozoic) and overlying Gairdner flood basalts. In contrast, detrital muscovites from this level have a broad scatter of Mesoproterozoic infrared (IR) laser total fusion Ar-Ar ages, while UV laser traverses indicate that the age spread reflects partial resetting by multiple heating events, rather than a mixture of sources. Younger Neoproterozoic sediments document replacement of the Gawler Craton by the more distant Musgrave and/or Albany-Fraser Orogens as the main provenance. The Cambrian Kanmantoo Group marks an abrupt change in depositional style and a new sediment source. The Kanmantoo Group have older Nd model ages than underlying strata, yet are dominated by near to deposition-aged (˜500-650 Ma) detrital zircons and muscovites, suggesting rapid cooling and exhumation of a tectonically active provenance region. Although this source remains uncertain, evidence points towards the distant Pan-African orogenic belts. Deposition in the Adelaide Rift Complex was terminated in the late Early Cambrian by the Delamerian Orogeny, and the results of previous detrital mineral dating studies from the Lachlan Fold Belt to the east are consistent with at least partial derivation of these sediments from reworked upper Adelaide Rift Complex (Kanmantoo

  4. Complex Multiplicative Calculus

    OpenAIRE

    Bashirov, Agamirza; Riza, Mustafa

    2011-01-01

    In the present paper we extend the concepts of multiplicative de- rivative and integral to complex-valued functions of complex variable. Some drawbacks, arising with these concepts in the real case, are explained satis- factorily. Properties of complex multiplicative derivatives and integrals are studied. In particular, the fundamental theorem of complex multiplicative calculus, relating these concepts, is proved. It is shown that complex multi- plicative calculus is not just another realizat...

  5. Heterotopic Ossification around the Knee after Internal Fixation of a Complex Tibial Plateau Fracture Combined with the Use of Demineralized Bone Matrix (DBM: A Case Report

    Directory of Open Access Journals (Sweden)

    1.\tSjoerd P.F.T. Nota

    2014-10-01

    Full Text Available Demineralized bone matrix has been successfully commercialized as an alternative bone graft material that not only can function as filler but also as an osteoinductive graft. Numerous studies have confirmed its beneficial use in clinical practice. Heterotopic ossification after internal fixation combined with the use of demineralized bone matrix has not been widely reported. In this paper we describe a 39 year old male who sustained a complex articular fracture that developed clinically significant heterotopic ossification after internal fixation with added demineralized bone matrix. Although we cannot be sure that there is a cause-and-effect relation between demineralized bone matrix and the excessive heterotopic ossification seen in our patient, it seems that some caution in using demineralised bone matrix in similar cases is warranted. Also, given the known inter- and intraproduct variability, the risks and benefits of these products should be carefully weighed.

  6. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report

    Science.gov (United States)

    Lee, Jong-Hoo; Byun, Jeong-Hyun; Choe, Yu-Ri; Lim, Seung-Kyu; Lee, Ka-Young

    2015-01-01

    A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere. PMID:26361601

  7. Primary mucosal sinonasal melanoma - Case report and review of the literature. The role of complex treatment-surgery and adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Aim: The place of adjuvant radiotherapy in the treatment of sinonasal melanoma. Background: Sinonasal mucosal melanoma is a rare disease with poor prognosis and requires a complex treatment. Elective neck dissection in patients with N0 and adjuvant radiotherapy has been a source of controversy. High late regional recurrence rates rise questions about elective irradiation of the neck nodes in patients with N0 stage disease. Methods: We present our two years follow up in a case of locally advanced sinonasal melanoma and literature review of the treatment options for mucosal melanoma. Results: In locally advanced sinonasal melanoma treated with surgical resection, postoperative radiotherapy and chemotherapy we had local tumor control. Two years later, a regional contralateral recurrence without distant metastasis occurred. Conclusions: Literature data for frequent neck lymph nodes recurrences justify elective neck dissection. Postoperative elective neck radiotherapy for patients with locally advanced sinonasal melanoma and clinically N0 appears to decrease the rate of late regional recurrences. (authors)

  8. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report.

    Science.gov (United States)

    Lee, Jong-Hoo; Byun, Jeong-Hyun; Choe, Yu-Ri; Lim, Seung-Kyu; Lee, Ka-Young; Choi, In-Sung

    2015-08-01

    A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere. PMID:26361601

  9. 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

    2016-07-01

    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.

  10. Connections and consequences in complex systems: insights from a case study of the emergence and local impact of crisis resolution and home treatment services.

    Science.gov (United States)

    Hannigan, Ben

    2013-09-01

    In this article the broad contours of a complexity perspective are outlined. Complexity ideas are then drawn on to frame an empirical examination of the connections running between different levels of organisation in health and social care, and to underpin investigation into the intended and unintended local system consequences of service development. Data are used from a study conducted in the UK's mental health field. Here, macro-level policy has led to the supplementing of longstanding community mental health teams by newer, more specialised, services. An example includes teams providing crisis resolution and home treatment (CRHT) care as an alternative to hospital admission. Using an embedded case study design, where 'the case' examined was a new CRHT team set in its surrounding organisational environment, ethnographic data (with interviews predominating) were generated in a single site in Wales over 18 months from the middle of 2007. In a large-scale context favourable to local decision-making, and against a background of a partial and disputed evidence base, the move to establish the new standalone service was contested. Whilst users valued the work of the team, and local practitioners recognised the quality of its contribution, powerful effects were also triggered across the locality's horizontal interfaces. Participants described parts of the interconnected system being closed to release resources, staff gravitating to new crisis services leaving holes elsewhere, and the most needy service users being cared for by the least experienced workers. Some community mental health team staff described unexpected increases in workload, and disputes over eligibility for crisis care with implications for system-wide working relations. Detailed data extracts are used to illustrate these connections and consequences. Concluding lessons are drawn on the use of evidence to inform policy, on the significance of local contexts and system interfaces, and on anticipating the

  11. Connections and consequences in complex systems: insights from a case study of the emergence and local impact of crisis resolution and home treatment services.

    Science.gov (United States)

    Hannigan, Ben

    2013-09-01

    In this article the broad contours of a complexity perspective are outlined. Complexity ideas are then drawn on to frame an empirical examination of the connections running between different levels of organisation in health and social care, and to underpin investigation into the intended and unintended local system consequences of service development. Data are used from a study conducted in the UK's mental health field. Here, macro-level policy has led to the supplementing of longstanding community mental health teams by newer, more specialised, services. An example includes teams providing crisis resolution and home treatment (CRHT) care as an alternative to hospital admission. Using an embedded case study design, where 'the case' examined was a new CRHT team set in its surrounding organisational environment, ethnographic data (with interviews predominating) were generated in a single site in Wales over 18 months from the middle of 2007. In a large-scale context favourable to local decision-making, and against a background of a partial and disputed evidence base, the move to establish the new standalone service was contested. Whilst users valued the work of the team, and local practitioners recognised the quality of its contribution, powerful effects were also triggered across the locality's horizontal interfaces. Participants described parts of the interconnected system being closed to release resources, staff gravitating to new crisis services leaving holes elsewhere, and the most needy service users being cared for by the least experienced workers. Some community mental health team staff described unexpected increases in workload, and disputes over eligibility for crisis care with implications for system-wide working relations. Detailed data extracts are used to illustrate these connections and consequences. Concluding lessons are drawn on the use of evidence to inform policy, on the significance of local contexts and system interfaces, and on anticipating the

  12. Factors affecting the implementation of complex and evolving technologies: multiple case study of intensity-modulated radiation therapy (IMRT in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Bak Kate

    2011-07-01

    Full Text Available Abstract Background Research regarding the decision to adopt and implement technological innovations in radiation oncology is lacking. This is particularly problematic since these technologies are often complex and rapidly evolving, requiring ongoing revisiting of decisions regarding which technologies are the most appropriate to support. Variations in adoption and implementation decisions for new radiation technologies across cancer centres can impact patients' access to appropriate and innovative forms of radiation therapy. This study examines the key steps in the process of adopting and implementing intensity modulated radiation therapy (IMRT in publicly funded cancer centres and identifies facilitating or impeding factors. Methods A multiple case study design, utilizing document analysis and key informant interviews was employed. Four cancer centres in Ontario, Canada were selected and interviews were conducted with radiation oncologists, medical physicists, radiation therapists, and senior administrative leaders. Results Eighteen key informants were interviewed. Overall, three centres made fair to excellent progress in the implementation of IMRT, while one centre achieved only limited implementation as of 2009. Key factors that influenced the extent of IMRT implementation were categorized as: 1 leadership, 2 training, expertise and standardization, 3 collaboration, 4 resources, and 5 resistance to change. Conclusion A framework for the adoption and implementation of complex and evolving technologies is presented. It identifies the key factors that should be addressed by decision-makers at specific stages of the adoption/implementation process.

  13. Knee megaprosthesis: a salvage solution for severe open and complex distal femoral fracture associated with an ipsilateral brachial plexus injury (a case report with literature review).

    Science.gov (United States)

    Ennaciri, Badr; Vasile, Christian; Lebredonchel, Thierry; Berrada, Mohamed Saleh; Montbarbon, Eric; Beaudouin, Emmanuel

    2015-01-01

    Complex distal femoral fractures in the young patient often occur as a result of high velocity trauma. Timely recognition and treatment is everything in such a situation, and it needs a robust staged management pathway to optimize the chance of limb preservation. We report a case of a motorcyclist admitted to the department of orthopedics at Chambery hospital, France, with a complex comminuted and open distal femoral fracture of the left leg, associated with a brachial plexus injury to the ipsilateral upper limb. On arrival to the emergency department, damage control stabilization and surgery was commenced, debridement of contaminated non-viable tissue, abundant antiseptic lavage and application of external fixation coupled with the use of antibiotic spacer. Following normalization of inflammatory markers and ensuring no clinical signs of infection, subsequent management consisted of joint reconstruction to achieve a functional knee. The external fixator and femoral spacer was removed and a modular megaprosthesis was implanted with a lateral gastrocnemius flap to cover the exposed knee joint and reinforce the extensor apparatus. Nerve graft to the left brachial plexus injury was performed at University Hospital of Grenoble. Our patient entered an intensive rehabilitation program and at 1 year follow-up achieved good knee function and sensation to the left upper limb. PMID:26421102

  14. Intraspecific Variation Patterns of the Caudal Complex in Extant and Fossil Teleosts, with Comments on Implications into Taxonomy and Systematics: a Case Study.

    Directory of Open Access Journals (Sweden)

    Maria Eduarda de Castro Leal

    2007-07-01

    Full Text Available Comparative morphology remains as afundamental support of the interrelationshiphypotheses of living and fossil fish taxa. Theconceptualization of the characters is only possibleafter the comparative analysis that shows themorphological variation of groups from differenttaxonomical rank. The intraspecific morphologicalvariation of a large number of teleostean speciesis relatively unknown. Osteological studies ofteninclude some few specimens minimizing thepossibility to recognize the intraspecific variation.This observation is also valid in the cases were theontogenetic changes are analyzed. The discoveryof such morphological variations requires the studyof a large sample size. The caudal skeleton is amajor anatomical complex and data source usedin the evaluation of teleostean interrelationships.However, the intraspecific variation of its elementshad been rarely investigated. Intraspecific variationobserved in extant taxa provides critical control forrecognition of intraspecific variation in fossil taxa,and integrated studies of fossil and living teleostsare required. Attempting to provide new data on thesubject, this study deals with intraspecific variationobserved in the caudal skeleton complex of twoteleost species: the extant Osteoglossum bicirrhosum(Osteoglossomorpha: Osteoglossidae from theAmazonian drainage, and the fossil Cladocyclusgardneri (Ichthyodectiformes from the LowerCretaceous of Araripe Basin, northeastern Brazil. Weanalyzed fifthy-three specimens of O. bicirrhosum(SL 37,4 mm to 580 mm and twenty-two specimensof C. gardneri (SL 70 mm to 260 mm, describing andquantifying the morphological variation. The caudalskeleton of O. bicirrhosum displays the highestdegrees of intraspecific variation in the patterns ofneural spines and hypurals associated to U2, andneural arches and spines counts for PU1, whereasC. gardneri presented a more conservative pattern.An overview of all the different patterns observedis given, and the implications

  15. Decentralized Building of Complex Software Systems-an eCommerce Case Study%复杂软件系统的分散式构造:一个电子商务案例研究

    Institute of Scientific and Technical Information of China (English)

    KASSEL Stephan; WINKELMANN Sabine; TITTMANN Claudia

    2007-01-01

    Software development skills are only partially trained with traditional programming languages and software engineering courses. To achieve practical skills needed in software industry, complex examples are necessary which have to be generated in a project-like setting. This includes common solution finding, intensive communication and structured programming tasks. Here, a case study from the domain of eCommerce is presented, showing the complexity needed for these learning processes.

  16. Non-invasive investigative techniques for the diachronic study of territorial compartments: a case study for the documentation and analysis of architectural complexes.

    Science.gov (United States)

    Di Lieto, Marco; Marchetta, Isabella; Ciriello, Rosanna; De Martino, Gregory; Della Mora, Dario

    2014-05-01

    The trend in the study of areas of land in their integrity and as dynamic, anthropic units in diachronic history has initiated long survey campaigns over several decades that have covered large areas mapping the evidence and attempting a reconstruction of the evolution of ancient settlements. The need for further study to disentangle the knots of modes and types of settlement boosted further investigations of targeted excavations, based on the quality and density of the findings from the field. Currently archaeological research can rely on non-invasive integrated methods to better define the areas to be investigated systematically obtaining new typologies of information and better management of time and research costs. In this paper we present a specific case study in which a variety of integrated survey methods have contributed to the documentation and analysis of monumental complexes linked to specific local contexts. The area under investigation lies in Italy, in the province of Potenza and, specifically in the town of Forenza. The survey activities, involving the entire municipality, have been running on and off for about 2 years and have already resulted in the collection of a lot of interesting data that will be useful to essential fieldwork. In particular, we carried out different types of investigation in three different sample sites: 1. monumental complex of Santa Maria de 'Armenis: to complement previous excavations which involved only a portion of the estimated area of interest, we carried out magnetometric and geo-electrical surveys aimed at a more precise definition of the true extent and interpretation of the monument in antiquity; 2. site of Monte Caruso: we carried out remote sensing using a remote-controlled UAV hexakopter drone with stereoscopic photogrammetric survey techniques aimed at the detailed documentation of the monumental evidence of a structure visible in elevation but in a context difficult to approach with traditional surveying

  17. Deep stratosphere-to-troposphere transport (STT over SE Europe: a complex case study captured by enhanced 7Be concentrations at the surface of a low topography region

    Directory of Open Access Journals (Sweden)

    A. Ioannidou

    2005-01-01

    Full Text Available In this study we present a complex case study of a Stratosphere-to-Troposphere Transport (STT event down to the surface of a low topography region in Northern Greece, during the second fortnight of March 2000. During this event our surface station at Livadi (23°15 E/40°32 N, 850 m a.s.l., was influenced by very different synoptic systems developing over Eastern Europe, N. America and the N. Atlantic, the last one evolving to a cut-off low over France/Spain. This is the first study, to our knowledge, that presents a down to the surface STT event in the eastern Mediterranean. The intrusion is primarily captured with the use of the cosmogenic radionuclide 7Be, which increased to 9.07 mBq m-3 and 9.37 mBq m-3 on 30 and 31 March 2000, respectively. A 7Be concentration of around 8 mBq m-3 recorded during parallel measurements at Thessaloniki (20 m a.s.l. gives strong evidence that air of stratospheric origins has even gone down to sea level. A rapid increase of 10–15 ppb is also observed in the surface ozone concentration on 31 March 2000. The relative increase of both tracers is consistent with a volume fraction of stratospheric air at the surface of about 5%, but the substantial increase in 7Be flags more clearly the event. Trajectory analyses, in conjunction with the evolution of the synoptic situation described by potential vorticity maps, are used for the exact identification of the different intrusions and the attribution of each intruding parcel of stratospheric air to a certain filament of high PV. Finally, the persistency of the stratospheric layers in the troposphere is another interesting point of this case study. The vast majority of the trajectories spent 7–10 days in the troposphere before reaching the surface at Livadi station.

  18. Complex relationships between occupation, environment, DNA adducts, genetic polymorphisms and bladder cancer in a case-control study using a structural equation modeling.

    Directory of Open Access Journals (Sweden)

    Stefano Porru

    Full Text Available DNA adducts are considered an integrate measure of carcinogen exposure and the initial step of carcinogenesis. Their levels in more accessible peripheral blood lymphocytes (PBLs mirror that in the bladder tissue. In this study we explore whether the formation of PBL DNA adducts may be associated with bladder cancer (BC risk, and how this relationship is modulated by genetic polymorphisms, environmental and occupational risk factors for BC. These complex interrelationships, including direct and indirect effects of each variable, were appraised using the structural equation modeling (SEM analysis. Within the framework of a hospital-based case/control study, study population included 199 BC cases and 213 non-cancer controls, all Caucasian males. Data were collected on lifetime smoking, coffee drinking, dietary habits and lifetime occupation, with particular reference to exposure to aromatic amines (AAs and polycyclic aromatic hydrocarbons (PAHs. No indirect paths were found, disproving hypothesis on association between PBL DNA adducts and BC risk. DNA adducts were instead positively associated with occupational cumulative exposure to AAs (p = 0.028, whereas XRCC1 Arg 399 (p<0.006 was related with a decreased adduct levels, but with no impact on BC risk. Previous findings on increased BC risk by packyears (p<0.001, coffee (p<0.001, cumulative AAs exposure (p = 0.041 and MnSOD (p = 0.009 and a decreased risk by MPO (p<0.008 were also confirmed by SEM analysis. Our results for the first time make evident an association between occupational cumulative exposure to AAs with DNA adducts and BC risk, strengthening the central role of AAs in bladder carcinogenesis. However the lack of an association between PBL DNA adducts and BC risk advises that these snapshot measurements are not representative of relevant exposures. This would envisage new scenarios for biomarker discovery and new challenges such as repeated measurements at different

  19. Dual-Positive (CD4+/CD8+ Acute Adult T-Cell Leukemia/Lymphoma Associated with Complex Karyotype and Refractory Hypercalcemia: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Shahzad Raza

    2010-12-01

    Full Text Available We describe a rare case of adult T-cell leukemia characterized by an expansion of CD4+ CD8+ double-positive lymphocytes associated with human T-lymphotropic virus type 1 (HTLV-1 and a complex karyotype in a 43-year-old Caribbean male who was initially admitted to our hospital with significant lethargy, visual disturbances, dysphagia, right facial palsy and numbness in both feet for 3 days. He was found to have severe hypercalcemia (15.6 mg/dl. Peripheral blood smear showed multilobulated clover-shaped nuclei. Bone marrow and CSF flow cytometries revealed abnormal monoclonal expansion of T cells positive for CD4, CD5, CD8 and CD25 but negative for CD7, CD20, CD56, CD68 and terminal deoxynucleotidyl transferase. The polymerase chain reaction analysis showed a distinct band of the T-cell receptor γ gene, revealing T-cell clonal integration of the proviral DNA of HTLV-1, thus confirming the diagnosis of acute adult T-cell leukemia/lymphoma. Cytogenetic study revealed a male karyotype with monosomy 12, unbalanced translocation 5q and 13q and additional material on 5q, 7q, 14q and 17q. The patient underwent prednisone (EPOCH chemotherapy followed by autologous transplantation with BEAM regimen. Although patients with a rare mixed CD4+ CD8+ immunophenotype usually present with an aggressive clinical course and have a poor prognosis, our patient was able to survive for 2.5 years.

