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Sample records for center lansce experiment

  1. The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

    International Nuclear Information System (INIS)

    This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation

  2. The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Farrer, R.; Longshore, A. [comps.

    1995-06-01

    This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation.

  3. The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports, 1991 run cycle

    International Nuclear Information System (INIS)

    This report briefly discusses experiments conducted at the Lansce neutron source facility. The experiments were conducted on the following instruments: high intensity powder diffractometer; neutron powder diffractometer; single crystal diffractometer; low-q diffractometer; surface profile analysis reflectometer; filter difference spectrometer; experiment reports, and pharos

  4. The Manuel Lujan, Jr. Neutron Scattering Center, LANSCE experiment reports: 1990 Run Cycle

    Energy Technology Data Exchange (ETDEWEB)

    DiStravolo, M.A. (comp.)

    1991-10-01

    This year was the third in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each six-month LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred thirty-four proposals were submitted for unclassified research and twelve proposals for research of a programmatic nature to the Laboratory. Our definition of beam availability is when the proton current from the PSR exceeds 50% of the planned value. The PSR ran at 65{mu}A current (average) at 20 Hz for most of 1990. All of the scheduled experiments were performed and experiments in support of the LANSCE research program were accomplished during the discretionary periods.

  5. The Manuel Lujan, Jr. Neutron Scattering Center, LANSCE experiment reports: 1990 Run Cycle

    International Nuclear Information System (INIS)

    This year was the third in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each six-month LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred thirty-four proposals were submitted for unclassified research and twelve proposals for research of a programmatic nature to the Laboratory. Our definition of beam availability is when the proton current from the PSR exceeds 50% of the planned value. The PSR ran at 65μA current (average) at 20 Hz for most of 1990. All of the scheduled experiments were performed and experiments in support of the LANSCE research program were accomplished during the discretionary periods

  6. The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports 1992 run cycle. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    DiStravolo, M.A. [comp.

    1993-09-01

    This year was the fifth in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory, examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred sixty-seven proposals were submitted for unclassified research and twelve proposals for research of a programmatic interest to the Laboratory; six experiments in support of the LANSCE research program were accomplished during the discretionary periods. Oversubscription for instrument beam time by a factor of three was evident with 839 total days requested and only 371 available for allocation.

  7. The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports 1992 run cycle

    International Nuclear Information System (INIS)

    This year was the fifth in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory, examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred sixty-seven proposals were submitted for unclassified research and twelve proposals for research of a programmatic interest to the Laboratory; six experiments in support of the LANSCE research program were accomplished during the discretionary periods. Oversubscription for instrument beam time by a factor of three was evident with 839 total days requested and only 371 available for allocation

  8. The Manuel Lujan, Jr. Neutron Scattering Center LANSCE experiment reports 1989 run cycle

    Energy Technology Data Exchange (ETDEWEB)

    Hyer, D.K.; DiStravolo, M.A. (comps.)

    1990-10-01

    This report contains a listing and description of experiments carried on at the LANSCE neutron scattering facility in the following areas: High Density Powder Diffraction; Neutron Powder Diffractometer, (NPD); Single Crystal Diffractometer, (SCD); Low-Q Diffractometer, (LQD); Surface Profile Analysis Reflectometer, (SPEAR); Filter Difference Spectrometer, (FDS); and Constant-Q Spectrometer.

  9. The Manuel Lujan, Jr. Neutron Scattering Center LANSCE experiment reports 1989 run cycle

    International Nuclear Information System (INIS)

    This report contains a listing and description of experiments carried on at the LANSCE neutron scattering facility in the following areas: High Density Powder Diffraction; Neutron Powder Diffractometer, (NPD); Single Crystal Diffractometer, (SCD); Low-Q Diffractometer, (LQD); Surface Profile Analysis Reflectometer, (SPEAR); Filter Difference Spectrometer, (FDS); and Constant-Q Spectrometer

  10. Design of the next generation target at Lujan center, LANSCE.

    Energy Technology Data Exchange (ETDEWEB)

    Ferres, Laurent [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-07-27

    This is a presentation given at Los Alamos National Laboratory (LANL) on the design of the next generation target at Lujan center, LANSCE. The motivation for this design is to enable new nuclear physics experiments (defense program applications (DANCE)) that are currently limited by neutron intensity or energy resolution available at LANSCE. The target is being redesigned so that the Flight Paths in the upper tier provide a higher intensity in the epithermal and medium energy ranges.

  11. The NPDGamma Experiment at LANSCE

    CERN Document Server

    Gericke, M T; Chupp, T E; Coulter, K P; Dabaghyan, M; Dawkins, M; Desai, D; Freedman, S J; Gentile, T R; Gillis, R C; Greene, G L; Hersman, F W; Ino, T; Jones, G L; Kandes, M; Lauss, B; Leuschner, M B; Lozowski, W R; Mahurin, R; Masuda, Y; Mason, M; Mitchell, G S; Muto, S; Nann, H; Page, S A; Penttila, S I; Ramsay, W D; Santra, S B; Seo, P N; Sharapov, E I; Smith, T B; Snow, W M; Wilburn, W S; Yuan, V; Zhu, H

    2005-01-01

    The NPDGamma collaboration has constructed and commissioned an apparatus to determine the size of the pion-nucleon coupling constant in the parity non conserving pion exchange weak potential for N-N interactions. This coupling constant is directly proportional to the parity violating up-down asymmetry in the angular distribution of gamma rays with respect to the neutron spin direction in the capture of polarized cold neutrons on protons. The measurement of the weak pNN coupling will provide a test for the effective theory, describing the nucleon-nucleon interaction as mediated by the exchange of mesons, and provide results against which to compare models describing QCD at low energy. NPDGamma is located at the Los Alamos Neutron Science Center (LANSCE) and utilizes the special features of cold spallation neutrons to make it possible to measure very small gamma ray asymmetries. In this paper, we present the motivation for the experiment and report on experimental setup as well as the current status of the proj...

  12. LANSCE '90: The Manuel Lujan Jr. Neutron Scattering Center

    Energy Technology Data Exchange (ETDEWEB)

    Pynn, R.

    1990-01-01

    This paper describes progress that has been made at the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) during the past two years. Presently, LANSCE provides a higher peak neutron flux than any other pulsed spallation neutron source. There are seven spectrometers for neutron scattering experiments that are operated for a national user program sponsored by the US Department of Energy. Two more spectrometers are under construction. Plans have been made to raise the number of beam holes available for instrumentation and to improve the efficiency of the target/moderator system. 9 refs., 4 figs.

  13. Recent operational experiments at the LANSCE facility

    Energy Technology Data Exchange (ETDEWEB)

    Rybarcyk, Lawrence J [Los Alamos National Laboratory

    2010-09-15

    The Los Alamos Neutron Science Center (LANSCE) consists of a pulsed 800-MeV room-temperature linear accelerator and an 800-MeV accumulator ring. It simultaneously provides H{sup +} and H{sup -} beams to several user facilities that have their own distinctive requirements, e.g. intensity, chopping pattern, duty factor, etc.. This multibeam operation presents challenges both from the standpoint of meeting the individual requirements but also achieving good overall performance for the integrated operation. Various aspects of more recent operations including the some of these challenges will be discussed.

  14. Los Alamos Neutron Science Center (LANSCE) Nuclear Science Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Ronald Owen [Los Alamos National Laboratory; Wender, Steve [Los Alamos National Laboratory

    2015-06-19

    The Los Alamos Neutron Science Center (LANSCE) facilities for Nuclear Science consist of a high-energy "white" neutron source (Target 4) with 6 flight paths, three low-energy nuclear science flight paths at the Lujan Center, and a proton reaction area. The neutron beams produced at the Target 4 complement those produced at the Lujan Center because they are of much higher energy and have shorter pulse widths. The neutron sources are driven by the 800-MeV proton beam of the LANSCE linear accelerator. With these facilities, LANSCE is able to deliver neutrons with energies ranging from a milli-electron volt to several hundreds of MeV, as well as proton beams with a wide range of energy, time and intensity characteristics. The facilities, instruments and research programs are described briefly.

  15. Prospects for a measurement of the 237U(n,f) cross section at the LANSCE Lujan Center

    Energy Technology Data Exchange (ETDEWEB)

    Devlin, Matthew James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mocko, Michal [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gavron, Victor [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Jandel, Marian [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rusev, Gencho Yordanov [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bredeweg, Todd Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-06-24

    A new measurement of the 237U(n, f) cross section from thermal to ≈ 100 keV is discussed, using one of the flightpaths at the LANSCE Lujan Center. Previous energy-resolved resonance-region measurements have been conducted using weapon test time-of-flight[1] and the LANSCE Lead Slowing Down Spectrometer[2], the former of which is limited in its energy range, and the latter in its energy resolution and range. We present here a proposal, based on simulations of the Lujan Center neutron flux and a hypothetical experiment, that is expected to adequately address both of these issues.

  16. The LANSCE (Los Alamos Neutron Scattering Center) target system

    International Nuclear Information System (INIS)

    During the summer of 1985, we replaced the WNR T-shaped target/moderator scheme with the LANSCE split-target/flux-trap-moderator design. The intent of this 'LANSCE upgrade' was to increase (to 12) the number of neutron beam lines serviced simultaneously, and to enhance the target area shielding and target system to accept 200 μA of 800-MeV protons. The four LANSCE moderators consist of three (chilled) water moderators, and a liquid hydrogen (20 K) moderator. The LANSCE target is machinable tungsten

  17. LANSCE (Los Alamos Neutron Scattering Center) target system performance

    International Nuclear Information System (INIS)

    The authors measured neutron beam fluxes at LANSCE using gold foil activation techniques. They did an extensive computer simulation of the as-built LANSCE Target/Moderator/Reflector/Shield geometry. They used this mockup in a Monte Carlo calculation to predict LANSCE neutronic performance for comparison with measured results. For neutron beam fluxes at 1 eV, the ratio of measured data to calculated varies from ∼0.6-0.9. The computed 1 eV neutron leakage at the moderator surface is 3.9 x 1010 n/eV-sr-s-μA for LANSCE high-intensity water moderators. The corresponding values for the LANSCE high-resolution water moderator and the liquid hydrogen moderator are 3.3 and 2.9 x 1010, respectively. LANSCE predicted moderator intensities (per proton) for a tungsten target are essentially the same as ISIS predicted moderator intensities for a depleted uranium target. The calculated LANSCE steady state unperturbed thermal (E 13 n/cm2-s. The unique LANSCE split-target/flux-trap-moderator system is performing exceedingly well. The system has operated without a target or moderator change for over three years at nominal proton currents of 25 μA of 800-MeV protons. 17 refs., 8 figs., 3 tabs

  18. LANSCE Activity Report

    Energy Technology Data Exchange (ETDEWEB)

    Amy Robinson; Audrey Archuleta; Barbara Maes; Dan Strottman; Earl Hoffman; Garth Tietjen; Gene Farnum; Geoff Greene; Joyce Roberts; Ken Johnson; Paul Lewis; Roger Pynn; Stan Schriber; Steve Sterbenz; Steve Wender; Sue Harper

    1999-02-01

    The Los Alamos Neutron Science Center Activity Report describes scientific and technological progress and achievements in LANSCE Division during the period of 1995 to 1998. This report includes a message from the Division Director, an overview of LANSCE, sponsor overviews, research highlights, advanced projects and facility upgrades achievements, experimental and user program accomplishments, news and events, and a list of publications. The research highlights cover the areas of condensed-matter science and engineering, accelerator science, nuclear science, and radiography. This report also contains a compact disk that includes an overview, the Activity Report itself, LANSCE operations progress reports for 1996 and 1997, experiment reports from LANSCE users, as well as a search capability.

  19. DANCE (Detector for Advanced Neutron Capture Experiments) is a 4π array of BaF2 crystals installed at LANSCE, Lujan Center. Neutron capture measurements on ^157Gd and ^89Y nuclei were conducted using this facility.

    Science.gov (United States)

    Chyzh, A.; Mitchell, G.; Vieira, D.; Bredeweg, T.; Ullmann, J.; Jandel, M.; Couture, A.; Keksis, A.; Rundberg, R.; Wilhelmy, J.; O'Donnell, J.; Baramsai, B.; Haight, R.; Wouters, J.; Krticka, M.; Parker, W.; Becker, J.; Agvaanlusan, U.

    2009-10-01

    DANCE (Detector for Advanced Neutron Capture Experiments) is a 4π array of BaF2 crystals installed at LANSCE, Lujan Center. Neutron capture measurements on ^157Gd and ^89Y nuclei were conducted using this facility. The absolute cross sections of the ^89Y(n,γ) reaction was measured for the first time ever in the neutron energy range of 10 eV -- 10 keV and improvements were made in the 10 -- 300 keV range. The error bars were significantly reduced and number of cross section points was increased since the past ^89Y(n,γ) experiments. The ^157Gd(n,γ) cross section was determined at En = 20 eV -- 300 keV by normalizing the experimental DANCE data to a well known resonance taken from the ENDF/B-VII library. Computer simulations of the ^157Gd(n,γ) cascades and DANCE pulse height function were made using DICEBOX and GEANT4 codes and simulated Esum and Eγ spectra are compared to the experimental DANCE data. Values of spin and photon strength function (PSF) of the ^157Gd(n,γ) resonances are provided in the range of En = 2 -- 300 eV using spin dependence upon a γ-ray multiplicity.

  20. Lujan at Los Alamos Neutron Science Center (LANSCE)

    Data.gov (United States)

    Federal Laboratory Consortium — The Lujan Neutron Scattering Center (Lujan Center) at Los Alamos National Laboratory is an intense pulsed neutrons source operating at a power level of 80 -100 kW....

  1. LANSCE Activity Report 1995-1998

    International Nuclear Information System (INIS)

    The Los Alamos Neutron Science Center Activity Report describes scientific and technological progress and achievements in LANSCE Division during the period of 1995 to 1998. This report includes a message from the Division Director, an overview of LANSCE, sponsor overviews, research highlights, advanced projects and facility upgrades achievements, experimental and user program accomplishments, news and events, and a list of publications. The research highlights cover the areas of condensed-matter science and engineering, accelerator science, nuclear science, and radiography. This report also contains a compact disk that includes an overview, the Activity Report itself, LANSCE operations progress reports for 1996 and 1997, experiment reports from LANSCE users, as well as a search capability

  2. Detector for advanced neutron capture experiments at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J. L. (John L.); Reifarth, R. (Rene); Haight, Robert C.; Hunt, L. F. (Lloyd F.); O' Donnell, J. M.; Bredeweg, T. A. (Todd A); Wilhelmy, J. B. (Jerry B.); Fowler, Malcolm M.; Vieira, D. J. (David J.); Wouters, J. M. (Jan Marc); Strottman, D.; Kaeppeler, F. (Franz K.); Heil, M.; Chamberlin, E. P. (Edwin P.)

    2002-01-01

    The Detector for Advanced Neutron Capture Experiments (DANCE) is a 159-element 4x barium fluoride array designed to study neutron capture on small quantities, 1 mg or less, of radioactive nuclides. It is being built on a 20 m neutron flight path which views the 'upper tier' water moderator at the Manuel J. Lujan Jr. Neutron Scattering Center at the Los Alamos Neutron Science Center. The detector design is based on Monte Carlo calculations which have suggested ways to minimize backgrounds due to neutron scattering events. A data acquisition system based on fast transient digitizers is bcing implemented

  3. Design of the Next Generation Target at the Lujan Neutron Scattering Center, LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ferres, Laurent [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); National Graduate School of Engineering and Research Center (ENSICAEN), Caen (France)

    2016-08-03

    Los Alamos National Laboratory (LANL) supports scientific research in many diverse fields such as biology, chemistry, and nuclear science. The Laboratory was established in 1943 during the Second World War to develop nuclear weapons. Today, LANL is one of the largest laboratories dedicated to nuclear defense and operates an 800 MeV proton linear accelerator for basic and applied research including: production of high- and low-energy neutrons beams, isotope production for medical applications and proton radiography. This accelerator is located at the Los Alamos Neutron Science Center (LANSCE). The work performed involved the redesign of the target for the low-energy neutron source at the Lujan Neutron Scattering Center, which is one of the facilities built around the accelerator. The redesign of the target involves modeling various arrangements of the moderator-reflector-shield for the next generation neutron production target. This is done using Monte Carlo N-Particle eXtended (MCNPX), and ROOT analysis framework, a C++ based-software, to analyze the results.

  4. Commissioning and initial operation of the Isotope Production Facility at the Los Alamos Neutron Science Center (LANSCE).

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, K. F. (Kenneth F.); Alvestad, H. W. (Henry W.); Barkley, W. C. (Walter C.); Barlow, D. B. (David B.); Barr, D. S. (Dean S.); Bennett, L. S. (Langdon S.); Bitteker, L. J. (Leo J.); Bjorklund, E. A. (Eric A.); Boedeker, W.; Borden, M. J. (Michael J.); Cardon, R.; Carr, G. (Gary); Casados, J. L. (Jeffrey L.); Cohen, Stanley; Cordova, J. F. (Justo J.; Faucett, John Allen,; Fresquez, M. (Matthew); Gallegos, F. R. (Floyd R.); Gilpatrick, J. D. (John Douglas); Gonzales, F. (Fermin); Gorman, F. W. (Frederick W.); Gulley, M. S. (Mark S.); Hall, M. J. (Michael J.); Hayden, D. J. (David J.); Heaton, R. C. (Richard C.); Henderson, D. B. (Dale B.); Ireland, D. B. (David B.); Jacobson, E. G. (Edward G.); Johns, G. D. (Glen D.); Kersteins, D. M. (Debora M.); Maestas, A. J. (Alfred J.); Martinez, A. M. (Alexandra M.); Martinez, D. G. (Derwin G.); Martinez, G.; Martinez, J.; Martinez, M. P. (Martin P.); Merl, R. B. (Robert B.); Merrill, J. B. (John B.); Meyer, B. J. (Bruce J.); Meyer, R., Sr.; Milder, M.; Morgan, E.; Nortier, M.; O' Hara, J. F. (James F.); Olivas, F. R. (Felix R.); Oothoudt, Michael; Pence, T. D. (Tim D.); Perets, Mikhaʾel ben Yosef; Peterson, E.; Pillai, C. (Chandra); Romero, F.; Rose, C.; Rybarcyk, L. J. (Lawrence J.); Sanchez, G. (Gary); Sandoval, J. B. (Jacob B.); Schaller, S. (Stuart); Shelley, F. E. (Fred E.); Shurter, R. B. (Robert B.); Sommer, Walter F.; Stettler, M. W. (Matthew W.); Stockton, J. L. (Jerry L.); Sturrock, J. C. (James C.); Tomei, T. L. (Tony L.); Valdez, F.; Vigil, V. P. (Victor P.); Walstrom, P. L. (Peter L.); Wanco, P. M. (Peter M.); Wilmarth, J.

    2004-01-01

    The recently completed 100-MeV H{sup +} Isotope Production Facility (IPF) at the LANSCE will provide radioisotopes for medical research and diagnosis, for basic research and for commercial use. A change to the LANSCE accelerator facility allowed for the installation of the IPF. Three components make up the LANSCE accelerator: an injector that accelerates the H{sup +} beam to 750-KeV, a drift-tube linac (DTL) that increases the beam energy to 100-MeV, and a side-coupled cavity linac (SCCL) that accelerates the beam to 800-MeV. The transition region, a space between the DTL and the SCCL, was modified to permit the insertion of a kicker magnet (23{sup o} kick angle) for the purpose of extracting a portion of the 100-MeV H{sup +} beam. A new beam line was installed to transport the extracted H{sup +} beam to the radioisotope production target chamber. This paper will describe the commissioning and initial operating experiences of IPF.

  5. Results From Cavitation Damage Experiments With Mercury Spallation Targets At The LANSCE WNR In 2008

    International Nuclear Information System (INIS)

    Damage assessment from proton beam induced cavitation experiments on mercury spallation targets done at the LANSCE WNR facility has been completed. The experiments investigated two key questions for the Spallation Neutron Source target, namely, how damage is affected by flow velocity in the SNS coolant channel geometry, and how damage scales with proton beam intensity at a given constant charge per pulse. With regard to the former question, prior in-beam experiments indicated that the coolant channel geometry with stagnant mercury was especially vulnerable to damage which might warrant a design change. Yet other results indicated a reduction in damage with the introduction of flow. Using more prototypic to the SNS, the 2008 experiment damage results show the channel is less vulnerable than the bulk mercury side of the vessel wall. They also show no benefit from increasing channel flow velocity beyond nominal SNS speeds. The second question probed a consensus belief that damage scales with beam intensity (protons per unit area) by a power law dependence with exponent of around 4. Results from a 2005 experiment did not support this power law dependence but some observations were inconsistent and unexplained. These latest results show weaker damage dependence.

  6. Shielding the LANSCE [Los Alamos Neutron Scattering Center] 800-MeV spallation neutron source

    International Nuclear Information System (INIS)

    Neutrons produced by medium-energy (800-MeV) proton reactions at the Los Alamos Neutron Scattering Center spallation neutron source cause a variety of difficult shield problems. We describe the general shielding questions encountered at such a spallation source, and contrast spallation and reactor source shielding issues using an infinite slab-shield composed of 100 cm of iron and 15 cm of borated polyethylene. The calculations show that (for an incident spallation spectrum characteristic of neutrons leaking at 90 degrees from a tungsten target) high-energy neutrons dominate the dose at the shield surface. Secondary low-energy neutrons (produced by high-energy neutron attenuation) and attendant gamma-rays add significantly to the dose. The primary low-energy neutrons produced directly at the tungsten source contribute negligibly to the dose, and behave similarly to neutrons with a fission spectrum distribution. 8 refs., 10 figs

  7. Neutron capture measurement on {sup 173}Lu at LANSCE with DANCE detector

    Energy Technology Data Exchange (ETDEWEB)

    Theroine, C.; Ebran, A.; Meot, V.; Roig, O. [CEA DAM DIF, F-91297 Arpajon (France); Bond, E. M.; Bredeweg, T. A.; Couture, A.; Haight, R. C.; Jandel, M.; Nortier, F. M.; O' Donnell, J. M.; Rundberg, R. S.; Taylor, W. A.; Ullmann, J. L.; Viera, D. J.; Wilhelmy, J. B.; Wouters, J. M. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    2013-06-10

    The (n,{gamma}) cross section on the unstable {sup 173}Lu(t{sub 1/2} = 1.37y) has been measured from thermal energy up to 200 eV at Los Alamos Neutron Science Center (LANSCE) with The Detector for Advanced Neutron Capture Experiements (DANCE). The main aim of this study is to validate and optimize reaction models for unstable nucleus. A preliminary capture yield will be presented in this paper.

  8. Neutron capture measurement on 173Lu at LANSCE with DANCE detector

    Science.gov (United States)

    Theroine, C.; Ebran, A.; Méot, V.; Roig, O.; Bond, E. M.; Bredeweg, T. A.; Couture, A.; Haight, R. C.; Jandel, M.; Nortier, F. M.; O'Donnell, J. M.; Rundberg, R. S.; Taylor, W. A.; Ullmann, J. L.; Viera, D. J.; Wilhelmy, J. B.; Wouters, J. M.

    2013-06-01

    The (n,γ) cross section on the unstable 173Lu(t1/2 = 1.37y) has been measured from thermal energy up to 200 eV at Los Alamos Neutron Science Center (LANSCE) with The Detector for Advanced Neutron Capture Experiements (DANCE). The main aim of this study is to validate and optimize reaction models for unstable nucleus. A preliminary capture yield will be presented in this paper.

  9. Neutron capture measurement on 173Lu at LANSCE with DANCE detector

    International Nuclear Information System (INIS)

    The (n,γ) cross section on the unstable 173Lu(t1/2 = 1.37y) has been measured from thermal energy up to 200 eV at Los Alamos Neutron Science Center (LANSCE) with The Detector for Advanced Neutron Capture Experiements (DANCE). The main aim of this study is to validate and optimize reaction models for unstable nucleus. A preliminary capture yield will be presented in this paper.

  10. LANSCE radiation security system (RSS)

    Energy Technology Data Exchange (ETDEWEB)

    Gallegos, F.R. [Los Alamos National Lab., NM (United States). Los Alamos Neutron Science Center

    1996-12-31

    The Radiation Security System (RSS) is an engineered safety system which automatically terminates transmission of accelerated ion beams in response to pre-defined abnormal conditions. It is one of the four major mechanisms used to protect people from radiation hazards induced by accelerated pulsed ion beams at the Los Alamos Neutron Science Center (LANSCE). The others are shielding, administrative policies and procedures, and qualified, trained personnel. Prompt radiation hazards at the half-mile long LANSCE accelerator exist due to average beam intensities ranging from 1 milli-amp for H{sup +} beam to 100 micro-amps for the high intensity H{sup {minus}} beam. Experimental programs are supplied with variable energy (maximum 800 MeV), pulse-width (maximum 1 msec), and pulse frequency (maximum 120 Hz) ion beams. The RSS includes personnel access control systems, beam spill monitoring systems, and beam current level limiting systems. It is a stand-alone system with redundant logic chains. A fault of the RSS will cause the insertion of fusible beam plugs in the accelerator low energy beam transport. The design philosophy, description, and operation of the RSS are described in this paper.

  11. Science-based stockpile stewardship at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Browne, J. [Los Alamos National Lab., NM (United States)

    1995-10-01

    Let me tell you a little about the Los Alamos Neutron Science Center (LANSCE) and how some of the examples you heard about from Sig Hecker and John Immele fit together in this view of a different world in the future where defense, basic and industrial research overlap. I am going to talk about science-based stockpile stewardship at LANSCE; the accelerator production of tritium (APT), which I think has a real bearing on the neutron road map; the world-class neutron science user facility, for which I will provide some examples so you can see the connection with defense science; and lastly, testing concepts for a high-power spallation neutron target and waste transmutation.

  12. Overview of the Neutron experimental facilities at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Mocko, Michal [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-06-30

    This presentation gives an overview of the neutron experimental facilities at LANSCE. The layout is mentioned in detail, with a map of the south-side experimental facilities, information on Target-4 and the Lujan Center. Then it goes into detail about neutron sources, specifically continuous versus pulsed. Target 4 is then discussed. In conclusion, we have introduced the south-side experimental facilities in operation at LANSCE. 1L target and Target 4 provide complementary neutron energy spectra. Two spallation neutron sources taken together cover more than 11 orders of magnitude in neutron energy.

  13. Need for an (n,α) Apparatus at the LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Koehler, Paul E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-03-05

    There is an urgent need for a new (n,α) measurement capability at the Los Alamos Neutrons Science Center (LANSCE) for several reasons. First, it has been shown that (n,α) measurements on medium- to heavy-mass nuclides can provide some of the best constraints on some of the most important reaction rates for explosive nucleosynthesis studies. A few such measurements have been made, but many more are needed. Second, there are a few (n,p) and (n,α) cross sections on lighter nuclides of importance to nuclear astrophysics that remain unmeasured. Third, it has been shown that (n,α) measurements can constrain photon strength functions (PSFs) at very low energies. This is important because recent experiments, theory, and astrophysical calculations have demonstrated that enhanced PSFs at these energies can have large impacts on nucleosynthesis occurring in explosive environments. Also, enhanced low-energy PSFs could have significant impact on (n,γ) cross sections of interest to radiochemical diagnostics of nuclear devices. However, the shape of PSFs at low energies is a subject of considerable controversy, so new data are badly needed. Fourth, previous (n,α) data have revealed a number of puzzles and hints of exotic atomic-nuclear interactions. In addition to being interesting in their own light, these interactions could be important for understanding high-energy-density environments such as in nuclear explosion and at the National Ignition Facility. Simulations indicate that the high neutron flux at the Manuel Lujan Jr. Neutron Scattering Center (MLNSC) at the LANSCE will make many more of the needed measurements feasible. Hence, a new (n,α) instrument at the MLNSC would enable a wide range of important and interesting basic and applied science.

  14. Neutron Imaging Developments at LANSCE

    Science.gov (United States)

    Nelson, Ron; Hunter, James; Schirato, Richard; Vogel, Sven; Swift, Alicia; Ickes, Tim; Ward, Bill; Losko, Adrian; Tremsin, Anton

    2015-10-01

    Neutron imaging is complementary to x-ray imaging because of its sensitivity to light elements and greater penetration of high-Z materials. Energy-resolved neutron imaging can provide contrast enhancements for elements and isotopes due to the variations with energy in scattering cross sections due to nuclear resonances. These cross section differences exist due to compound nuclear resonances that are characteristic of each element and isotope, as well as broader resonances at higher energies. In addition, multi-probe imaging, such as combined photon and neutron imaging, is a powerful tool for discerning properties and features in materials that cannot be observed with a single probe. Recently, we have demonstrated neutron imaging, both radiography and computed tomography, using the moderated (Lujan Center) and high-energy (WNR facility) neutron sources at LANSCE. Flat panel x-ray detectors with suitable scintillator-converter screens provide good sensitivity for both low and high neutron energies. Micro-Channel-Plate detectors and iCCD scintillator camera systems that provide the fast time gating needed for energy-resolved imaging have been demonstrated as well. Examples of recent work will be shown including fluid flow in plants and imaging through dense thick objects. This work is funded by the US Department of Energy, National Nuclear Security Administration, and performed by Los Alamos National Security LLC under Contract DE-AC52-06NA25396.

  15. Proceedings of the workshop on neutron-induced gamma-ray physics at LANSCE/WNR

    Energy Technology Data Exchange (ETDEWEB)

    Strottman, D.D.

    1996-07-01

    The purpose of the workshop was to present the unique capabilities of LANSCE coupled with a large scale Compton suppressed Ge detector array and to help define a future experimental research program. This document contains the vuegraphs from the unclassified session. The vuegraphs were kindly provided by the invited speakers who came from both the university and the national laboratory communities. The talks focused on planned as well as potential experiments at LANSCE/WNR and their importance to the field.

  16. BEAM POSITION AND PHASE MONITORS FOR THE LANSCE LINAC

    Energy Technology Data Exchange (ETDEWEB)

    McCrady, Rodney C. [Los Alamos National Laboratory; Gilpatrick, John D. [Los Alamos National Laboratory; Watkins, Heath A. [Los Alamos National Laboratory

    2012-04-11

    New beam-position and phase monitors are under development for the linac at the Los Alamos Neutron Science Center (LANSCE.) Transducers have been designed and are being installed. We are considering many options for the electronic instrumentation to process the signals and provide position and phase data with the necessary precision and flexibility to serve the various required functions. We'll present the various options under consideration for instrumentation along with the advantages and shortcomings of these options.

  17. GTC Exhibition and Experience Center Launched

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    On May 18, the Exhibition and Experience Center of the Beijing Global Trade Center (GTC) was inaugurated and put into service. A grand inauguration ceremony was held with participation from agent representatives in GTC, which is a complex of Grade-A office units and comprehensive commercial facilities.

  18. Neutron Imaging Developments at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Ronald Owen [Los Alamos National Laboratory; Hunter, James F. [Los Alamos National Laboratory; Schirato, Richard C. [Los Alamos National Laboratory; Vogel, Sven C. [Los Alamos National Laboratory; Swift, Alicia L. [Los Alamos National Laboratory; Ickes, Timothy Lee [Los Alamos National Laboratory; Ward, William Carl [Los Alamos National Laboratory; Losko, Adrian Simon [University of California at Berkeley; Tremsin, Anton [University of California at Berkeley; Sevanto, Sanna Annika [Los Alamos National Laboratory; Espy, Michelle A. [Los Alamos National Laboratory; Dickman, Lee Thoresen [Los Alamos National Laboratory; Malone, Michael [Los Alamos National Laboratory

    2015-10-29

    Thermal, epithermal, and high-energy neutrons are available from two spallation sources at the 800 MeV proton accelerator. Improvements in detectors and computing have enabled new capabilities that use the pulsed beam properties at LANSCE; these include amorphous Si (aSi) detectors, intensified charge-coupled device cameras, and micro-channel plates. Applications include water flow in living specimens, inclusions and fission products in uranium oxide, and high-energy neutron imaging using an aSi flat panel with ZnS(Ag) scintillator screen. images of a metal/plastic cylinder from photons, low-energy and high-energy neutrons are compared.

  19. LANSCE beam instrumentation and the LANSCE refurbishment project

    Energy Technology Data Exchange (ETDEWEB)

    Mccrady, Rodney C [Los Alamos National Laboratory; Blind, Barbara [Los Alamos National Laboratory; Gilpatrick, John D [Los Alamos National Laboratory; Pillai, Chandra [Los Alamos National Laboratory; Power, John F [Los Alamos National Laboratory; Rybarcyk, Lawrence J [Los Alamos National Laboratory; Sedillo, James D [Los Alamos National Laboratory; Gruchalla, Michael E [Los Alamos National Laboratory

    2010-01-01

    The heart of the LANSCE accelerator complex consists of Cockroft-Walton-type injectors, a drift-tube linac (DTL) and a side-coupled linac (CCL). These systems are approaching 40 years of age and a project to re-establish high-power capability and to extend the lifetime is underway. Many of the present beam diagnostic systems are difficult to maintain, and the original beam position monitors don't provide any data at all. These deficiencies hamper beam tuning and trouble-shooting efforts. One thrust of the refurbishment project is to restore reliable operation of the diagnostic systems. This paper describes the present diagnostics systems and their limitations and the envisaged next-generation systems. The emphasis will be on the uses and requirements for the systems rather than the solutions and engineering aspects of the refurbishment.

  20. Characterizing and Controlling Beam Losses at the LANSCE Facility

    Energy Technology Data Exchange (ETDEWEB)

    Rybarcyk, Lawrence J. [Los Alamos National Laboratory

    2012-09-12

    The Los Alamos Neutron Science Center (LANSCE) currently provides 100-MeV H{sup +} and 800-MeV H{sup -} beams to several user facilities that have distinct beam requirements, e.g. intensity, micropulse pattern, duty factor, etc. Minimizing beam loss is critical to achieving good performance and reliable operation, but can be challenging in the context of simultaneous multi-beam delivery. This presentation will discuss various aspects related to the observation, characterization and minimization of beam loss associated with normal production beam operations in the linac.

  1. LANSCE personnel access control system (PACS)

    International Nuclear Information System (INIS)

    The Radiation Security System (RSS) at the Los Alamos Neutron Science Center (LANSCE) provides personnel protection from prompt radiation due to accelerated beam. The Personnel Access Control System (PACS) is a component of the RSS that is designed to prevent personnel access to areas where prompt radiation is a hazard. PACS was designed to replace several older personnel safety systems (PSS) with a single modem unified design. Lessons learned from the operation over the last 20 years were incorporated into a redundant sensor, single-point failure safe, fault tolerant, and tamper-resistant system that prevents access to the beam areas by controlling the access keys and beam stoppers. PACS uses a layered philosophy to the physical and electronic design. The most critical assemblies are battery backed up, relay logic circuits; less critical devices use Programmable Logic Controllers (PLCs) for timing functions and communications. Outside reviewers have reviewed the operational safety of the design. The design philosophy, lessons learned, hardware design, software design, operation, and limitations of the device are described

  2. The LANSCE Low Momentum Beam Monitor

    CERN Document Server

    Merl, R

    2004-01-01

    A diagnostic has been developed at the Los Alamos Neutron Science Center (LANSCE) for the purpose of identifying low momentum beam tails in the linear accelerator. These tails must be eliminated in order to maintain the transverse and longitudinal beam size. Instead of the currently used phosphor camera system, this instrument consists of a Multi Wire Proportional Chamber (MWPC) front end coupled to an EPICS compliant VME-based electronics package. Low momentum tails are detected with a resolution of 5 mm in the MWPC at a high dispersion point near a bending magnet. While phosphor is typically not sensitive in the nano amp range, the MWPC is sensitive down to about a pico amp. The electronics package processes the signals from each of the MWPC wires to generate an array of beam currents at each of the lower energies. The electronics has an analog front end with a high-speed analog to digital converter for each wire. Data from multiple wires are processed with an embedded digital signal processor and results p...

  3. Lead Slowing-Down Spectrometer Research at Lansce

    Science.gov (United States)

    Haight, R. C.; Bredeweg, T. A.; Devlin, M.; Gavron, A.; Jandel, M.; O'Donnell, J. M.; Wender, S. A.; Bélier, G.; Granier, T.; Laurent, B.; Taieb, J.; Danon, Y.; Thompson, J. T.

    2013-03-01

    The lead slowing-down spectrometer (LSDS) at Los Alamos is a 20 ton cube of lead with numerous channels, one for the proton beam from the LANSCE accelerator and others for samples and detectors. A pulsed spallation neutron source at the center of the cube is produced by the 800 MeV proton beam incident on an air-cooled tungsten target. Neutrons from this source are quickly downscattered by various reactions until their energies are less than the first excited state of 207Pb (0.57 MeV). After that, the neutrons slow down by elastic scattering where they lose on the average 1% of their energy per collision. The mean energy of the neutron distribution then changes with time as ~ 1/(t + to)2, where "to" is a constant. The low neutron absorption cross section of lead and multiple scattering of the neutrons leads to a very large neutron flux, approximately 1000 times that available in beams at the intense neutron source at the Lujan Center at LANSCE. Thus nuclear cross sections can be measured with very small samples, or conversely, very small cross sections can be measured with somewhat larger samples. Present research with the LSDS at LANSCE includes measuring fission cross sections on short-lived isotopes such as 237U, developing techniques to measure (n,p) and (n, α) cross sections, testing new types of detectors for use in the extreme radiation environment, and, in an applied context, assessing the possibility of measuring the isotopic content of actinide samples with the eventual goal of characterizing fresh and used reactor fuel rods.

  4. Hepatoblastoma: Experience from a single center

    OpenAIRE

    Singh, T.; C T Satheesh; Appaji, L.; Aruna Kumari BS; M Padma; Kumar, M V; Mukherjee, G.

    2010-01-01

    Background: The cornerstones of successful treatment of hepatoblastoma (HB) include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. Aims: We analyzed our single center experience with neoadjuvant chemotherapy (NACT) and surgery in HBs. Settings and Design: Our study included all ch...

  5. NASA Lewis Research Center combustion MHD experiment

    Science.gov (United States)

    Smith, J. M.

    1982-01-01

    The MHD power generation experiments were conducted in a high field strength cryomagnet which was adapted from an existing facility. In its original construction, it consisted of 12 high purity aluminum coils pool cooled in a bath of liquid neon. In this configuration, a peak field of 15 tesla was produced. For the present experiments, the center four coils were removed and a 23 cm diameter transverse warm bore tube was inserted to allow the placement of the MHD experiment between the remaining eight coils. In this configuration, a peak field of 6 tesla should be obtainable. The time duration of the experiment is limited by the neon supply which allows on the order of 1 minute of total operating time followed by an 18-hour reliquefaction period. As a result, the experiments are run in a pulsed mode. The run duration for the data presented here was 5 sec. The magnetic field profile along the MHD duct is shown. Since the working fluid is in essence superheated steam, it is easily water quenched at the exit of the diffuser and the components are designed vacuum tight so that the exhaust pipe and demister an be pumped down to simulate the vacuum of outer space.

  6. Optimizing X Center experience : case study: Company X

    OpenAIRE

    Lehtinen, Timo

    2014-01-01

    This Master’s thesis explores customer experience management and customer experience optimization. The aim is to optimize customer experience in the case company’s X Center. The thesis studies customer experience and customer experience management as a core factor in holding successful X Center events. The study is conducted in cooperation with Company X. Company X launched a new concept called X Center in Finland 2011. X Center is a place where custom-ers and company representatives can ...

  7. Cross Section Measurements at LANSCE for Defense, Science and Applications

    Directory of Open Access Journals (Sweden)

    Nelson Ronald O.

    2015-01-01

    Full Text Available The Los Alamos Neutron Science Center (LANSCE has three neutron sources that are used for nuclear science measurements. These sources are driven by an 800 MeV proton linear accelerator and cover an energy range from sub-thermal to hundreds of MeV. Research at the facilities is performed under the auspices of a US DOE user program under which research proposals are rated for merit by a program advisory committee and are scheduled based on merit and availability of beam time. A wide variety of instruments is operated at the neutron flight paths at LANSCE including neutron detector arrays, gamma-ray detector arrays, fission fragment detectors, and charged particle detectors. These instruments provide nuclear data for multiple uses that range from increasing knowledge in fundamental science to satisfying data needs for diverse applications such as nuclear energy, global security, and industrial applications. Highlights of recent research related to cross sections measurements are presented, and future research initiatives are discussed.

  8. Wire Scanner Beam Profile Measurements for the LANSCE Facility

    Energy Technology Data Exchange (ETDEWEB)

    Gilpatrick, John D. [Los Alamos National Laboratory; Gruchalla, Michael E. [Los Alamos National Laboratory; Martinez, Derwin [Los Alamos National Laboratory; Pillai, Chandra [Los Alamos National Laboratory; Rodriguez Esparza, Sergio [Los Alamos National Laboratory; Sedillo, James Daniel [Los Alamos National Laboratory; Smith, Brian G. [Los Alamos National Laboratory

    2012-05-15

    The Los Alamos Neutron Science Center (LANSCE) is replacing beam profile measurement systems, commonly known as Wire Scanners (WS). Using the principal of secondary electron emission, the WS measurement system moves a wire or fiber across an impinging particle beam, sampling a projected transverse-beam distribution. Because existing WS actuators and electronic components are either no longer manufactured or home-built with antiquated parts, a new WS beam profile measurement is being designed, fabricated, and tested. The goals for these new WS's include using off-the-shelf components while eliminating antiquated components, providing quick operation while allowing for easy maintainability, and tolerating external radioactivation. The WS measurement system consists of beam line actuators, a cable plant, an electronics processor chassis, and software located both in the electronics chassis (National Instruments LabVIEW) and in the Central Control Room (EPICS-based client software). This WS measurement system will measure Hand H{sup +} LANSCE-facility beams and will also measure less common beams. This paper describes these WS measurement systems.

  9. An overview of DANCE: a 4II BaF[2] detector for neutron capture measurements at LANSCE.

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J. L. (John L.)

    2004-01-01

    The Detector for Advanced Neutron Capture experiments (DANCE) is a 162-element, 4{pi} BaF{sub 2} array designed to make neutron capture cross-section measurements on rare or radioactive targets with masses as little as 1 mg. Accurate capture cross sections are needed in many research areas, including stellar nucleosynthesis, advanced nuclear fuel cycles, waste transmutation, and other applied programs. These cross sections are difficult to calculate accurately and must be measured. Up to now, except for a few long-lived nuclides there are essentially no differential capture measurements on radioactive nuclei. The DANCE array is located at the Lujan Neutron Scattering Center at LANSCE, which is a continuous-spectrum neutron source with useable energies from below thermal to about 100 keV. Data acquisition is done with 320 fast waveform digitizers. The design and initial performance results, including background minimization, will be discussed.

  10. An overview of DANCE: a 4π BaF2 detector for neutron capture measurements at LANSCE

    International Nuclear Information System (INIS)

    The Detector for Advanced Neutron Capture experiments (DANCE) is a 162-element, 4π BaF2 array designed to make neutron capture cross-section measurements on rare or radioactive targets with masses as little as 1 mg. Accurate capture cross sections are needed in many research areas, including stellar nucleosynthesis, advanced nuclear fuel cycles, waste transmutation, and other applied programs. These cross sections are difficult to calculate accurately and must be measured. Up to now, except for a few long-lived nuclides there are essentially no differential capture measurements on radioactive nuclei. The DANCE array is located at the Lujan Neutron Scattering Center at LANSCE, which is a continuous-spectrum neutron source with useable energies from below thermal to about 100 keV. Data acquisition is done with 320 fast waveform digitizers. The design and initial performance results, including background minimization, will be discussed.

  11. Airline experience with reliability-centered maintenance

    International Nuclear Information System (INIS)

    Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.)

  12. Neutron Capture Measurements on Unstable Nuclei at LANSCE

    International Nuclear Information System (INIS)

    Although neutron capture by stable isotopes has been extensively measured, there are very few measurements on unstable isotopes. The intense neutron flux at the Manual Lujan Jr. Neutron Scattering Center at LANSCE enables us to measure capture on targets with masses of about 1 mg over the energy range from 1 eV to 100 keV. These measurements are important not only for understanding the basic physics, but also for calculations of stellar nucleosynthesis and Science-Based Stockpile Stewardship. Preliminary measurements on 169Tm and 171Tm have been made with deuterated benzene detectors. A new detector array at the Lujan center and a new radioactive isotope separator will combine to give Los Alamos a unique capability for making these measurements

  13. Neutron capture measurements on unstable nuclei at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J.L.; Haight, R.C. [LANSCE-3, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Fowler, M.M.; Miller, G.G.; Rundberg, R.S.; Wilhelmy, J.B. [CST-11, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    1999-06-01

    Although neutron capture by stable isotopes has been extensively measured, there are very few measurements on unstable isotopes. The intense neutron flux at the Manual Lujan Jr. Neutron Scattering Center at LANSCE enables us to measure capture on targets with masses of about 1 mg over the energy range from 1 eV to 100 keV. These measurements are important not only for understanding the basic physics, but also for calculations of stellar nucleosynthesis and Science-Based Stockpile Stewardship. Preliminary measurements on {sup 169}Tm and {sup 171}Tm have been made with deuterated benzene detectors. A new detector array at the Lujan center and a new radioactive isotope separator will combine to give Los Alamos a unique capability for making these measurements. {copyright} {ital 1999 American Institute of Physics.}

  14. Neutron Capture Measurements on Unstable Nuclei at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J.; Haight, R.; Wilhelmy, J.; Fowler, M.; Rundberg, R.; Miller, G.

    1998-11-04

    Although neutron capture by stable isotopes has been extensively measured, there are very few measurements on unstable isotopes. The intense neutron flux at the Manual Lujan Jr. Neutron Scattering Center at LANSCE enables us to measure capture on targets with masses of about 1 mg over the energy range from 1 eV to 100 keV. These measurements are important not only for understanding the basic physics, but also for calculations of stellar nucleosynthesis and Science-Based Stockpile Stewardship. Preliminary measurements on {sup 169}Tm and {sup 171}Tm have been made with deuterated benzene detectors. A new detector array at the Lujan center and a new radioactive isotope separator will combine to give Los Alamos a unique capability for making these measurements.

  15. Hepatoblastoma: Experience from a single center

    Directory of Open Access Journals (Sweden)

    T Singh

    2010-01-01

    Full Text Available Background: The cornerstones of successful treatment of hepatoblastoma (HB include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. Aims: We analyzed our single center experience with neoadjuvant chemotherapy (NACT and surgery in HBs. Settings and Design: Our study included all children with HBs who received NACT and underwent surgical excision from January 1997 to July 2004. Materials and Methods: Patient characteristics, clinical features, clinical course, treatment modalities, and long-term outcome were analyzed. Results: There were 9 boys and 3 girls, aged 5-60 months (median age at tumor diagnosis was 24 months. All received NACT containing cisplatin and doxorubicin. Of the 12 children, 9 underwent hepatectomy and among them, 4 patients each had right and left hepatectomy and 1 patient underwent right extended hepatectomy. After surgery, all patients completed rest of the chemotherapy course (total 6 cycles. R0 resection was carried out in all the 9 cases with no life-threatening complications. Conclusions: Our experience of the 9 cases, although less in number, reaffirms the advantages of NACT followed by surgery. The prognosis for patients with resectable tumors is fairly good in combination with chemotherapy.

  16. Single Center Experience of Acute Disseminated Encephalomyelitis

    OpenAIRE

    J Gordon Millichap

    2013-01-01

    Investigators at Department of Pediatrics, Neurology Division, Adana Medical Research Center; and Division of Child Neurology, Ankara, Turkey, retrospectively evaluated 15 children with acute disseminated encephalomyelitis (ADEM) in children from the center in Adana.

  17. Overview of progress on the improvement projects for the LANSCE accelerator and target facilities

    International Nuclear Information System (INIS)

    Three projects have been initiated since 1994 to improve the performance of the accelerator and target facilities for the Los Alamos Neutron Science Center (LANSCE). The LANSCE Reliability Improvement Project (LRIP) was separated into two phases. Phase 1, completed in 1995, targeted near-term improvements to beam reliability and availability that could be completed in one-year's time. Phase 2, now underway and scheduled for completion in May 1998, consists of two projects: (a) implementation of direct H-injection for the Proton Storage Ring (PSR) and (b) an upgrade of the target/moderator system for the short pulse spallation neutron (SPSS) source. The latter will reduce the target change-out time from about 10 months to about three weeks. The third project, the SPSS Enhancement Project, is aimed at increasing the PSR output beam current to 200 microA at 30 Hz and providing up to seven new neutron scattering instruments

  18. Different approaches to modeling the LANSCE H- ion source filament performance

    Science.gov (United States)

    Draganic, I. N.; O'Hara, J. F.; Rybarcyk, L. J.

    2016-02-01

    An overview of different approaches to modeling of hot tungsten filament performance in the Los Alamos Neutron Science Center (LANSCE) H- surface converter ion source is presented. The most critical components in this negative ion source are two specially shaped wire filaments heated up to the working temperature range of 2600 K-2700 K during normal beam production. In order to prevent catastrophic filament failures (creation of hot spots, wire breaking, excessive filament deflection towards source body, etc.) and to improve understanding of the material erosion processes, we have simulated the filament performance using three different models: a semi-empirical model, a thermal finite-element analysis model, and an analytical model. Results of all three models were compared with data taken during LANSCE beam production. The models were used to support the recent successful transition from the beam pulse repetition rate of 60 Hz-120 Hz.

  19. Different approaches to modeling the LANSCE H{sup −} ion source filament performance

    Energy Technology Data Exchange (ETDEWEB)

    Draganic, I. N., E-mail: draganic@lanl.gov; O’Hara, J. F.; Rybarcyk, L. J. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    2016-02-15

    An overview of different approaches to modeling of hot tungsten filament performance in the Los Alamos Neutron Science Center (LANSCE) H{sup −} surface converter ion source is presented. The most critical components in this negative ion source are two specially shaped wire filaments heated up to the working temperature range of 2600 K–2700 K during normal beam production. In order to prevent catastrophic filament failures (creation of hot spots, wire breaking, excessive filament deflection towards source body, etc.) and to improve understanding of the material erosion processes, we have simulated the filament performance using three different models: a semi-empirical model, a thermal finite-element analysis model, and an analytical model. Results of all three models were compared with data taken during LANSCE beam production. The models were used to support the recent successful transition from the beam pulse repetition rate of 60 Hz–120 Hz.

  20. Experience-Centered Design Designers, Users, and Communities in Dialogue

    CERN Document Server

    Wright, Peter

    2010-01-01

    Experience-centered design, experience-based design, experience design, designing for experience, user experience design. All of these terms have emerged and gained acceptance in the Human-Computer Interaction (HCI) and Interaction Design relatively recently. In this book, we set out our understanding of experience-centered design as a humanistic approach to designing digital technologies and media that enhance lived experience. The book is divided into three sections. In Section 1, we outline the historical origins and basic concepts that led into and flow out from our understanding of experi

  1. The Renewal Center Time, Experience, Memory

    OpenAIRE

    Tennant, Mark

    2005-01-01

    Time, Experience, Memory Through experience we are conscious of time. Through time, our experiences become memories, influencing both conscious and unconscious thought. It is through our five senses; touch, sight, hearing, smell and taste, that these experiences are gathered. Humans are also born with inherent knowledge that our species has collected from generation to generation. This inherent knowledge, also called the collective unconscious, has a direct effect on the way we perce...

  2. A New Approach to Measuring the Neutron Decay Correlations with Cold Neutrons at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Wilburn, W.S.; Bowman, J.D.; Greene, G.L.; Jones, G.L.; Kapustinsky, J.S.; Penttila, S.I.

    1999-06-08

    Precision measurements of the neutron beta-decay correlations A, B, a, and b provide important tests of the standard model of electroweak interactions: a test of the unitarity of the first row of the CKM matrix, a search for new weak interactions, a test of the theory of nuclear beta decays, and a test of the conserved-vector-current hypothesis. The authors are designing an experiment at the LANSCE short-pulse spallation source to measure all four correlations to an order of magnitude better accuracy than the existing measurements. The accuracy of the previous measurements was limited by systematics. The design of the proposed experiment makes use of the pulsed nature of the LANSCE source to reduce systematic errors associated with the measurement of the neutron polarization as well as other systematic errors. In addition, the authors are developing silicon strip detectors for detecting both the proton and electron from the neutron decay.

  3. Increasing Counseling Center Utilization: Yeshiva University's Experience

    Science.gov (United States)

    Schwartz, Victor; Nissel, Chaim; Eisenberg, Daniel; Kay, Jerald; Brown, Joshua T.

    2012-01-01

    Yeshiva University established a counseling center during the 2004-2005 academic year. As a religiously based institution, the administration recognized that there would likely be significant impediments to utilization of on-campus mental health services as a result of negative attitudes about mental illness and its treatment--stigma. To combat…

  4. Transplant nephrectomy - A single-center experience

    Directory of Open Access Journals (Sweden)

    Arun Ariyarathenam

    2015-01-01

    Full Text Available Transplant nephrectomy (TN is associated with significant morbidity and mortality and influences the outcome of subsequent renal transplantation. The aim of this study was to identify the reasons for TN in a single transplant center in the United Kingdom and to determine the complication rate, effect on relisting and re-transplantation. We studied all the TNs in our center from January 2000 to December 2011. Detailed information including cause of allograft failure and reason for TN were analyzed. Of 602 renal transplants performed at our center during the period of the study, 42 TNs were performed on 38 (6% patients (24 men and 14 women. The median age of the patients at the time of transplantation who subsequently underwent TN was 56 years (range: 28-73 years and 71% of the allografts were donated after circulatory death. The mean human leucocyte antigen mismatch for these patients was 2.3. The most commonly used immunosuppression was a combination of prednisolone, mycophenolate and tacrolimus, which was used in 50% of the patients. Twenty-five (60% of the TNs in this series were for allografts failing during the first month of transplantation. The most common indication for the TN was graft thrombosis (50%, with an overall in-hospital mortality rate of 9.5% and a morbidity rate of 31%. Seven of 19 patients listed underwent successful re-transplantation. Although TN is associated with a risk of significant morbidity and mortality, it does not preclude from listing for re-transplantation. The difficulty of access to complete information about transplant failures and TN highlights the need for a national registry.

  5. Neutron chopper development at LANSCE

    International Nuclear Information System (INIS)

    Progress is reported on neutron chopper systems for the Los Alamos Neutron Scattering Center pulsed spallation neutron source. This includes the development of 600+ Hz active magnetic bearing neutron chopper and a high speed control system designed to operate with the Proton Storage Ring to phase the chopper to the neutron source. 5 refs., 3 figs

  6. Progress on the PSR/LANSCE upgrade

    International Nuclear Information System (INIS)

    A two-phase improvement program for the spallation neutron facilities at LANSCE is underway and scheduled to be completed early in 1998. The primary goals are a beam reliability or availability of 85% or greater, a capability for routine and sustained beam operations for eight months per year, access to the experimental room (ER-1) closest to the neutron production target with beam on, and 100 μA average beam current from PSR. Many reliability improvements are included in the project along with implementation of direct H-injection into PSR and a major upgrade of the target/moderator system. (author) 3 figs., 6 refs

  7. Pregnancy during Hemodialysis: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Bahadi Abdelali

    2010-01-01

    Full Text Available Successful pregnancy outcome is an uncommon occurrence in women requiring chronic dialysis treatment. We reviewed the course and outcome of 9 pregnancies occurred in women on chronic hemodialysis in our center from 1999-2007; 5 of them ended with delivery of alive newborns, 2 with fetal deaths in-utero, and 2 with abortions. The average age of patients was 34 years. The etiology of the original kidney disease was unknown in 44.4% of the cases, and only 22.2% of the patients maintained diuresis. Dialysis started in 8 cases before the diagnosis of pregnancy. The average gestational age at diagnosis was 14 weeks. We modified the prescription of dialysis in 4 patients by increasing the frequency of the dialysis sessions to 6 per week and in 3 by increasing the duration of each session to 6 hours. Anemia was present in all the cases; 3 patients received erythropoietin and 4 patients required transfusion. The pregnancy was com-plicated in 44% of the cases by a polyhydramnios. The average time at delivery was 33 weeks and it was achieved in 80% of pregnancies through vaginal route. The average weight of newborns was to 2380 g. We conclude that pregnancy in women on hemodialysis is possible. The success of pregnancy may be influenced by the residual diuresis and early diagnosis to improve the quality of dialysis by increasing the dialysis dose.

  8. Prior Experiences Shaping Family Science Conversations at a Nature Center

    Science.gov (United States)

    McClain, Lucy R.; Zimmerman, Heather Toomey

    2014-01-01

    Using families as the analytical focus, this study informs the field of informal science education with a focus on the role of prior experiences in family science conversations during nature walks at an outdoor-based nature center. Through video-based research, the team analyzed 16 families during walks at a nature center. Each family's prior…

  9. Ambulatory laparoscopic cholecystectomy: A single center experience

    Directory of Open Access Journals (Sweden)

    Cagri Tiryaki

    2016-01-01

    Full Text Available Aim: To evaluate the demographic and clinical parameters affecting the outcomes of ambulatory laparoscopic cholecystectomy (ALC in terms of pain, nausea, anxiety level, and satisfaction of patients in a tertiary health center. Materials and Methods: ALC was offered to 60 patients who met the inclusion criteria. Follow-up (questioning for postoperative pain or discomfort, nausea or vomiting, overall satisfaction was done by telephone contact on the same day at 22:00 p.m. and the first day after surgery at 8: 00 a.m. and by clinical examination one week after operation. STAI I and II data were used for proceeding to the level of anxiety of patients before and/or after the operation. Results: Sixty consecutive patients, with a mean age of 40.6 ± 8.1 years underwent ALC. Fifty-five (92% patients could be sent to their homes on the same day but five patients could not be sent due to anxiety, pain, or social indications. Nausea was reported in four (6.7% cases and not associated with any demographic or clinical features of patients. On the other hand, pain has been reported in 28 (46.7% cases, and obesity and shorter duration of gallbladder disease were associated with the increased pain perception (P = 0.009 and 0.004, respectively. Preopereative anxiety level was significantly higher among patients who could not complete the ALC procedure (P = 0.018. Conclusion: Correct management of these possible adverse effects results in the increased satisfaction of patients and may encourage this more cost-effective and safe method of laparoscopic cholecystectomy.

  10. CUBED: South Dakota 2010 Research Center For Dusel Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Christina [University of South Dakota, Vermillion, SD 57069 (United States); Alton, Drew [Augustana College, Sioux Falls, SD 57197 (United States); Bai Xinhau [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Durben, Dan [Black Hills State University, 1200 University Street, Spearfish, SD, 57799 (United States); Heise, Jaret [Sanford Lab, Lead, SD 57754 (United States); Hong Haiping; Howard, Stan [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Jiang Chaoyang [University of South Dakota, Vermillion, SD 57069 (United States); Keeter, Kara [Black Hills State University, 1200 University Street, Spearfish, SD, 57799 (United States); McTaggart, Robert [South Dakota State University, Brookings, SD 57007 (United States); Medlin, Dana [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Mei Dongming [University of South Dakota, Vermillion, SD 57069 (United States); Petukhov, Andre [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Rauber, Joel [South Dakota State University, Brookings, SD 57007 (United States); Roggenthen, Bill [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Spaans, Jason; Sun Yongchen [University of South Dakota, Vermillion, SD 57069 (United States); Szczerbinska, Barbara [Department of Physical Sciences, Dakota State University, Madison, SD 57042 (United States); Thomas, Keenan [University of South Dakota, Vermillion, SD 57069 (United States); Zehfus, Michael [Black Hills State University, 1200 University Street, Spearfish, SD, 57799 (United States)

    2010-03-01

    With the selection of the Homestake Mine in western South Dakota by the National Science Foundation (NSF) as the site for a national Deep Underground Science and Engineering Laboratory (DUSEL), the state of South Dakota has sought ways to engage its faculty and students in activities planned for DUSEL. One such effort is the creation of a 2010 Research Center focused on ultra-low background experiments or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The goals of this center include to 1) bring together the current South Dakota faculty so that one may begin to develop a critical mass of expertise necessary for South Dakota's full participation in large-scale collaborations planned for DUSEL; 2) to increase the number of research faculty and other research personnel in South Dakota to complement and supplement existing expertise in nuclear physics and materials sciences; 3) to be competitive in pursuit of external funding through the creation of a center which focuses on areas of interest to experiments planned for DUSEL such as an underground crystal growth lab, a low background counting facility, a purification/depletion facility for noble liquids, and an electroforming copper facility underground; and 4) to train and educate graduate and undergraduate students as a way to develop the scientific workforce of the state. We will provide an update on the activities of the center and describe in more detail the scientific foci of the center.

  11. CUBED: South Dakota 2010 Research Center For Dusel Experiments

    International Nuclear Information System (INIS)

    With the selection of the Homestake Mine in western South Dakota by the National Science Foundation (NSF) as the site for a national Deep Underground Science and Engineering Laboratory (DUSEL), the state of South Dakota has sought ways to engage its faculty and students in activities planned for DUSEL. One such effort is the creation of a 2010 Research Center focused on ultra-low background experiments or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The goals of this center include to 1) bring together the current South Dakota faculty so that one may begin to develop a critical mass of expertise necessary for South Dakota's full participation in large-scale collaborations planned for DUSEL; 2) to increase the number of research faculty and other research personnel in South Dakota to complement and supplement existing expertise in nuclear physics and materials sciences; 3) to be competitive in pursuit of external funding through the creation of a center which focuses on areas of interest to experiments planned for DUSEL such as an underground crystal growth lab, a low background counting facility, a purification/depletion facility for noble liquids, and an electroforming copper facility underground; and 4) to train and educate graduate and undergraduate students as a way to develop the scientific workforce of the state. We will provide an update on the activities of the center and describe in more detail the scientific foci of the center.

  12. The LANSCE 805 MHZ RF System History and Status

    CERN Document Server

    Lynch, Michael; Tallerico, Paul J

    2005-01-01

    The Los Alamos Neutron Science Center (LANSCE) linear accelerator runs at 201.25 MHz for acceleration to 100 MeV. The remainder of the acceleration to 800 MeV is at 805 MHz. This is done with 44 accelerator cavity stages driven by 805 MHz klystrons. Each klystron has a peak power capability of 1.25 MeV. Originally, 97 klystrons were purchased, which was 70 from Varian/CPI and 27 from Litton. The 44 RF systems are laid out in sectors with either 6 or 7 klystrons per sector. The klystrons in each sector are powered from a common HV sytem. The current arrangement uses the Varian/CPI klystrons in 6 of the 7 sectors and Litton klystrons in the remaining sector. With that arrangement there are 38 CPI klystrons installed and 1 spare klystron per sector and 6 Litton klystrons installed in the final sector with 2 spares. The current average life of all of the operating and spare klystrons (52 total) is >112,000 filament hours and >93,000 HV hours. That is three times the typical klystron lifetime today f...