  20. Complex Regional Pain Syndrome type I of the upper limb - treatment based on Stress Loading Program: a case study

    Directory of Open Access Journals (Sweden)

    Aline Sarturi Ponte

    2015-03-01

    Full Text Available The daily life of an individual suffering from Complex Regional Pain Syndrome type I (CPRS I becomes limited, because this syndrome causes signs and symptoms located in the affected limb, and may occur in other parts. From this premise, this study aims to present the contributions of Occupational Therapy and the Rehabilitation Stress Loading Program for a subject with CRPS I in the upper limb, attended by the Group of Pain from the University Hospital of Santa Maria (HUSM, Rio Grande do Sul state. This research is characterized as a case study, experimental, which deals with pre and post occupational therapy intervention. The instruments used for data collection were the protocols of Disabilities of the Arm, Shoulder and Hand (DASH, the International Classification of Disability, Functioning and Health (ICF, the Canadian Occupational Performance Measure (COPM, the Visual Analogue Scale, and goniometry (EVA. After assessment, the subject was exposed to the treatment of compressive active resistive exercises; after this treatment was completed, the subject was reassessed. It was observed that the treatment applied has contributed to the reduction of the pain and to the improvement in the Range of Motion (ROM of the subject. The use of the stress protocol and active compression contributed significantly to the reduction of pain, ADM gain and occupational performance improvement.

  1. Fatal Fusarium solani species complex infections in elasmobranchs: the first case report for black spotted stingray (Taeniura melanopsila) and a literature review.

    Science.gov (United States)

    Fernando, Nimal; Hui, Suk-Wai; Tsang, Chi-Ching; Leung, Shui-Yee; Ngan, Antonio H Y; Leung, Raymond W W; Groff, Joseph M; Lau, Susanna K P; Woo, Patrick C Y

    2015-07-01

    Fusarium species are environmental saprophytic fungi. Among the many Fusarium species, members of the Fusarium solani species complex (FSSC) are the most prevalent and virulent in causing human and animal infections. In this study, we describe the first case of fatal FSSC infection in a black spotted stingray and three concomitant infections in scalloped hammerhead sharks. In the stingray, cutaneous lesions were characterised by ulcers and haemorrhage of the ventral pectoral fin, or 'ray', especially around the head; while cutaneous lesions in the sharks were characterised by ulcers, haemorrhage, as well as white and purulent exudates at the cephalic canals of the cephalofoil and lateral line. Histological sections of the cutaneous lesions revealed slender (1-4 μm in diameter), branching, septate fungal hyphae. Internal transcribed spacer region and 28S nrDNA sequencing of the fungal isolates from the fish showed two isolates were F. keratoplasticum (FSSC 2) and the other two were FSSC 12. Environmental investigation revealed the FSSC strains isolated from water and biofilms in tanks that housed the elasmobranchs were also F. keratoplasticum and FSSC 12. Fusarium is associated with major infections in elasmobranchs and FSSC 12 is an emerging cause of infections in marine animals. DNA sequencing is so far the most reliable method for accurate identification of Fusarium species.

  2. Restoration and conversion to re-use of historic buildings incorporating increased energy efficiency: A case study - the Haybarn complex, Hilandar Monastery, Mount Athos

    Directory of Open Access Journals (Sweden)

    Ivanović-Šekularac Jelena A.

    2016-01-01

    Full Text Available A proper approach to restoration of historic buildings is crucial for monumental heritage protection. The objective of the paper is to define a methodology for historic buildings restoration in order to increase energy efficiency and re-usability in accordance with modern standards. The main method used in the paper is the observation of historic buildings during their restoration and exploitation, analysis and evaluation of achieved results regarding energy efficiency and energy saving, through the examples of the buildings belonging to Hilandar Monastery, Mount Athos, in Greece. Mount Athos was inscribed on the UNESCO World Heritage List for its cultural and natural values. This case study discusses the abandoned and dilapidated historic buildings of the Haybarn Complex (Stable, Mulekeepers’ House and Haybarn, the achieved results regarding the restoration of these buildings, their energy efficiency and turning into the premises for occasional stays. The research results are recommendations for increasing energy efficiency while performing the restoration of historic buildings, so that these buildings could be re-used in a new way. The most significant contribution of the paper is the practical test of energy refurbishment of these historic buildings conducted using the principles and methods of energy efficiency, in compliance with conservation requirements and authenticity of historic buildings.

  3. [Control of generalized chronic periodontitis combined with calcium-antagonist-related gingival overgrowth by a complex periodontal-endodontic-prosthodontic treatment. Case report].

    Science.gov (United States)

    Szánto, Erika; Gera, István

    2011-12-01

    To day a relatively high percentage of elderly population of the industrialized world suffers with different cardiovascular diseases and are on permanent antihypertensive therapy. One of the most frequently used drugs is the calcium channel blockers prescribed against high blood pressure. The most common oral side effect of these drugs is the gingival enlargement that might develop even on otherwise healthy gingiva. The incidence of chronic periodontitis in this age group is also high and the Ca antagonist medication in those individuals might substantially modify the clinical course of periodontal inflammation leading to gingival enlargement and hypertrophic pocket wall. The case presented here is a 52 years old hypertonic woman with a long history of Ca-antagonist therapy and generalized chronic periodontitis combined with gingival hyperplasia. After the change of medication the 1,5 years comprehensive periodontal endodontic and prosthodontic therapy restored patient's periodontal health and provided complex dental rehabilitation. Nevertheless, only regular periodontal supportive therapy could ensure predictable outcome and guarantee long lasting periodontal health.

  4. The complex case of V445 Lyr observed with Kepler: Two Blazhko modulations, a non-radial mode, possible triple mode RR Lyrae pulsation, and more

    CERN Document Server

    Guggenberger, E; Nemec, J M; Smolec, R; Benkő, J M; Ngeow, C -C; Cohen, J G; Sesar, B; Szabó, R; Catelan, M; Moskalik, P; Kinemuchi, K; Seader, S E; Smith, J C; Tenenbaum, P; Kjeldsen, H

    2012-01-01

    Rapid and strong changes in the Blazhko modulation of RR Lyrae stars, as they have recently been detected in high precision satellite data, have become a crucial topic in finding an explanation of the long-standing mystery of the Blazhko effect. We present here an analysis of the most extreme case detected so far, the RRab star V445 Lyr (KIC 6186029) which was observed with the Kepler space mission. V445 Lyr shows very strong cycle-to-cycle changes in its Blazhko modulation, which are caused both by a secondary long-term modulation period as well as irregular variations. In addition to the complex Blazhko modulation, V445 Lyr also shows a rich spectrum of additional peaks in the frequency range between the fundamental pulsation and the first harmonic. Among those peaks, the second radial overtone could be identified, which, combined with a metallicity estimate of [Fe/H]=-2.0 dex from spectroscopy, allowed to constrain the mass (0.55-0.65 M_sun) and luminosity (40-50 L_sun) of V445 Lyr through theoretical Pete...

  5. Minimally Invasive Treatment of a Complex Tibial Plateau Fracture with Diaphyseal Extension in a Patient with Uncontrolled Diabetes Mellitus: A Case Report and Review of Literature.

    Science.gov (United States)

    Rathod, Ashok K; Dhake, Rakesh P; Pawaskar, Aditya

    2016-01-01

    Fractures of the proximal tibia comprise a huge spectrum of injuries with different fracture configurations. The combination of tibia plateau fracture with diaphyseal extension is a rare injury with sparse literature being available on treatment of the same. Various treatment modalities can be adopted with the aim of achieving a well-aligned, congruous, stable joint, which allows early motion and function. We report a case of a 40-year-old male who sustained a Schatzker type VI fracture of left tibial plateau with diaphyseal extension. On further investigations, the patient was diagnosed to have diabetes mellitus with grossly deranged blood sugar levels. The depressed tibial condyle was manipulated to lift its articular surface using K-wire as a joystick and stabilized with an additional K-wire. Distal tibial skeletal traction was maintained for three weeks followed by an above knee cast. At eight months of follow-up, X-rays revealed a well-consolidated fracture site, and the patient had attained a reasonably good range of motion with only terminal restriction of squatting. Tibial plateau fractures with diaphyseal extension in a patient with uncontrolled diabetes mellitus is certainly a challenging entity. After an extended search of literature, we could not find any reports highlighting a similar method of treatment for complex tibial plateau injuries in a patient with uncontrolled diabetes mellitus. PMID:27335711

  6. [Trabecular hyalinizing adenoma of the thyroid (HAT): A report of two cases].

    Science.gov (United States)

    Román-González, Alejandro; Simón-Duque, Carlos; Camilo-Pérez, Juan; Vélez-Hoyo, Alejandro

    2016-01-01

    The hyalinizing trabecular adenoma is a rare lesion of the thyroid. There is controversy in the literature about the correct name for this disease. Dr. Carney defended the benign nature of this condition and therefore continues calling it adenoma, the World Health Organization calls for the potential of tumor malignancy, and others qualify it as a variant of papillary carcinoma based on the presence of rearranged in transformation/papillary thyroid carcinoma (RET/PTC) rearrangements. In Latin America there are few reported cases. Two cases of hyalinizing trabecular adenoma are reported. The first is a 40-year-old woman with a thyroid nodule of 3x3 cm. The immunohistochemistry was positive for thyroglobulin and calcitonin and negative for cytokeratin 19 and chromogranin. The second case is a 36-year-old patient with a thyroid nodule of 4x4 cm with an immunohistochemical pattern identical to the first case. Trabecular hyalinizing adenoma is a benign disease, easily confused with papillary or medullary thyroid carcinoma. Awareness of this entity will allow a better classification and management of thyroid conditions. PMID:26927651

  7. Complex communication signals: the case of the Blue-black Grassquit Volatinia jacarina (Aves, Emberizidae song. Part I - A structural analysis

    Directory of Open Access Journals (Sweden)

    Hernán Fandiño-Mariño

    2004-06-01

    Full Text Available The song of the Blue-black Grassquit Volatinia jacarina is different for every individual and the structural differences between individuals are quite complex. Samples of songs from different Brazilian localities, as well as from Venezuela and Mexico, were studied through a comparative analysis of their sonograms. From the structural point of view, the results show a song composed of a single note that is compacted in a ''window'' between 2 and 13 kHz and rarely occupying more than half of a second. The note is essentially pure and is repeatedly uttered with a high level of fidelity. A global frequency modulation decreases from the beginning to the end of the song. The main song components are referred to as ''Blocks'' and are of three types: ''Vibrations'' (Buzzes or Vibratos, ''Arabesques'' (complex notes and ''Isolated Modulations'' (simple syllables. Among other characteristics are double voices, which are quite diverse and probably function as codes for individual recognition. This song is considered a special case where a signature system has been developed to a high level of inter-individual variability.O canto do Tiziu Volatinia jacarina é único para cada indivíduo e as diferenças estruturais entre um e outro indivíduo são muito complexas. Cantos gravados em diversos lugares do Brasil e alguns da Venezuela e do México foram estudados através de uma análise comparativa dos seus sonogramas. Do ponto de vista estrutural, os resultados mostram que o canto é constituído por uma nota única que se encontra compactada numa ''janela'' entre 2 e 13 kHz e raramente ultrapassa meio segundo de duração. A nota, essencialmente pura, é repetida com alto grau de fidelidade entre uma emissão e outra. Constata-se uma modulação de freqüência global descendente do início ao fim do canto. Os principais componentes do canto do Tiziu foram denominados ''Blocos'' e são basicamente de três tipos: as ''Vibrações'' (Buzzes ou Vibratos, os

  8. Greigite-related complex magnetic polarity records unraveled through an integrated rock magnetic analysis: A case study on Neogene sections in East Timor

    Science.gov (United States)

    Aben, F. M.; Bakker, R. R.; Dekkers, M. J.; Van Hinsbergen, D. J.; Harris, R. A.; Zachariasse, J.; Duffy, B. G.

    2013-12-01

    Inconsistent polarity patterns in greigite-bearing (marine) sediments are a common problem in magnetostratigraphic and paleomagnetic research. Prolonged diagenesis can result in multiple generations of greigite being present in a sedimentary record. The associated remanence ';haystack' can be filtered to some extent by paleomagnetic field tests but not all rock records are suitable for such an approach. Here, we test whether end-member modeling of IRM-acquisition curves as a basis for an integrated rock magnetic and (electron) microscopic research approach can be used to identify all magnetic mineral suites, to evaluate the nature of the magnetic remanences, and to use the acquired knowledge to isolate the ChRM from such complex magnetic records. To this end, a case study was performed on uppermost Miocene to Pliocene deep-marine clastic and chalk bearing Viqueque Type section in East Timor. This section was originally sampled to establish a bio- and magnetostratigraphic age model dating the uplift history of the young Timor-orogen. An in principle straightforward polarity record was obtained, which, however, was impossible to reconcile with the biostratigraphy of the section. Among the dominant magnetic carriers was greigite. Two magnetic end-members were distinguished in the Viqueque Type section, which were analyzed further for rock magnetic properties. With microscopy, three magnetic mineral suites are shown to result in the two end-members. The first suite occurs in all lithologies and consists of detrital magnetite with a viscous NRM, caused by partial reductive dissolution of detrital magnetite grains after deposition. This mineral suite therefore is unreliable for magnetostratigraphic use. The second and third suite both consist of interacting single domain greigite grains with a chemical remanent magnetization. The second suite is present in almost all clay levels of the Viqueque Type section and is characterized by early diagenetic framboidal greigite

  9. Active faulting Vs other surface displacing complex geomorphic phenomena. Case studies from a tectonically active area, Abruzzi Region, central Apennines, Italy

    Science.gov (United States)

    Lo Sardo, Lorenzo; Gori, Stefano; Falcucci, Emanuela; Saroli, Michele; Moro, Marco; Galadini, Fabrizio; Lancia, Michele; Fubelli, Giandomenico; Pezzo, Giuseppe

    2016-04-01

    could be possible to infer the genesis of the scarps as due to complex tectono-karstic phenomena. As for case (ii), our ongoing analyses are aimed to analyze the tectonic "significance" of some closed depressions, up to 4 km long and to 0,5-1 km large, that occur along the south-western slope of the Gran Sasso Range. All these small depression are NW-SE trending. As already described by Bosi et al. (1989), Galadini and Giuliani (1993), D'Agostino et al. (1998), Falcucci et al. (2015), these closed depressions are bounded by scarps carved onto the carbonate bedrock and, subordinately, onto early Quaternary slope deposits, reaching height of up to 5 m. These scarps are preferentially NE dipping, even if in few cases some SW dipping scarp are also present . The field work has permitted to attest that these scarps are related to shear planes that that displaced two subsequent of Early Pleistocene breccias formations (the Valle Valiano Fm. and Fonte Vedice Fm.; Bosi e Bertini, 1993; D'agostino et al., 1997). A paleoseismological trench was also performed across one of these scarps, attesting the activity of these shear planes also in recent times, providing indications result about the deformation style. Reference Bertini, T., & Bosi, C. (1993). La tettonica quaternaria della conca di Fossa (L'Aquila). Il Quaternario, 6(2), 293-314. Bertini, T., Bosi, C., & Galadini, F. (1989). La conca di Fossa-S. Demetrio dei Vestini. CNR, Centro di Studio per la Geologia Tecnica, ENEA, PAS in Elementi di tettonica pliocenicoquaternaria ed indizi di sismicita olocenica nell'Appennino laziale-abruzzese, Societa Geologica Italiana, L'Aquila, 26-58. Bosi, C., & Bertini, T. (1970). Geologia della media valle dell'Aterno. Memorie Società Geologica Italiana, 9(4), 719-777. D'Agostino, N., F. Speranza, & R. Funiciello., (1997) "Le Brecce Mortadella dell'Appennino Centrale: primi risultati di stratigrafia magnetica." Il Quaternario10.2: 385-388. D'Agostino, N., Chamot-Rooke, N., Funiciello, R

  10. Useless hearing in male Emblemasoma auditrix (Diptera, Sarcophagidae--a case of intralocus sexual conflict during evolution of a complex sense organ?

    Directory of Open Access Journals (Sweden)

    Reinhard Lakes-Harlan

    Full Text Available Sensory modalities typically are important for both sexes, although sex-specific functional adaptations may occur frequently. This is true for hearing as well. Consequently, distinct behavioural functions were identified for the different insect hearing systems. Here we describe a first case, where a trait of an evolutionary novelty and a highly specialized hearing organ is adaptive in only one sex. The main function of hearing of the parasitoid fly Emblemasoma auditrix is to locate the host, males of the cicada species Okanagana rimosa, by their calling song. This task is performed by female flies, which deposit larvae into the host. We show that male E. auditrix possess a hearing sense as well. The morphology of the tympanal organ of male E. auditrix is rather similar to the female ear, which is 8% broader than the male ear. In both sexes the physiological hearing threshold is tuned to 5 kHz. Behavioural tests show that males are able to orient towards the host calling song, although phonotaxis often is incomplete. However, despite extensive observations in the field and substantial knowledge of the biology of E. auditrix, no potentially adaptive function of the male auditory sense has been identified. This unique hearing system might represent an intralocus sexual conflict, as the complex sense organ and the behavioural relevant neuronal network is adaptive for only one sex. The correlated evolution of the sense organ in both sexes might impose substantial constraints on the sensory properties of the ear. Similar constraints, although hidden, might also apply to other sensory systems in which behavioural functions differ between sexes.

  11. SWI/SNF Complex-deficient Undifferentiated/Rhabdoid Carcinomas of the Gastrointestinal Tract: A Series of 13 Cases Highlighting Mutually Exclusive Loss of SMARCA4 and SMARCA2 and Frequent Co-inactivation of SMARCB1 and SMARCA2.

    Science.gov (United States)

    Agaimy, Abbas; Daum, Ondrej; Märkl, Bruno; Lichtmannegger, Ines; Michal, Michal; Hartmann, Arndt

    2016-04-01

    Undifferentiated gastrointestinal tract carcinomas are rare highly aggressive neoplasms with frequent but not obligatory rhabdoid features. Recent studies showed loss of SMARCB1 (INI1), a core subunit of the SWI/SNF chromatin remodeling complex, in 50% of tested cases. However, the molecular pathways underlying histologically similar but SMARCB1-intact cases are unknown. We herein analyzed 13 cases for expression of 4 SWI/SNF complex subunits SMARCB1, SMARCA2, SMARCA4, and ARID1A and the mismatch-repair proteins MLH1, MSH2, MSH6, and PMS2 by immunohistochemistry. Patients included 12 men and 1 woman aged 32 to 81 years (median, 57 y). Site of origin was colon (5), small bowel (2), stomach (3), small+large intestine (1), small intestine+ampulla of Vater (1), and esophagogastric junction (1). All tumors showed anaplastic large to medium-sized cells with variable rhabdoid features, pleomorphic giant cells, and, rarely, spindle cell foci. Abortive gland formation was seen in 3 cases and bona fide glandular component in 1 case. Most cases strongly expressed vimentin and variably pancytokeratin. In total, 12/13 cases (92%) showed loss of at least 1 SWI/SNF component. Loss of SMARCB1 (5/13), SMARCA2 (10/13), SMARCA4 (2/13), and ARID1A (2/13) was observed either in combination or isolated. SMARCA2 loss was isolated in 5 cases and coexisted with lost SMARCB1 in 5 cases (all 5 SMARCB1-deficient tumors showed loss of SMARCA2 as well). Co-inactivation of SMARCB1 and SMARCA4 or of SMARCA2 and SMARCA4 was not observed. Two mismatch-repair-deficient cases (MLH1/PMS2) showed concurrent loss of SMARCB1, SMARCA2, and (one of them) ARID1A. This study illustrates for the first time loss of different components of the SWI/SNF complex other than SMARCB1 in undifferentiated gastrointestinal carcinomas including novel SMARCA4-deficient and SMARCA2-deficient cases. Our results underline the close link between SWI/SNF deficiency and the aggressive rhabdoid phenotype. Frequent loss of SMARCA

  12. Complex Beauty

    OpenAIRE

    Franceschet, Massimo

    2014-01-01

    Complex systems and their underlying convoluted networks are ubiquitous, all we need is an eye for them. They pose problems of organized complexity which cannot be approached with a reductionist method. Complexity science and its emergent sister network science both come to grips with the inherent complexity of complex systems with an holistic strategy. The relevance of complexity, however, transcends the sciences. Complex systems and networks are the focal point of a philosophical, cultural ...

  13. HYALINIZING TRABECULAR ADENOMA FEIGNING PAPILLARY CARCINOMA THYROID: CASE REPORT WITH REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Kandukuri Mahesh

    2014-05-01

    Full Text Available Hyalinizing Trabecular Adenoma (HTA of the thyroid is a rare neoplasm that was first described by Carney in 1987. It is a tumor of follicular derivation with peculiar nuclear, architectural, histochemical, and immunohistochemical features. We report a case of Hyalinizing trabecular adenoma in a 36-year-old woman with enlarged thyroid lobe. Ultrasonographic features and fine needle aspiration cytology (FNAC of the enlarged thyroid was performed and the diagnosis given was Papillary carcinoma of the thyroid. The patient underwent total thyroidectomy, with a histopathological diagnosis of hyalinizing trabecular Adenoma (HTA. We present this case in view of its rarity and to discuss the clinical and diagnostic approach, including the role of FNAC, and the pathologic features of HTA with special reference to the possible differential diagnosis and also review of literature. Although rare cases of malignant Hyalinizing trabecular adenoma (HTA have been documented, this tumor should be considered a benign neoplasm or at most, a neoplasm of extremely low malignant potential, however invasion of the capsule should be considered on histopathology. An awareness of hyalinizing trabecular adenomas and their characteristic features is valuable for their recognition and management as well as for the possible prevention of over diagnosis and over treatment for benign disease

  14. 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

  15. 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...

  16. A rare case of a three way complex variant positive Philadelphia translocation involving chromosome (9;11;22)(q34;p15;q11) in chronic myeloid leukemia: A case report

    Science.gov (United States)

    Asif, Muhammad; Hussain, Abrar; Rasool, Mahmood

    2016-01-01

    The t(9;22)(q34;q11) translocation is present in 90–95% of patients with chronic myeloid leukemia (CML). Variant complex translocations have been observed in 5–8% of CML patients, in which a third chromosome other than (9;22) is involved. Imatinib mesylate is the first line breakpoint cluster region-Abelson gene (BCR/ABL)-targeted oral therapy for CML, and may produce a complete response in 70–80% of CML patients in the chronic phase. In the present study, a bone marrow sample was used for conventional cytogenetic analysis, and the fluorescence in situ hybridization (FISH) test was used for BCR/ABL gene detection. A hematological analysis was also performed to determine the white blood cell (WBC) count, red blood cell count, hemoglobin levels, packed and mean cell volumes, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and platelet values of the patient. The hematological analysis of the patient indicated the increased WBC of 186.5×103 cells/µl, and decreased hemoglobin levels of 11.1 g/dl. The FISH test revealed that 67% cells demonstrated BCR/ABL gene translocation. The patient was treated with 400 mg imatinib mesylate daily, and was monitored at various intervals over a 6-month period. The present study reports the rare case of a patient that demonstrates a three-way Philadelphia chromosome-positive translocation involving 46XY,t(9;11;22)(q34;p15;q11)[10], alongside CML in the chronic phase. The translocation was analyzed using cytogenetic and FISH tests. PMID:27602125

  17. Cushing’s Syndrome Secondary to isolated Micronodular Adrenocortical Disease (iMAD) associated with Rapid Onset Weight Gain and Negative Abdominal MRI Findings in a 3 year old Male

    Science.gov (United States)

    Henry, Rohan K.; Keil, Margaret F.; Stratakis, Constantine A.; Fechner, Patricia Y.

    2011-01-01

    Cushing’s syndrome (CS) is uncommon in childhood. CS may be either dependent or independent of adrenocorticotrophic hormone (ACTH). ACTH independent micronodular adrenocortical (MAD) disease may present in the second to third decade of life or between ages 2–3years. It may occur in isolation, or as a part of the Carney complex and it represents an elusive entity to diagnose. We present a 3 year 7 month old boy with isolated MAD (iMAD). Abdominal CT revealed prominent mildly lobulated anteromedial margin of adrenals with nodular appearance. Cardiac echo, thyroid and testicular ultrasounds performed as a work up for Carney complex were normal. Bilateral adrenalectomy confirmed MAD as the cause of CS. We present the history’ and identification of a unique case of iMAD. PMID:20662336

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

    DEFF Research Database (Denmark)

    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 c...... 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....

  19. Surgical management of a large complex odontoma of the mandibular angle-ramus region through intra-oral buccal approach--A case report.

    Science.gov (United States)

    Ogunlewe, M O; Adeyemo, W L; Ladeinde, A L; Bamgbose, B O; Ajayi, O F

    2005-12-01

    Large complex odontomas of the jaws are rare. A report of a large complex odontoma of the mandibular angle-ramus region enucleated through intra-oral buccal approach is presented. A review of the literature on different modalities of treatment is also undertaken. A large expansile complex odontoma of the angle-ramus region of the mandible was excised through an intraoral buccal approach under general anaesthesia. Recovery and immediate post-operative period were uneventful. There was no altered sensation in the distribution of the inferior alveolar nerve and lingual nerve; and wound healing was satisfactory. Post-operative radiograph 2 years after the operation showed satisfactory bone regeneration. Intraoral buccal approach to large complex odontomas of the angle-ramus region of the mandible is a relatively safe procedure with minimal complication.

  20. Management approaches for environmental restoration at the U.S. Department of Energy Weapons Complex, Savannah River Site: A case study

    International Nuclear Information System (INIS)

    This paper introduces the management approaches for environmental restoration at the US Department of Energy Weapons Complex. A brief chronology of environmental restoration complex-wide is presented. This chronology, which focuses on the changing climate at DOE facilities, is then keyed to activities at the Savannah River Site (SRS) in Aiken, South Carolina, USA. Past, present, and future environmental restoration activities at SRS are discussed, reflecting the change in emphasis at the site

  1. Bucolic Complexes

    CERN Document Server

    Brešar, Bostjan; Chepoi, Victor; Gologranc, Tanja; Osajda, Damian

    2012-01-01

    In this article, we introduce and investigate bucolic complexes, a common generalization of systolic complexes and of CAT(0) cubical complexes. This class of complexes is closed under Cartesian products and amalgamations over some convex subcomplexes. We study various approaches to bucolic complexes: from graph-theoretic and topological viewpoints, as well as from the point of view of geometric group theory. Bucolic complexes can be defined as locally-finite simply connected prism complexes satisfying some local combinatorial conditions. We show that bucolic complexes are contractible, and satisfy some nonpositive-curvature-like properties. In particular, we prove a version of the Cartan-Hadamard theorem, the fixed point theorem for finite group actions, and establish some results on groups acting geometrically on such complexes. We also characterize the 1-skeletons (which we call bucolic graphs) and the 2-skeletons of bucolic complexes. In particular, we prove that bucolic graphs are precisely retracts of Ca...

  2. Intervention description is not enough: evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions

    Directory of Open Access Journals (Sweden)

    Wells Mary

    2012-06-01

    Full Text Available Abstract Background A number of single case reports have suggested that the context within which intervention studies take place may challenge the assumptions that underpin randomised controlled trials (RCTs. However, the diverse ways in which context may challenge the central tenets of the RCT, and the degree to which this information is known to researchers or subsequently reported, has received much less attention. In this paper, we explore these issues by focusing on seven RCTs of interventions varying in type and degree of complexity, and across diverse contexts. Methods This in-depth multiple case study using interviews, focus groups and documentary analysis was conducted in two phases. In phase one, a RCT of a nurse-led intervention provided a single exploratory case and informed the design, sampling and data collection within the main study. Phase two consisted of a multiple explanatory case study covering a spectrum of trials of different types of complex intervention. A total of eighty-four data sources across the seven trials were accessed. Results We present consistent empirical evidence across all trials to indicate that four key elements of context (personal, organisational, trial and problem context are crucial to understanding how a complex intervention works and to enable both assessments of internal validity and likely generalisability to other settings. The ways in which context challenged trial operation was often complex, idiosyncratic, and subtle; often falling outside of current trial reporting formats. However, information on such issues appeared to be available via first hand ‘insider accounts’ of each trial suggesting that improved reporting on the role of context is possible. Conclusions Sufficient detail about context needs to be understood and reported in RCTs of complex interventions, in order for the transferability of complex interventions to be assessed. Improved reporting formats that require and encourage

  3. [An autopsy case of amyotrophic lateral sclerosis with prominent muscle cramps, fasciculation, and high titer of anti-voltage gated potassium channel (VGKC) complex antibody].

    Science.gov (United States)

    Sato, Aki; Sakai, Naoko; Shinbo, Junsuke; Hashidate, Hideki; Igarashi, Shuichi; Kakita, Akiyoshi; Yamazaki, Motoyoshi

    2014-01-01

    The patient was a 55-year-old male who had prominent fasciculation and muscle cramps. Muscle weakness and atrophy of the trunk, respiratory system, and extremities gradually progressed. On the basis of these features, we diagnosed this patient as having amyotrophic lateral sclerosis (ALS), however, the upper motor neuron signs were not significant. Following the detection of the anti-voltage gated potassium channel (VGKC) complex antibody at 907.5 pM (normal VGKC complex antibody in the development of cramp-fasciculation syndrome has been speculated. In this ALS patient, the antibodies might be associated with pathomechanisms underlying the characteristic symptoms.

  4. Learning from Simple Ebooks, Online Cases or Classroom Teaching When Acquiring Complex Knowledge. A Randomized Controlled Trial in Respiratory Physiology and Pulmonology

    OpenAIRE

    Bjarne Skjødt Worm

    2013-01-01

    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 ...

  5. The complex case of V445 Lyr observed with Kepler: two Blazhko modulations, a non-radial mode, possible triple mode RR Lyrae pulsation, and more

    DEFF Research Database (Denmark)

    Guggenberger, E.; Kolenberg, K.; Nemec, J. M.;

    2012-01-01

    detected so far, the RRab star V445 Lyr (KIC 6186029) which was observed with the Kepler space mission. V445 Lyr shows very strong cycle-to-cycle changes in its Blazhko modulation, which are caused both by a secondary long-term modulation period as well as irregular variations. In addition to the complex...

  6. Supporting complex search tasks

    DEFF Research Database (Denmark)

    Gäde, Maria; Hall, Mark; Huurdeman, Hugo;

    2015-01-01

    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 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...... introductory to specialized, and from authoritative to speculative or opinionated, when to show what sources of information? How does the information seeking process evolve and what are relevant differences between different stages? With complex task and search process management, blending searching, browsing...

  7. Supporting complex search tasks

    DEFF Research Database (Denmark)

    Gäde, Maria; Hall, Mark; Huurdeman, Hugo;

    2015-01-01

    , and recommendations, and supporting exploratory search to sensemaking and analytics, UI and UX design pose an overconstrained challenge. How do we know that our approach is any good? Supporting complex search task requires new collaborations across the whole field of IR, and the proposed workshop will bring together......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 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...

  8. SDHB immunohistochemistry: A useful tool in the diagnosis of Carney-Stratakis and Carney triad gastrointestinal stromal tumors

    NARCIS (Netherlands)

    J. Gaal (José); C.A. Stratakis (Constantine); M. Carney; E.R. Ball (Evan R.); E. Korpershoek (Esther); M.B. Lodish (Maya Beth); I. Levy (Isaac); P. Xekouki (Paraskevi); F.H. van Nederveen (Francien); M.A. den Bakker (Michael); M.J. O'Sullivan (Maureen); W.N.M. Dinjens (Winand); R.R. de Krijger (Ronald)

    2011-01-01

    textabstractMutations in the tumor suppressor genes SDHB, SDHC, and SDHD (or collectively SDHx) cause the inherited paraganglioma syndromes, characterized by pheochromocytomas and paragangliomas. However, other tumors have been associated with SDHx mutations, such as gastrointestinal stromal tumors

  9. Characterizing reactions to fabricate thin films of charge transfer complexes by synchrotron photoelectron spectroscopy: A case study of DCNQI-Cu

    Science.gov (United States)

    Shimada, Toshihiro; Mochida, Michihiro; Koma, Atsushi

    1997-04-01

    Ultraviolet photoelectron spectroscopy with various photon energies using synchrotron radiation was used to characterize chemical reactions associated with thin film growth of organic charge transfer complex (DMe-DCNQI) 2Cu. Other molecular systems H 2Pc, CuPc and C 60 were also studied to clarify the origin of the systematic relation between the spectra and the incident photon energy. Characteristic photon energy dependence of the photo-ionization cross section of molecular orbitals is useful to analyze the intermolecular reactions.

  10. Comprehensive evaluation technology for shale gas sweet spots in the complex marine mountains, South China: A case study from Zhaotong national shale gas demonstration zone

    Directory of Open Access Journals (Sweden)

    Xing Liang

    2016-01-01

    Full Text Available The exploration and development of marine shale gas reservoirs in South China is challenged by complex geological and geographical conditions, such as strong transformation, post maturity, complex mountains and humanity. In this paper, the evaluations on shale gas sweet spots conducted in Zhaotong demonstration zone in the past six years and the construction of 500 million m3 shale gas productivity in Huangjinba region were discussed, and the results of shale gas reservoir evaluations in China and abroad were investigated. Accordingly, it is proposed that another two key indicators be taken into consideration in the evaluation on shale gas sweet spots in marine mountains in South China, i.e. shale gas preservation conditions and pore pressure, and the research on ground stress and natural microfracture systems should be strengthened. Then, systematic analysis was conducted by integrating shale gas multidisciplinary data and geological and engineering integration study was carried out. Finally, a 3D model, which was composed of “geophysics, reservoir geology, fracture system and rock geomechanics”, was established for shale gas reservoirs. Application practice shows that the geological engineering integration and the 3D reservoir modeling are effective methods for evaluating the shale gas sweet spots in complex marine mountains in South China. Besides, based on shale gas sweet spot evaluation, 3D spatial congruency and superposition effects of multiple attributes and multiple evaluation parameters are presented. Moreover, the short-plate principle is the factor controlling the distribution patterns and evaluation results of shale gas sweet spots. It is concluded that this comprehensive evaluation method is innovative and effective in avoiding complex geological and engineering risks, so it is of guiding significance in exploration and development of marine shale gas in South China.

  11. Unravelling the complexity of organizational and occupational culture through an exploration of eight cultural schools: a case study of chefs working in luxury hotels and restaurants

    OpenAIRE

    Cameron, Derek

    2009-01-01

    This paper focuses on the cultural concept with an attempt to unravel cultural complexity and diversity in conceptual forms of organizational and occupational culture. Drawing from classical papers related to social anthropology and using the framework of Allaire and Firsirotu (1984), eight cultural schools are explored to themes of organizational- and chefoccupational culture. It was observed that all eight schools were instrumental in identifying the rudiments of applied hotel- and restaura...

  12. Methodological approach to determine of small spatial units in a highly complex terrain in atmospheric pollution research: the case of Zasavje region in Slovenia

    OpenAIRE

    Andreja Kukec; Marija Z. Boznar; Primoz Mlakar; Bostjan Grasic; Andrej Herakovic; Vesna Zadnik; Lijana Zaletel-Kragelj; Jerneja Farkas; Ivan Erzen

    2014-01-01

    The study of atmospheric air pollution research in complex terrains is challenged by the lack of appropriate methodology supporting the analysis of the spatial relationship between phenomena affected by a multitude of factors. The key is optimal design of a meaningful approach based on small spatial units of observation. The Zasavje region, Slovenia, was chosen as study area with the main objective to investigate in practice the role of such units in a test environment. The process consisted ...

  13. Governance of Protected Areas in West Africa - The case of the W-Arly-Pendjari (WAP) Complex in Benin and Burkina Faso

    OpenAIRE

    Konrad, Tillmann

    2015-01-01

    Protected areas are the central strategy for preserving biodiversity in the face of overexploitation and global change. To ensure their long-term survival, however, these areas may not be regarded as last havens of wilderness, but as complex social-ecological systems. Modern approaches of protected area (PA) management support this view by balancing conservation and development issues in a sustainable way and adapted to the local context. However, success of these strategies in achieving thei...

  14. Application of molecular cytogenetic techniques to clarify apparently balanced complex chromosomal rearrangements in two patients with an abnormal phenotype: case report

    Directory of Open Access Journals (Sweden)

    Rongen Michel A

    2009-07-01

    Full Text Available Abstract Background Complex chromosomal rearrangements (CCR are rare cytogenetic findings that are difficult to karyotype by conventional cytogenetic analysis partially because of the relative low resolution of this technique. High resolution genotyping is necessary in order to identify cryptic imbalances, for instance near the multiple breakpoints, to explain the abnormal phenotype in these patients. We applied several molecular techniques to elucidate the complexity of the CCRs of two adult patients with abnormal phenotypes. Results Multicolour fluorescence in situ hybridization (M-FISH showed that in patient 1 the chromosomes 1, 10, 15 and 18 were involved in the rearrangement whereas for patient 2 the chromosomes 5, 9, 11 and 13 were involved. A 250 k Nsp1 SNP-array analysis uncovered a deletion in chromosome region 10p13 for patient 1, harbouring 17 genes, while patient 2 showed no pathogenic gains or losses. Additional FISH analysis with locus specific BAC-probes was performed, leading to the identification of cryptic interstitial structural rearrangements in both patients. Conclusion Application of M-FISH and SNP-array analysis to apparently balanced CCRs is useful to delineate the complex chromosomal rearrangement in detail. However, it does not always identify cryptic imbalances as an explanation for the abnormal phenotype in patients with a CCR.

  15. Modelling and simulation of electrical energy systems through a complex systems approach using agent-based models. Case study: Under-frequency load shedding for refrigerators

    Energy Technology Data Exchange (ETDEWEB)

    Kremers, Enrique [Karlsruhe Institute of Technology (KIT), Karlsruhe (Germany). European Inst. for Energy Research (EIFER); Gonzalez de Durana, Jose Maria; Barambones, Oscar [Universidad del Pais Vasco, Vitoria (Spain). Escuela Universitaria de Ingenieria de Vitoria-Gasteiz

    2013-09-01

    One of the ways of studying complex systems is through modelling and simulation, which are used as tools to represent these systems in a virtual environment. Current advances in computing performance (which has been a major constraint in this field for some time) allow for the simulation these kinds of systems within reasonable time horizons. One of the tools for simulating complex systems is agent-based modelling. This individual-centric approach is based on autonomous entities that can interact with each other, thus modelling the system in a disaggregated way. Agent-based models can be coupled with other modelling methods, such as continuous models and discrete events, which can be embedded or run in parallel to the multi-agent system. When representing the electrical energy system in a systemic and multi-layered way, it is treated as a true socio-technical system, in which not only technical models are taken into account, but also socio-behavioural ones. In this work, a number of different models for the parts of an electrical system are presented, related to production, demand and storage. The models are intended to be as simple as possible in order to be simulated in an integrated framework representing the system as a whole. Furthermore, the models allow the inclusion of social behaviour and other, not purely engineering-related aspects of the system, which have to be considered from a complex point of view. (orig.)