  13. Monte Carlo simulation of the spear reflectometer at LANSCE

    International Nuclear Information System (INIS)

    The Monte Carlo instrument simulation code, MCLIB, contains elements to represent several components found in neutron spectrometers including slits, choppers, detectors, sources and various samples. Using these elements to represent the components of a neutron scattering instrument, one can simulate, for example, an inelastic spectrometer, a small angle scattering machine, or a reflectometer. In order to benchmark the code, we chose to compare simulated data from the MCLIB code with an actual experiment performed on the SPEAR reflectometer at LANSCE. This was done by first fitting an actual SPEAR data set to obtain the model scattering-length-density profile, Β(z), for the sample and the substrate. Then these parameters were used as input values for the sample scattering function. A simplified model of SPEAR was chosen which contained all of the essential components of the instrument. A code containing the MCLIB subroutines was then written to simulate this simplified instrument. The resulting data was then fit and compared to the actual data set in terms of the statistics, resolution and accuracy

  14. Stripping of H- beams by residual gas in the linac at the Los Alamos neutron science center

    Energy Technology Data Exchange (ETDEWEB)

    Mccrady, Rodney C [Los Alamos National Laboratory; Ito, Takeyasu [Los Alamos National Laboratory; Cooper, Martin D [Los Alamos National Laboratory; Alexander, Saunders [Los Alamos National Laboratory

    2010-09-07

    The linear accelerator at the Los Alamos Neutron Science Center (LANSCE) accelerates both protons and H{sup -} ions using Cockroft-Walton-type injectors, a drift-tube linac and a coupled-cavity linac. The vacuum is maintained in the range of 10{sup -6} to 10{sup -7} Torr; the residual gas in the vacuum system results in some stripping of the electrons from the H{sup -} ions resulting in beam spill and the potential for unwanted proton beams delivered to experiments. We have measured the amount of fully-stripped H{sup -} beam (protons) that end up at approximately 800 MeV in the beam switchyard at LANSCE using image plates as very sensitive detectors. We present here the motivation for the measurement, the measurement technique and results.

  15. AMS experiment takes off for Kennedy Space Center August 2010

    CERN Multimedia

    CERN Video Productions

    2010-01-01

    Geneva, 18 August 2010. The Alpha Magnetic Spectrometer (AMS), an experiment that will search for antimatter and dark matter in space, leaves CERN next Tuesday on the next leg of its journey to the International Space Station. The AMS detector is being transported from CERN to Geneva International Airport in preparation for its planned departure from Switzerland on 26 August, when it will be flown to the Kennedy Space Center in Florida on board a US Air Force Galaxy transport aircraft.

  16. 16O(n,α cross section investigation using LENZ instrument at LANSCE

    Directory of Open Access Journals (Sweden)

    Lee H.Y.

    2016-01-01

    Full Text Available Importance of studying the 16O(n,α reaction is motivated by multiple nuclear applications. The Los Alamos Neutron Science Center (LANSCE produces a white neutron spectrum ranging from thermal to several hundreds of MeV energies. We have recently developed the LENZ (Low Energy NZ-neutron induced charged particle detection capability to measure high-precision (n,α cross sections. In order to provide more reliable data, we have enhanced solid angle coverage, and improved signal-to-noise ratios and time-of-flight resolution by implementing digitizer waveform analysis. The LENZ was commissioned by studying the 59Co(n,α reaction with neutron beams in early 2015. For the 16O(n,α reaction, we investigate solid oxygen targets and make a relative measurement to a better known cross section, such as the 6Li(n,α reaction in order to further reduce systematic uncertainty. We will discuss the progress of the 16O(n,α study at LANSCE and the outlook for improving Hauser-Feshbah prediction on (n,p reaction cross sections.

  17. 16O(n,α) cross section investigation using LENZ instrument at LANSCE

    Science.gov (United States)

    Lee, H. Y.; Mosby, S.; Haight, R. C.; White, M. C.

    2016-06-01

    Importance of studying the 16O(n,α) reaction is motivated by multiple nuclear applications. The Los Alamos Neutron Science Center (LANSCE) produces a white neutron spectrum ranging from thermal to several hundreds of MeV energies. We have recently developed the LENZ (Low Energy NZ-neutron induced charged particle detection) capability to measure high-precision (n,α) cross sections. In order to provide more reliable data, we have enhanced solid angle coverage, and improved signal-to-noise ratios and time-of-flight resolution by implementing digitizer waveform analysis. The LENZ was commissioned by studying the 59Co(n,α) reaction with neutron beams in early 2015. For the 16O(n,α) reaction, we investigate solid oxygen targets and make a relative measurement to a better known cross section, such as the 6Li(n,α) reaction in order to further reduce systematic uncertainty. We will discuss the progress of the 16O(n,α) study at LANSCE and the outlook for improving Hauser-Feshbah prediction on (n,p) reaction cross sections.

  18. Center for Ultra-Low Background Experiments at Dusel

    International Nuclear Information System (INIS)

    The selection of Homestake Mine in Lead South Dakota by National Science Foundation (NSF) as the site for Deep Underground Science and Engineering Laboratory (DUSEL) opened new research opportunities in the state of South Dakota. One of many efforts allowing the scientists a significant participation in the activities planned at DUSEL was the creation of a 2010 Research Center focused on the production of ultra-low background materials or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The main objectives of this research center are: (1) to bring together the current South Dakota faculty to develop a critical mass of expertise necessary for the state's full participation in the large scale collaboration at DUSEL; (2) to increase the number of research faculty members in the state to complement and supplement existing expertise in nuclear physics and materials sciences; (3) to train and educate graduate and undergraduate students. The main research focus of CUBED is aimed at experiments searching for rare and difficult to detect phenomena such as neutrinoless double beta decay and dark matter. Major scientific activities proposed by CUBED include a low background counting facility, an underground crystal growth lab, a purification/depletion facility on noble gases, and an underground electroforming copper facility. We will provide detailed information of research activities at CUBED. (author)

  19. Experience with Server Self Service Center (S3C)

    CERN Multimedia

    Sucik, J

    2009-01-01

    CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

  20. Experience with Server Self Service Center (S3C)

    CERN Document Server

    Sucik, J; CERN. Geneva. IT Department

    2010-01-01

    CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

  1. Advanced Life Support Project: Crop Experiments at Kennedy Space Center

    Science.gov (United States)

    Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil

    2004-01-01

    Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and

  2. Installation of center disk baffle into Madison Dynamo Experiment vessel

    Science.gov (United States)

    Clark, M. M.; Nornberg, M. D.; Taylor, N. Z.; Wallace, J. P.; Forest, C. B.

    2013-10-01

    The Madison Dynamo Experiment (MDE) comprises a 1 m diameter spherical chamber that contains a turbulent flow of liquid sodium driven by two counter rotating impellers. One of the goals of the MDE is to observe a magnetic field grow at the expense of kinetic energy in the liquid sodium flow. It has been found that turbulence in the MDE plays a significant and solely detrimental role in the generation of magnetic fields. The installation of an equatorial baffle and the three rotatable vanes in each hemisphere resulted in a reduction of large scale eddies in the flow and enhanced field generation. However, no self-excited field was observed. This Poster will present recent modifications made to the experiment consisting of installing a copper disk baffle in the center of the spherical vessel. The design and installation of the structure will be illustrated and discussed. Results from before and after the center disk baffle installation will be shown. Supported by NSF and DoE.

  3. Management of Cushing's disease: a single-center experience.

    Science.gov (United States)

    Solak, Mirsala; Kraljevic, Ivana; Dusek, Tina; Melada, Ante; Kavanagh, Marcel Marjanovic; Peterkovic, Vjerislav; Ozretic, David; Kastelan, Darko

    2016-03-01

    The purpose of this study was to review therapeutic outcomes and comorbidities of patients with Cushing's disease (CD) in a single center. We conducted a retrospective study of 33 patients with CD undergoing transsphenoidal surgery from January 2007 to February 2014 (27 females and 6 males, median age 38 years, range 18-71 years). The diagnosis of Cushing's syndrome was established on the basis of the patient's history, characteristic clinical features, and laboratory data including an elevated 24-h urinary free cortisol level, lack of serum cortisol suppression after dexamethasone suppression tests and an elevated midnight cortisol level. In 28/33 patients, the tumor was visualized on MR of the sellar region, while in 5 it was diagnosed using an inferior petrosal sinus sampling. Out of the 33 patients, 10 had macroadenoma and the remaining 23 had microadenoma. Twenty-one patients (63.6%) had hypertension, 17 (51.5%) dyslipidemia, and 7 (21.2%) had type 2 diabetes or impaired glucose tolerance. The median follow-up period was 28 months. Remission after transsphenoidal surgery was achieved in 78.8% of patients, while 7 patients failed to achieve disease remission. Those patients were treated with second-line treatment modalities (second operation, radiotherapy, bilateral adrenalectomy, and/or ketoconazole). One patient rejected all the treatment modalities after surgery. Cumulative remission after all the treatment modalities was achieved in 87.9% patients. Patients with Cushing's disease should be managed in centers with much experience due to high patient load. In our Center, the remission of the disease has been achieved in 78.8% of the patients following transsphenoidal surgery. Multimodal treatment which included radiotherapy and medical treatment led to biochemical remission of the disease in 87.9% of patients.

  4. Characteristics of a lead slowing-down spectrometer coupled to the LANSCE accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Rochman, D. [LANSCE-3, Los Alamos National Laboratory, MS H855, Los Alamos, NM 87545 (United States)]. E-mail: drochman@bnl.gov; Haight, R.C. [LANSCE-3, Los Alamos National Laboratory, MS H855, Los Alamos, NM 87545 (United States)]. E-mail: haight@lanl.gov; O' Donnell, J.M. [LANSCE-3, Los Alamos National Laboratory, MS H855, Los Alamos, NM 87545 (United States)]. E-mail: odonnell@lanl.gov; Michaudon, A. [LANSCE-3, Los Alamos National Laboratory, MS H855, Los Alamos, NM 87545 (United States)]. E-mail: michaudon@lanl.gov; Wender, S.A. [LANSCE-3, Los Alamos National Laboratory, MS H855, Los Alamos, NM 87545 (United States)]. E-mail: wender@lanl.gov; Vieira, D.J. [C-INC, Los Alamos National Laboratory, MS J514, Los Alamos, NM 87545 (United States)]. E-mail: vieira@lanl.gov; Bond, E.M. [C-INC, Los Alamos National Laboratory, MS J514, Los Alamos, NM 87545 (United States)]. E-mail: bond@lanl.gov; Bredeweg, T.A. [C-INC, Los Alamos National Laboratory, MS J514, Los Alamos, NM 87545 (United States)]. E-mail: toddb@lanl.gov; Kronenberg, A. [C-INC, Los Alamos National Laboratory, MS J514, Los Alamos, NM 87545 (United States)]. E-mail: kronenberga@mail.phy.ornl.gov; Wilhelmy, J.B. [C-INC, Los Alamos National Laboratory, MS J514, Los Alamos, NM 87545 (United States)]. E-mail: j_wilhelmy@lanl.gov; Ethvignot, T. [Commissariat a l' Energie Atomique, DIF/DPTA/Service de Physique Nucleaire, BP 12, 91680 Bruyeres-le-Cha-hat tel (France)]. E-mail: thierry.ethvignot@cea.fr; Granier, T. [Commissariat a l' Energie Atomique, DIF/DPTA/Service de Physique Nucleaire, BP 12, 91680 Bruyeres-le-Cha-hat tel (France)]. E-mail: thierry.granier@cea.fr; Petit, M. [Commissariat a l' Energie Atomique, DIF/DPTA/Service de Physique Nucleaire, BP 12, 91680 Bruyeres-le-Chatel (France)]. E-mail: michael.petit@cea.fr; Danon, Y. [Rensselaer Polytechnic Institute, Troy, New York, NY 12180 (United States)]. E-mail: danony@rpi.edu

    2005-09-11

    A description is given of a lead slowing-down spectrometer (LSDS) installed at the 800-MeV proton accelerator of the Los Alamos Neutron Science Center (LANSCE). The LSDS is designed to study neutron-induced fission on actinides that can only be obtained or used in small quantities. The characteristics of this LSDS (energy-time relation, energy resolution, neutron flux) are presented through simulations with MCNPX and measurements with several different methods. Results on neutron-induced fission of {sup 235}U and {sup 239}Pu with tens of micrograms and tens of nanograms, respectively, are presented. Finally, additional MCNPX calculations have been performed to simulate the measurement of the cross-section for U235m(n,f) using different target quantities and different initial isomer-to-ground state compositions.

  5. GEANIE at WNR/LANSCE -- A new instrument for neutron science

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, R.O.; Becker, J.A.; Archer, D.E. [and others

    1997-09-01

    GEANIE, an array of escape-suppressed high-resolution Ge detectors now installed at the white-neutron source at the Los Alamos Neutron Science Center, is the first large Ge detector array to be used at a high-energy spallation neutron source. GEANIE consists of 20 Ge detectors including both coaxial Ge detectors and planar Ge detectors to enhance capabilities for low-energy {gamma}-ray spectroscopy. The array is located on a 20 m flight path with a neutron flux spanning the energy range from 1 to over 200 MeV. Installation of the first phase of GEANIE was recently completed and data were acquired on a number of samples, including actinides. The unique combination of GEANIE with the neutron source at LANSCE provides new capabilities for neutron science. The status of the array and recent results are presented, and new opportunities for physics and nuclear data are discussed.

  6. CCSDS telemetry systems experience at the Goddard Space Flight Center

    Science.gov (United States)

    Carper, Richard D.; Stallings, William H., III

    1990-09-01

    NASA Goddard Space Flight Center (GSFC) designs, builds, manages, and operates science and applications spacecraft in near-earth orbit, and provides data capture, data processing, and flight control services for these spacecraft. In addition, GSFC has the responsibility of providing space-ground and ground-ground communications for near-earth orbiting spacecraft, including those of the manned spaceflight programs. The goal of reducing both the developmental and operating costs of the end-to-end information system has led the GSFC to support and participate in the standardization activities of the Consultative Committee for Space Data Systems (CCSDS), including those for packet telemetry. The environment in which such systems function is described, and the GSFC experience with CCSDS packet telemetry in the context of the Gamma-Ray Observatory project is discussed.

  7. Surface-loss power calculations for the LANSCE DTL

    Energy Technology Data Exchange (ETDEWEB)

    Kurennoy, Surgey S [Los Alamos National Laboratory

    2008-01-01

    The surface losses in the drift-tube linac (DTL) tanks 3 and 4 of the LANSCE linear accelerator are calculated using 3-D electromagnetic modeling with the CST MicroWave Studio (MWS). The results are used to provide more realistic power estimates for the 201.25MHz RF upgrade design within the LANSCE-R project. We compared 3-D MWS results with those from traditional 2-D Superfish computations for DTL cells and their simplified models and found differences on the level of a few percent. The differences are traced to a 3-D effect consisting in a redistribution of the surface currents on the drift tubes (DT) produced by the DT stem. The dependence of MWS results on the mesh size used in computations is also discussed.

  8. SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2011-01-01

    Full Text Available Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

  9. Los Alamos neutron science center nuclear weapons stewardship and unique national scientific capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Schoenberg, Kurt F [Los Alamos National Laboratory

    2010-12-15

    This presentation gives an overview of the Los Alamos Neutron Science Center (LANSCE) and its contributions to science and the nuclear weapons program. LANSCE is made of multiple experimental facilities (the Lujan Center, the Weapons Neutron Research facility (WNR), the Ultra-Cold Neutron facility (UCN), the proton Radiography facility (pRad) and the Isotope Production Facility (IPF)) served by the its kilometer long linear accelerator. Several research areas are supported, including materials and bioscience, nuclear science, materials dynamics, irradiation response and medical isotope production. LANSCE is a national user facility that supports researchers worldwide. The LANSCE Risk Mitigation program is currently in progress to update critical accelerator equipment to help extend the lifetime of LANSCE as a key user facility. The Associate Directorate of Business Sciences (ADBS) plays an important role in the continued success of LANSCE. This includes key procurement support, human resource support, technical writing support, and training support. LANSCE is also the foundation of the future signature facility MARIE (Matter-Radiation Interactions in Extremes).

  10. Single-center experience in double kidney transplantation.

    Science.gov (United States)

    Fontana, I; Magoni Rossi, A; Gasloli, G; Santori, G; Giannone, A; Bertocchi, M; Piaggio, F; Bocci, E; Valente, Umberto

    2010-05-01

    Use of organs from marginal donors for transplantation is a current strategy to expand the organ donor pool. Its efficacy is universally accepted among data from multicenter studies. Herein, we have reviewed outcomes of double kidney transplantation (DKT) over an 9-year experience in our center. The aim of this study was to evaluate possible important differences between a monocenter versus multicenter studies. Between 1999 and 2008, we performed 59 DKT. Recipient mean age was 63 +/- 5 years. Mean HLA-A, -B, and -DR mismatches were 3.69 +/- 0.922. Donor mean age was 69 +/- 7 years and mean creatinine clearance was 69.8 +/- 30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130 +/- 216 and 48 +/- 11 minutes, respectively. The right and left kidney scores were 4.18 +/- 2 and 4.21 +/- 2, respectively. Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). In three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), whereas we observed a cyclosporine-related toxicity in 7 (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. In this study, we applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. In our experience, the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation. PMID:20534235

  11. Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-01

    Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  12. LIVER TRANSPLANTATION. A SINGLE CENTER EXPERIENCE OF 100 CASES

    Directory of Open Access Journals (Sweden)

    A. M. Granov

    2012-01-01

    Full Text Available A single center experience of first 100 liver transplantations (LTs is summarized. Analysis of trends in cadaver donor population and waiting list status changes, and also of early and late postoperative complications are presented. 100 LTs were performed for 95 patients (pts, retransplantation – 4 pts; one patient received 3 liver transplants (female – 55 pts, male – 40 pts, mean age – 39.9 ± 12.1 years. Cumulative 1-year survival rate of pts by Kaplan–Meyer was 91%, 3-year – 83%. Biliary complications were revealed in 9% of pts during 2–9 months after LT. 77 pts have been regularly observed in outpatient clinic, mean age – 44 ± 9.2 years, male – 35, fema- le – 42, follow-up period – 1 months up to 13 years after LT. 3.9% remained invalid with limitation of ability to work, 61.8% have been working, 22.3% were capable to work, retirees were 10.5%. Development of preoperati- ve planning, adequate organ selection will allow to improve the results of LT. Study of hematopoietic stem cells role will expand tools of prognosis of posttransplant complications. 

  13. Encapsulating peritoneal sclerosis: experience of a tertiary referral center.

    LENUS (Irish Health Repository)

    Phelan, P J

    2010-05-01

    Encapsulating peritoneal sclerosis (EPS) is arguably the most serious complication of chronic peritoneal dialysis (PD) therapy with extremely high mortality rates. We aimed to establish the rates of EPS and factors associated with its development in a single center.

  14. National Spherical Torus Experiment (NSTX) Center Stack Upgrade

    Energy Technology Data Exchange (ETDEWEB)

    Neumeyer, C; Chrzanowski, J; Dudek, L; Fan, H; Hatcher, R; Heitzenroeder, P; Menard, J; Ono, M; Ramakrishnan, S; Titus, P; Woolley, R

    2009-09-24

    The purpose of the NSTX Center Stack Upgrade project is to expand the NSTX operational space and thereby the physics basis for next-step ST facilities. The plasma aspect ratio (ratio of plasma major to minor radius) of the upgrade is increased to 1.5 from the original value of 1.26, which increases the cross sectional area of the center stack by a factor of ~ 3 and makes possible higher levels of performance and pulse duration.

  15. HELIOS: A high intensity chopper spectrometer at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Mason, T.E. [Oak Ridge National Lab., TN (United States); Broholm, C. [Johns Hopkins Univ., Baltimore, MD (United States). Dept. of Physics and Astronomy; Fultz, B. [California Inst. of Tech., Pasadena, CA (United States). Dept. of Materials Science] [and others

    1998-12-31

    A proposal to construct a high intensity chopper spectrometer at LANSCE as part of the SPSS upgrade project is discussed. HELIOS will be optimized for science requiring high sensitivity neutron spectroscopy. This includes studies of phonon density of states in small polycrystalline samples, magnetic excitations in quantum magnets and highly correlated electron systems, as well as parametric studies (as a function of pressure, temperature, or magnetic field) of S(Q,{omega}). By employing a compact design together with the use of supermirror guide in the incident flight path the neutron flux at HELIOS will be significantly higher than any other comparable instrument now operating.

  16. User-Centered Design in Practice: The Brown University Experience

    Science.gov (United States)

    Bordac, Sarah; Rainwater, Jean

    2008-01-01

    This article presents a case study in user-centered design that explores the needs and preferences of undergraduate users. An analysis of LibQual+ and other user surveys, interviews with public service staff, and a formal American with Disabilities Act accessibility review served as the basis for planning a redesign of the Brown University…

  17. The Amistad Research Center: Documenting the African American Experience.

    Science.gov (United States)

    Chepesiuk, Ron

    1993-01-01

    Describes the Amistad Research Center housed at Tulane University which is a repository of primary documents on African-American history. Topics addressed include the development and growth of the collection; inclusion of the American Missionary Association archives; sources of support; civil rights; and collecting for the future. (LRW)

  18. Early experiences with big data at an academic medical center.

    Science.gov (United States)

    Halamka, John D

    2014-07-01

    Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC.

  19. Thrombolytics in VAD management — A single-center experience

    OpenAIRE

    Nair, N.; Schmitt, A A; E.M. Rau; Anders, S.; Sandler, D.; T.B. Icenogle

    2016-01-01

    Background: With continued increase in the use of mechanical circulatory support, the incidence of device thrombus remains a challenge. This study is a retrospective analysis of data at a single center to assess the safety and efficacy of thrombolytic use in durable mechanical assist devices. Methods: Data was analyzed retrospectively from 154 patients who underwent left ventricular assist device (LVAD) implantation from 1/1/2005 to 6/30/2014. The HMII device was implanted in 131 patients ...

  20. Clinical spectrum of hypopituitarism in India: A single center experience

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2012-01-01

    Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

  1. Acute renal transplant rejections: A single center experience

    Directory of Open Access Journals (Sweden)

    Jabur Wael

    2008-01-01

    Full Text Available We undertook this observational study to assess the incidence of acute rejections (AR in the first six months after transplantation at Al-Karama Hospital, Iraq. Sixty eight patients (49 males and 19 females underwent renal transplantation in 2006 and were followed up weekly. Forty six received kidneys from related donors and 22 from unrelated donors. During the first six months after transplantation AR occurred in 16 patients (23%; 11 (23% related and 5 (23% unrelated donor transplantation. We conclude that the incidence of acute rejection was similar in related and unrelated donor transplantation and the general incidence was comparable to that reported from most centers.

  2. Docker experience at INFN-Pisa Grid Data Center

    Science.gov (United States)

    Mazzoni, E.; Arezzini, S.; Boccali, T.; Ciampa, A.; Coscetti, S.; Bonacorsi, D.

    2015-12-01

    Clouds and virtualization offer typical answers to the needs of large-scale computing centers to satisfy diverse sets of user communities in terms of architecture, OS, etc. On the other hand, solutions like Docker seems to emerge as a way to rely on Linux kernel capabilities to package only the applications and the development environment needed by the users, thus solving several resource management issues related to cloud-like solutions. In this paper, we present an exploratory (though well advanced) test done at a major Italian Tier2, at INFN-Pisa, where a considerable fraction of the resources and services has been moved to Docker. The results obtained are definitely encouraging, and Pisa is transitioning all of its Worker Nodes and services to Docker containers. Work is currently being expanded into the preparation of suitable images for a completely virtualized Tier2, with no dependency on local configurations.

  3. Blunt pancreatic trauma: experience at a rural referral center.

    Science.gov (United States)

    Timberlake, G A

    1997-03-01

    The objective of this study was to compare mechanism of injury, treatment methods, and outcome of blunt pancreas trauma patients transferred from another hospital to those of patients brought directly from the scene. A retrospective review was conducted of 6078 patients treated at a Level I trauma center from 1/1/90 to 12/31/94. Blunt pancreas injury was found in 39 (0.64%) patients (mean age, 33.2 years). Mechanism of injury included 34 (87%) motor vehicle crashes, 3 (8%) motorcycle crashes, and 2 (5%) other injuries. There were 11 transfer patients (28%), and 28 (72%) admitted directly from the scene. Eighty-two per cent of the motor vehicle crash patients were unrestrained, and 35 per cent had ethanol intoxication. Exploratory laparotomy was performed on 32 (82%); eight (25%) required repair or resection; 22 (69%) had trivial injuries, at most requiring drainage; and two (6.3%) exsanguinated. No patients required Whipple resection or pancreatiocojejunostomy. At operation, an average of 2.5 associated intra-abdominal injuries were found. Overall survival was 35 of 39 (90%). Among the patients brought directly to the trauma center, 93 per cent survived, whereas survival among transferred patients was 82 per cent (chi2 = 0.19; P = 0.66). Blunt pancreatic injuries vary in severity, but radical resection is rarely required. Lack of safety restraint and ethanol use are major risk factors. Despite the high likelihood of associated injuries, survivability is high. No difference in outcome was seen between directly admitted and transferred patients. PMID:9036900

  4. Establishing Group Autonomy through Self-Access Center Learning Experiences

    Directory of Open Access Journals (Sweden)

    Harumi Kimura

    2014-03-01

    Full Text Available In this article, I argue that a self-access center (SAC should be able to foster group autonomy, although SACs were originally developed for individually autonomous L2 learning experiences—i.e., each student studying L2 on his or her own. Along with offering learning materials and chances for individual self-study, a SAC should provide opportunities for building and maintaining a learner community. The data obtained by a narrative frame and subsequent e-mail correspondence demonstrated that active users often come to SACs to do homework and prepare for classes. They are happy to work together and have opportunities to make friends with students in different classes and in different year groups—i.e., mutual peer support is vital. Fun activities for establishing rapport and boosting L2 learning motivation are worth implementing. Learner autonomy ultimately involves interdependence between learners in a well-functioning learner community, and for this purpose a SAC can and should be a physical space where students can comfortably spend time and interact with other students, as well as with counselors and teachers.

  5. Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Abdul Rouf Khawaja

    2014-01-01

    Full Text Available Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients. Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients. Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram. Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

  6. Experience report: a training center for health response

    International Nuclear Information System (INIS)

    The Professor Nelson Valverde Training Center was created within FEAM (The ELETRONUCLEAR Medical Assistance Foundation) with the objective of capacitating Radio Nuclear Accident Responders for the Health Area in the Almirante Alvaro Alberto Nuclear Central (Angra dos Reis - RJ - Brazil). The first step was structuring the contents for this training using IAEA's Manuals as base (EPR Medical - 2005, EPR First Responders - 2006 and TMT - Handbook - 2009) and data from REAC/TS. The second step was to capacitate instructors. The third step was the integration with the Company's Radiological Protection Division, giving radiological assessment. Finally, the development of training applications, ending with Drills, Tests and Assessment, gathering data and suggestions, objectifying the constant improvement. Training Programs with pre and post evaluations have been started. Since 2004 training internal courses were ministered for 125 professionals with annual re-training and were ministered to 130 professionals from several external institutions. During the same period training courses were ministered to 140 trainees from the Radiological Protection Division of The Nuclear Power Plant of Angra dos Reis, as First Lay Responders, objectifying the improvement of the quality of the emergency response. (author)

  7. DISTRIBUTION OF CONGENITAL HEART DISEASES AT TERTIARY CARE CENTER: SINGLE CENTER EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Vaishali

    2016-02-01

    Full Text Available BACKGROUND The current study was undertaken at a tertiary care center, Bhopal, MP, India, with the objective of establishing frequency of occurrence of congenital heart diseases by echocardiography. MATERIALS AND METHOD 10,000 consecutive cases undergoing Echo Color Doppler in the Cardiology Department Hamidia Hospital, Bhopal, between 1st Jan 2009 and July 2011 were analysed. Echo CD was performed by consultant cardiologist using Acuson Aspen Color Doppler machine following the ASE guidelines. RESULTS AND CONCLUSIONS In the present study out of 10,000consecutive cases undergoing echo 648 were identified to having congenital heart diseases. Isolated VSD (30.5%, isolated ASD (23.6% PDA (9% and TOF (8.3% were commonest defect observed. Most common congenital heart disease found in the present study is VSD and is most prevalent in males and is highest among 0-5 yrs.

  8. Status of a new switchyard design for LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Garnett, R.W.; Rose, C.; Shelley, F.; Zumbro, J.D.

    1998-12-31

    Funding was recently received to study modifications of a section of the LANSCE beam switchyard. At present, the switchyard is used to deliver a proton beam to experimental Area A and an H{sup {minus}}-ion beam down Line D. The total H{sup {minus}} repetition rate is 120 Hz, 100 Hz is transported to the Weapons Neutron Research (WNR) area. The remaining 20 Hz is injected into the Proton Storage Ring (PSR). In order to provide H{sup {minus}} beam to other experimental areas without interfering with the PSR operations, a new design of the switchyard is in progress. The authors are presently investigating a solution that would use pulsed kicker magnets to deflect a fraction of the WNR H{sup {minus}} beam down a separate existing beam-line at the demand of the experimenters.

  9. Location-based solutions in the experience center

    DEFF Research Database (Denmark)

    Witzner Hansen, Dan; Alapetite, Alexandre; Holdgaard, Nanna;

    2009-01-01

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the NaturBornholm [1] experience centre in Denmar...... using a combination of Bluetooth, Near field communication (NFC), GPS and QR-codes. Bluetooth, NFC, and GPS are used for location-based information and QR-codes are used to convey user preferences. [1] http://naturbornholm.dk...

  10. Transverse match of high peak-current beam into the LANSCE DTL using PARMILA

    International Nuclear Information System (INIS)

    A new algorithm that uses a multiparticle PARMILA-based code to match high peak current H+ beam (∼21 mA) into the Los Alamos Neutron Science Center (LANSCE) drift tube linac (DTL) has been developed. Two single cell rf bunchers in the low energy beam transport (LEBT) prepare the initially unbunched beam for DTL capture. The transverse distribution at the entrance to the DTL is set with four quadrupoles in the 1.26 m between the last transverse emittance measuring station and the DTL entrance. Previous matching algorithms used TRACE and TRACE 3-D to determine these quadrupole strengths. PARMILA simulation show this procedure produces non-zero mismatch and additional emittance growth through the DTL for high current beams. Because of strong space-charge forces and a rapidly forming longitudinal bunch, simple envelope calculations do not model the beam evolution in the LEBT well. A PARMILA model of this region was combined with ant iterative search routine to set the LEBT quadrupole strengths to achieve a better transverse match into the DTL. Simulations predict a significant reduction in transverse emittance at the exit of the DTL over the typical TRACE 3-D result

  11. A Qualitative Examination of Connections between Learner-Centered Teaching and Past Significant Learning Experiences

    Science.gov (United States)

    Brackenbury, Tim

    2012-01-01

    Learner-centered teaching is a collection of instructional practices that shift the emphasis of courses from the instructors' goals and methods of delivery to the knowledge and skills that the students develop. This study examined potential commonalities between features of learner-centered teaching and the past significant learning experiences of…

  12. Bombs, Bosons and Beer Cans-Research at the Los Alamos Neutron Science Center

    Science.gov (United States)

    Pynn, Roger

    1997-04-01

    The neutron scattering community is justifiably proud of the contributions it has made to basic research in many areas of science. Information obtained using neutrons has contributed strongly to our basic understanding of phenomena in diverse systems of interest to physicists, chemists and biologists - think, for example, of how little we would know about excitations in quantum fluids, the spin-density-wave state of chromium, electronic back-donation in the bonding of organometallic compounds, or the conformation of proteins and DNA in nucleosomes without neutron scattering. However, illustrious as this history of neutron scattering may be, it is not the only type of contribution neutrons have made to our modern scientific and technological enterprise. Increasingly in recent years, we have witnessed the application of neutrons to later parts of the R&D cycle, to problems that have been called ''strategic research'' and even in areas that are ''applied research'' or ''product development''. The purpose of my talk at this meeting is to illustrate this aspect of research at spallation neutron sources, using examples of work that has been done at the Los Alamos Neutron Science Center (LANSCE). Some of this work is driven by the fact that our principal funding agency, the Office of Defense Programs within the U.S. Department of Energy, has a need to master the science behind technologies relevant to nuclear weapons. Even so, most of the examples I have picked are equally relevant to the industrial sector and several would not shame even the most devout proponent of ''pure'' research. To demonstrate the breadth of the research performed at LANSCE, I will describe examples of recent experiments in the following areas: materials texture; temperature and particle velocity measurement in reacting high explosives; radiographic imaging with protons; chemical bonding in metal-dihydride complexes; and the structure of thin adhesive layers. LANSCE operates a user program and

  13. Mycophenolate mofetil in pediatric renal transplantation: a single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2012-02-01

    We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  14. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Shpend Idrizi

    2015-08-01

    Full Text Available BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74% of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg to 39.1 mmHg (20-80 mmHg. Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9% required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55% patients, and four (9% patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results.

  15. Five years' experience with capsule endoscopy in a single Center

    Institute of Scientific and Technical Information of China (English)

    Taylan Kav; Yusuf Bayraktar

    2009-01-01

    Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its efficacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been proven in several trials, data on uses of CE in different small bowel diseases are rapidly accumulating in the literature, and it has been found to be superior to alternative diagnostic tools in a range of such diseases.Based on literature evidence, CE is recommended as a first-line investigation for OGIB after negative bidirectional endoscopy. CE has gained an important role in the diagnosis and follow-up of Crohn's disease and celiac disease and in the surveillance of small bowel tumors and polyps in selected patients. Capsule retention is the major complication, with a frequency of 1%-2%. The purpose of this review was to discuss the procedure, indications, contraindications and adverse effects associated with CE. We also review and share our five-year experience with CE in various small bowel diseases. The recently developed balloon-assisted enteroscopies have both diagnostic and therapeutic capability. At the present time, CE and balloon-assisted enteroscopies are complementary techniques in the diagnosis and management of small bowel diseases.

  16. Valve replacement in pediatric patients:a single center experience

    Institute of Scientific and Technical Information of China (English)

    YU Jian-hua; GUO Hong-wei; ZHANG Gong; WU Shu-ming; SONG Guang-min; SUN Wen-yu

    2011-01-01

    Background Reconstructive surgery is the primary goal in pediatric patients with valve disease.However,in cases with irreparable valve lesions,valve replacement is the only option.This study aimed to retrospectively analyze the clinical experience of heart valve prosthesis replacement in children.Methods Between January 1990 and July 2009,35 pediatric patients (16 boys,19 girls) underwent mechanical valve replacement in Shandong University Qilu Hospital.The ages ranged from 2.5 to 14 years (mean,(8.8±3.8) years) and body weight varied from 11 to 37 kg (mean,(22.1±5.2) kg).Mechanical valve replacement was performed because of congenital heart disease in 23 patients,rheumatic disease in ten patients and infective endocarditis in two patients.St.Jude bileaflet mechanical valves were implanted in all the 35 patients including mitral valve replacement (MVR) in 18,aortic valve replacement (AVR) in 12,tricuspid valve replacement (TVR) in two,AVR and MVR in two and MVR and TVR in one.The size of the prostheses ranged between 19 and 27 mm.All patients received long-term anticoagulation treatment with sodium warfarin,aiming to maintain an international normalized ratio between 1.5 to 2.0.Follow-up was performed in all the patients with a total follow-up of 119.4 patient-years.Results The operative mortality was 8.57% (3/35).One patient,who underwent cardiac debridement and AVR,died 2 hours after being admitted to the intensive care unit because of severe low cardiac output syndrome and ventricular fibrillation.Two patients died of cardiogenic shock and renal failure during initial hospitalization after the operation.One patient who received replacement of a tricuspid valve developed complete heart block requiring temporary pacing and recovered sinus rhythm 4 days later.Thirty-two patients survived and their cardiac function was in New York Heart Association (NYHA) class Ⅰ to class Ⅱ when discharged.Late events included hemorrhage and endocarditis.Two patients required

  17. MRI-guided stereotactic amygdalohippocampectomy: a single center experience

    Directory of Open Access Journals (Sweden)

    Vojtěch Z

    2015-02-01

    Full Text Available Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Liščák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.Methods: The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.Results: At their last postsurgical visit, 43 (70.5% patients were Engel class I, six (9.8% class II, nine (14.8% class III, and three (4.9% class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%. Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ scores of 4, 3, and 4 IQ points, respectively (P<0.05. Five (17.2%, four (13.8%, and four (13.3% patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05. Global memory improved in three (10.3% patients, verbal memory in one (3.4%, and one patient (3.3% showed deterioration in visual memory.Conclusion: Stereotactic radiofrequency amygdalohippocampectomy offers a

  18. Parents' Experiences with Childhood Deafness: Implications for Family-Centered Services

    Science.gov (United States)

    Jackson, Carla Wood; Traub, Randi J.; Turnbull, Ann P.

    2008-01-01

    In response to the need for family-centered follow-up, this study examined parents' experiences with deafness after early identification. Qualitative inquiry methods were used to explore and describe the perceptions and experiences of nine parents of children identified with severe to profound deafness. Parents participated in face-to-face…

  19. Learner-Centered Blogging: A Preliminary Investigation of EFL Student Writers' Experience

    Science.gov (United States)

    Lin, Ming Huei

    2015-01-01

    This study aims to investigate the effectiveness of integrating a learner-centered blogging approach into the EFL writing classroom in Taiwan. For this purpose, a 16-week experiment was conducted, involving an intact class of 18 university-level Taiwanese EFL student writers. During the experiment, the participants first created their own blogs on…

  20. Ecology-Centered Experiences among Children and Adolescents: A Qualitative and Quantitative Analysis

    Science.gov (United States)

    Orton, Judy

    2013-01-01

    The present research involved two studies that considered "ecology-centered experiences" (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the…

  1. LANSCE wire scanner AFE: analysis, design, and fabrication

    International Nuclear Information System (INIS)

    The goal of the design LANSCE-R Wire-Scanner Analog Front-end Electronics is to develop a high-performance, dual-axis wire-scanner analog front-end system implemented in a single cRIO module. This new design accommodates macropulse widths as wide as 700 μs at a maximum pulse rate of 120Hz. A lossey integrator is utilized as the integration element to eliminate the requirement for providing gating signals to each wire scanner. The long macropulse and the high repetition rate present conflicting requirements for the design of the integrator. The long macropulse requires a long integration time constant to assure minimum integrator droop for accurate charge integration, and the high repetition rate requires a short time constant to assure adequate integrator reset between macropulses. Also, grounding is a serious concern due to the small signal levels. This paper reviews the basic Wire Scanner AFE system design implemented in the cRIO-module form factor to capture the charge information from the wire sensors and the grounding topology to assure minimum noise contamination of the wire signals.

  2. Early Clinical Experiences for Second-Year Student Pharmacists at an Academic Medical Center

    OpenAIRE

    McLaughlin, Jacqueline E.; Amerine, Lindsey B.; Chen, Sheh-Li; Luter, David N.; Arnall, Justin; Smith, Shayna; Roth, Mary T.; Rodgers, Philip T.; Williams, Dennis M.; Pinelli, Nicole R.

    2015-01-01

    Objective. To examine student outcomes associated with the Student Medication and Reconciliation Team (SMART) program, which was designed to provide second-year student pharmacists at the University of North Carolina (UNC) Eshelman School of Pharmacy direct patient care experience at UNC Medical Center.

  3. Neutron Capture Experiments Using the DANCE Array at Los Alamos

    International Nuclear Information System (INIS)

    The Detector for Advanced Neutron Capture Experiments (DANCE) is designed for neutron capture measurements on very small and/or radioactive targets. The DANCE array of 160 BaF2 scintillation detectors is located at the Lujan Center at the Los Alamos Neutron Science Center (LANSCE). Accurate measurements of neutron capture data are important for many current applications as well as for basic understanding of neutron capture. The gamma rays following neutron capture reactions have been studied by the time-of-flight technique using the DANCE array. The high granularity of the array allows measurements of the gamma-ray multiplicity. The gamma-ray multiplicities and energy spectra for different multiplicities can be measured and analyzed for spin and parity determination of the resolved resonances.

  4. Cyberattack analysis through Malaysian Nuclear Agency experience as nuclear research center

    International Nuclear Information System (INIS)

    As a nuclear research center, Nuclear Malaysia is one of the Critical National Information Infrastructure (CNII) in the country. One of the easiest way to launch a malicious attack is through the online system, whether main web site or online services. Recently, we also under port scanning and hack attempts from various sources. This paper will discuss on analysis based on Nuclear Malaysia experience regarding these attempts which keep arising nowadays. (author)

  5. Women’s experience regarding the role of health centers in empowering them for family planning

    OpenAIRE

    Kohan, Shahnaz; Simbar, Masoumeh; Taleghani, Fariba

    2012-01-01

    Background: Nowadays, the concept of family planning has been detached from the population control and it is expressed as an essential element in women’s reproductive rights, empowering them and promoting their status in society. Family planning services have an important role in fertility decisions using contraception methods in women. This study was carried out to explore the experience of women from the role of health centers in empowering them for family planning. Materials and Methods: T...

  6. Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience.

    OpenAIRE

    Erkan, Murat Mert; Michalski, Christoph W.; Kong, Bo; Jaeger, Carsten; Kloe, Silke; Beier, Barbara; Braren, Rickmer; Esposito, Irene; Friess, Helmut; Kleeff, Jorg

    2015-01-01

    RESEARCH ARTICLE Open Access Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience Christoph W. Michalski1,4, Bo Kong1, Carsten Jäger1, Silke Kloe1, Barbara Beier1, Rickmer Braren2, Irene Esposito3,5, Mert Erkan1,6, Helmut Friess1† and Jorg Kleeff1*† Abstract Background: Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the ...

  7. OCCUPATIONAL THERAPY EXPERIENCES IN THE FAMILY HEALTH SUPPORT CENTERS (NASF) IN THE DISTRITO FEDERAL

    OpenAIRE

    Kelly Ranyelle Alves Araujo; Thiara Dias Café Alves; Thais Lima; Vagner Dos Santos; Andrea Donatti Gallassi

    2013-01-01

    To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF). The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how student...

  8. Preparing an Academic Medical Center to Manage Patients Infected with Ebola: Experiences of a University Hospital

    OpenAIRE

    Schultz, Ch.; Koenig, KL; Alassaf, W

    2015-01-01

    © 2015 Society for Disaster Medicine and Public Health, Inc. As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered t...

  9. LOS ALAMOS NEUTRON SCIENCE CENTER CONTRIBUTIONS TO THE DEVELOPMENT OF FUTURE POWER REACTORS

    Energy Technology Data Exchange (ETDEWEB)

    GAVRON, VICTOR I. [Los Alamos National Laboratory; HILL, TONY S. [Los Alamos National Laboratory; PITCHER, ERIC J. [Los Alamos National Laboratory; TOVESSON, FREDERIK K. [Los Alamos National Laboratory

    2007-01-09

    The Los Alamos Neutron Science Center (LANSCE) is a large spallation neutron complex centered around an 800 MeV high-currently proton accelerator. Existing facilities include a highly-moderated neutron facility (Lujan Center) where neutrons between thermal and keV energies are produced, and the Weapons Neutron Research Center (WNR), where a bare spallation target produces neutrons between 0.1 and several hundred MeV.The LANSCE facility offers a unique capability to provide high precision nuclear data over a large energy region, including that for fast reactor systems. In an ongoing experimental program the fission and capture cross sections are being measured for a number of minor actinides relevant for Generation-IV reactors and transmutation technology. Fission experiments makes use of both the highly moderated spallation neutron spectrum at the Lujan Center, and the unmoderated high energy spectrum at WNR. By combininb measurements at these two facilities the differential fission cross section is measured relative to the {sup 235}U(n,f) standard from subthermal energies up to about 200 MeV. An elaborate data acquisition system is designed to deal with all the different types of background present when spanning 10 energy decades. The first isotope to be measured was {sup 237}Np, and the results were used to improve the current ENDF/B-VII evaluation. Partial results have also been obtained for {sup 240}Pu and {sup 242}Pu, and the final results are expected shortly. Capture cross sections are measured at LANSCE using the Detector for Advanced Neutron Capture Experiments (DANCE). This unique instrument is highly efficient in detecting radiative capture events, and can thus handle radioactive samples of half-lives as low as 100 years. A number of capture cross sections important to fast reaction applications have been measured with DANCE. The first measurement was on {sup 237}Np(n,{gamma}), and the results have been submitted for publication. Other capture

  10. Scientific Advancements and Technological Developments of High P-T Neutron Diffraction at LANSCE, Los Alamos

    Science.gov (United States)

    Zhao, Y.; Daemen, L. L.; Zhang, J.

    2003-12-01

    In-situ high P-T neutron diffraction experiments provide unique opportunities to study the crystal structure, hydrogen bonding, magnetism, and thermal parameters of light elements (eg. H, Li, B) and heavy elements (eg. Ta, U, Pu,), that are virtually impossible to determine with x-ray diffraction techniques. For example, thermoelasticity and Debye-Waller factor as function of pressure and temperature can be derived using in-situ high P-T neutron diffraction techniques. These applications can also be extended to a much broader spectrum of scientific problems. For instance, puzzles in Earth science such as the carbon cycle and the role of hydrous minerals for water exchange between lithosphere and biosphere can be directly addressed. Moreover, by introducing in-situ shear, texture of metals and minerals accompanied with phase transitions at high P-T conditions can also be studied by high P-T neutron diffraction. We have successfully conducted high P-T neutron diffraction experiments at LANSCE and achieved simultaneous high pressures and temperatures of 10 GPa and 1500 K. With an average 3-6 hours of data collection, the diffraction data are of sufficiently high quality for the determination of structural parameters and thermal vibrations. We have studied hydrous mineral (MgOD), perovskite (K.15,Na.85)MgF3, clathrate hydrates (CH4-, CO2-, and H2-), metals (Mo, Al, Zr), and amorphous materials (carbon black, BMG). The aim of our research is to accurately map bond lengths, bond angles, neighboring atomic environments, and phase stability in P-T-X space. Studies based on high-pressure neutron diffraction are important for multi-disciplinary science and we welcome researchers from all fields to use this advanced technique. We have developed a 500-ton toroidal press, TAP-98, to conduct simultaneous high P-T neutron diffraction experiments inside of HIPPO (High-Pressure and Preferred-Orientation diffractometer). We have also developed a large gem-crystal anvil cell, ZAP-01

  11. Development of a RAMI model for LANSCE and high power APT accelerators

    International Nuclear Information System (INIS)

    Assessment of the reliability, availability, maintainability and inspectability (RAMI) of all high power, high cost systems is important to justify and improve the cost effectiveness of these systems. For the very large (over 100 MW) accelerator systems associated with APT, a RAMI model is very valuable in guiding the design and allocation of resources. A RAMI model of an existing machine is also valuable, since machine improvement funds must be allocated to increase the availability by the largest amount. The authors have developed a RAMI model using the critical subsystems of the LANSCE accelerator and beam delivery complex as an example and to evaluate the effectiveness for estimating reliability and beam availability. LAMPF and LANSCE together provide most of the features required for the accelerator and beam delivery part of a high-power APT machine, but LANSCE is pulsed, rather than CW. This complex is capable of a 1-MW average power H- beam, and it is the most powerful proton accelerator in the US built to date

  12. Uncovering paradoxes from physicians' experiences of patient-centered ward-round.

    Science.gov (United States)

    Bååthe, Fredrik; Ahlborg, Gunnar; Edgren, Lars; Lagström, Annica; Nilsson, Kerstin

    2016-05-01

    Purpose The purpose of this paper is to uncover paradoxes emerging from physicians' experiences of a patient-centered and team-based ward round, in an internal medicine department. Design/methodology/approach Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings. Findings This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician's professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician's professional identity was centered. Physicians with more of a We-perspective experienced challenges with the new round, while physicians with more of an I-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered. Practical implications For change processes affecting physicians' professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure. Originality/value This paper provides increased understanding about how physicians' professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement. PMID:27198705

  13. Health professionals’ experiences of person-centered collaboration in mental health care

    Directory of Open Access Journals (Sweden)

    Rita Sommerseth

    2008-10-01

    Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

  14. The Deep Impact Network Experiment Operations Center Monitor and Control System

    Science.gov (United States)

    Wang, Shin-Ywan (Cindy); Torgerson, J. Leigh; Schoolcraft, Joshua; Brenman, Yan

    2009-01-01

    The Interplanetary Overlay Network (ION) software at JPL is an implementation of Delay/Disruption Tolerant Networking (DTN) which has been proposed as an interplanetary protocol to support space communication. The JPL Deep Impact Network (DINET) is a technology development experiment intended to increase the technical readiness of the JPL implemented ION suite. The DINET Experiment Operations Center (EOC) developed by JPL's Protocol Technology Lab (PTL) was critical in accomplishing the experiment. EOC, containing all end nodes of simulated spaces and one administrative node, exercised publish and subscribe functions for payload data among all end nodes to verify the effectiveness of data exchange over ION protocol stacks. A Monitor and Control System was created and installed on the administrative node as a multi-tiered internet-based Web application to support the Deep Impact Network Experiment by allowing monitoring and analysis of the data delivery and statistics from ION. This Monitor and Control System includes the capability of receiving protocol status messages, classifying and storing status messages into a database from the ION simulation network, and providing web interfaces for viewing the live results in addition to interactive database queries.

  15. Group Violence and Migration Experience among Latin American Youths in Justice Enforcement Centers (Madrid, Spain).

    Science.gov (United States)

    Martínez García, José Manuel; Martín López, María Jesús

    2015-10-30

    Group violence among Latin American immigrant youth has led to ongoing debates in political, legal, and media circles, yet none of those many perspectives has arrived at a solid, empirically supported definition for the phenomenon. This study aims to explore the relationship between the immigrant experience and violent group behavior in youths from Latin America serving prison sentences in Justice Enforcement Centers in the Community of Madrid. Semi-structured interviews were conducted with 19 juveniles, and content analysis was applied to the resulting transcripts, employing Grounded Theory to create an axial codification of intra- and inter-categorical contents, and Delphi panels for quality control. The research team delved into 62 topics, addressing participants' perceptions of the immigrant experience and its effects on five socialization settings (neighborhood, school, family, peer group, and significant other), and each one's relationship to violent behavior. The results led us to believe the young people's immigration experiences had been systematically examined. Their personal and social development was influenced by negative socioeconomic conditions, ineffective parental supervision, maladjustment and conflict at school, and experiences of marginalization and xenophobia. All those conditions favored affiliation with violent groups that provided them instrumental (economic and material), expressive, or affective support.

  16. Group Violence and Migration Experience among Latin American Youths in Justice Enforcement Centers (Madrid, Spain).

    Science.gov (United States)

    Martínez García, José Manuel; Martín López, María Jesús

    2015-01-01

    Group violence among Latin American immigrant youth has led to ongoing debates in political, legal, and media circles, yet none of those many perspectives has arrived at a solid, empirically supported definition for the phenomenon. This study aims to explore the relationship between the immigrant experience and violent group behavior in youths from Latin America serving prison sentences in Justice Enforcement Centers in the Community of Madrid. Semi-structured interviews were conducted with 19 juveniles, and content analysis was applied to the resulting transcripts, employing Grounded Theory to create an axial codification of intra- and inter-categorical contents, and Delphi panels for quality control. The research team delved into 62 topics, addressing participants' perceptions of the immigrant experience and its effects on five socialization settings (neighborhood, school, family, peer group, and significant other), and each one's relationship to violent behavior. The results led us to believe the young people's immigration experiences had been systematically examined. Their personal and social development was influenced by negative socioeconomic conditions, ineffective parental supervision, maladjustment and conflict at school, and experiences of marginalization and xenophobia. All those conditions favored affiliation with violent groups that provided them instrumental (economic and material), expressive, or affective support. PMID:26514376

  17. Atmospheric monitoring of a perfluorocarbon tracer at the 2009 ZERT Center experiment

    Science.gov (United States)

    Pekney, Natalie; Wells, Arthur; Rodney Diehl, J.; McNeil, Matthew; Lesko, Natalie; Armstrong, James; Ference, Robert

    2012-02-01

    Field experiments at Montana State University are conducted for the U.S. Department of Energy as part of the Zero Emissions Research and Technology Center (ZERT) to test and verify monitoring techniques for carbon capture and storage (CCS). A controlled release of CO 2 with an added perfluorocarbon tracer was conducted in July 2009 in a multi-laboratory study of atmospheric transport and detection technologies. Tracer plume dispersion was measured with various meteorological conditions using a tethered balloon system with Multi-Tube Remote Samplers (MTRS) at elevations of 10 m, 20 m, and 40 m above ground level (AGL), as well as a ground-based portable tower with monitors containing sorbent material to collect the tracer at 1 m, 2 m, 3 m, and 4 m AGL. Researchers designed a horizontal grid of sampling locations centered at the tracer plume source, with the tower positioned at 10 m and 30 m in both upwind and downwind directions, and the MTRS spaced at 50 m and 90 m downwind and 90 m upwind. Tracer was consistently detected at elevated concentrations at downwind sampling locations. With very few exceptions, higher tracer concentrations correlated with lower elevations. Researchers observed no statistical difference between sampling at 50 m and 90 m downwind at the same elevation. The US EPA AERMOD model applied using site-specific information predicted transport and dispersion of the tracer. Model results are compared to experimental data from the 2009 ZERT experiment. Successful characterization of the tracer plume simulated by the ZERT experiment is considered a step toward demonstrating the feasibility of remote sampling with unmanned aerial systems (UAS's) at future sequestration sites.

  18. Development of PET in Latin America. Experience of the first PET-Cyclotron Center

    International Nuclear Information System (INIS)

    Aim: Describe the experience of the first PET-Cyclotron Center in Latin America. Demonstrate the viability of running a PET Center in Argentina despite the economic crisis. Materials and Methods: For this study, we used a UGM/GE Quest 250 PET scan, a RDS 112 cyclotron and a Radiosynthesis Laboratory installed at the (FUESMEN) Nuclear Medicine School Foundation, located in Mendoza City, in the middle-west of Argentina. From January 1999 to March 2002, 741 studies were obtained, 731 were 18FluorDeoxyGlucose-PET studies and 10 phantoms for calibration purposes. We used acquisition and imaging processing standard protocols, as well as research protocols designed according to the pathology under investigation. To better correlate anatomical and functional images, we used fusion techniques with (CT) Computed Tomography in some (WB) whole-body PET scans. Results: A total of 731 patients were retrospectively analyzed and classified according to statistics variables such as: 1-sex: 317 women and 414 men, 2-type of scan: 439 WB cases, 267 brain studies and 25 cardiac. From this data we divided them as PET indications and resulted in 17 cases as healthy volunteers, 422 oncological cases, 267 neurological studies and 25 cardiac for myocardial viability. According to the origin they were classified as patients coming from Mendoza 544, Buenos Aires 112, other argentine provinces 60 and foreign (Chile, Brazil and Uruguay) 15 cases. In terms of billing, 181 studies were done free of charge, 95 under research protocols were also done free of charge and 451 were charged. Conclusion: Not only the economical and political factors play an important role limiting the advances of PET Imaging in Latin America, but also the lack of a neighboring cyclotron that circumscribe many hospitals to have access to the radiopharmaceutical agent. FUESMEN was established in 1991 by three governmental entities: the (CONEA) National Commission of Atomic Energy, the (UNC) National University of Cuyo and

  19. Training for life science experiments in space at the NASA Ames Research Center

    Science.gov (United States)

    Rodrigues, Annette T.; Maese, A. Christopher

    1993-01-01

    As this country prepares for exploration to other planets, the need to understand the affects of long duration exposure to microgravity is evident. The National Aeronautics and Space Administration (NASA) Ames Research Center's Space Life Sciences Payloads Office is responsible for a number of non-human life sciences payloads on NASA's Space Shuttle's Spacelab. Included in this responsibility is the training of those individuals who will be conducting the experiments during flight, the astronauts. Preparing a crew to conduct such experiments requires training protocols that build on simple tasks. Once a defined degree of performance proficiency is met for each task, these tasks are combined to increase the complexity of the activities. As tasks are combined into in-flight operations, they are subjected to time constraints and the crew enhances their skills through repetition. The science objectives must be completely understood by the crew and are critical to the overall training program. Completion of the in-flight activities is proof of success. Because the crew is exposed to the background of early research and plans for post-flight analyses, they have a vested interest in the flight activities. The salient features of this training approach is that it allows for flexibility in implementation, consideration of individual differences, and a greater ability to retain experiment information. This training approach offers another effective alternative training tool to existing methodologies.

  20. Assessing exploitation experiences of girls and boys seen at a Child Advocacy Center

    Science.gov (United States)

    Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B.; Saewyc, Elizabeth

    2015-01-01

    The primary aim of this study was to describe the abuse experiences of sexually exploited runaway adolescents seen at a Child Advocacy Center (N = 62). We also sought to identify risk behaviors, attributes of resiliency, laboratory results for sexually transmitted infection (STI) screens, and genital injuries from colposcopic exams. We used retrospective mixed-methods with in-depth forensic interviews, together with self-report survey responses, physical exams and chart data. Forensic interviews were analyzed using interpretive description analytical methods along domains of experience and meaning of sexual exploitation events. Univariate descriptive statistics characterized trauma responses and health risks. The first sexual exploitation events for many victims occurred as part of seemingly random encounters with procurers. Older adolescent or adult women recruited some youth working for a pimp. However, half the youth did not report a trafficker involved in setting up their exchange of sex for money, substances, or other types of consideration. 78% scored positive on the UCLA PTSD tool; 57% reported DSM IV criteria for problem substance use; 71% reported cutting behaviors, 75% suicidal ideation, and 50% had attempted suicide. Contrary to common depictions, youth may be solicited relatively quickly as runaways, yet exploitation is not always linked to having a pimp. Avoidant coping does not appear effective, as most patients exhibited significant symptoms of trauma. Awareness of variations in youth’s sexual exploitation experiences may help researchers and clinicians understand potential differences in sequelae, design effective treatment plans, and develop community prevention programs. PMID:25982287

  1. Assessing exploitation experiences of girls and boys seen at a Child Advocacy Center.

    Science.gov (United States)

    Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B; Saewyc, Elizabeth

    2015-08-01

    The primary aim of this study was to describe the abuse experiences of sexually exploited runaway adolescents seen at a Child Advocacy Center (N=62). We also sought to identify risk behaviors, attributes of resiliency, laboratory results for sexually transmitted infection (STI) screens, and genital injuries from colposcopic exams. We used retrospective mixed-methods with in-depth forensic interviews, together with self-report survey responses, physical exams and chart data. Forensic interviews were analyzed using interpretive description analytical methods along domains of experience and meaning of sexual exploitation events. Univariate descriptive statistics characterized trauma responses and health risks. The first sexual exploitation events for many victims occurred as part of seemingly random encounters with procurers. Older adolescent or adult women recruited some youth working for a pimp. However, half the youth did not report a trafficker involved in setting up their exchange of sex for money, substances, or other types of consideration. 78% scored positive on the UCLA PTSD tool; 57% reported DSM IV criteria for problem substance use; 71% reported cutting behaviors, 75% suicidal ideation, and 50% had attempted suicide. Contrary to common depictions, youth may be solicited relatively quickly as runaways, yet exploitation is not always linked to having a pimp. Avoidant coping does not appear effective, as most patients exhibited significant symptoms of trauma. Awareness of variations in youth's sexual exploitation experiences may help researchers and clinicians understand potential differences in sequelae, design effective treatment plans, and develop community prevention programs. PMID:25982287

  2. Postchemotherapy Retroperitoneal Lymph Node Dissection in Patients With Nonseminomatous Testicular Cancer: A Single Center Experiences

    Directory of Open Access Journals (Sweden)

    Nowroozi

    2015-09-01

    Full Text Available Background Testicular cancer accounts for about 1 - 1.5% of all malignancies in men. Radical orchiectomy is curative in 75% of patients with stage I disease, but advance stage with retroperitoneal lymph node involvement needs chemotherapy. All patients who have residual masses ≥ 1 cm after chemotherapy should undergo postchemotherapy retroperitoneal lymph node dissection (PC-RPLND. Objectives Treatment of advanced nonseminomatous testicular cancer is usually a combination of chemotherapy and surgery. We described our experience about postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in our center. Patients and Methods In a retrospective cross-sectional study between 2006 and 2011, patients with a history of postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in Imam Khomeini hospital were evaluated. All patients had normal postchemotherapy serum tumor markers and primary nonseminomatous cancer. We reviewed retrospectively clinical, pathological, and surgical parameters associated with PC-RPLND in our center. Results Twenty-one patients underwent bilateral PC-RPLND. Mean age was 26.3 years (ranged 16 - 47. Mean size of retroperitoneal mass after chemotherapy was 7.6 cm. Mean operative time was 198 minutes (120 - 246 minutes. Mean follow-up time was 38.6 months. Pathologic review showed presence of fibrosis/necrosis, viable germ cell tumor and teratoma in 8 (38.1%, 10 (47.6% and 3 (14.28% patients, respectively. One patient in postoperative period of surgery and three patients in two first years after surgery were expired. Of 17 alive patients, only two (11.8% had not retrograde ejaculation. Conclusions PC-RPLND is one the major operations in the field of urology, which is associated with significant adjunctive surgeries. In appropriate cases, PC-RPLND was associated with good cancer specific survival in tertiary oncology center.