  16. Environmental and complexation effects on the structures and spectroscopic signatures of organic pigments relevant to cultural heritage: the case of alizarin and alizarin-Mg(II)/Al(III) complexes.

    Science.gov (United States)

    Carta, Luciano; Biczysko, Malgorzata; Bloino, Julien; Licari, Daniele; Barone, Vincenzo

    2014-02-21

    An integrated computational approach allowed an unbiased analysis of optical and structural properties of alizarin-based pigments, which can be directly compared with experimental results. Madder lake pigments have been modeled by Mg(II)- and Al(III)-coordinated alizarin taking into account solvation and metal-linkage effects, responsible for colour modifications. Moreover, different environmental conditions have been analyzed for free alizarin, showing in all cases semi-quantitative agreement with experimental spectroscopic data (UV-VIS). Our results point out the ability of in silico approaches to unravel the subtle interplay of stereo-electronic, dynamic, and environmental effects in tuning the physico-chemical properties of pigments relevant to cultural heritage.

  17. Can the Language of Rights Get Hold of the Complex Realities of Child Domestic Work?: The Case of Young Domestic Workers in Abidjan, Ivory Coast

    Science.gov (United States)

    Jacquemin, Melanie

    2006-01-01

    This review examines refractions of children's rights in development practice from an anthropological point of view and considers the case of young domestic girls working in Abidjan. The author argues that child labour legislation and the children's rights perspective in Abidjan is permeated by patriarchal values that mask the exploitation of work…

  18. Investigation of the validity of BEM for simulation of wind turbines in complex load cases and comparison with experiment and CFD

    Science.gov (United States)

    Rahimi, H.; Dose, B.; Stoevesandt, B.; Peinke, J.

    2016-09-01

    The aim of this work is to investigate the validity of simulation codes based on the Blade Element Momentum (BEM) theory for three important design load conditions. This paper includes the cases of yawed inflow, rotor tower interaction for downwind turbines and the standstill case. Computational Fluid Dynamics (CFD) and experimental data (when available) are used for the evaluation of the obtained results. For the yawed inflow, the results indicate that significant deviations between BEM and experiments & CFD can be observed. This discrepancy is caused by unsteady phenomena such as the advancing & retreating blade effect and the skewed wake effect. In the case of the rotor and tower interaction of the downwind turbine, the results show that the BEM based code overpredicts the sectional forces in terms of the normal and tangential forces by 20%. In the case of standstill, the evaluation of the results based on tip deflections shows clear differences in the output of both numerical approaches. While the flapwise deflections show a reasonable agreement, the CFD-based coupled solver predicts much larger edgewise vibrations.

  19. Integrating care for older people with complex needs: key insights and lessons from a seven-country cross-case analysis

    Directory of Open Access Journals (Sweden)

    Walter P Wodchis

    2015-09-01

    Full Text Available Background: To address the challenges of caring for a growing number of older people with a mix of both health problems and functional impairment, programmes in different countries have different approaches to integrating health and social service supports. Objective: The goal of this analysis is to identify important lessons for policy makers and service providers to enable better design, implementation and spread of successful integrated care models. Methods: This paper provides a structured cross-case synthesis of seven integrated care programmes in Australia, Canada, the Netherlands, New Zealand, Sweden, the UK and the USA. Key findings: All seven programmes involved bottom-up innovation driven by local needs and included: (1 a single point of entry, (2 holistic care assessments, (3 comprehensive care planning, (4 care co-ordination and (5 a well-connected provider network. The process of achieving successful integration involves collaboration and, although the specific types of collaboration varied considerably across the seven case studies, all involved a care coordinator or case manager. Most programmes were not systematically evaluated but the two with formal external evaluations showed benefit and have been expanded. Conclusions: Case managers or care coordinators who support patient-centred collaborative care are key to successful integration in all our cases as are policies that provide funds and support for local initiatives that allow for bottom-up innovation. However, more robust and systematic evaluation of these initiatives is needed to clarify the ‘business case’ for integrated health and social care and to ensure successful generalization of local successes.

  20. Evaluating the Performance of DFT Functionals in Assessing the Interaction Energy and Ground-State Charge Transfer of Donor/Acceptor Complexes: Tetrathiafulvalene−Tetracyanoquinodimethane (TTF−TCNQ) as a Model Case

    KAUST Repository

    Sini, Gjergji

    2011-03-08

    We have evaluated the performance of several density functional theory (DFT) functionals for the description of the ground-state electronic structure and charge transfer in donor/acceptor complexes. The tetrathiafulvalene- tetracyanoquinodimethane (TTF-TCNQ) complex has been considered as a model test case. Hybrid functionals have been chosen together with recently proposed long-range corrected functionals (ωB97X, ωB97X-D, LRC-ωPBEh, and LC-ωPBE) in order to assess the sensitivity of the results to the treatment and magnitude of exact exchange. The results show an approximately linear dependence of the ground-state charge transfer with the HOMO TTF-LUMOTCNQ energy gap, which in turn depends linearly on the percentage of exact exchange in the functional. The reliability of ground-state charge transfer values calculated in the framework of a monodeterminantal DFT approach was also examined. © 2011 American Chemical Society.

  1. Emergency management of major bleeding in a case of maxillofacial trauma and anticoagulation: utility of prothrombin complex concentrates in the shock room

    Directory of Open Access Journals (Sweden)

    Alessandro Morotti

    2015-03-01

    Full Text Available Life-threatening bleeding in anticoagulation with Warfarin is an emergency challenging issue. Several approaches are available to treat bleeding in either over-anticoagulation or propeanticoagulation, including vitamin K, fresh frozen plasma and prothrombin complex concentrates (PCC administration. In coexisting trauma-induced bleeding and anticoagulation, reversal of anticoagulation must be a rapid and highly effective procedure. Furthermore the appropriate treatment must be directly available in each shock rooms to guarantee the rapid management of the emergency. PCC require a simple storage, rapid accessibility, fast administration procedures and high effectiveness. Here we report the utility of PCC in management of a craniofacial trauma in proper-anticoagulation.

  2. Structure-function relationships within Keppler-type antitumor ruthenium(III) complexes: the case of 2-aminothiazolium[trans-tetrachlorobis(2-aminothiazole)ruthenate(III)].

    Science.gov (United States)

    Mura, Pasquale; Piccioli, Francesca; Gabbiani, Chiara; Camalli, Mercedes; Messori, Luigi

    2005-07-11

    Keppler-type ruthenium(III) complexes exhibit promising antitumor properties. We report here a study of 2-aminothiazolium[trans-tetrachlorobis(2-aminothiazole)ruthenate(III)], both in the solid state and in solution. The crystal structure has been solved and found to exhibit classical features. Important solvatochromic effects were revealed. Notably, we observed that introduction of an amino group in position 2 greatly accelerates chloride hydrolysis compared to the thiazole analogue; this latter finding may be of interest for a fine-tuning of the reactivity of these novel metallodrugs.

  3. Joint impact of rainfall and tidal level on flood risk in a coastal city with a complex river network: a case study for Fuzhou city, China

    OpenAIRE

    Lian, J. J.; Xu, K.; Ma, C.

    2012-01-01

    Coastal cities are particularly vulnerable to flood under the combined effect of multivariable variables, such as heavy rainfall, high sea level and large waves. For better assessment and management of flood risk the combined effect and joint probability should be considered. This paper aims to study the joint impact of rainfall and tidal level on flood risk by estimating the combined risk degree of flood and the joint flood probability. The area of case study is a typical coastal city...

  4. Complex Laparoscopic Myomectomy with Severe Adhesions Performed with Proper Preventive Measures and Power Morcellation Provides a Safe Choice in Certain Infertility Cases

    Science.gov (United States)

    Alfaro-Alfaro, Jaime; Flores-Manzur, María de los Ángeles; Nevarez-Bernal, Roberto

    2016-01-01

    Laparoscopic myomectomy offers a real benefit to infertile patients with uterine fibroids and peritoneal adhesions. The procedure requires a skilled surgeon and laparoscopy technique to minimize adhesion formation and other proven benefits. Restrictions arise since this procedure requires power morcellation for fibroid tissue extraction. Two years ago, the Food and Drug Administration in the United States of America (FDA) issued the alert on power morcellation for uterine leiomyomas, addressing the risk of malignant cell spreading within the abdominal cavity (actual risk assessment from 1 in 360 to 1 in 7400 cases). We review a 30-year-old female, without previous gestations, hypermenorrhea, intermenstrual bleeding, and chronic pelvic pain. Transvaginal ultrasound reports multiple fibroids in the right portion of a bicornuate uterus. Relevant history includes open myomectomy 6 years before and a complicated appendectomy, developing peritonitis within a year. Laparoscopy revealed multiple adhesions blocking uterine access, a bicornuate uterus, and myomas in the expected site. Myomectomy was performed utilizing power morcellation with good results. FDA recommendations have diminished this procedure's selection, converting many to open variants. This particular case was technically challenging, requiring morcellation, and safety device deployment was impossible, yet the infertility issue was properly addressed. Patient evaluation, safety measures, and laparoscopy benefits may outweigh the risks in particular cases as this one. PMID:27668110

  5. Facilities Management Service Delivery in Public and Private High Rise Residential Buildings in Nigeria: A case study of Eko Court Complex and Niger Towers

    Directory of Open Access Journals (Sweden)

    Olanrele O. O.

    2014-01-01

    Full Text Available This study assessed and compared the delivery of Facilities Management (FM services in public and private high rise residential buildings in Lagos, Nigeria. While some facilities or services may not be available in some public estates, the efficiency of the available ones is inadequate in comparison with the adequacy and efficiency of services provided in private estates. The objectives set for the study include identification of services that are provided in the case studies, service delivery method, and an assessment of the residents’ satisfaction of the services. This study adopted questionnaire survey for collection of data. 127 questionnaires were distributed to the residents of the case studies and 93 were returned. Three of which were discarded for incompleteness, thus 90 were analysed. The study found that most but not all of the facilities services expected in high rise buildings are available in the case studies and the services are outsourced under a standard Service Level Agreement. The service delivery in private high rise residential building is better than the public residential high rise buildings as revealed by the study. The study recommends improved standardization of services, customized services and meeting customer’s expectation for improved service delivery.

  6. Prospective outcome of the influence of complexation by natural organic matter on enhanced or retarded transport of radionuclides: case of humic substances retention

    International Nuclear Information System (INIS)

    This document takes a prospective stock of the natural organic matter influence on the possible effects on radionuclide migration, as well as a brief critical analysis of the literature data. A comparison with the retention of the 'simple' organic complexing agents is done in order to fix the limit of the 'simplistic' analogies done in the literature very often. It appears that the magnitude of the effects is function of the residence time in the medium, and of the possibilities for the organic complexes to be retained on the mineral surfaces. The contact time between radionuclides and the natural organic matter is also an influent parameter, as it influences part of the reversibility of this interaction vis-a-vis surface retention. Modelling of the metal-organic-surface systems is only satisfying up to now when accounting fractions of organic matter that are less susceptible to form colloidal aggregates, i.e., fulvic acids. These non-aggregated fractions could be considered as simple ligands in a first approximation. Conversely, when it comes to aggregated colloids of organic origin, i.e., humic acids, modelling are limited by the lack of theoretical understanding of their structure and of their evolution in response to geochemical condition variations, as ionic strength (harsh meteoric events), acidity or water composition (non-saturated water table). (author)

  7. A System Dynamic Analysis approach to deal with complexity in water resources management: the case of groundwater protection in the Apulia region (Southern Italy)

    Science.gov (United States)

    Giordano, Raffaele; Pluchinotta, Irene; Brugnach, Marcela; Pagano, Alessandro

    2015-04-01

    The increasing complexity and uncertainty of water resources management is claiming changes in the role of tools and methods aiming to support decision makers. Complexity due to the densely interconnected networks in which decision-actors operate. Uncertainty arises because of the fact that whatever action other decision agents involved in the network are going to do is largely unknown. In these complex and uncertain environments, it is very difficult to determine how effective a policy will be. Part of the difficulty resides in the fact that any action choice will influence and be influenced by the actions choices of the other actors. While these interactions among a diversity of actors may contribute to the development of beneficial adaptive behaviours, they can also result in dysfunctional dynamics, often leading to policy resistance. Action choices are not neutral, but commensurate with the problem frames held by the actors making the decisions. Our research hypothesis is that neglecting differences in problem framings leads decision makers to oversimplify the complexity of the interactions within the system to be managed, and to act as if the system is as simple as the decision makers presume it to be. Therefore, decision tools and methodologies should support the decision makers to become aware of the complexity of the interaction space, to disclose and analyse the existing interconnections, and to govern those interactions. In these circumstances, decision makers could take advantage from the interactional nature of the knowledge creation process. In order to demonstrate the research hypothesis, a methodology based on System Dynamic Modelling (SDM) was implemented in the Apulia Region (Southern Italy) to support the implementation of the groundwater (GW) protection policy. Due to the increasing of GW withdrawal for irrigation purposes, several phenomena are drastically reducing the quality of the GW resources. In order to protect the quality of GW, the

  8. Complex adaptive systems ecology

    DEFF Research Database (Denmark)

    Sommerlund, Julie

    2003-01-01

    In the following, I will analyze two articles called Complex Adaptive Systems EcologyI & II (Molin & Molin, 1997 & 2000). The CASE-articles are some of the more quirkyarticles that have come out of the Molecular Microbial Ecology Group - a groupwhere I am currently making observational studies...

  9. 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...

  10. Engaging complexity

    Directory of Open Access Journals (Sweden)

    Gys M. Loubser

    2014-01-01

    Full Text Available In this article, I discuss studies in complexity and its epistemological implications for systematic and practical theology. I argue that engagement with complexity does not necessarily assurea non-reductionist approach. However, if complexity is engaged transversally, it becomes possible to transcend reductionist approaches. Moreover, systematic and practical the ologians can draw on complexity in developing new ways of understanding and, therefore, new ways of describing the focus, epistemic scope and heuristic structures of systematic and practical theology. Firstly, Edgar Morin draws a distinction between restricted and general complexity based on the epistemology drawn upon in studies in complexity. Moving away from foundationalist approaches to epistemology, Morin argues for a paradigm of systems. Secondly,I discuss Kees van Kooten Niekerk�s distinction between epistemology, methodology andontology in studies in complexity and offer an example of a theological argument that drawson complexity. Thirdly, I argue for the importance of transversality in engaging complexity by drawing on the work of Wentzel van Huyssteen and Paul Cilliers. In conclusion, I argue that theologians have to be conscious of the epistemic foundations of each study in complexity, and these studies illuminate the heart of Reformed theology.Intradisciplinary and/or interdisciplinary implications: Therefore, this article has both intradisciplinary and interdisciplinary implications. When theologians engage studies incomplexity, the epistemological roots of these studies need to be considered seeing thatresearchers in complexity draw on different epistemologies. Drawing on transversality wouldenhance such considerations. Furthermore, Edgar Morin�s and Paul Cilliers� approach tocomplexity will inform practical and theoretical considerations in church polity and unity.

  11. Age estimation of the mid-Pleistocene microtektite event in the South China Sea: A case showing the complexity of the sea-land correlation

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The present study confirms the stratigraphical position of microtektite layer being clearly located below the Brunhes/Matuyama (B/M) boundary. Based on the sedimentation rate derived from the stable isotopic and magnetic data of ODP Site 772A, cores 17957 and 17959 in the South China Sea, the age of the mid-Pleistocene impact event was estimated at 10-12 ka earlier than the Brunhes-Matuyama polarity reversal. However, the microtektites were found above the measured B/M boundary in the loess profile due to the downward deviation of the measured B/M boundary from its true position[1] . This demonstrates the complexity of paleo-magnetic records in the loess profiles which, in turn, causes the confusion in the sea-land stratigraphic correlation.

  12. [Disseminated Mycobacterium avium complex infections in AIDS. Apropos of 100 cases. Groupe d'Epidémiologie clinique du SIDA en Aquitaine].

    Science.gov (United States)

    Lasseur, C; Maugein, J; Pellegrin, J L; Dupon, M; Ragnaud, J M; Morlat, P; Pellegrin, I; Constans, J; Monlun, E; Chene, G

    1995-01-01

    The improvement of survival of AIDS patients allowed the emergence of disseminated Mycobacterium avium Complex infections (D.MAC). Here we report the experience of the group of "Epidémiologie clinique du sida en Aquitaine (GECSA)" about 100 patients. There were no differences according to sex, age and route of acquisition of HIV. Clinical and biological characteristics of the infections were not specific. The mean TCD4+ lymphocytes count was 18/mm3. The diagnostic was generally established by systematic blood culture on Septi-Chek in patients with TCD4+ lymphocytes count below 75/mm3. The recommendations on therapy for D.MAC are to use regimen containing azithromycin or clarithromycin, ethambutol and one of the following drugs, rifabutin, clofazimine, amikacin, or ciprofloxacin. Rifabutin is recommended for prophylaxis in patients with lymphocytes TCD4+ count below 100/mm3.

  13. Is Scale-Up of Community Mobilisation among Sex Workers Really Possible in Complex Urban Environments? The Case of Mumbai, India

    Science.gov (United States)

    Kongelf, Anine; Bandewar, Sunita V. S.; Bharat, Shalini; Collumbien, Martine

    2015-01-01

    Background In the last decade, community mobilisation (CM) interventions targeting female sex workers (FSWs) have been scaled-up in India’s national response to the HIV epidemic. This included the Bill and Melinda Gates Foundation’s Avahan programme which adopted a business approach to plan and manage implementation at scale. With the focus of evaluation efforts on measuring effectiveness and health impacts there has been little analysis thus far of the interaction of the CM interventions with the sex work industry in complex urban environments. Methods and Findings Between March and July 2012 semi-structured, in-depth interviews and focus group discussions were conducted with 63 HIV intervention implementers, to explore challenges of HIV prevention among FSWs in Mumbai. A thematic analysis identified contextual factors that impact CM implementation. Large-scale interventions are not only impacted by, but were shown to shape the dynamic social context. Registration practices and programme monitoring were experienced as stigmatising, reflected in shifting client preferences towards women not disclosing as ‘sex workers’. This combined with urban redevelopment and gentrification of traditional red light areas, forcing dispersal and more ‘hidden’ ways of solicitation, further challenging outreach and collectivisation. Participants reported that brothel owners and ‘pimps’ continued to restrict access to sex workers and the heterogeneous ‘community’ of FSWs remains fragmented with high levels of mobility. Stakeholder engagement was poor and mobilising around HIV prevention not compelling. Interventions largely failed to respond to community needs as strong target-orientation skewed activities towards those most easily measured and reported. Conclusion Large-scale interventions have been impacted by and contributed to an increasingly complex sex work environment in Mumbai, challenging outreach and mobilisation efforts. Sex workers remain a vulnerable

  14. Validation of sensitivity and reliability of GPR and microgravity detection of underground cavities in complex urban settings: Test case of a cellar

    Science.gov (United States)

    Chromčák, Jakub; Grinč, Michal; Pánisová, Jaroslava; Vajda, Peter; Kubová, Anna

    2016-03-01

    We test here the feasibility of ground-penetrating radar (GPR) and microgravity methods in identifying underground voids, such as cellars, tunnels, abandoned mine-workings, etc., in complex urban conditions. For this purpose, we selected a cellar located under a private lot in a residential quarter of the town of Senec in Western Slovakia, which was discovered by chance when a small sinkhole developed on the yard just two meters away from the house. The size of our survey area was limited 1) by the presence of a technical room built at the back of the yard with a staircase leading to the garden, and 2) by the small width of the lot. Therefore the geophysical survey was carried out only in the backyard of the lot as we were not permitted to measure on neighbouring estates. The results from the GPR measurements obtained by the GSSI SIR-3000 system with 400 MHz antenna were visualized in the form of 2D radargrams with the corresponding transformed velocity model of studied cross-sections. Only the profiles running over the pavement next to the house yielded interpretable data because the local geological situation and the regular watering of the lawn covering prevailingly the backyard caused significant attenuation of the emitted GPR signal. The Bouguer gravity map is dominated by a distinctive negative anomaly indicating the presence of a shallow underground void. The quantitative interpretation by means of Euler deconvolution was utilized to validate the depth of the center and location of the cellar. Comparison with the gravitational effect of the cellar model calculated in the in-house program Polygrav shows a quite good correlation between the modelled and observed fields. Only a part of the aerial extent of the anomaly could be traced by the used geophysical methods due to accessibility issues. Nevertheless, the test cellar was successfully detected and interpreted by both methods, thus confirming their applicability in similar environmental and geotechnical

  15. Impacts of population structure and analytical models in genome-wide association studies of complex traits in forest trees: a case study in Eucalyptus globulus.

    Directory of Open Access Journals (Sweden)

    Eduardo P Cappa

    Full Text Available The promise of association genetics to identify genes or genomic regions controlling complex traits has generated a flurry of interest. Such phenotype-genotype associations could be useful to accelerate tree breeding cycles, increase precision and selection intensity for late expressing, low heritability traits. However, the prospects of association genetics in highly heterozygous undomesticated forest trees can be severely impacted by the presence of cryptic population and pedigree structure. To investigate how to better account for this, we compared the GLM and five combinations of the Unified Mixed Model ( UMM on data of a low-density genome-wide association study for growth and wood property traits carried out in a Eucalyptus globulus population (n = 303 with 7,680 Diversity Array Technology (DArT markers. Model comparisons were based on the degree of deviation from the uniform distribution and estimates of the mean square differences between the observed and expected p-values of all significant marker-trait associations detected. Our analysis revealed the presence of population and family structure. There was not a single best model for all traits. Striking differences in detection power and accuracy were observed among the different models especially when population structure was not accounted for. The UMM method was the best and produced superior results when compared to GLM for all traits. Following stringent correction for false discoveries, 18 marker-trait associations were detected, 16 for tree diameter growth and two for lignin monomer composition (S:G ratio, a key wood property trait. The two DArT markers associated with S:G ratio on chromosome 10, physically map within 1 Mbp of the ferulate 5-hydroxylase (F5H gene, providing a putative independent validation of this marker-trait association. This study details the merit of collectively integrate population structure and relatedness in association analyses in undomesticated, highly

  16. Construction of a general library for the rational design of nanomagnets and spin qubits based on mononuclear f-block complexes. The polyoxometalate case.

    Science.gov (United States)

    Baldoví, José J; Clemente-Juan, Juan M; Coronado, Eugenio; Duan, Yan; Gaita-Ariño, Alejandro; Giménez-Saiz, Carlos

    2014-09-15

    This paper belongs to a series of contributions aiming at establishing a general library that helps in the description of the crystal field (CF) effect of any ligand on the splitting of the J ground states of mononuclear f-element complexes. Here, the effective parameters associated with the oxo ligands (effective charges and metal-ligand distances) are extracted from the study of the magnetic properties of the first two families of single-ion magnets based on lanthanoid polyoxometalates (POMs), formulated as [Ln(W5O18)2](9-) and [Ln(β2-SiW11O39)2](13-) (Ln = Tb, Dy, Ho, Er, Tm, Yb). This effective CF approach provides a good description of the lowest-lying magnetic levels and the associated wave functions of the studied systems, which is fully consistent with the observed magnetic behavior. In order to demonstrate the predictive character of this model, we have extended our model in a first step to calculate the properties of the POM complexes of the early 4f-block metals. In doing so, [Nd(W5O18)2](9-) has been identified as a suitable candidate to exhibit SMM behavior. Magnetic experiments have confirmed such a prediction, demonstrating the usefulness of this strategy for the directed synthesis of new nanomagnets. Thus, with an effective barrier of 51.4 cm(-1) under an applied dc field of 1000 Oe, this is the second example of a Nd(3+)-based single-ion magnet. PMID:25156530

  17. Is scale-up of community mobilisation among sex workers really possible in complex urban environments? The case of Mumbai, India.

    Directory of Open Access Journals (Sweden)

    Anine Kongelf

    Full Text Available In the last decade, community mobilisation (CM interventions targeting female sex workers (FSWs have been scaled-up in India's national response to the HIV epidemic. This included the Bill and Melinda Gates Foundation's Avahan programme which adopted a business approach to plan and manage implementation at scale. With the focus of evaluation efforts on measuring effectiveness and health impacts there has been little analysis thus far of the interaction of the CM interventions with the sex work industry in complex urban environments.Between March and July 2012 semi-structured, in-depth interviews and focus group discussions were conducted with 63 HIV intervention implementers, to explore challenges of HIV prevention among FSWs in Mumbai. A thematic analysis identified contextual factors that impact CM implementation. Large-scale interventions are not only impacted by, but were shown to shape the dynamic social context. Registration practices and programme monitoring were experienced as stigmatising, reflected in shifting client preferences towards women not disclosing as 'sex workers'. This combined with urban redevelopment and gentrification of traditional red light areas, forcing dispersal and more 'hidden' ways of solicitation, further challenging outreach and collectivisation. Participants reported that brothel owners and 'pimps' continued to restrict access to sex workers and the heterogeneous 'community' of FSWs remains fragmented with high levels of mobility. Stakeholder engagement was poor and mobilising around HIV prevention not compelling. Interventions largely failed to respond to community needs as strong target-orientation skewed activities towards those most easily measured and reported.Large-scale interventions have been impacted by and contributed to an increasingly complex sex work environment in Mumbai, challenging outreach and mobilisation efforts. Sex workers remain a vulnerable and disempowered group needing continued support

  18. Complex-Valued Autoencoders

    CERN Document Server

    Baldi, Pierre; Lu, Zhiqin

    2011-01-01

    Autoencoders are unsupervised machine learning circuits whose learning goal is to minimize a distortion measure between inputs and outputs. Linear autoencoders can be defined over any field and only real-valued linear autoencoder have been studied so far. Here we study complex-valued linear autoencoders where the components of the training vectors and adjustable matrices are defined over the complex field with the $L_2$ norm. We provide simpler and more general proofs that unify the real-valued and complex-valued cases, showing that in both cases the landscape of the error function is invariant under certain groups of transformations. The landscape has no local minima, a family of global minima associated with Principal Component Analysis, and many families of saddle points associated with orthogonal projections onto sub-space spanned by sub-optimal subsets of eigenvectors of the covariance matrix. The theory yields several iterative, convergent, learning algorithms, a clear understanding of the generalizatio...

  19. Simplifying complexity

    NARCIS (Netherlands)

    Leemput, van de I.A.

    2016-01-01

    In this thesis I use mathematical models to explore the properties of complex systems ranging from microbial nitrogen pathways and coral reefs to the human state of mind. All are examples of complex systems, defined as systems composed of a number of interconnected parts, where the systemic behavior

  20. Percutaneous nephrolithotomy combined with auxiliary method in the treatment of 40 complex calculus of kidney cases%经皮肾镜结合辅助方法治疗复杂肾结石40例

    Institute of Scientific and Technical Information of China (English)

    蒋建武

    2016-01-01

    Objective To investigate clinical effect by percutaneous nephrolithotomy combined with auxiliary method in the treatment of complex calculus of kidney. Methods A total of 40 patients with complex calculus of kidney as study subjects received percutaneous nephrolithotomy combined with auxiliary methods for treatment. Their complete clearance rate and complications were observed. Results Among the 40 cases, 28 cases had single clearance, with single clearance rate as 70.0%, and 11 cases had secondary clearance, as their complete clearance rate was 97.5%. After treatment, complicated occurred in 13 cases, with incidence of complications as 32.5%. Conclusion Combination of percutaneous nephrolithotomy and auxiliary method provides good effect and high clearance rate in treating complex calculus of kidney. This method effectively relieve symptoms and reduce pain, along with highly medical significance, and it is worth clinical promotion.%目的:探究经皮肾镜结合辅助方法治疗复杂肾结石的临床效果。方法40例复杂肾结石患者作为观察对象,采用经皮肾镜结合辅助方法来进行治疗。观察患者结石完全清除率以及并发症情况。结果本组40例患者中,结石一次清除28例,一次清除率为70.0%,二次手术后结石清除11例,总结石清除率达97.5%;在治疗后,出现13例并发症,并发症发生率为32.5%。结论经皮肾镜结合辅助方法治疗复杂肾结石,效果较好,结石清除率较高,有效缓解患者的症状,减少痛苦,具有较高的医学意义,值得临床推广。

  1. Monitoring Cloud-prone Complex Landscapes At Multiple Spatial Scales Using Medium And High Resolution Optical Data: A Case Study In Central Africa

    Science.gov (United States)

    Basnet, Bikash

    Tracking land surface dynamics over cloud-prone areas with complex mountainous terrain and a landscape that is heterogeneous at a scale of approximately 10 m, is an important challenge in the remote sensing of tropical regions in developing nations, due to the small plot sizes. Persistent monitoring of natural resources in these regions at multiple spatial scales requires development of tools to identify emerging land cover transformation due to anthropogenic causes, such as agricultural expansion and climate change. Along with the cloud cover and obstructions by topographic distortions due to steep terrain, there are limitations to the accuracy of monitoring change using available historical satellite imagery, largely due to sparse data access and the lack of high quality ground truth for classifier training. One such complex region is the Lake Kivu region in Central Africa. This work addressed these problems to create an effective process for monitoring the Lake Kivu region located in Central Africa. The Lake Kivu region is a biodiversity hotspot with a complex and heterogeneous landscape and intensive agricultural development, where individual plot sizes are often at the scale of 10m. Procedures were developed that use optical data from satellite and aerial observations at multiple scales to tackle the monitoring challenges. First, a novel processing chain was developed to systematically monitor the spatio-temporal land cover dynamics of this region over the years 1988, 2001, and 2011 using Landsat data, complemented by ancillary data. Topographic compensation was performed on Landsat reflectances to avoid the strong illumination angle impacts and image compositing was used to compensate for frequent cloud cover and thus incomplete annual data availability in the archive. A systematic supervised classification, using the state-of-the-art machine learning classifier Random Forest, was applied to the composite Landsat imagery to obtain land cover thematic maps

  2. In search for instructional techniques to maximize the use of germane cognitive resources: A case of teaching complex tasks in physics

    Science.gov (United States)

    Sliva, Yekaterina

    The purpose of this study was to introduce an instructional technique for teaching complex tasks in physics, test its effectiveness and efficiency, and understand cognitive processes taking place in learners' minds while they are exposed to this technique. The study was based primarily on cognitive load theory (CLT). CLT determines the amount of total cognitive load imposed on a learner by a learning task as combined intrinsic (invested in comprehending task complexity) and extraneous (wasteful) cognitive load. Working memory resources associated with intrinsic cognitive load are defined as germane resources caused by element interactivity that lead to learning, in contrast to extraneous working memory resources that are devoted to dealing with extraneous cognitive load. However, the amount of learner's working memory resources actually devoted to a task depends on how well the learner is engaged in the learning environment. Since total cognitive load has to stay within limits of working memory capacity, both extraneous and intrinsic cognitive load need to be reduced. In order for effective learning to occur, the use of germane cognitive resources should be maximized. In this study, the use of germane resources was maximized for two experimental groups by providing a learning environment that combined problem-solving procedure with prompts to self-explain with and without completion problems. The study tested three hypotheses and answered two research questions. The first hypothesis predicting that experimental treatments would reduce total cognitive load was not supported. The second hypothesis predicting that experimental treatments would increase performance was supported for the self-explanation group only. The third hypothesis that tested efficiency measure as adopted from Paas and van Merrienboer (1993) was not supported. As for the research question of whether the quality of self-explanations would change with time for the two experimental conditions, it was

  3. Surgical Treatment of Diverticulitis: Hand-Assisted Laparoscopic Resection Is Predominantly Used for Complex Cases and Is Associated With Increased Postoperative Complications and Prolonged Hospitalization.

    Science.gov (United States)

    Miyagaki, Hiromichi; Rhee, Rebecca; Shantha Kumara, H M C; Yan, Xiaohong; Njoh, Linda; Cekic, Vesna; Whelan, Richard L

    2016-06-01

    Introduction Laparoscopic (LAP) colectomy is now the "gold" standard for diverticulitis; the role of hand-assisted LAP (HAL) and Open methods today is unclear. This study assessed the elective use of these methods for diverticulitis. Methods A retrospective review of demographic, comorbidity (Carlson Comorbidity Index [CCI]), resection type, and short-term outcomes was carried out. Results There were 125 (44.5%) LAP, 125 (44.5%) HAL, and 31 (11%) Open cases (overall N = 281). The mean age, body mass index, and percentage of high-risk patients (CCI score >2) of the HAL group were greater (P 2 was greater when compared with the LAP group (P bowel movement was not different; however, there was a stepwise increase in median length of stay (LOS; days) from the LAP (5 days) to HAL (6 days) to Open group (7 days) (P surgery utilization rate (89%). PMID:26611789

  4. Foreshocks and short-term hazard assessment of large earthquakes using complex networks: the case of the 2009 L'Aquila earthquake

    Science.gov (United States)

    Daskalaki, Eleni; Spiliotis, Konstantinos; Siettos, Constantinos; Minadakis, Georgios; Papadopoulos, Gerassimos A.

    2016-08-01

    The monitoring of statistical network properties could be useful for the short-term hazard assessment of the occurrence of mainshocks in the presence of foreshocks. Using successive connections between events acquired from the earthquake catalog of the Istituto Nazionale di Geofisica e Vulcanologia (INGV) for the case of the L'Aquila (Italy) mainshock (Mw = 6.3) of 6 April 2009, we provide evidence that network measures, both global (average clustering coefficient, small-world index) and local (betweenness centrality) ones, could potentially be exploited for forecasting purposes both in time and space. Our results reveal statistically significant increases in the topological measures and a nucleation of the betweenness centrality around the location of the epicenter about 2 months before the mainshock. The results of the analysis are robust even when considering either large or off-centered the main event space windows.

  5. Displaced/re-worked rhodolith deposits infilling parts of a complex Miocene multistorey submarine channel: A case history from the Sassari area (Sardinia, Italy)

    Science.gov (United States)

    Murru, Marco; Bassi, Davide; Simone, Lucia

    2015-08-01

    In the Sassari area (north-western Sardinia, Italy), the Miocene Porto Torres sub-basin sequences represent the complex multistorey mixed carbonate-siliciclastic submarine feature called the Sassari Channel. During the late Burdigalian-early Serravallian, repeated terrigenous supplies from uplifted Paleozoic crystalline substrata fed the Sassari Channel system by means of turbidity and locally hyper-concentrated turbidity flows. Shelfal areas were the source of terrigenous clasts, but open shelf rhodalgal/foramol carbonate areas were very productive and largely also contributed to the channel infilling. Re-worked sands and skeletal debris were discontinuously re-sedimented offshore as pure terrigenous, mixed and/or carbonate deposits. Major sediment supply was introduced between the latest Burdigalian and the start of the middle Langhian, during which a large amount of carbonate, mixed and siliciclastic sediments reached the Porto Torres Basin (Sassari Channel I). Contributions from shallow proximal source areas typify the lower intervals (Unit A) in marginal sectors of the channel. Upward, these evolve into autochthonous rhodolith deposits, winnowed by strong currents in relatively shallow well lit settings within a complex network of narrow tidally-controlled channels (Unit D) locally bearing coral assemblages. Conversely, re-sedimented rhodoliths from the Units B and C accumulated under conditions of higher turbidity. In deeper parts of the channel taxonomically diversified rhodoliths point to the mixing of re-deposited skeletal components from different relatively deep bathmetric settings. In the latest early Langhian, major re-sedimentation episodes, resulting in large prograding bodies (Unit D), triggered by repeated regression pulses in a frame of persistent still stand. During these episodes photophile assemblages dwelled in the elevated margin sectors of the channel. A significant latest early Langhian drop in relative sea-level resulted in impressive mass

  6. Petrogenesis of the Neoproterozoic Ngondo Plutonic complex (Cameroon, west central Africa): a case of late-collisional ferro-potassic magmatism

    Science.gov (United States)

    Tagne-Kamga, Gabriel

    2003-04-01

    The Ngondo complex is a late-collisional pluton, which was emplaced around 600 Ma along a N030° E strike-slip shear zone in the southwestern part of the Neoproterozoic Fold Belt of Cameroon. It comprises three successively emplaced plutonic groups of rocks: (i) mafic to felsic intrusive rocks (MFR), (ii) fine-grained granites (FGG) and (iii) coarse-grained granites (CGG). Late aplitic and pegmatite dykes were emplaced along brittle fractures in these plutons. The complex is metaluminous to weakly peraluminous, high-K, calc-alkaline to " trans-alkaline" ferro-potassic, with mineralogical and geochemical characteristic of I-type granites. The plutonic rocks are characterised by high Ba, Sr, Rb and ∑REE concentrations and low Ni and Cr contents in the mafic members. They also display chondrite-normalised REE patterns characterised by variable LREE enrichment, moderate to minor HREE fractionation with moderate to pronounced negative Eu anomalies (Eu/Eu∗: 0.6-0.9 (MFR), 0.2-0.5 (FGG), 0.3-0.7 (CGG)). Trace element distribution patterns for the three plutonic groups are similar with a distinctive depletion in Nb, Sr and Ti relative to other trace elements and a greater enrichment in LILE compared to HFSE. These plutonic groups present distinct evolutionary trends precluding their origin from differentiation of a single parental magma. The geochemical and isotopic data indicate that they derived from partial melting of heterogeneous (meta)-igneous mafic lower crustal materials, having possibly the composition of amphibolitised high-K calc-alkaline basaltic andesites and andesitic metagreywackes. Petrographic evidences such as the presence of quartz-ocelli, xenocrysts of feldspar, fragments of country rocks (migmatitic gneisses) strongly indicate that crustal contamination may have played an important role in the genesis of the plutonic rocks. This contamination process is further supported by the variation of major and trace elements together with Sr-Nd isotopic data

  7. P-T path and timing of crustal thickening during amalgamation of East and West Gondwana: A case study from the Hafafit Metamorphic Complex, Eastern Desert of Egypt

    Science.gov (United States)

    Abu El-Enen, Mahrous M.; Abu-Alam, Tamer S.; Whitehouse, Martin J.; Ali, Kamal A.; Okrusch, Martin

    2016-10-01

    The southeastern sector of the Hafafit Metamorphic Complex, southern Eastern Desert of Egypt comprises infrastructural orthogneisses of tonalite and syenogranite parentage, amphibolites, and a volcano-sedimentary association. These are overthrust by an obducted suprastructural ophiolite nappes via the Nugrus thrust. The protolith of the biotite-hornblende-gneisses was formed during island-arc accretion, while that of the garnet-biotite gneisses were formed in a within-plate regime, consistent with a transition to a post-collisional setting. The volcano-sedimentary association comprises interbedded and intercalated highly foliated metapelitic schists, metabasites, and leucocratic gneisses, deposited in a back-arc basin. The metapelites and the leucocratic gneisses originated from immature Fe-shales and arkoses derived from intermediate-mafic and acidic igneous rocks, respectively, via weak chemical weathering in a tectonically active island arc terrane. The intercalated amphibolites were derived from tholeiitic basalts generated in a back-arc setting. The volcano-sedimentary association was metamorphosed under upper-amphibolite facies conditions with pressures of 9-13 kbar and temperatures of 570-675 °C, as derived from conventional geothermobarometry and pseudosection calculation. A steep, tight clockwise P-T path is constrained and a geothermal gradient around 20 °C/km is estimated for the peak metamorphism. We assume that deformation and metamorphism are due to crustal thickening during the collision of East and West Gondwana, where peak metamorphism took place in the middle to lower crust at 33 km average crustal depth. This was followed by a subsequent quasi-isothermal decompression due to rapid exhumation during wrench tectonics. Sinistral transcurrent shearing with extensional denudation resulted in vertical ductile thinning that was accompanied by heat input from magmatism, as indicated by a higher geothermal gradient during retrograde metamorphism and

  8. Complex Strategic Choices

    DEFF Research Database (Denmark)

    Leleur, Steen

    . Complex Strategic Choices provides clear principles and methods which can guide and support strategic decision making to face the many current challenges. By considering ways in which planning practices can be renewed and exploring the possibilities for acquiring awareness and tools to add value...... and students in the field of planning and decision analysis as well as practitioners dealing with strategic analysis and decision making. More broadly, Complex Strategic Choices acts as guide for professionals and students involved in complex planning tasks across several fields such as business...... 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...