  3. Academic Career Selection and Retention in Radiation Oncology: The Joint Center for Radiation Therapy Experience

    International Nuclear Information System (INIS)

    Purpose: The United States healthcare system has witnessed declining reimbursement and increasing documentation requirements for longer than 10 years. These have decreased the time available to academic faculty for teaching and mentorship. The impact of these changes on the career choices of residents is unknown. The purpose of this report was to determine whether changes have occurred during the past decade in the proportion of radiation oncology trainees from a single institution entering and staying in academic medicine. Methods and Materials: We performed a review of the resident employment experience of Harvard Joint Center for Radiation Therapy residents graduating during 13 recent consecutive years (n = 48 residents). The outcomes analyzed were the initial selection of an academic vs. nonacademic career and career changes during the first 3 years after graduation. Results: Of the 48 residents, 65% pursued an academic career immediately after graduation, and 44% remained in academics at the last follow-up, after a median of 6 years. A later graduation year was associated with a decrease in the proportion of graduates immediately entering academic medicine (odds ratio, 0.78; 95% confidence interval, 0.65-0.94). However, the retention rate at 3 years of those who did immediately enter academics increased with a later graduation year (p = 0.03). Conclusion: During a period marked by notable changes in the academic healthcare environment, the proportion of graduating Harvard Joint Center for Radiation Therapy residents pursuing academic careers has been declining; however, despite this decline, the retention rates in academia have increased

  4. Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

    2011-03-15

    Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

  5. The Real Astronomy Experience: Making the IVO Effective for International Planetaria and Science Centers

    Science.gov (United States)

    Pennypacker, Carl

    The Real Astronomy Experience, or RAE, is a new exhibit just beginning development in the late fall of 2002, hopefully to be funded by the US National Science Foundation. RAE will allow public visitors in science centers, museums, and planetaria to operate and acquire images from a either a remote telescope in the southern hemisphere or from IVO data bases. RAE can operate from Europe and North America during daylight at the exhibit site. This project will be implemented also by international Global Hands-On Universe ("GHOU") collaborators. Greater international success will be facilitated by other GHOU nations joining the collaboration to build a viable network of small, inexpensive telescopes, and federating their data bases for the IVO.

  6. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience

    Directory of Open Access Journals (Sweden)

    Andrea Algauer BSN, RN

    2015-05-01

    Full Text Available With increasing wait times in emergency departments (ED across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by visiting the patient in the ED and introducing and setting expectations for the inpatient environment (i.e. telemetry alarms, roommates, hourly comfort rounds. Along with improving the patient experience, this program intends to improve the collaboration between ED nurses and inpatient nurses. With the continued support of our nurse management, hospital administrators and most important, our staff, this concept is aimed to increase patient satisfaction scores and subsequently employee satisfaction.

  7. Teaching about vulnerable populations: nursing students' experience in a homeless center.

    Science.gov (United States)

    Stanley, Mary Jo

    2013-10-01

    Cultural competence is not limited to ethnicity, religion, or race but is inclusive of vulnerable groups, such as the homeless. The complex health and social issues related to homelessness requires educational instruction that supports students' ability to address and care for the multidimensional elements that surround this group. Exposure to homeless populations provides nursing students with increased awareness of the issues related to health disparities, while promoting introspective reflection on one's values and beliefs. To increase student exposure to working with homeless clients, a service-learning project using a critical social theory (CST) lens was offered at a homeless center. The students' response that clients were "just like" them, coupled with ambiguity regarding the complex social-economic-political issues surrounding the homeless, may indicate a need for further education regarding cultural understanding, sensitivity, and vulnerability. This project demonstrates the need for learning experiences that support advocacy and social responsibility for vulnerable groups. PMID:24040771

  8. Experiments and contexts in the interactive exhibitions of centers and museums of science

    Directory of Open Access Journals (Sweden)

    Maura Ventura Chinelli

    2009-12-01

    Full Text Available Here is described a research that meant to indentify, through analysis of experiments and contexts in interactive expositions held by centers and museums of science, the necessary conditions for grasping the scientific culture in the post-positivist conception. The project was developed with the participation of students in training courses for teachers on a proposal based on the principles and methods of action research, in order to form skills that lead to interferences in the professional future. The results show that the samples of interactive exhibits are organized according to the classic paradigm: they offer opportunities for experimentation that produce observational data supposedly neutral and maintain separate nature and human being. In conclusion, we have those exhibits contribute to bringing the visitors closer to the positivistic science, not contributing to bring them closer to the concept of science based on the contemporary paradigm of complexity.

  9. Technology Transfer from University-Based Research Centers: The University of New Mexico Experience.

    Science.gov (United States)

    Rogers, Everett M.; Hall, Brad; Hashimoto, Michio; Steffensen, Morten; Speakman, Kristen L.; Timko, Molly K.

    1999-01-01

    A study of 55 research centers at the University of New Mexico investigated the nature of the typical center, why funding has risen during the 1990s, reasons for founding the centers, the director's role, how university-based research centers transfer technology to private companies and other organizations, and what determines program…

  10. Laparoscopy Versus Robotic Surgery for Colorectal Cancer: A Single-Center Initial Experience.

    Science.gov (United States)

    Ferrara, Francesco; Piagnerelli, Riccardo; Scheiterle, Maximilian; Di Mare, Giulio; Gnoni, Pasquale; Marrelli, Daniele; Roviello, Franco

    2016-08-01

    Background Minimally invasive approach has gained interest in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics for colorectal cancer in terms of oncologic and clinical outcomes in an initial experience of a single center. Materials and Methods Clinico-pathological data of 100 patients surgically treated for colorectal cancer from March 2008 to April 2014 with laparoscopy and robotics were analyzed. The procedures were right colonic, left colonic, and rectal resections. A comparison between the laparoscopic and robotic resections was made and an analysis of the first and the last procedures in the 2 groups was performed. Results Forty-two patients underwent robotic resection and 58 underwent laparoscopic resection. The postoperative mortality was 1%. The number of harvested lymph nodes was higher in robotics. The conversion rate was 7.1% for robotics and 3.4% for laparoscopy. The operative time was lower in laparoscopy for all the procedures. No differences were found between the first and the last procedures in the 2 groups. Conclusions This initial experience has shown that robotic surgery for the treatment of colorectal adenocarcinoma is a feasible and safe procedure in terms of oncologic and clinical outcomes, although an appropriate learning curve is necessary. Further investigation is needed to demonstrate real advantages of robotics over laparoscopy. PMID:26721500

  11. Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

    Directory of Open Access Journals (Sweden)

    Bjelović Miloš

    2015-01-01

    Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

  12. Toward quality assurance for metaphase FISH: A multi-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Dewald, G. [Mayo Clinic, Rochester, NY (United States); Higgins, R. [Abbott Northwestern Hospital, Minneapolis, MN (United States); Hirsch, B. [Univ. Minnesota Hospitals and Clinics, Minneapolis, MN (United States)] [and others

    1996-09-06

    Although fluorescent in situ hybridization (FISH) is rapidly becoming a part of clinical cytogenetics, no organization sponsors multi-center determinations of the efficacy of probes. We report on 23 laboratories that volunteered to provide slides and to use a probe for SNRPN and a control locus. Experiences with FISH for these laboratories during 1994 ranged from 0 to 645 utilizations (median = 84) involving blood, amniotic fluid and bone marrow. In an initial study of hybridization efficiency, the median percentage of metaphases from normal individuals showing two SNRPN and 2 control signals for slides prepared at each site was 97.0 (range = 74-100); for slides prepared by a central laboratory, it was 97.8 (range = 81.6-100). In a subsequent blind study, each laboratory attempted to score 5 metaphases from each of 23 specimens [8 with del(15)(q11.2{r_arrow}q12) and 15 with normal 15 chromosomes]. Of 529 challenges, the correct SNRPN pattern was found in 5 of 5 metaphases in 457 (86%) and in 4 of 5 in 33 (6%). Ambiguous, incomplete or no results were reported for 32 (6%) challenges. Seven (1%) diagnostic errors were made including 6 false positives and 1 false negative: 1 laboratory made 3 errors, 1 made 2, and 2 made 1 each. Most errors and inconsistencies seemed due to inexperience with FISH. The working time to process and analyze slides singly averaged 49.5 minutes; slides processed in batches of 4 and analyzed singly required 36.9 minutes. We conclude that proficiency testing for FISH using an extensive array of challenges is possible and that multiple centers can collaborate to test probes and to evaluate costs. 10 refs., 1 fig., 4 tabs.

  13. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

    2010-10-15

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  14. A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

    Directory of Open Access Journals (Sweden)

    Rakhee Sodhi

    2016-03-01

    Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

  15. Outcomes of adult-to-adult living donor liver transplantation:a single center experience

    Institute of Scientific and Technical Information of China (English)

    FENG Xi; YUAN Ding; WEI Yong-gang; LI Fu-qiang; WEN Tian-fu; ZENG Yong; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing; YANG Jia-yin; MA Yu-kui; CHEN Zhe-yu; YE Hui; YAN Lü-nan; LI Bo

    2009-01-01

    Background Since January 2002,adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers.This study presents a detailed analysis of the outcomes of AALDLT in a single center.Methods A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007.Among these,67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts.Three-dimensional volumetric computed tomography,magnetic resonance imaging with angiography and cholangiography were performed preoperatively.Recipient operation time,intraoperative transfusion requirement,length of intensive care unit stay,length of hospital stay,liver function tests,coagulation tests and surgical outcomes were routinely investigated throughout this study.Results All donors survived the procedure with an overall complication rate of 15.3%.Overall recipient 1-year survival and complication rates were 87.1% and 34.2%,respectively.Among the 70 cases,average graft recipient weight ratio was 0.94% (0.72%-1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74%-71.68%).All residual liver volumes exceeded 35%.Liver function and coagulation recovered rapidly within the first 7 days after transplantation.Conclusions AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease.Patient selection and timely decision-making for transplantation are essential in achieving good outcomes.With accumulation of experience in surgery and clinical management,timely feedback and proper modification,we foresee better outcomes in the future.

  16. Congenital duodenal obstruction in neonates:a decade's experience from one center

    Institute of Scientific and Technical Information of China (English)

    Qing-Jiang Chen; Zhi-Gang Gao; Jin-Fa Tou; Yun-Zhong Qian; Min-Ju Li; Qi-Xing Xiong; Qiang Shu

    2014-01-01

    Background: Congenital duodenal obstruction (CDO) is one of the most common anomalies in newborns, and accounting for nearly half of all cases of neonatal intestinal obstruction. This study aimed to review our single-center experience in managing congenital duodenal obstruction while evaluate the outcomes. Methods: We conducted a retrospective analysis of the records of all neonates dianogsed with congenital duodenal obstruction admitted to our center between January 2003 and December 2012. We analyzed demographic criteria, clinical manifestations, associated anomalies, radiologic findings, surgical methods, postoperative complications, and fi nal outcomes. Results: The study comprised 287 newborns (193 boys and 94 girls). Birth weight ranged from 950 g to 4850 g. Fifty-three patients were born prematurely between 28 and 36 weeks' gestation. Malrotation was diagnosed in 174 patients, annular pancreas in 66, duodenal web in 55, duodenal atresia or stenosis in 9, preduodenal portal vein in 2, and congenital band compression in 1. Twenty patients had various combinations of these conditions. Presenting symptoms included bilious vomiting, dehydration, and weight loss. X-rays of the upper abdomen demonstrated the presence of a typical doublebubble sign or air-fl uid levels in 68.64% of patients, and confi rmatory upper and/or lower gastrointestinal contrast studies were obtained in 64.11%. Multiple associated abnormalities were observed in 50.52% of the patients. Various surgical approaches were used, including Ladd's procedure, duodenoplasty, duodenoduodenostomy, duodenojejunostomy, or a combination of these. Seventeen patients died postoperatively and 14 required re-operation. Conclusions: Congenital duodenal obstruction is a complex entity with various etiologies and often includes multiple concomitant disorders. Timely diagnosis and aggressive surgery are key to improving prognosis. Care should be taken to address all of the causes of duodenal obstruction and

  17. Nuclear Energy Experiments to the Center for Global Security and Cooperation.

    Energy Technology Data Exchange (ETDEWEB)

    Osborn, Douglas M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-06-01

    This is to serve as verification that the Center 6200 experimental pieces supplied to the Technology Training and Demonstration Area within the Center of Global Security and Cooperation are indeed unclassified unlimited released for viewing.

  18. Review of the Lujan neutron scattering center: basic energy sciences prereport February 2009

    Energy Technology Data Exchange (ETDEWEB)

    Hurd, Alan J [Los Alamos National Laboratory; Rhyne, James J [Los Alamos National Laboratory; Lewis, Paul S [Los Alamos National Laboratory

    2009-01-01

    The Lujan Neutron Scattering Center (Lujan Center) at LANSCE is a designated National User Facility for neutron scattering and nuclear physics studies with pulsed beams of moderated neutrons (cold, thermal, and epithermal). As one of five experimental areas at the Los Alamos Neutron Science Center (LANSCE), the Lujan Center hosts engineers, scientists, and students from around the world. The Lujan Center consists of Experimental Room (ER) 1 (ERl) built by the Laboratory in 1977, ER2 built by the Office of Basic Energy Sciences (BES) in 1989, and the Office Building (622) also built by BES in 1989, along with a chem-bio lab, a shop, and other out-buildings. According to a 1996 Memorandum of Agreement (MOA) between the Defense Programs (DP) Office of the National Nuclear Security Agency (NNSA) and the Office of Science (SC, then the Office of Energy Research), the Lujan Center flight paths were transferred from DP to SC, including those in ERI. That MOA was updated in 2001. Under the MOA, NNSA-DP delivers neutron beam to the windows of the target crypt, outside of which BES becomes the 'landlord.' The leveraging nature of the Lujan Center on the LANSCE accelerator is a substantial annual leverage to the $11 M BES operating fund worth approximately $56 M operating cost of the linear accelerator (LINAC)-in beam delivery.

  19. The Fernald Preserve Visitors Center The Fernald Experience-Revealing, Engaging, and Preserving

    International Nuclear Information System (INIS)

    The U.S. Department of Energy (DOE) Office of Legacy Management's public involvement activities at the Fernald, Ohio, site include continued communication about groundwater remediation, the management of legacy waste, and the future of the Fernald site. The completion of the Fernald Preserve Visitors Center, in August 2008, ensures that information continues to be readily available and effectively communicated to the public. A primary goal of the Visitors Center is to function as an informational and educational center within the surrounding community, with the information available at the Visitors Center serving as an institutional control. By offering information on a variety of topics, from the site's history to its current condition, the Visitors Center increases public awareness and helps prevent unsafe disturbances to and uses of the site. The Office of Legacy Management maintains and operates the Visitors Center, continues to solicit stakeholder opinion, and will periodically reevaluate the use of the Visitors Center and its programming. (authors)

  20. Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

    Science.gov (United States)

    Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

    2015-02-01

    Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients. PMID:25162618

  1. Stent treatment for basilar artery dissection: A single-center experience of 21 patients.

    Science.gov (United States)

    Li, Li; Li, Tianxiao; Xue, Jiangyu; Wang, Ziliang; Bai, Weixing; Zhu, Liangfu; Feng, Guang; Xu, Gangqin; Yang, Bowen

    2016-06-01

    Basilar artery dissection is a rare disease with high morbidity and mortality. No well-established management strategy exists for this lesion. Endovascular reconstructive therapy using stents (with or without coiling) may be the optimum strategy.We describe our center's experience for this treatment strategy in 21 patients with basilar artery dissection from January 2009 to July 2014 (17 men, four women; age range, 18-70 years; median age, 56 years). We divided patients into two groups: Group 1 patients received stent-assisted coiling treatment, and Group 2 patients received stent-only treatment. Pre-treatment, peri-operation and follow-up evaluation were investigated for complications, clinical outcome and angiographic results. The median follow-up time was 20 months (range, 3-67 months).All patients were treated endovascularly by stent-assisted coiling (14 patients) or stent only (seven patients). Immediate angiography showed: in Group 1, five of 14 lesions were completely occluded, five were partially occluded, four revealed retention of contrast media; in Group 2, all patients (seven of seven) had contrast retention. At the follow-up visit (median seven months, 3-29 months), the aneurysms were angiographically improved in five of 13 patients in Group 1 compared with immediately post-operation, while six of sevenimproved in Group 2. Five patients (all in Group 1) had ischemic or hemorrhage peri-operation complications. Long-term good clinical outcomes (modified Rankin Scale score (mRS) ≤ 2) were achieved in all patients except three death cases (two in Group1, one in Group 2).In our experience, endovascular reconstructive therapy using stents (with or without coiling) for basilar artery dissection is effective and safe. Stent-only treatment seems have a better safety profile during the peri-operation period. PMID:26842610

  2. An Experience Using Performance-Centered Mobile Learning to Enhance Fieldwork Education

    Directory of Open Access Journals (Sweden)

    Silviya Stoyanova-Petrova

    2011-11-01

    Full Text Available Mobile performance support system (mPSS focuses on helping students to perform an authentic task with minimum support of others, providing them with sufficient information such as expert advice and procedures, just-in-time. Providing this support on a mobile device enables students to make their learning more efficient and relevant. Fieldwork has long been identified as providing students undertaking professional studies with a means of implementing theory into real life situations. In many ways there is a natural link between fieldwork and mobile technology. This paper reports our experience using performance-centered mobile learning to enhance active, fieldwork education and the investigation of its impact on students learning. Fieldwork education is vital for many engineering courses. Two case studies held outside the classroom are presented. In the first case, the students are admitted to the technical equipment in a base station of a Bulgarian mobile operator outside the city of Plovdiv. In the second case, students visit an electronics manufacturing plant and directly inspect the production process.

  3. Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience

    Science.gov (United States)

    Liu, Wei-Cheng; Wan, Song-Lin; Yaseen, SM; Ren, Xiang-Hai; Tian, Cui-Ping; Ding, Zhao; Zheng, Ken-Yan; Wu, Yun-Hua; Jiang, Cong-Qing; Qian, Qun

    2016-01-01

    Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS. However, no procedure has been proved to be superior to others at present. Each operation has its own merits and defects. Thus, choosing appropriate transanal surgical procedures for the treatment of ODS remains a challenge for all surgeons. This review provides an introduction of the current problems and options for treatment of ODS and a detailed summary of the essential assessments needed for patient evaluation before carrying out transanal surgery. Besides, an overview of the benefits and problems of current transanal surgical procedures for treatment of ODS is summarized in this review. A report of clinical experience of some transanal surgical techniques used in the authors’ center is also presented. PMID:27672293

  4. Leukapheresis in acute myeloid leukemia patients with hyperleukocytosis: A single center experience.

    Science.gov (United States)

    Berber, Ilhami; Kuku, Irfan; Erkurt, Mehmet Ali; Kaya, Emin; Bag, Harika Gozukara; Nizam, Ilknur; Koroglu, Mustafa; Ozgul, Mustafa; Bazna, Sezai

    2015-10-01

    Hyperleukocytosis is defined as WBC count above 100,000/mm(3) in peripheral blood. Increased WBC count leads to leukocyte aggregation, increased blood viscosity, and consequently results in stasis in small blood vessels. Ultimate neurological, pulmonary, gastrointestinal complications, coagulopathy, and tumor lysis syndrome cause increase in morbidity and mortality. Leukapheresis is a treatment modality used for hyperleukocytosis. In patients presenting with hyperleukocytosis the indications for leukapheresis were accepted as having symptoms of leukostasis and prophylactic. Indications for leukapheresis in prophylactic group evaluated according to WBC count. We report a single center experience about leukapheresis in managing 31 AML patients with hyperleukocytosis. In addition to demographic characteristics, disease-related clinical and laboratory findings of the patients were recorded. Survival rates were also calculated. Ten patients were female. The most common of AML subtype was AML-M2. The median number of leukapheresis per patient was 2 and totally 60 leukapheresis cycles were performed in all patients. There was a significant decrease in WBC count and LDH level after leukapheresis as compared with the baseline values (p 0.05). None of our patients suffered serious side effects and tumor lysis syndrome during or after apheresis. Leukapheresis is an effective and safe approach to reduce WBC counts in patients with AML with hyperleukocytosis. Further evidence-based data obtained from larger sample sizes are required to better understand the impact of prophylaxis leukapheresis on early and total mortality of AML patients with hyperleukocytosis. PMID:25843763

  5. Endovascular Aortic Aneurysm Repair for Abdominal Aortic Aneurysm: Single Center Experience in 122 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yun Young; Song, Jang Hyeon; Kim, Yong Tae; Yim, Nam Yeol; Kim, Jae Kyu; Lee, Ho Kyun; Choi, Soo Jin Na; Chung, Sang Young [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju (Korea, Republic of); Kim, Soo Hyun; Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine, Hwasun (Korea, Republic of)

    2013-02-15

    To analyze a single center experience of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. Results of 122 patients who underwent EVAR were analyzed, retrospectively. Sex, age, aneurysmal morphology, hostile neck anatomy, preprocedural and postprocedural sac-diameter, technical and clinical success, postprocedural complication and need of additional procedure were analyzed. A total of 111 male and 11 female patients were included. Morphology of the aneurysms was as follows: fusiform (n = 108), saccular (n = 3) and ruptured type (n = 11). Sixty-four patients had hostile neck anatomy. The preprocedural mean sac-diameter was 52.4 mm. Postprocedural sac-diameter was decreased or stable in 110 patients (90.2%) and increased in 8 patients (6.6%). Technical success rate was 100% and clinical success rate was 86.1%. Fifty-one patients showed endoleak (41.8%) and 15 patients (12.3%) underwent secondary intervention due to type I endoleak (n = 4), type II endoleak (n = 4) and stent-graft thrombosis (n = 7). EVAR is a safe and effective therapy for abdominal aortic aneurysm, and it has high technical success and clinical success rate, and low complication rate.

  6. OCCUPATIONAL THERAPY EXPERIENCES IN THE FAMILY HEALTH SUPPORT CENTERS (NASF IN THE DISTRITO FEDERAL

    Directory of Open Access Journals (Sweden)

    Kelly Ranyelle Alves Araujo

    2013-09-01

    Full Text Available To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF. The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how students and practitioners of occupational therapy falls within that service, identifying the main limitations and the work that advances the health care setting. Results: The students and occupational therapist service sought to develop an integrated and intersectoral. Actions were part of the home visits, group approaches with different community groups, active search for users and partnerships in the community. Thus, the work is still very limited assistance and connected to the matricial point of view, as recommended. We conclude that, despite the NASF be a new field of labor for occupational therapists, the actions of social inclusion, empowerment and citizenship developed can encourage healthy habits, but practices need to be revised to follow the proposal of this device.

  7. Turner syndrome: review of clinical, neuropsychiatric, and EEG status: an experience of tertiary center.

    Science.gov (United States)

    Saad, Khaled; Abdelrahman, Ahmed A; Abdel-Raheem, Yasser F; Othman, Essam R; Badry, Reda; Othman, Hisham A K; Sobhy, Karema M

    2014-03-01

    We reviewed the clinical, neuropsychiatric, and EEG status of 53 turner syndrome (TS) females, aged 3-16 years, in Assiut university hospitals, Upper Egypt. The diagnosis and care of patients with TS in Egypt is still in the developing stage. Hence this study was undertaken to review the details of patients with TS with respect to the pattern of cognitive, psychiatric, and motor dysfunction. We aimed to provide a comprehensive data about the experience of our center comparable to previous studies, which have been published in this field. This will contribute to a better definition of the neuropsychiatric features that may be specific to TS that allows early and better detection and management of these cases. We found FSIQ and verbal IQ that seem to be at a nearly normal level and a decreased performance IQ. ADHD and autistic symptoms were found in 20.70 and 3.77 % of our cohort, respectively. The motor performance in TS was disturbed, with some neurological deficits present in 17 % (reduced muscle tone and reduced muscle power). In addition, females with TS in our study exhibit social and emotional problems, including anxiety (5.66 %) and depression (11.30 %). The EEG results revealed abnormalities in seven patients (13.20 %). One patient presenting with generalized tonic-clonic seizures showed generalized epileptiform activity, and six patients presenting with intellectual disabilities showed abnormal EEG background activity.

  8. Three-Year Experience of an Academic Medical Center Ombuds Office.

    Science.gov (United States)

    Raymond, John R; Layde, Peter M

    2016-03-01

    An ombuds is an individual who informally helps people or groups (visitors) resolve disputes and/or interpersonal conflicts as an alternative to formal dispute resolution mechanisms within an organization. Ombuds are nearly ubiquitous in many governmental, business, and educational settings but only recently have gained visibility at medical schools. Medical schools in the United States are increasingly establishing ombuds offices as part of comprehensive conflict management systems to address concerns of faculty, staff, students, and others. As of 2015, more than 35 medical schools in the United States have active ombuds Web pages. Despite the growing number of medical schools with ombuds offices, the literature on medical school ombuds offices is scant. In this article, the authors review the first three years of experience of the ombuds office at the Medical College of Wisconsin, a freestanding medical and graduate school with a large physician practice. The article is written from the perspective of the inaugural ombuds and the president who initiated the office. The authors discuss the rationale for, costs of, potential advantages of, and initial reactions of faculty, staff, and administration to having an ombuds office in an academic medical center. Important questions relevant to medical schools that are considering an ombuds office are discussed. The authors conclude that an ombuds office can be a useful complement to traditional approaches for conflict management, regulatory compliance, and identification of systemic issues. PMID:26675192

  9. Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

    Directory of Open Access Journals (Sweden)

    Xiquan Tian

    2015-04-01

    Full Text Available Purpose To present our surgical techniques and experiences of retroperitoneal laparoscopic nephroureterectomy for the treatment of tuberculous nonfunctioning kidneys. Materials and Methods From March 2005 to March 2013, a total of 51 patients with tuberculous nonfunctioning kidney underwent retroperitoneal laparoscopic nephroureterectomy at our medical center. The techniques included early control of renal vessels and dissection of the diseased kidney along the underlying layer outside the Gerato’s fascia. The distal ureter was dissected through a Gibson incision and the entire specimen was removed en bloc from the incision. Patient demographics, perioperative characteristics and laboratory parameters as well as postoperative outcome were retrospectively reviewed. Results Retroperitoneal laparoscopic nephroureterectomy was successfully performed in 50 patients, whereas one case required conversion to open surgery due to non-progression of dissection. The mean operating time was 123.0 minutes (107-160 minutes and the mean estimated blood loss was 134 mL (80-650 mL.The mean postoperative hospital stay was 3.6 days (3-5days and the mean return to normal activity was 11.6 days (10-14days. Most intra-operative and post-operative complications were minor complications and can be managed conservatively. After 68 months (12-96 months follow-up, the outcome was satisfactory, and ureteral stump syndrome did not occur. Conclusions Retroperitoneal laparoscopic nephroureterectomy as a minimally invasive treatment option is feasible for treatment of tuberculous nonfunctioning kidneys.

  10. Early liver retransplantation versus late liver retransplantation:analysis of a single-center experience

    Institute of Scientific and Technical Information of China (English)

    CHEN Gui-hua; ZHANG Jun-feng; ZHANG Tong; WANG Guo-ying; FU Bin-sheng; YANG Yang; CAI Chang-jie; LU Min-qiang; LI Hua; WANG Gen-shu; YI Shu-hong; XU Chi

    2008-01-01

    Background Orthotopic liver retransplantation (re-OLT) is the only effective therapy for irreversible failure of a liver graft. Early and late graft failure gives way to two different clinical conditions that should be discussed separately. This study was designed to compare early and late re-OLT for patients with poor graft function after primary transplantation at our center and sum up our clinical experience in re-OLT.Methods The clinical data of 31 re-OLTs at our center from January 2004 to February 2007 were analyzed retrospectively, consisting of the first group with 14 cases of early re-OLT and the second group with 17 cases of late re-OLT.Results Biliary tract complications were the main indications for early re-OLT (57.1%) and late re-OLT (52.9%). Other common indications were vascular complications in early re-OLT and recurrence of primary diseases in late re-OLT. No significant differences were found between the groups with regard to the volume of bleeding during operation, cold ischemia time, operative duration, and perioperative mortality; except for the model of end-stage liver disease (MELD) score. Outcome was fatal for 7 patients in early re-OLT and 9 patients in late re-OLT. Two deaths were due to multiple organ failure with 3 deaths due to severe sepsis-related disease in early re-OLT, and 4 deaths were due to severe sepsis-related disease with 3 deaths due to recurrence of hepatocellular carcinoma (HCC) in late re-OLT. One and 2-year actuarial survival rates after re-OLT were 55.2% and 36.9%, respectively, for patients in early re-OLT, and 65.1% and 52% respectively, for patients in late re-OLT. No significant differences were found regarding survival rates between the two groups.Conclusions Similar clinical results can be achieved in early and late re-OLT. Proper indications and optimal operation timing, adequate preoperative preparation, experienced surgical procedures, and effective perioperative anti-infection strategy contribute to the

  11. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    International Nuclear Information System (INIS)

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

  12. Advancing user experience research to facilitate and enable patient-centered research: current state and future directions.

    Science.gov (United States)

    Payne, Philip R O

    2013-01-01

    Human-computer interaction and related areas of user experience (UX) research, such as human factors, workflow evaluation, and data visualization, are thus essential to presenting data in ways that can further the analysis of complex data sets such as those used in patient-centered research. However, a review of available data on the state of UX research as it relates to patient-centered research demonstrates a significant underinvestment and consequently a large gap in knowledge generation. In response, this report explores trends in funding and research productivity focused on UX and patient-centered research and then presents a set of recommendations to advance innovation at this important intersection point. Ultimately, the aim is to catalyze a community-wide dialogue concerning future directions for research and innovation in UX as it applies to patient-centered research.

  13. Parent Perspectives on How a Child-Centered Preschool Experience Shapes Children's Navigation of Kindergarten

    Science.gov (United States)

    Recchia, Susan; Bentley, Dana Frantz

    2013-01-01

    The authors used qualitative case study methodology to explore parents' perceptions of their children's readiness for kindergarten. The authors interviewed parents, focusing on their children's experiences during their transition from a child-centered, play-based preschool setting guided by an emergent curriculum into a range of…

  14. 47. A cardiac center experience with Brugada syndrome who survived sudden cardiac death

    Directory of Open Access Journals (Sweden)

    I. Suliman

    2016-07-01

    Full Text Available Brugada syndrome is a heritable arrhythmia syndrome that is characterized by an electrocardiographic pattern consisting of coved-type ST-segment elevation (2 mm followed by a negative T wave in the right precordial leads, V1 through V3 (often referred to as type 1 Brugada electrocardiographic pattern, here we describe 3 cases of Brugada who survived sudden cardiac death (SCD cardiac center experience with survived Brugada syndrome patients – case series. First Case: The Father 45 years old male, presented in 2005 after involvement in unprovoked motor vehicle accident, the patient was the driver who lost consciousness and rushed to the hospital. On arrival to our ER and putting the patient on the bed, the ER doctor observed a brief episode of VF on the monitor. The patient was taken to the catheterization Lab , his coronaries were normal. The diagnosis of Brugada was established and the patient received a defibrillator. At That Time all family members were screened and were negative. Second Case: The Son of the first patient 5 years later his 23 years old male rushed to our ER after he lost consciousness, he was passenger in the car of his friend. Third Case: The pilot A military pilot aged a male 35 years old was in very good health when he lost consciousness and brought to the hospital after resuscitation in 2005. He had full invasive cardiac evaluation, subsequently he received a defibrillator in the same admission period, till 2015 he is doing fine. Brugada syndrome is associated with high tendency for sudden cardiac death. In our three cases the first clinical presentation was survived sudden cardiac death (SCD and all three male patients survived. We did not encounter a female patient who survived sudden cardiac death.

  15. Retrograde approach for the recanalization of coronary chronic total occlusion: preliminary experience of a single center

    Institute of Scientific and Technical Information of China (English)

    GE Lei; XU Shi-kun; ZHANG Feng; WANG Xiang-fei; WANG Qi-bing; FAN Bing; YAN Yan; FENG Qi; WANG Hao; SHEN An; ZHU Ming-hui; QIAN Ju-ying; GE Jun-bo; LIU Xue-bo; QIN Qing; CUI Shan-jing; YAO Kang; SHEN Li; MA Jian-ying; HUANG Dong

    2010-01-01

    Background The success rate of antegrade approach for chronic total occlusions (CTO) recanalization has not dramatically increased, especially in complex CTO subset. The retrograde technique may hold great promise. This report aimed to describe our experience of retrograde recanalization for CTO, focusing on its safety and feasibility. Methods We identified 42 patients who underwent revascularization in CTO with retrograde approach from July 2005 to November 2009 in our center.Results Three kinds of strategy were applied: retrograde as primary strategy (50.0%), retrograde immediately after antegrade failure (26.2%) and repeat procedure after previous antegrade failure (23.8%). Septal collaterals were more frequently used as the retrograde access route (92.9%). Overall success rate was 88.1%. In patients with successful retrograde wire crossing collateral channel to the distal cap of CTO, the success rate of recanalization was 94.1%. In patient with failure to cross the collaterals, the success rate was 62.5%. Eight different kinds of retrograde techniques were used: kissing wire technique (35.3%), wire trapped and reverse wire trapped technique (17.6%), back-end balloon and microcatherer reversal technique (14.7%), controlled antegrade and retrograde subintimal tracking (CART) technique (8.8%), reverse CART and modified reverse CART technique (8.8%), retrograde wire crossing technique (2.9%). There were 4 complications occurred without in-hospital major adverse cardiac events (MACE). In-hospital MACE was 7.7%. All of them were non-Q wave myocardial infarction. There were no cases of death or target vessel revascularization, either surgery or percutaneous.Conclusions The retrograde approach can be an effective tool for increasing the success rate of recanalization in the very complex CTO. To ensure the success and safety of the approach, careful case selection and device handling by experienced operators is essential.

  16. Liver Transplantation for Hepatocellular Carcinoma: A Single Center Resume Overlooking Four Decades of Experience

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2016-01-01

    Full Text Available Background. This is a single center oncological resume overlooking four decades of experience with liver transplantation (LT for hepatocellular carcinoma (HCC. Methods. All 319 LT for HCC that were performed between 1975 and 2011 were included. Predictors for HCC recurrence (HCCR and survival were identified by Cox regression, Kaplan-Meier analysis, Log Rank, and χ2-tests where appropriate. Results. HCCR was the single strongest hazard for survival (exp⁡B=10.156. Hazards for HCCR were tumor staging beyond the histologic MILAN (exp⁡B=3.645, bilateral tumor spreading (exp⁡B=14.505, tumor grading beyond G2 (exp⁡B=8.668, and vascular infiltration of small or large vessels (exp⁡B=11.612, exp⁡B=18.324, resp.. Grading beyond G2 (exp⁡B=10.498 as well as small and large vascular infiltrations (exp⁡B=13.337, exp⁡B=16.737, resp. was associated with higher hazard ratios for long-term survival as compared to liver transplantation beyond histological MILAN (exp⁡B=4.533. Tumor dedifferentiation significantly correlated with vascular infiltration (χ2p=0.006 and intrahepatic tumor spreading (χ2p=0.016. Conclusion. LT enables survival from HCC. HCC dedifferentiation is associated with vascular infiltration and intrahepatic tumor spreading and is a strong hazard for HCCR and survival. Pretransplant tumor staging should include grading by biopsy, because grading is a reliable and easily accessible predictor of HCCR and survival. Detection of dedifferentiation should speed up the allocation process.

  17. Congenital bronchopulmonary malformations: A single-center experience and a review of literature

    Directory of Open Access Journals (Sweden)

    Kumar Basant

    2008-01-01

    Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

  18. Thirty-day outcome of carotid artery stenting in Chinese patients: a single-center experience

    Institute of Scientific and Technical Information of China (English)

    JIAO Li-qun; SONG Gang; LI Shen-mao; MIAO Zhong-rong; ZHU Feng-shui; JI Xun-ming; YIN Guo-yang

    2013-01-01

    Background Carotid artery stenting (CAS) as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies.This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population.Methods Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed.Postoperative 30-day complication rates were analyzed and compared with those of other studies.Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction (MI),stroke,and death.Results The overall 30-day rate of MI,stroke,and death after CAS was 2.53%.In univariate analysis,patients who were symptomatic,had a neurological deficit (modified Rankin score (mRS) ≥3; P=0.001),and who were not taking statins experienced a significantly increased rate of MI,stroke,and death (P=-0.017).In multivariate Logistic regression analysis,the presence of symptoms (odds ratio (OR)=2.485; 95% confidence interval (CI)=1.267-4.876; P=0.008) and a neurological deficit (mRS ≥3) (OR=3.025; 95% CI=1.353-6.763; P=0.007) were independent risk factors for perioperative MI,stroke,and death.Conclusions According to this single-center experience,CAS may effectively prevent and treat carotid artery stenosis that would otherwise lead to stroke.Being symptomatic and having a neurological deficit (mRS ≥3) increased the risk of perioperative MI,stroke,and death.

  19. Acute promyelocytic leukemia, study of predictive factors for Differentiation Syndrome, single center experience

    International Nuclear Information System (INIS)

    Reports about patients with acute promyelocytic leukemia from the Middle East are few; in this study we are reporting our single center experience of treating 29 patients over 6 years. Acute promyelocytic leukemia treatment response is markedly improved after the introduction of ATRA. Treatment related complication is still an important issue particularly Differentiation Syndrome. Prediction to its occurrence has been tried by other groups. We aimed to study all the possible predictive factors of acute promyelocytic leukemia. Our chemotherapy induction protocol is AIDA protocol which includes ATRA 45 mg/m2/d in divided doses every 12h, and Idarubicin 12 mg/ m2/d IV on days 3, 5, 7, and 9. Differentiation Syndrome occurred in 48.3% of patients and was mainly presented by pulmonary symptoms in 55.2%, 6 cases died during induction. None of the predictive factors studied showed a statistically significant difference between patients who developed Differentiation Syndrome and those who did not. Differentiation Syndrome did not affect overall survival. Cox regression showed an inverse yet a non significant association between PET- HEMA and overall survival probability (P = 0.168). In conclusion, Differentiation Syndrome has no clear predictive factor to date. The best approach is to hold ATRA and give dexamethasone which is quite effective as reported in the literature. PETHEMA risk model has a moderately significant prognostic value look for all possible predictive factors of Differentiation syndrome (DS) which were first described in 1992 by frankel et al. (4) and represented the major complication through this disease course: studies had reported conflicting results about this (5,6). In addition we will compare our data to other areas of the world

  20. Living Related Donor Kidney Transplantation in Libya: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Elusta Ahmed

    2008-01-01

    Full Text Available The aim of this study is to report the experience from a single center in Libya, on the prevailing live-related kidney transplantation program. The results of three years work on kidney transplantation at the Tripoli Central Hospital (National Organ Transplant Program in Libya were evaluated. The transplant program was launched on 17 th August, 2004 and 135 patients have been transplanted since then till 17 th August, 2007. All donors and recipients were screened thoroughly prior to transplant and monitored closely in the post-transplant period. Our immuno-suppressive protocol was cyclosporine-based. Among the 135 accepted pairs, donors and reci-pients were genetically-related in 133 cases (98.5% and emotionally-related in two others. The mean donor age was 37 ± 9.5 years (range 18-56 years and recipient age 37 ± 13.6 years (range 7-67 years. There were 95 males (70.4% and 40 females (29.6% among the recipients while among the donors, there were 102 males (75.6% and 33 females (24.4%. Delayed graft function was seen in three patients (2.2%, acute rejection in six (4.4%, post-transplant urinary tract infection in six (4.4%, pneumonia in three (2.2%, ureteric kink in two (1.5% and urine leak in four (3.0%. Graft survival at 36 months was 93.3% while patient survival at the same period was 96.3%. This report indicates that the results of our transplant program are good and comparable with other international programs.

  1. Outcome of deceased donor renal transplantation - A single-center experience from developing country

    Directory of Open Access Journals (Sweden)

    Himanshu V Patel

    2013-01-01

    Full Text Available Renal transplantation (RTx is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD. Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr, rejection episodes, and delayed graft function (DGF. Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%, diabetes (12.7%, and hypertension (10.6%. Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.

  2. The Brave New World of GEC Evaluation: The Experience of the Rhode Island Geriatric Education Center

    Science.gov (United States)

    Filinson, Rachel; Clark, Phillip G.; Evans, Joann; Padula, Cynthia; Willey, Cynthia

    2012-01-01

    In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these…

  3. New insights into the clinical evaluation of hereditary transthyretin amyloidosis patients: a single center's experience

    Directory of Open Access Journals (Sweden)

    Suhr OB

    2012-08-01

    Full Text Available Ole B Suhr,1 Sandra Gustavsson,1 Victoria Heldestad,2 Rolf Hörnsten,3 Per Lindqvist,1 Erik Nordh,2 Urban Wiklund41Department of Public Health and Clinical Medicine, 2Department of Pharmacology and Clinical Neuroscience, 3Department of Surgical and Perioperative Sciences, Clinical Physiology, Heart Centre, 4Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, SwedenAbstract: Over the last decade, new medical treatment modalities have emerged based on increased insights into amyloid formation. With the increased possibilities for treatment of amyloidosis caused by transthyretin (TTR amyloid deposits comes the need for diagnostic procedures for early diagnosis and better tools to follow disease progression. This is of particular importance in clinical trials evaluating the efficacy of new treatments. Until recently, the treatment of TTR amyloidosis (ATTR was based solely on liver transplantation, a procedure that has halted disease progression in many patients. Liver transplantation has been especially effective in patients under the age of 50 years carrying the TTR V30M mutation, whereas the outcome of the procedure has been variable for others, particularly elderly male patients and those carrying a non-V30M mutation. This review concentrates on new insights derived from our center's experience with liver transplantation, how to implement this experience in evaluation of new treatment modalities for ATTR, and how to facilitate early diagnosis of neuropathy with easily available diagnostic tools. Attention has focused on manifestations of the disease that involve the heart and the peripheral nervous system; change in peripheral nerve function has been the primary endpoint in two controlled clinical trials, one finished and one ongoing. New insights into the amyloid formation process and the lessons learned from liver transplantation give the opportunity to design potentially effective treatment modalities for ATTR

  4. Status of the Ultracold neutron source upgrade at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Pattie, Robert Wayne Jr. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-10-31

    Several slides show the source and flux of ultracold neutrons produced. In summary, an upgraded UCN source has been designed, and parts are currently being fabricated. Nickel phosphorus-coated guides will improve transport to the experiment hall. The source will be installed in the spring of 2016 and commissioned in the fall of 2016.

  5. Staff's experiences of a person-centered health education group intervention for people with a persistent mental illness.

    Science.gov (United States)

    Jormfeldt, Henrika; Brunt, David Arthur; Rask, Mikael; Bengtsson, Agneta; Svedberg, Petra

    2013-07-01

    Patient education in mental health care is a conventional intervention to increase patients' knowledge about their illness and treatment. A provider-centered focus in patient education may put patients in a passive role, which can counteract their processes of recovery. There is an increasing emphasis on recovery-oriented practice, an approach that is aligned with the service user perspective, but little is known about health care staff's perspectives on person-centered mental health care. A qualitative approach was used to describe staff's experiences of being group leaders in a person-centered health education intervention in municipal services for persons with a persistent mental illness. The analysis of staff experiences revealed three core categories: (1) implications of the division of responsibility among local authorities, (2) awareness of facilitating factors of growth, and (3) the meaning of dialogue. These formed the theme Preconditions for Person-Centered Care. Further research is required to explore larger economic, political, and social structures as backdrops to person-centered mental health care, from the perspective of service users, families, health professionals, and the community at large. PMID:23875550

  6. Centering Ability and Influence of Experience When Using WaveOne Single-File Technique in Simulated Canals

    Directory of Open Access Journals (Sweden)

    Mathieu Goldberg

    2012-01-01

    Full Text Available Introduction. WaveOne is a single endodontic instrument that reciprocates with a dedicated motor to shape root canal systems. The present study assessed the centering ability of this simplified protocol along with the effect of experience in simulated plastic canals. Methods. One experienced operator shaped two groups of simulated canals. Groups 1 and 3 each comprised 30 blinded L-shaped canals or S-shaped canals, respectively. Photographs were taken before and after shaping and digitally assessed centering after superimposition of the pictures. Time of shaping, number of passes, canal aberrations, and instrument degradation were recorded. In group 2 shaping was done on 30 blinded L-shaped canals by 30 different students with no prior experience with WaveOne. Results. All three groups yielded satisfactory, reproducible shaping. Centering ratios were low and homogeneous in all groups, with no significant differences between the experienced operator and the students. Apical transportation values were very low (≤0.138 mm with no instances of blockage or separation. The average shaping time was short (43 to 101,6 sec. Conclusions. Within the limits of the study, the WaveOne instrument had excellent centering ability with a low risk of fracture or blockage and a short shaping time, regardless of the operator’s level of experience.

  7. Spent fuel storage facility at science and technical center 'Sosny': Experience of ten years activity

    International Nuclear Information System (INIS)

    Spent fuel storage of the Academic Science and Technical Center in Minsk is in operation already more then 10 years. In the paper aspects of its design, operation practice, problems and decisions for future are discussed. (author)

  8. Culturally Focused Community-Centered Service Learning: An International Cultural Immersion Experience

    Science.gov (United States)

    Tomlinson-Clarke, Saundra M.; Clarke, Darren

    2010-01-01

    An immersion training model is described that incorporates culturally focused community-centered service in South Africa as an experiential learning approach. Recommendations for developing international cultural immersion training with a goal of developing cultural competencies are suggested.

  9. Upgrades to the Polarized Neutron Reflectometer Asterix at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Pynn, Roger

    2015-03-16

    We have upgraded the polarized neutron reflectometer, Asterix, at the Lujan Neutron Scattering Center at Los Alamos for the benefit of the research communities that study magnetic and complex-fluid films, both of which play important roles in support of the DOE’s energy mission. The upgrades to the instrument include: • A secondary spectrometer that was integrated with a Huber sample goniometer purchased with other funds just prior to the start of our project. The secondary spectrometer provides a flexible length for the scattered flight path, includes a mechanism to select among 3 alternative polarization analyzers as well as a support for new neutron detectors. Also included is an optic rail for reproducible positioning of components for Spin Echo Scattering Angle Measurement (SESAME). The entire secondary spectrometer is now non-magnetic, as required for neutron Larmor labeling. • A broad-band neutron polarizer for the incident neutron beam based on the V geometry. • A wide-angle neutron polarization analyzer • A 2d position-sensitive neutron detector • Electromagnetic coils (Wollaston prisms) for SESAME plus the associated power supplies, cooling, safety systems and integration into the data acquisition system. The upgrades allowed a nearly effortless transition between configurations required to serve the polarized neutron reflectometry community, users of the 11 T cryomagnet and users of SESAME.

  10. Treatment of patients with metastatic pancreatic cancer: Experience from a tertiary Indian cancer center

    OpenAIRE

    Sirohi, B; S Dawood; S. Rastogi; Pandey, A.; Bal, M; N Shetty; Shrikhande, S. V.

    2015-01-01

    Background: The aim of this study was to look at the outcome of patients with metastatic pancreatic cancer treated at a tertiary cancer center in India. Patients And Methods: A total of 101 patients with locally advanced and metastatic pancreatic cancer diagnosed between May 2012 and July 2013 were identified from a prospectively maintained database at the tertiary cancer center. Overall survival (OS) was computed using the Kaplan–Meir product limit method and compared across groups using the...

  11. Axial lumbar interbody fusion: a 6-year single-center experience

    Directory of Open Access Journals (Sweden)

    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  12. Retinoblastoma: experience of a referral center in the North Region of Portugal

    Directory of Open Access Journals (Sweden)

    Rocha-Bastos R

    2014-05-01

    Full Text Available RA da Rocha-Bastos,1 JR Araújo,1 RS Silva,2 MJ Gil-da-Costa,2 E Brandão,1 NJ Farinha,2,3 F Falcão-Reis,1,4 T Dinah-Bragança1 1Department of Ophthalmology, Hospital São João, 2Hematology and Oncology Unit, Pediatric Hospital, Hospital São João, 3Pediatrics Department, Faculty of Medicine, University of Porto, 4Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal Purpose: To describe the experience of the Ophthalmology Department of Hospital São João (HSJ, a tertiary health care center in North Region, Portugal, in terms of the diagnosis, treatment, and follow-up of retinoblastoma. Methods: This was a retrospective study of patients diagnosed with retinoblastoma in Hospital São João, between 1978 and 2012. Results: Fifty patients with retinoblastoma were evaluated in our institution between 1978 and 2012. Four patients were excluded due to loss of follow-up. Among the 46 retinoblastoma cases, 33 (71.7% were unilateral and 13 (28.3% bilateral, with a mean age at diagnosis of 22.19 months and 6.92 months, respectively (P<0.001. Leukocoria was the most common presenting sign (36.9%, followed by strabismus (19.6%, a combination of leukocoria and strabismus (8.7%, and buphthalmia (2.2%. Between 1978 and 1992, nine retinoblastoma cases were referred to our hospital, all of them unilateral, and, in each case, enucleation was performed, with or without salvage therapy. Between 1993 and 2012, 18 eyes with retinoblastoma were successfully managed with conservative treatment. Conclusion: Demographic results were generally coincident with previous reports. It is crucial to screen leukocoria in pediatric practice, even in asymptomatic children. The outcome of retinoblastoma treatment in our hospital is similar to other series in developed countries. Keywords: retinoblastoma, leukocoria, strabismus, enucleation, pediatric cancer

  13. Fabrication of a tantalum-clad tungsten target for LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, A.T., E-mail: atnelson@lanl.gov [Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM 87545 (United States); O' Toole, J.A.; Valicenti, R.A. [Accelerator Operations and Technology Division, Los Alamos National Laboratory, Los Alamos, NM 87545 (United States); Maloy, S.A. [Civilian Nuclear Program Office, Los Alamos National Laboratory, Los Alamos, NM 87545 (United States)

    2012-12-15

    Development of a solid state bonding technique suitable to clad tungsten targets with tantalum was completed to improve operation of the Los Alamos Neutron Science Centers spallation target. Significant deterioration of conventional bare tungsten targets has historically resulted in transfer of tungsten into the cooling system through corrosion resulting in increased radioactivity outside the target and reduction of delivered neutron flux. The fabrication method chosen to join the tantalum cladding to the tungsten was hot isostatic pressing (HIP) given the geometry constraints of a cylindrical assembly and previous success demonstrated at KENS. Nominal HIP parameters of 1500 Degree-Sign C, 200 MPa, and 3 h were selected based upon previous work. Development of the process included significant surface engineering controls and characterization given tantalums propensity for oxide and carbide formation at high temperatures. In addition to rigorous acid cleaning implemented at each step of the fabrication process, a three layer tantalum foil gettering system was devised such that any free oxygen and carbon impurities contained in the argon gas within the HIP vessel was mitigated to the extent possible before coming into contact with the tantalum cladding. The result of the numerous controls and refined techniques was negligible coarsening of the native Ta{sub 2}O{sub 5} surface oxide, no measureable oxygen diffusion into the tantalum bulk, and no detectable carburization despite use of argon containing up to 5 ppm oxygen and up to 40 ppm total CO, CO{sub 2}, or organic contaminants. Post bond characterization of the interface revealed continuous bonding with a few microns of species interdiffusion.

  14. Fabrication of a tantalum-clad tungsten target for LANSCE

    Science.gov (United States)

    Nelson, A. T.; O'Toole, J. A.; Valicenti, R. A.; Maloy, S. A.

    2012-12-01

    Development of a solid state bonding technique suitable to clad tungsten targets with tantalum was completed to improve operation of the Los Alamos Neutron Science Centers spallation target. Significant deterioration of conventional bare tungsten targets has historically resulted in transfer of tungsten into the cooling system through corrosion resulting in increased radioactivity outside the target and reduction of delivered neutron flux. The fabrication method chosen to join the tantalum cladding to the tungsten was hot isostatic pressing (HIP) given the geometry constraints of a cylindrical assembly and previous success demonstrated at KENS. Nominal HIP parameters of 1500 °C, 200 MPa, and 3 h were selected based upon previous work. Development of the process included significant surface engineering controls and characterization given tantalums propensity for oxide and carbide formation at high temperatures. In addition to rigorous acid cleaning implemented at each step of the fabrication process, a three layer tantalum foil gettering system was devised such that any free oxygen and carbon impurities contained in the argon gas within the HIP vessel was mitigated to the extent possible before coming into contact with the tantalum cladding. The result of the numerous controls and refined techniques was negligible coarsening of the native Ta2O5 surface oxide, no measureable oxygen diffusion into the tantalum bulk, and no detectable carburization despite use of argon containing up to 5 ppm oxygen and up to 40 ppm total CO, CO2, or organic contaminants. Post bond characterization of the interface revealed continuous bonding with a few microns of species interdiffusion.

  15. Alternative funding for academic medicine: experience at a Canadian Health Sciences Center.

    Science.gov (United States)

    Rosenbaum, Paul; Shortt, S E D; Walker, D M C

    2004-03-01

    In 1994 the School of Medicine of Queen's University in Kingston, Ontario, its clinical teachers, and the three principal teaching hospitals initiated a new approach to funding, the Alternative Funding Plan, a pragmatic response to the inability of fee-for-service billing by clinical faculty to subsidize the academic mission of the health sciences center. The center was funded to provide a package of service and academic deliverables (outputs), rather than on the basis of payment for physician clinical activity (inputs). The new plan required a new governance structure representing stakeholders and raised a number of important issues: how to reconcile the preservation of physician professional autonomy with corporate responsibilities; how to gather requisite information so as to equitably allocate resources; and how to report to the Ontario Ministry of Health and Long-term Care in order to demonstrate accountability. In subsequent iterations of the agreement it was necessary to address issues of flexibility resulting from locked-in funding levels and to devise meaningful performance measures for departments and the center as a whole. The authors conclude that the Alternative Funding Plan represents a successful innovation in funding for an academic health sciences center in that it has created financial stability, as well as modest positive effects for education and research. The Ontario government hopes to replicate the model at the province's other four health sciences centers, and it may have applicability in any jurisdiction in which the costs of medical education outstrip the capacity of faculty clinical earnings. PMID:14985191

  16. Alternative funding for academic medicine: experience at a Canadian Health Sciences Center.

    Science.gov (United States)

    Rosenbaum, Paul; Shortt, S E D; Walker, D M C

    2004-03-01

    In 1994 the School of Medicine of Queen's University in Kingston, Ontario, its clinical teachers, and the three principal teaching hospitals initiated a new approach to funding, the Alternative Funding Plan, a pragmatic response to the inability of fee-for-service billing by clinical faculty to subsidize the academic mission of the health sciences center. The center was funded to provide a package of service and academic deliverables (outputs), rather than on the basis of payment for physician clinical activity (inputs). The new plan required a new governance structure representing stakeholders and raised a number of important issues: how to reconcile the preservation of physician professional autonomy with corporate responsibilities; how to gather requisite information so as to equitably allocate resources; and how to report to the Ontario Ministry of Health and Long-term Care in order to demonstrate accountability. In subsequent iterations of the agreement it was necessary to address issues of flexibility resulting from locked-in funding levels and to devise meaningful performance measures for departments and the center as a whole. The authors conclude that the Alternative Funding Plan represents a successful innovation in funding for an academic health sciences center in that it has created financial stability, as well as modest positive effects for education and research. The Ontario government hopes to replicate the model at the province's other four health sciences centers, and it may have applicability in any jurisdiction in which the costs of medical education outstrip the capacity of faculty clinical earnings.

  17. Min Bei Irradiation Center. Food and Agriculture organization project experience, Jianou, Fujian Province, China

    International Nuclear Information System (INIS)

    The Food and Agriculture Organization (FAO), a United Nations Organization, in an effort to increase food supplies by post harvest irradiation treatment, participated in the development of the Min Bei Irradiation Center (MBIC) located in Fujian Province, China. FAO in conjunction with Shanghai Nuclear Energy Research and Design Institute (SNERDI), MBIC staff, and the Ministry of Agriculture completed Project TCP CPR 6763/8961 culminating in the recent commissioning of one of China's newest irradiation facilities. From the feasibility phase initiated in 1986, through the construction period and the eventual commissioning in 1991, FAO participated in the technical overview of the irradiation center. MBIC was developed both as a research and development center as well as a production irradiation facility for the primary purpose of reduction of post harvest food loss in Fujian Province. This retrospective review of the project provides a hindsight view for the development of MBIC. (author)

  18. Measuring User Experience of the Student-Centered e-Learning Environment

    Science.gov (United States)

    Santoso, Harry B.; Schrepp, Martin; Isal, R. Yugo Kartono; Utomo, Andika Yudha; Priyogi, Bilih

    2016-01-01

    The aim of the current study is to develop an adapted version of User Experience Questionnaire (UEQ) and evaluate a learning management system. Although there is a growing interest on User Experience, there are still limited resources (i.e. measurement tools or questionnaires) available to measure user experience of any products, especially…

  19. Experiences of CFD simulations at Foster Wheeler Energia Oy`s Karhula R and D center

    Energy Technology Data Exchange (ETDEWEB)

    Hyppaenen, T. [Foster Wheeler Energia Oy, Karhula (Finland). Karhula R and D Center

    1996-12-31

    Karhula R and D Center is specialized in the research of solid fuel combustion based on circulating fluidized bed technology. Since the 1970`s, numerical models have been utilized in process development to enhance fundamental understanding of the technology. Both own and commercial computer models have been used. Until now, a special problem in circulating fluidized beds has been the modeling of dense phase multiphase flow, especially for industrial solid-fuel boilers. This has prevented the Karhula R and D Center from using commercial codes, and as a consequence, own modeling approaches have been necessary. This presentation describes some main points of the modeling activities in circulating fluidized bed boilers. (author)

  20. Design of low energy beam transport for new LANSCE H+ injector

    Science.gov (United States)

    Batygin, Y. K.; Draganic, I. N.; Fortgang, C. M.; Garnett, R. W.; Kurennoy, S. S.; McCrady, R. C.; O'Hara, J. F.; Rybarcyk, L. J.

    2014-07-01

    The present LANSCE injector utilizes two 750-keV Cockcroft-Walton (CW) based injectors for simultaneous injection of H+ and H- beams into 800-MeV accelerator. To reduce long-term operational risks, the new project to replace the existing H+ CW injector with a Radio-Frequency Quadrupole (RFQ) accelerator is underway [1]. The new injector requires a Low-Energy Beam Transport (LEBT). An ion source and 2-solenoid magnetic LEBT have been designed and optimized to transport beams over a wide range of space-charge neutralization and transverse emittance, while allowing sufficient space for diagnostics and a beam deflector. The design layout minimizes the beam size in the LEBT and potential emittance growth due to solenoid aberrations and nonlinear space-charge forces. This paper describes the details of the LEBT design activity.

  1. Design of low energy beam transport for new LANSCE H{sup +} injector

    Energy Technology Data Exchange (ETDEWEB)

    Batygin, Y.K., E-mail: batygin@lanl.gov; Draganic, I.N.; Fortgang, C.M.; Garnett, R.W.; Kurennoy, S.S.; McCrady, R.C.; O’Hara, J.F.; Rybarcyk, L.J.

    2014-07-01

    The present LANSCE injector utilizes two 750-keV Cockcroft–Walton (CW) based injectors for simultaneous injection of H{sup +} and H{sup −} beams into 800-MeV accelerator. To reduce long-term operational risks, the new project to replace the existing H{sup +} CW injector with a Radio-Frequency Quadrupole (RFQ) accelerator is underway [1]. The new injector requires a Low-Energy Beam Transport (LEBT). An ion source and 2-solenoid magnetic LEBT have been designed and optimized to transport beams over a wide range of space-charge neutralization and transverse emittance, while allowing sufficient space for diagnostics and a beam deflector. The design layout minimizes the beam size in the LEBT and potential emittance growth due to solenoid aberrations and nonlinear space-charge forces. This paper describes the details of the LEBT design activity.

  2. Multi-objective particle swarm and genetic algorithm for the optimization of the LANSCE linac operation

    Energy Technology Data Exchange (ETDEWEB)

    Pang, X., E-mail: xpang@lanl.gov; Rybarcyk, L.J.

    2014-03-21

    Particle swarm optimization (PSO) and genetic algorithm (GA) are both nature-inspired population based optimization methods. Compared to GA, whose long history can trace back to 1975, PSO is a relatively new heuristic search method first proposed in 1995. Due to its fast convergence rate in single objective optimization domain, the PSO method has been extended to optimize multi-objective problems. In this paper, we will introduce the PSO method and its multi-objective extension, the MOPSO, apply it along with the MOGA (mainly the NSGA-II) to simulations of the LANSCE linac and operational set point optimizations. Our tests show that both methods can provide very similar Pareto fronts but the MOPSO converges faster.

  3. [Management of motor disability in rural Sahelian environment. Experience of the center for rehabilitation and devices in Bogande, Burkina Faso].

    Science.gov (United States)

    Condamine, J L; Artigues, S; Catherine, V; Diagnougou, N; Ouoba, T

    1998-01-01

    The center for rehabilitation and fitting of the disabled in Bogande, Burkina Faso has been in operation since 1992. It was created by a non-governmental organization named Actions de Solidarité Internationale (ASI). The primary goal of the center is to provide support devices to restore upright position and mobility and allow social reinsertion especially for disabled persons between the ages of 0 and 20 years. Approximately one hundred people are treated annually. Treatment is delivered either directly in villages or in dispensaries if the disabled person can be brought in with the assistance of family members or health care workers. This policy has enhanced the quality of information, training, and prevention. Patients with severe disabilities beyond the scope of treatment at the center are contraindicated. The activities of the center have been organized with a view to covering costs. A welding shop has been set up to produce aid devices and provide revenues to pay for some services. The major lessons of this experience involve the need for active recruitment in villages, for contraindicating patients with severe untreatable disability, for developing economically sustainable programs, for training management staff, and for good financial planning. In 4 years of operation, the rehabilitation and fitting center has demonstrated its ability to meet the needs of the disabled in Bogande.

  4. Experiences of Multidisciplinary Development Team Members During User-Centered Design of Telecare Products and Services: A Qualitative Study

    OpenAIRE

    Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura MJ; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P.

    2014-01-01

    Background User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. Objective The primary objective of this study was t...