  9. Beyond complex Langevin equations

    CERN Document Server

    Wosiek, Jacek

    2016-01-01

    A simple integral relation between a complex weight and the corresponding positive distribution is derived by introducing a second complex variable. Together with the positivity and normalizability conditions, this sum rule allows to construct explicitly equivalent pairs of distributions in simple cases. In particular the well known solution for a complex gaussian distribution is generalized to an arbitrary complex slope. This opens a possibility of positive representation of Feynman path integrals directly in the Minkowski time. Such construction is then explicitly carried through in the second part of this presentation. The continuum limit of the new representation exists only if some of the additional couplings tend to infinity and are tuned in a specific way. The approach is then successfully applied to three quantum mechanical examples including a particle in a constant magnetic field -- a simplest prototype of a Wilson line. Further generalizations are shortly discussed and an amusing interpretation of ...

  10. Applicability of major histocompatibility complex DRB1 alleles as markers to detect vertebrate hybridization: a case study from Iberian ibex × domestic goat in southern Spain

    Directory of Open Access Journals (Sweden)

    Alasaad Samer

    2012-09-01

    Full Text Available Abstract Background Hybridization between closely related wild and domestic species is of great concern because it can alter the evolutionary integrity of the affected populations. The high allelic variability of Major Histocompatibility Complex (MHC loci usually excludes them from being used in studies to detect hybridization events. However, if a the parental species don’t share alleles, and b one of the parental species possesses an exceptionally low number of alleles (to facilitate analysis, then even MHC loci have the potential to detect hybrids. Results By genotyping the exon2 of the MHC class II DRB1 locus, we were able to detect hybridization between domestic goats (Capra hircus and free-ranging Iberian ibex (Capra pyrenaica hispanica by molecular means. Conclusions This is the first documentation of a Capra pyrenaica × Capra hircus hybridization, which presented us the opportunity to test the applicability of MHC loci as new, simple, cost-effective, and time-saving approach to detect hybridization between wild species and their domesticated relatives, thus adding value to MHC genes role in animal conservation and management.

  11. Metal complexes of a pentadentate N2O3bis(semicarbazone) Schiff-base. A case study of structure-spectroscopy correlation

    Science.gov (United States)

    Inoue, Mayara Hissami; Ribeiro, Ronny Rocha; Sabino, José Ricardo; Nunes, Fábio Souza

    2016-07-01

    Schiff condensation of 2,6-diformyl 4-methylphenol with semicarbazide hydrochloride in 1:2 molar ratio produces the bis(semicarbazone) ligand, herein called H3L. A comprehensive spectroscopic analysis of the compound was performed by 1H and 13C NMR, FTIR and electronic spectroscopies. Assignments to the UV-vis spectrum of H3L were supported by semi-empirical quantum mechanics ZINDO/S calculations. The ligand H3L forms monoclinic crystals in the space group P21/c and its structure is stabilized by classic hydrogen bonds with propanone molecules. It promptly reacts with first row metal ions to produce the following coordination compounds: [Co2(L)(μ-NO3)]·DMF, [Ni2(H2L)(μ-CH3COO)(CH3COO)2]·2H2O, [Cu2(L)(μ-NO3)(H2O)2]·H2O, [Cu2(L)(μ-CH3COO)(H2O)2]·H2O and [Cu2(H2L)(μ-Cl)Cl2]·3H2O, that have different compositions, depending on the degree of deprotonation of the ligand upon coordination. Electronic and EPR spectroscopies as well as effective magnetic moment measurements of the complexes were used in an attempt to better understand their mode of coordination, the microsymmetry around the metal ions and magnetic properties.

  12. Joint impact of rainfall and tidal level on flood risk in a coastal city with a complex river network: a case study of Fuzhou City, China

    Directory of Open Access Journals (Sweden)

    J. J. Lian

    2013-02-01

    Full Text Available Coastal cities are particularly vulnerable to flood under multivariable conditions, such as heavy precipitation, high sea levels, and storms. The combined effect of multiple sources and the joint probability of extremes should be considered to assess and manage flood risk better. This paper aims to study the combined effect of rainfall and the tidal level of the receiving water body on flood probability and severity in Fuzhou City, which has a complex river network. Flood severity under a range of precipitation intensities, with return periods (RPs of 5 yr to 100 yr, and tidal levels was assessed through a hydrodynamic model verified by data observed during Typhoon Longwang in 2005. According to the percentages of the river network where flooding occurred, the threshold conditions for flood severity were estimated in two scenarios: with and without working pumps. In Fuzhou City, working pumps efficiently reduce flood risk from precipitation within a 20-yr RP. However, the pumps may not work efficiently when rainfall exceeds a 100-yr RP because of the limited conveyance capacity of the river network. Joint risk probability was estimated through the optimal copula. The joint probability of rainfall and tidal level both exceeding their threshold values is very low, and the greatest threat in Fuzhou comes from heavy rainfall. However, the tidal level poses an extra risk of flood. Given that this extra risk is ignored in the design of flood defense in Fuzhou, flood frequency and severity may be higher than understood during design.

  13. Managing Complexity

    DEFF Research Database (Denmark)

    Maylath, Bruce; Vandepitte, Sonia; Minacori, Patricia;

    2013-01-01

    and into French. The complexity of the undertaking proved to be a central element in the students' learning, as the collaboration closely resembles the complexity of international documentation workplaces of language service providers. © Association of Teachers of Technical Writing.......This article discusses the largest and most complex international learning-by-doing project to date- a project involving translation from Danish and Dutch into English and editing into American English alongside a project involving writing, usability testing, and translation from English into Dutch...

  14. Complex variables

    CERN Document Server

    Fisher, Stephen D

    1999-01-01

    The most important topics in the theory and application of complex variables receive a thorough, coherent treatment in this introductory text. Intended for undergraduates or graduate students in science, mathematics, and engineering, this volume features hundreds of solved examples, exercises, and applications designed to foster a complete understanding of complex variables as well as an appreciation of their mathematical beauty and elegance. Prerequisites are minimal; a three-semester course in calculus will suffice to prepare students for discussions of these topics: the complex plane, basic

  15. 'Pseudofailure' of spinal cord stimulation for neuropathic pain following a new severe noxious stimulus: learning points from a case series of failed spinal cord stimulation for complex regional pain syndrome and failed back surgery syndrome.

    Science.gov (United States)

    Muquit, Samiul; Moussa, Ahmad Abdelhai; Basu, Surajit

    2016-05-01

    Failure of spinal cord stimulation (SCS) may be due to hardware problems, migration of electrodes and, in the long-term, plasticity in the spinal cord with habituation to the stimulation current. We describe a series of seven patients who experienced acute therapeutic loss of SCS effects following an acute nociceptive event unrelated to primary pathology. There were no hardware problems. We called this 'Pseudofailure', as the effective stimulation returned in all patients following a period off stimulation or reprogramming. This phenomenon has not been reported previously in the literature. Over a 4-year period, we managed seven patients with this feature: four had received SCS for complex regional pain syndrome and three for failed back surgery syndrome. In all seven cases, there was cessation of the pain relief afforded by SCS following an acute painful event: four patients had trauma, two patients had domestic electric shock and one patient suffered shingles (varicella zoster infection). We excluded hardware-related problems in all cases. In two patients, SCS effects could be regained by an initial attempt at reprogramming. In the remaining five cases reprogramming was unsuccessful, and stimulation was switched off for several months before recommencing, when we discovered a return of good therapeutic effect. We conclude that SCS may seem to fail following a separate strong nociceptive stimulus. Stimulation may be regained with reprogramming or following a period with stimulation switched off. We would, therefore, advise against removal of SCS hardware in the first instance. PMID:27551417

  16. Spinal cord stimulation for complex regional pain syndrome type 1 with dystonia: a case report and discussion of the literature [v1; ref status: indexed, http://f1000r.es/348

    Directory of Open Access Journals (Sweden)

    Caroline Voet

    2014-04-01

    Full Text Available Background: Complex Regional Pain Syndrome type 1 (CRPS-1 is a debilitating chronic pain disorder, the physiopathology of which can lead to dystonia associated with changes in the autonomic, central and peripheral nervous system. An interdisciplinary approach (pharmacological, interventional and psychological therapies in conjunction with a rehabilitation pathway is central to progress towards pain reduction and restoration of function. Aim: This case report aims to stimulate reflection and development of mechanism-based therapeutic strategies concerning CRPS associated with dystonia. Case description: A 31 year old female CRPS-1 patient presented with dystonia of the right foot following ligamentoplasty for chronic ankle instability. She did not have a satisfactory response to the usual therapies. Multiple anesthetic blocks (popliteal, epidural and intrathecal were not associated with significant anesthesia and analgesia. Mobilization of the foot by a physiotherapist was not possible. A multidisciplinary approach with psychological support, physiotherapy and spinal cord stimulation (SCS brought pain relief, rehabilitation and improvement in the quality of life. Conclusion: The present case report demonstrates the occurrence of multilevel (peripheral and central pathological modifications in the nervous system of a CRPS-1 patient with dystonia. This conclusion is based on the patient’s pain being resistant to anesthetic blocks at different levels and the favourable, at least initially, response to SCS. The importance of the bio-psycho-social model is also suggested, permitting behavioural change.

  17. Magma mixing, crustal contamination, contamination before chemical analysis or complex history? The case study from the Wołek Hill, SW Poland

    Science.gov (United States)

    Nowak, Monika

    2015-04-01

    Wołek Hill is one of the smallest exposures from ca. 300 occurrences of Cenozoic volcanic rocks from SW Poland. The outcrop is located about 100 km SW from Wrocław and belongs to the Złotoryja Volcanic Field, which is one of the largest volcanic fields in the Polish part of the Central European Volcanic Province (Ladenberger et al. 2006). The volcanic body, which is about 20 m wide, cross-cuts older Permian volcanic rocks (trachyandesites and rhyolites) and is well exposed in an old abandoned quarry. The occurrence was studied in detail because of great amount of mantle and crustal xenoliths brought to the surface by magma. Wołek Hill is one of the two occurrences in SW Poland where amphibole crystals were recognized as results of modal metasomatism in lithospheric mantle (Nowak et al. 2012). The volcanic rock from Wołek Hill represents complex history, difficult to explain by simple model. The rock was classified as basanite (Nowak, 2012). Its texture is porphyritic to glomeroporphyritic, olivine (Ol) and clinopyroxene (Cpx) occurs as phenocrysts, Cpx is also the dominant phase in the groundmass. Wołek Hill basanite differs from other exposures in Złotoryja Volcanic Field by presence of xenocrysts of Ol and Cpx from mantle rocks and also quartz (Qrtz) and feldspars (Feld) xenocrysts from crustal rocks. Those xenocrysts with additional carbonate veins, probably related with post-volcanic processes, were a great difficulty during rock preparation for whole-rock and isotopic analyses. The complex history of Wołek Hill basanite is visible in its chemical content (slight increase of SiO2, positive Pb anomaly, 87Sr/86Sr and 143Nd/144Nd values), but also in its petrography (e.g. by three types of olivine phenocrysts Fo82-91 with differences in zonation patterns reflecting Fo content; the most abundant are phenocrysts with normal zoning, but also crystals with opposite zoning and oscillatory zoning were recognised). According to available data from the basanite

  18. Complex Covariance

    Directory of Open Access Journals (Sweden)

    Frieder Kleefeld

    2013-01-01

    Full Text Available According to some generalized correspondence principle the classical limit of a non-Hermitian quantum theory describing quantum degrees of freedom is expected to be the well known classical mechanics of classical degrees of freedom in the complex phase space, i.e., some phase space spanned by complex-valued space and momentum coordinates. As special relativity was developed by Einstein merely for real-valued space-time and four-momentum, we will try to understand how special relativity and covariance can be extended to complex-valued space-time and four-momentum. Our considerations will lead us not only to some unconventional derivation of Lorentz transformations for complex-valued velocities, but also to the non-Hermitian Klein-Gordon and Dirac equations, which are to lay the foundations of a non-Hermitian quantum theory.

  19. Isotopic and hydrogeochemical characterization of high-altitude karst aquifers in complex geological settings. The Ordesa and Monte Perdido National Park (Northern Spain) case study

    Energy Technology Data Exchange (ETDEWEB)

    Lambán, L.J., E-mail: javier.lamban@igme.es [Geological Survey of Spain (IGME) (Spain); Jódar, J., E-mail: jorge.jodar@upc.edu [Department of Geotechnical Engineering and Geosciences, Technical University of Catalonia (UPC), Barcelona (Spain); Custodio, E., E-mail: emilio.custodio@upc.edu [Department of Geotechnical Engineering and Geosciences, Technical University of Catalonia (UPC), Barcelona (Spain); Soler, A., E-mail: albertsoler@ub.edu [Grup de Mineralogia Aplicada i Medi Ambient, Departament Cristal lografia Mineralogia i Dipòsits Minerals, Facultat de Geologia, Universitat de Barcelona (UB) (Spain); Sapriza, G., E-mail: g.sapriza@usask.ca [Global Institute for Water Security, National Hydrology Research Centre (Canada); Soto, R., E-mail: r.soto@igme.es [Geological Survey of Spain (IGME) (Spain)

    2015-02-15

    The Ordesa and Monte Perdido National Park, located in the Southern Pyrenees, constitutes the highest karst system in Western Europe. No previous studies regarding its geochemical and isotopic groundwater characterization are available in this area. This work presents the results of field and sampling campaigns carried out between July 2007 and September 2013. The groundwater presents high calcium bicarbonate contents due to the occurrence of upper Cretaceous and lower Paleocene–Eocene carbonate materials in the studied area. Other relevant processes include dissolution of anhydrite and/or gypsum and incongruent dissolution of Mg-limestone and dolomite. The water stable isotopes (δ{sup 18}O, δ{sup 2}H) show that the oceanic fronts from the Atlantic Ocean are responsible for the high levels of precipitation. In autumn, winter, and spring, a deuterium excess is found in the recharge water, which could be related to local atmospheric transport of low-altitude snow sublimation vapour and its later condensation on the snow surface at higher altitude, where recharge is mostly produced. The recharge zones are mainly between 2500 m and 3200 m a.s.l. The tritium content of the water suggests short groundwater transit times. The isotopic composition of dissolved sulphate points to the existence of regional fluxes mixed with local discharge in some of the springs. This work highlights the major role played by the altitude difference between the recharge and discharge zones in controlling the chemistry and the vertical variability of the isotopic composition in high-altitude karst aquifers. - Highlights: • Environmental tracers are essential to study complex alpine karst aquifers. • The long presence of snow controls the deuterium excess in groundwater. • Seasonal δD content in springs depends on gap between recharge and discharge points. • The first hydrogeological characterization of the Ordesa National Park is presented. • Sulphate content in springs comes

  20. Isotopic and hydrogeochemical characterization of high-altitude karst aquifers in complex geological settings. The Ordesa and Monte Perdido National Park (Northern Spain) case study

    International Nuclear Information System (INIS)

    The Ordesa and Monte Perdido National Park, located in the Southern Pyrenees, constitutes the highest karst system in Western Europe. No previous studies regarding its geochemical and isotopic groundwater characterization are available in this area. This work presents the results of field and sampling campaigns carried out between July 2007 and September 2013. The groundwater presents high calcium bicarbonate contents due to the occurrence of upper Cretaceous and lower Paleocene–Eocene carbonate materials in the studied area. Other relevant processes include dissolution of anhydrite and/or gypsum and incongruent dissolution of Mg-limestone and dolomite. The water stable isotopes (δ18O, δ2H) show that the oceanic fronts from the Atlantic Ocean are responsible for the high levels of precipitation. In autumn, winter, and spring, a deuterium excess is found in the recharge water, which could be related to local atmospheric transport of low-altitude snow sublimation vapour and its later condensation on the snow surface at higher altitude, where recharge is mostly produced. The recharge zones are mainly between 2500 m and 3200 m a.s.l. The tritium content of the water suggests short groundwater transit times. The isotopic composition of dissolved sulphate points to the existence of regional fluxes mixed with local discharge in some of the springs. This work highlights the major role played by the altitude difference between the recharge and discharge zones in controlling the chemistry and the vertical variability of the isotopic composition in high-altitude karst aquifers. - Highlights: • Environmental tracers are essential to study complex alpine karst aquifers. • The long presence of snow controls the deuterium excess in groundwater. • Seasonal δD content in springs depends on gap between recharge and discharge points. • The first hydrogeological characterization of the Ordesa National Park is presented. • Sulphate content in springs comes from material

  1. Genetic Sensitivity to the Environment: The Case of the Serotonin Transporter Gene and Its Implications for Studying Complex Diseases and Traits

    Science.gov (United States)

    Caspi, Avshalom; Hariri, Ahmad R.; Holmes, Andrew; Uher, Rudolf; Moffitt, Terrie E.

    2010-01-01

    Evidence of marked variability in response among people exposed to the same environmental risk implies that individual differences in genetic susceptibility might be at work. The study of such Gene-by-Environment (G×E) interactions has gained momentum. In this article, the authors review research about one of the most extensive areas of inquiry: variation in the promoter region of the serotonin transporter gene (SLC6A4; also known as 5-HTT) and its contribution to stress sensitivity. Research in this area has both advanced basic science and generated broader lessons for studying complex diseases and traits. The authors evaluate four lines of evidence about the 5-HTT stress-sensitivity hypothesis: 1) observational studies about the serotonin transporter linked polymorphic region (5-HTTLPR), stress sensitivity, and depression in humans; 2) experimental neuroscience studies about the 5-HTTLPR and biological phenotypes relevant to the human stress response; 3) studies of 5-HTT variation and stress sensitivity in nonhuman primates; and 4) studies of stress sensitivity and genetically engineered 5-HTT mutations in rodents. The authors then dispel some misconceptions and offer recommendations for G×E research. The authors discuss how G×E interaction hypotheses can be tested with large and small samples, how G×E research can be carried out before as well as after replicated gene discovery, the uses of G×E research as a tool for gene discovery, the importance of construct validation in evaluating G×E research, and the contribution of G×E research to the public understanding of genetic science. PMID:20231323

  2. Reconstrucción del complejo areola-pezón: revisión de 60 casos Nipple-areola complex reconstruction: revision of 60 cases

    Directory of Open Access Journals (Sweden)

    R. Fernández García

    2007-06-01

    hay ninguna cuyos resultados se sobrepongan a las demás, pero sí una vez que se reconstruye la areola siendo la técnica que más satisface la del injerto inguinal. A pesar de ello, el aspecto más notable a mejorar está en la reconstrucción del pezón, dada la frecuente disconformidad de las pacientes con la proyección conseguida a lo largo del tiempo por la posible reabsorción del mismo.The creation of the nipple-areola complex is the latest time in breast reconstruction, transforming the reconstruction of the breast mound into a real breast. We have to consider the reconstruction of the areola and the nipple as the culmination of breast reconstruction. There are a lot of documented techniques for nipple-areola complex reconstruction. The aim of this study is to determine the grade of psychological satisfaction of patients after this reconstruction This study was designed as a retrospective clinic review of 60 patients. After reviewing medical histories, the patients were interviewed and asked to complete a questionnaire. The most common desired aspect was to correct the absence/lost of nipple projection. However, 22% of patients answered they would not change anything regarding their reconstruction. The satisfaction with the mammary mound was excellent or good for 68%, normal for 23 % and poor for 9 %. On the other hand, satisfaction for the nippleareola complex reconstruction was excellent or good for 50%, normal for 45% and poor for 5%. There were no statistical differences among the different techniques depending on the time between the mastectomy intervention and the third reconstruction (p=0,06. For nipple reconstruction, the contralateral nipple donation technique offered more satisfaction (2.67 points and projection (7.23 points. In spite of the differences in their means, there were no statistically significant differences. Taking into account the technique used for the areola reconstruction, the donation-graft of inguinal skin was the one that

  3. Simplifying complexity

    OpenAIRE

    Leemput, van de, J.C.H.