  5. Single-center experience in pediatric renal transplantation using thymoglobulin induction and steroid minimization.

    Science.gov (United States)

    Warejko, Jillian K; Hmiel, S Paul

    2014-12-01

    Our center has offered thymoglobulin induction with steroid minimization to our pediatric renal transplant patients for the last 10 yr. Steroid minimization or avoidance has shown favorable results in survival, kidney function, and growth in previous studies of pediatric patients. We report our experience with this protocol over the past 10 yr with respect to patient/graft survival, acute rejection episodes, renal function, linear growth, bone density, cardiovascular risk factors, and opportunistic infections. A retrospective chart review was performed for pediatric renal transplant patients on the steroid-minimized protocol between January 2002 and December 2011 on an intention to treat basis. Patient demographics, height, weight, serum creatinine, iGFR, biopsies, and survival data were collected. Height and weight z-scores were calculated with EpiInfo 7, using the CDC 2000 growth charts. Survival was calculated using Kaplan-Meier analysis. eGFR was calculated using the original and modified Schwartz equations. Forty-four pediatric patients were identified, aged 13 months to 19 yr. Five-yr survival was 95.5% for males and 94.4% for females. Only five patients had biopsy-proven ACR, two of which were at more than 12 months post-transplantation. Height delta z-scores from transplant to one, three, and five yr were 0.34, 0.38, and 0.79, respectively. Weight delta z-scores from transplant to one, three, and five yr were 0.87, 0.79, and 0.84, respectively. Mean original Schwartz eGFR was 84.3 ± 15.8 mL/min/1.73 m(2) , modified Schwartz eGFR was 59.3 ± 11.5 mL/min/1.73 m(2) , and iGFR was 64.2 ± 8.5 mL/min/1.73 m(2) at three yr. Of 18 subjects who had a bone density exam, none had a z-score less than -2 on DEXA exam at one-yr post-transplantation. Fifty-one percent of patients were on antihypertensives at the time of transplant compared with 43% at one-yr post-transplantation. Three yr post-transplantation, the average LDL was <100 mg/dL, and

  6. Intergenerational Learning at a Nature Center: Families Using Prior Experiences and Participation Frameworks to Understand Raptors

    Science.gov (United States)

    Zimmerman, Heather Toomey; McClain, Lucy Richardson

    2014-01-01

    Using a sociocultural framework to approach intergenerational learning, this inquiry examines learning processes used by families during visits to one nature center. Data were collected from videotaped observations of families participating in an environmental education program and a follow-up task to draw the habitat of raptors. Based on a…

  7. The Structure and Functioning of a Low-Budget Center for Applied Linguistics: The Brazilian Experience.

    Science.gov (United States)

    Gomes de Matos, Francisco

    1980-01-01

    Describes the structure and functioning of the "Centro de Linguistica Aplicada do Instituto de Idiomas Yazigi" of Sao Paulo and comments on its role in promoting applied linguistics studies in Latin America. Also outlines the Center's historical background and its educational services, particularly those related to the teaching of English. (MES)

  8. Family Centered Health Care--A Viable Reality? The Denver Experience.

    Science.gov (United States)

    Cowen, David L:; Sbarbaro, John A.

    In early 1966, the Denver Department of Health and Hospitals embarked on a city-wide, decentralized health program in an effort to provide family centered "team" health care to medically indigent patients. The program encompasses 28 different clinics and facilities. Factors hindering or influencing the final pattern of health care delivery…

  9. Understanding and Engagement in Places of Science Experience: Science Museums, Science Centers, Zoos, and Aquariums

    Science.gov (United States)

    Schwan, Stephan; Grajal, Alejandro; Lewalter, Doris

    2014-01-01

    Science museums, science centers, zoos, and aquariums (MCZAs) constitute major settings of science learning with unique characteristics of informal science education. Emphasis will be given to the analysis of four specific characteristics of MCZAs that seem relevant for educational research and practice, namely, conditions of mixed motives and…

  10. The Hamovitch Research Center: An Experiment in Collective Responsibility for Advancing Science in the Human Services

    Science.gov (United States)

    Flynn, Marilyn; Brekke, John S.; Soydan, Haluk

    2008-01-01

    Research centers in schools of social work are growing in number and scope. In this article the authors argue that this increase is in line with the growing recognition that research and science are critical components of the mission of the social work profession. The authors examine the purposes and various models for establishing research…

  11. Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms

    NARCIS (Netherlands)

    Veith, Frank J.; Lachat, Mario; Mayer, Dieter; Malina, Martin; Holst, Jan; Mehta, Manish; Verhoeven, Eric L. G.; Larzon, Thomas; Gennai, Stefano; Coppi, Gioacchino; Lipsitz, Evan C.; Gargiulo, Nicholas J.; van der Vliet, J. Adam; Blankensteijn, Jan; Buth, Jacob; Lee, W. Anthony; Biasi, Giorgio; Deleo, Gaetano; Kasirajan, Karthikeshwar; Moore, Randy; Soong, Chee V.; Cayne, Neal S.; Farber, Mark A.; Raithel, Dieter; Greenberg, Roy K.; van Sambeek, Marc R. H. M.; Brunkwall, Jan S.; Rockman, Caron B.; Hinchliffe, Robert J.

    2009-01-01

    Background: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. Objective: To clarify these we examined a c

  12. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

    NARCIS (Netherlands)

    Veith, F.J.; Lachat, M.; Mayer, D.; Malina, M.; Holst, J.; Mehta, M.; Verhoeven, E.L.; Larzon, T.; Gennai, S.; Coppi, G.; Lipsitz, E.C.; Gargiulo, N.J.; Vliet, J.A. van der; Blankensteijn, J.D.; Buth, J.; Lee, W.A.; Biasiol, G.; Deleo, G.; Kasirajan, K.; Moore, R.; Soong, C.V.; Cayne, N.S.; Farber, M.A.; Raithel, D.; Greenberg, R.K.; Sambeek, M.R. van; Brunkwall, J.S.; Rockman, C.B.; Hinchliffe, R.J.

    2009-01-01

    BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a c

  13. Social and Architectural Aspects of Revitalization of Historic Urban Centers: Foreign Experience

    Directory of Open Access Journals (Sweden)

    Indrė Gražulevičiutė-Vileniškė

    2011-03-01

    Full Text Available The structure and architecture of many European cities has started their development during the Middle Ages or even earlier. The historic cores gradually had become centers of contemporary cities and are constantly evolving. They are affected by the tendencies of destruction, initiatives and movements of preservation are also taking place there. The comprehensive works of rehabilitation of Lithuanian historic urban centers were carried out during the period of soviet occupation. The insularity of the Soviet empire, ideological reasons and the absence of the private property has determined certain architectural expressions and solutions for the social problems. After the restoration of the country‘s independence the problems and tendencies typical to Western city centers, such as commercialization and gentrification, started to appear in Lithuanian historic urban cores. This justifies the aim of the article which is to analyze the tendencies of revitalization of historic city centers in Western countries with the main attention to the social and architectural aspects.Article in Lithuanian

  14. Toxicological consultation data management system based on experience of Pomeranian Center of Toxicology

    Directory of Open Access Journals (Sweden)

    Piotr Maciej Kabata

    2015-10-01

    Full Text Available Background: In this paper the structure of poisonings is described, based on the material collected from tele-toxicology consults by the Pomeranian Center of Toxicology in Gdańsk and harvested from its Electronic Poison Information Management System. In addition, we analyzed conclusions drawn from a 27-month operation of the system. Material and Methods: Data were harvested from the Electronic Poison Information Management System developed in 2012 and used by the Pomeranian Center of Toxicology since then. The research was based on 2550 tele-toxicology consults between January 1 and December 31, 2014. Subsequently the data were electronically cleaned and presented using R programming language. Results: The Pomeranian voivodeship was the prevalent localisation of calls (N = 1879; 73.7%. Most of the calls came from emergency rooms (N = 1495; 58.63%. In the case of 1396 (54.7% patients the time-lag between intoxication and the consult was less than 6 h. There were no differences in the age distribution between genders. Mean age was 26.3 years. Young people predominated among intoxicated individuals. The majority of intoxications were incidental (N = 888; 34.8% or suicidal (N = 814; 31.9% and the most of them took place in the patient’s home. Conclusions: Information about Poison Control Center consultations access should be better spread among medical service providers. The extent of poison information collected by Polish Poison Control Centers should be limited and unified. This should contribute to the increased percentage of properly documented consultations. Additional duties stemming from the need of digital archiving of consults provided, require the involvement of additional staff, leading to the increased operation costs incurred by Poison Control Centers. Med Pr 2015;66(5:635–644

  15. A furnace with rotating load frame for in situ high temperature deformation and creep experiments in a neutron diffraction beam line

    Energy Technology Data Exchange (ETDEWEB)

    Reiche, H. M. [LANSCE Lujan Center, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); New Mexico State University, Las Cruces, New Mexico 88003 (United States); Vogel, S. C.; Larson, E. J. [LANSCE Lujan Center, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Mosbrucker, P. [LANSCE Lujan Center, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Department of Mechanical and Materials Engineering, Queen' s University, Kingston K7L 3N6 (Canada); Daymond, M. R. [Department of Mechanical and Materials Engineering, Queen' s University, Kingston K7L 3N6 (Canada)

    2012-05-15

    A resistive furnace combined with a load frame was built that allows for in situ neutron diffraction studies of high temperature deformation, in particular, creep. A maximum force of 2700 N can be applied at temperatures up to 1000 deg. C. A load control mode permits studies of, e.g., creep or phase transformations under applied uni-axial stress. In position control, a range of high temperature deformation experiments can be achieved. The examined specimen can be rotated up to 80 deg. around the vertical compression axis allowing texture measurements in the neutron time-of-flight diffractometer HIPPO (High Pressure - Preferred Orientation). We present results from the successful commissioning, deforming a Zr-2.5 wt.% Nb cylinder at 975 deg. C. The device is now available for the user program of the HIPPO diffractometer at the LANSCE (Los Alamos Neutron Science Center) user facility.

  16. A Proposed Experiment to Study Relaxation Formation of a Spherical Tokamak with a Plasma Center Column

    CERN Document Server

    Hsu, S C

    2006-01-01

    A spherical tokamak (ST) with a plasma center column (PCC) can be formed via driven magnetic relaxation of a screw pinch plasma. An ST-PCC could in principle eliminate many problems associated with a material center column, a key weakness of the ST reactor concept. This work summarizes the design space for an ST-PCC in terms of flux amplification, aspect ratio, and elongation, based on the zero-beta Taylor-relaxed analysis of Tang & Boozer [Phys. Plasmas 13, 042514 (2006)]. The paper will discuss (1) equilibrium and stability properties of the ST-PCC, (2) issues for an engineering design, and (3) key differences between the proposed ST-PCC and the ongoing Proto-Sphera effort in Italy.

  17. Volume of Cataract Surgery and Surgeon Gender: The Florida Ambulatory Surgery Center Experience 2005 Through 2012.

    Science.gov (United States)

    French, Dustin D; Margo, Curtis E; Campbell, Robert R; Greenberg, Paul B

    2016-01-01

    Cataract is the most common surgically reversible cause of vision loss and the most common major surgical procedure performed in the United States. To understand how gender composition might affect differences in health services, we examined the surgeon gender-specific rates of routine cataract surgery performed in ambulatory surgical centers in Florida. Routine cataract surgeries were identified through the Florida Agency for Health Care Administration (AHCA) ambulatory surgery center dataset. The background of individual surgeons was determined by linking license numbers in the dataset to physician profiles publicly available from AHCA. From 2005 through 2012, women ophthalmologists in Florida performed roughly half the annual rate of cataract surgery as their male counterparts. This difference is not explained by greater time in clinical practice for men. Further investigation into the causes of this gender-volume disparity is warranted to determine what roles choice and barriers may play.

  18. Post–Endoscopic Retrograde Cholangiopancreaticography complications in liver transplanted patients, a single-center experience

    DEFF Research Database (Denmark)

    Ambrus, R B; Svendsen, Lars Bo; Hillingsø, J G;

    2015-01-01

    BACKGROUND: Complications in the biliary tract occur in 5%-30% after liver transplantation and the main part of the complications is successfully managed with endoscopic retrograde cholangiopancreaticography (ERCP). The incidence and risk factors for post-ERCP complications in liver transplantation...... patients are not well described. Our objective was to define the frequency of post-ERCP complications in liver transplantation patients at the Abdominal Center, Rigshospitalet, the only Liver Transplantation Center in Denmark. METHODS: Retrospective study of all ERCPs performed in liver transplantation...... cholangitis occurred after two procedures, respectively. Multivariate analysis concerning overall complications identified biliary sphincterotomy (p = 0.006) and time since liver transplantation within 90 days postoperatively (p = 0.044) as risk factors for post-ERCP complications. Specifically concerning...

  19. My personal experiences at the BEST Medical Center: A day in the clinic-the afternoon.

    Science.gov (United States)

    Cohen, Philip R; Kurzrock, Razelle

    2016-01-01

    Dr. Ida Lystic is a gastroenterologist who recently began her new faculty position at the BEST (Byron Edwards and Samuel Thompson) Medical Center. After completing her MD degree at the prestigious Harvey Medical School (recently renamed the Harvey Provider School), she did her internal medicine residency and fellowship training at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center. Her morning in gastroenterology clinic was highlighted by: (1) being reprimanded by the clinic nurse manager for a patient who not only arrived early, before clinic had opened, but also neglected to schedule the anesthesiologist for his colonoscopy; (2) the continued challenges of LEGEND (also known as Lengthy and Excessively Graded Evaluation and Nomenclature for Diagnosis by her colleagues), the new electronic medical record system after the BEST discarded the SIMPLE (Succinct Input Making Patient's Lives Electronic) system; (3) a nurse's interruption of an office visit-once the egg timer on the examination room door ran out-because she had exceeded the allocated time for the appointment; and (4) her chairman's unanticipated arrival in the clinic to visit with the clinic nurse manager. In addition to seeing her patients, Dr. Lystic's afternoon is occupied by attending a LOST (Laboratory OverSight and Testing) Committee meeting and a visit from a wayfinding and signage specialist to depersonalize the doorpost plaques of the examination rooms. Her day ends with a demeaning email from her chairman regarding the poor results of the most recent patient satisfaction survey and being personally held accountable to develop solutions to improve not only her performance but also that of the clinic. Although Dr. Ida Lystic and the gastroenterology clinic at "the BEST Medical Center" are creations of the authors' imagination, the majority of the anecdotes mentioned in this essay are based on individual patients and their physicians, clinics in medical centers and their administration

  20. Various anatomic locations of surgically proven endometriosis: A single-center experience

    OpenAIRE

    Lee, Hyun Ju; Park, Ye Mi; Jee, Byung Chul; Kim, Yong Beom; Suh, Chang Suk

    2015-01-01

    Objective To report the various anatomic locations of surgically and pathologically proven endometriosis. Methods Pathologic reports (n=1,376) of women who underwent surgeries at a single center between April 2005 and March 2013 were retrieved from the electronic medical record system of the hospital. Pathologic reports were included after performing a search by using the key-words "endometrial cyst," "endometriotic cyst," "endometriosis," or "endometrioma." Only reports dealing with female p...

  1. Aligning Incentives in Orthopaedics: Opportunities and Challenges—the Case Medical Center Experience

    OpenAIRE

    Marcus, Randall E.; Zenty, Thomas F.; Adelman Esq., Harlin G.

    2009-01-01

    For 30 years, the orthopaedic faculty at Case Western Reserve University worked as an independent private corporation within University Hospitals Case Medical Center (Hospital). However, by 2002, it became progressively obvious to our orthopaedic practice that we needed to modify our business model to better manage the healthcare regulatory changes and decreased reimbursement if we were to continue to attract and retain the best and brightest orthopaedic surgeons to our practice. In 2002, our...

  2. Robotic Mobile Manipulation Experiments at the U.S. Army Maneuver Support Center

    Energy Technology Data Exchange (ETDEWEB)

    BENNETT, PHIL C.; ANDERSON, ROBERT J.

    2002-06-01

    This activity brought two robotic mobile manipulation systems developed by Sandia National Laboratories to the Maneuver Support Center (MANSCEN) at Ft. Leonard Wood for the following purposes: Demonstrate advanced manipulation and control capabilities; Apply manipulation to hazardous activities within MANSCEN mission space; Stimulate thought and identify potential applications for future mobile manipulation applications; and Provide introductory knowledge of manipulation to better understand how to specify capability and write requirements.

  3. Lupus and Pregnancy. 15 Years of Experience in a Tertiary Center

    OpenAIRE

    Ambrósio, P; Lermann, R; Cordeiro, A.; Borges, A.; Nogueira, I.; Serrano, F.

    2010-01-01

    This retrospective study was designed to evaluate the outcome of pregnancies in women diagnosed with systemic lupus erythematosus (SLE) followed in a tertiary fetal–maternal center. Data were collected from clinical charts between January 1993 and December 2007, with a total of 136 pregnancies (107 patients). Mean maternal age was 29 years, with the vast majority of patients being Caucasian. Most patients were in remission 6 months prior to pregnancy (93%) and the most frequently affect...

  4. Information Retrieval eXperience (IRX): Towards a Human-Centered Personalized Model of Relevance

    NARCIS (Netherlands)

    Sluis, van der Frans; Broek, van den Egon L.; Dijk, van Betsy; Hoeber, O.; Li, Y.; Huang, X.J.

    2010-01-01

    We approach Information Retrieval (IR) from a User eXperience (UX) perspective. Through introducing a model for Information Retrieval eXperience (IRX), this paper operationalizes a perspective on IR that reaches beyond topicality. Based on a document's topicality, complexity, and emotional value, a

  5. Congenital cystic lesions of the lungs: The perils of misdiagnosis - A single-center experience

    Directory of Open Access Journals (Sweden)

    V Shankar Raman

    2015-01-01

    Full Text Available Background: A majority of cystic lesions in the western world are detected antenatally, whereas, the diagnosis in our setup occurs once the child becomes symptomatic. Surgical management is primarily dictated by the presence of symptoms, recurrent infection, and rarely by the potential risk of malignant transformation. Materials and Methods: A retrospective analysis was carried out on all consecutive patients with cystic lung lesions managed at our center from January 2000 through June 2011 for antenatal diagnosis, presentation, diagnostic modalities, treatment, and complications. Results: Forty cystic lung lesions were identified. Only 8% were antenatally detected. Out of 40, the final diagnosis was congenital cystic adenomatoid malformation in 19, congenital lobar emphysema in 11, and bronchogenic cysts and pulmonary sequestration in five each. Of these, 20% had received a course of prior antitubercular therapy and 30% had an intercostal drain inserted prior to referral to our center. Postoperative morbidity in the form of bronchopleural fistula, pneumothorax, and non-expansion of the residual lung was noted in 10% of the patients. Conclusion: Antenatal diagnosis of these lesions is still uncommon in third world countries. Prior to referral to a pediatric surgical center a large number of patients received antitubercular drugs and an intercostal drain insertion, due to incorrect diagnosis.

  6. 64-row multi-dector computed tomography coronary image from a center with early experience: first illustration of learning curve

    Institute of Scientific and Technical Information of China (English)

    Sze Piaw CHIN; Tiong Kiam ONG; Wei Ling CHAN; Chee Khoon LIEW; M.Tobias Seyfarth; Fong Yean Yip ALAN; Houng Bang LIEW; Kui Hian SIM

    2006-01-01

    Background and objectives The recent joint ACCF/AHA clinical competence statement on cardiac imaging with multi-detector computed tomography recommended a minimum of 6 months training and 300 contrast examinations, of which the candidate must be directly involved in at least 100 studies. Whether this is adequate to become proficient in interpretation of coronary computed tomogsignificant coronary stenosis in a center with 1 year's experience using a 64-row scanner. Methods A total of 778 patients underwent contrast-enhanced CTA between January and December 2005. Out of these patients, 301 patients also underwent contrast-enhanced conventional coronary angiography (CCA). These patients were divided into 4 groups according to the time the examination was underwent. Group Q1: first quarter of the year (n=20), Group Q2: second quarter (n=128), Group Q3: third quarter (n=134), and Group Results The sensitivity, specificity, positive, and negative predictive values were Q1 - 64%, 89%, 49% and 94%, respectively; Q2 -79%, 96%, 74% and 97%, respectively; Q3 - 78%, 96%, 74%, 97%, respectively, and Q4 - 100% for all. Conclusions In a center with formal training and high caseload, our accuracy in CTA analysis reached a plateau after 6 months experience. Test-bolus protocols produce better image quality and can improve accuracy. New centers embarking on CTA will need to overcome an initial 6-month learning curve depending upon the caseload during which time they should consider correlation with CCA.

  7. Experience in procurement and processing of heart valves at the Northwest Tissue Center

    International Nuclear Information System (INIS)

    The Northwest Tissue Center established a human heart valve program in 199 1. It is one of four non-profit tissue banks and one for-profit program that recover and process heart valves in the United States. During the eight years in which the Northwest Tissue Center has been involved in heart valve banking, there have been a total of 673 hearts procured for processing. The age of the donors ranged from <1 to 44 years with a mean of 26.2 years, 66% werw male,and 6.5% of the hearts procered were discarded due to a variety of medical and criteria reason. The primary reasons for differal were questions of possible cancer and questions of high risk behavior/social history. Of the 1,264 cardiovascular tissues processed, 6% were lost because of donor history, 17% were lost because of microbiology results, and 5% were lost because of donor serology . There were total a total of 190 aortic valves and 48 pulmonic conduits transplanted over this time period. The mean age of the recipients was 23.4 with a median or 23 years; 102 of the recipients were less than one year of age. Males comprised 62% of the recipients. Since 1993, there has been a clear shift towards more use of pulmonic valves over aortic valves as a results of the acceptance of the Ross procedure. Early in the program, reports were received from surgeons that some heart valves appeared to have cracks in the conduits. Experimentations in the laboratory led to the discovery that thawing too rapidly would result in cracking of these materials. Packaging was designed to reduce the rate of thawing and this has resolved the problem with cracking. The heart valve program at the Northwest Tissue Center has been very successful in providing the necessary valves for patients in the Northwest Region of the United States

  8. Environmental center for integrated waste management: an experience in the Amazon

    Energy Technology Data Exchange (ETDEWEB)

    Jaramillo V, Jairo; Banalcazar, Fernando L.; Noboa Garcia, Gabriel [EnCanEcuador S.A., Houston, TX (United States)

    2004-07-01

    The creation of a large amount of both solid and liquid waste within the petroleum industry should be the reason for providing a facility that makes it possible to apply proper treatment to the waste matter, depending on the degree of complexity, especially if these operations are taking place within or in the area of influence of a national park or a biosphere reserve. EnCanEcuador has invested $1 200,000 in the construction of facilities and equipment for an integrated environmental management center, which will allow us to create in-house resources for the management of waste control. Organic waste is grinded, homogenized with sawdust and placed in a dynamic sanitary fill to form fertilizer. The leachates material will be used as foliage fertilizer. Inorganic waste is classified, grinded, compacted, packed and sent to different recycling companies or in some cases incinerated in a low emission incinerator. Drilling waste: Drilling mud water based potassium nitrate is treated through a de-nitrification process using bioremediation methods. Liquid waste: from well completion, washing vehicles, drains from production stations, is passed through an API separator system into two physical-chemical treatment pits for its later re-injection. Contaminated soil: that may be caused by petroleum activity is treated in a pit where the greatest possible amount of hydrocarbon is recovered by means of hot hydro-washing and is then treated with native bacteria in two land farming centers. Dangerous solid waste is transported to a secure fill for its confinement. Laboratory and Meteorological Station: For the control and monitoring of petroleum activities and to determine climatic variations. Plant nursery: it will have a capacity to produce 300,000 plants a year. Community Cooperatives will manage the center, enforcing our Social responsibility in our daily activities. (author)

  9. Communication for heath behavior change: experiences lived at the Center for Communication Programs at Johns Hopkins University.

    Directory of Open Access Journals (Sweden)

    Ana Carolina de Oliveira Monteiro dos SANTOS

    2016-01-01

    Full Text Available Sharing experiences is the best way to learn and contribute to the construction of knowledge. It is with this intention that arises this article, a result of the lived experience of the author in workshop taught by the Center for Communication Programs - CCP (Communication Programs Center at Johns Hopkins University in Baltimore, USA, in June 2014. In this workshop intensive of 20 days, with daily classes full-time, the author had the opportunity to study and share experiences with great thinkers and professionals from Johns Hopkins. This promoted contact with the philosophy of the institution and the methodologies they developed and implemented in countries around the world, in order to promote improvements in the health status of populations through strategic planning focused on behavior change communication. This was an experience not just in study and planning communication, but a leadership training experience, withmore aware, engaged and complete professionals and, above all, of self-knowledge and personal growth. An article would not be enough to describe all this experience, so we chose to focus on issues about the institution’s vision on health, the practice of health communication, behavior change and an overview of the essential aspects the methodology developed and used by them, called P process. In this article, the reader will come across a breach of academic theoretical reflections promoted by further technical discussions practices, managerial characteristics. This ends up reflecting the logic implemented by the CCP, which develops the practice based on a broad theoretical framework. And in the same way that the institution does not close in their theories and allows to reinvent itself, this article will also feature the author’s own reflections about some of the issues presented.

  10. Acute kidney injury in severe acute pancreatitis: An experience from a tertiary care center

    OpenAIRE

    Ravindra Kumar; Naresh Pahwa; Neeraj Jain

    2015-01-01

    Acute kidney injury (AKI) is an important cause of morbidity and mortality in severe acute pancreatitis (SAP). We aimed in our study to explore the risk factors of AKI in patients with SAP and assess the prognosis of patients with SAP and AKI. This is a retrospective study consisting of analysis of outcome and complications encountered in 72 severe acute pancreatitis patients admitted to a tertiary care center at Indore, India, from May 2011 to April 2012. We encountered 14 AKI cases in the S...

  11. Exclusion Reasons of Living Kidney Donor Candidates: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Ayşegül ORUÇ

    2014-05-01

    Full Text Available OBJECTIVE: Due to severe organ shortage, living kidney donors are important choices for transplantation. In Muslim countries, such as Turkey, living kidney donors are the main source of donor pool. In the literature, reasons for living donor exclusion are reported from several countries. However, there is no published study that focused on exclusion reasons of donor candidates in Turkey where living kidney transplantation rate is 73.4%. The goal of this retrospective study was to examine the exclusion reasons for donation among living kidney donor candidates at a single center in Turkey. MATERIAL and METHODS: A total 538 adults were evaluated as a living kidney donor candidate between December 1988 and January 2012. Evaluation outcome, exclusion reasons and demographic data were examined from electronic file system and immunology laboratory records. RESULTS: In this period 451 kidney transplantations (38.6% cadaveric, 61.4% living donor was performed. Overall 261 (48.5% donor candidates who underwent evaluation could not donate. We were able to find the precise cause of exclusion of 86 donors (33%. Among excluded donor candidates the most common exclusion reason was medical causes (64% such as diabetes mellitus, low glomerular filtration rate and hypertension. CONCLUSION: Our study suggests that medical causes are significant exclusion reasons for living kidney donation at our center.

  12. Treatment of patients with metastatic pancreatic cancer: Experience from a tertiary Indian cancer center

    Directory of Open Access Journals (Sweden)

    B Sirohi

    2015-01-01

    Full Text Available Background: The aim of this study was to look at the outcome of patients with metastatic pancreatic cancer treated at a tertiary cancer center in India. Patients And Methods: A total of 101 patients with locally advanced and metastatic pancreatic cancer diagnosed between May 2012 and July 2013 were identified from a prospectively maintained database at the tertiary cancer center. Overall survival (OS was computed using the Kaplan–Meir product limit method and compared across groups using the log-rank statistics. Cox proportional hazards model, adjusted for a number of patient and tumor characteristics, was then used to determine factors prognostic for OS. Results: Median age at diagnosis was 55 years (range: 21–81 years. 57.4% (n = 58 of patients were male, 22% (n = 22 had performance status (PS of <2 at diagnosis and 89% received first-line chemotherapy, while the rest received best supportive care. For the whole cohort, 6 month and 1-year OS was 57% (95% confidence interval [CI]: 46–66% and 47% (95% CI: 35–57%, respectively. In a multivariable model, PS <2 and oligometastatic disease were associated with a significantly decreased risk of death. Conclusion: Results from our analysis indicate that the prognostic outcome among Indian patients with metastatic pancreatic cancer is poor with survival outcomes similar to those reported in North America and Europe.

  13. Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

    Science.gov (United States)

    Trestrail, J H; al-Mahasneh, Q M

    1989-04-01

    From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world. PMID:2929130

  14. Rapid steroid discontinuation for pediatric renal transplantation: a single center experience.

    Science.gov (United States)

    Lau, Keith K; Haddad, Maha N; Berg, Gerre M; Perez, Richard V; Butani, Lavjay

    2007-08-01

    To determine the outcomes of pediatric renal transplant recipients who received immunosuppression consisting of early withdrawal of corticosteroids at a single Northern California center. Protocols using minimal steroid exposure have been recently reported in adult transplant recipients with successful results. We examined the outcomes of pediatric renal transplant recipients who were managed at our center using a protocol with very early discontinuation of steroids after renal transplantation. We retrospectively studied the medical records of all renal transplant recipients followed at the Children's Hospital at the University of California, Davis Medical Center from 01/2004 to 12/2005. All patients were less than 18 yr of age at the time of transplantation. The immunosuppressive protocol included three tapering daily doses of methylprednisolone, together with five doses of thymoglobulin followed by maintenance therapy with tacrolimus and MMF. Eight patients with equal numbers of males and females were transplanted during this time period. There were equal numbers of Caucasians, African-Americans, Hispanics, and Asians. A total of 37.5% (3/8) of the subjects received preemptive transplantation, 25% (2/8) received peritoneal, and 37.5% (3/8) received hemodialysis before transplantation. The median (range) age at transplantation was 12.3 (3.1-16.0) year with a follow-up of 1.7 (0.9-2.8) year. At one yr post-transplantation, 57% (4/7) of patients still required anti-hypertensives. Three children required erythropoietin supplementation after transplantation. The mean delta height standard deviation score at 12 months was 0.20 +/- 0.56. There were no episodes of clinical acute rejection. One patient switched from tacrolimus to sirolimus due to biopsy-proven CAN. No patient became diabetic or required hypoglycemic agents. Surveillance biopsies showed no subclinical acute rejection in any patient. Steroid-free immunosuppression is safe in children after renal

  15. Acute kidney injury in severe acute pancreatitis: An experience from a tertiary care center

    Directory of Open Access Journals (Sweden)

    Ravindra Kumar

    2015-01-01

    Full Text Available Acute kidney injury (AKI is an important cause of morbidity and mortality in severe acute pancreatitis (SAP. We aimed in our study to explore the risk factors of AKI in patients with SAP and assess the prognosis of patients with SAP and AKI. This is a retrospective study consisting of analysis of outcome and complications encountered in 72 severe acute pancreatitis patients admitted to a tertiary care center at Indore, India, from May 2011 to April 2012. We encountered 14 AKI cases in the SAP study patients. There was a significant association of diabetes and alcohol with AKI in patients with SAP. Alcohol was found to be an independent significant risk factor for AKI in SAP. All the eight patients with SAP who expired had AKI. None of the patients of SAP without AKI expired during the study. We conclude that the patients with SAP with AKI have a greater mortality rate as compared with the SAP patients without AKI.

  16. Primary breast cancer: The experience of the joint center for radiation therapy

    International Nuclear Information System (INIS)

    While radiation therapy began to be administered in the treatment of breast cancer shortly after the discovery of X rays in 1895, the efficacious use of external beam radiation for early breast cancer required supervoltage radiation in order to get effective doses to the tumor, as well as the skin sparing, required for satisfactory cosmetic results. The use of interstitial radiation began shortly after the discovery of radium by the Curies. The first systematic report of such an approach was presented by Goeffrey Keynes, who reported equivalent results with radium implants as compared to those with mastectomy. These two techniques, supervoltage and interstitial radiation, have been used in the modern era of radiotherapy and reported by a number of centers, some of which are presented in this symposium

  17. Outcome science in practice: an overview and initial experience at the Vanderbilt Spine Center.

    Science.gov (United States)

    McGirt, Matthew J; Speroff, Theodore; Godil, Saniya Siraj; Cheng, Joseph S; Selden, Nathan R; Asher, Anthony L

    2013-01-01

    In terms of policy, research, quality improvement, and practice-based learning, there are essential principles--namely, quality, effectiveness, and value of care--needed to navigate changes in the current and future US health care environment. Patient-centered outcome measurement lies at the core of all 3 principles. Multiple measures of disease-specific disability, generic health-related quality of life, and preference-based health state have been introduced to quantify disease impact and define effectiveness of care. This paper reviews the basic principles of patient outcome measurement and commonly used outcome instruments. The authors provide examples of how utilization of outcome measurement tools in everyday neurosurgical practice can facilitate practice-based learning, quality improvement, and real-world comparative effectiveness research, as well as promote the value of neurosurgical care.

  18. Experience Transitioning Models and Data at the NOAA Space Weather Prediction Center

    Science.gov (United States)

    Berger, Thomas

    2016-07-01

    The NOAA Space Weather Prediction Center has a long history of transitioning research data and models into operations and with the validation activities required. The first stage in this process involves demonstrating that the capability has sufficient value to customers to justify the cost needed to transition it and to run it continuously and reliably in operations. Once the overall value is demonstrated, a substantial effort is then required to develop the operational software from the research codes. The next stage is to implement and test the software and product generation on the operational computers. Finally, effort must be devoted to establishing long-term measures of performance, maintaining the software, and working with forecasters, customers, and researchers to improve over time the operational capabilities. This multi-stage process of identifying, transitioning, and improving operational space weather capabilities will be discussed using recent examples. Plans for future activities will also be described.

  19. Metastases of esophageal carcinoma to skeletal muscle:Single center experience

    Institute of Scientific and Technical Information of China (English)

    Jan Cincibuch; Miroslav Myslive(c)ek; Bohuslav Melichar; (C)estmír Neoral; Iva Metelková; Michaela Zezulová; Hana Procházková-(S)tudentová

    2012-01-01

    Metastases of esophageal carcinoma to the skeletal muscle are rare,but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT).A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases.Four patients had skeletal muscle metastases of esophageal carcinoma,including two patients with squamous cell carcinoma.In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases,muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma.In all cases,skeletal muscle metastases were the first manifestation of systemic disease.In three patients palliation was obtained with the combination of external beam radiation therapy,systemic chemotherapy or surgical resection.Skeletal muscle metastases are a rare complication of esophageal carcinoma.

  20. De novo cancers following liver transplantation: a single center experience in China.

    Directory of Open Access Journals (Sweden)

    Songfeng Yu

    Full Text Available BACKGROUND: De novo cancers are a growing problem that has become one of the leading causes of late mortality after liver transplantation. The incidences and risk factors varied among literatures and fewer concerned the Eastern population. AIMS: The aim of this study was to examine the incidence and clinical features of de novo cancers after liver transplantation in a single Chinese center. METHODS: 569 patients who received liver transplantation and survived for more than 3 months in a single Chinese center were retrospectively reviewed. RESULTS: A total of 18 de novo cancers were diagnosed in 17 recipients (13 male and 4 female after a mean of 41 ± 26 months, with an overall incidence of 3.2%, which was lower than that in Western people. Of these, 8 (3.32% cases were from 241 recipients with malignant liver diseases before transplant, while 10 (3.05% cases were from 328 recipients with benign diseases. The incidence rates were comparable, p = 0.86. Furthermore, 2 cases developed in 1 year, 5 cases in 3 years and 11 cases over 3 years. The most frequent cancers developed after liver transplantation were similar to those in the general Chinese population but had much higher incidence rates. CONCLUSIONS: Liver transplant recipients were at increased risk for developing de novo cancers. The incidence rates and pattern of de novo cancers in Chinese population are different from Western people due to racial and social factors. Pre-transplant malignant condition had no relationship to de novo cancer. Exact risk factors need further studies.

  1. Blood blister-like aneurysms: Single center experience and systematic literature review

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Ana Marcos; Narata, Ana Paula; Yilmaz, Hasan [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Bijlenga, Philippe; Radovanovic, Ivan; Schaller, Karl [Service of Neurosurgery, University Hospital of Geneva (Switzerland); Lovblad, Karl-Olof [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes, E-mail: vitormpbr@hotmail.com [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland)

    2014-01-15

    Blood blister-like aneurysms (BBAs) are a controversial entity. They arise from non-branching sites on the supraclinoid internal carotid artery (ICA) and are suspected to originate from a dissection. Our aim is to describe the BBA cases seen in our center and to present a systematic review of the literature on BBAs. We analyzed the eleven cases of BBA admitted to our center from 2003 to 2012. We assessed the medical history, treatment modality (endovascular and/or surgery), complications and clinical outcome. The cohort included 8 women and 4 men with a mean age of 53.16 years. Treatment of the BBA consisted of stenting and coiling in 5 patients, stenting only in 4 patients, coiling and clipping in 1 patient, clipping only in 1 patient, and conservative treatment in 1 patient. A good outcome was found in 10 patients, as defined by a modified Rankin Scale (mRS) less than or equal to two at three months. A systematic review of the literature was performed, and 314 reported patients were found: 221 patients were treated with a primarily surgical approach, and 87 patients were treated with a primarily endovascular approach. A rescue or second treatment was required in 46 patients (21%). The overall estimated treatment morbidity rate was 17%, and the mortality rate was 15%. BBAs exhibit more aggressive behavior compared to saccular aneurysms, and more intra-operative complications occur with BBAs, independent of the treatment type offered. They are also significantly more likely to relapse and rebleed after treatment. Endovascular treatment offers a lower morbidity–mortality compared with surgical approaches. Multilayer flow-diverting stents appear to be a promising strategy.

  2. The 10-year Trend of Periprocedural Complication Following Carotid Artery Stenting; Single Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jeong-Ho [Keimyung University Dongsan Medical Center, Department of Neurology (Korea, Republic of); Kang, Jihoon; Yeo, Min-Ju; Kim, Beom Joon; Jang, Min Uk; Bae, Hee-Joon [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of); Kwon, O-Ki; Hwang, Gyo Jun; Oh, Chang Wan [Seoul National University Bundang Hospital, Department of Neurosurgery (Korea, Republic of); Jung, Cheolkyu [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of); Lee, Ji Sung [Soonchunhyang University Medical Center, Biostatistical Consulting Unit (Korea, Republic of); Han, Moon-Ku, E-mail: mkhan@snu.ac.kr [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of)

    2015-04-15

    PurposeCarotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.MethodsWe collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication.ResultsThe mean age was 68.8 years (82.8 % males; range of 20–89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders.ConclusionsOur study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.

  3. Charcot Neuropathic Arthropathy of the Foot: A Literature Review and Single-Center Experience

    Science.gov (United States)

    Shaikh, Haroun Hassan

    2016-01-01

    Charcot neuropathic osteoarthropathy of the foot is a relatively common complication of diabetic neuropathy. Incorrect diagnosis and improper treatment often result in the extremity having to be amputated. This paper summarises the current view on the etiology, diagnostics, and treatment of diabetic Charcot neuropathic osteoarthropathy, with particular focus on preserving the extremity through surgical intervention from our own experiences. PMID:27656656

  4. Online Digital Archives Technology That Supports Rich, Student-Centered Learning Experiences

    Science.gov (United States)

    Hofer, Mark

    2004-01-01

    Today's students watch the newest movie trailers on the Web, share music files, play video games with other players over the Internet, and swap digital pictures of the latest teen idols. Donald Tapscott points out in his book Growing Up Digital that as this rich multimedia experience becomes more a part of students' lives outside of school, they…

  5. Group Project Work and Student-centered Active Learning: Two Different Experiences.

    Science.gov (United States)

    Livingstone, David; Lynch, Kenneth

    2000-01-01

    Compared experiences with group-based student projects in a Geographical Information Systems degree taught by one faculty member and in geography degree modules taught by another. Concludes that care must be taken in the design and execution of these projects to avoid problems that might reinforce myths about negative effects of team-based…

  6. Implementing PDA technology in a medical library: experiences in a hospital library and an academic medical center library.

    Science.gov (United States)

    Morgen, Evelyn Breck

    2003-01-01

    Personal digital assistants (PDAs) have grown from being a novelty in the late 1990s to an essential tool for healthcare professionals in the 2000s. This paper describes the experiences of a librarian who implemented PDA technology first in a hospital library, and then at an academic medical center library. It focuses on the role of the library in supporting PDA technology and resources. Included are programmatic issues such as training for library staff and clinicians, and technical issues such as Palm and Windows operating systems. This model could be used in either a hospital or academic health sciences library.

  7. A 5-year retrospective analysis of Necrotizing fasciitis: A single center experiences

    Directory of Open Access Journals (Sweden)

    Kiralj Aleksandar I

    2015-01-01

    Full Text Available Background/Aim. Necrotizing fasciitis (NF is usually an acute infection of superficial fascia with rapid progression in around soft tissue. If not promptly recognized and aggressively treated NF usualy leads to sepsis and multiorgan failure with fatal outcome, thus early diagnosis and prompt surgical treatment are crucial for healing of these patients. The aim of this article was to evaluate the clinical presentation of all patients with acute NF diagnosed and treated in surgical clinics of Clinical Center of Vojvodina, Novi Sad, Serbia. Methods. The medical records of patients treated for acute NF localized on a different parts of the body in Clinical Center of Vojvodina, Novi Sad, Serbia, during a 5- year period (from January 2008 to December 2012 were retrospectively evaluated. This study enrolled patients admitted via Emergency Center of Vojvodina with the diagnosis of acute NF either as the primary diagnosis or with the diagnosis at discharge after surgical treatment. Results. During a 5-year period there were 216 patients with final diagnosis of acute NF. Most of our patients (140 - 64.81% were admitted with the initial diagnosis of cellulitis, abscesses, phlegmons or sepsis. Unfortunately, the clinical symptoms of acute NF were atypical at time of initial examination. Pain and swelling of the affected localization were the most presented bias of symptoms (183 - 84.72%. The majority of our patients were male (164 - 75.92%. Among the 216 patients, the most common pre-existing single factor was drug abuse (39 - 18.05%, followed by obesity (38 - 17.59% and diabetes mellitus (31 - 14.35%. Trauma was most common etiological factor (22 - 10.8% in infected wounds, followed by abdominal (15 - 6.94% and orthopedic (11 - 5.09% surgical intervention. In the present study idiopathic acute NF was diagnosed in 22 (10.18% patients and more than one etiological factor were diagnosed in 20 (9.25% patients. The majority of our patients had type I acute NF

  8. Continuous ambulatory peritoneal dialysis: three-year experience at one center.

    Science.gov (United States)

    Nolph, K D; Sorkin, M; Rubin, J; Arfania, D; Prowant, B; Fruto, L; Kennedy, D

    1980-05-01

    Three years of clinical experience with continuous ambulatory peritoneal dialysis are summarized. Serum urea nitrogen, creatinine, hematocrit, nerve conduction velocity, calcium, inorganic phosphorus, serum proteins, and electrolytes have been maintained in acceptable ranges. Peritonitis, although reduced in incidence because of solutions in plastic bags and a new adapter, is still a problem. Excessive carbohydrate absorption, obesity, and high serum triglyceride concentrations may be long-term problems in some patients. PMID:7387001

  9. [Diagnosis and treatment of pediatric subglottic stenosis: experience in a tertiary care center].

    Science.gov (United States)

    Botto, Hugo Alberto; Pérez, Cinthia Giselle; Cocciaglia, Alejandro; Nieto, Mary; Rodríguez, Hugo Aníbal

    2015-08-01

    Subglottic stenosis is among the most common causes of airway obstruction in children, 90% of which resulting from endotracheal intubation. The diagnosis is based on the patient's clinical, radiologic evaluation, flexible laryngoscopy and rigid airway endoscopy under general anesthesia. It must be suspected in children with respiratory distress after extubation. The therapeutic approach depends on the severity of the subglottic stenosis and the patient's symptoms. We describe our experience with the subglottic stenosis etiologies, diagnosis, treatment and outcome of patients with this condition.

  10. Minimally invasive video-assisted thyroidectomy: experience of 200 cases in a single center

    OpenAIRE

    Haitao, Zheng; Jie, Xu; Lixin, Jiang

    2014-01-01

    Introduction Minimally invasive techniques in thyroid surgery including video-assisted technique originally described by Miccoli have been accepted in several continents for more than 10 years. Aim To analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and to evaluate the feasibility and effects of this method in a general department over a 4-year period. Material and methods Initial experience was presented based on a series of 200 patients selected f...

  11. Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review

    OpenAIRE

    Muhammad Rizwan Sardar; Andrea Greway; Michael DeAngelis; Erin O'Malley Tysko; Shawn Lehmann; Melinda Wohlstetter; Riti Patel

    2015-01-01

    Eating disorders have multiple medical sequelae, including potentially life-threatening cardiovascular complications. This article describes our cardiology practice experience of treating adults with eating disorders in the outpatient setting and documents baseline cardiac findings in this complex patient population. We describe our findings in patients across the spectrum of eating disorders; past studies have generally focused on anorexia only. This article also includes a review of the cur...

  12. COMBREX-DB: an experiment centered database of protein function: knowledge, predictions and knowledge gaps

    OpenAIRE

    Chang, Yi-Chien; Hu, Zhenjun; Rachlin, John; Anton, Brian P.; Kasif, Simon; Roberts, Richard J.; Steffen, Martin

    2015-01-01

    The COMBREX database (COMBREX-DB; combrex.bu.edu) is an online repository of information related to (i) experimentally determined protein function, (ii) predicted protein function, (iii) relationships among proteins of unknown function and various types of experimental data, including molecular function, protein structure, and associated phenotypes. The database was created as part of the novel COMBREX (COMputational BRidges to EXperiments) effort aimed at accelerating the rate of gene functi...

  13. Analysis of patterns of palliative radiotherapy in north west India: A regional cancer center experience

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    Akhil Kapoor

    2015-01-01

    Full Text Available Background: Palliative radiotherapy (PRT is the eventual requirement in 30-50% of all cancer patients. PRT is primarily aimed to relieve pain and prevent/treat collapse or fracture in case of bone metastasis, to reduce edema in patients with cranial metastasis, and to control distressing symptoms of rapid primary growth. An audit of PRT planned in a busy cancer center can help in the characterization of the requirements of the patients and the formulation of institutional policies. Materials and Methods: In total, 516 patients who received PRT in our regional cancer center from January 2012 to December 2012 and whose complete records were available for analysis were selected for this retrospective study. Medical records and radiotherapy files were analyzed to obtain data such as sociodemographic parameters, prescription of PRT, and follow up. Descriptive statistics were evaluated in terms of frequencies and percentages to allow comparisons. Results: Of the 516 patients, 73% patients were male; the median age of the patients receiving PRT was 62 years (range 13-83 years. About 48% ( n = 248 patients received PRT at the primary site while rest (52% were given PRT at the metastatic site. The most common indication of PRT was pain (56.8% cases, followed by cytostatic PRT (19.8% and raised ICT (12.4%. The median dose prescribed was 30 Gy (range 8-36 Gy delivered in 1-12 fractions over the duration of 1-18 days. The overall response rate was about 43% at 2 weeks of completion of PRT; the median follow-up of the patients was 154 days (range 9-256 days. The long-term symptom relief at median follow up was 8%. Conclusions: Good clinical judgment and expertise is required in prescribing correct fractionation schedule to achieve effective symptom palliation with lowest possible cost and inconvenience to the patients and relatives. Hypofractionated radiotherapy is a feasible treatment option in patients with advanced incurable disease to achieve effective

  14. Cochlear implant surgery at the Clinical Center of Vojvodina - ten-year experience

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    Dankuc Dragan

    2014-01-01

    Full Text Available Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9% and in 15 (15.1%, respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4% children, whereas in four (4.6% children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patients, i.e. 74 (74.75% manifested idiopathic deafness of unknown cause. A range of usually reported hearing loss etiologies included ototoxic medications in seven (7.07%, hereditary factor in six (6.06%, and bacterial meningitis in four (4.04% patients. Somewhat less common causes were perinatal hypoxia in three (3.03%, premature birth in three (3.03%, Down syndrome in one (1.01%, and chronic otitis media in one (1.01% patient. Conclusion. Both intraoperative and postoperative complications were analyzed in the investigated patient population. The complications developed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5% were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification and transient ataxia occurred more rarely. Stimulation of facial nerve, intraoperative

  15. Marginal living donor in kidney transplantation: experience in a Chinese single center

    Institute of Scientific and Technical Information of China (English)

    LI Gang; WANG Yun-peng; MA Lu-lin; ZHANG Jing; ZHANG Hong-xian; HUANG Yi; HOU Xiao-fei

    2013-01-01

    Background Living donor kidney transplantation is becoming popular in China,whereas,in clinical situations,some kidney donors may be sub-optimal,namely marginal living donor.The present study aimed to evaluate the safety and efficacy of marginal living donor kidney transplantation in a Chinese single center.Methods Between January 2001 and December 2009,888 kidney transplantations were performed in our center; 149were living donor kidney transplantations.The living donors and recipients were followed up regularly after the operation.Of the living donors,30 donors were marginal,who were older than 60 years or suffered from kidney anomaly or some benign diseases.Among the non-marginal living kidney transplantations,58 donors and recipients had complete perioperative and follow-up data.We compared the marginal and non-marginal living donor kidney transplantations with regard to donor age,follow-up period,donor's serum creatinine at the last follow-up,recipient's serum creatinine at the last follow-up,and graft survival at the last follow-up.Results The mean age of donors in the marginal and non-marginal living donors were (55±9) (37-66) and (43±12) (30-59) years.The mean follow-up times of the marginal and non-marginal groups were (26.4±13.4) months and (28.8±14.8)months.The donor and recipient serum creatinine levels at the last follow-up were (1.16±0.20) mg/dl and (1.30±0.24) mg/dl in the marginal group,and (1.12±0.32) mg/dl and (1.34±0.32) mg/dl in the non-marginal group.Three recipients in the marginal group and five recipients in the non-marginal group had acute rejection episodes during the first year.Actuarial 3-year graft survival was 96.7% in the marginal group and 100% in the non-marginal group.No significant differences were detected between the two groups with regard to these data.Conclusion Utilization of highly selective marginal living donors can be a safe,feasible,and effective way for the treatment of patients with end stage renal disease.

  16. Circumcision with Glubran® 2 in children: experience of Italian Center

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    Cerchia, Elisa; Molinaro, Francesco; Bulotta, Anna Lavinia; Ferrara, Francesco; Bindi, Edoardo; Messina, Mario

    2016-01-01

    Background Circumcision is one of the most common surgical procedures in the world. Despite it is known its wide prevalence for religious and medical reasons in children, it remains a controversial practice in paediatric age. To date, there is no described the gold standard technique to circumcise paediatric patients. We started to use glue for circumcision about 2 years ago. We designed this prospective study with the aim to compare two surgical techniques, which were used in our hospital to perform circumcision in children. The implication for practice was the understanding if there were differences between these approaches related to patient’s and parents benefits to manage this condition and benefits for surgeon and hospital in term of saving money and time. Methods This is a randomized, single-blind one-center study. It was conducted at the Department of Paediatric Surgery of Siena. Data were collected between March 2011 and December 2012. Study’s population involved all patients who required circumcision. Two randomizes groups: group one which involved patients who underwent circumcision using sutures and group two, which involved patients who underwent circumcision using surgical glue (Glubran® 2). Two exclusion criteria were used: the redo-circumcision and the allergy or hyper-sensibility to cyanoacrylate (main component of glue). Results We report 99 patients who underwent circumcision with Glubran® 2 in comparison with a group of children circumcised with sutures (vycril rapide). We measured three outcomes (operating time, postoperative pain and assessment of cosmetic), which, even if not all statistically significant, allowed us to draw any conclusions about the use of glue in circumcision. Conclusions Traditional circumcision is performed using a standard sleeve technique with sutures for the approximation of the skin edges. However, since some years a tissue adhesive as N-butyl-2-cyanoacrylate (NBCA) (Glubran® 2) is used in many centers to

  17. Efficacy of liver transplantation for acute hepatic failure:a single-center experience

    Institute of Scientific and Technical Information of China (English)

    Xian-Jie Shi; Hong-Bin Xu; Wen-Bin Ji; Yu-Rong Liang; Wei-Dong Duan; Lei He; Ming-Jun Wang; Zhi-Ming Zhao

    2011-01-01

    BACKGROUND: Acute hepatic failure (AHF) is a devastating clinical syndrome with a high mortality rate. The outcome of AHF varies with etiology, but liver transplantation (LT) can significantly improve the prognosis and survival rate of such patients. This study aimed to detect the role of LT and artificial liver support systems (ALSS) for AHF patients and to analyze the etiology and outcome of patients with this disease. METHODS: A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our center. We analyzed and compared the etiology, outcome, prognosis, and survival rates of patients between the transplantation (LT) group and the non-transplantation (N-LT) group. RESULTS: AHF was due to viral hepatitis in 25 patients (52.1%; hepatitis B virus in 22), drug or toxic reactions in 14 (29.2%; acetaminophen in 6), Wilson disease in 4 (8.3%), unknown reasons in 3 (6.3%), and miscellaneous conditions in 2 (4.2%). In the LT group, 36 patients (7 underwent living donor LT, and 29 cadaveric LT) had an average model for end-stage liver disease score (MELD) of 35.7. Twenty-eight patients survived with good graft function after a follow-up of 27.3± 4.5 months. During the waiting time, 6 patients were treated with ALSS and 2 of them died during hospitalization. The 30-day, 12-month, and 18-month survival rates were 77.8%, 72.2%, and 66.7%, respectively. In the N-LT group, 12 patients had an average MELD score of 34.5. Four patients were treated with ALSS and all died during hospitalization. The 90-day and 1-year survival rates were only 16.7% and 8.3%, respectively. CONCLUSIONS: Hepatitis is the most prominent cause of AHF at our center. Most patients with AHF, who fulfill the Kings College Criteria for LT, did not survive longer without LT. ALSS did not improve the prognosis of AHF patients, but may extend the waiting time for a donor. Currently, LT is still the most effective way to improve the prognosis

  18. Attending an activity center: positive experiences of a group of home-dwelling persons with early-stage dementia

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    Söderhamn U

    2014-11-01

    Full Text Available Ulrika Söderhamn,1 Live Aasgaard,2 Bjørg Landmark2,3 1Centre for Caring Research Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Institute of Research and Development for Nursing and Care Services, Municipality of Drammen, 3Faculty of Health, Buskerud and Vestfold University College, Drammen, Norway Background: In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers.Methods: The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis.Results: Four categories, ie, “appreciated activities”, “praised nurses and volunteers”, “being more active”, and “being included in a fellowship”, as well as the overall theme “participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being” emerged in the analysis. The informants appreciated the adapted physical and social activities and expressed their enjoyment and gratitude. They found the physical activities useful, and they felt themselves to be included in a fellowship through cheerful nurses and volunteers. The nurses were able to create a good atmosphere and spread joy in the center together with the volunteers. The informants felt themselves valued as the persons they were. These findings indicated that such activities may have had a positive influence on the informants’ health and well-being.Conclusion: In order to succeed with this kind of activity center, it is decisive that the nurses are able to

  19. [De novo malignant tumors following liver transplantation. A single-center experience in Argentina].

    Science.gov (United States)

    Antinucci, Florencia; Anders, Margarita; Orozco, Federico; Mella, José; Cobos, Manuel; McCormack, Lucas; Mastai, Ricardo

    2015-01-01

    The aim of the present study was to evaluate the incidence and clinical features of de novo tumors in patients undergoing liver transplantation in our center as well as to assess survival. We retrospectively analyzed 168 liver transplantations (159 patients) performed from May 2006 to May 2014. The incidence of de novo tumors was 7.5% (n = 12). The mean age at diagnosis was 63 ± 7 years. The most frequent neoplasms were non melanoma skin tumors and adenocarcinomas. Fifty percent of the tumors developed in the second and third year after transplantation. Type of immunosuppression did not influence tumoral type, although most patients receive tacrolimus in combination with mycofenolate and/or corticoids. The mean duration of follow-up after diagnosis of the tumor was 25 ± 29 months (range 0-76) and the mortality was 41%. The actuarial probability of survival at 1 and 5 years was 83 and 55%, respectively. De novo tumors are frequent after liver transplantation and their clinical course differs from that in the general population. Because their clinical course is more aggressive, regular follow up of these patients is essential for early diagnosis. PMID:25637895

  20. Aggressive Treatment of Patients with Metastatic Colorectal Cancer Increases Survival: A Scandinavian Single-Center Experience

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    Kristoffer Watten Brudvik

    2013-01-01

    Full Text Available Background. We examined overall and disease-free survivals in a cohort of patients subjected to resection of liver metastasis from colorectal cancer (CRLM in a 10-year period when new treatment strategies were implemented. Methods. Data from 239 consecutive patients selected for liver resection of CRLM during the period from 2002 to 2011 at a single center were used to estimate overall and disease-free survival. The results were assessed against new treatment strategies and established risk factors. Results. The 5-year cumulative overall and disease-free survivals were 46 and 24%. The overall survival was the same after reresection, independently of the number of prior resections and irrespectively of the location of the recurrent disease. The time intervals between each recurrence were similar (11 ± 1 months. Patients with high tumor load given neoadjuvant chemotherapy had comparable survival to those with less extensive disease without neoadjuvant chemotherapy. Positive resection margin or resectable extrahepatic disease did not affect overall survival. Conclusion. Our data support that one still, and perhaps to an even greater extent, should seek an aggressive therapeutic strategy to achieve resectable status for recurrent hepatic and extrahepatic metastases. The data should be viewed in the context of recent advances in the understanding of cancer biology and the metastatic process.

  1. Comparison of Capsule Endoscopy Findings to Subsequent Double Balloon Enteroscopy: A Dual Center Experience

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    Amandeep S. Kalra

    2015-01-01

    Full Text Available Background. There has been a growing use of both capsule endoscopy (CE and double balloon enteroscopy (DBE to diagnose and treat patients with obscure gastrointestinal blood loss and suspected small bowel pathology. Aim. To compare and correlate sequential CE and DBE findings in a large series of patients at two tertiary level hospitals in Wisconsin. Methods. An IRB approved retrospective study of patients who underwent sequential CE and DBE, at two separate tertiary care academic centers from May 2007 to December 2011, was performed. Results. 116 patients were included in the study. The mean age ± SD was 66.6 ± 13.2 years. There were 56% males and 43.9% females. Measure of agreement between prior capsule and DBE findings was performed using kappa statistics, which gave kappa value of 0.396 with P<0.001. Also contingency coefficient was calculated and was found to be 0.732 (P<0.001. Conclusions. Our study showed good overall agreement between DBE and CE. Findings of angioectasia had maximum agreement of 69%.

  2. Frequency of kidney diseases and clinical indications of pediatric renal biopsy: A single center experience.

    Science.gov (United States)

    Imtiaz, S; Nasir, K; Drohlia, M F; Salman, B; Ahmad, A

    2016-01-01

    Kidney biopsy occupies a fundamental position in the management of kidney diseases. There are very few renal pathology studies available in the literature from developing world. This study scrutinized the frequency and clinicopathological relationship of kidney biopsies done at the kidney center from 1997 to 2013 amongst pediatric patients. Kidney allograft biopsy were excluded. The specimen was examined under light microscopy and immunofluorescence while electron microscopy was not done. The study includes 423 patients, mean age was 10.48 ± 4.58 years, males 245 (57.9%) were more than females 178 (42.1%). Nephrotic syndrome 314 (74.2%) was the most common clinical presentation followed by acute nephritic syndrome 35 (8.3%) and acute renal failure 24 (5.7%). Primary glomerulonephritis (PGN) was the most common group of diseases, seen in 360 (85.1%) followed by secondary glomerulonephritis (SGN) in 27 (6.4%) and tubulointerstitial nephritis in 21 (5.0%). Among PGN, minimal change disease (MCD) was the most dominant disease, with 128 (30.3%) cases followed by focal segmental glomerulosclerosis FSGS in 109 (25.8%) and membranous glomerulonephropathy in 27 (6.4%). Lupus nephritis (LN) was the leading cause of glomerular disease in SGN followed by hemolytic uremic syndrome. In conclusion, MCD is the most common histological finding, especially in younger children and FSGS is second to it. SGN is rare, and the most common disease in this category is LN while tubulointerstitial and vascular diseases are infrequent. PMID:27194835

  3. Genotypic and phenotypic features of citrin deficiency: five-year experience in a Chinese pediatric center.

    Science.gov (United States)

    Song, Yuan-Zong; Deng, Mei; Chen, Feng-Ping; Wen, Fang; Guo, Li; Cao, Shui-Liang; Gong, Jian; Xu, Hao; Jiang, Guang-Yu; Zhong, Le; Kobayashi, Keiko; Saheki, Takeyori; Wang, Zi-Neng

    2011-07-01

    Citrin is a liver-type aspartate/glutamate carrier (AGC) encoded by the gene SLC25A13. Two phenotypes for human citrin deficiency have been described, namely the adult-onset citrullinemia type II (CTLN2) and the neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD). However, citrin deficiency currently remains a perplexing and poorly recognized disorder. In particular, description of post-NICCD clinical presentations before CTLN2 onset is rather limited. Analysis of SLC25A13 mutations, identification of dysmorphic erythrocytes, hepatobiliary scintigraphic imaging and investigation of post-NICCD clinical presentations were performed in a citrin-deficient cohort comprised of 51 cases of children diagnosed with citrin deficiency in a Chinese pediatric center. Twelve SLC25A13 mutations were detected in this cohort, including the novel V411M and G283X mutations. Among the 51 citrin-deficient subjects, 7 cases had echinocytosis, which was associated with more severe biochemical abnormalities. Delayed hepatic discharge and bile duct/bowel visualization were common scintigraphic findings. Moreover, 9 of the 34 post-NICCD cases demonstrated concurrent failure to thrive and dyslipidemia, constituting a clinical phenotype different from NICCD and CTLN2. The novel mutations, echinocytosis, hepatobiliary scintigraphic features and the novel clinical phenotype in this study expanded the genotypic and phenotypic spectrum of citrin deficiency, and challenge the traditionally-assumed 'apparently healthy' period after the NICCD state for this disease entity. PMID:21424115

  4. Perinatal Diagnostic Approach to Fetal Skeletal Dysplasias: Six Years Experience of a Tertiary Center.

    Science.gov (United States)

    Toru, Havva Serap; Nur, Banu Guzel; Sanhal, Cem Yasar; Mihci, Ercan; Mendilcioğlu, İnanç; Yilmaz, Elanur; Yilmaz, Gulden Tasova; Ozbudak, Irem Hicran; Karaali, Kamil; Alper, Ozgul M; Karaveli, Fatma Şeyda

    2015-01-01

    Skeletal dysplasias (SDs) constitute a group of heterogeneous disorders affecting growth morphology of the chondro-osseous tissues. Prenatal diagnosis of SD is a considerable clinical challenge due to phenotypic variability. We performed a retrospective analysis of the fetal autopsies series conducted between January 2006 and December 2012 at our center. SD was detected in 54 (10%) out of 542 fetal autopsy cases which included; 11.1% thanatophoric dysplasia (n = 6), 7.4% achondroplasia (n = 4), 3.7% osteogenesis imperfect (n = 2), 1.9% Jarcho-Levin Syndrome (n = 1), 1.9% arthrogryposis (n = 1), 1.9% Dyggve-Melchior-Clausen syndrome (n = 1), 72.1% of dysostosis cases (n = 39). All SD cases were diagnosed by ultrasonography. In 20 of the cases, amniocentesis was performed, 4 cases underwent molecular genetic analyses. Antenatal identification of dysplasia is important in the management of pregnancy and in genetic counseling. Our data analysis showed that SD is usually detected clinically after the 20th gestational week. Genetic analyses for SD may provide early diagnosis and management. PMID:26376227

  5. Simultaneous liver and kidney transplantation:analysis of a single-center experience

    Institute of Scientific and Technical Information of China (English)

    MA Yi; WANG Guo-dong; HE Xiao-shun; LI Qiang; LI Jun-liang; ZHU Xiao-feng; WANG Chang-xi

    2010-01-01

    Background Simultaneous liver and kidney transplantation (SLKT) has been proven to be a favorable treatment for combined renal and hepatic end-stage disease.However, recipients receiving SLKT have a long medical history, poor general condition that is often accompanied by anemia, hypoalbuminemia, coagulopathy, water-electrolyte imbalance and acid-base disorders.This study aimed to explore the indications, surgical techniques, therapeutic experience,prevention and treatment of postoperative complications of SLKT.Methods The clinical data of 22 SLKTs cases performed at the First Affiliated Hospital of Sun Yat-sen University from January 2001 to December 2008 were retrospectively studied.Indications for SLKT, surgical techniques, perioperative fluid management, immunosuppressive regimen and experience in prevention and treatment of postoperative complications were analyzed.Results All operations were successfully performed.Postoperative complications occurred in 13 cases (59.1%), including pleural effusions (7), intra-abdominal bleeding (2), biliary complications (2), repeated upper gastrointestinal bleeding (1), and acute liver graft rejection (1).All complications were treated conservatively.In this study, there were five deaths during follow-up, in which three perioperative deaths occurred due to serious conditions.Mortality at 3 months was 13.6%.The one and three year patient survival rate was 81.3% and 73.9% respectively.Conclusions SLKT is an effective therapy for end-stage liver disease with chronic renal failure or severe damage to renal function.It is a complex surgical procedure, causing a large disturbance of circulation and fluid balance, and more postoperative complications.The SLKT surgical techniques selected are based on the experience of surgeons, the anatomy of the recipient and primary diseases.It is essential to use the correct perioperative fluid management, reasonable immunosuppressive regimen, and prevention and treatment of postoperative

  6. REPEATED LIVER TRANSPLANTATION: EXPERIENCE OF RUSSIAN SCIENTIFIC CENTER OF RADIOLOGY AND SURGICAL TECHNOLOGY (RSCRST

    Directory of Open Access Journals (Sweden)

    D. A. Granov

    2011-01-01

    Full Text Available The article gives the report about the experience in repeated liver transplantation (LT. Totally 99 LT including 6 repeated operation at five patients performed between june 1999 and june 2011. In 3 of 6 cases bile ducts necroses was the indication to repeated LT. Retransplantations were connected with difficulties, enlargement of duration and replacement therapy volume, also explained high number of complication after operation. It is demonstrated that chronic biliary infection and bad condition of patients are the main reasons of complication and poor prognosis after repeated liver transplantation. 

  7. Neurological complications of dengue fever: Experience from a tertiary center of north India

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    Rajesh Verma

    2011-01-01

    Full Text Available Introduction: Dengue, an acute viral disease transmitted by Aedes mosquitoes, is highly endemic in many tropical and subtropical areas of the world. Neurological complications of dengue infection have been observed more frequently in the recent past and some studies highlighted varied neurological complications arising in the course of dengue illness. In this retrospective study, we report various neurological complications observed during the last 2 years in patients of dengue fever. Materials and Methods: The patients presenting with neurological complications with positive serology (IgM antibody for dengue infection were consecutively recruited from the Department of Neurology/Medicine from a tertiary center of Lucknow, India. These patients were subjected to a detailed clinical evaluation, laboratory assessment including blood count, hematocrit, coagulation parameters, biochemical assays, serology for dengue fever, enzyme-linked immunosorbent assay for human immunodeficiency virus and other relevant investigations. Results: Twenty-six patients with neurological complications associated with confirmed dengue infection were observed during the last 2 years. Eighteen of these patients were male. Of the 26 patients, 10 patients were suffering from brachial neuritis, four patients had encephalopathy, three patients were consistent with the diagnosis of Guillain Barre syndrome, three patients had hypokalemic paralysis associated with dengue fever and two patients had acute viral myositis. Opsoclonus-myoclonus syndrome was diagnosed in two patients, myelitis in one patient and acute disseminated encephalo-myelitis also in one patient. Conclusion: Dengue fever was associated with widespread neurological complications. Brachial neuritis and opsoclonus-myoclonus syndrome were observed for the first time in this study.

  8. Breast Conserving Surgery and Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer: Single Center Experience

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    Atakan Sezer

    2011-06-01

    Full Text Available Objective: Patients with locally advanced breast cancer may undergo breast conserving surgery after neoadjuvant chemotherapy. The aim of the study is to evaluate the results of locally advanced breast cancer patients who underwent breast conserving surgery, axillary dissection and sentinel lymph node biopsy in a single center. Material and Methods: 12 patients with locally advanced breast cancer stage IIIA/IIIB were included in the study between 2002-2009. The patients were given anthracycline-based regimen before surgery. Patients underwent breast conserving surgery, axillary dissection, and sentinel lymph node biopsy followed by radiotherapy. Results: There were five patients in stage IIIA, six in stage IIIB, and one in stage IIIC. Patients had received 3-6 regimen of FAC/FEC. Eight had partial and four had complete response. Five positive axilla were detected. The median value of the lymph nodes was 12 (n:8-19. Five patients underwent sentinel lymph node biopsy. The biopsy has failed in one patient and the median value of dissected sentinel node was 3.5 (n:3-4. Locoregional recurrence was not observed in any patients. The mean follow-up of the patients was 29.8 months and median time was 16 (n:2-80 months.Of the 12 patients 10 are alive and 2 were deceased. Conclusion: In selected locally advanced patients, breast conserving surgery and sentinel lymph node biopsy may be applied by a multidisciplinary approach, and excellent success may be achieved in those patients as in early breast cancer patients.

  9. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

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    Abdel-Razeq H

    2011-03-01

    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  10. Percutaneous CT-guided radiofrequency ablation of solitary small renal masses. A single center experience

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    Pieper, C.C.; Fischer, S.; Strunk, H.; Meyer, C.; Thomas, D.; Willinek, W.A.; Schild, H. [Univ. Bonn (Germany). Dept. of Radiology; Hauser, S. [Univ. Bonn (Germany). Dept. of Urology; Nadal, J. [Univ. Bonn (Germany). Inst. for Medical Biometry; Wilhelm, K. [Johanniter Hospital Bonn (Germany). Dept. of Radiology

    2015-07-15

    To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period. Patient records of renal RFAs (07/2003 - 11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests. 38 patients (16 females, mean age 70.0 years [range 52 - 87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95 % of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4 ± 0.8 % and 50.3 ± 1.0 %, respectively (mean follow-up 54.6 months, range 1 - 127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS. There was no difference in survival between patients with benign and malignant tumors. RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression.

  11. Evaluation of Sensorimotor Nerve Damage in Patients with Maxillofacial Trauma; a Single Center Experience

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    Behnaz Poorian

    2016-04-01

    Full Text Available Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, Iran Methods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate. Results: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1% women among the patients. The frequency of nerve injuries was 67.7% (336 patients. The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%. Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1% was the most common involved branch followed by infraorbital branch (135 patients 27.2%. Mandibular fracture was the most common injured bone being reported in 376 patient (75.9% patients followed by zygomatic bone in 100 patient (20%. Conclusion: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature.

  12. Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases

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    Wong Hoi She; Albert CY Chan; Tan To Cheung; Kenneth SH Chok; See Ching Chan; Ronnie TP Poon; Chung Mau Lo

    2016-01-01

    BACKGROUND: Acute pancreatitis is a relatively rare but po-tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS: A total of 1632 patients with hepatocellular car-cinoma who had undergone transarterial chemoembolization from January 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com-plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS: Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa-tients was 61 years. Most (79.6%) of the patients suffered from HBV-related hepatocellular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut-ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven (0.4%) patients suffered from acute pancre-atitis post-chemoembolization. Six patients had chemoembo-lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxorubicin eluting bead had a higher risk of acute pancreatitis [6/145 (4.1%) vs 1/1487 (0.1%), P CONCLUSIONS: Acute pancreatitis after transarterial chemo-embolization could result in serious complications, especially after treatment with doxorubicin eluting bead. Continuation of current treatment with transarterial chemoembolization after acute pancreatitis is feasible providing the initial attack is completely resolved.

  13. Five years renal transplantation data: Single-center experience from Iraq

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    Ala A Ali

    2016-01-01

    Full Text Available Renal transplantation is the treatment of choice for patients with end-stage renal disease. In Iraq, renal transplantation started in 1973 and has continued until now with live donor transplantation, since deceased donor transplant program is not approved as yet. Long-term transplant data are still scarce. The aim of our study is to present data on transplantation and medical follow-up at one year and, survival analysis at one, three and five years. A total of 250 renal transplantations were performed at the Nephrology and Renal Transplantation Center, Baghdad between January 2009 and January 2014. It is a living donor, blood group compatible donor program. All patients received triple immunosuppression (calcineurine inhibitor, mycophenolate mofetil or mycophenolic acid, and steroid. The Kaplan-Meier method was used to determine the survival rate. There were 92 live related donors, 143 unrelated donors, and 15 spouse donors. The mean age was 34.07 ± 12.2 years. The one-year graft survival for related and unrelated donor transplants was 98.9% and 91.8%, respectively. Graft survival was lower (82.9% in recipients with acute rejection episodes. The patient survival at one-year was 94%. The three-year graft and patient survival was 91% and 90%, respectively, and five-year survival for grafts and patients was 87.1% and 88%, respectively. The outcome of the renal transplantation in Iraq is improving. Long-term patient follow-up needs more meticulous attention. The development of renal transplant registry is critical for future planning. Moreover, renal transplantation practice in Iraq needs more social, religious, and governmental support.

  14. Clinical profile of primary hyperparathyroidism from western India: A single center experience

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    Gopal R

    2010-01-01

    Full Text Available Background: Primary hyperparathyroidism (PHPT has a variable clinical presentation and symptomatic PHPT is still the predominant form of the disease in India. Data from western India is lacking. Aim : To present the clinical profile of PHPT from western India. Settings and Design : This retrospective study was conducted at a tertiary care referral center. Materials and Methods : We analyzed the clinical presentation, biochemical, radiological features, and operative findings in adult patients with PHPT (1986-2008 and compared with our published data of children and adolescent patients with PHPT. Statistical Analysis : was done with SPSS 16 software. Results : Seventy-nine patients (F: M-2:1 with age ranging from 21 to 55 years (mean 33.5±8.82 were analyzed. Skeletal manifestations (75.5%, renal calculi (40.5% and proximal muscle weakness (45.5% were the most common symptoms of presentation with mean duration of symptoms being 33.70 (median: 24, range 1-120 months. Biochemical features included hypercalcemia (total corrected calcium 12.55±1.77 mg/dl, low inorganic phosphorus (1.81±0.682 mg/dl, elevated total alkaline phosphatase (mean: 762.2; median: 559; range: 50-4930IU/L and high parathyroid hormone (PTH (mean±SD: 866.61±799.15; median: 639.5; range: 52-3820 pg/ml. Preoperative localization was achieved in 74 patients and single adenoma was found during surgery in 72 patients. Hungry bone disease was seen in 30.3% and transient hypoparathyroidism developed in 62% patients. In comparison to PHPT in children there were no significant differences with regard to clinical, laboratory and radiological features. Conclusions : PHPT in western India is symptomatic disorder with skeletal and renal mani-festations at a much younger age. Clinical profile of PHPT in children is similar to that of adults.

  15. Cryptococcal meningitis in HIV infected: Experience from a North Indian tertiary center

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    Kumar Susheel

    2008-01-01

    Full Text Available Background: Cryptococcal meningitis is a common opportunistic infection in Human Immunodeficiency Virus (HIV-infected individuals. There is little information specifically addressing cryptococcal meningitis in HIV-infected patients from North India. Aims: To determine clinical presentation, hospital course, response to treatment, complications developed, in-hospital mortality, any recurrence of cryptococcal meningitis and reasons of recurrence during follow-up. Settings and Design: A retrospective observational study undertaken in a large tertiary care center. Materials and Methods: Patient′s demographic data, presenting clinical symptomatology, physical findings, laboratory parameters, cerebrospinal fluid (CSF examination findings, side-effects of treatment, development of any complications and hospital outcome were analyzed. During follow-up any recurrence of cryptococcal meningitis, possible reasons of recurrence, type of treatment received, complications developed and outcome was recorded as well. Results: Forty patients diagnosed to have cryptococcal meningitis were analyzed. Twenty-two (55% patients had acute/ subacute presentation. Thirty-six (90% patients presented with headache and 18 (45% had altered sensorium. Twenty (50% patients had no cells in the CSF. Hypoglycorrhchia was seen in 30 (75% patients. Cryptococcal meningitis was the first acquired immune deficiency syndrome (AIDS-defining illness in 30 (75% patients. Thirty-five patients developed some adverse effects to amphotericin-B. Thirty-three patients improved with treatment while three patients died. Four patients had recurrence of cryptococcal meningitis within six months of first episode. Non-compliance of fluconazole therapy was the reason for recurrence in all of these patients. Conclusions: Cryptococcal meningitis is a common initial AIDS-defining illness. Acute and/or subacute presentation of cryptococcal meningitis is not uncommon in HIV-infected individuals. An early

  16. Occult Hepatitis C Virus Infection in Haemodialysis Unit: A Single-center Experience

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    Abdel Hamid A. Serwah1, Waleed S. Mohamed1, Mohamed Serwah1, Awateif Edreis2, Ahmad El Zaydi3

    2014-07-01

    Full Text Available Background & Aims: Detection of hepatitis C virus RNA in peripheral blood mononuclear cells (PBMC and/or hepatocytes in the absence of HCV RNA in serum, designated as ‘occult HCV infection’, has been a matter of controversy in the recent years. Occult hepatitis C virus (HCV infection has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis (CHD patients in a single heamodialysis center at Al-Taif, KSA. Methods: We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients. For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a control group. Results: In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in peripheral blood mononuclear cells (PBMNCs, was found in 13.4 % of the patients; 83 % of these patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on heamodialysis and had significantly higher mean alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients, those with occult HCV have less elevated bilirubin, AST and ALT. Conclusions: The prevalence of occult HCV infection was moderate in our CHD patients, and it did not appear to be clinically relevant. Further studies in other geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups. Abbreviations HCV, Hepatitis C Virus ; antibody against HCV; PBMC, peripheral blood mononuclear cells; rRT-PCR, real time reverse transcriptase polymerase chain reaction; CHD, chronic

  17. Perinatal Outcomes in Women with Preeclampsia: Experience of a Tertiary Referral Center

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    Semra Eroglu

    2015-11-01

    , pregestational medical evaluation and regular antenatal follow-up visits especially for high-risk women should be emphasized. Whenever possible, women diagnosed with severe preeclampsia or HELLP syndrome should be transferred to a tertiary medical center with adequate capabilities for maternal and neonatal intensive care in order to decrease perinatal morbidities.

  18. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

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    Silber, Toni; Ziemann, Ulf [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany); Ernemann, Ulrike [Department of Diagnostic and Interventional Neuroradiology, University of Tübingen (Germany); Bischof, Felix, E-mail: felix.bischof@uni-tuebingen.de [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany)

    2014-12-15

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology.

  19. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    International Nuclear Information System (INIS)

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology

  20. Mycetoma: experience of 482 cases in a single center in Mexico.

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    Alexandro Bonifaz

    2014-08-01

    Full Text Available Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013. A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11% were actinomycetomas and 38 cases (7.88% were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years. The main affected localization was lower and upper limbs (70.74% and 14.52% respectively. Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported. The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%. Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21% and Actinomadura madurae (8.7%; meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

  1. Mycetoma: experience of 482 cases in a single center in Mexico.

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    Bonifaz, Alexandro; Tirado-Sánchez, Andrés; Calderón, Luz; Saúl, Amado; Araiza, Javier; Hernández, Marco; González, Gloria M; Ponce, Rosa María

    2014-08-01

    Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013). A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11%) were actinomycetomas and 38 cases (7.88%) were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years). The main affected localization was lower and upper limbs (70.74% and 14.52% respectively). Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported). The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%). Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21%) and Actinomadura madurae (8.7%); meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii) were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

  2. Initial clinical experience with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO)

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    We report the initial toxicity data with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO). In September 2011, CNAO commenced patient treatment with scanned proton beams within two prospective Phase II protocols approved by the Italian Health Ministry. Patients with chondrosarcoma or chordoma of the skull base or spine were eligible. By October 2012, 21 patients had completed treatment. Immobilization was performed using rigid non-perforated thermoplastic-masks and customized headrests or body-pillows as indicated. Non-contrast CT scans with immobilization devices in place and MRI scans in supine position were performed for treatment-planning. For chordoma, the prescribed doses were 74 cobalt grey equivalent (CGE) and 54 CGE to planning target volume 1 (PTV1) and PTV2, respectively. For chondrosarcoma, the prescribed doses were 70 CGE and 54 CGE to PTV1 and PTV2, respectively. Treatment was delivered five days a week in 35-37 fractions. Prior to treatment, the patients' positions were verified using an optical tracking system and orthogonal X-ray images. Proton beams were delivered using fixed-horizontal portals on a robotic couch. Weekly MRI incorporating diffusion-weighted-imaging was performed during the course of proton therapy. Patients were reviewed once weekly and acute toxicities were graded with the Common Terminology Criteria for Adverse Events (CTCAE). Median age of patients =50 years (range, 21-74). All 21 patients completed the proton therapy without major toxicities and without treatment interruption. Median dose delivered was 74 CGE (range, 70-74). The maximum toxicity recorded was CTCAE Grade 2 in four patients. Our preliminary data demonstrates the clinical feasibility of scanned proton beams in Italy. (author)

  3. "Awake Veno-arterial Extracorporeal Membrane Oxygenation" in Pediatric Cardiogenic Shock: A Single-Center Experience.

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    Schmidt, F; Jack, T; Sasse, M; Kaussen, T; Bertram, H; Horke, A; Seidemann, K; Beerbaum, P; Koeditz, H

    2015-12-01

    In pediatric patients with acute refractory cardiogenic shock (CS), extracorporeal membrane oxygenation (ECMO) remains an established procedure to maintain adequate organ perfusion. In this context, ECMO can be used as a bridging procedure to recovery, VAD or transplantation. While being supported by ECMO, most centers tend to keep their patients well sedated and supported by invasive ventilation. This may be associated with an increased risk of therapy-related morbidity and mortality. In order to optimize clinical management in pediatric patients with ECMO therapy, we report our strategy of veno-arterial ECMO (VA-ECMO) in extubated awake and conscious patients. We therefore present data of six of our patients with CS, who were treated by ECMO being awake without continuous analgosedation and invasive ventilation. Of these six patients, four were 14 years of age. Median time on ECMO was 17.4 days (range 6.9-94.2 days). Median time extubated, while receiving ECMO support was 9.5 days. Mean time extubated was 78 % of the total time on ECMO. Three patients reached full recovery of cardiac function on "Awake-VA-ECMO," whereas the other three were successfully bridged to destination therapy (VAD, heart transplantation, withdrawal). Four out of our six patients are still alive. Complications related to ECMO therapy (i.e., severe bleeding, site infection or dislocation of cannulas) were not observed. We conclude that "Awake-VA-ECMO" in extubated, spontaneously breathing conscious pediatric patients is feasible and safe for the treatment of acute CS and can be used as a "bridging therapy" to recovery, VAD implantation or transplantation.

  4. Febrile neutropenia in children with acute lymphoblastic leukemia: single center experience

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    Özdemir, Nihal; Tüysüz, Gülen; Çelik, Nigar; Yantri, Leman; Erginöz, Ethem; Apak, Hilmi; Özkan, Alp; Yıldız, İnci; Celkan, Tiraje

    2016-01-01

    Aim: An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia. Material and Methods: Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study. The data related to demographic characteristics, treatment features, relapse and febrile neutropenia incidences, risk factors, culture results and prognosis were retrospectively evaluated from the patients’ files. Results: A total of two hundred-ninety nine febrile neutropenia attacks observed in the patients during initial treatment and relapse treatment were evaluated. When the incidence of febrile neutropenia was evaluated by years, it was observed that the patients treated after year 2000 had statistically significantly more febrile neutopenia attacks compared to the patients treated before year 2000. When the incidences of febrile neutropenia during initial treatment and during relapse treatment were compared, it was observed that more febrile neutropenia attacks occured during relapse treatment. Fifty-nine percent of all febrile neutropenia attacks were fever of unknown origin. Eighty microorganisms grew in cultures during febrile neutropenia throughout treatment in 75 patients; 86% were bacterial infections (50% gram positive and 50% gram negative), 8% were viral infections and 6% were fungal infections. Coagulase negative staphylococcus (n=17) was the most frequent gram positive pathogen; E. Coli (n=17) was the most commonly grown gram negative pathogen. Conclusions: In this study, it was found that an increase in the incidence of febrile neutropenia occured in years. Increments in treatment intensities increase the incidence of febrile neutropenia while improving

  5. Clinical outcomes of liver transplantation for polycystic liver disease: a single center experience.

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    Chandok, Natasha; Uhanova, Julia; Marotta, Paul

    2010-01-01

    Polycystic liver disease (PLD) is a celiopathy characterized by progressive growth of multiple hepatic cysts. In a minority of patients, severe symptomatic hepatomegaly necessitates liver transplantation (LT). The purpose of this study is to describe the postoperative and long-term outcomes of all patients transplanted for PLD at our center. All patients who underwent LT for PLD were identified through our database. Using patient charts, data were extracted on patient demographics and medical history, postoperative surgical and medical complications, length of hospitalization, prevalence of chronic kidney failure, and patient and graft survival. Subjects were contacted in April 2010 to verify their survival and confirm their need, if any, for hemodialysis and/or kidney transplantation. Descriptive statistics for patient and graft survival were performed. From 1993 to 2010, 14 subjects underwent LT and 1 subject underwent combined kidney and LT; all subjects were female and the mean age was 49.0 years. 10 (66.7%) subjects had polycystic kidney disease. Patients experienced a high rate of vascular complications, including hepatic artery thrombosis (HAT) or stenosis in 3 (20%) and 2 (13.3%) subjects, respectively. One subject had early graft loss due to HAT and underwent re-transplantation. The mean length of hospitalization was 18.8 days. After a mean of 66.8 months of follow-up (3-200), 13 (86.7%) subjects are alive with satisfactory graft function, and no patients had renal failure. In conclusion, patients who underwent LT for PLD had a high rate of postoperative vascular complications. However, long-term patient and graft survival, and kidney function, is excellent. PMID:20720268

  6. Hepatic Steatosis Following Pancreatic Surgery: A Swedish Centers Experience with Demographics, Risks and Outcome

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    Tommy Ivanics

    2015-11-01

    Full Text Available Objective Non-alcoholic fatty liver disease encompasses a spectrum of fatty changes in the liver ranging from simple steatosis to nonalcoholic steatohepatitis. Certain patients may develop hepatic steatosis following pancreatic resections. The aim of our study was to investigate factors possibly associated with steatosis after pancreatic resection and to see if the survival of patients was influenced by its development. Methods 182 consecutive patients that underwent pancreatic surgery (between 2010-2013 in a Swedish high volume pancreatic center were retrospectively reviewed from the preoperative work-up until at least 6 months postoperatively. Pre-versus postoperative values of Hounsfield Units were checked on CT scans and utilized as a proxy for development of hepatic steatosis. Demographic data and a number of possible risk factors were recorded together with survival after surgery. Results 17 percent of our patient group developed hepatic steatosis within the first year of surgery. The development of steatosis occurred significantly more frequently in females and in patients over the age of 70. Hepatic steatosis was positively associated with increased levels of alanine amino transferase (ALT after surgery. No association was noted between grade of weight loss and steatosis. Nor were there any correlations between the incidence of steatosis and the type of operation. Post-operative hepatic steatosis did not adversely affect overall survival. Conclusion Our results demonstrate that certain demographic and laboratory values are associated with the development of hepatic steatosis after pancreatic resections. However, despite its development, hepatic steatosis is of no apparent clinical significance and does not affect overall survival following pancreatic surgery.

  7. Neonates born to mothers with immune thrombocytopenic purpura: a single-center experience of 20 years.

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    Bayhan, Turan; Tavil, Betül; Korkmaz, Ayşe; Ünal, Şule; Hanalioğlu, Damla; Yiğit, Şule; Gümrük, Fatma; Çetin, Mualla; Yurdakök, Murat

    2016-01-01

    Neonates born to mothers with immune thrombocytopenic purpura (ITP) have an increased risk of having thrombocytopenia and bleeding. The aim of our study was to determine maternal and fetal factors that can predict bleeding risk in neonates born to mothers with ITP, and effective treatment strategies by retrospective analysis of our single-center data. We performed a retrospective data review of neonates that were recorded as 'neonates born to mothers with ITP' in the Neonatal ICU of Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey. Medical records of 36 neonates born from 35 mothers were analyzed. Among the 36 neonates born to mothers with ITP, thrombocytopenia (platelet count of less than 150 × 10/l) was detected in 20 (56.0%) neonates on the first day of life. Twelve of the 20 neonates with thrombocytopenia (60.0%) required treatment to increase the platelet counts. Clinical findings related to thrombocytopenia occurred in three (15.0%) neonates, but none of them presented with severe bleeding. There was no statistically significant association between neonatal lowest platelet count and maternal lowest platelet count, maternal platelet count at the time of delivery, and duration of thrombocytopenia, respectively. Neonates born to mothers with ITP have an increased tendency to develop thrombocytopenia, but severe bleeding is very rare in these neonates. Clinicians should pay special attention to follow these neonates. According to our results, both intravenous immunoglobulin and methyl prednisolone were found to be in equivalent efficacy for the treatment of neonatal thrombocytopenia due to maternal ITP. PMID:26258676

  8. Lung transplantation in a Chinese single center:7 years of experience

    Institute of Scientific and Technical Information of China (English)

    HE Wen-xin; ZHANG Peng; LIU Ming; JIANG Ge-ning; DING Jia-an; GAO Wen; ZHU Yu-ming; ZHOU Xiao; CHEN Chang; WANG Hao; FAN Jiang

    2011-01-01

    Background Lung transplantation (LT) is a viable option for patients with end-stage lung diseases,but in China,the supply is limited,and the experience with LT is rare too. This study aimed to evaluate the survival and postoperative complications of recipients undergone LT.Methods From January 2003 to May 2010,all patients who underwent LT were included. The clinical data of recipients were analyzed retrospectively,including demographic characteristics,survival rate,and the occurrences of postoperative complications,acute rejection and bronchiolitis obliterans syndrome. Results In total,37 patients underwent LT. The early mortality (<30 days) was 14% (5/37). Cumulative survival rate was 78%,70%,70% and 42% at 1,3,5 and 6 years,respectively. In 37 patients,5 (14%) developed fungal infections,9 (24%)pulmonary bacterial infections,and 6 (16%) had bronchial anastomosis complications after LT. At three months posttransplantation,a significant improvement was observed in lung function (P <0.05). Fifteen recipients (41%) developed acute rejection within the first year. Freedom from bronchiolitis obliterans syndrome was 89%,85% and 80% at 1,2 and 3years after transplantation.Conclusions Despite the limited number of cases,the survival and occurrences of complications after LT were comparable to the international experience. Single LT may be a reasonable option for some patients with end-stage pulmonary diseases.

  9. A Ventral Visual Stream Reading Center Independent of Sensory Modality and Visual Experience

    Directory of Open Access Journals (Sweden)

    Lior Reich

    2011-10-01

    Full Text Available The Visual Word Form Area (VWFA is a ventral-temporal-visual area that develops expertise for visual reading. It encodes letter-strings irrespective of case, font, or location in the visual-field, with striking anatomical reproducibility across individuals. In the blind, reading can be achieved using Braille, with a comparable level-of-expertise to that of sighted readers. We investigated which area plays the role of the VWFA in the blind. One would expect it to be at either parietal or bilateral occipital cortex, reflecting the tactile nature of the task and crossmodal plasticity, respectively. However, according to the notion that brain areas are task specific rather than sensory-modality specific, we predicted recruitment of the left-hemispheric VWFA, identically to the sighted and independent of visual experience. Using fMRI we showed that activation during Braille reading in congenitally blind individuals peaked in the VWFA, with striking anatomical consistency within and between blind and sighted. The VWFA was reading-selective when contrasted to high-level language and low-level sensory controls. Further preliminary results show that the VWFA is selectively activated also when people learn to read in a new language or using a different modality. Thus, the VWFA is a mutlisensory area specialized for reading regardless of visual experience.

  10. LANSCE-R WIRE-SCANNER ANALOG FRONT-END ELECTRONICS

    International Nuclear Information System (INIS)

    A new AFE is being developed for the new LANSCE-R wire-scanner systems. The new AFE is implemented in a National Instruments Compact RIO (cRIO) module installed a BiRa 4U BiRIO cRIO chassis specifically designed to accommodate the cRIO crate and all the wire-scanner interface, control and motor-drive electronics. A single AFE module provides interface to both X and Y wire sensors using true DC coupled transimpedance amplifiers providing collection of the wire charge signals, real-time wire integrity verification using the normal dataacquisition system, and wire bias of 0V to +/-50V. The AFE system is designed to accommodate comparatively long macropulses (>1ms) with high PRF (>120Hz) without the need to provide timing signals. The basic AFE bandwidth is flat from true DC to 50kHz with a true first-order pole at 50kHz. Numeric integration in the cRIO FPGA provides real-time pulse-to-pulse numeric integration of the AFE signal to compute the total charge collected in each macropulse. This method of charge collection eliminates the need to provide synchronization signals to the wire-scanner AFE while providing the capability to accurately record the charge from long macropulses at high PRF.

  11. Design and fabrication of a duoplasmatron extraction geometry and LEBT for the LANSCE H(+) RFQ project.

    Science.gov (United States)

    Fortgang, C M; Batygin, Y K; Draganic, I N; Garnett, R W; McCrady, R C; Rybarcyk, L J

    2016-02-01

    The 750-keV H(+) Cockcroft-Walton at LANSCE will be replaced with a recently fabricated 4-rod Radio Frequency Quadrupole (RFQ) with injection energy of 35 keV. The existing duoplasmatron source extraction optics need to be modified to produce up to 35 mA of H(+) current with an emittance work over a range of space-charge neutralized currents and emittances. The LEBT is optimized in the sense that it minimizes the beam size in both solenoids for a point design of a given neutralized current and emittance. Special attention has been given to estimating emittance growth due to source extraction optics and solenoid aberrations. Examples of source-to-RFQ matching and emittance growth (due to both non-linear space charge and solenoid aberrations) are presented over a range of currents and emittances about the design point. A mechanical layout drawing will be presented along with the status of the source and LEBT, design, and fabrication. PMID:26932079

  12. Design and fabrication of a duoplasmatron extraction geometry and LEBT for the LANSCE H+ RFQ project

    Science.gov (United States)

    Fortgang, C. M.; Batygin, Y. K.; Draganic, I. N.; Garnett, R. W.; McCrady, R. C.; Rybarcyk, L. J.

    2016-02-01

    The 750-keV H+ Cockcroft-Walton at LANSCE will be replaced with a recently fabricated 4-rod Radio Frequency Quadrupole (RFQ) with injection energy of 35 keV. The existing duoplasmatron source extraction optics need to be modified to produce up to 35 mA of H+ current with an emittance work over a range of space-charge neutralized currents and emittances. The LEBT is optimized in the sense that it minimizes the beam size in both solenoids for a point design of a given neutralized current and emittance. Special attention has been given to estimating emittance growth due to source extraction optics and solenoid aberrations. Examples of source-to-RFQ matching and emittance growth (due to both non-linear space charge and solenoid aberrations) are presented over a range of currents and emittances about the design point. A mechanical layout drawing will be presented along with the status of the source and LEBT, design, and fabrication.

  13. Radiological safety experience in nuclear fuel cycle operations at Bhabha Atomic Research Center, Trombay, Mumbai, India

    International Nuclear Information System (INIS)

    Activities at Bhabha Atomic Research Centre (BARC), Mumbai, cover nuclear fuel cycle operations based on natural uranium as the fuel. The facilities include: plant for purification and production of nuclear grade uranium metal, fuel fabrication, research reactor operation, fuel reprocessing and radioactive waste management in each stage. Comprehensive radiation protection programmes for assessment and monitoring of radiological impact of these operations, both in occupational and public environment, have been operating in BARC since beginning. These programmes, based on the 1990 ICRP Recommendations as prescribed by national regulatory body, the Atomic Energy Regulatory Board (AERB), are being successfully implemented by the Health, Safety and Environment Group, BARC. Radiation Hazards Control Units attached to the nuclear fuel cycle facilities provide radiation safety surveillance to the various operations. The radiation monitoring programme consists of measurement and control of external exposures by thermoluminescent dosimeters (TLDs), hand-held and installed instruments, and internal exposures by bioassay and direct whole body counting using shadow shield counter for beta gamma emitters and phoswich detector based system for plutonium. In addition, an environmental monitoring programme is in place to assess public exposures resulting from the operation of these facilities. The programme involves analysis of various matrices in the environment such as bay water, salt, fish, sediment and computation of resulting public exposures. Based on the operating experience in these plants, improved educating and training programmes for plant operators, have been designed. This, together with the application of new technologies have brought down individual as well as average doses of occupational workers. The environmental releases remain a small fraction of the authorised limits. The operating health physics experience in some of these facilities is discussed in this paper

  14. Wellbeing in healthcare environments : a human-centered design research approach to improving the cancer patient experience during radiation therapy

    OpenAIRE

    Mullaney, Tara; Nyholm, Tufve; Edvardsson, David

    2011-01-01

    Healthcare and medical products are often designed with the singular focus of providing the best treatment available to patients. However, research has shown that this treatment-based approach does not result in quality care. There are many factors that play into making a healthcare experience patient-centered, and this paper explores the use of human-centered design research to understand this experience. This paper presents a case-study of a Radiotherapy Department at a University Hospital,...

  15. Epilepsia Partialis Continua over last 14 years: experience from a tertiary care center from south India.

    Science.gov (United States)

    Sinha, S; Satishchandra, P

    2007-04-01

    Epilepsia Partialis Continua (EPC), a subtype of status epilepticus has varied etiology and the outcome depends on the cause. The aim of this study was to analyze the demographic, semiology, etiology, radiological findings, therapeutic response and outcome of EPC. This is a retrospective analysis of 76 patients (M:F: 46:30; mean age: 30.2+/-23.4 years; median age: 26 years) evaluated at our center over last 14 years. Twenty-three subjects (30.3%) had epilepsy for a mean of 25.8+/-52.3 months (range: 1-81 years; median: 14) before developing EPC and in half of them, seizures were controlled with anti-epileptic drugs (AEDs). Rest 53 (69.3%) manifested as de novo. The mean duration of EPC was 47.02+/-188.2 days (range: 1h to 48 months; median: 3 days). One patient of generalized convulsive SE (GCSE) evolved into EPC while five patients of EPC evolved into GCSE. CT scan of brain (n-76) was abnormal in 53 (69.7%) while all the 11 MRI scans which were available were abnormal. EEG (n-21) was abnormal in all but one, however it was non-specific in 7. The diagnoses were-idiopathic: 17, ischemic stroke: 15, meningo-encephalitis: 8, Rasmussen's encephalitis (RE): 7, granuloma: 6, diabetic-non-ketotic-hyperosmolar-coma (DNKHC): 6, CNS malignancies (primary/secondary): 4, birth injury: 4, cerebral venous thrombosis: 3, CNS tuberculosis: 2, and cerebritis, HIV-related, toxemia of pregnancy, and MERRF one each. Patients of >40 years (n=21) had stroke (10), idiopathic (6), DNKHC (4) and metastasis (1) as common causes. Only 12 of them received single AED, while others required 2 or more AEDs to control the seizures. The outcome (n=72) was-controlled: 43 (59.7%); uncontrolled: 26 (36.1%) (RE: 7, idiopathic: 5, birth injury: 4, encephalitis: 3, malignancy: 2, granuloma and MERRF: 1 each) and three patients succumbed (encephalitis: 2, idiopathic: 1). Causes of EPC are varied and it depends on age. Underlying cause determined the outcome and could be refractory in RE, idiopathic, and

  16. Spectrum of intradialytic complications during hemodialysis and its management: A single-center experience

    Directory of Open Access Journals (Sweden)

    Prabhakar

    2015-01-01

    Full Text Available Hemodialysis (HD is one of the important modalities of renal replacement therapy in acute renal failure (ARF as well as chronic renal failure (CRF. This study was performed to evaluate the various intradialytic complications that occur during HD and their management. This is a retrospective study performed in patients who underwent conventional HD during the period of 1 January 2000 to 31 December 2011 at our center. Clinical details, various complications faced and their management were retrieved from dialysis case sheets. A total of 2325 patients of renal failure (790 ARF and 1535 CRF patients were assessed for the intradialytic complications of HD. During the study period, there were 12,785 bicarbonate dialyses performed on these patients. In the ARF patients, the common intradialytic complications were: Hypotension, seen in 1296 sessions (30.4%, nausea and vomiting seen in 1125 sessions (26.4%, fever and chills seen in 818 sessions (19.2%, headache seen in 665 sessions (15.6%, cramps seen in 85 sessions (2.0%, chest pain and back pain seen in 82 sessions (1.92%, hypoglycemia seen in 77 sessions (1.8%, first-use syndrome seen in 72 sessions (1.7% and femoral hematoma seen in 31 sessions (0.73%. In the CRF group, common complications were hypotension in 2230 sessions (26.1%, nausea and vomiting in 1211 sessions (14.2%, fever and chills in 1228 sessions (14.4%, chest pain and back pain in 1108 cases (13.0%, hypertension in 886 sessions (10.4%, headache in 886 sessions (10.4%, cramps in 256 sessions (3.0%, hematoma in 55 sessions (0.64%, intracerebral hemorrhage in three sessions (0.03% and catheter tip migration in three sessions (0.03%. There is a need for special attention for the diagnosis and management of intradialytic complications of HD because such complications could be managed successfully without the need for termination of the dialysis procedure.

  17. Conversion from temporary to tunneled catheters by nephrologists: report of a single-center experience

    Directory of Open Access Journals (Sweden)

    Silva BC

    2016-04-01

    Full Text Available Bruno C Silva, Camila E Rodrigues, Regina CRM Abdulkader, Rosilene M Elias Nephrology Division, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil Background: Nephrologists have increasingly participated in the conversion from temporary catheters (TC to tunneled-cuffed catheters (TCCs for hemodialysis. Objective: To prospectively analyze the outcomes associated with TCC placement by nephrologists with expertise in such procedure, in different time periods at the same center. The impact of vancomycin or cefazolin as prophylactic antibiotics on the infection outcomes was also tested. Patients and methods: Hemodialysis patients who presented to such procedure were divided into two cohorts: A (from 2004 to 2008 and B (from 2013 to 2015. Time from TC to TCC conversion, prophylactic antibiotics, and reasons for TCC removal were evaluated. Results: One hundred and thirty patients were included in cohort A and 228 in cohort B. Sex, age, and follow-up time were similar between cohorts. Median time from TC to TCC conversion was longer in cohort A than in cohort B (14 [3; 30] vs 4 [1; 8] days, respectively; P<0.0001. Infection leading to catheter removal occurred in 26.4% vs 18.9% of procedures in cohorts A and B, respectively, and infection rate was 0.93 vs 0.73 infections per 1,000 catheter-days, respectively (P=0.092. Infection within 30 days from the procedure occurred in 1.4% of overall cohort. No differences were observed when comparing vancomycin and cefazolin as prophylactic antibiotics on 90-day infection-free TCC survival in a Kaplan–Meier model (log-rank = 0.188. TCC removal for low blood flow occurred in 8.9% of procedures. Conclusion: Conversion of TC to TCC by nephrologists had overall infection, catheter patency, and complications similar to data reported in the literature. Vancomycin was not superior to cefazolin as a prophylactic antibiotic. Keywords: renal dialysis, tunneled catheters, interventional nephrology

  18. Tolerability of sirolimus: a decade of experience at a single cardiac transplant center.

    Science.gov (United States)

    Thibodeau, Jennifer T; Mishkin, Joseph D; Patel, Parag C; Kaiser, Patricia A; Ayers, Colby R; Mammen, Pradeep P A; Markham, David W; Ring, William Steves; Peltz, Matthias; Drazner, Mark H

    2013-01-01

    Sirolimus is used in cardiac transplant recipients to prevent rejection, progression of cardiac allograft vasculopathy, and renal dysfunction. However, sirolimus has many potential side effects and its tolerability when used outside of clinical trials is not well established. We describe a decade of experience with sirolimus in cardiac transplant recipients at our institution. We retrospectively reviewed records of all adult cardiac transplant recipients living between September 1999 and February 2010 (n = 329) and identified 67 patients (20%) who received sirolimus. The indications for sirolimus were cardiac allograft vasculopathy (67%), renal dysfunction (25%), rejection (4%), and intolerability of tacrolimus (3%). One-third of patients discontinued sirolimus at a median (25th, 75th percentiles) of 0.9 (0.2, 1.6) yr of duration. Over 70% of subjects experienced an adverse event attributed to sirolimus. Adverse events were associated with higher average sirolimus levels (9.1 ng/mL vs. 7.1 ng/mL, p = 0.004). We conclude that sirolimus is frequently used in cardiac transplant recipients (20%) and commonly causes side effects, often necessitating discontinuation. Higher average sirolimus levels were associated with adverse events, suggesting that tolerability may improve if levels are maintained within the lower end of the current therapeutic range; however, the improvement in tolerability would need to be balanced with the potential for decreased efficacy. PMID:24304376

  19. Determination of Significant Composite Processing Factors by Designed Experiment (MSFC Center Director's Discretionary Fund)

    Science.gov (United States)

    Finckenor, J. L.

    2003-01-01

    To determie composite material properties' effects from porcessing variables, a 3 factorial designed experiment with two replicates was conducted. The factors were cure method (oven versus autoclave), layup (hand versus tape-laying machine), and thickness (8 versus 52 ply). Four material systems were tested: AS4/3501-6, IM7/8551-7, IM7/F655 bismaleimide (BMI), and shear tests on IM7/F584. Material properties were G(sub 12), v(sub 12), E(sub 1c) and E(sub 2c). Since the samples were necessarily nonstandard, strengths, though recorded, cannot be considered valid. Void content was also compared. Autoclave curing helped material properties for the low modulus fiber material but showed little benefit for higher stiffness fibers. The number of plies was very important for epoxy composites but not for the BMI. E(sub 1) was generally unaffected by any factor. Particularly high void content did correlate to reduced properties. Autoclave curing reduced void content over oven curiing but a moderate amount of voids, less than 1 percent void content, didnot correlate with material properties. Oven cures and hand layups can produce high-quality parts. Part thickness of epoxy composites is important, though cure optimization may improve performance. Significant variations can be caused by processing and it is important that test coupons always reflect the layup and processes of the final part.

  20. COMBREX-DB: an experiment centered database of protein function: knowledge, predictions and knowledge gaps.

    Science.gov (United States)

    Chang, Yi-Chien; Hu, Zhenjun; Rachlin, John; Anton, Brian P; Kasif, Simon; Roberts, Richard J; Steffen, Martin

    2016-01-01

    The COMBREX database (COMBREX-DB; combrex.bu.edu) is an online repository of information related to (i) experimentally determined protein function, (ii) predicted protein function, (iii) relationships among proteins of unknown function and various types of experimental data, including molecular function, protein structure, and associated phenotypes. The database was created as part of the novel COMBREX (COMputational BRidges to EXperiments) effort aimed at accelerating the rate of gene function validation. It currently holds information on ∼ 3.3 million known and predicted proteins from over 1000 completely sequenced bacterial and archaeal genomes. The database also contains a prototype recommendation system for helping users identify those proteins whose experimental determination of function would be most informative for predicting function for other proteins within protein families. The emphasis on documenting experimental evidence for function predictions, and the prioritization of uncharacterized proteins for experimental testing distinguish COMBREX from other publicly available microbial genomics resources. This article describes updates to COMBREX-DB since an initial description in the 2011 NAR Database Issue. PMID:26635392

  1. COMBREX-DB: an experiment centered database of protein function: knowledge, predictions and knowledge gaps.

    Science.gov (United States)

    Chang, Yi-Chien; Hu, Zhenjun; Rachlin, John; Anton, Brian P; Kasif, Simon; Roberts, Richard J; Steffen, Martin

    2016-01-01

    The COMBREX database (COMBREX-DB; combrex.bu.edu) is an online repository of information related to (i) experimentally determined protein function, (ii) predicted protein function, (iii) relationships among proteins of unknown function and various types of experimental data, including molecular function, protein structure, and associated phenotypes. The database was created as part of the novel COMBREX (COMputational BRidges to EXperiments) effort aimed at accelerating the rate of gene function validation. It currently holds information on ∼ 3.3 million known and predicted proteins from over 1000 completely sequenced bacterial and archaeal genomes. The database also contains a prototype recommendation system for helping users identify those proteins whose experimental determination of function would be most informative for predicting function for other proteins within protein families. The emphasis on documenting experimental evidence for function predictions, and the prioritization of uncharacterized proteins for experimental testing distinguish COMBREX from other publicly available microbial genomics resources. This article describes updates to COMBREX-DB since an initial description in the 2011 NAR Database Issue.

  2. Outcomes of arteriovenous fistula for hemodialysis in Sudanese patients: Single-center experience

    Directory of Open Access Journals (Sweden)

    Gamal Mustafa Ahmed

    2012-01-01

    Full Text Available A well-functioning arteriovenous fistula (AVF is essential for the maintenance of hemodialysis (HD in patients with chronic renal failure. Our aim is to review our experience of creating AVF and to asses its success rate and common complication. A prospective, hospital-based study was conducted on 73 patients (48 males and 25 females on chronic HD in Gezira Hospital for Renal Diseases and Surgery, from January to July 2007. Their mean age was 43.9 years (range from 18 to 72 years. Seventy-one (97.3% of the study subjects had been dialyzed before creation of the AVF, 67 (91.8% of them having undergone HD with temporary access. All patients (n=73 had a native AVF as the permanent vascular access (VA. A primary radiocephalic AVF was created in 78.1% of the patients, cubital fossa in 20.5% and one case had left snuff box AVF (1.4%. Percentage of AVF maturation was reported in 67.1% of the cases within the first six weeks and in 9.6% of the cases AVF never matured. Failure of AVF function occurred in 26% of the cases, due to thrombosis in 20.5% (n=15 and aneurysm in 5.5% of the cases. We conclude that an optimum outcome is likely when there is a multidisciplinary team approach, and early referral to vascular surgery is paramount.

  3. Results of candidemia treatment in children with hematologic malignancies: single center experience

    Directory of Open Access Journals (Sweden)

    I. I. Kalinina

    2014-07-01

    Full Text Available Candidemia is one of the most serious infectious complications in children with hematological malignancies and has a high morta lity rate.Seven-year experience of candidemia diagnosis and therapy in patients with various hematologic malignancies w as analyzed. Candidemia registered in 37 patients (AML and MDS — 14, ALL — 10, solid tumors — 5, histocytic syndromes — 4, AA — 3, other non-malignancy diseases— 2. C. non-albicans (36 isolates from 32 patients was common cause of, while C. albicans isolated in 5 patients (8 strains. Antifungal prophylactic therapy was applied to 31 patients. 22 patients at the time of candidemia have neutropenia (< 0.5 × 10 9/l. Main clinical manifestations were febrile fever (100 % cases and pneumonia (21.6 % cases. Less frequent multiorgan failure (8.1 %, septic shoc k (5.4 %, chronic disseminated candidiasis (5.4 % and meningitis (2.7 % were registered. All patients received antifungal therapy (monotherapy — 17, combination therapy — 20. Central venous catheter removed in 21 patients. In 14 patients hematopoietic recovery w as registered, none of these patients died, while from group of patients without hematopoietic recovery 6 patients died (p = 0.0001. Recurrent candidemia episodes were seen in 4 patients. Overall survival was 0.37 ± 0.09.

  4. Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience

    Directory of Open Access Journals (Sweden)

    Armin D. Goralczyk

    2009-01-01

    Full Text Available Adult living donor liver transplantations (ALDLTs across the ABO blood group barrier have been reported in Asia, North Americas, and Europe, but not yet in Germany. Several strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host, but no gold standard has yet emerged. Here, we present the first experiences with three ABO-incompatible adult living donor liver transplantations in Germany applying different immunosuppressive strategies. Four patient-donor couples were considered for ABO-incompatible ALDLT. In these patients, resident ABO blood group antibodies (isoagglutinins were depleted by plasmapheresis or immunoadsorption and replenishment was inhibited by splenectomy and/or B-cell-targeted immunosuppression. Despite different treatments ALDLT could safely be performed in three patients and all patients had good initial graft function without signs for antibody-mediated rejection (AMR. Two patients had long-term graft survival with stable graft function. We thus propose the feasibility of ABO-incompatible ALDLT with these protocols and advocate further expansion of ABO incompatible ALDLT in multicenter trials to improve efficacy and safety.

  5. Phenylketonuria. Experience at one center in the first year of screening in California.

    Science.gov (United States)

    Peterson, R M; Koch, R; Schaeffler, G E; Wohlers, A; Acosta, P B; Boyle, D

    1968-05-01

    One year's experience with phenylketonuria during the calendar year 1966, the first year for compulsory newborn screening in California, was reviewed. The over-all prevalence rate from reported cases in California during this period was one case per 19,500 persons tested. Fifty-seven persons suspected of having pku were evaluated, and 25 of them were determined to be phenylketonuric. Eleven of the 25 were infants in whom the abnormality was detected through the newborn screening program or because it was detected in a sibling through a screening program. All the newborn phenylketonuric patients were developing normally at the time of last report (although the follow-up periods were short). In nine of the other children, pku was detected because they were retarded. Five retarded children who were diagnosed as phenylketonuric at another clinic were given dietary assistance. Five additional infants had elevated serum phenylalanines but did not have the classic biochemical findings of pku and are being evaluated further. Nine infants with positive screening tests exhibited biochemical and clinical findings consistent with transient tyrosinemia. Eighteen other children were evaluated and found to have no metabolic abnormality. The newborn screening program for pku is of decided benefit in early identification of a group of infants who have a high rate of potentially serious metabolic disease. Early identification permits treatment soon enough to prevent mental retardation. Newly identified patients should be evaluated in a medical setting capable of careful pediatric, biochemical and nutritional surveillance. PMID:5652755

  6. Phenylketonuria—Experience at One Center in the First Year of Screening in California

    Science.gov (United States)

    Peterson, Raymond M.; Koch, Richard; Schaeffler, Graciela E.; Wohlers, Audrey; Acosta, Phyllis B.; Boyle, David

    1968-01-01

    One year's experience with phenylketonuria during the calendar year 1966, the first year for compulsory newborn screening in California, was reviewed. The over-all prevalence rate from reported cases in California during this period was one case per 19,500 persons tested. Fifty-seven persons suspected of having pku were evaluated, and 25 of them were determined to be phenylketonuric. Eleven of the 25 were infants in whom the abnormality was detected through the newborn screening program or because it was detected in a sibling through a screening program. All the newborn phenylketonuric patients were developing normally at the time of last report (although the follow-up periods were short). In nine of the other children, pku was detected because they were retarded. Five retarded children who were diagnosed as phenylketonuric at another clinic were given dietary assistance. Five additional infants had elevated serum phenylalanines but did not have the classic biochemical findings of pku and are being evaluated further. Nine infants with positive screening tests exhibited biochemical and clinical findings consistent with transient tyrosinemia. Eighteen other children were evaluated and found to have no metabolic abnormality. The newborn screening program for pku is of decided benefit in early identification of a group of infants who have a high rate of potentially serious metabolic disease. Early identification permits treatment soon enough to prevent mental retardation. Newly identified patients should be evaluated in a medical setting capable of careful pediatric, biochemical and nutritional surveillance. PMID:5652755

  7. Results of candidemia treatment in children with hematologic malignancies: single center experience

    Directory of Open Access Journals (Sweden)

    I. I. Kalinina

    2011-01-01

    Full Text Available Candidemia is one of the most serious infectious complications in children with hematological malignancies and has a high morta lity rate.Seven-year experience of candidemia diagnosis and therapy in patients with various hematologic malignancies w as analyzed. Candidemia registered in 37 patients (AML and MDS — 14, ALL — 10, solid tumors — 5, histocytic syndromes — 4, AA — 3, other non-malignancy diseases— 2. C. non-albicans (36 isolates from 32 patients was common cause of, while C. albicans isolated in 5 patients (8 strains. Antifungal prophylactic therapy was applied to 31 patients. 22 patients at the time of candidemia have neutropenia (< 0.5 × 10 9/l. Main clinical manifestations were febrile fever (100 % cases and pneumonia (21.6 % cases. Less frequent multiorgan failure (8.1 %, septic shoc k (5.4 %, chronic disseminated candidiasis (5.4 % and meningitis (2.7 % were registered. All patients received antifungal therapy (monotherapy — 17, combination therapy — 20. Central venous catheter removed in 21 patients. In 14 patients hematopoietic recovery w as registered, none of these patients died, while from group of patients without hematopoietic recovery 6 patients died (p = 0.0001. Recurrent candidemia episodes were seen in 4 patients. Overall survival was 0.37 ± 0.09.

  8. Robotic versus conventional laparoscopic colorectal operations: a-single center experience

    Science.gov (United States)

    Bozkurt, Mehmet Abdussamet; Kocataş, Ali; Gemici, Eyüp; Kalaycı, Mustafa Uygar; Alış, Halil

    2016-01-01

    Objective: Robotic surgery was first introduced in 2000 especially to overcome the limitations of low rectum cancer surgery. There is still no consensus regarding the standard method for colorectal surgery. The aim of this study was to compare robotic surgery with laparoscopic colorectal surgery. Material and Methods: This is a retrospective study. Data of patients with a diagnosis of colon or rectal cancer were analyzed for robotic colorectal surgery and laparoscopic colorectal surgery. Results: The cost of robotic surgery group was statistically higher than the laparoscopic surgery group (p=0.032). The average operation duration was 178 minutes in the laparoscopic surgery group and 228 minutes in the robotic surgery group, and this difference was statistically significant (p=0.044). There was no statistically significant difference between the groups regarding other parameters. Discussion: Disadvantages of robotic surgery seem to be its higher cost and longer operation duration as compared to laparoscopic surgery. We claim that an increase in the number of cases and experience may shorten the operation time while the increase in commercial interest may decrease the cost disadvantage of robotic surgery.

  9. Strengthening the role of universities in addressing sustainability challenges: the Mitchell Center for Sustainability Solutions as an institutional experiment

    Directory of Open Access Journals (Sweden)

    David D. Hart

    2015-06-01

    Full Text Available As the magnitude, complexity, and urgency of many sustainability problems increase, there is a growing need for universities to contribute more effectively to problem solving. Drawing upon prior research on social-ecological systems, knowledge-action connections, and organizational innovation, we developed an integrated conceptual framework for strengthening the capacity of universities to help society understand and respond to a wide range of sustainability challenges. Based on experiences gained in creating the Senator George J. Mitchell Center for Sustainability Solutions (Mitchell Center, we tested this framework by evaluating the experiences of interdisciplinary research teams involved in place-based, solutions-oriented research projects at the scale of a single region (i.e., the state of Maine, USA. We employed a multiple-case-study approach examining the experiences of three interdisciplinary research teams working on tidal energy development, adaptation to climate change, and forest vulnerability to an invasive insect. Drawing upon documents, observations, interviews, and other data sources, three common patterns emerged across these cases that were associated with more effective problem-solving strategies. First, an emphasis on local places and short-term dynamics in social-ecological systems research provides more frequent opportunities for learning while doing. Second, iterative stakeholder engagement and inclusive forms of knowledge co-production can generate substantial returns on investment, especially when researchers are dedicated to a shared process of problem identification and they avoid framing solutions too narrowly. Although these practices are time consuming, they can be accelerated by leveraging existing stakeholder relationships. Third, efforts to mobilize interdisciplinary expertise and link knowledge with action are facilitated by an organizational culture that emphasizes mutual respect, adaptability, and solutions

  10. Conjoined twins: twenty years' experience at a reference center in Brazil

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    Ana Cristina Aoun Tannuri

    2013-01-01

    Full Text Available OBJECTIVE: This study reports on the experience of one hospital regarding the surgical aspects, anatomic investigation and outcomes of the management of 21 conjoined twin pairs over the past 20 years. METHODS: All cases of conjoined twins who were treated during this period were reviewed. A careful imaging evaluation was performed to detail the abdominal anatomy (particularly the liver, inferior vena cava, spleen and pancreas, either to identify the number of organs or to evaluate the degree of organ sharing. RESULTS: There were eight sets of ischiopagus twins, seven sets of thoracopagus twins, three sets of omphalopagus twins, two sets of thoraco-omphalo-ischiopagus twins and one set of craniopagus twins. Nine pairs of conjoined twins could not be separated due to the complexity of the organs (mainly the liver and heart that were shared by both twins; these pairs included one set of ischiopagus twins, six sets of thoracopagus twins and one set of thoraco-omphalo-ischiopagus twins. Twelve sets were separated, including seven sets of ischiopagus twins, three sets of omphalopagus twins, one set of thoracopagus twins and one set of craniopagus conjoined twins. The abdominal wall was closed in the majority of patients with the use of mesh instead of the earlier method of using tissue expanders. The surgical survival rate was 66.7%, and one pair of twins who did not undergo separation is currently alive. CONCLUSION: A detailed anatomic study of the twins and surgical planning must precede separation. A well-prepared pediatric surgery team is sufficient to surgically manage conjoined twins.

  11. Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: A single center experience

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    Sirin Sait

    2011-01-01

    Full Text Available Background/Aim. Management of patients with recurrent glioblastoma (GB comprises a therapeutic challenge in neurooncology owing to the aggressive nature of the disease with poor local control despite a combined modality treatment. The majority of cases recur within the highdose radiotherapy field limiting the use of conventional techniques for re-irradiation due to potential toxicity. Stereotactic radiosurgery (SRS offers a viable noninvasive therapeutic option in palliative treatment of recurrent GB as a sophisticated modality with improved setup accuracy allowing the administration of high-dose, precise radiotherapy. The aim of the study was to, we report our experience with single-dose linear accelerator (LINAC based SRS in the management of patients with recurrent GB. Methods. Between 1998 and 2010 a total of 19 patients with recurrent GB were treated using single-dose LINAC-based SRS. The median age was 47 (23-65 years at primary diagnosis. Karnofsky Performance Score was ≥ 70 for all the patients. The median planning target volume (PTV was 13 (7-19 cc. The median marginal dose was 16 (10-19 Gy prescribed to the 80%-95% isodose line encompassing the planning target volume. The median follow-up time was 13 (2-59 months. Results. The median survival was 21 months and 9.3 months from the initial GB diagnosis and from SRS, respectively. The median progression-free survival from SRS was 5.7 months. All the patients tolerated radiosurgical treatment well without any Common Toxicity Criteria (CTC grade > 2 acute side effects. Conclusion. Single-dose LINAC-based SRS is a safe and well- tolerated palliative therapeutic option in the management of patients with recurrent GB.

  12. Successful Splenectomy for Hypersplenism in Wilson’s Disease: A Single Center Experience from China

    Science.gov (United States)

    Chen, Huai-Zhen; Wu, Yun-Hu; Fang, Xiang; Zhang, Jing; Wang, Zhen; Han, Yong-Sheng; Wang, Yu

    2015-01-01

    Splenomegaly and pancytopenia are common in Wilson’s disease (WD) and splenectomy is one of the conventional treatments for splenomegaly and the associated pancytopenia. However, splenectomy remained controversial for hypersplenism in WD as it was reported that splenectomy leaded to serious emotional and neurological deterioration in WD patients with hypersplenism. In the current study, we present our experiences in 70 WD patients with hypersplenism who had undergone splenectomy, outlining the safety and efficacy of splenectomy in WD. The clinical database of 70 WD patients with hypersplenism who had undergone splenectomy in our hospital between 2009 and 2013 were reviewed and followed-up regularly. Before splenectomy, all the patients accepted a short period of anti-copper treatment with intravenous sodium 2, 3-dimercapto-1-propane sulfonate (DMPS). All the patients demonstrated a marked improvement in platelet and leucocyte counts after splenectomy. No severe postoperative complication was observed. In particular, none of the 37 patients with mixed neurologic and hepatic presentations experienced neurological deterioration after splenectomy, and none of the patients with only hepatic presentations newly developed neurological symptoms. During the one year follow-up period, no patient presented hepatic failure or hepatic encephalopathy, no hepatic patient newly developed neurological presentations, and only 3 patients with mixed neurologic and hepatic presentations suffered neurological deterioration and these 3 patients had poor compliance of anti-copper treatment. Quantative analysis of the neurological symptoms in the 37 patients using the Unified Wilson’s Disease Rating Scale (UWDRS) showed that the neurological symptoms were not changed in a short-term of one week after splenectomy but significantly improved in a long-term of one year after splenectomy. Additionally, compared to that before splenectomy, the esophageal gastric varices in most patients

  13. Successful Splenectomy for Hypersplenism in Wilson's Disease: A Single Center Experience from China.

    Directory of Open Access Journals (Sweden)

    Liang-Yong Li

    Full Text Available Splenomegaly and pancytopenia are common in Wilson's disease (WD and splenectomy is one of the conventional treatments for splenomegaly and the associated pancytopenia. However, splenectomy remained controversial for hypersplenism in WD as it was reported that splenectomy leaded to serious emotional and neurological deterioration in WD patients with hypersplenism. In the current study, we present our experiences in 70 WD patients with hypersplenism who had undergone splenectomy, outlining the safety and efficacy of splenectomy in WD. The clinical database of 70 WD patients with hypersplenism who had undergone splenectomy in our hospital between 2009 and 2013 were reviewed and followed-up regularly. Before splenectomy, all the patients accepted a short period of anti-copper treatment with intravenous sodium 2, 3-dimercapto-1-propane sulfonate (DMPS. All the patients demonstrated a marked improvement in platelet and leucocyte counts after splenectomy. No severe postoperative complication was observed. In particular, none of the 37 patients with mixed neurologic and hepatic presentations experienced neurological deterioration after splenectomy, and none of the patients with only hepatic presentations newly developed neurological symptoms. During the one year follow-up period, no patient presented hepatic failure or hepatic encephalopathy, no hepatic patient newly developed neurological presentations, and only 3 patients with mixed neurologic and hepatic presentations suffered neurological deterioration and these 3 patients had poor compliance of anti-copper treatment. Quantative analysis of the neurological symptoms in the 37 patients using the Unified Wilson's Disease Rating Scale (UWDRS showed that the neurological symptoms were not changed in a short-term of one week after splenectomy but significantly improved in a long-term of one year after splenectomy. Additionally, compared to that before splenectomy, the esophageal gastric varices in most

  14. Initial Management of Childhood Acute Immune Thrombocytopenia: Single-Center Experience of 32 Years.

    Science.gov (United States)

    Yildiz, Inci; Ozdemir, Nihal; Celkan, Tiraje; Soylu, Selen; Karaman, Serap; Canbolat, Aylin; Dogru, Omer; Erginoz, Ethem; Apak, Hilmi

    2015-01-01

    Immune thrombocytopenia (ITP) is an acute self-limited disease of childhood, mostly resolving within 6 months irrespective of whether therapy is given or not. Treatment options when indicated include corticosteroids, intravenous immune globulin (IVIG), and anti-RhD immunoglobulin. We reviewed our 32 years' experience for first-line therapy of acute ITP. Five hundred forty-one children (mean age: 5.3 years) diagnosed and treated for ITP were evaluated retrospectively. Among 491 acute ITP patients, IVIG was used in 27%, high-dose steroids in 27%, low-dose steroids in 20%, anti-D immunoglobulin G (IgG) in 2%, and no therapy in 22%. When the initial response (platelets >50 × 10(9)/L) to first-line treatment modalities were compared, 89%, 84%, and 78% patients treated by low-dose steroids, high-dose steroids, and IVIG responded to treatment, respectively (P > .05). Mean time to recovery of platelets was 16.8, 3.8, and 3.0 days in patients treated with low-dose steroids, high-dose steroids, and IVIG, respectively (P < .0001). Thrombocytopenia recurred in 23% of low-dose steroid, 39% of high-dose steroid, and in 36% of IVIG (P < .0001) treatment groups. Of 108 patients who were observed alone, 4 (3%) had a recurrence on follow-up and only 2 of these required treatment subsequently. Recurrence was significantly less in no therapy group compared with children treated with 1 of the 3 options of pharmacotherapy (P < .0001). Response rates were similar between patients treated by IVIG and low- and high-dose steroids; however, time to response was slower in patients treated with low-dose steroids compared with IVIG and high-dose steroids. PMID:26154620

  15. A Single-Center 10-Year Experience with Pasireotide in Cushing's Disease: Patients' Characteristics and Outcome.

    Science.gov (United States)

    Trementino, L; Michetti, G; Angeletti, A; Marcelli, G; Concettoni, C; Cardinaletti, C; Polenta, B; Boscaro, M; Arnaldi, G

    2016-05-01

    Pasireotide is the first pituitary-directed drug approved for treating patients with Cushing's disease (CD). Our 10-year experience with pasireotide in CD is reported here. Twenty patients with de novo, persistent, or recurrent CD after pituitary surgery were treated with pasireotide from December 2003 to December 2014. Twelve patients were treated with pasireotide in randomized trials and 8 patients with pasireotide sc (Signifor(®); Novartis AG, Basel, Switzerland) in clinical practice. The mean treatment duration was 20.5 months (median 9 months; range, 3-72 months). Urinary free cortisol (UFC) levels mean percentage change (± SD) at last follow-up was-40.4% (± 35.1; range, 2-92%; median reduction 33.3%) with a normalization rate of 50% (10/20). Ten patients achieved sustained normalized late night salivary cortisol (LNSC) levels during treatment. LNSC normalization was associated with UFC normalization in 7/10 patients. Serum cortisol and plasma ACTH significantly decreased from baseline to last follow-up. Body weight decrease and blood pressure improvement during pasireotide treatment were independent from UFC response. Glucose profile worsening was observed in all patients except one. The frequency of diabetes mellitus increased from 40% (8/20) at baseline to 85% (17/20) at last follow-up requiring initiation of medical treatment only in 44% of patients. Pasireotide treatment was associated with sustained biochemical and clinical benefit in about 60% of CD patients. Glucose profile alteration is a frequent complication of pasireotide treatment; however, it seems to be easy to manage with diet and lifestyle intervention in almost half of the patients. PMID:27127913

  16. Thromboprophylaxis and Outcomes for Total Joint Arthroplasty in Congenital Bleeding Disorders: A Single-Center Experience.