    2016-01-01

    In this thesis I use mathematical models to explore the properties of complex systems ranging from microbial nitrogen pathways and coral reefs to the human state of mind. All are examples of complex systems, defined as systems composed of a number of interconnected parts, where the systemic behavior leads to the emergence of properties that would not be expected from behavior or properties of the individual parts of the system. Although the full behavior of the systems I address will probably...

  4. The political economy of corporate social responsibility and community development: a case study of Norway's Snoehvit natural gas complex

    Energy Technology Data Exchange (ETDEWEB)

    Klick, Matthew T.

    2009-07-01

    This project uses stakeholder evidence from semi-structured interviews to analyze the relative effectiveness of an oil company's stated 'corporate social responsibility' (CSR) initiatives in a new, Arctic host community. Specifically, this project analyzes the outcomes of StatoilHydro initiatives to date in Hammerfest, Norway, where the Snoehvit (Snow White) natural gas project began production in 2007. It gauges the ability of 'socially responsible' approaches to development to internalize negative externalisation and promote positive 'spin-offs'. Arctic countries are increasingly prioritizing petroleum development. The convergence of dramatic climate change, increasing energy demands, and high energy prices has made the Arctic an alluring frontier for the oil industry and Arctic governments. Small Arctic communities are increasingly playing host to large energy projects with the potential for dramatic cultural, social, environmental, and economic upheaval, but also economic growth and increased human capital. In this case study, CSR initiatives resulted in a broader accounting of social costs and benefits, an outcome that better internalized externalities, and pareto-improving trades between stakeholders and industry. (Author). 87 refs., 5 figs., 5 tabs

  5. X-ray Damage to the Mn4Ca Complex in Single Crystals ofPhotosystem II: A Case Study for Metalloprotein Crystallography

    Energy Technology Data Exchange (ETDEWEB)

    Yano, Junko; Kern, Jan; Irrgang, Klaus-Dieter; Latimer, Matthew; Bergmann, Uwe; Glatzel, Pieter; Pushkar, Yulia; Biesiadka, Jacek; Loll,Bernhard; Sauer, Kenneth; Messinger, Johannes; Zouni, Athina; Yachandra,Vittal K.

    2005-06-21

    X-ray absorption spectroscopy was used to measure the damage caused by exposure to X-rays to the Mn4Ca active site in single crystals of photosystem II, as a function of dose and energy of X-rays, temperature, and time. These studies reveal that the conditions used for structure determination by X-ray crystallography cause serious damage specifically to the metal-site structure. The X-ray absorption spectra show that the structure changes from one that is characteristic of a high-valent Mn4(III2,IV2) oxo-bridged Mn4Ca cluster, to that of Mn(II) in aqueous solution. This damage to the metal site occurs at a dose that is more than an order of magnitude lower than that resulting in loss of diffractivity, and commonly considered safe for protein crystallography. These results establish the first quantitative X-ray dose parameters applicable to redox-active metallo-proteins. This case study shows that a careful evaluation of the structural intactness of the active sites by spectroscopic techniques can validate structures derived from crystallography, and it can be a valuable complementary method before structure-function correlations of metallo-proteins can be made on the basis of high resolution X-ray crystal structures.

  6. X-ray damage to the Mn4Ca complex in single crystals of photosystem II: a case study for metalloprotein crystallography.

    Science.gov (United States)

    Yano, Junko; Kern, Jan; Irrgang, Klaus-Dieter; Latimer, Matthew J; Bergmann, Uwe; Glatzel, Pieter; Pushkar, Yulia; Biesiadka, Jacek; Loll, Bernhard; Sauer, Kenneth; Messinger, Johannes; Zouni, Athina; Yachandra, Vittal K

    2005-08-23

    X-ray absorption spectroscopy was used to measure the damage caused by exposure to x-rays to the Mn(4)Ca active site in single crystals of photosystem II as a function of dose and energy of x-rays, temperature, and time. These studies reveal that the conditions used for structure determination by x-ray crystallography cause serious damage specifically to the metal-site structure. The x-ray absorption spectra show that the structure changes from one that is characteristic of a high-valent Mn(4)(III(2),IV(2)) oxo-bridged Mn(4)Ca cluster to that of Mn(II) in aqueous solution. This damage to the metal site occurs at a dose that is more than one order of magnitude lower than the dose that results in loss of diffractivity and is commonly considered safe for protein crystallography. These results establish quantitative x-ray dose parameters that are applicable to redox-active metalloproteins. This case study shows that a careful evaluation of the structural intactness of the active site(s) by spectroscopic techniques can validate structures derived from crystallography and that it can be a valuable complementary method before structure-function correlations of metalloproteins can be made on the basis of high-resolution x-ray crystal structures.

  7. Progress in Computational Complexity Theory

    Institute of Scientific and Technical Information of China (English)

    Jin-Yi Cai; Hong Zhu

    2005-01-01

    We briefly survey a number of important recent achievements in Theoretical Computer Science (TCS), especially Computational Complexity Theory. We will discuss the PCP Theorem, its implications to inapproximability on combinatorial optimization problems; space bounded computations, especially deterministic logspace algorithm for undirected graph connectivity problem; deterministic polynomial-time primality test; lattice complexity, worst-case to average-case reductions;pseudorandomness and extractor constructions; and Valiant's new theory of holographic algorithms and reductions.

  8. Metal nanostructures with complex surface morphology: The case of supported lumpy Pd and Pt nanoparticles produced by laser processing of metal films

    Science.gov (United States)

    Ruffino, F.; Maugeri, P.; Cacciato, G.; Zimbone, M.; Grimaldi, M. G.

    2016-09-01

    In this work we report on the formation of lumpy Pd and Pt nanoparticles on fluorine-doped tin oxide/glass (FTO/glass) substrate by a laser-based approach. In general, complex-surface morphology metal nanoparticles can be used in several technological applications exploiting the peculiarities of their physical properties as modulated by nanoscale morphology. For example plasmonic metal nanoparticles presenting a lumpy morphology (i.e. larger particles coated on the surface by smaller particles) can be used in plasmonic solar cell devices providing broadband scattering enhancement over the smooth nanoparticles leading, so, to the increase of the device efficiency. However, the use of plasmonic lumpy nanoparticles remains largely unexplored due to the lack of simply, versatile, low-cost and high-throughput methods for the controllable production of such nanostructures. Starting from these considerations, we report on the observation that nanoscale-thick Pd and Pt films (17.6 and 27.9 nm, 12.1 and 19.5 nm, respectively) deposited on FTO/glass surface irradiated by nanosecond pulsed laser at fluences E in the 0.5-1.5 J/cm2 range, produce Pd and Pt lumpy nanoparticles on the FTO surface. In addition, using scanning electron microscopy analyses, we report on the observation that starting from each metal film of fixed thickness h, the fraction F of lumpy nanoparticles increases with the laser fluence E and saturates at the higher fluences. For each fixed fluence, F was found higher starting from the Pt films (at each starting film thickness h) with respect to the Pd films. For each fixed metal and fluence, F was found to be higher decreasing the starting thickness of the deposited film. To explain the formation of the lumpy Pd and Pt nanoparticles and the behavior of F as a function of E and h both for Pd and Pt, the thermodynamic behavior of the Pd and Pt films and nanoparticles due to the interaction with the nanosecond laser is discussed. In particular, the

  9. Climate change and viticulture in Mediterranean climates: the complex response of socio-ecosystems. A comparative case study from France and Australia (1955-2040)

    Science.gov (United States)

    Lereboullet, A.-L.; Beltrando, G.; Bardsley, D. K.

    2012-04-01

    The wine industry is very sensitive to extreme weather events, especially to temperatures above 35°C and drought. In a context of global climate change, Mediterranean climate regions are predicted to experience higher variability in rainfall and temperatures and an increased occurrence of extreme weather events. Some viticultural systems could be particularly at risk in those regions, considering their marginal position in the growth climatic range of Vitis vinifera, the long commercial lifespan of a vineyard, the high added-value of wine and the volatile nature of global markets. The wine industry, like other agricultural systems, is inserted in complex networks of climatic and non-climatic (other physical, economical, social and legislative) components, with constant feedbacks. We use a socio-ecosystem approach to analyse the adaptation of two Mediterranean viticultural systems to recent and future increase of extreme weather events. The present analysis focuses on two wine regions with a hot-summer Mediterranean climate (CSb type in the Köppen classification): Côtes-du-Roussillon in southern France and McLaren Vale in southern Australia. Using climate data from two synoptic weather stations, Perpignan (France) and Adelaide (Australia), with time series running from 1955 to 2010, we highlight changes in rainfall patterns and an increase in the number of days with Tx >35°c since the last three decades in both regions. Climate models (DRIAS project data for France and CSIRO Mk3.5 for Australia) project similar trends in the future. To date, very few projects have focused on an international comparison of the adaptive capacity of viticultural systems to climate change with a holistic approach. Here, the analysis of climate data was complemented by twenty in-depth semi-structured interviews with key actors of the two regional wine industries, in order to analyse adaptation strategies put in place regarding recent climate evolution. This mixed-methods approach

  10. Statistical Complexity in Traveling Densities

    OpenAIRE

    Lopez-Ruiz, Ricardo; Sanudo, Jaime

    2009-01-01

    In this work, we analyze the behavior of statistical complexity in several systems where two identical densities that travel in opposite direction cross each other. The crossing between two Gaussian, rectangular and triangular densities is studied in detail. For these three cases, the shape of the total density presenting an extreme value in complexity is found.

  11. Complex networks: Patterns of complexity

    Science.gov (United States)

    Pastor-Satorras, Romualdo; Vespignani, Alessandro

    2010-07-01

    The Turing mechanism provides a paradigm for the spontaneous generation of patterns in reaction-diffusion systems. A framework that describes Turing-pattern formation in the context of complex networks should provide a new basis for studying the phenomenon.

  12. Dynamics and chemistry of Venus' large and complex cloud system : a science case for an in-situ long-term chemical laboratory

    Science.gov (United States)

    Widemann, Thomas; Määttänen, Anni; Wilquet, Valérie; McGouldrick, Kevin; Jessup, Kandis Lea; Wilson, Colin; Limaye, Sanjay; EuroVenus Consortium, the

    2014-05-01

    combine through meso-scale convection. In situ sampling of these aerosols represents a key measurement for constraining their properties, and identifying their role in the sulfurohydrological cycle by means of microphysical models of steadily increasing complexity. A probe/lander making a single descent will lack the spatial, temporal and local time coverage to address the coupling of compositional variations with radiative and dynamical properties of the atmosphere at cloud level, requiring a long duration flight. Establishing a long-term chemical laboratory in the cloud layer which would measure the detailed composition of both gas and liquid phases, and their latitudinal, diurnal and vertical variability using a combination of mass spectrometry, gas chromatography, tunable laser transmission spectrometry, and polar nephelometry would significantly address all of these objectives. It would allow the determination of the size distribution, shape, and real and imaginary refractive indices of the cloud particles, and the measurement of intensity and polarization phase functions. Our target species would include those known to be associated with cloud formation (e.g. H2SO4, SO3, SO2, H2O), as well as species important in stratospheric chemistry (e.g. CO, ClCOx, Ox, HCl, HF) and surface-atmosphere buffering (e.g. CO, OCS, SOx, Ox, H2S).

  13. Complex analysis

    CERN Document Server

    Freitag, Eberhard

    2005-01-01

    The guiding principle of this presentation of ``Classical Complex Analysis'' is to proceed as quickly as possible to the central results while using a small number of notions and concepts from other fields. Thus the prerequisites for understanding this book are minimal; only elementary facts of calculus and algebra are required. The first four chapters cover the essential core of complex analysis: - differentiation in C (including elementary facts about conformal mappings) - integration in C (including complex line integrals, Cauchy's Integral Theorem, and the Integral Formulas) - sequences and series of analytic functions, (isolated) singularities, Laurent series, calculus of residues - construction of analytic functions: the gamma function, Weierstrass' Factorization Theorem, Mittag-Leffler Partial Fraction Decomposition, and -as a particular highlight- the Riemann Mapping Theorem, which characterizes the simply connected domains in C. Further topics included are: - the theory of elliptic functions based on...

  14. 类获得性免疫缺陷(阴性HIV)“患者”的流行病学调查%Epidemiological investigation of cases with complained AIDS-related complex (HIV negative)

    Institute of Scientific and Technical Information of China (English)

    刘雅琼; 林辉; 于磊; 王清青; 王太武; 马翔宇; 凌华; 吴国辉; 张路

    2013-01-01

    目的 对社区类获得性免疫缺陷(AIDS)综合征(阴性HIV)“患者”进行病因探索.方法 采用定性系统分析筛检国内外相关综合征报道病例,探索类AIDS综合征“患者”临床特征可能的聚类属性;通过现况调查掌握“患者”人群的一般特征和临床特征.结果 定性系统分析显示,目前在世界范围,与类AIDS综合征(阴性HIV)“患者”相似的疾病有2种,即CD4+T淋巴细胞缺陷综合征(ICL)和非结核分枝杆菌感染(NTM感染);通过174例网络调查和52例现场观察,发现“患者”人群以男性为主,青、中年为主;在国内分布地区广泛;主诉症状涉及呼吸道、消化道、皮肤、肌肉、骨骼和神经系统;根据症状特点,病程有急性期和稳定期之分;群体症状及体征为:淋巴结部位肿胀感、骨痛、肌肉“跳”(痛)、淋巴结节、皮肤结节(皮疹)、舌苔白厚、关节弹响、皮肤干燥;52例“患者”检测发现CD4+T淋巴细胞< 500/μL 17例(32.69%)、CD4/CD8比值异常16例(30.77%)、干扰素-γ抗体阳性17例(36.69%)和PPD阳性39例(++~+++,75.00%);高危险性行为是可疑的暴露因素之一.结论 类AIDS综合征(阴性HIV)“患者”现象不能完全用心理因素予以解释,其呈现的临床特征有明显的一致性和规律性,亟待开展深入研究进行分析.%Objective To investigate the possible causes of AIDS-related complex (HIV negative) in community population. Methods Qualitative systematic analysis was used to screen the cases with AIDS-related complex (HIV negative) that had been reported. The possible clustering types of the clinical features of AIDS-related complex were explored based on a cross-section study that had been conducted to observe the personality and clinical features of the cases with AIDS-related complex. Results The qualitative systematic analysis suggested that the idiopathic CD4+ T lymphocytopenia (ICL) and infection of

  15. A Multi-Data Source and Multi-Sensor Approach for the 3D Reconstruction and Web Visualization of a Complex Archaelogical Site: The Case Study of “Tolmo De Minateda”

    Directory of Open Access Journals (Sweden)

    Jose Alberto Torres-Martínez

    2016-06-01

    Full Text Available The complexity of archaeological sites hinders creation of an integral model using the current Geomatic techniques (i.e., aerial, close-range photogrammetry and terrestrial laser scanner individually. A multi-sensor approach is therefore proposed as the optimal solution to provide a 3D reconstruction and visualization of these complex sites. Sensor registration represents a riveting milestone when automation is required and when aerial and terrestrial datasets must be integrated. To this end, several problems must be solved: coordinate system definition, geo-referencing, co-registration of point clouds, geometric and radiometric homogeneity, etc. The proposed multi-data source and multi-sensor approach is applied to the study case of the “Tolmo de Minateda” archaeological site. A total extension of 9 ha is reconstructed, with an adapted level of detail, by an ultralight aerial platform (paratrike, an unmanned aerial vehicle, a terrestrial laser scanner and terrestrial photogrammetry. Finally, a mobile device (e.g., tablet or smartphone has been used to integrate, optimize and visualize all this information, providing added value to archaeologists and heritage managers who want to use an efficient tool for their works at the site, and even for non-expert users who just want to know more about the archaeological settlement.

  16. Complex partial seizures and aphasia as initial manifestations of non-ketotic hyperglycemia: case report Crises parciais complexas e afasia como manifestações iniciais de hiperglicemia não cetótica: relato de caso

    Directory of Open Access Journals (Sweden)

    MARCUS SABRY AZAR BATISTA

    1998-06-01

    Full Text Available We describe a case of non-ketotic hyperglycemia (NKH, heralded by complex partial seizures and aphasia of epileptic origin, besides versive and partial motor seizures. This clinical picture was accompanied by left fronto-temporal spikes in the EEG. The seizures were controlled by carbamazepine only after the control of the diabetes. A month later, carbamazepine was discontinued. The patient remained without seizures, with normal language, using only glybenclamide. Complex partial seizures, opposed to simple partial seizures, are rarely described in association to NKH. Epileptic activity localized over language regions can manifest as aphasia.Descrevemos um caso de hiperglicemia não-cetótica (HNC cujas manifestações iniciais foram crises parciais complexas e afasia de origem epiléptica, além de crises versivas e parcias motoras. Este quadro clínico foi acompanhado por atividade epileptiforme na região fronto-temporal esquerda ao eletrencefalograma. As crises epilépticas foram controladas com carbamazepina (CBZ apenas após o controle do diabetes mellitus. Após um mês, a CBZ foi suspensa, permanecendo a paciente com linguagem normal, sem novas crises epilépticas, em uso apenas de glibenclamida. Crises parciais complexas, ao contrário de crises parciais simples, são raramente descritas como manifestação de HNC. Atividade epileptiforme nas regiões relacionadas a linguagem podem manifestar-se como afasia.

  17. Cluster Mode Analysis about the Development of Tourism Complex--A case of OCT east%旅游综合体开发的集聚模式分析--以深圳东部华侨城为例

    Institute of Scientific and Technical Information of China (English)

    陈海明; 陈芳

    2014-01-01

    Tourism Complex is a new type of industry complex with tourism,estate,recreation,business and culture. It has developed rapidly because it is an important engine to promote the development of mode-rn tourism.This paper expounds the four elements include land,industry,function and operation of Tourism Complex. As a case study of OCT East,analyzed it’s development subsequence, planning layout and in-dustrial distribution. Conclude that its development cluster mode was based on development cluster, prod-uct cluster,function cluster and operation cluster. Ultimately achieve it’s value about amplification effect,s-pillover effect,cluster effect and promotion effect.%旅游综合体是一种结合旅游、地产、娱乐、商业、文化为一体的新型业态,因其是促进现代旅游业发展的重要引擎而发展迅速。本文通过文献综述,阐述了旅游综合体的“土地”、“产业”、“功能”和“运营”等四个要素。并以深圳东部华侨城为例,归纳其旅游综合体开发时序、规划布局和业态分布,分析其开发聚集模式为开发聚集、产品聚集、功能聚集和运营聚集,最终实现企业的放大效应、溢出效应、聚集效应和提升效应等聚集价值。

  18. The Complexity of Coverage

    CERN Document Server

    Chatterjee, Krishnendu; Majumdar, Rupak

    2008-01-01

    We study the problem of generating a test sequence that achieves maximal coverage for a reactive system under test. We formulate the problem as a repeated game between the tester and the system, where the system state space is partitioned according to some coverage criterion and the objective of the tester is to maximize the set of partitions (or coverage goals) visited during the game. We show the complexity of the maximal coverage problem for non-deterministic systems is PSPACE-complete, but is NP-complete for deterministic systems. For the special case of non-deterministic systems with a re-initializing ``reset'' action, which represent running a new test input on a re-initialized system, we show that the complexity is again co-NP-complete. Our proof technique for reset games uses randomized testing strategies that circumvent the exponentially large memory requirement in the deterministic case.