    Science.gov (United States)

    Holderness, Britt M; Goto, Yuika; McKernan, Laurel; Bernini, Philip; Ornstein, Deborah L

    2016-09-01

    Total joint arthroplasty (TJA) improves the quality of life for patients with end-stage osteoarthritis but is associated with an increased risk of venous thromboembolism (VTE), thus pharmacologic thromboprophylaxis is recommended for most patients. Patients with congenital bleeding disorders may develop severe arthropathies due to repeated hemarthroses and derive similar benefit from TJA as the general population. No guidelines for pharmacologic thromboprophylaxis in this population exist, however, as the risks and benefits are not well defined. We undertook the current study to assess the safety and efficacy of pharmacologic VTE prophylaxis in patients with congenital bleeding disorders undergoing TJA. We retrospectively reviewed the medical records of patients with bleeding disorders who underwent TJA at our academic institution between 1987 and 2012. We identified 28 patients who underwent 38 TJA procedures. Low-molecular-weight heparin (LMWH) was administered in 29 procedures (76%) and was discontinued early in 3 procedures (2 patients) due to nonjoint bleeding. No symptomatic VTE was identified, and no joint or deep wound infections were seen. Twenty-two patients accounting for 31 procedures were contacted to discuss their experience with TJA. All reported decreased pain, and 97% reported improved function after the surgery. Impressively, 97% stated that they would choose to have the surgery again. These results confirm the benefit of TJA in patients with congenital bleeding disorders and end-stage arthropathies and suggest that LMWH thromboprophylaxis is safe. No patient in our cohort developed symptomatic VTE, whether or not thromboprophylaxis was administered, thus necessity of thromboprophylaxis remains an unanswered question. PMID:27099385

  17. The efficacy of topiramate in adult refractory status epilepticus: experience of a tertiary care center.

    Science.gov (United States)

    Synowiec, Andrea S; Yandora, Kristin A; Yenugadhati, Vamsi; Valeriano, James P; Schramke, Carol J; Kelly, Kevin M

    2012-02-01

    Refractory status epilepticus (RSE) occurs in patients with SE when they fail to respond to traditional medical therapy. Because there are very few case reports of topiramate (TPM) treatment of RSE in adult patients, we examined our experience with TPM with regard to its safety and efficacy in seizure termination in RSE in an adult patient population. We report a retrospective review of 35 adult patients with RSE who were treated with TPM in addition to other antiepileptic drugs (AEDs) between 2003 and 2010. After failure of initial treatments of benzodiazepines and weight-based intravenous loading doses of standard AEDs, TPM tablets were crushed and administered via nasogastric tube. Data were collected on age, gender, history of epilepsy, etiology of RSE, daily dose of TPM, co-therapeutic agents, treatment response, and disposition. Following initiation of TPM use and discontinuation of continuous intravenous anesthetics with no additional AEDs administered, cumulative cessation of RSE in patients was 4/35 (11%) at one day, 10/35 (29%) at two days, and 14/35 (40%) at three days. However, when including all patients and comparing the two patient groups in which RSE was or was not terminated within three days of initiating TPM as the last or not last AED given, there was no significant difference. Time to TPM response was not associated with the type of seizures, etiology of SE, or whether there was a history of epilepsy. There were no documented side effects or complications of therapy with TPM. This study provides support for the use of TPM as an adjunctive agent in the treatment of RSE.

  18. Single center experience in endovascular aortic repair: review of technical and clinical aspects

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    Sinan Demirtaş

    2014-09-01

    Full Text Available Objective: The aim of this study is sharing of our endovascular aortic repair experiments in patients with high risk for surgery and contributing to literature with comparing previous report according to mortality complicationsand additional operations. Methods:Patients with endovascular aortic repair application were evaluated retrospectively. Perioperative one month mortality, additional applications during procedure, occurred complications, endoleak types, approaching anesthetical technique, diagnosis of disease, comorbid factors and demographical data registered. Results were compared with data in the literature Results: Abdominal endovascular aortic repair (EVAR applicated into 19 patients. Thoracic endovascular aor tic repair (TEVAR applicated into 11 patients. EVAR patients were operated with diagnosis of abdominal aortic aneurysm. Nine of these patients were emergely operated due to rupture. TEVAR applicated 8 patients were operated due to Type 3 Aortic Dissection and 1 patient was operated due to transsection. One month mortality of all patients were found as 10% (three atients. Endoleaks were occurred 6 patients: Three of them were Type 1a, two of them were Type1b and one of them was Type2. Balloon angioplasty applicated in two patients due to Type 1a endoleak and, in one patient due to Type 1b endoleak. Chronic renal failure was developed in one patient (3.3% due to contrast nephropathy. Reexploration was applicated in two patients (6.7% due to hematoma. Conclusion: Endovascular techniques are become frequently preferred treatment modality with the developing technology. We believed that endovascular approaches are safely preferable alternative in patients with high surgical risk as our series.

  19. Conservative Surgery and Primary Radiotherapy for Early Breast Cancer; Yonsei Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Chang Ok; Lee, Hy De; Lee, Kyung Sik; Jung, Woo Hee; Oh, Ki Keun; Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation 1991 and treated on hundred and forty patients during the next three years. Purpose: To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results: Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven patients were N0 and 27 patients were N1. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occurred at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation peumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer in proven to be safe and comfortable treatment method without

  20. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience

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    Jigish B Vyas

    2013-01-01

    Full Text Available Objectives: The safety and efficacy of transrectal ultrasound (TRUS guided aspiration of prostatic abscess (PA is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. Materials and Methods: After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS. Success was defined as complete resolution of the abscess and/or symptoms. Results: Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79 years. The DRE diagnosed PA in 22 (45.83% patients, while abdominal sonography diagnosed PA in 13 (27.08% patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100% patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8 cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml. Complete resolution after first aspiration was observed in 20 (41.66% patients. An average of 4.1 (range 1-7 aspirations was required for complete resolution which was seen in 41 patients (85.42%. Seven (14.58% patients required transurethral resection (deroofing of the abscess cavity. We formulated a treatment algorithm based on the above findings. Conclusion: The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are

  1. Outcomes of Surgical Repair for Persistent Truncus Arteriosus from Neonates to Adults: A Single Center's Experience

    Science.gov (United States)

    Chen, Qiuming; Gao, Huawei; Hua, Zhongdong; Yang, Keming; Yan, Jun; Zhang, Hao; Ma, Kai; Zhang, Sen; Qi, Lei; Li, Shoujun

    2016-01-01

    Objective This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus. Methods From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median follow-up time was 3.4 years (range, 3 months to 10 years). Results Fifty patients underwent anatomical repair at a median age of 19.6 months (range, 20 days to 19.1 years). Thirty patients (60%) were older than one year. The preoperative pulmonary vascular resistance and mean pulmonary artery pressure were 4.1±2.1 (range, 0.1 to 8.9) units.m2 and 64.3±17.9 (range, 38 to 101) mmHg, respectively. Significant truncal valve regurgitation was presented in 14 (28%) patients. Hospital death occurred in 3 patients, two due to pulmonary hypertensive crisis and the other due to pneumonia. Three late deaths occurred at 3, 4 and 11 months after surgery. The actuarial survival rates were 87.7% and 87.7% at 1 year and 5 years, respectively. Multivariate analysis identified significant preoperative truncal valve regurgitation was a risk factor for overall mortality (odds ratio, 7.584; 95%CI: 1.335–43.092; p = 0.022). Two patients required reoperation of truncal valve replacement. One patient underwent reintervention for conduit replacement. Freedom from reoperation at 5 years was 92.9%. At latest examination, there was one patient with moderate-to-severe truncal valve regurgitation and four with moderate. Three patients had residual pulmonary artery hypertension. All survivors were in New York Heart Association class I-II. Conclusions Complete repair of persistent truncus arteriosus can be achieved with a relatively low mortality and acceptable early- and mid-term results, even in cases with late presentation. Significant preoperative truncal valve regurgitation remains a risk factor for overall mortality. The long-term outcomes warrant further follow-up. PMID:26752522

  2. Outcomes of Surgical Repair for Persistent Truncus Arteriosus from Neonates to Adults: A Single Center's Experience.

    Directory of Open Access Journals (Sweden)

    Qiuming Chen

    Full Text Available This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus.From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median follow-up time was 3.4 years (range, 3 months to 10 years.Fifty patients underwent anatomical repair at a median age of 19.6 months (range, 20 days to 19.1 years. Thirty patients (60% were older than one year. The preoperative pulmonary vascular resistance and mean pulmonary artery pressure were 4.1±2.1 (range, 0.1 to 8.9 units.m2 and 64.3±17.9 (range, 38 to 101 mmHg, respectively. Significant truncal valve regurgitation was presented in 14 (28% patients. Hospital death occurred in 3 patients, two due to pulmonary hypertensive crisis and the other due to pneumonia. Three late deaths occurred at 3, 4 and 11 months after surgery. The actuarial survival rates were 87.7% and 87.7% at 1 year and 5 years, respectively. Multivariate analysis identified significant preoperative truncal valve regurgitation was a risk factor for overall mortality (odds ratio, 7.584; 95%CI: 1.335-43.092; p = 0.022. Two patients required reoperation of truncal valve replacement. One patient underwent reintervention for conduit replacement. Freedom from reoperation at 5 years was 92.9%. At latest examination, there was one patient with moderate-to-severe truncal valve regurgitation and four with moderate. Three patients had residual pulmonary artery hypertension. All survivors were in New York Heart Association class I-II.Complete repair of persistent truncus arteriosus can be achieved with a relatively low mortality and acceptable early- and mid-term results, even in cases with late presentation. Significant preoperative truncal valve regurgitation remains a risk factor for overall mortality. The long-term outcomes warrant further follow-up.

  3. [Post-transplant lymphoproliferative disease in liver transplant recipients--Merkur University Hospital single center experience].

    Science.gov (United States)

    Filipec-Kanizaj, Tajana; Budimir, Jelena; Colić-Cvrlje, Vesna; Kardum-Skelin, Ika; Sustercić, Dunja; Naumovski-Mihalić, Slavica; Mrzljak, Anna; Kolonić, Slobodanka Ostojić; Sobocan, Nikola; Bradić, Tihomir; Dolić, Zrinka Misetić; Kocman, Branislav; Katicić, Miroslava; Zidovec-Lepej, Snjezana; Vince, Adriana

    2011-09-01

    favoring the diagnosis. The management of PTLD poses a major therapeutic challenge and although there is reasonable agreement about the overall principles of treatment, there is still considerable controversy about the optimal treatment of individual patients. EBV-related PTLDs are a significant cause of mortality in patients undergoing orthotopic liver transplantation with the observed mortality rate of up to 50%. This paper presents the experience acquired at Merkur University Hospital in the diagnosis and treatment of patients with liver transplantation and PTLD. PMID:23126028

  4. Extracorporeal membrane oxygenation during double-lung transplantation: single center experience

    Institute of Scientific and Technical Information of China (English)

    XU Ling-feng; LI Xin; GUO Zhen; XU Mei-yin; GAO Cheng-xin; ZHU Jin-hong; JI Bing-yang

    2010-01-01

    Background For patients with end-stage lung diseases, lung transplantation is the final therapeutic option. Sequential double-lung transplantation is recognized as an established procedure to avoid cardiopulmonary bypass (CPB). But some of the sequential double-lung transplantations require CPB support during the surgical procedure for various reasons. However, conventional CPB may increase the risk of bleeding and early allograft dysfunction. Extracorporeal membrane oxygenation (ECMO) is more advantageous than conventional CPB during the perioperative period of transplantation. Replacing traditional CPB with ECMO is promising for those patients needing cardiopulmonary support during a sequential double-lung transplantation procedure. This study aimed to summarize the preliminary experience of ECMO practice in lung transplantation.Methods Between November 2002 and October 2008, twelve patients with end-stage lung diseases undergoing sequential double-lung transplantation were subjected to ECMO during the surgical procedure. Eleven patients were prepared were prepared for the procedure via transverse thoracostomy (clamshell) and cannulated through the ascending aorta and right atrium for ECMO. The first patient who underwent bilateral thoracotomy for bilateral sequential lung transplantation required emergency ECMO via the femoral artery and vein during the second lung implantation. The Medtronic centrifugal pump and ECMO package (CB1V97R1, Medtronic, Inc., USA) were used for all of the patients.Results During ECMO,the blood flow rate was set between 1.88-2.0 L·m~(-2)·min~(-1) to keep hemodynamic and oxyhgen saturation stable; colloid oncotic pressure was maintained at more than 18 mmHg with albumin and hematocrit (HCT) kept at 28% or more. Two patients died early in this series and the other 10 patients were weaned from ECMO successfully. The duration of ECMO was 1.38-67.00 hours, and postoperative intubation was 10.5-67.0 hours.Conclusions As an established

  5. EXPERIENCE TUTORIALS IN THE GRADUATE FROM THE CENTER OF UPDATE OF THE MAGISTERIUM IN THE STATE OF DURANGO

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    Diana María Espinosa Sánchez

    2013-09-01

    Full Text Available Following the experiences we have had in the Teacher Upgrading Center in tutorials graduate programs in the State of Durango we could detect the strengths and weaknesses, enabling us to make the diagnosis in order to reduce them and develop strengths. The biggest problem that humanity is to educate its members and society as it enters the twenty-first century requires changes and improvements to the educational systems, it is clear the need of teaching and learning for the continued existence of society, higher education institutions should strive to achieve development in man and woman, tutoring in higher education, is a complementary action to develop ethical behavior, intellectual skills and teaching skills. The study is predominantly qualitative and case study method.

  6. Gamma Emission Spectra from Neutron Resonances in 234,236,238U Measured Using the Dance Detector at Lansce

    Science.gov (United States)

    Ullmann, J. L.; Bredeweg, T. A.; Couture, A. J.; Haight, R. C.; Jandel, M.; Kawano, T.; Keksis, A. L.; O'Donnell, J. M.; Rundberg, R. S.; Vieira, D. J.; Wouters, J. M.; Wilhelmy, J. B.; Wu, C. Y.; Becker, J. A.; Chyzh, A.; Baramsai, B.; Mitchell, G. E.; Krticka, M.

    2013-03-01

    An accurate knowledge of the radiative strength function and level density is needed to calculate of neutron-capture cross sections. An additional constraint on these quantities is provided by measurements of γ-ray emission spectra following capture. We present γ-emission spectra from several neutron resonances in 234,236,238U, measured using the DANCE detector at LANSCE. The measurements are compared to preliminary calculations of the cascade. It is observed that the generalized Lorentzian form of the E1 strength function cannot reproduce the shape of the emission spectra, but a better description is made by adding low-lying M1 Lorentzian strength.

  7. Option study of an orthogonal X-ray radiography axis for pRad at LANSCE area C, Los Alamos.

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, Bryan Velten; Johnson, David L.; Leckbee, Joshua J.; Jones, Peter (Ktech Corp., Albuquerque, NM)

    2010-10-01

    We report on an option study of two potential x-ray systems for orthogonal radiography at Area C in the LANSCE facility at Los Alamos National Laboratory. The systems assessed are expected to be near equivalent systems to the presently existing Cygnus capability at the Nevada Test Site. Nominal dose and radiographic resolution of 4 rad (measured at one meter) and 1 mm spot are desired. Both a system study and qualitative design are presented as well as estimated cost and schedule. Each x-ray system analyzed is designed to drive a rod-pinch electron beam diode capable of producing the nominal dose and spot.

  8. Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Quigley DD

    2015-07-01

    Full Text Available Denise D Quigley,1 Peter J Mendel,1 Zachary S Predmore,2 Alex Y Chen,3 Ron D Hays41RAND Corporation, Santa Monica, CA, 2RAND Corporation, Boston, MA, 3AltaMed Health Services Corporation, 4Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USAObjective: To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS® Clinician and Group (CG-CAHPS data in transitioning toward a patient-centered medical home (PCMH.Study design: Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.Participants: Thirty-eight interviews were conducted with lead physicians (n=13, site clinic administrators (n=13, nurse supervisors (n=10, and executive leadership (n=2.Results: Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS® was used: 1 for quality improvement (QI and focusing changes for PCMH transformation; 2 to maintain focus on patient experience; 3 alongside other data; 4 for monitoring site-level trends and changes; 5 to identify, analyze, and monitor areas for improvement; 6 for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7 for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.Conclusion: Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the

  9. Distance to the Center of the Milky Way Galaxy: An Experiment for Intermediate-Level Students Using Research Data and Professional Analysis Tools

    Science.gov (United States)

    Fitzgerald, M. T.; Feteris, S. M.; Gillessen, S.; Eisenhauer, F.

    2008-01-01

    The most recent data on stars orbiting Sagittarius A*, the black hole at the center of the Milky Way galaxy, have been used in an experiment undertaken by second-year university students to determine the distance R[theta] to the center of the galaxy. Students applied each of Kepler's 17th-century laws, in turn, to 21st-century data. The…

  10. Review of the High Performance Antiproton Trap (HiPAT) Experiment at the Marshall Space Flight Center

    Science.gov (United States)

    Pearson, J. B.; Sims, Herb; Martin, James; Chakrabarti, Suman; Lewis, Raymond; Fant, Wallace

    2003-01-01

    The significant energy density of matter-antimatter annihilation is attractive to the designers of future space propulsion systems, with the potential to offer a highly compact source of power. Many propulsion concepts exist that could take advantage of matter-antimatter reactions, and current antiproton production rates are sufficient to support basic proof-of-principle evaluation of technology associated with antimatter- derived propulsion. One enabling technology for such experiments is portable storage of low energy antiprotons, allowing antiprotons to be trapped, stored, and transported for use at an experimental facility. To address this need, the Marshall Space Flight Center's Propulsion Research Center is developing a storage system referred to as the High Performance Antiproton Trap (HiPAT) with a design goal of containing 10(exp 12) particles for up to 18 days. The HiPAT makes use of an electromagnetic system (Penning- Malmberg design) consisting of a 4 Telsa superconductor, high voltage electrode structure, radio frequency (RF) network, and ultra high vacuum system. To evaluate the system normal matter sources (both electron guns and ion sources) are used to generate charged particles. The electron beams ionize gas within the trapping region producing ions in situ, whereas the ion sources produce the particles external to the trapping region and required dynamic capture. A wide range of experiments has been performed examining factors such as ion storage lifetimes, effect of RF energy on storage lifetime, and ability to routinely perform dynamic ion capture. Current efforts have been focused on improving the FW rotating wall system to permit longer storage times and non-destructive diagnostics of stored ions. Typical particle detection is performed by extracting trapped ions from HiPAT and destructively colliding them with a micro-channel plate detector (providing number and energy information). This improved RF system has been used to detect various

  11. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience

    Directory of Open Access Journals (Sweden)

    Linda Thomas-Hemak

    2015-02-01

    Full Text Available Purpose. The effect of patient centered medical home (PCMH curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24 Internal Medicine residents—12 Traditional (TR track residents and 12 Teaching Health Center (THC track residents—began training in Academic Year (AY 2011 at the Wright Center for Graduate Medical Education (WCGME. They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents.

  12. Being a family physician: Experience of general physicians working in rural and urban healthcare centers in Iran

    Directory of Open Access Journals (Sweden)

    Setareh Abdoli

    2014-01-01

    Full Text Available Background: The family physician program in the form of a referral system is one the best administrative strategies, especially in rural and low populated regions (under 20,000 people of Iran in 2006. Objectives: This study was conducted with the aim of general physician′s experience as practicing in family physician program. Materials and Methods: This study was a qualitative study using conventional content analysis. The data were gathered by in-depth interview with 12 family physicians working in rural and low populated urban health and treatment center in a province located in west of Iran in 2011. Findings: The findings highlighted that five main themes and 12 subthemes reflected the general physician′s experience as family physicians. They were: The physician′s lost identity (physician: Belittled and physician: Shattered in the system, the physician left in the system (physician: Extorted and lacking supportive environment, passive and thoughtless practice (learning, a faded element, and scientific practice on the verge of demise, the unstable foundation of the program (insufficient groundwork, lack of comprehensiveness, and the change in the program′s nature during practice, and sparks of success (satisfaction with need-based practice, proper distribution of general physicians within the country, and effective management of chronic diseases. Interpretation and Conclusions: The findings indicated serious challenges in family physician program. Ignoring these problems may lead to medical and financial resources wasting. So a permanent progressing program needs solving defects of the valuable program in Iran to improve healthcare in rural and low-populated regions.

  13. Technical and clinical success of infrarenal endovascular abdominal aortic aneurysm repair: A 10-year single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Steingruber, I.E. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)]. E-mail: iris.steingruber@uibk.ac.at; Neuhauser, B. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Seiler, R. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Greiner, A. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Chemelli, A. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Kopf, H. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Walch, C. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Waldenberger, P. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Jaschke, W. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Czermak, B. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)

    2006-09-15

    Objective: The aim of our retrospective study was to review our single-center experience with aortic abdominal aneurysm (AAA) repair retrospectively. Material and methods: From 1995 to 2005, 70 consecutive patients affected by AAA were treated by endovascular stent-graft repair. Mean follow-up was 23.9 months. Follow-up investigations were performed at 6 and 12 months and yearly thereafter. Five different stent-graft designs were compared to each other. Primary technical success (PTS), assisted primary technical success (APTS), primary clinical success (PCS) and secondary clinical success (SCS) were evaluated. Results: All over PTS was achieved in 94.3%, APTS in 97.1%, PCS in 61.4%, APCS in 64.3% and SCS in 70%. There were 3 type I endoleaks, 25 type II endoleaks, 4 type III endoleaks, 8 limb problems, 5 conversions to open surgery, 10 aneurysm sac expansions and 14 device migrations. Patients with newer generation devices showed better results than patients with first generation prosthesis. In addition results were better for grafts with suprarenal fixation (versus infrarenal fixation) and grafts with barbs and hooks (versus grafts without barbs and hooks). Patients with bad anatomic preconditions showed a higher complication rate. Conclusion: Contrary to first generation products, new stent-graft designs show acceptable technical and clinical results in endovascular AAA aneurysm repair. However, this therapy still should be reserved only for patients with significant comorbities and suitable anatomic conditions.

  14. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2011-01-01

    Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

  15. Setting Up an Efficient Therapeutic Hypothermia Team in Conscious ST Elevation Myocardial Infarction Patients: A UK Heart Attack Center Experience.

    Science.gov (United States)

    Islam, Shahed; Hampton-Till, James; MohdNazri, Shah; Watson, Noel; Gudde, Ellie; Gudde, Tom; Kelly, Paul A; Tang, Kare H; Davies, John R; Keeble, Thomas R

    2015-12-01

    Patients presenting with ST elevation myocardial infarction (STEMI) are routinely treated with percutaneous coronary intervention to restore blood flow in the occluded artery to reduce infarct size (IS). However, there is evidence to suggest that the restoration of blood flow can cause further damage to the myocardium through reperfusion injury (RI). Recent research in this area has focused on minimizing damage to the myocardium caused by RI. Therapeutic hypothermia (TH) has been shown to be beneficial in animal models of coronary artery occlusion in reducing IS caused by RI if instituted early in an ischemic myocardium. Data in humans are less convincing to date, although exploratory analyses suggest that there is significant clinical benefit in reducing IS if TH can be administered at the earliest recognition of ischemia in anterior myocardial infarction. The Essex Cardiothoracic Centre is the first UK center to have participated in administering TH in conscious patients presenting with STEMI as part of the COOL-AMI case series study. In this article, we outline our experience of efficiently integrating conscious TH into our primary percutaneous intervention program to achieve 18 minutes of cooling duration before reperfusion, with no significant increase in door-to-balloon times, in the setting of the clinical trial.

  16. CMS Software Distribution and Installation Systems:Concepts,Practical Solutions and Experience at Fermilab as a CMS Tier 1 Center

    Institute of Scientific and Technical Information of China (English)

    NataliaM.Ratnikova; GregoryE.Graham

    2001-01-01

    The CMS Collaboration of 2000 scientists involves 150 institutions from 31 nations spread all over the world.CMS software system integration and release management is performed at CERN.Code management is based on CVS,with read or write access to the repository via a CVS server,Software configuration,release management tools(SCRAM) are being developed at CERN.Software releases are then distributed to regional centers,where the software is used by a local community for a wide variety of tasks,such as software development detector simulation and reconstruction and physics analysis.Depending on specific application,the system environment and local hardware requirements,different approaches and tools are used for the CMS software installation at different places.This presentation describes concepts and reactial solutions for a variety of ways of software distribution,with an emphasis on the CMS experience at Fermilab,Installation and usage of different models used for the production farm,for code development and for physics analysis are described.

  17. Endovascular treatment of central venous obstruction as a complication of prolonged hemodialysis – Preliminary experience in a tertiary care center

    Science.gov (United States)

    Yadav, Mukesh K; Sharma, Madhurima; Lal, Anupam; Gupta, Vivek; Sharma, Ashish; Khandelwal, Niranjan

    2015-01-01

    Background: Central venous disease is a serious complication in patients undergoing hemodialysis, often presenting with symptoms of venous hypertension. Treatment is aimed to provide symptomatic relief and to maintain hemodialysis access site patency. Aim: To describe our initial experience in the endovascular treatment of central venous stenosis or obstruction in patients undergoing hemodialysis. Settings and Design: This was a retrospective study carried out in a tertiary care center. Study duration was 24 months. Follow-up was variable. Materials and Methods: Eleven patients of chronic renal failure undergoing hemodialysis presented with central vein stenosis or obstruction having ipsilateral vascular access, between July 2012 and July 2014. All the patients underwent endovascular treatment and were analyzed retrospectively. Results and Conclusion: A total of 11 patients (4 male and 7 female) underwent 18 interventions for 13 stenotic segments during a time period of 2 years. Eight stenotic segments were in brachiocephalic vein, three in subclavian vein, and two in axillary veins. The technical success rate for endovascular treatment was 81.8%. Two patients underwent percutaneous transluminal angioplasty (PTA) alone and presented with restenosis later. Balloon angioplasty followed by stenting was done in seven patients, two of which required reintervention during follow-up. We found endovascular treatment safe and effective in treating central venous disease. PMID:26752817

  18. Recent Experiences of the NASA Engineering and Safety Center (NESC) GN and C Technical Discipline Team (TDT)

    Science.gov (United States)

    Dennehy, Cornelius J.

    2010-01-01

    The NASA Engineering and Safety Center (NESC), initially formed in 2003, is an independently funded NASA Program whose dedicated team of technical experts provides objective engineering and safety assessments of critical, high risk projects. The GN&C Technical Discipline Team (TDT) is one of fifteen such discipline-focused teams within the NESC organization. The TDT membership is composed of GN&C specialists from across NASA and its partner organizations in other government agencies, industry, national laboratories, and universities. This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA projects. This paper will then describe selected recent experiences, over the period 2007 to present, of the GN&C TDT in which they directly performed or supported a wide variety of NESC assessments and consultations.

  19. Therapeutic rigid bronchoscopy at a tertiary care center in North India: Initial experience and systematic review of Indian literature

    Directory of Open Access Journals (Sweden)

    Karan Madan

    2014-01-01

    Full Text Available Background and Aim: Rigid bronchoscopy is often an indispensable procedure in the therapeutic management of a wide variety of tracheobronchial disorders. However, it is performed at only a few centers in adult patients in India. Herein, we report our initial 1-year experience with this procedure. Materials and Methods: A prospective observational study on the indications, outcomes, and safety of various rigid bronchoscopy procedures performed between November 2009 and October 2010. Improvement in dyspnea, cough, and the overall quality of life was recorded on a visual analog scale from 0 to 100 mm. A systematic review of PubMed was performed to identify studies reporting the use of rigid bronchoscopy from India. Results: Thirty-eight rigid bronchoscopies (50 procedures were performed in 19 patients during the study period. The commonest indication was benign tracheal stenosis followed by central airway tumor, and the procedures performed were rigid bronchoplasty, tumor debulking, and stent placement. The median procedure duration was 45 (range, 30-65 min. There was significant improvement in quality of life associated with therapeutic rigid bronchoscopy. Minor procedural complications were encountered in 18 bronchoscopies, and there was no procedural mortality. The systematic review identified 15 studies, all on the role of rigid bronchoscopy in foreign body removal. Conclusions: Rigid bronchoscopy is a safe and effective modality for treatment of a variety of tracheobronchial disorders. There is a dire need of rigid bronchoscopy training at teaching hospitals in India.

  20. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    Energy Technology Data Exchange (ETDEWEB)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)

    2007-11-15

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.

  1. Demystifying the Chemistry Literature: Building Information Literacy in First-Year Chemistry Students through Student-Centered Learning and Experiment Design

    Science.gov (United States)

    Bruehl, Margaret; Pan, Denise; Ferrer-Vinent, Ignacio J.

    2015-01-01

    This paper describes curriculum modules developed for first-year general chemistry laboratory courses that use scientific literature and creative experiment design to build information literacy in a student-centered learning environment. Two curriculum units are discussed: Exploring Scientific Literature and Design Your Own General Chemistry…

  2. The impact of center experience on results of reduced intensity:allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

    DEFF Research Database (Denmark)

    Giebel, S; Labopin, M; Mohty, M;

    2013-01-01

    Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related...

  3. Pedagogies, Perspectives, and Practices: Mobile Learning through the Experiences of Faculty Developers and Instructional Designers in Centers for Teaching and Learning

    Science.gov (United States)

    Hosler, Kim A.

    2013-01-01

    The purpose of this qualitative case study was to explore the experiences, perceptions, and pedagogy of nine self-identified faculty developers and instructional designers who work in centers for teaching and learning supporting faculty members requesting assistance with mobile learning. With the ever-increasing use of mobile devices across…

  4. Asian-American Students' Severity of Problems and Willingness To Seek Help from University Counseling Centers: Role of Previous Counseling Experience, Gender, and Ethnicity.

    Science.gov (United States)

    Solberg, V. Scott; And Others

    1994-01-01

    Examined concerns and help-seeking likelihood of Asian American college students (n=596). Results indicated that previous counseling experience was related to higher ratings for substance abuse concerns and willingness to seek help from university counseling center to address academic, interpersonal, and substance abuse concerns. Asian American…

  5. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D. [Emory University Hospital, Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David J. [University Hospitals Case Medical Center, Departments of Radiology and Biomedical Engineering, Cleveland, OH (United States)

    2014-11-15

    The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

  6. The impact of interventional nephrologists on the growth of a peritoneal dialysis program: Long-term, single-center experience.

    Science.gov (United States)

    Ros-Ruiz, Silvia; Alonso-Esteve, Ángela; Gutiérrez-Vílchez, Elena; Rudas-Bermúdez, Edisson; Hernández, Domingo

    2016-01-01

    Peritoneal dialysis (PD) is an underutilized form of renal replacement therapy. Although a variety of factors have been deemed responsible, timely insertion of a PD catheter may also be a contributory factor. Furthermore, a good catheter implantation technique is important to allow for effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with surgeons have been limited to small single-center experiences. Thus, the objective of this study was to explore the impact of the peritoneal dialysis (PD) catheter insertion by nephrologists compared to surgeons on early catheter complications and on technique survival. We also examine whether PD catheter insertion by nephrologists has a positive impact on the growth in the number of patients using PD. We performed 313 consecutive procedures: 192 catheter insertions and 121 catheter removal from January 1, 2006 to December 31, 2013. The main reasons for catheter removal were: renal transplantation, 52 (43%) follow of transfer to HD, 48 (40%) and catheter malfunction, 16 (13%). The patients were mostly male (63.4%) with the mean age of 50.8±15.1 years and 23.8 were diabetics. We only observed seven (2.5%) early complications (<4 weeks) associated to peritoneal catheter surgery (3 peritonitis episodes, 2 hemoperitoneum episodes, one complicated hernia and one omental entrapment). There were not significant differences in surgery-related complications in both periods. The penetration ratio of PD after 2006 was 117% higher compared with procedures performing before this date. In conclusions, we have demonstrated a positive impact on the growth of the PD population when catheter insertion is performed by nephrologists with a minimal incidence of complications associated.

  7. Epstein–Barr Virus in Gastro-Esophageal Adenocarcinomas – Single Center Experiences in the Context of Current Literature

    Science.gov (United States)

    Genitsch, Vera; Novotny, Alexander; Seiler, Christian A.; Kröll, Dino; Walch, Axel; Langer, Rupert

    2015-01-01

    Epstein–Barr virus (EBV)-associated gastric carcinomas (GC) represent a distinct and well-recognized subtype of gastric cancer with a prevalence of around 10% of all GC. In contrast, EBV has not been reported to play a major role in esophageal adenocarcinomas (EAC) and adenocarcinomas of the gastro-esophageal junction (GEJ). We report our experiences on EBV in collections of gastro-esophageal adenocarcinomas from two surgical centers and discuss the current state of research in this field. Tumor samples from 465 primary resected gastro-esophageal adenocarcinomas (118 EAC, 73 GEJ, and 274 GC) were investigated. Presence of EBV was determined by EBV-encoded small RNAs (EBER) in situ hybridization. Results were correlated with pathologic parameters (UICC pTNM category, Her2 status, tumor grading) and survival. EBER positivity was observed in 14 cases. None of the EAC were positive for EBER. In contrast, we observed EBER positivity in 2/73 adenocarcinomas of the GEJ (2.7%) and 12/274 GC (4.4%). These were of intestinal type (seven cases) or unclassifiable (six cases), while only one case was of diffuse type according to the Lauren classification. No association between EBV and pT, pN, or tumor grading was found, neither was there a correlation with clinical outcome. None of the EBER positive cases were Her2 positive. In conclusion, EBV does not seem to play a role in the carcinogenesis of EAC. Moreover, adenocarcinomas of the GEJ show lower rates of EBV positivity compared to GC. Our data only partially correlate with previous reports from the literature. This highlights the need for further research on this distinct entity. Recent reports, however, have identified specific epigenetic and genetic alterations in EBV-associated GC, which might lead to a distinct treatment approach for this specific subtype of GC in the future. PMID:25859432

  8. 'Damage control orthopaedics' in patients with delayed referral to a tertiary care center: experience from a place where Composite Trauma Centers do not exist

    Directory of Open Access Journals (Sweden)

    Tabish Amin

    2008-01-01

    Full Text Available Abstract Background Management of orthopaedic injuries in polytrauma cases continues to challenge the orthopaedic traumatologist. Mass disasters compound this challenge further due to delayed referral. Recently there has been increasing evidence showing that damage control surgery has advantages that are absent in the early total care modality. We studied the damage control modality in the management of polytrauma cases with orthopaedic injuries who had been referred to our hospital after more than 24 hours of sustaining their injuries in an earthquake. This study was conducted on 51 cases after reviewing their records and complete management one year after the trauma. Results At one year, out of the 62 fractures, 3 were still under treatment, while the others had united. As per the radiological and functional scoring there were 20 excellent, 29 good, 5 fair and 5 poor results. In spite of the delayed referral there was no mortality. Conclusion In situations of delayed referral in areas where composite trauma centers do not exist the damage control modality provides an acceptable method of treatment in the management of polytrauma cases.

  9. Nutmeg Poisonings: A Retrospective Review of 10 Years Experience from the Illinois Poison Center, 2001–2011

    OpenAIRE

    Ehrenpreis, Jamie E.; DesLauriers, Carol; Lank, Patrick; Armstrong, P. Keelan; Leikin, Jerrold B.

    2014-01-01

    Nutmeg is a commonly consumed spice. The toxic effects of nutmeg have been purported to be due mainly to myristicin oil. Prior poison center series of nutmeg exposures show very few unintentional exposures of nutmeg to children younger than 13. Case series from these centers did not record drug exposures combined with nutmeg. This study is a review of Illinois Poison Center (IPC) data regarding nutmeg exposures from January of 2001 to December 2011. The goal of this study was to compare the I...

  10. Evidence for the Heavy Baryon Resonance State Lambda b*0 Observed with the CDF II Detector, and Studies of New Particle Tracking Technologies Using the LANSCE Proton Beam

    Science.gov (United States)

    Palni, Prabhakar

    To discover and probe the properties of new particles, we need to collide highly energetic particles. The Tevatron at Fermilab has collided protons and anti-protons at very high energies. These collisions produce short lived and stable particles, some known and some previously unknown. The CDF detector is used to study the products of such collisions and discover new elementary particles. To study the interaction between high energy charged particles and the detector materials often requires development of new instruments. Thus this dissertation involves a measurement at a contemporary experiment and development of technologies for related future experiments that will build on the contemporary one. Using data from proton-antiproton collisions at sqrt(s) = 1.96TeV recorded by the CDF II detector at the Fermilab Tevatron, evidence for the excited resonance state Lambda_b. *0 is presented in its Lambda_b. 0 pi. + pi. - decay,followed by the Lambda_b. 0 -> Lambda_c. + pi. - and Lambda_c. + -> p K. - pi. +decays. The analysis is based on a data sample corresponding to an integrated luminosity of 9.6 fb. -1 collected by an online event selection process basedon charged particle tracks displaced from the proton-antiproton interaction point. The significance of the observed signal is 3.5sigma The mass of the observed state is found to be 5919.22 +/- 0.76 MeV/c 2 in agreement with similar findings in proton-proton collision experiments. To predict the radiation damage to the components of new particle tracking detectors, prototype devices are irradiated at test beam facilities that reproduce the radiation conditions expected. The profile of the test beam and the fluence applied per unit time must be known. We have developed a technique to monitor in real time the beam profile and fluence using an array of pin semiconductor diodes whose forward voltage is linear with fluence over the fluence regime relevant to, for example, silicon tracking detectors in the LHC upgrade era

  11. O doador marginal: experiência de um centro de transplante de fígado The marginal donor: a single-center experience in orthotopic liver transplantation

    Directory of Open Access Journals (Sweden)

    Olival Cirilo Lucena da Fonseca-Neto

    2008-03-01

    Full Text Available RACIONAL: Desde que o uso de enxertos marginais é solução aceita para escassez de órgãos para transplante, ele tornou-se muito comum em todo mundo e a literatura vem mostrando efetividade desses enxertos no transplante de fígado. OBJETIVO: Apresentar a experiência do Serviço de Transplante Hepático do Hospital Universitário Oswaldo Cruz, em transplante de fígado com o uso de doadores marginais. MÉTODOS: Estudo retrospectivo em 137 transplantes ortotópicos de fígado, usando enxertos marginais entre 1999 e 2006, com acompanhamento mínimo de 180 dias. Os receptores foram classificados de acordo com a função inicial do enxerto no pós-operatório como normal (FN e disfunção primária (DP. RESULTADOS: Não foi observada diferença estatisticamente significante entre os grupos FN e DP com os seguintes parâmetros dos doadores: idade, sódio sérico, tempo de protrombina, esteatose hepática, transaminases sérica, pressão sanguínea, drogas vasoativas, índice de massa corpórea, parada cardíaca antes da doação de órgão, doador em assistolia e tempo de isquemia quente. Análise da curva de sobrevida (Kaplan-Meier de pacientes e de enxertos de fígado de pacientes que receberam fígado de doadores ideais versus doadores marginais não mostrou diferença com significância estatística. CONCLUSÃO: Pode ser recomendado o uso de enxertos marginais para transplantes hepáticos, inclusive os provenientes de doadores com o coração parado.BACKGROUND: Since marginal grafts are a solution to deal with the shortage of organ donors, its use became more common worldwide, and the literature had shown its effectiveness in the liver transplantation (LT outcomes. AIM: To present a single center experience, at the Liver Transplantation Unit of Oswaldo Cruz University Hospital, with orthotopic LT using marginal organ donors. METHODS: Retrospectivety review of 137 orthotopic LT using marginal grafts between 1999 and 2006, with a minimum 180

  12. Multistatic SAR Imaging: First Results of a Four Phase Center Experiment with TerraSAR-X and TanDEM-X

    OpenAIRE

    Kraus, Thomas; Bräutigam, Benjamin; Bachmann, Markus; Krieger, Gerhard

    2016-01-01

    Multichannel synthetic aperture radar (SAR) imaging offers the possibility to overcome the pulse repetition frequency (PRF) constraints inherent to single-channel SAR systems. The multichannel approach enables the acquisition of wide swathes with high azimuth resolution. Using a constellation or swarm of small satellites, a cost efficient, faulttolerant system can be envisaged. This paper describes the first results of a multistatic four phase center experiment conducted with TerraSAR-X an...

  13. The role of dosimetry audits in radiotherapy quality assurance: The 8 year experience in Greek radiotherapy and brachytherapy centers

    International Nuclear Information System (INIS)

    Twenty six (26) radiotherapy (RT) centers (public and private) operate in Greece up to date (Apr. 2010), where 36 linacs and 8 Co-60 teletherapy units are being used, producing 64 photon beams (Co60, 6-23 MV) and 126 electron beams (4-21 MeV) in total. Furthermore, 7 HDR Ir192 and 2 MDR/LDR Cs137 remote afterloading brachytherapy systems operate. The Ionizing Radiation Calibration Laboratory (IRCL) of the Greek Atomic Energy Commission (GAEC) runs dosimetry audits in all Greek radiotherapy centers by means of on-site visits, in order to assess the dose accuracy, to identify and resolve problems on dosimetry, to provide intercomparisons to hospitals and disseminate the IAEA TRS 398 protocol. Additionally, the GAEC's IRCL calibrates the reference dosimetry equipment of all RT centers, in terms of absorbed dose in water at Co60 beam quality and air kerma strength at Ir192 qualities. The GAEC's dosimetry audit is a continuous process: The 1st round has been completed for the photons beams (2002 - 2006), electrons (2002 - 2008) and brachytherapy (2006-2009). The 2nd round is at the final stage for photons (2006-2010) and in progress for the rest, while a 3rd round for photons has already been initiated. The audit results for the photons 1st round have been published. This work presents the results of these audits and focuses on the improvements of RT centers' dosimetry during the successive audit rounds

  14. Higher Rates of Retinopathy of Prematurity after Increasing Oxygen Saturation Targets for Very Preterm Infants: Experience in a Single Center.

    Science.gov (United States)

    Manley, Brett J; Kuschel, Carl A; Elder, James E; Doyle, Lex W; Davis, Peter G

    2016-01-01

    Randomized trials of oxygen saturation target ranges for extremely preterm infants showed increased survival but increased retinopathy of prematurity with higher compared with lower target ranges. In our center, changing from a target range of 88%-92% to 91%-95% has been associated with increased rates and severity of retinopathy of prematurity. PMID:26548746

  15. The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study: a single-center experience

    OpenAIRE

    Falcone, Adam M.; Bose, Rahul; Stoler, Robert C; Kim, Michael; Laible, Emily; Kang, Lucy; Waters, Kim; Dunkerley, Janet; Choi, James W.

    2011-01-01

    The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study is a multicenter randomized prospective controlled trial evaluating the safety of and patient satisfaction with same-day discharge following ambulatory percutaneous intervention with a closure device. This article reviews the findings from a single center, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, from October 2008 through April 2010, with 23 patients in the same-day discharge group and 21 patients in th...

  16. Clinicopathological correlates of primary central nervous system lymphoma: Experience from a tertiary care center in South India

    Directory of Open Access Journals (Sweden)

    Bimal Patel

    2015-01-01

    Full Text Available Background: Primary central nervous system lymphomas (PCNSL constitute a rare group of extranodal non-Hodgkin′s lymphomas (NHLs. Aim: To study the clinical and immunophenotypic profile of patients with a PCNSL who presented between the years 2000 and 2013 in a tertiary care center in South India. Materials and Methods: This was a retrospective study. Demographic and clinical data were obtained from the clinical case records. Inclusion criteria: Cases of PCNSL involving brain. Exclusion criteria: Cases of PCNSL involving the spinal cord, meninges and orbit as well as intravascular large B-cell lymphoma, lymphomas with evidence of systemic disease or secondary lymphomas. Archived slides and tissue blocks were retrieved. All cases had hematoxylin and eosin stained sections and immunohistochemistry for CD20, CD3, and MIB-1. Additional immunohistochemistry was performed for CD10, BCL6, and MUM1 on paraffin blocks with sufficient tissue. Results: There were a total of 73 cases with the mean age of presentation being 45.9 years (range 8-71 years and with a male predominance (male: female (M:F = 2.3:1. Headache was the commonest presenting complaint. The mean duration of symptoms was 10.6 weeks. All patients were immunocompetent. Most tumors were supratentorial in location. Out of 73 cases, 70 presented with a diffuse large B-cell lymphoma (DLBCL, two with a Burkitt′s lymphoma, and one with a lymphomatoid granulomatosis. Only 51 of the DLBCL cases had sufficient tissue for additional studies. Non-germinal center was the most common phenotype seen in 65.7% (33/51 of cases. Germinal center B-cell (GCB phenotype was seen in 18/51 cases (34.3%. Conclusion: DLBCL constituted the majority of PCNSLs and although non-germinal center was the predominant phenotype, more than a third of the cases were of the GCB phenotype. As the germinal center phenotype is known to have a better prognosis, further studies to explore its relevance in the Asian population are

  17. Nutmeg poisonings: a retrospective review of 10 years experience from the Illinois Poison Center, 2001-2011.

    Science.gov (United States)

    Ehrenpreis, Jamie E; DesLauriers, Carol; Lank, Patrick; Armstrong, P Keelan; Leikin, Jerrold B

    2014-06-01

    Nutmeg is a commonly consumed spice. The toxic effects of nutmeg have been purported to be due mainly to myristicin oil. Prior poison center series of nutmeg exposures show very few unintentional exposures of nutmeg to children younger than 13. Case series from these centers did not record drug exposures combined with nutmeg. This study is a review of Illinois Poison Center (IPC) data regarding nutmeg exposures from January of 2001 to December 2011. The goal of this study was to compare the Illinois data to the literature as well as look for current trends in nutmeg poisonings. The data were extracted using the code for hallucinogenic plants in the IPC database, and poisonings unrelated to nutmeg exposure were eliminated. Medical outcomes were noted as recorded. Thirty-two cases of nutmeg ingestion were reported. Of the 17 (53.1 %) unintentional exposures, 10 subjects (58.8 %) were under the age of 13. Four of the exposures in children under the age of 13 were ocular exposures. Fifteen exposures (46.9 %) were intentional exposures. Of these intentional exposures, five (33.3 %) were recorded to have combined drug intoxication. All of these were between the ages of 15 and 20. One patient with polypharmaceutical exposure required ventilatory support in the hospital. Our study shows an unexpected percentage of unintentional exposures in juveniles under the age of 13, out of the total exposures to nutmeg. Mixing of nutmeg with other drugs was seen and required more intervention in adolescents. More education about these two factors, i.e., nutmeg exposures as intentional polypharmacy in adolescents and unintentional exposures in young children, is advised. PMID:24452991

  18. Role of water quality assessments in hospital infection control: Experience from a new oncology center in eastern India

    Directory of Open Access Journals (Sweden)

    Ramkrishna Bhalchandra

    2014-01-01

    Full Text Available Water quality assessment and timely intervention are essential for health. Microbiology, total dissolved solids (TDS and free residual chlorine were measured for water quality maintenance in an oncology center in India. Impact of these interventions over a period of 22 months has been demonstrated with four cardinal events. Pseudomonas in hospital water was controlled by adequate chlorination, whereas high TDS in the central sterile supply department water was corrected by the installation of electro-deionization plant. Contaminated bottled water was replaced using quality controlled hospital supply. Timely detection and correction of water-related issues, including reverse osmosis plant was possible through multi-faceted approach to water quality.

  19. The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans

    OpenAIRE

    Bailey, Martha J.; Andrew Goodman-Bacon

    2015-01-01

    This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest tha...

  20. Implementing health information technology in a patient-centered manner: patient experiences with an online evidence-based lifestyle intervention.

    Science.gov (United States)

    Lyden, Jennifer R; Zickmund, Susan L; Bhargava, Tina D; Bryce, Cindy L; Conroy, Molly B; Fischer, Gary S; Hess, Rachel; Simkin-Silverman, Laurey R; McTigue, Kathleen M

    2013-01-01

    The patient-centered care (PCC) model and the use of health information technology (HIT) are major initiatives for improving U.S. healthcare quality and delivery. A lack of published data on patient perceptions of Internet-based care makes patient-centered implementation of HIT challenging. To help ascertain patients' perceptions of an online intervention, patients completing a 1-year web-based lifestyle intervention were asked to complete a semistructured interview. We used qualitative methodology to determine frequency and types of interview responses. Overall satisfaction with program features was coded on a Likert-type scale. High levels of satisfaction were seen with the online lifestyle coaching (80%), self-monitoring tools (57%), and structured lesson features (54%). Moderated chat sessions and online resources were rarely used. Frequently identified helpful aspects were those that allowed for customized care and shared decision-making consistent with the tenets of PCC. Unhelpful program aspects were reported less often. Findings suggest that despite challenges for communicating effectively in an online forum, the personalized support, high-tech data management capabilities, and easily followed evidence-based curricula afforded by HIT may be a means of providing PCC and improving healthcare delivery and quality. PMID:24004039

  1. Farm machinery injuries: the 15-year experience at an urban joint trauma center system in a rural state.

    Science.gov (United States)

    Jawa, Randeep S; Young, David H; Stothert, Joseph C; Yetter, Diane; Dumond, Robbie; Shostrom, Valerie K; Cemaj, Samuel; Rautiainen, Risto H; Mercer, David W

    2013-01-01

    Farm machinery is a major source of injury. The objective of this study is to characterize the incidence, injury characteristics, and outcomes of patients admitted with farm machinery injuries (FMIs) to an urban joint trauma system in a rural state. A retrospective 15-year review of the trauma registries of the two trauma centers that function as a single state-designated Level I joint trauma center system was conducted. There were 65 admissions for FMIs at hospital A and 41 at hospital B; this represents under 0.4% of total trauma admissions. The patients ranged in age from 2 to 87 years. At hospital A, 89% of admitted patients sustained extremity injuries, 16% sustained torso trauma, 92% required surgical intervention, and the mortality rate was 0%. At hospital B, 60% of admitted patients sustained extremity injuries, 36.6% of patients sustained torso trauma, 63% required surgical intervention, and the mortality rate was 14.6%. Tractor-related injuries were responsible for 17% of admissions at hospital A and 69% at hospital B. Of the six fatalities, five were tractor related. The data demonstrate that FMIs affect people in nearly all decades of life. FMIs at the two hospitals had differing injury characteristics and outcomes, in large part secondary to the differing frequency of tractor-related injuries. FMIs frequently required surgical intervention.

  2. Intermediate photovoltaic system application experiment operational performance report. Volume 5 for Lovington Square Shopping Center, Lovington, NM

    Energy Technology Data Exchange (ETDEWEB)

    1981-12-01

    For the months of September and October, 1981, operational performance data are presented for a photovoltaic power system at a New Mexico shopping center. The electrical energy yield, incident solar energy, and efficiency of the solar cell array are given, including daily and monthly energy yield and insolation and efficiency, and energy yield as a function of power level, voltage, cell temperature, and hour of the day. Data are presented for two power conditioning units, including power conditioner input, output, and efficiency. The total photovoltaic system efficiency and capacity factor are given as well as daily availability data. Meteorological data include monthly insolation data, heating and cooling degree days, average monthly ambient temperature, monthly average wind speed and distribution of wind directions. Also included are plots of cell temperature, ambient temperature, wind speed, and insolation versus the hour of the day. Also included is a brief narrative description of the system operation and data. (LEW)

  3. Total-skin electron irradiation for cutaneous T-cell lymphoma: The Northern Israel Oncology Center experience

    Energy Technology Data Exchange (ETDEWEB)

    Kuten, A.; Stein, M.; Mandelzweig, Y.; Tatcher, M.; Yaacov, G.; Epelbaum, R.; Rosenblatt, E. (Northern Israel Oncology Center, Haifa (Israel). Radiotherapy Unit)

    1991-07-01

    Total skin electron irradiation (TSEI) is effective and frequently used in the treatment of cutaneous T-cell lymphoma. A treatment technique has been developed at our center, using the Philips SL 75/10 linear accelerator. In our method, the patient is irradiated in a recumbent position by five pairs of uncollimated electron beams at a source to skin distance of 150 cm. This method provides a practical solution to clinical requirements with respect to uniformity of electron dose and low X-ray contamination. Its implementation does not require special equipment or modification of the linear accelerator. 19 of 23 patients (83%) with mycosis fungoides, treated by this method, achieved complete regression of their cutaneous lesions. (orig.).

  4. Improving Quality of Life and Career Attitudes of Youth with Disabilities: Experiences from the Adolescent Employment Readiness Center

    Science.gov (United States)

    Wolf-Branigin, Michael; Schuyler, Vincent; White, Patience

    2007-01-01

    Improving quality of life is the primary focus as adolescents with disabilities enter adulthood. They increasingly, however, encounter difficulties transitioning into domains such as employment as these services occur near the end of their high school experience. Using an ecosystems model within a developmental approach, the program sought to…

  5. Training Consumer Educators: A Curriculum and Program Handbook. A Report on the Experience of the Consumer Law Training Center.

    Science.gov (United States)

    New York Law School, NY. Consumer Law Training Center.

    Information is presented on the administration of consumer education programs to train teachers and community group leaders who will be teaching consumer education in their own communities. Suggestions and examples are based on experience in creating and teaching such a program in consumer law in New York City. The first three chapters give…

  6. Lessons Learned from Delayed Versus Immediate Microsurgical Reconstruction of Complex Maxillectomy and Midfacial Defects: Experience in a Tertiary Center in Mexico.

    Science.gov (United States)

    Santamaria, Eric; de la Concha, Erika

    2016-10-01

    Microsurgical reconstruction of complex midfacial and maxillectomy defects is among the most challenging procedures in plastic surgery, and it often requires composite flaps to improve functional and aesthetic results. Various factors have been identified as having influence in the outcome of microsurgical reconstruction. In this article, the authors present their experience with immediate and delayed reconstruction of complex maxillectomy defects in a tertiary center in Mexico. The authors present a total of 37 patients with microsurgical reconstruction of a complex maxillectomy defect; 13 patients had immediate and 24 had delayed reconstructions. The authors recommend doing immediate reconstruction when feasible. PMID:27601395

  7. New data acquisition system for the lujan center

    International Nuclear Information System (INIS)

    To meet the data acquisition requirements for six new neutron scattering instruments at the Los Alamos Science Center (LANSCE), we are building systems using Web tools, commercial hardware and software, software developed by the controls community, and custom hardware developed by the neutron scattering community. To service these new instruments as well as seven existing instruments, our data acquisition system needs common software and hardware core capabilities and the means to flexibly integrate them while differentiating the needs of the diverse instrument suite. Neutron events are captured and processed in VXI modules while controls for sample environment and beam line setup are processed with PCs. Typically users access the system through web browsers. (author)

  8. The Impact of Labour Epidural Analgesia on the Childbirth Expectation and Experience at a Tertiary Care Center in Southern India.

    OpenAIRE

    Bhatt, Hitanshu; Pandya, Sunil; Kolar, Geeta; Nirmalan, Praveen Kumar

    2014-01-01

    Background: Labour epidural analgesia is increasingly used as a means of pain relief for women during labour and delivery. The significant pain during labour and delivery can be terrifying for mothers-to-be and the prospect of relief from pain can help reduce fear of childbirth to an extent. However, it is not necessary that reduced fear of childbirth may lead to an increased satisfaction with the childbirth experience.

  9. Being a family physician: Experience of general physicians working in rural and urban healthcare centers in Iran

    OpenAIRE

    Setareh Abdoli; Samereh Abdoli

    2014-01-01

    Background: The family physician program in the form of a referral system is one the best administrative strategies, especially in rural and low populated regions (under 20,000 people) of Iran in 2006. Objectives: This study was conducted with the aim of general physician′s experience as practicing in family physician program. Materials and Methods: This study was a qualitative study using conventional content analysis. The data were gathered by in-depth interview with 12 family physicians wo...

  10. Outcomes of acute upper gastrointestinal bleeding in relation to timing of endoscopy and the experience of endoscopist: a tertiary center experience

    Science.gov (United States)

    Mohammed, Noor; Rehman, Amer; Swinscoe, Mark Thomas; Mundre, Pradeep; Rembacken, Bjorn

    2016-01-01

    Introduction: Patients with gastrointestinal bleeding admitted out of hours or at the weekends may have an excess mortality rate. The literature reports around this are conflicting. Aims and methods: We aimed to analyze the outcomes of emergency endoscopies performed out of hours and over the weekends in our center. We retrospectively analyzed data from April 2008 to June 2012. Results: A total of 507 ‘high risk’ emergency gastroscopies were carried out over the study period for various indications. Patients who died within 30 days of the index procedure [22 % (114 /510)] had a significantly higher Rockall score (7.6 vs. 6.0, P < 0.0001), a higher American Society of Anesthesiologists (ASA) status (3.5 vs. 2.7, P < 0.001), and a lower systolic blood pressure (BP) at the time of the examination (94.8 vs 103, P = 0.025). These patients were significantly older (77.7 vs. 67.5 years, P = 0.006), and required more blood transfusion (5.9 versus 3.8 units). Emergency out-of-hours endoscopy was not associated with an increased risk of death [relative risk (RR) 1.09, 95 % confidence interval (CI) 1.12 – 1.95]. Whether the examination was carried out by a senior specialist registrar (senior trainee) or a consultant made no difference to the survival of the patient (RR 0.98, CI 0.77 – 1.32). Conclusion: Higher pre-endoscopy Rockall score and ASA status contributed significantly to the 30-day mortality following upper gastrointestinal bleeding, whereas lower BP tended towards significance. Outcomes did not vary with the time of the endoscopy nor was there any difference between a consultant and a senior specialist registrar led service. PMID:27004244

  11. Liquid Metal Processing and Casting Experiences at the U.S. Department of Energy's Albany Research Center

    Energy Technology Data Exchange (ETDEWEB)

    Jablonski, Paul D.; Turner, Paul C.

    2005-09-01

    In this paper we will discuss some of the early pioneering work as well as some of our more recent research. The Albany Research Center (ARC) has been involved with the melting and processing of metals since it was established in 1942. In the early days, hardly anything was known about melting refractory or reactive metals and as such, virtually everything had to be developed in-house. Besides the more common induction heated air-melt furnaces, ARC has built and/or utilized a wide variety of furnaces including vacuum arc remelt ingot and casting furnaces, cold wall induction furnaces, electric arc furnaces, cupola furnaces and reverberatory furnaces. The melt size of these furnaces range from several grams to a ton or more. We have used these furnaces to formulate custom alloys for wrought applications as well as for such casting techniques as spin casting, investment casting and lost foam casting among many. Two early spin-off industrializations were Wah Chang (wrought zirconium alloys for military and commercial nuclear applications) and Oremet (both wrought and cast Ti). Both of these companies are now part of the ATI Allegheny Ludlum Corporation.

  12. Donor safety in adult living donor liver transplantation using the right lobe:Single center experience in China

    Institute of Scientific and Technical Information of China (English)

    Fu-Gui Li; Lu-Nan Yan; Yong Zeng; Jia-Yin Yang; Qi-Yuan Lin; Xiao-Zhong Jiang; Bin Liu

    2007-01-01

    AIM: To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China.METHODS: We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2±7.4years. Residual liver volume was 42.1%±4.7%. Mean operative time was 420±76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4±8.6 d; and mean follow-up period, 6 mo.RESULTS: There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2,and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required reoperation. Return to pre-donation activity occurred within 5-8 wk.CONCLUSION: Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.

  13. Carrier Screening for β Thalassemia in Pregnant Indian Women: Experience at a Single Center in Madhya Pradesh.

    Science.gov (United States)

    Baxi, Asha; Manila, Kaushal; Kadhi, Pooja; Heena, Baxi

    2013-06-01

    To study the prevalence of β thalassemia trait in pregnancy in urban population screening for β thalassemia in pregnant women at a single center in Indore (MP) has been conducted for a period of 2 year. Blood samples were tested for complete blood count and hemoglobin electrophoresis. During the 2 year period a total of 1,006 women were screened; 28 women who carried abnormal pattern were detected. The mean gestational age for screening was 13 ± 4 weeks. The prevalence of carriers was 2.78 %. As much as 99 % of pregnant women undergoing screening were willing for prenatal diagnosis if required. The economic burden to the society for treating thalassemic patients is huge. The institution of prevention programs like carrier screening has proven costeffective in populations with a high frequency of carriers. Screening of pregnant women early in pregnancy followed by prenatal diagnosis is acceptable and effective strategy for control of thalassemia in developing countries like India. PMID:24426339

  14. Achievement of Therapeutic Goals with Low-Dose Imiglucerase in Gaucher Disease: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Irina Tukan

    2013-01-01

    Full Text Available Gaucher disease, a lysosomal storage disorder, is a multisystem disorder with variable and unpredictable onset and severity. Disease-specific enzyme replacement therapy (ERT has been shown to reverse or ameliorate disease-specific hepatosplenomegaly and anemia and thrombocytopenia. ERT also impacts bone manifestations, including bone crises, bone pain, and appearance of new osteonecrosis, and improves bone mineral density to varying degrees. The objective of this study was to assess achievement of predefined therapeutic goals based on international registry outcomes for Israeli patients with Gaucher disease receiving imiglucerase for four consecutive years on a low-dose regimen followed in a single center. All data were taken from patient files. The therapeutic goals were taken from standards published in the literature for disease-specific clinical parameters. Among 164 patients at baseline, values for spleen and liver volumes, hemoglobin and platelet counts, and Z-scores for lumbar spine and femoral were significantly different from the goal. After four years ERT, there was a significant improvement ( in each of the therapeutic goal parameters from baseline. 15.2% of these patients achieved all hematology-visceral goals. In children, there was achievement of linear growth and puberty. This survey highlights the good overall response in symptomatic patients receiving low-dose ERT with imiglucerase in Israel.

  15. Insulation Failure of the Linox Defibrillator Lead: A Case Report and Retrospective Review of a Single Center Experience.

    Science.gov (United States)

    Howe, Andrew J; McKeag, Nicholas A; Wilson, Carol M; Ashfield, Kyle P; Roberts, Michael J

    2015-06-01

    Implantable cardioverter defibrillator (ICD) lead insulation failure and conductor externalization have been increasingly reported. The 7.8F silicon-insulated Linox SD and Linox S ICD leads (Biotronik, Berlin, Germany) were released in 2006 and 2007, respectively, with an estimated 85,000 implantations worldwide. A 39-year-old female suffered an out-of-hospital ventricular fibrillation (VF) arrest with successful resuscitation. An ICD was implanted utilizing a single coil active fixation Linox(Smart) S lead (Biotronik, Berlin, Germany). A device-triggered alert approximately 3 years after implantation confirmed nonphysiological high rate sensing leading to VF detection. A chest X-ray showed an abnormality of the ICD lead and fluoroscopic screening confirmed conductor externalization proximal to the defibrillator coil. In view of the combined electrical and fluoroscopic abnormalities, urgent lead extraction and replacement were performed. A review of Linox (Biotronik) and Vigila (Sorin Group, Milan, Italy) lead implantations within our center (n = 98) identified 3 additional patients presenting with premature lead failure, 2 associated with nonphysiological sensed events and one associated with a significant decrease in lead impedance. All leads were subsequently removed and replaced. This case provides a striking example of insulation failure affecting the Linox ICD lead and, we believe, is the first to demonstrate conductor externalization manifesting both electrical and fluoroscopic abnormalities. PMID:25711237

  16. Integration of an academic medical center and a community hospital: the Brigham and Women's/Faulkner hospital experience.

    Science.gov (United States)

    Sussman, Andrew J; Otten, Jeffrey R; Goldszer, Robert C; Hanson, Margaret; Trull, David J; Paulus, Kenneth; Brown, Monte; Dzau, Victor; Brennan, Troyen A

    2005-03-01

    Brigham and Women's Hospital (BWH), a major academic tertiary medical center, and Faulkner Hospital (Faulkner), a nearby community teaching hospital, both in the Boston, Massachusetts area, have established a close affiliation relationship under a common corporate parent that achieves a variety of synergistic benefits. Formed under the pressures of limited capacity at BWH and excess capacity at Faulkner, and the need for lower-cost clinical space in an era of provider risk-sharing, BWH and Faulkner entered into a comprehensive affiliation agreement. Over the past seven years, the relationship has enhanced overall volume, broadened training programs, lowered the cost of resources for secondary care, and improved financial performance for both institutions. The lessons of this relationship, both in terms of success factors and ongoing challenges for the hospitals, medical staffs, and a large multispecialty referring physician group, are reviewed. The key factors for success of the relationship have been integration of training programs and some clinical services, provision of complementary clinical capabilities, geographic proximity, clear role definition of each institution, commitment and flexibility of leadership and medical staff, active and responsive communication, and the support of a large referring physician group that embraced the affiliation concept. Principal challenges have been maintaining the community hospital's cost structure, addressing cultural differences, avoiding competition among professional staff, anticipating the pace of patient migration, choosing a name for the new affiliation, and adapting to a changing payer environment. PMID:15734807

  17. Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers

    Directory of Open Access Journals (Sweden)

    Daniela Sandoval

    2012-01-01

    Full Text Available Objective. To assess the blood pressure control and cardiovascular risk factors (CVRFs in a population of hypertensive patients with access to care under a government-financed program, the Cardiovascular Health Program (CHP. Design. A cross-sectional and multicenter study. Setting. 52 primary care centers, metropolitan area of Santiago, Chile. Participants. 1,194 patients were selected by a systematic random sampling from a universe of 316,654 hypertensive patients. Key Measurements. Demographic information, blood pressure (BP measurements, and CVRF were extracted from medical records of patients followed for a 12-month period. Results. 59.7% of patients reached target BP <140/90 mmHg. More women were captured in the sampling (2.1 : 1, achieving better BP control than men. Diabetic patients (26.4% had worse BP control than nondiabetics. Antihypertensive medications were used in 91.5%, with multidrug therapy more frequent in patients with higher BP and more difficult control. Conclusions. The success in improving the BP control to values <140/90 mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies. However, fewer hypertensive men than women were captured by this program, and it is of concern the underperforming of BP control observed in diabetics.

  18. Effectiveness of percutaneous metal stent placement in cholangiocarcinoma patients with midterm follow-up: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Kose, Fatih, E-mail: fatihkose@gmail.com [Baskent University Faculty of Medicine, Department of Medical Oncology, Adana (Turkey); Oguzkurt, Levent [Department of Interventional Radiology, Adana (Turkey); Besen, Ayberk; Sumbul, Taner; Sezer, Ahmet; Karadeniz, Cemile; Disel, Umut; Mertsoylu, Huseyin; Ozyilkan, Ozgur [Baskent University Faculty of Medicine, Department of Medical Oncology, Adana (Turkey)

    2012-08-15

    Purpose: Patients with advanced cholangiocarcinoma present with high rate of local complications. The primary aim of this study is to report clinical course of advanced cholangiocarcinoma patients those who were presented with biliary obstruction and treated with percutaneous biliary stenting. Material and methods: Patients with unresectable locally advanced or metastatic cholangiocarcinoma followed by our center for a period of 4 years were analyzed. For statistical analysis demographic and clinical characteristics of patients, primary biliary drainage method, metal stent occlusion rate, time to stent occlusion, and overall survival rates were recorded. Results: A total of 34 eligible patients were analyzed. 27 patients had metal stent placement. These 27 patients formed the basis of this study. Median overall survival (OS) was 6.0 months. After metal stent deployment bilurubin levels were normalized within a mean of 10 days. During the follow-up period, 13 patients were experienced metal stent occlusion. Median TtSO was 10 weeks. Cytotoxic chemotherapy was administered to 14 (52%) patients. Patients without stent dysfunction had significantly higher rate of chemotherapy exposure rate (p = 0.021). Statistical analysis, however, failed to exhibit significant effect of stent dysfunction on OS. Conclusion: In advanced cholangiocarcinoma, relief of bile duct obstruction is an important part of the initial patient management. This study therefore described the clinical value of percutaneous metal stent in cholangiocarcinoma patients and raises the question about patency of metal stent in cholangiocarcinoma whether we can expect success similar to the success achieved in pancreas carcinoma.

  19. Effectiveness of percutaneous metal stent placement in cholangiocarcinoma patients with midterm follow-up: Single center experience

    International Nuclear Information System (INIS)

    Purpose: Patients with advanced cholangiocarcinoma present with high rate of local complications. The primary aim of this study is to report clinical course of advanced cholangiocarcinoma patients those who were presented with biliary obstruction and treated with percutaneous biliary stenting. Material and methods: Patients with unresectable locally advanced or metastatic cholangiocarcinoma followed by our center for a period of 4 years were analyzed. For statistical analysis demographic and clinical characteristics of patients, primary biliary drainage method, metal stent occlusion rate, time to stent occlusion, and overall survival rates were recorded. Results: A total of 34 eligible patients were analyzed. 27 patients had metal stent placement. These 27 patients formed the basis of this study. Median overall survival (OS) was 6.0 months. After metal stent deployment bilurubin levels were normalized within a mean of 10 days. During the follow-up period, 13 patients were experienced metal stent occlusion. Median TtSO was 10 weeks. Cytotoxic chemotherapy was administered to 14 (52%) patients. Patients without stent dysfunction had significantly higher rate of chemotherapy exposure rate (p = 0.021). Statistical analysis, however, failed to exhibit significant effect of stent dysfunction on OS. Conclusion: In advanced cholangiocarcinoma, relief of bile duct obstruction is an important part of the initial patient management. This study therefore described the clinical value of percutaneous metal stent in cholangiocarcinoma patients and raises the question about patency of metal stent in cholangiocarcinoma whether we can expect success similar to the success achieved in pancreas carcinoma.

  20. Matrix support strategies: the experience of two Family Health Support Centers (NASFs) in São Paulo, Brazil.

    Science.gov (United States)

    Barros, Juliana de Oliveira; Gonçalves, Rita Maria de Abreu; Kaltner, Ronaldo Pires; Lancman, Selma

    2015-09-01

    The aim of Family Health Support Centers (NASFs) is to expand and qualify primary health care initiatives. Working together with Family Health Teams (EqSFs) they use matrix support strategies. This paper discusses how NASF professionals develop their work, emphasizing how matrix support approaches are appropriated and incorporated into daily working practices. The results that are presented are based on a case study of the work process of NASFs in a region of the city of São Paulo, Brazil. In order to investigate this issue, specific questions were introduced at different stages of the ergonomic work analysis. The implementation of the NASF, without a review of the guidance documents provided by the EqSF, created the following paradoxes: the different requirements of productivity and the working strategies between the NASF and the EqSF; the different demands of care for the population and different priorities for action, which were reflected in the division of tasks and the time allocated to each of them, etc. The practices that have been accumulated since the creation of the NASF suggests a review of these documents in order to transform the organization of planned work of these organizations in order to create better conditions for shared working practices. PMID:26331516

  1. Determinants of graft survival in pediatric and adolescent live donor kidney transplant recipients: a single center experience.

    Science.gov (United States)

    El-Husseini, Amr A; Foda, Mohamed A; Shokeir, Ahmed A; Shehab El-Din, Ahmed B; Sobh, Mohamed A; Ghoneim, Mohamed A

    2005-12-01

    To study the independent determinants of graft survival among pediatric and adolescent live donor kidney transplant recipients. Between March 1976 and March 2004, 1600 live donor kidney transplants were carried out in our center. Of them 284 were 20 yr old or younger (mean age 13.1 yr, ranging from 5 to 20 yr). Evaluation of the possible variables that may affect graft survival were carried out using univariate and multivariate analyses. Studied factors included age, gender, relation between donor and recipient, original kidney disease, ABO blood group, pretransplant blood transfusion, human leukocyte antigen (HLA) matching, pretransplant dialysis, height standard deviation score (SDS), pretransplant hypertension, cold ischemia time, number of renal arteries, ureteral anastomosis, time to diuresis, time of transplantation, occurrence of acute tubular necrosis (ATN), primary and secondary immunosuppression, total dose of steroids in the first 3 months, development of acute rejection and post-transplant hypertension. Using univariate analysis, the significant predictors for graft survival were HLA matching, type of primary urinary recontinuity, time to diuresis, ATN, acute rejection and post-transplant hypertension. The multivariate analysis restricted the significance to acute rejection and post-transplant hypertension. The independent determinants of graft survival in live-donor pediatric and adolescent renal transplant recipients are acute rejection and post-transplant hypertension. PMID:16269048

  2. Three Experiments Examining the Use of Electroencephalogram,Event-Related Potentials, and Heart-Rate Variability for Real-Time Human-Centered Adaptive Automation Design

    Science.gov (United States)

    Prinzel, Lawrence J., III; Parasuraman, Raja; Freeman, Frederick G.; Scerbo, Mark W.; Mikulka, Peter J.; Pope, Alan T.

    2003-01-01

    Adaptive automation represents an advanced form of human-centered automation design. The approach to automation provides for real-time and model-based assessments of human-automation interaction, determines whether the human has entered into a hazardous state of awareness and then modulates the task environment to keep the operator in-the-loop , while maintaining an optimal state of task engagement and mental alertness. Because adaptive automation has not matured, numerous challenges remain, including what the criteria are, for determining when adaptive aiding and adaptive function allocation should take place. Human factors experts in the area have suggested a number of measures including the use of psychophysiology. This NASA Technical Paper reports on three experiments that examined the psychophysiological measures of event-related potentials, electroencephalogram, and heart-rate variability for real-time adaptive automation. The results of the experiments confirm the efficacy of these measures for use in both a developmental and operational role for adaptive automation design. The implications of these results and future directions for psychophysiology and human-centered automation design are discussed.

  3. 电工电子实验教学示范中心建设探索%Exploration of Establishing Electrical and Electronic Experiment Center

    Institute of Scientific and Technical Information of China (English)

    郗艳华; 张辉; 王西明

    2013-01-01

    Students' practical ability and innovation ability can be promoted, the integration of resources sharing can be got, and school-running level and teaching quality can be enhanced by the construction of experimental teaching demonstration center. To improve power of professional applied talents training quality, exploration of the construction of electrical and electronic ex-perimental teaching demonstration center of ideas is provided by constructing the hierarchical experimental teaching system, opti-mizing experiment content, riching teaching methods and means, strengthening the construction of teaching staff and the experi-mental teaching platform construction.%实验教学示范中心建设能推动学生实践能力和创新能力培养,促进资源整合共享,提高学校办学水平和教学质量。该文提出了从构建实验教学平台,改革实验教学体系,优化实验教学方法和手段以及加强师资队伍建设等方面探索电工电子实验教学示范中心建设的思路,为提高电类专业应用型人才培养质量进行探讨。

  4. Preparation of a one-curie 171Tm target for the Detector for Advanced Neutron Capture Experiments (DANCE)

    Energy Technology Data Exchange (ETDEWEB)

    Schwantes, Jon M.; Taylor, Wayne A.; Rundberg, Robert S.; Vieira, David J.

    2008-05-15

    Roughly one curie of 171Tm (t1/2=1.92a) has been produced and purified for the purpose of making a nuclear target for the first measurements of its neutron capture cross section. Target preparation consisted of three key steps: (1) material production; (2) separation and purification; and (3) electrodeposition onto a suitable backing material. Approximately 1.5 mg of the target material (at the time of separation) was produced by irradiating roughly 250 mg of its stable enriched 170Er lanthanide neighbor with neutrons at the ILL reactor in France. This production method resulted in a “difficult-to-separate” 1:167 mixture of near-neighboring lanthanides, Tm and Er. Separation and purification was accomplished using high-performance liquid chromatorgraphy (HPLC), with a proprietary cation exchange column (Dionex, CS-3) and alpha-hydroxyisobutyric acid (a-HIB) eluent. This technique yielded a final product of ~95% purity with respect to Tm. A portion (20 ug) of the Tm was electrodeposited on thin Be foil and delivered to the Los Alamos Neutron Science CEnter (LANSCE) for preliminary analysis of its neutron capture cross section using the Detector for Advanced Neutron Capture Experiments (DANCE). This paper discusses the major hurdles associated with the separation and purification step including, scale-up issues related to the use of HPLC for material separation and purification of the target material from a-HIB and 4-(2-pyridylazo)resorcinol (PAR) colorant.

  5. Preparation of a one-curie 171Tm target for the detector for advanced neutron capture experiments (DANCE)

    International Nuclear Information System (INIS)

    Approximately one curie of 171Tm (T1/2 = 1.92a) has been produced and purified for the purpose of making a nuclear target for the first measurements of its neutron capture cross section. Target preparation consisted of three key steps: (1) material production; (2) separation and purification; and (3) electrodeposition onto a suitable backing material. Approximately 1.5 mg of the target material (at the time of separation) was produced by irradiating ca. 250 mg of its stable enriched 170Er lanthanide neighbour with neutrons at the ILL reactor in France. This production method resulted in a 'difficult-to-separate' 1:167 mixture of near-neighboring lanthanides, Tm and Er. Separation and purification was accomplished using high-performance liquid chromatography (HPLC), with a proprietary cation-exchange column (Dionex, CS-3) and alphahydroxyisobutyric acid (α-HIB) eluent. This technique yielded a final product of ∼95% purity with respect to Tm. A portion (20 μg) of the Tm was electrodeposited onto thin Be foil and delivered to the Los Alamos Neutron Science Center (LANSCE) for preliminary analysis of its neutron capture cross section using the Detector for Advanced Neutron Capture Experiments (DANCE). This paper discusses the major hurdles associated with the separation and purification step, including scale-up issues related to the use of HPLC for material separation and purification of the target material from α-HIB and 4-(2-pyridylazo)resorcinol (PAR) colorant. (author)

  6. Clinical Outcomes of Myasthenia Gravis with Thymoma and Thymic Hyperplasia Undergoing Extended Transsternal Thymectomy: A Single-Center Experience

    Science.gov (United States)

    Nazarbaghi, Surena; Amiri-Nikpour, Mohammad Reza; Mahmodlou, Rahim; Arjmand, Nasim; Rezaei, Yousef

    2015-01-01

    Background: Despite the widespread use of thymectomy in myasthenia gravis (MG) patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA) criteria, response to therapy was defined as complete stable remission (CSR), pharmacologic remission (PR), and minimal manifestation (MM) as secondary endpoints. Results: Majority of the patients were male (60%) and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60%) and 10 patients (40%) had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months). The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584). Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia. PMID:26713298

  7. Clinical outcomes of myasthenia gravis with thymoma and thymic hyperplasia undergoing extended transsternal thymectomy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Surena Nazarbaghi

    2015-01-01

    Full Text Available Background: Despite the widespread use of thymectomy in myasthenia gravis (MG patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA criteria, response to therapy was defined as complete stable remission (CSR, pharmacologic remission (PR, and minimal manifestation (MM as secondary endpoints. Results: Majority of the patients were male (60% and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60% and 10 patients (40% had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months. The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584. Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia.

  8. Radiological imaging features and clinicopathological correlation of hemosiderotic fibrolipomatous tumor: experience in a single tertiary cancer center

    Energy Technology Data Exchange (ETDEWEB)

    O' Driscoll, Dearbhail; Athanasian, Edward; Hameed, Meera; Hwang, Sinchun [Memorial Sloan Kettering Cancer Center, New York, NY (United States)

    2015-05-01

    To determine the imaging features of hemosiderotic fibrolipomatous tumor (HFLT), which has a propensity towards local recurrence and the potential to transform into myxoinflammatory fibroblastic sarcoma (MIFS). The study included 8 patients with a diagnosis of HFLT and imaging at a tertiary cancer center. Imaging studies included radiographs (n = 2), ultrasound (n = 3), and MRI (n = 16). Imaging features were evaluated including location, calcification, sonographic echogenicity, vascular flow, size, border, signal characteristics, contrast enhancement, and blooming on MRI. The HFLT was located in the ankle/foot in 4 out of 8 and was subcutaneous in 8 out of 8, ranging in size from 2 to 18 cm. Histology at initial diagnosis was HFLT in 5 out of 8 and HFLT with MIFS in 3 out of 8. None was calcified on radiography. On ultrasound 2 out of 3 were heterogeneously echogenic with ≥10 foci of vascular flow. Two out of 8 patients had MRI only at local recurrence. The tumor border was infiltrative in 4 out of 6 at initial diagnosis and in 2 patients with MRI at recurrence only. Fat and septae were present in 7 out of 8 at initial diagnosis and at recurrence. Signal intensity was iso-/hypointense to muscle on T1-weighted sequences in more than two thirds of the tumor in 4 out of 7 and hyperintense to muscle in at least one third of the tumor on fluid-sensitive sequences in 6 out of 8. Contrast enhancement was heterogeneous in 7 out of 7; blooming in two thirds of the tumor on gradient-echo sequence MRI indicated hemorrhage. The HFLT commonly presents as a mass with an infiltrative border, interspersed fat and septations at initial diagnosis and local recurrence on MRI regardless of histology of HFLT alone or with MIFS. Hemosiderin deposits may be detected as blooming on gradient-echo sequences. (orig.)

  9. Clinical utility of panfungal polymerase chain reaction for the diagnosis of invasive fungal disease: a single center experience.

    Science.gov (United States)

    Trubiano, J A; Dennison, A M; Morrissey, C O; Chua, K Y; Halliday, C L; Chen, S C-A; Spelman, D

    2016-02-01

    The role of panfungal polymerase chain reaction (PCR) assays for diagnosis of invasive fungal disease (IFD) is inadequately defined. We describe the use of an internal transcribed spacer 1 (ITS-1) region-directed panfungal PCR in this context at a tertiary referral transplant center. A retrospective review of patients at Alfred Health, Melbourne, Australia (2009-2014) who had clinical samples referred for panfungal PCR testing was conducted. Baseline patient characteristics, antifungal drug history, fungal culture/histopathology, and radiology results were recorded. For bronchoalveolar lavage (BAL) fluid samples, identification of a fungus other than a Candida spp. was defined as a potential pathogen.Of 138 panfungal PCR tests (108 patients), 41 (30%) were positive for a fungal product. Ninety-seven percent (134/138) of specimens were from immunocompromised hosts. Thirteen percent (19/138) of panfungal PCR positive results were for potential pathogens and potential pathogens were detected more frequently in tissue as compared with BAL (12/13 vs. 6/26; P = .0001). No positive panfungal PCR results were obtained from CSF specimens. If histopathology examination was negative, panfungal PCR identified a potential pathogen in only 12% (11/94) of specimens. For the 20 culture negative/histopathology positive specimens, diagnosis of IFD to causative species level by panfungal PCR occurred in 35% (6/20).Sterile site specimens, in particular tissue, were more frequently panfungal PCR positive for potential pathogens than BAL. The utility of panfungal PCR appears greatest in tissue specimens, as an adjunct to histopathology to improve diagnostic sensitivity and specificity. Based on the results of this study we are now only testing tissue specimens by panfungal PCR.

  10. Radiotherapy and Sorafenib in the Management of Patients with Hepatocellular Carcinoma Have Led to Improved Survival: A Single Center Experience

    Science.gov (United States)

    Moore, Assaf; Cohen-Naftaly, Michal; Benjaminov, Ofer; Braun, Marius; Issachar, Assaf; Mor, Eitan; Tovar, Anna; Sarfaty, Michal; Gordon, Noa; Stemmer, Salomon M.

    2016-01-01

    Background & Aims: Hepatocellular Carcinoma (HCC) is the sixth most common malignancy and the third most common cause of cancer mortality worldwide. We aimed to assess the effect of novel treatment options on the survival of HCC patients. Methods: This retrospective study included all HCC patients diagnosed between 2000 and 2013 referred to the Davidoff center and treated by a multidisciplinary team. Results: The analysis included 321 patients (median age, 64 years; 74.8% males; 74.1% viral carriers; 76.0% cirrhosis; 56.7% diagnosis at an early stage). The estimated hazard ratio by multivariate analysis for the effect of the period of diagnosis (2007-2013 vs. 2000-2006) on survival was 0.72 (95% CI: 0.54-0.96; p=0.027). There was no difference in the distribution by CP score, by BCLC stage at diagnosis or in the proportion of patients undergoing surgical procedures (liver transplantation or resection). In the later time frame, there was a significant decrease in the proportion of patients undergoing percutaneous treatments (14.6% vs.4.2%, p=0.004) and embolization (46.9% vs.24.6%, p=0.001), and a significant increase in radiotherapy (1.5% vs. 8.4%, p=0.009) and treatment with sorafenib (6% vs. 18.3%, p=0.002). Conclusion: Technological/pharmaceutical innovations have led to advancement in HCC treatment. Since there was no significant difference in the proportion of patients undergoing surgical procedures during the evaluated timeframe, the improved survival may stem from better management of advanced stage patients by a multidisciplinary team. PMID:27313777

  11. An analysis of clinical process measures for acute healthcare delivery in Appalachia: The Roane Medical Center experience

    Directory of Open Access Journals (Sweden)

    Sills Eric

    2006-03-01

    Full Text Available Abstract Objective To survey management of selected emergency healthcare needs in a Tennessee community hospital. Materials and methods In this descriptive report, discharges and associated standard process measures were retrospectively studied for Roane Medical Center (RMC in Harriman, Tennessee (pop. 6,757. Hospital data were extracted from a nationwide database of short-term acute care hospitals to measure 16 quality performance measures in myocardial infarction (MI, heart failure, and pneumonia during the 14 month interval ending March 2005. The data also permitted comparisons with state and national reference groups. Results Of RMC patients with myocardial infarction (MI, 94% received aspirin on arrival, a figure higher than both state (85% and national (91% averages. Assessment of left ventricular dysfunction among heart failure patients was also higher at RMC (98% than the state (74% or national (79% average. For RMC pneumonia patients, 79% received antibiotics within 4 h of admission, which compared favorably with State (76% and national (75% average. RMC scored higher on 13 of 16 clinical process measures (p95% CI compared to state and national averages. Discussion Although acute health care needs are often met with limited resources in medically underserved regions, RMC performed above state and national average for most process measures assessed in this review. Our data were derived from one facility and the associated findings may not be applicable in other healthcare settings. Further studies are planned to track other parameters and specific clinical outcomes at RMC, as well as to identify specific institutional policies that facilitate attainment of target quality measures.

  12. Quality Improvement in the National Cancer Institute Community Cancer Centers Program: The Quality Oncology Practice Initiative Experience

    Science.gov (United States)

    Siegel, Robert D.; Castro, Kathleen M.; Eisenstein, Jana; Stallings, Holley; Hegedus, Patricia D.; Bryant, Donna M.; Kadlubek, Pam J.; Clauser, Steven B.

    2015-01-01

    Purpose: The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) began in 2007; it is a network of community-based hospitals funded by the NCI. Quality of care is an NCCCP priority, with participation in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) playing a fundamental role in quality assessment and quality improvement (QI) projects. Using QOPI methodology, performance on quality measures was analyzed two times per year over a 3-year period to enhance our implementation of quality standards at NCCCP hospitals. Methods: A data-sharing agreement allowed individual-practice QOPI data to be electronically sent to the NCI. Aggregated data with the other NCCCP QOPI participants were presented to the network via Webinars. The NCCCP Quality of Care Subcommittee selected areas in which to focus subsequent QI efforts, and high-performing practices shared voluntarily their QI best practices with the network. Results: QOPI results were compiled semiannually between fall 2010 and fall 2013. The network concentrated on measures with a quality score of ≤ 0.75 and planned voluntary group-wide QI interventions. We identified 13 measures in which the NCCCP fell at or below the designated quality score in fall 2010. After implementing a variety of QI initiatives, the network registered improvements in all parameters except one (use of treatment summaries). Conclusion: Using the NCCCP as a paradigm, QOPI metrics provide a useful platform for group-wide measurement of quality performance. In addition, these measurements can be used to assess the effectiveness of QI initiatives. PMID:25538082

  13. Extranodal diffuse large B-cell lymphoma: Experience from a tertiary care oncology center in South India

    Directory of Open Access Journals (Sweden)

    K. C. Lakshmaiah

    2014-01-01

    Full Text Available Aims: Diffuse large B-cell lymphoma (DLBCL is the most common non-Hodgkin′s lymphoma (NHL with frequent extra nodal (EN presentation. The overall occurrence of lymphomas has been increasing; however, those of EN-NHL have been increasing much more rapidly. There is limited data found on EN-DLBCL in the Indian population and hence we carried out this retrospective observational study of primary EN-DLBCL at our center in Southern India. Materials and Methods: A total of 90 consecutive cases diagnosed as EN-DLBCL (according to the standard criteria by tissue biopsy confirmed by immunohistochemistry between 2007 and 2011 were included. Staging workup including computed tomography of neck, thorax and abdomen and pelvis, bone marrow aspiration and biopsy was done and International Prognostic Index (IPI calculated. Staging was according to Cotswold′s modification of Ann Arbor. The actuarial survival analysis was performed by Kaplan-Meier. Data were analyzed using the SPSS (version 16 statistical software. Results: The median age in this study was 49 years (18-88 with results showing EN-DLBCL to be 1.36 times more common in males. Advanced stages were seen in 15 subjects (16.6% and bulky disease in 13 subjects (14.4%. CD20 was positive in 89 (98.8% while 32 had high serum lactate dehydrogenase. According to the IPI most were low-risk-56 (66.6%. Overall response rate for the various combination chemotherapies was 85.7% with complete response in 62.3%. The overall survival range spanned from 2 to 123 months. Univariate analysis showed only bulky disease was associated with inferior survival. Conclusions: EN-DLBCL was present at an early age compared to nodal DLBCL, present more often in early stage and low IPI score. Chemoimmunotherapy with radiotherapy to the EN or bulky site is the standard treatment at present.

  14. The Role of Wrist Magnetic Resonance Arthrography in Diagnosing Triangular Fibrocartilage Complex Tears; Experience at King Hussein Medical Center, Jordan

    Directory of Open Access Journals (Sweden)

    Asem A. Al-Hiari

    2013-05-01

    Full Text Available Objectives: The aims of the study were to evaluate the role of magnetic resonance arthrography (MRA of the wrist in detecting full-thickness tears of the triangular fibrocartilage complex (TFCC and to compare the results of the magnetic resonance arthrography (MRA with the gold standard arthroscopic findings. Methods:The study was performed at King Hussein Medical Center, Amman, Jordan, between January 2008 and December 2011. A total of 42 patients (35 males and 7 females who had ulnar-sided wrist pain and clinical suspicions of TFCC tears were included in the study. All patients underwent wrist magnetic resonance arthrography (MRA and then a wrist arthroscopy. The results of MRA were compared with the arthroscopic findings. Results: After comparison with the arthroscopic findings, the MRA had three false-negative results (sensitivity = 93% and no false-positive results. A total of 39 patients were able to return to work. Satisfaction was high in 38 of the patients and 33 had satisfactorypain relief. The sensitivity of the wrist MRA in detecting TFCC full-thickness tears was 93% (39, and specificity was 80% (16/20. The overall accuracy of wrist arthroscopy in detecting a full-thickness tear of the TFCC in our study was 85% (29/34. Conclusion: These results illustrate the role of wrist MRA in assessing the TFCC pathology and suggest its use as the first imaging technique, following a plain X-ray, in evaluating patients with chronic ulnar side wrist pain with suspected TFCC injuries.

  15. Initial CT-guided needle biopsy of extremity skeletal lesions: Diagnostic performance and experience of a tertiary musculoskeletal center

    Energy Technology Data Exchange (ETDEWEB)

    Nouh, Mohamed Ragab, E-mail: mragab73@yahoo.com [Department of Radiology, Faculty of Medicine, Alexandria University (Egypt); Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait); Abu Shady, Hamdy Mohamed, E-mail: hamdi_abushadi@yahoo.com [Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait)

    2014-02-15

    Introduction: Appendicular long bones are the target for a wide spectrum of bony lesions with variable clinical presentations. Biopsy procedures are needed for subsequent proper patient's management. Most of the available literature globally assessed musculoskeletal biopsies with inclusion of repeat biopsy results. We thought to retrospectively assess the diagnostic performance of initial CT-guided percutaneous core needle biopsy (PCNB) of extremity long bone lesions in a tertiary musculoskeletal referral center. Patients and methods: We retrospectively analyzed the outcome of initial CT-guided PCNB of 49 patients who presented with extremity long bone lesions which were biopsied in our hospital during a 36 months’ time period. The diagnostic performance was assessed in terms of diagnostic yield and accuracy. Results: There were 34 males and 15 females with a mean age of 33.69 years (range from 4 to 77 years). The overall diagnostic yield of initial biopsies was 87.75% with a diagnostic accuracy of 82.85% derived from the surgically proven cases. The higher diagnostic yield was recorded with malignancy, presence of extra-osseous soft-tissue component as well as mixed and sclerotic lesions. The pathologies of the non-diagnostic biopsies included large-cell lymphoma, giant-cell tumor, langerhans cell histiocytosis, osteoid osteoma and a non-ossifying fibroma. Conclusion: Initial CT-guided PCNB in extremities’ long bones lesions showed high diagnostic performance in malignant, mixed and/or sclerotic lesions as well as lesions with extra-osseous exophytic tissue growth. Lack of extra-osseous components, benign and lytic lesions all had worse diagnostic performance.

  16. Implantable cardioverter defibrillator therapy in pediatric and congenital heart disease patients: a single tertiary center experience in Korea

    Directory of Open Access Journals (Sweden)

    Bo Kyung Jin

    2013-03-01

    Full Text Available Purpose: The use of implantable cardioverter defibrillators (ICDs to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was 14.5±5.4 years (range, 2 to 22 years. The follow-up duration was 28.9±20.4 months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1, cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years. Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia.During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

  17. Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience

    Directory of Open Access Journals (Sweden)

    Hassan Al-Thani

    2016-07-01

    Full Text Available Objectives: A thyroglossal duct cyst (TDC is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. Methods: A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients’ demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. Results: We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6–13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%, thyroid function test (44%, and fine-needle aspiration cytology (10%. The median size of the cyst was 25 (2–60 mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%, followed by fistula (9%, infection (2%, and dysphagia (2%. Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9–60 vs. 22 (2–55 mm; p = 0.005 and required prolonged operation time (69 (1–169 vs. 32.5 (1–140 mins; p = 0.004 compared to the pediatric group. Conclusion: The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the

  18. The concept of negative pressure wound therapy (NPWT after poststernotomy mediastinitis – a single center experience with 54 patients

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    Vogt Peter M

    2009-01-01

    Full Text Available Abstract Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe and reliable as other techniques for the therapy of deep sternal infections, complications are not absent. We report about our experiences and complications using this therapy in a set of 54 patients out of 3668 patients undergoing cardiac surgery in our institution between January 2005 and April 2007.

  19. Taquiarritmias supraventriculares no feto. Experiência de uma unidade de referência em cardiologia fetal Fetal supraventricular tachyarrhythmias. Experience of a fetal cardiology reference center

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    Paulo Zielinsky

    1998-05-01

    Full Text Available OBJETIVO: Avaliar a forma de apresentação, diagnóstico e tratamento das taquiarritmias supraventriculares fetais, através do relato de uma série de casos acompanhados em um centro terciário de cardiologia fetal. MÉTODOS: São descritos 25 casos de taquiarritmia supraventricular diagnosticados intra-útero, no período de janeiro/89 a outubro/97, em uma população compreendendo 3117 gestantes. RESULTADOS: Foram diagnosticados 17 casos de taquiarritmia supraventricular e 8 casos de flutter atrial fetal. As idades gestacionais variaram de 26 a 40 semanas. Doze fetos apresentavam hidropisia no momento do diagnóstico (6 com taquicardia supraventricular (TSV e 6 com flutter atrial. Quatro fetos com TSV apresentavam cardiopatias estruturais (dois casos de anomalia de Ebstein e dois com comunicação interventricular. Todos os fetos foram internados na Unidade de Cardiologia Fetal para monitorização e tratamento. Entre os 17 fetos com TSV, 12 apresentaram reversão da arritmia após administração de digoxina, mas esta medida não foi eficaz em nenhum paciente com flutter. Dois pacientes com TSV e seis com flutter necessitaram interrupção da gestação para cardioversão elétrica pós-natal. A mortalidade foi de 3/17 no grupo da TSV (incluindo dois pacientes com anomalia de Ebstein e de 0/8 no grupo com flutter. CONCLUSÃO: As taquiarritmias supraventriculares fetais são eventos raros na população geral. Entretanto, podem provocar insuficiência cardíaca e óbito intra-uterino. Como a resposta ao tratamento é satisfatória, tornam-se de extrema importância o diagnóstico precoce e o tratamento adequado.PURPOSE: To describe the presentation, diagnosis and treatment of fetal supraventricular tachyarrhythmias in a series of fetuses followed in a tertiary Fetal Cardiology Center. METHODS: Twenty-five fetuses with diagnosis of supraventricular tachyarrhytmia were reported from January 1989 to October 1997, among 3117 pregnant women

  20. Predictors of caregivers’ burden of Parkinson’s disease in India: experience of a tertiary care center in India

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    Agrawal V

    2012-11-01

    Full Text Available Vikas Agrawal,1 Vinay Goyal,2 Garima Shukla,2 Madhuri Behari21Department of Neurology, Yashoda Hospital, Secunderabad, Andhra Pradesh, India; 2Department of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaIntroduction: Parkinson’s disease (PD is a progressive neurodegenerative disorder characterized by increasing dependence on caregivers for activities of daily living that imposes a major burden upon the patients’ caregiver. Caregiver burden (CB refers to the physical, mental, and socioeconomic problems experienced by the caregivers of chronic patients.Patients and methods: This is a onetime cross-sectional observational study carried out in the movement disorder clinic of a tertiary referral center in India. Persons with PD were interviewed and information was collected regarding demographic and clinical details, treatment taken, and presence of non-motor features such as dementia, psychosis, depression, etc, on a pre-tested format and their caregivers were interviewed for self-perceived burden using Zerit’s caregivers’ burden inventory.Results: We interviewed 91 persons with PD (71 [78%] men, 20 [22%] women with their primary caregivers. The age of the patients ranged from 25 to 75 years (mean 56.66 ± 11.83 years. After regression analysis, depression in patients (beta = 0.352, 95% confidence interval [CI]: 0.275 to 0.790, high UPDRS-motor scores (beta = 0.255, 95% CI: 0.108 to 0.532, and presence of sleep disturbances in the atient (beta = 0.206, 95% CI: 0.817 to 11.823 were associated with increased caregiver burden and the presence of multiple caregivers was associated with lower caregiver burden (beta = −0.311, 95% CI: −10.155 to −3.436.Conclusion: The total number of caregivers was found to be an important predictor for reducing CB. Multiple caregivers is a phenomenon which has not been studied till now. Other factors which were found to have adverse predictive effect on caregiver burden are presence of

  1. Combined liver-thoracic transplantation: single-center experience with introduction of the 'Liver-first' principle.

    Science.gov (United States)

    Ceulemans, Laurens J; Strypstein, Sébastien; Neyrinck, Arne; Verleden, Stijn; Ruttens, David; Monbaliu, Diethard; De Leyn, Paul; Vanhaecke, Johan; Meyns, Bart; Nevens, Frederik; Verleden, Geert; Van Raemdonck, Dirk; Pirenne, Jacques

    2016-06-01

    Combined liver/thoracic transplantation (cLiThTx) is a complex procedure for end-stage/advanced liver and heart(H)/lung(Lu) disease. To avoid futile use of multiple organs in single recipients, results should be scrutinously analyzed. Single-center cLiThTx (04/2000-12/2015) were reviewed for the following: demographics, indications, surgical technique, complications, rejection, and five-year patient survival. Results are reported as median (range). Fourteen consecutive patients underwent cLiThTx: 3 cLiHTx, 10 cLiLuTx, and 1 cLiHLuTx. Recipient age was 42 years (17-63 years). Most frequent indications were cystic fibrosis (n = 5), hepatopulmonary fibrosis (n = 2), amyloidosis (n = 2), and epithelioid hemangio-endothelioma (n = 2). Thoracic organs were transplanted first, except in three where LiTx preceded LuTx. In the latter, lungs were preserved by normothermic ex vivo lung perfusion. Stenting was performed for stenosis of bile duct (n = 4), hepatic artery (n = 2), and bronchus (n = 2). Abdominal interventions were required for bleeding (n = 3), evisceration (n = 1), and adhesiolysis (n = 1). One liver (cLiLuTx) was lost to hepatic artery thrombosis 3 months post-transplant and successfully retransplanted. One patient (cLiHTx) died 4 months post-transplant (myocardial infarction). Follow-up was 4 years (2 months-16 years). One liver and 5 pulmonary rejections occurred, all mild and reversible. Two patients developed bronchiolitis obliterans, one is clinically well 16 years post-transplant, and the other successfully retransplanted. Estimated 5-year patient survival is 90%. CLiThTx is safe with excellent short-/long-term surgical and immunological results.

  2. Allogeneic Stem Cell Transplantation in Congenital Hemoglobinopathies Using a Tailored Busulfan-Based Conditioning Regimen: Single-Center Experience.

    Science.gov (United States)

    Zaidman, Irina; Rowe, Jacob M; Khalil, Abdalla; Ben-Arush, Myriam; Elhasid, Ronit

    2016-06-01

    Hematopoietic stem cell transplantation (HSCT) is the only proven curative option for patients with hemoglobinopathies, both thalassemia and sickle cell anemia (SCA). A busulfan-based myeloablative conditioning regimen is the standard of care for HSCT in these patients, although increased treatment-related morbidity, including veno-occlusive disease (VOD), has been demonstrated. Thirty-eight pediatric patients, median age 8 years (range, 6 months to 22 years), suffering from hemoglobinopathy were treated at Rambam Medical Center in Haifa, Israel, between 1998 and 2011. Thirty-four patients had thalassemia major and 4 had SCA. The 38 patients underwent 40 HSCTs, 34 of which were first transplants and 6 second transplants. Most transplants (32/40) were from matched sibling donors. Sources of stem cells were peripheral blood in 30 transplants, bone marrow in 7 transplants, and cord blood in 3 transplants. All received different customized busulfan-based conditioning regimens tailored by pharmacokinetic analysis of busulfan levels. Primary engraftment occurred in 37 of 40 transplants. Neutrophil engraftment (>.5 × 10(9)/L) occurred at a median of 15.3 days post-transplantation (range, 10 to 45). Platelet transfusion independence (>20 × 10(9)/L) occurred at a median of 22.3 days (range, 11 to 60). The rate of 5-year overall survival for thalassemia patients after first transplantation was 90.5% ± 5.3%. The rate of 5-year thalassemia-free survival was 81.7% ± 6.8%. Cumulative incidence of acute graft-versus-host disease (GVHD) was 17.6%. Rate of grades III to IV GVHD was 8.8%. Cumulative incidence of chronic GVHD was 23.5%, with 11.8% incidence of extensive chronic GVHD. One patient developed VOD. Full donor chimerism occurred in 36.4% of patients with class 1 + 2 thalassemia, compared with 78.6% in class 3 thalassemia (P = .049). Overall survival above 90% in patients undergoing their first transplant was demonstrated using busulfan

  3. Experience of offering HIV rapid testing to at-risk patients in community health centers in eight Chinese cities.

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    Dapeng Zhang

    Full Text Available OBJECTIVE: To explore the feasibility of offering HIV counseling and testing in community health centers (CHCs and to provide evidence for the HIV/AIDS response in China. METHODS: Forty-two CHCs were selected from the eight cities that participated in the study. Rapid testing was mainly provided to: clients seeking HIV testing and counseling (HTC; outpatients with high-risk behavior of contracting HIV; inpatients and outpatients of key departments. Aggregate administrative data were collected in CHCs and general hospitals and differences between the two categories were compared. RESULTS: There were 23,609 patients who underwent HIV testing, accounting for 0.37% of all estimated clinic visits at the 42 sites (0.03%-4.35% by site. Overall, positive screening prevalence was 0.41% (95% confidence interval [CI] 0.33%-0.49%, range 0.00%-0.98%, which is higher than in general hospitals (0.17%. The identification efficiency was 0.22% (95% CI: 0.16%-0.27% in pilot CHCs, 3.5 times higher than in general hospitals (0.06% (Chi square test = 95.196, p<0.001. The percentage of those receiving confirmatory tests among those who screened positive was slightly lower in CHCs (73.7% than in general hospitals (80.1% (Chi-square test = 17.472, p<0.001. Composition of clients mobilized for testing was consistent with the usage of basic public health and medical services in CHCs. The rate of patients testing HIV positive was higher among patients from key CHC departments (0.68% than among high-risk Voluntary Counseling and Testing (VCT clients (0.56%, those participating in outreach activities (0.41%, pregnant women (0.05%, and surgical patients (0.00%. CONCLUSION: This project demonstrates that providing HIV testing services for patients who exhibit high risk behavior has a high HIV case detection rate and that CHCs have the capacity to integrate HTC into routine work. It provides concrete evidence supporting the involvement of CHCs in the expansion of HIV

  4. Design and fabrication of a duoplasmatron extraction geometry and LEBT for the LANSCE H{sup +} RFQ project

    Energy Technology Data Exchange (ETDEWEB)

    Fortgang, C. M., E-mail: cfortgang@lanl.gov; Batygin, Y. K.; Draganic, I. N.; Garnett, R. W.; McCrady, R. C.; Rybarcyk, L. J. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    2016-02-15

    The 750-keV H{sup +} Cockcroft-Walton at LANSCE will be replaced with a recently fabricated 4-rod Radio Frequency Quadrupole (RFQ) with injection energy of 35 keV. The existing duoplasmatron source extraction optics need to be modified to produce up to 35 mA of H{sup +} current with an emittance <0.02 π-cm-mrad (rms, norm) for injection into the RFQ. Parts for the new source have been fabricated and assembly is in process. We will use the existing duoplasmatron source with a newly designed extraction system and low energy beam transport (LEBT) for beam injection into the RFQ. In addition to source modifications, we need a new LEBT for transport and matching into the RFQ. The LEBT uses two magnetic solenoids with enough drift space between them to accommodate diagnostics and a beam deflector. The LEBT is designed to work over a range of space-charge neutralized currents and emittances. The LEBT is optimized in the sense that it minimizes the beam size in both solenoids for a point design of a given neutralized current and emittance. Special attention has been given to estimating emittance growth due to source extraction optics and solenoid aberrations. Examples of source-to-RFQ matching and emittance growth (due to both non-linear space charge and solenoid aberrations) are presented over a range of currents and emittances about the design point. A mechanical layout drawing will be presented along with the status of the source and LEBT, design, and fabrication.

  5. Breast-conserving therapy for ductal carcinoma in situ of the breast: the French Cancer Centers' experience

    International Nuclear Information System (INIS)

    Purpose: To assess the long-term outcome for women with ductal carcinoma in situ of the breast treated in current clinical practice by conservative surgery with or without definitive breast irradiation. Methods and Materials: We analyzed 705 cases of ductal carcinoma in situ treated between 1985 and 1995 in nine French regional cancer centers; 515 underwent conservative surgery and radiotherapy (CS+RT) and 190 CS alone. The median follow-up was 7 years. Results: The 7-year crude local recurrence (LR) rate was 12.6% (95% confidence interval [CI] 9.4-15.8) and 32.4% (95% CI 25-39.7) for the CS+RT and CS groups, respectively (p<0.0001). The respective 10-year results were 18.2% (95% CI 13.3-23) and 43.8% (95% CI 30-57.7). A total of 125 LRs occurred, 66 and 59 in the CS+RT and CS groups, respectively. Invasive or microinvasive LRs occurred in 60.6% and 52% of the cases in the same respective groups. The median time to LR development was 55 and 41 months. Nine (1.7%) and 6 (3.1%) nodal recurrences occurred in the CS+RT and CS groups, respectively. Distant metastases occurred in 1.4% and 3% of the respective groups. Patient age and excision quality (final margin status) were both significantly associated with LR risk in the CS+RT group: the LR rate was 29%, 13%, and 8% among women aged ≤40, 41-60, and ≥61 years (p<0.001). Even in the case of complete excision, we observed a 24% rate of LR (6 of 25) in women <40 years. Patients with negative, positive, or uncertain margins had a 7-year crude LR rate of 9.7%, 25.2%, and 12.2%, respectively (p=0.008). RT reduced the LR rate in all subgroups, especially in those with comedocarcinoma (17% vs. 59% in the CS+RT and CS groups, respectively, p<0.0001) and mixed cribriform/papillary tumors (9% vs. 31%, p<0.0001). In the multivariate Cox regression model, young age and positive margins remained significant in the CS+RT group (p=0.00012 and p=0.016). Finally, the relative LR risk in the CS+RT group compared with the CS group

  6. Intravenous Drug Users Can Achieve a High Sustained Virological Response Rate: experience From Croatian Reference Center for Viral Hepatitis

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    Ivan Kurelac

    2011-12-01

    Full Text Available Background: Hepatitis C virus (HCV is one of the major infectious disease agents among injecting drug users (IVDUs. However, most of the IVDUs are not still treated.Objectives: To examine the treatment course, adherence, tolerability and safety profiles and SVR rates in IVDUs compared to non-IVDUs.Patients and Methods: Demographic and clinical data were collected from medical records of 345 adult patients diagnosed with chronic hepatitis C (CHC who were treated with a PEG-IFN-α and ribavirin in Croatian Reference Center for Viral Hepatitis in Zagreb between January 2003 and January 2010. Efficacy, safety and tolerability treatment profiles were analyzed in IVDUs vs. non-IVDUs. Positive predictors for treatment outcome were evaluated by univariate and multivariate logistic regression.Results: A total of 106 (30.46% IVDUs were identified. The IVDUs were mainly male (81.13% vs. 52.30%, P = 0.0001, young (mean ± SD age: 32.46 ± 5.33 y vs. 46.12 ± 11.48 y, P = 0.0001, had lower fibrosis and HAI score (measured by ISHAK and shorter duration of infection (mean ± SD: 8.98 ± 5.87 vs. 16.79 ± 8.99 y, P = 0.0001 compared to non-IVDU group. In IVDUs, genotype 1a (24.52% and 3a (38.68% were predominant. There were no differences in completion rate between the two studied groups. IVDUs achieved a significantly higher rate of overall SVR (70.75% vs. 51.04%, P < 0.0009 and in genotypes 1 and 4 (65.08% vs. 48.73%, P = 0.0294 vs. non-IVDUs. Treatment discontinuation rates due to side-effects were not significantly different in IVDUs and non-IVDUs (2.83% vs. 7.11%, P = 0.1390. IVDU group had a higher rate of lost to follow-up (13.21% vs. 4.60%, P = 0.0071. There were no statistically significant differences in SVR rate between IVDUs with, or without substitution therapy (55.55% vs. 74.62%, P = 0.0866. Independent predictors of SVR were age < 40 years and genotypes 2 and 3. Type of PEG-IFN-α used was not associated with SVR.Conclusions: Treatment of CHC in

  7. Experience of limited pancreatic head resection for management of branch duct intraductal papillary mucinous neoplasm in a single center

    Institute of Scientific and Technical Information of China (English)

    Kwang Yeol Paik; Seong Ho Choi

    2009-01-01

    AIM: To share our surgical experience and the outcome of limited pancreatic head resection for the management of branch duct intraductal papillary mucinous neoplasm (IPMN). METHODS: Between May 2005 and February 2008, nine limited pancreatic head resections (LPHR) were performed for IPMN of the pancreatic head. We reviewed the nine patients, retrospectively. RESULTS: Tumor was located in the uncinate process of the pancreas in all nine patients. Three patients had stents inserted in the main pancreatic duct due to injury. The mean size of tumor was 28.4 mm. Postoperative complications were found in five patients: 3 pancreatic leakages, a pancreatitis, and a duodenal stricture. Pancreatic leakages were improved by external drainage. No perioperative mortality was observed and all patients are recorded alive during the mean follow-up period of 17.2 mo. CONCLUSION: In selected patients after careful evaluation, LPHR can be used for the treatment of branch duct type IPMN. In order to avoid pancreatic ductal injury, pre- and intra-operative definite localization and careful operative techniques are required.

  8. Comparison of Optimal Cardiovascular Risk Factor Management in Patients with Type 2 Diabetes Who Attended Urban Medical Health Center with those Attended a Tertiary Care Center: Experiences from Tehran, Iran

    Science.gov (United States)

    Moradi, Sedighe; Haji Ghanbari, Mohammad Javad; Ebrahimi, Hedyeh

    2016-01-01

    Background: Diabetes is a leading cause of cardiovascular disease (CVD). Moreover, CVD accounts for primary cause of death among diabetic patients. Physicians, especially in the primary care setting, have effective role in the management of cardiovascular risk factors. Therefore, we aimed to compare the prevalence of modifiable cardiovascular risk factors in Type 2 diabetic patients attending to an urban health center as a primary care center with Institute of Endocrinology and Metabolism Diabetes Clinic (IEMDC) as a tertiary center. Methods: This cross-sectional study was performed on 200 adult diabetic patients attending urban health center (Abouzar Health Center) and 201 diabetic patients in a tertiary center. The patients’ cardiovascular risk factors including lipid profile, systolic and diastolic blood pressure (BP), and smoking history were recorded. The number of patients who did not achieve the target according to the American Diabetes Association guidelines was determined and compared. Results: The patients in urban health center were older than those who attending IEMDC (P = 0.004). The duration of diabetes was longer among urban center patients (P glycosylated hemoglobin level, high-density lipoprotein level, and systolic BP. Conclusions: Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers. PMID:27761215

  9. Home mechanical ventilation in childhood-onset hereditary neuromuscular diseases: 13 years' experience at a single center in Korea.

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    Young Joo Han

    Full Text Available Children with hereditary neuromuscular diseases (NMDs are at a high risk of morbidity and mortality related to respiratory failure. The use of home mechanical ventilation (HMV has saved the lives of many children with NMD but, due to a lack of studies, dependable guidelines are not available. We drew upon our experience to compare the various underlying NMDs and to evaluate HMV with regard to respiratory morbidity, the proper indications and timing for its use, and to develop a policy to improve the quality of home noninvasive ventilation (NIV.We retrospectively analyzed the medical records of 57 children with childhood-onset hereditary NMDs in whom HMV was initiated between January 2000 and May 2013 at Seoul National University Children's Hospital. The degree of respiratory morbidity was estimated by the frequency and duration of hospitalizations caused by respiratory distress.The most common NMD was spinal muscular atrophy (SMA, n = 33. Emergent mechanical ventilation was initiated in 44% of the patients before the confirmed diagnosis, and the indicators of pre-HMV respiratory morbidity (e.g., extubation trials, hypoxia, hospitalizations, and intensive care unit stay were greater in these patients than in others. The proportion of post-HMV hospitalizations (range, 0.00-0.52; median, 0.01 was lower than that of pre-HMV hospitalizations (0.02-1.00; 0.99 (P < 0.001. Eight patients were able to maintain home NIV. The main causes of NIV failure were air leakage and a large amount of airway secretions.The application of HMV helped reduce respiratory morbidity in children with childhood-onset hereditary NMD. Patients with SMA type I can benefit from an early diagnosis and the timely application of HMV. The choice between invasive and noninvasive HMV should be based on the patient's age and NIV trial tolerance. Systematic follow-up guidelines provided by a multidisciplinary team are needed.

  10. A experiência social da psicose no contexto de um Centro de Atenção Psicossocial The social experience of psychosis in the context of a Psychosocial Care Center

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    Marcelo Kimati Dias

    2011-04-01

    Full Text Available Este estudo discute as relações existentes entre os aspectos institucionais de um Centro de Atenção Psicossocial (Caps e a experiência de pacientes psicóticos. Com o referencial da experiência social da psicose, mais ampla do que a descrição da vivência de sintomas, mas considerando aspectos culturais da experiência, foram realizados três estudos de caso em dois momentos diferentes. Todos os pacientes estudados foram entrevistados tanto em 1995 quanto em 2003. Além dos próprios sujeitos, foram realizadas entrevistas abertas com seus familiares e profissionais que os atendem, considerando assim as redes de rela��ão social dos pacientes. Enfatizaram-se três planos principais: (1 estudo da história do adoecimento; (2 estudo das representações da doença; e (3 descrição do cotidiano e das relações sociais dos pacientes. A partir de uma abordagem antropológica, foram realizadas considerações a respeito do tratamento de pacientes psicóticos inseridos nos Centros de Atenção Psicossocial.This study discusses the relations existing between the institutional aspects of a Psychosocial Care Center (Caps and the experience of psychotic patients. Using the referential base of the social experience of psychosis, which is broader in scope than a description of the experience of symptoms, while considering cultural aspects of the experience, three case studies were conducted at two different times. All of the patients studied were interviewed in 1995 and again in 2003. In addition to interviews with the subjects themselves, open interviews were conducted with their families and their professional carers, thereby taking the social relationship networks of the patients into consideration. Three central aspects were emphasized: (1 study of the history of the illness; (2 study of the representations of the disease; and (3 description of the everyday life and social relationships of the patients. Aspects with respect to the treatment

  11. Preliminary experience in adult-to-adult living donor liver transplantation in a single center in China

    Institute of Scientific and Technical Information of China (English)

    YAN Lunan; CHEN Zheyu; LIU Jiangwen; WU Hong; LI Bo; ZENG Yong; WEN Tianfu; ZHAO Jichun; WANG Wentao; YANG Jiayin; XU Mingqing; MA Yukui

    2007-01-01

    The aim of this paper is to report the authors'experience in performing adult-to-adult living donor liver transplantation (LDLT)by using a modified technique in using grafts of the right lobe of the liver.From January 2002 to September 2006,56 adult patients underwent LDLT using right lobe grafts at the Wlest China Hospital.Sichuan University Medical School,China.All patients underwent a modified operation designed to improve the reconstruction of the right hepatic vein (RHV)and the tributariers of the middle hepatic vein(MHV)by interposing a vessel graft,and by anastomosing the hepatic arteries and bile ducts.There were no severe complications or deaths in all donors.Fifty-two (92.8%) recipients survived the operations.Among the 56 recipients,complications were seen in 15 recipients(26.8%),including hepatic vein stricture(one case),small-for-size syndrome(one case),hepatic artery thrombosis(two cases),intestinal bleeding (one case),bile leakage(two cases),left subphrenic abscess (one case),renal failure(two cases)and pulmonary infection (five cases).Within three months after transplantation,four recipients(7.1 4%)died due to smallfor-size syndrome(one case),renal failure(one case)and multiple organ failure(two cases).All patients underwent direct anastomoses of the RHV and the inferior vena cava (IVC),and in 23 cases,reconstruction of the right inferior hepatic vein was also done.In 24 patients,the reconstruction of the tributaries of the MHV was also done by interposing a vessel graft to provide sufficient venous outflow.Trifurcation of the portal vein was seen in nine cases.Thus,veno-plasty or separate anastomoses were performed.The graft and recipient body weight ratios(GRWR)were between 0.72%and 1.43%,and in three cases it was<0.8%.The graft weight to recipient standard liver volume ratios (GV/SLV) were between 31.86%and 71.68%.among which four cases had<40%.No "small-for-size syndrome"occurred.With modification of the surgical technique,especially in the

  12. Safety of atrial fibrillation ablation with novel multi-electrode array catheters on uninterrupted anticoagulation-a single-center experience.

    LENUS (Irish Health Repository)

    Hayes, Christopher Ruslan

    2012-02-01

    INTRODUCTION: A recent single-center report indicated that the performance of atrial fibrillation ablation in patients on uninterrupted warfarin using a conventional deflectable tip electrode ablation catheter may be as safe as periprocedural discontinuation of warfarin and bridging with heparin. Novel multi-electrode array catheters for atrial fibrillation ablation are currently undergoing clinical evaluation. While offering the possibility of more rapid atrial fibrillation ablation, they are stiffer and necessitate the deployment of larger deflectable transseptal sheaths, and it remains to be determined if they increase the risk of cardiac perforation and vascular injury. Such potential risks would have implications for a strategy of uninterrupted periprocedural anticoagulation. METHOD AND RESULTS: We audited the safety outcomes of our atrial fibrillation ablation procedures using multi-electrode array ablation catheters in patients on uninterrupted warfarin (CHADS2 score>or=2) and in patients not on warfarin (uninterrupted aspirin). Two bleeding complications occurred in 49 patients on uninterrupted warfarin, both of which were managed successfully without longterm sequelae, and no bleeding complication occurred in 32 patients not on warfarin (uninterrupted aspirin). There were no thromboembolic events or other complication with either anticoagulant regimen. CONCLUSION: Despite the larger diameter and increased stiffness of multi-electrode array catheters and their deflectable transseptal sheaths, their use for catheter ablation in patients with atrial fibrillation on uninterrupted warfarin in this single-center experience does not appear to be unsafe, and thus, an adequately powered multicenter prospective randomized controlled trial should be considered.