  19. 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...

  20. Complex Networks

    CERN Document Server

    Evsukoff, Alexandre; González, Marta

    2013-01-01

    In the last decade we have seen the emergence of a new inter-disciplinary field focusing on the understanding of networks which are dynamic, large, open, and have a structure sometimes called random-biased. The field of Complex Networks is helping us better understand many complex phenomena such as the spread of  deseases, protein interactions, social relationships, to name but a few. Studies in Complex Networks are gaining attention due to some major scientific breakthroughs proposed by network scientists helping us understand and model interactions contained in large datasets. In fact, if we could point to one event leading to the widespread use of complex network analysis is the availability of online databases. Theories of Random Graphs from Erdös and Rényi from the late 1950s led us to believe that most networks had random characteristics. The work on large online datasets told us otherwise. Starting with the work of Barabási and Albert as well as Watts and Strogatz in the late 1990s, we now know th...

  1. Complexity of Formation in Holography

    CERN Document Server

    Chapman, Shira; Myers, Robert C

    2016-01-01

    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' (arXiv:1509.07876, arXiv:1512.04993), 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.

  2. Complex wounds Feridas complexas

    OpenAIRE

    Marcus Castro Ferreira; Paulo Tuma Júnior; Viviane Fernandes de Carvalho; Fábio Kamamoto

    2006-01-01

    Complex wound is the term used more recently to group those well-known difficult wounds, either chronic or acute, that challenge medical and nursing teams. They defy cure using conventional and simple "dressings" therapy and currently have a major socioeconomic impact. The purpose of this review is to bring these wounds to the attention of the health-care community, suggesting that they should be treated by multidisciplinary teams in specialized hospital centers. In most cases, surgical treat...

  3. Nonergodic complexity management

    Science.gov (United States)

    Piccinini, Nicola; Lambert, David; West, Bruce J.; Bologna, Mauro; Grigolini, Paolo

    2016-06-01

    Linear response theory, the backbone of nonequilibrium statistical physics, has recently been extended to explain how and why nonergodic renewal processes are insensitive to simple perturbations, such as in habituation. It was established that a permanent correlation results between an external stimulus and the response of a complex system generating nonergodic renewal processes, when the stimulus is a similar nonergodic process. This is the principle of complexity management, whose proof relies on ensemble distribution functions. Herein we extend the proof to the nonergodic case using time averages and a single time series, hence making it usable in real life situations where ensemble averages cannot be performed because of the very nature of the complex systems being studied.

  4. Managing Complexity

    Energy Technology Data Exchange (ETDEWEB)

    Chassin, David P.; Posse, Christian; Malard, Joel M.

    2004-08-01

    Physical analogs have shown considerable promise for understanding the behavior of complex adaptive systems, including macroeconomics, biological systems, social networks, and electric power markets. Many of today’s most challenging technical and policy questions can be reduced to a distributed economic control problem. Indeed, economically-based control of large-scale systems is founded on the conjecture that the price-based regulation (e.g., auctions, markets) results in an optimal allocation of resources and emergent optimal system control. This paper explores the state of the art in the use physical analogs for understanding the behavior of some econophysical systems and to deriving stable and robust control strategies for them. In particular we review and discussion applications of some analytic methods based on the thermodynamic metaphor according to which the interplay between system entropy and conservation laws gives rise to intuitive and governing global properties of complex systems that cannot be otherwise understood.

  5. PS complex

    CERN Multimedia

    1972-01-01

    A view of the present PS complex taken at the end of 1972. The earth embankment covering the Ring is clearly visible; in the foreground are the North and South Experimental Halls; to the right is the East Hall, and to the left the Booster surface buildings. The West Hall is too far to the left to seen, and also invisible is the SPS being constructed.

  6. Managing complex systems: The Labdata case

    OpenAIRE

    Pettersen, Mads Walle

    2014-01-01

    The aim of this master thesis is to explore the organization of a program within Digital Fornying, namely Labdata. The goal of Labdata is to introduce a common, standard, laboratory system for the South-Eastern Norway Regional Health Authority. We compare the organization of Labdata with theoretical concepts from adaptive co-management, Weill & Ross, project and program management. In order to manage this, we have developed the following research question: What are the challenges involved...

  7. Blog and Complex Thinking: A Case Study

    Science.gov (United States)

    Ramos, Maria Altina Silva

    2010-01-01

    The access to a vast array of resources is facilitated by the Internet, which, in its turn, does not promote learning by itself as children and young people often use it passively. As a consequence, the teachers' role is regarded essential so that they are helped to interpret and analyze available information critically. Nowadays, when referring…

  8. Modelling Complexity: the case of Climate Science

    CERN Document Server

    Lucarini, Valerio

    2011-01-01

    We briefly review some of the scientific challenges and epistemological issues related to climate science. We discuss the formulation and testing of theories and numerical models, which, given the presence of unavoidable uncertainties in observational data, the non-repeatability of world-experiments, and the fact that relevant processes occur in a large variety of spatial and temporal scales, require a rather different approach than in other scientific contexts. A brief discussion of the intrinsic limitations of geo-engineering solutions to global warming is presented, and a framework of investigation based upon non-equilibrium thermodynamics is proposed. We also critically discuss recently proposed perspectives of development of climate science based purely upon massive use of supercomputer and centralized planning of scientific priorities.

  9. Managing complexity of aerospace systems

    Science.gov (United States)

    Tamaskar, Shashank

    Growing complexity of modern aerospace systems has exposed the limits of conventional systems engineering tools and challenged our ability to design them in a timely and cost effective manner. According to the US Government Accountability Office (GAO), in 2009 nearly half of the defense acquisition programs are expecting 25% or more increase in unit acquisition cost. Increase in technical complexity has been identified as one of the primary drivers behind cost-schedule overruns. Thus to assure the affordability of future aerospace systems, it is increasingly important to develop tools and capabilities for managing their complexity. We propose an approach for managing the complexity of aerospace systems to address this pertinent problem. To this end, we develop a measure that improves upon the state-of-the-art metrics and incorporates key aspects of system complexity. We address the problem of system decomposition by presenting an algorithm for module identification that generates modules to minimize integration complexity. We demonstrate the framework on diverse spacecraft and show the impact of design decisions on integration cost. The measure and the algorithm together help the designer track and manage complexity in different phases of system design. We next investigate how complexity can be used as a decision metric in the model-based design (MBD) paradigm. We propose a framework for complexity enabled design space exploration that introduces the idea of using complexity as a non-traditional design objective. We also incorporate complexity with the component based design paradigm (a sub-field of MBD) and demonstrate it on several case studies. The approach for managing complexity is a small but significant contribution to the vast field of complexity management. We envision our approach being used in concert with a suite of complexity metrics to provide an ability to measure and track complexity through different stages of design and development. This will not

  10. Complex-Valued Autoencoders

    Science.gov (United States)

    Baldi, Pierre; Lu, Zhiqin

    2012-01-01

    Autoencoders are unsupervised machine learning circuits, with typically one hidden layer, whose learning goal is to minimize an average distortion measure between inputs and outputs. Linear autoencoders correspond to the special case where only linear transformations between visible and hidden variables are used. While linear autoencoders can be defined over any field, only real-valued linear autoencoders have been studied so far. Here we study complex-valued linear autoencoders where the components of the training vectors and adjustable matrices are defined over the complex field with the L2 norm. We provide simpler and more general proofs that unify the real-valued and complex-valued cases, showing that in both cases the landscape of the error function is invariant under certain groups of transformations. The landscape has no local minima, a family of global minima associated with Principal Component Analysis, and many families of saddle points associated with orthogonal projections onto sub-space spanned by sub-optimal subsets of eigenvectors of the covariance matrix. The theory yields several iterative, convergent, learning algorithms, a clear understanding of the generalization properties of the trained autoencoders, and can equally be applied to the hetero-associative case when external targets are provided. Partial results on deep architecture as well as the differential geometry of autoencoders are also presented. The general framework described here is useful to classify autoencoders and identify general properties that ought to be investigated for each class, illuminating some of the connections between autoencoders, unsupervised learning, clustering, Hebbian learning, and information theory. PMID:22622264

  11. Complex-valued autoencoders.

    Science.gov (United States)

    Baldi, Pierre; Lu, Zhiqin

    2012-09-01

    Autoencoders are unsupervised machine learning circuits, with typically one hidden layer, whose learning goal is to minimize an average distortion measure between inputs and outputs. Linear autoencoders correspond to the special case where only linear transformations between visible and hidden variables are used. While linear autoencoders can be defined over any field, only real-valued linear autoencoders have been studied so far. Here we study complex-valued linear autoencoders where the components of the training vectors and adjustable matrices are defined over the complex field with the L(2) norm. We provide simpler and more general proofs that unify the real-valued and complex-valued cases, showing that in both cases the landscape of the error function is invariant under certain groups of transformations. The landscape has no local minima, a family of global minima associated with Principal Component Analysis, and many families of saddle points associated with orthogonal projections onto sub-space spanned by sub-optimal subsets of eigenvectors of the covariance matrix. The theory yields several iterative, convergent, learning algorithms, a clear understanding of the generalization properties of the trained autoencoders, and can equally be applied to the hetero-associative case when external targets are provided. Partial results on deep architecture as well as the differential geometry of autoencoders are also presented. The general framework described here is useful to classify autoencoders and identify general properties that ought to be investigated for each class, illuminating some of the connections between autoencoders, unsupervised learning, clustering, Hebbian learning, and information theory.

  12. Complex Systems

    Directory of Open Access Journals (Sweden)

    Yi Zhao

    2012-01-01

    Full Text Available Quantum instanton (QI approximation is recently proposed for the evaluations of the chemical reaction rate constants with use of full dimensional potential energy surfaces. Its strategy is to use the instanton mechanism and to approximate time-dependent quantum dynamics to the imaginary time propagation of the quantities of partition function. It thus incorporates the properties of the instanton idea and the quantum effect of partition function and can be applied to chemical reactions of complex systems. In this paper, we present the QI approach and its applications to several complex systems mainly done by us. The concrete systems include, (1 the reaction of H+CH4→H2+CH3, (2 the reaction of H+SiH4→H2+SiH3, (3 H diffusion on Ni(100 surface; and (4 surface-subsurface transport and interior migration for H/Ni. Available experimental and other theoretical data are also presented for the purpose of comparison.

  13. Familial gigantism

    Directory of Open Access Journals (Sweden)

    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.

  14. Cosmic Complexity

    Science.gov (United States)

    Mather, John C.

    2012-01-01

    What explains the extraordinary complexity of the observed universe, on all scales from quarks to the accelerating universe? My favorite explanation (which I certainty did not invent) ls that the fundamental laws of physics produce natural instability, energy flows, and chaos. Some call the result the Life Force, some note that the Earth is a living system itself (Gaia, a "tough bitch" according to Margulis), and some conclude that the observed complexity requires a supernatural explanation (of which we have many). But my dad was a statistician (of dairy cows) and he told me about cells and genes and evolution and chance when I was very small. So a scientist must look for me explanation of how nature's laws and statistics brought us into conscious existence. And how is that seemll"!gly Improbable events are actually happening a!1 the time? Well, the physicists have countless examples of natural instability, in which energy is released to power change from simplicity to complexity. One of the most common to see is that cooling water vapor below the freezing point produces snowflakes, no two alike, and all complex and beautiful. We see it often so we are not amazed. But physlc!sts have observed so many kinds of these changes from one structure to another (we call them phase transitions) that the Nobel Prize in 1992 could be awarded for understanding the mathematics of their common features. Now for a few examples of how the laws of nature produce the instabilities that lead to our own existence. First, the Big Bang (what an insufficient name!) apparently came from an instability, in which the "false vacuum" eventually decayed into the ordinary vacuum we have today, plus the most fundamental particles we know, the quarks and leptons. So the universe as a whole started with an instability. Then, a great expansion and cooling happened, and the loose quarks, finding themselves unstable too, bound themselves together into today's less elementary particles like protons and

  15. Cosmic Complexity

    Science.gov (United States)

    Mather, John C.

    2012-01-01

    What explains the extraordinary complexity of the observed universe, on all scales from quarks to the accelerating universe? My favorite explanation (which I certainty did not invent) ls that the fundamental laws of physics produce natural instability, energy flows, and chaos. Some call the result the Life Force, some note that the Earth is a living system itself (Gaia, a "tough bitch" according to Margulis), and some conclude that the observed complexity requires a supernatural explanation (of which we have many). But my dad was a statistician (of dairy cows) and he told me about cells and genes and evolution and chance when I was very small. So a scientist must look for me explanation of how nature's laws and statistics brought us into conscious existence. And how is that seemll"!gly Improbable events are actually happening a!1 the time? Well, the physicists have countless examples of natural instability, in which energy is released to power change from simplicity to complexity. One of the most common to see is that cooling water vapor below the freezing point produces snowflakes, no two alike, and all complex and beautiful. We see it often so we are not amazed. But physlc!sts have observed so many kinds of these changes from one structure to another (we call them phase transitions) that the Nobel Prize in 1992 could be awarded for understanding the mathematics of their common features. Now for a few examples of how the laws of nature produce the instabilities that lead to our own existence. First, the Big Bang (what an insufficient name!) apparently came from an instability, in which the "false vacuum" eventually decayed into the ordinary vacuum we have today, plus the most fundamental particles we know, the quarks and leptons. So the universe as a whole started with an instability. Then, a great expansion and cooling happened, and the loose quarks, finding themselves unstable too, bound themselves together into today's less elementary particles like protons and

  16. Partially - conformal mappings in multidimensional complex spaces

    CERN Document Server

    Bakhtin, A K

    2011-01-01

    The paper proposes a vector generalization of the basic concepts of the theory of complex variable: the concept of modulus and argument of complex number. The author introduces some generalizations of the notion of holomorphic functions and mappings to the case of infinite-dimensional complex spaces. This approach allows us to generalize several well-known results of geometric function theory to the case of infinite-dimensional complex spaces. In particular, the author summarizes a number of known theorems on the theory of functions of class S on infinite-dimensional complex space.

  17. Complex silumins

    Directory of Open Access Journals (Sweden)

    S. Pietrowski

    2007-09-01

    Full Text Available Purpose: The study presents the results of investigations carried out on silumins with additions of Mg, Ni, Cu, Cr, Mo and W. The silumins containing Mg, Cu and Ni are well-known and commonly used in construction of machines and equipment.Design/methodology/approach: Additions of Cr, Mo and W have not been thoroughly investigated yet. They are considered a new family of innovative cast aluminium alloys.Findings: In Al-Si systems they form silicides, like Cr3Si, Mo3Si, W3Si and intermetallic phases of Al13Cr4Si4, Al12Mo, Al12W and AlWSi. The silicides crystallise in cubic lattice of parameters similar to aluminium and silicon.Research limitations/implications: Therefore they can act as crystallisation substrates and occur as separate phases. The examinations under the microscope and X-ray microanalysis of the linear and point distribution of elements confirmed the presence of the above mentioned phases. A combination of two elements, e.g. Cr and Mo, or Cr and W, was observed to cause the formation of complex silicide layers of Mo3Si and (Cr, Mo3Si, or Cr3Si as well as (W, Cr3Si.Originality/value: The presence of the silicides has been indicated as a possible source of the refinement of α(Al and β(Si phases. The precipitations of these phases and of the intermetallic phases favour a high degree of the silumins hardening. A characteristic feature is the fact that nucleation and crystallisation of the successive phases takes place at the phase boundaries formed between the previously precipitated phase and solid solution α. The studies carried out so far have indicated that in complex silumins at high temperatures crystallise the silicides and peritectic phases of Al12W, AlWSi, Al12Mo and Al13Cr4Si4. Phases α or β are the next ones to crystallise, followed by complex eutectic α + β +Al(Si, Cr, Mo, W, Fe. Further crystallise the phases of Mg2Si, Al3Ni and Al2Cu. The silumins presented here are characterised by high mechanical properties: Rp0

  18. Quantum Entanglement and Communication Complexity

    OpenAIRE

    Buhrman, Harry; Cleve, Richard; Van Dam

    1997-01-01

    We consider a variation of the multi-party communication complexity scenario where the parties are supplied with an extra resource: particles in an entangled quantum state. We show that, although a prior quantum entanglement cannot be used to simulate a communication channel, it can reduce the communication complexity of functions in some cases. Specifically, we show that, for a particular function among three parties (each of which possesses part of the function's input), a prior quantum ent...

  19. Stable generalized complex structures

    CERN Document Server

    Cavalcanti, Gil R

    2015-01-01

    A stable generalized complex structure is one that is generically symplectic but degenerates along a real codimension two submanifold, where it defines a generalized Calabi-Yau structure. We introduce a Lie algebroid which allows us to view such structures as symplectic forms. This allows us to construct new examples of stable structures, and also to define period maps for their deformations in which the background three-form flux is either fixed or not, proving the unobstructedness of both deformation problems. We then use the same tools to establish local normal forms for the degeneracy locus and for Lagrangian branes. Applying our normal forms to the four-dimensional case, we prove that any compact stable generalized complex 4-manifold has a symplectic completion, in the sense that it can be modified near its degeneracy locus to produce a compact symplectic 4-manifold.

  20. NDT for Complex Projects

    Science.gov (United States)

    Carnevale, Mario

    2013-04-01

    Non-destructive testing of structures composed of various types of materials is performed using a variety of methods. Most commonly, electromagnetic and acoustic methods are used to perform this task. Advances in computer software and electro-mechanical hardware have resulted in semi-automated systems for performing simple low-cost in-situ concrete testing. These systems are designed to be operated by anyone who can read a manual and push the right buttons. Although useful in many circumstances, we ask: "What happens when concrete structures are not simple and are too complex to be analyzed by these semi-automated systems and, most importantly, by minimally trained operators?" Many infrastructure projects are boldly pushing the limit of traditional engineering design. As structures become more complex, the methods and techniques used to evaluate these structures must also evolve. A first step towards adapting geophysical methods to evaluate complex structures is to develop pre-investigation conceptual models of possible responses that structures will have to available geophysical methods. This approach is important for designing the geometry and data acquisition parameters necessary for achieving the desired results. Examples of case by case assessments of the application of GPR to concrete investigations are examined. These include complex concrete wall structures, soil tunnel structures, and airport runways. HGI's adaption of ground penetrating radar (GPR) and seismic methods for assessing the substrate of a heavily reinforced concrete structure up to seven feet thick is reviewed. A range of GPR antenna frequencies were used to image the concrete and the underlying material. Time and frequency domain GPR analyses where used in the assessment. A multi-channel seismic survey using a roll-along data collection technique was used to assess the resonant frequency of the concrete structure, the nature of the underlying medium, and behavior of the structural system.