  13. Historical Center of Quito: an experience for the preservation of courtyard houses with an emphasis on user awareness

    Directory of Open Access Journals (Sweden)

    Sanchez, Lorena Marina

    2016-03-01

    Full Text Available The early declaration of Quito as a World Heritage site in 1978, makes this city a Latin American example with a remarkable preservationist experience. Its Historical Centre composes a blend of periods and goods, emphasizing on the presence of Spanish-Aborigine syncretism stands. This hybridation survives in the buffer area, made up of different neighborhoods, through a residential property typology: the patio houses. With endless complexities to their approach, these homes comprise the residential identity of Quito, but they have only recently taken on a new protagonism within a residential protection framework. Therefore, and through a historical-architectural and social approach, has been investigated the patrimonial fragment of the neighbourhood of San Juan, which is representative of what happens in the buffer area. Diagnosisand guidelines are exposed from a conception of exploratory study, mainly qualitative and focused on users awareness. This approximation has been carried on through the observation in situ, the analysis of planimetry, bibliography, photographs, the carrying out of interviews and opinion polls. Thus, final reflections are presented along with a methodological development feasible of being adapted to other residential properties in other urban contexts. La temprana declaración de Quito como Patrimonio de la Humanidad en 1978 la convierte en un ejemplo latinoamericano con una singular experiencia preservacionista. Su Centro Histórico compone una amalgama de períodos y bienes, destacándose la presencia del sincretismo español-aborigen. Esta hibridación sobrevive en el área de amortiguación, compuesta por diferentes barrios, a través de una tipología residencial característica: las casas patio. Con un sinfín de complejidades para su tratamiento, estas viviendas componen gran parte de la identidad habitacional quiteña, aunque sólo recientemente han adquirido un nuevo protagonismo dentro del marco de protecci

  14. Klystron Modulator Design for the Los Alamos Neutron Science Center Accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Reass, William A. [Los Alamos National Laboratory; Baca, David M. [Los Alamos National Laboratory; Partridge, Edward R. [retired; Rees, Daniel E. [Los Alamos National Laboratory

    2012-06-22

    This paper will describe the design of the 44 modulator systems that will be installed to upgrade the Los Alamos Neutron Science Center (LANSCE) accelerator RF system. The klystrons can operate up to 86 kV with a nominal 32 Amp beam current with a 120 Hz repetition rate and 15% duty cycle. The klystrons are a mod-anode design. The modulator is designed with analog feedback control to ensure the klystron beam current is flat-top regulated. To achieve fast switching while maintaining linear feedback control, a grid-clamp, totem-pole modulator configuration is used with an 'on' deck and an 'off' deck. The on and off deck modulators are of identical design and utilize a cascode connected planar triode, cathode driven with a high speed MOSFET. The derived feedback is connected to the planar triode grid to enable the flat-top control. Although modern design approaches suggest solid state designs may be considered, the planar triode (Eimac Y-847B) is very cost effective, is easy to integrate with the existing hardware, and provides a simplified linear feedback control mechanism. The design is very compact and fault tolerant. This paper will review the complete electrical design, operational performance, and system characterization as applied to the LANSCE installation.

  15. An 800-MeV proton radiography facility for dynamic experiments

    Energy Technology Data Exchange (ETDEWEB)

    King, N.S.P.; Adams, K.; Alrick, K.R.; Crow, M.L.; Cushing, S.B.; Eddleman, J.C.; Fife, T.T.; Gallegos, R.A.; Gray, N.T.; Hogan, G.E.; Holmes, V.H.; Knudsson, J.N.; London, R.K.; Lopez, R.R.; McDonald, T.E.; McClelland, J.B.; Merrill, F.E.; Morley, K.B.; Morris, C.L.; Naivar, F.J.; Pazuchanics, P.D.; Pillai, C.; Riedel, C.M.; Sarracino, J.S.; Shelley, F.E. Jr.; Stacy, H.L.; Takala, B.E.; Tucker, H.E.; Yates, G.J.; Ziock, H.-J.; Zumbro, J.D. [Los Alamos National Laboratory, Los Alamos, NM 87545 (United States); Ables, E. [Livermore National Laboratory, Livermore, CA 94550 (United States); Balzar, Stephen [Bechtel Nevada, Los Alamos, NM 87545 (United States); Barnes, P.D. Jr. [Livermore National Laboratory, Livermore, CA 94550 (United States); Flores, Paul [Bechtel Nevada, Los Alamos, NM 87545 (United States); Fujino, D. [Livermore National Laboratory, Livermore, CA 94550 (United States); Hartouni, E.P. [Livermore National Laboratory, Livermore, CA 94550 (United States); Jaramillo, S.A. [Los Alamos National Laboratory, Los Alamos, NM 87545 (United States); Parker, E.L. [Livermore National Laboratory, Livermore, CA 94550 (United States); Park, H.S. [Livermore National Laboratory, Livermore, CA 94550 (United States); Thompson, Richard [Bechtel Nevada, Los Alamos, NM 87545 (United States)

    1999-11-03

    The capability has successfully been developed at the Los Alamos Nuclear Science Center (LANSCE) to utilize a spatially and temporally prepared 800 MeV proton beam to produce proton radiographs. A series of proton bursts are transmitted through a dynamic object and transported, via a unique magnetic lens system, to an image plane. The magnetic lens system permits correcting for the effects of multiple coulomb scattering which would otherwise completely blur the spatially transmitted information at the image plane. The proton radiographs are recorded either on a time integrating film plate or with a recently developed multi-frame electronic imaging camera system. The latter technique permits obtaining a time dependent series of proton radiographs with time intervals (modulo 358 ns) up to many microseconds and variable time intervals between images. One electronically shuttered, intensified, CCD camera is required per image. These cameras can detect single protons interacting with a scintillating fiber optic array in the image plane but also have a dynamic range which permits recording radiographs with better than 5% statistics for observation of detailed density variations in the object. A number of tests have been carried out to characterize the quality of the proton radiography system for absolute mass determination, resolution, and dynamic range. Initial dynamic experiments characterized the temporal and spatial behavior of shock propagation in a high explosive sample with up to six images per experiment. Based on experience with the prototype system, a number of upgrades are being implemented including the anticipated capability for enhanced mass discrimination through differential multiple coulomb scattering radiographs and more images with improved imaging techniques.

  16. A description of the Galactic Center excess in the Minimal Supersymmetric Standard Model and the Dark Matter signatures for the LHC and direct and indire ct detection experiments

    CERN Document Server

    Caron, Sascha; Hendriks, Luc; de Austri, Roberto Ruiz; Weniger, Christoph

    2015-01-01

    Observations with the Fermi Large Area Telescope (LAT) indicate an excess in gamma rays originating from the center of our Galaxy. A possible explanation for this excess is the annihilation of Dark Matter particles. We have investigated the annihilation of neutralinos as Dark Matter candidates within the phenomenological Minimal Supersymmetric Standard Model (pMSSM). An iterative particle filter approach was used to search for solutions within the pMSSM. We found solutions that are consistent with astroparticle physics and collider experiments, and provide a reasonable fit to the energy spectrum of the excess. The neutralino is a Bino/Higgsino mixture and a mass in the range $84-92$~GeV yielding a Dark Matter relic density $0.06 < \\Omega h^2 <0.13$. These pMSSM solutions make clear forecasts for LHC, direct and indirect DM detection experiments. If the pMSSM explanation of the excess seen by Fermi-LAT is correct, a DM signal might be discovered soon.

  17. Lujan Center Cold Source Upgrade Studies

    International Nuclear Information System (INIS)

    The Manuel Lujan Jr. Neutron Scattering Center (Lujan Center) at the Los Alamos National Laboratory is the most powerful pulsed neutron scattering facility in North America. It currently produces the highest time-averaged cold source brightness of any pulsed neutron scattering facility in the world, and efforts are underway to increase this even further. The Lujan Center is a part of the Los Alamos Neutron Science Center (LANSCE), a complex centered around an 800-MeV proton linear accelerator capable of accelerating 1 mA beam current. The LANSCE accelerator delivers 125 μA of H¯ beam in 0.65-ms-long pulses at 20 Hz to a proton storage ring, which compresses them to a width of 300 ns, each of which contains 4 x 1013 protons per pulse. These pulses are then transported to a 90° dipole magnet which directs them vertically downward onto the Lujan Center target system. The protons induce spallation reactions in the split tungsten target, producing mostly evaporation neutrons, some of which are reflected by the surrounding Be reflector into one of six moderator. Four (three water and one liquid hydrogen) of these are arranged in flux-trap geometry between the upper and lower portions of the split tungsten target; the other two (one water and one liquid hydrogen) are located above the upper portion of the target in what is known as upstream backscattering geometry. Those arranged around the flux trap are called lower-tier moderators, and the other two are known as upper-tier moderators. The lower-tier moderators serve three flight paths each, while the upper-tier moderators serve two flight paths each, for a total of 16 flight paths. Fourteen of these flight paths have operating instruments on them, one more has an instrument under construction, and one is unassigned. The instruments serve a variety of applications, including materials science, biology, chemistry, nuclear physics, and engineering. The Lujan Center is currently operating on a third generation target

  18. Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

    Directory of Open Access Journals (Sweden)

    Coluccia A

    2014-09-01

    Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

  19. Small Gas Bubble Experiment for Mitigation of Cavitation Damage and Pressure Waves in Short-pulse Mercury Spallation Targets

    Energy Technology Data Exchange (ETDEWEB)

    Wendel, Mark W [ORNL; Felde, David K [ORNL; Sangrey, Robert L [ORNL; Abdou, Ashraf A [ORNL; West, David L [ORNL; Shea, Thomas J [ORNL; Hasegawa, Shoichi [Japan Atomic Energy Agency (JAEA); Kogawa, Hiroyuki [Japan Atomic Energy Agency (JAEA); Naoe, Dr. Takashi [Japan Atomic Energy Agency (JAEA); Farny, Dr. Caleb H. [Boston University; Kaminsky, Andrew L [ORNL

    2014-01-01

    Populations of small helium gas bubbles were introduced into a flowing mercury experiment test loop to evaluate mitigation of beam-pulse induced cavitation damage and pressure waves. The test loop was developed and thoroughly tested at the Spallation Neutron Source (SNS) prior to irradiations at the Los Alamos Neutron Science Center - Weapons Neutron Research Center (LANSCE-WNR) facility. Twelve candidate bubblers were evaluated over a range of mercury flow and gas injection rates by use of a novel optical measurement technique that accurately assessed the generated bubble size distributions. Final selection for irradiation testing included two variations of a swirl bubbler provided by Japan Proton Accelerator Research Complex (J-PARC) collaborators and one orifice bubbler developed at SNS. Bubble populations of interest consisted of sizes up to 150 m in radius with achieved gas void fractions in the 10^-5 to 10^-4 range. The nominal WNR beam pulse used for the experiment created energy deposition in the mercury comparable to SNS pulses operating at 2.5 MW. Nineteen test conditions were completed each with 100 pulses, including variations on mercury flow, gas injection and protons per pulse. The principal measure of cavitation damage mitigation was surface damage assessment on test specimens that were manually replaced for each test condition. Damage assessment was done after radiation decay and decontamination by optical and laser profiling microscopy with damaged area fraction and maximum pit depth being the more valued results. Damage was reduced by flow alone; the best mitigation from bubble injection was between half and a quarter that of flow alone. Other data collected included surface motion tracking by three laser Doppler vibrometers (LDV), loop wall dynamic strain, beam diagnostics for charge and beam profile assessment, embedded hydrophones and pressure sensors, and sound measurement by a suite of conventional and contact microphones.

  20. Beam Position and Phase Monitors Characterized and Installed in the LANSCE CCL

    Energy Technology Data Exchange (ETDEWEB)

    Gilpatrick, John D [Los Alamos National Laboratory; Kutac, Vincent G. [Los Alamos National Laboratory; Martinez, Derwin [Los Alamos National Laboratory; McCrady, Rodney C. [Los Alamos National Laboratory; O' Hara, James F. [Los Alamos National Laboratory; Olivas, Felix R. [Los Alamos National Laboratory; Shurter, Robert B. [Los Alamos National Laboratory; Watkins, Heath A. [Los Alamos National Laboratory

    2012-04-11

    The Los Alamos Neutron Science Center - Risk Mitigation Project is in the process of replacing older Coupled-Cavity-Linac (CCL) Beam-Position Monitors (BPMs) with newer Beam Position and Phase Monitors (BPPMs) and their associated electronics and cable plants. In many locations, these older BPMs include a separate Delta-T loop for measuring the beam's central phase and energy. Thirty-one BPPMs have been installed and many have monitored the charged particle beam. The installation of these newer BPPMs is the first step to installing complete BPPM measurement systems. Prior to the installation, a characterization of each BPPM took place. The characterization procedure includes a mechanical inspection, a vacuum testing, and associated electrical tests. The BPPM electrical tests for all four electrodes include contact resistance measurements, Time Domain Reflectometer (TDR) measurements, relative 201.25-MHz phase measurements, and finally a set of position-sensitive mapping measurements were performed which included associated fitting routines. This paper will show these data for a typical characterized BPPM.

  1. Autoimmune thyroiditis, a center experience

    OpenAIRE

    Tomé, S; Bandeira, A; H. Cardoso; Borges, T

    2008-01-01

    Introdução: A doença auto-imune da tiróide é a principal causa de Hipotiroidismo adquirido na criança e adolescente, a sua incidência em idade escolar é de 1.3%1. Objectivo: Caracterizar os doentes com Tiroidite Auto-Imune da consulta de Endocrinologia Pediátrica do Hospital Geral de Santo António em seguimento no ano de 2006. Metodologia: Foi efectuado um estudo retrospectivo com revisão dos processos clínicos, considerando os seguintes parâmetros: idad...

  2. Design and Implementation of Experiment Apparatus Booking and Management System for Research Experiment Center%科研试验中心实验预约管理系统的设计与实现

    Institute of Scientific and Technical Information of China (English)

    沈俊辉; 马星光; 刘仁权

    2011-01-01

    The paper describes a few key points related to the establishment of centrally managed experiment booking system applied in large/mega sized research and education centers. These points include: general design idea, system structure and functionality. The system is based on ASP. Net technology and coded by C# programming language and uses SQL Server 2008 database. The system greatly improve booking processes, such as online booking, examining and endorsing, booking system management, booking system inquiry or statistics, etc. The work proves to be a successful in dealing with more demanding booking work in large scale research or education centers using network technology.%介绍了科研实验中心的试验预约管理系统的设计思路、技术架构和功能实现.该系统使用ASP.Net技术,采用C#编程语言,使用SQL Server 2008数据库,实现了科研试验中心的实验申请网上预约、审批、管理、统计等功能,为试验仪器资源的网络化管理探索了一条有效途径.

  3. The Magnetospheric Multiscale (MMS) Mission Science Data Center: Technologies, Methods, and Experiences in Making Available Large Volumes of In-Situ Particle and Field Data

    Science.gov (United States)

    Pankratz, Christopher; Kokkonen, Kim; Larsen, Kristopher; Panneton, Russell; Putnam, Brian; Schafer, Corey; Baker, Daniel; Burch, James

    2016-04-01

    On September 1, 2015 the Magnetospheric MultiScale (MMS) constellation of four satellites completed their six-month commissioning period and began routine science data collection. Science operations for the mission is conducted at the Science Operations Center (SOC) at the Laboratory for Atmospheric and Space Physics, University of Colorado in Boulder, Colorado, USA. The MMS Science Data Center (SDC) is a component of the SOC responsible for the data production, management, dissemination, archiving, and visualization of the data from the extensive suite of 100 instruments onboard the four spacecraft. As of March 2016, MMS science data are openly available to the entire science community via the SDC. This includes hundreds of science parameters, and 50 gigabytes of data per day distributed across thousands of data files. Products are produced using integrated software systems developed and maintained by teams at other institutions using their own institutional software management procedures and made available via a centralized public web site and web services. To accomplish the data management, data processing, and system integration challenges present on this space mission, the MMS SDC incorporates a number of evolutionary techniques and technologies. This presentation will provide an informatics-oriented view of the MMS SDC, summarizing its technical aspects, novel technologies and data management practices that are employed, experiences with its design and development, and lessons learned. Also presented is the MMS "Scientist-in-the-Loop" (SITL) system, which is used to leverage human insight and expertise to optimize the data selected for transmission to the ground. This smoothly operating system entails the seamless interoperability of multiple mission facilities and data systems that ultimately translate scientist insight into uplink commands that triggers optimal data downlink to the ground.

  4. Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Setton, Jeremy; Caria, Nicola; Romanyshyn, Jonathan; Koutcher, Lawrence; Wolden, Suzanne L.; Zelefsky, Michael J.; Rowan, Nicholas [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Sherman, Eric J.; Fury, Matthew G.; Pfister, David G. [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Wong, Richard J.; Shah, Jatin P.; Kraus, Dennis H. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Shi Weiji; Zhang Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Schupak, Karen D.; Gelblum, Daphna Y.; Rao, Shyam D. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Lee, Nancy Y., E-mail: Leen2@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-01-01

    Purpose: To update the Memorial Sloan-Kettering Cancer Center's experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27-91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. Results: Median follow-up among surviving patients was 36.8 months (range, 3-135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia {>=}Grade 2 was 11% and 29%, respectively. Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

  5. WE-G-BRE-07: Proton Therapy Enhanced by Tumor-Targeting Gold Nanoparticles: A Pilot in Vivo Experiment at The Proton Therapy Center at MD Anderson Cancer Center

    International Nuclear Information System (INIS)

    Purpose: Assess tumor-growth delay and survival in a mouse model of prostate cancer treated with tumor-targeting gold nanoparticles (AuNPs) and proton therapy. Methods: We first examined the accumulation of targeting nanoparticles within prostate tumors by imaging AuNPs with ultrasound-guided photoacoustics at 24h after the intravenous administration of goserelin-conjugated AuNPs (gAuNP) in three mice. Nanoparticles were also imaged at the cellular level with TEM in PC3 cells incubated with gAuNP for 24h. Pegylated AuNPs (pAuNP) were also imaged in vivo and in vitro for comparison. PC3 cells were then implanted subcutaneously in nude mice; 51mice with 8–10mm tumors were included. AuNPs were injected intravenously at 0.2%w/w final gold concentration 24h before irradiation. A special jig was designed to facilitate tumor irradiation perpendicular to the proton beam. Proton energy was set to 180MeV, the radiation field was 18×18cm2, and 9cm or 13.5cm thick solid-water compensators were used to position the tumors at either the beam entrance (BE) or the SOBP. Physical doses of 5Gy were delivered to all tumors on a patient beam line at MD Anderson's Proton Therapy Center. Results: The photoacoustic experiment reveled that our nanoparticles leak from the tumor-feeding vasculature and accumulate within the tumor volume over time. Additionally, TEM images showed gAuNP are internalized in cancer cells, accumulating within the cytoplasm, whereas pAuNP are not. Tumor-growth was delayed by 11 or 32days in mice receiving gAuNP irradiated at the BE or the SOBP, relative to proton radiation alone. Survival curves (ongoing experiment) reveal that gAuNPs improved survival by 36% or 74% for tumors irradiated at the BE or SOBP. Conclusion: These important, albeit preliminary, in vivo findings reveal nanoparticles to be potent sensitizers to proton therapy. Further, conjugation of AuNPs to tumor-specific antigens that promote enhanced cellular internalization improved both

  6. WE-G-BRE-07: Proton Therapy Enhanced by Tumor-Targeting Gold Nanoparticles: A Pilot in Vivo Experiment at The Proton Therapy Center at MD Anderson Cancer Center

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, T; Grant, J; Wolfe, A; Gillin, M; Krishnan, S [MD Anderson Cancer Ctr., Houston, TX (United States)

    2014-06-15

    Purpose: Assess tumor-growth delay and survival in a mouse model of prostate cancer treated with tumor-targeting gold nanoparticles (AuNPs) and proton therapy. Methods: We first examined the accumulation of targeting nanoparticles within prostate tumors by imaging AuNPs with ultrasound-guided photoacoustics at 24h after the intravenous administration of goserelin-conjugated AuNPs (gAuNP) in three mice. Nanoparticles were also imaged at the cellular level with TEM in PC3 cells incubated with gAuNP for 24h. Pegylated AuNPs (pAuNP) were also imaged in vivo and in vitro for comparison. PC3 cells were then implanted subcutaneously in nude mice; 51mice with 8–10mm tumors were included. AuNPs were injected intravenously at 0.2%w/w final gold concentration 24h before irradiation. A special jig was designed to facilitate tumor irradiation perpendicular to the proton beam. Proton energy was set to 180MeV, the radiation field was 18×18cm{sup 2}, and 9cm or 13.5cm thick solid-water compensators were used to position the tumors at either the beam entrance (BE) or the SOBP. Physical doses of 5Gy were delivered to all tumors on a patient beam line at MD Anderson's Proton Therapy Center. Results: The photoacoustic experiment reveled that our nanoparticles leak from the tumor-feeding vasculature and accumulate within the tumor volume over time. Additionally, TEM images showed gAuNP are internalized in cancer cells, accumulating within the cytoplasm, whereas pAuNP are not. Tumor-growth was delayed by 11 or 32days in mice receiving gAuNP irradiated at the BE or the SOBP, relative to proton radiation alone. Survival curves (ongoing experiment) reveal that gAuNPs improved survival by 36% or 74% for tumors irradiated at the BE or SOBP. Conclusion: These important, albeit preliminary, in vivo findings reveal nanoparticles to be potent sensitizers to proton therapy. Further, conjugation of AuNPs to tumor-specific antigens that promote enhanced cellular internalization improved

  7. GEANT simulations of neutron capture experiments with a 4p BaF2 detector

    CERN Document Server

    Heil, M; Kaeppeler, F; Wisshak, K; Voss, F; Ullmann, J L; Haight, R C; Seabury, E H; Wilhelmy, J B; Rundberg, R S; Fowler, M M

    2004-01-01

    The goal of this research project is to give quantitative information useful for the design of a g-ray detector to investigate neutron capture (n, g) reactions on radioactive nuclei at the Manuel Lujan Jr. Neutron Scattering Center (MLNSC) moderated neutron source at LANSCE. Data for neutron energies from thermal up to approximately 500 keV are desired. The radioactive nuclei can have half-lives as short as a few months. With the sample sizes foreseen, typically 1 mg, the radioactive decay rate can exceed tens of Curies (Ci).

  8. Simultaneous multi-tear exclusion:an optimal strategy for type B thoracic aortic dissection initially proved by a single center's 8 years experience

    Institute of Scientific and Technical Information of China (English)

    YUAN Liang-xi; BAO Jun-min; ZHAO Zhi-qing; FENG Xiang; OU Le-feng; FENG Rui; LU Qing-sheng; MEI Zhi-jun; JING Zai-ping

    2007-01-01

    Background Endovascular stent-grafting is widely used to treat thoracic aortic dissection.However,little information is available regarding outcome following simultaneous exclusion of multiple tears.This report details eight years of experience using simultaneous multi-tear exclusion for treatment of Stanford type B thoracic aortic dissection resulting in successful aortic remodeling without adverse events.Methods From September 1998 to January 2006,29 type B thoracic aortic dissection patients(24 men,5 women;27 chronic,2 acute;mean age 58 years,range 45-77 years)were treated by simultaneous multi-tear exclusion in our center.Magnetic resonance angiography was used as the preoperative evaluation method.Different kinds of stent-grafts were used.The patients were followed up with contrast-enhanced spiral computed tomography at 6 months postoperatively and yearly thereafter.Results Twenty-nine surgeries were completed successfully using at least 2 stent-grafts per patient(range:2-6,mean:2.7).No major procedure-related complications,such as rupture,paraplegia,aortic branch ischemia or cerebral infarction,were observed.During follow-up,favorable remodeling of the aorta was observed.Conclusions The mid-term result of thoracic aortic dissection with simultaneous multi-tear exclusion was satisfactory.With the improvement of stent-grafts,simultaneous multi-tear exclusion should find wider application and become an optimal strategy for thoracic aortic dissection.

  9. Observation of the intermediate vector bosons W+- and Z0 in proton-antiproton collisions at 546 GeV center of mass energy. UA2 experiment

    International Nuclear Information System (INIS)

    The Standard Model of electromagnetic and weak interactions predicts the existence of the intermediate vector bosons W+- and Z0 and gives precise predictions for their masses. Antiproton accumulation by stochastic cooling and the operation of the CERN SPS accelerator in collider mode made accessible pantip at 546 GeV center of mass energy. This thesis presents the observation of the intermediate vector bosons through their decays Z0 → e+e-, W → eν. During running periods 1982 and 1983, 8 decays Z0 → e+e- and 32 decays W → eν with an electron of Psub(T) > 25 GeV/c were observed in UA2 experiment. Cross sections of W+- and Z0 production and the weak interaction parameters: Msub(W), Msub(Z), sin2thetasub(W) and rho are determined. These results are in agreement with Standard Model predictions, thus confirming theory in a spectacular way. An upper limit to the total width of the Z0 is given. An upper limit to the number of additional neutrinos is inferred. Radiative decays of the intermediate vector bosons are discussed

  10. The International Science and Technology Center (ISTC) - Fifteen-Year Experience in Management of Innovative Nuclear and Other Programs (Information Review)

    International Nuclear Information System (INIS)

    : - Are managing internationally; - Have plans and results, available for international collaborators; - Results may be passed to international centers (OECD/NEA and/or others) for further international benchmarking. As for today - a set of demonstration and basic-type experiments, which fit closely with IAEA/ INPRO and GIF program, with EU Frame-Work programs, - had been done or under development now in the frame of ISTC projects and programs with active international collaboration. The ISTC - as a unique international tool - is ready to take part and manage further this activity. Among five thousand project proposals submitted to ISTC, there are about five hundred related to different aspects of nuclear technologies and Nuclear Fuel Cycle (NFC). Survey of the ISTC project results: The following information will be included in the review, with special attention on details of corresponding experimental programs: - Novel reactor concepts, corresponding to GIF: - Fast reactors (Sodium-, Lead-and Lead-Bismuth-cooled); - Supercritical Pressure Water aspects; - HTGR - critical modeling, engineering. - Molten salts. - Nuclear Fuel Cycle options (including Partitioning and Transmutation). - Reactor data benchmarking and verification, critical experiments. - Nuclear Power Plant life management (Reactor pressure vessel and internals control, etc.). - Nuclear data measurements. - Severe accident study (Corium modelling, Quench-effect, Chernobyl). - Sky-shine experiments. - Depleted Uranium for RAW storage. - Technical and economical analysis of NFC, including non-proliferation issues. - Novel reactor engineering systems - experimental and computer modelling (steam-generators, etc.). - Accelerator Driven Systems (experimental modeling). References: The ISTC Annual Reports - ISTC, Moscow, 1996 - 2007. Web-site: www.istcinfo.ru. (authors)

  11. International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China

    Directory of Open Access Journals (Sweden)

    Chengquan Zhao

    2015-01-01

    Full Text Available Background: Telepathology is increasingly being employed to support diagnostic consultation services. Prior publications have addressed technology aspects for telepathology, whereas this paper will address the clinical telepathology experience of KingMed Diagnostics, the largest independent pathology medical laboratory in China. Beginning in 2012 the University of Pittsburgh Medical Center (UPMC and KingMed Diagnostics partnered to establish an international telepathology consultation service. Materials and Methods: This is a retrospective study that summarizes the telepathology experience and diagnostic consultation results between UPMC and KingMed over a period of 3 years from January 2012 to December 2014. Results: A total of 1561 cases were submitted for telepathology consultation including 144 cases in 2012, 614 cases in 2013, and 803 in 2014. Most of the cases (61.4% submitted were referred by pathologists, 36.9% by clinicians, and 1.7% by patients in China. Hematopathology received the most cases (23.7%, followed by bone/soft tissue (21.0% and gynecologic/breast (20.2% subspecialties. Average turnaround time (TAT per case was 5.4 days, which decreased from 6.8 days in 2012 to 5.0 days in 2014. Immunostains were required for most of the cases. For some difficult cases, more than one round of immunostains was needed, which extended the TAT. Among 855 cases (54.7% where a primary diagnosis or impression was provided by the referring local hospitals in China, the final diagnoses rendered by UPMC pathologists were identical in 25.6% of cases and significantly modified (treatment plan altered in 50.8% of cases. Conclusion: These results indicate that international telepathology consultation can significantly improve patient care by facilitating access to pathology expertise. The success of this international digital consultation service was dependent on strong commitment and support from leadership, information technology expertise, and

  12. Hastings Center

    Science.gov (United States)

    ... Public Events October 19, Hastings Center Seminar, Garrison : Human Genetic Engineering: Wh at Can We Do? What Should We ... Public Events October 19, Hastings Center Seminar, Garrison : Human Genetic Engineering: Wh at Can We Do? What Should We ...

  13. The Activity of Archive to Preserve the Memory of the Events and Participants of the Great Patriotic War: the Experience of the Documentation Center of the Modern History of the Rostov Region

    Directory of Open Access Journals (Sweden)

    Olga V. Valuyskova

    2015-07-01

    Full Text Available The article characterizes the forms of use of archival documents about World War II in order to popularize scientific knowledge and patriotic education. This article was prepared on the basis of experience of the Documentation Center of the Modern History of the Rostov Region.

  14. The Place of Computed Tomography as a Guidance Modality in Percutaneous Nephrostomy: Analysis of a 10-Year Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Egilmez, H.; Oztoprak, I.; Atalar, M.; Cetin, A.; Gumus, C.; Gultekin, Y.; Bulut, S.; Arslan, M.; Solak, O. [Depts. of Radiology, Obstetrics and Gynecology, and Urology, Cumhuriyet Univ. School of Medicine, Sivas (Turkey)

    2007-09-15

    Background: Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. Purpose: To retrospectively review experience with CT-guided PCN over a 10-year period in a single center. Material and Methods: All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications. Results: PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure. Conclusion: CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis. Keywords: Computed tomography; percutaneous nephrostomy; urinary obstruction.

  15. Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

    International Nuclear Information System (INIS)

    Purpose: To update the Memorial Sloan-Kettering Cancer Center’s experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27–91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. Results: Median follow-up among surviving patients was 36.8 months (range, 3–135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia ≥Grade 2 was 11% and 29%, respectively. Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

  16. Single-Center Experience and 1-Year Follow-up Results of 'Sandwich Technique' in the Management of Common Iliac Artery Aneurysms During EVAR

    Energy Technology Data Exchange (ETDEWEB)

    Ricci, Carmelo; Ceccherini, Claudio, E-mail: claudiocec@hotmail.it; Cini, Marco; Vigni, Francesco; Leonini, Sara [Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Radiologia Interventistica (Italy); Tommasino, Giulio; Muzzi, Luigi; Tucci, Enrico; Benvenuti, Antonio; Neri, Eugenio [Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Chirurgia del Cuore e dei grossi vasi (Italy)

    2012-10-15

    Purpose: Abdominal aortic aneurysm (AAA) accompanied by common iliac artery (CIA) aneurysms requires a more demanding procedure owing to the difficulties in obtaining an adequate distal landing zone for the stent-graft limb(s), a potential site of endoleak. The 'sandwich technique' is a procedure to increase EVAR feasibility in the setting of adverse or challenging CIA anatomy. Its main advantages include no restrictions in terms of CIA diameter or length or internal iliac artery (IIA) diameter, no need to wait for a specific stent-graft. Our purpose is to describe our single-center experience and one year follow-up results of this new procedure. Materials and Methods: From April 2009 to June 2010, the sandwich technique was performed in our institution in 7 patients treated for AAA and unilateral CIA aneurysms (n. 5) or bilateral CIA aneurysms (n. 2). Inclusion criteria were the presence of unilateral or bilateral CIA aneurysm (independently from its diameter), IIA artery measuring up to 9 mm in its maximum diameter, not dilatation of IIA and EIA. Results: The mean follow-up length was 15 months (range: 14-20 months). All stent-implanted iliac branches remained patent on 1 year follow-up and IIA flow was preserved. None of the patients had symptoms of pelvic ischemia. CT scan follow-up showed aneurysm shrinkage in five patients, without any sign of endoleaks in all cases. Conclusions: In selected cases, the 'sandwich technique' showed good outcomes confirming to be a safe and easy to perform way to overcome anatomical constraints and expanding the limits of EVAR.

  17. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience.

    Science.gov (United States)

    Dağgülli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utanğaç, Mehmet Mazhar; Bodakçi, Mehmet Nuri; Penbegül, Necmettin; Hatipoğlu, Namık Kemal; Çakmakçı, Süleyman

    2015-11-01

    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70% of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80% (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL.

  18. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience.

    Science.gov (United States)

    Dağgülli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utanğaç, Mehmet Mazhar; Bodakçi, Mehmet Nuri; Penbegül, Necmettin; Hatipoğlu, Namık Kemal; Çakmakçı, Süleyman

    2015-11-01

    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70% of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80% (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL. PMID:26002160

  19. Feasibility and safety of combined interventional procedures in elderly patients with complex cardiovascular diseases:experience of a single medical center

    Institute of Scientific and Technical Information of China (English)

    Caiyi LU; Haiyun WU; Shiwen WANG; Xinli WU; Qiao XUE; Taohong HU; Muyang YAN; Rui CHEN; Zhongren ZHAO

    2005-01-01

    Objectives:To report the clinical experience of combined interventional procedures in the treatment of elderly patients with coexisting two or more cardiovascular diseases in our medical center, and to assess the feasibility, safety and therapeutic efficacy of this management strategy. Methods : Patients were selected to the study if: 1) age >65 years; 2) with coexistence of two or more cardiovascular diseases which are indications for interventional therapy; 3) patients' general condition and organ functions allow the performance of combined multiple procedures; 4) the predicted procedure time is within 150 min; 5) the predicted contrast medium dosage is within 300 ml. The criteria we analyzed included procedural type, rocedural time, fluoroscopy time, dosage of contrast medium, success rates of the procedures, complications and in-hospital mortality. All patients were followed up for 30.4 ± 9.3 months,to determine the all-cause mortality, recurrence rates and adverse cardiac events. Results : From January 2000 to December 2004,combined interventional procedures were performed on 136 patients, with 2 procedures on 134 patients and 3 procedures on 2 patients.The mean procedure time was 115.4±11.6 min, the mean fluoroscopy time was 35.7±9.3 min, and the mean dosage of contrast medium used was 183.6±19.4 ml. Procedural success rate was 100%, no procedure related death or major complications occurred.Conclusion: Performed by a competent team, combined interventional procedures in elderly patients with multiple cardiovascular diseases were feasible and relatively safe.

  20. Evolving progress in oncologic and operative outcomes for esophageal and junctional cancer: lessons from the experience of a high-volume center.

    LENUS (Irish Health Repository)

    Reynolds, John V

    2012-05-01

    Modern series from high-volume esophageal centers report an approximate 40% 5-year survival in patients treated with curative intent and postoperative mortality rates of less than 4%. An objective analysis of factors that underpin current benchmarks within high-volume centers has not been performed.

  1. Excel Center

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Citigroup,one of the World top 500 companies,has now settled in Excel Center,Financial Street. The opening ceremony of Excel Center and the entry ceremony of Citigroup in the center were held on March 31.Government leaders of Xicheng District,the Excel CEO and the heads of Asia-Pacific Region leaders of Citibank all participated in the ceremony.

  2. Job center

    Science.gov (United States)

    To better meet the needs of AGU members, a program has been started to increase the effectiveness of the Job Center activity at the Spring and Fall Meetings. As a result, participation in the Job Center at the 1988 AGU Spring Meeting in Baltimore increased substantially compared to previous Spring Meetings. The number of employers, applicants, and interviews scheduled more than doubled compared to the 1987 Spring Job Center.In order to make the meeting Job Centers even better, a survey is being conducted of employers and applicants who participated in the 1988 Spring Job Center. Evaluation of this survey will be useful in continuing increased participation in and the effectiveness of the Job Center at the 1988 Fall Meeting. Past participants and those interested in the future of the Job Center are encouraged to forward comments and suggestions to AGU, Member Programs Division, 2000 Florida Ave., N.W., Washington, DC 20009.

  3. Guidelines for the diagnosis and management of chylomicron retention disease based on a review of the literature and the experience of two centers

    Directory of Open Access Journals (Sweden)

    Castagnetti Justine

    2010-09-01

    Full Text Available Abstract Familial hypocholesterolemia, namely abetalipoproteinemia, hypobetalipoproteinemia and chylomicron retention disease (CRD, are rare genetic diseases that cause malnutrition, failure to thrive, growth failure and vitamin E deficiency, as well as other complications. Recently, the gene implicated in CRD was identified. The diagnosis is often delayed because symptoms are nonspecific. Treatment and follow-up remain poorly defined. The aim of this paper is to provide guidelines for the diagnosis, treatment and follow-up of children with CRD based on a literature overview and two pediatric centers 'experience. The diagnosis is based on a history of chronic diarrhea with fat malabsorption and abnormal lipid profile. Upper endoscopy and histology reveal fat-laden enterocytes whereas vitamin E deficiency is invariably present. Creatine kinase (CK is usually elevated and hepatic steatosis is common. Genotyping identifies the Sar1b gene mutation. Treatment should be aimed at preventing potential complications. Vomiting, diarrhea and abdominal distension improve on a low-long chain fat diet. Failure to thrive is one of the most common initial clinical findings. Neurological and ophthalmologic complications in CRD are less severe than in other types of familial hypocholesterolemia. However, the vitamin E deficiency status plays a pivotal role in preventing neurological complications. Essential fatty acid (EFA deficiency is especially severe early in life. Recently, increased CK levels and cardiomyopathy have been described in addition to muscular manifestations. Poor mineralization and delayed bone maturation do occur. A moderate degree of macrovesicular steatosis is common, but no cases of steatohepatitis cirrhosis. Besides a low-long chain fat diet made up uniquely of polyunsaturated fatty acids, treatment includes fat-soluble vitamin supplements and large amounts of vitamin E. Despite fat malabsorption and the absence of postprandial chylomicrons

  4. Functional Centering

    CERN Document Server

    Hahn, M

    1996-01-01

    Based on empirical evidence from a free word order language (German) we propose a fundamental revision of the principles guiding the ordering of discourse entities in the forward-looking centers within the centering model. We claim that grammatical role criteria should be replaced by indicators of the functional information structure of the utterances, i.e., the distinction between context-bound and unbound discourse elements. This claim is backed up by an empirical evaluation of functional centering.

  5. [Scientific and methodologic basis of a program for occupational control of ambient air quality within a totally sanitary protective zone at an industrial center borderline (Permsky area experience)].

    Science.gov (United States)

    Maĭ, I V; Balashov, S Iu

    2013-01-01

    The authors suggested and tested an algorithm to select optimal placement of stationary and mobile points for controlling ambient air quality on borderline of united sanitary protective zone of industrial center. The method involves claster analysis to outline sites even in levels and lists of parameters, on borderline of united sanitary protective zone of industrial center. Informative value of the occupational control parameters is evaluated through conjugated analysis of general level of surface concentration of admixtures and enterprise's contribution into pollution. For each enterprise, separate control program is provided. Tests of the method demonstrated that it is effective and conclusive in formation of minimally sufficient programs for occupational control in complicated conditions of industrial centers with single-field enterprises, when industrial releases are close in composition and in created pollution level. PMID:24640091

  6. Distribution center

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Distribution center is a logistics link fulfill physical distribution as its main functionGenerally speaking, it's a large and hiahly automated center destined to receive goods from various plants and suppliers,take orders,fill them efficiently,and deliver goods to customers as quickly as possible.

  7. 5 years of experience implementing a methicillin-resistant Staphylococcus aureus search and destroy policy at the largest university medical center in the Netherlands

    NARCIS (Netherlands)

    M.C. Vos (Margreet); M.D. Behrendt (Myra); D.C. Melles (Damian); F.P.N. Mollema (Femke); W. de Groot (Woutrinus); G. Parlevliet (Gerard); A. Ott (Alewijn); D. Horst-Kreft (Deborah); A.F. van Belkum (Alex); H.A. Verbrugh (Henri)

    2009-01-01

    textabstractOBJECTIVE: To evaluate the effectiveness of a rigorous search and destroy policy for controlling methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. DESIGN: Hospital-based observational follow-up study. SETTING: Erasmus University Medical Center Rotterdam, a 1,2

  8. Neutron Capture Experiments on Unstable Nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Jon M. Schwantes; Ralf Sudowe; Heino Nitsche; Darleane C. Hoffman

    2003-12-16

    A primary objective of this project is to study neutron capture cross sections for various stable and unstable isotopes that will contribute to the Science Based Stockpile Stewardship (SBSS) program by providing improved data for modeling and interpretation of nuclear device performance. The information obtained will also be important in astrophysical modeling of nucleosynthesis. During this reporting period, the emphasis has been on preparing a radioactive target of {sup 155}Eu (half-life = 4.7 years), and several stable targets, including isotopically separated {sup 154}Sm, {sup 151}Eu, and {sup 153}Eu. Measurements of their neutron capture cross sections will be conducted in collaboration with researchers at the Los Alamos Neutron Science Center (LANSCE) facility using the Detector for Advanced Neutron Capture Experiments (DANCE). A suitable backing material (beryllium) for the targets has been selected after careful calculations of its contribution to the background of the measurements. In addition, a high voltage plating procedure has been developed and optimized. Stable targets of {sup 151}Eu and {sup 153}Eu and a target of natural Eu ({approx}50% {sup 151}Eu and {approx}50% {sup 153}Eu) have each been plated to a mass thickness of >1 mg/cm{sup 2} and delivered to the DANCE collaboration at Los Alamos National Laboratory (LANL). Natural Eu targets will be tested first to confirm that the target dimensions and backing are appropriate prior to performing measurements on the extremely valuable targets of separated isotopes. In order to prepare a target of the radioactive {sup 155}Eu, it must first be separated from the {sup 154}Sm target material that was irradiated in a very high neutron flux of 1.5x1015 neutrons/cm{sup 2}/s for 50 days. The reaction is {sup 154}Sm (n,f){sup 155}Sm (half-life = 22 minutes) {sup 155}Eu. Considerable progress has been made in developing a suitable high-yield and high-purity separation method for separating Eu from targets

  9. Senior Centers

    Medline Plus

    Full Text Available ... Karen Albers] We provide a wide variety of activities -- physical, health, mental health programs with Senior Plus, cognitive ... of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ...

  10. Senior Centers

    Medline Plus

    Full Text Available ... Living independently at home is something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, and meals programs are long- ...

  11. Senior Centers

    Medline Plus

    Full Text Available ... variety of social and recreational activities. [Karen Albers] We provide a wide variety of activities -- physical, health, ... senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, tap dancing, ballroom dancing, ...

  12. Senior Centers

    Medline Plus

    Full Text Available ... transportation, and meals programs are long-term care services available in the community which make it easier ... about senior centers and other long-term care services available in your community, contact the Eldercare Locator ...

  13. Senior Centers

    Medline Plus

    Full Text Available ... of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ... chi, tap dancing, ballroom dancing, square dancing, chair exercise, arthritis classes, yoga, and lots of dancing. [Narrator] ...

  14. Increasing the operational efficiency and safety in operation control centers: the TRANSPETRO experience; Aumentando a seguranca e eficiencia operacional em centros de controle: a experiencia da TRANSPETRO

    Energy Technology Data Exchange (ETDEWEB)

    Felicio, Marco Aurelio Fierro; Frisoli, Caetano [PETROBRAS Transporte S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil)

    2009-12-19

    The increase in operational efficiency and safety in operation control centers has been traditionally obtained through direct actions in the operational activity itself and on the resources and systems used for that. Modern supervisory and control systems, sophisticated simulation software, cutting-edge last generation equipment and installations, clear and comprehensive procedures definitions and intensive and constant training of the operation teams are, usually, the chosen paths followed by control centers in their incessant quest for increased operational efficiency and safety. This paper presents the path followed by the TRANSPETRO's National Operational Control Center - Natural Gas (Centro Nacional de Controle Operacional - CNCO-Gas) - that has not only focused with the traditional aspects above, but has also made intensive investments in systems and data base integrations, aiming at eliminating data inconsistencies and redundancies and at including automation, standardization and systematization of non-operational and complementary operational activities. These investments allowed TRANSPETRO CNCO-Gas face the big challenge of growing that TRANSPETRO's gas transportation activity is facing now and will be facing in the near future: from 2,600 km to 7,000 km of gas pipelines, and a volume of transported natural gas from 35 MMm{sup 3}/day to 100 MMm{sup 3}/day. (author)

  15. Reliability Centered Maintenance - Methodologies

    Science.gov (United States)

    Kammerer, Catherine C.

    2009-01-01

    Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

  16. Fusion engineering design center

    International Nuclear Information System (INIS)

    In the spring of 1985, the Department of Energy (DOE) directed the Design Center to take a lead responsibility in assessing the engineering feasibility of a very compact tokamak experiment with copper coils. Following this assessment, the Design Center studied the Ignitor concept at the request of DOE and arrived at a design configuration. Many features of this configuration have been incorporated into the national baseline conceptual design for a Compact Ignition Tokamak (CIT). The Design Center continued to participate in the mirror program by contributing to the Minimars design effort, a two-year program to develop and describe an attractive tandem mirror reactor concept. The Design Center's principal role is in configuration definition of the candidate concepts. The Design Center continues to lead the engineering activities for the International Tokamak Reactor program. Advanced commercial tokamaks were studied by the Design Center as part of the Tokamak Power Systems Studies project coordinated by the DOE Office of Fusion Energy. The Design Center also provided design integration of the US effort. A cost accounting system that is applicable to all magnetic fusion reactor design studies was developed and applied to different confinement concepts and types of projects. The system provides the structure for development of a fusion cost database and validated cost estimating procedures

  17. Measurement of the 238U neutron-capture cross section and gamma-emission spectra from 10 eV to 100 keV using the DANCE detector at LANSCE

    International Nuclear Information System (INIS)

    A careful new measurement of the 238U(n,γ) cross section from 10 eV to 100 keV has been made using the DANCE detector at LANSCE. DANCE is a 4π calorimetric scintillator array consisting of 160 BaF2 crystals. Measurements were made on a 48 mg/cm2 depleted uranium target. The cross sections are in general good agreement with previous measurements. The gamma-ray emission spectra, as a function of gamma multiplicity, were also measured and compared to model calculations.

  18. Measurement of the 238U neutron-capture cross section and gamma-emission spectra from 10 eV to 100 keV using the DANCE detector at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, John L [Los Alamos National Laboratory; Couture, A J [Los Alamos National Laboratory; Keksis, A L [Los Alamos National Laboratory; Vieira, D J [Los Alamos National Laboratory; O' Donnell, J M [Los Alamos National Laboratory; Jandel, M [Los Alamos National Laboratory; Haight, R C [Los Alamos National Laboratory; Rundberg, R S [Los Alamos National Laboratory; Kawano, T [Los Alamos National Laboratory; Chyzh, A [NORTH CAROLINA STATE UNIV; Baramsai, B [NORTH CAROLINA STATE UNIV; Wu, C Y [LLNL; Mitchell, G E [NORTH CAROLINA STATE UNIV; Becker, J A [LLNL; Krticka, M [CHARLES UNIV

    2010-01-01

    A careful new measurement of the {sup 238}U(n,{gamma}) cross section from 10 eV to 100 keV has been made using the DANCE detector at LANSCE. DANCE is a 4{pi} calorimetric scintillator array consisting of 160 BaF{sub 2} crystals. Measurements were made on a 48 mg/cm{sup 2} depleted uranium target. The cross sections are in general good agreement with previous measurements. The gamma-ray emission spectra, as a function of gamma multiplicity, were also measured and compared to model calculations.

  19. An Approach for Calculating Student-Centered Value in Education – A Link between Quality, Efficiency, and the Learning Experience in the Health Professions

    Science.gov (United States)

    Ooi, Caryn; Reeves, Scott; Walsh, Kieran

    2016-01-01

    Health professional education is experiencing a cultural shift towards student-centered education. Although we are now challenging our traditional training methods, our methods for evaluating the impact of the training on the learner remains largely unchanged. What is not typically measured is student-centered value; whether it was ‘worth’ what the learner paid. The primary aim of this study was to apply a method of calculating student-centered value, applied to the context of a change in teaching methods within a health professional program. This study took place over the first semester of the third year of the Bachelor of Physiotherapy at Monash University, Victoria, Australia, in 2014. The entire third year cohort (n = 78) was invited to participate. Survey based design was used to collect the appropriate data. A blended learning model was implemented; subsequently students were only required to attend campus three days per week, with the remaining two days comprising online learning. This was compared to the previous year’s format, a campus-based face-to-face approach where students attended campus five days per week, with the primary outcome—Value to student. Value to student incorporates, user costs associated with transportation and equipment, the amount of time saved, the price paid and perceived gross benefit. Of the 78 students invited to participate, 76 completed the post-unit survey (non-participation rate 2.6%). Based on Value to student the blended learning approach provided a $1,314.93 net benefit to students. Another significant finding was that the perceived gross benefit for the blended learning approach was $4014.84 compared to the campus-based face-to-face approach of $3651.72, indicating that students would pay more for the blended learning approach. This paper successfully applied a novel method of calculating student-centered value. This is the first step in validating the value to student outcome. Measuring economic value to the

  20. Prevalence and associated factors of dry eye: Our experience in patients above 40 years of age at a Tertiary Care Center

    OpenAIRE

    Suchi Shah; Harsha Jani

    2015-01-01

    Context: Dry eye is a very common as well as under-diagnosed ocular disorder. It is not only troublesome in terms of its symptoms but also imposes a great financial burden. Aims: To determine the prevalence of dry eye in ophthalmology out-patients at a Tertiary Care Hospital and its association with various clinico-epidemiological factors. Settings and Design: A hospital-based study at a Tertiary Care Center was conducted including 400 out-patients of age 40 years and above. Material...

  1. An Approach for Calculating Student-Centered Value in Education - A Link between Quality, Efficiency, and the Learning Experience in the Health Professions.

    Science.gov (United States)

    Nicklen, Peter; Rivers, George; Ooi, Caryn; Ilic, Dragan; Reeves, Scott; Walsh, Kieran; Maloney, Stephen

    2016-01-01

    Health professional education is experiencing a cultural shift towards student-centered education. Although we are now challenging our traditional training methods, our methods for evaluating the impact of the training on the learner remains largely unchanged. What is not typically measured is student-centered value; whether it was 'worth' what the learner paid. The primary aim of this study was to apply a method of calculating student-centered value, applied to the context of a change in teaching methods within a health professional program. This study took place over the first semester of the third year of the Bachelor of Physiotherapy at Monash University, Victoria, Australia, in 2014. The entire third year cohort (n = 78) was invited to participate. Survey based design was used to collect the appropriate data. A blended learning model was implemented; subsequently students were only required to attend campus three days per week, with the remaining two days comprising online learning. This was compared to the previous year's format, a campus-based face-to-face approach where students attended campus five days per week, with the primary outcome-Value to student. Value to student incorporates, user costs associated with transportation and equipment, the amount of time saved, the price paid and perceived gross benefit. Of the 78 students invited to participate, 76 completed the post-unit survey (non-participation rate 2.6%). Based on Value to student the blended learning approach provided a $1,314.93 net benefit to students. Another significant finding was that the perceived gross benefit for the blended learning approach was $4014.84 compared to the campus-based face-to-face approach of $3651.72, indicating that students would pay more for the blended learning approach. This paper successfully applied a novel method of calculating student-centered value. This is the first step in validating the value to student outcome. Measuring economic value to the student may

  2. Person--job match among frontline staff working in residential treatment centers: the impact of personality and child psychopathology on burnout experiences.

    Science.gov (United States)

    Leon, Scott C; Visscher, Linn; Sugimura, Niwako; Lakin, Brittany L

    2008-04-01

    Prior research has shown that the personality variables extraversion and neuroticism predict burnout among frontline staff working in residential treatment centers. This study tested the hypothesis that the effect of personality on burnout would be moderated by the psychiatric characteristics of the youth served on the milieu. Two hundred and three frontline staff working in 21 residential treatment centers in Illinois serving troubled youth completed surveys regarding opinions about their jobs, the Big Five Inventory (BFI), a youth presenting problems scale for the entire milieu, and the Maslach Burnout Inventory (MBI). Results indicated that the effect of neuroticism on burnout is moderated by psychosis and posttraumatic stress disorder (PTSD); high and moderate milieu ratings of psychosis and PTSD showed a positive relationship between neurosis and burnout, while low ratings of these conditions showed no relationship. These findings suggest that the optimal work setting is a function of the interaction between specific personality characteristics and specific work environments, with implications for personnel selection and future research on person-environment fit.

  3. 全球科技创新中心建设的台湾经验及启示%Taiwan’s Experience on the Development of Global Science & Technology Innovation Center

    Institute of Scientific and Technical Information of China (English)

    陶希东; 安永生

    2015-01-01

    The construction of Global Technology Innovation Center is a new goal after Shanghai completes the 'Four Centers' target of Shanghai. Science is the most critical factor that determines the trends of the real economy, meanwhile, it affects the global competition situation in future.The construction of Global Technology Innovation Center needs a global view, drawing experience from home and abroad. For Shanghai, Hsinchu Science-based Industry Park is a good example. Through taking advantage of Shanghai's merits and learning Taiwan's successful experience, we can elegantly solve the problems encountering in the construction of Global Technology Innovation Center, such as the cooperation of industry, university and research, talent introduction, investment management , science and technology service,etc.%建设具有全球影响力的科技创新中心,是上海在"四个中心"之后又一个全新目标.科技是决定实体经济走势的最关键因素,并左右着未来全球竞争格局.建设国际化的科技创新中心,需要放眼全球,广泛吸取经验.对于上海来说,台湾新竹科技园是一个很好的楷模,结合上海已经具有的各种优势,并借鉴台湾的成功经验,就能够很好地解决在科创中心建设中遇到的"产学研"结合、人才引进、投资管理、科技服务等各方面的问题.

  4. Senior Centers

    Medline Plus

    Full Text Available ... dancing. [Narrator] These centers can provide entree to new activities and expand a person’s social contacts. [Karen ... meeting all their interests and introducing them to new things; whether it’s an arts and crafts project, ...

  5. Management of the 2009 A/H1N1 influenza pandemic in patients with hematologic diseases: a prospective experience at an Italian center.

    Science.gov (United States)

    Girmenia, Corrado; Mercanti, Caterina; Federico, Vincenzo; Rea, Massimiliano; De Vellis, Annalisa; Valle, Veronica; Micozzi, Alessandra; Latagliata, Roberto; Breccia, Massimo; Morano, Salvatore Giacomo; Brunetti, Gregorio Antonio; Sali, Michela; Delogu, Giovanni; Foà, Robin; Alimena, Giuliana; Gentile, Giuseppe

    2011-01-01

    Data derived from epidemiologic surveillance adopted at our center in hematologic and stem cell transplant patients during the 2009 influenza A (H1N1)v pandemic are reported. Of the 52 patients with influenza-like disease we observed, 37 underwent a real-time PCR evaluation and 21 had a confirmed diagnosis. Of the RT-PCR-confirmed cases, 23.8% were children (age 65 years; 47.6% presented with a pulmonary infiltrate and 33.3% with respiratory failure. Pulmonary involvement was observed more frequently in patients with comorbidities. All patients received a course of oseltamivir therapy starting an average of 1 day (range <1-2) after the onset of symptoms. No patient was transferred to the intensive care unit. The viral disease had a generally favorable outcome despite the high frequency of pulmonary involvement. A prompt clinical evaluation with an early antiviral and supportive therapy may have played a beneficial role in the outcome. PMID:21411983

  6. [Comprehensive healthcare for female victims of sexual violence: the experience of the Women's Comprehensive Healthcare Center, State University in Campinas, Brazil].

    Science.gov (United States)

    Bedone, Aloisio José; Faúndes, Anibal

    2007-02-01

    The Women's Comprehensive Healthcare Center (CAISM) has provided care for women who have suffered sexual violence since 1986. Since 1998, a special multidisciplinary team has been in charge of emergency and long-term care for victims of sexual violence. From August 1998 to May 2006, 1,174 women were treated, with an average of 150 per year in the last five years. During the same period, 71/109 women who became pregnant after rape had their pregnancies terminated, 23/109 continued the pregnancy to term, and 15/109 did not undergo abortion due to gestational age greater than 20 weeks. In Brazil, there are not enough public services to treat female victims of sexual violence who require legal abortion. Nationwide implementation of new services should be encouraged, in addition to all measures known to reduce the problem such as sex education in schools and widespread information and easy access to effective contraception. PMID:17221097

  7. Anti-HMGCR antibodies as a biomarker for immune-mediated necrotizing myopathies: A history of statins and experience from a large international multi-center study.

    Science.gov (United States)

    Musset, Lucile; Allenbach, Yves; Benveniste, Olivier; Boyer, Olivier; Bossuyt, Xavier; Bentow, Chelsea; Phillips, Joe; Mammen, Andrew; Van Damme, Philip; Westhovens, René; Ghirardello, Anna; Doria, Andrea; Choi, May Y; Fritzler, Marvin J; Schmeling, Heinrike; Muro, Yoshinao; García-De La Torre, Ignacio; Ortiz-Villalvazo, Miguel A; Bizzaro, Nicola; Infantino, Maria; Imbastaro, Tiziana; Peng, Qinglin; Wang, Guochun; Vencovský, Jiří; Klein, Martin; Krystufkova, Olga; Franceschini, Franco; Fredi, Micaela; Hue, Sophie; Belmondo, Thibaut; Danko, Katalin; Mahler, Michael

    2016-10-01

    In an effort to find naturally occurring substances that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), statins were first discovered by Endo in 1972. With the widespread prescription and use of statins to decrease morbidity from myocardial infarction and stroke, it was noted that approximately 5% of all statin users experienced muscle pain and weakness during treatment. In a smaller proportion of patients, the myopathy progressed to severe morbidity marked by proximal weakness and severe muscle wasting. Remarkably, Mammen and colleagues were the first to discover that the molecular target of statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), is an autoantibody target in patients that develop an immune-mediated necrotizing myopathy (IMNM). These observations have been confirmed in a number of studies but, until today, a multi-center, international study of IMNM, related idiopathic inflammatory myopathies (IIM), other auto-inflammatory conditions and controls has not been published. Accordingly, an international, multi-center study investigated the utility of anti-HMGCR antibodies in the diagnosis of statin-associated IMNM in comparison to different forms of IIM and controls. This study included samples from patients with different forms of IIM (n=1250) and patients with other diseases (n=656) that were collected from twelve sites and tested for anti-HMGCR antibodies by ELISA. This study confirmed that anti-HMGCR autoantibodies, when found in conjunction with statin use, characterize a subset of IIM who are older and have necrosis on muscle biopsy. Taken together, the data to date indicates that testing for anti-HMGCR antibodies is important in the differential diagnosis of IIM and might be considered for future classification criteria.

  8. Preparative Isolation of Polar Antioxidant Constituents from Abies koreana Using Centrifugal Partition Chromatography Guided by DPPH center dot-HPLC Experiment

    NARCIS (Netherlands)

    Jeon, Je-Seung; Kim, Ji Hoon; Park, Chae Lee; Kim, Chul Young

    2015-01-01

    Preparative separation of antioxidant constituents from the leaves of Abies koreana Wilson (Pinaceae) was performed by centrifugal partition chromatography (CPC) with a two-phase solvent system of ethyl acetate-isopropanol-water (9:1:10, v/v) target-guided by DPPH•-HPLC experiment. In DPPH•-HPLC exp

  9. METALS (Minority Education Through Traveling and Learning in the Sciences) and the Value of Collaborative Field-centered Experiences in the Geosciences (Invited)

    Science.gov (United States)

    White, L. D.

    2013-12-01

    METALS (Minority Education Through Traveling and Learning in the Sciences) is a field-based, geoscience diversity program developed by a collaborative venture among San Francisco State University, the University of Texas at El Paso, the University of New Orleans, and Purdue University. Since 2010, this program has created meaningful geoscience experiences for underrepresented minorities by engaging 30 high school students in experiential learning opportunities each year. During METALS field trips, the primarily urban students observe natural landforms, measure water quality, conduct beach profiles, and interpret stratigraphic and structural features in locations that have included southern Utah, southern Louisiana, central Wyoming, and northern California. In these geological settings participants are also able to focus on societally relevant, community-related issues. Results from program evaluation suggest that student participants view METALS as: (1) opening up new opportunities for field-based science not normally available to them, (2) engaging in a valuable science-based field experience, (3) an inspirational, but often physically challenging, undertaking that combines high-interest geology content with an exciting outdoor adventure, and (4) a unique social experience that brings together people from various parts of the United States. Further evaluation findings from the four summer trips completed thus far demonstrate that active learning opportunities through direct interaction with the environment is an effective way to engage students in geoscience-related learning. Students also seem to benefit from teaching strategies that include thoughtful reflection, journaling, and teamwork, and mentors are positive about engaging with these approaches. Participants appear motivated to explore geoscience topics further and often discuss having new insights and new perspectives leading to career choices in geosciences. Additionally, students who had a prior and

  10. Background identification and suppression for the measurement of (n,{gamma}) reactions with the DANCE array at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Reifarth, R. E-mail: reifarth@lanl.gov; Bredeweg, T.A.; Alpizar-Vicente, A.; Browne, J.C.; Esch, E.-I.; Greife, U.; Haight, R.C.; Hatarik, R.; Kronenberg, A.; O' Donnell, J.M.; Rundberg, R.S.; Ullmann, J.L.; Vieira, D.J.; Wilhelmy, J.B.; Wouters, J.M

    2004-10-01

    In the commissioning phase of the DANCE project (Detector for Advanced Neutron Capture Experiments) measurements have been performed with special emphasis on the identification and suppression of possible backgrounds for the planned (n,{gamma}) experiments. This report describes several background sources, observed in the experiment or anticipated from simulations, which will need to be suppressed in this and in similar detectors that are planned at other facilities. First successes are documented in the suppression of background from scattered neutrons captured in the detector as well as from the internal radiation. Experimental results and simulations using the GEANT code are compared.

  11. Background identification and suppression for the measurement of (n,g) reactions with the DANCE array at LANSCE

    CERN Document Server

    Reifarth, R; Alpizar-Vicente, A; Browne, J C; Esch, E -I; Greife, U; Haight, R C; Hatarik, R; Kronenberg, A; O'Donnell, J M; Rundberg, R S; Ullmann, J L; Vieira, D J; Wilhelmy, J B; Wouters, J M

    2013-01-01

    In the commissioning phase of the DANCE project (Detector for Advanced Neutron Capture Experiments) measurements have been performed with special emphasis on the identification and suppression of possible backgrounds for the planned (n,g) experiments. This report describes several background sources, observed in the experiment or anticipated from simulations, which will need to be suppressed in this and in similar detectors that are planned at other facilities. First successes are documented in the suppression of background from scattered neutrons captured in the detector as well as from the internal radiation. Experimental results and simulations using the GEANT code are compared.

  12. Background identification and suppression for the measurement of (n,γ) reactions with the DANCE array at LANSCE

    International Nuclear Information System (INIS)

    In the commissioning phase of the DANCE project (Detector for Advanced Neutron Capture Experiments) measurements have been performed with special emphasis on the identification and suppression of possible backgrounds for the planned (n,γ) experiments. This report describes several background sources, observed in the experiment or anticipated from simulations, which will need to be suppressed in this and in similar detectors that are planned at other facilities. First successes are documented in the suppression of background from scattered neutrons captured in the detector as well as from the internal radiation. Experimental results and simulations using the GEANT code are compared

  13. Constructing and Implementing of the Administrating System of Experiment Teaching Center%实验教学中心管理体系的构建与实践

    Institute of Scientific and Technical Information of China (English)

    陈雪芬; 郭伟良

    2011-01-01

    构建了实验教学中心管理新体系,建立健全了实验教学人员、管理人员、实验经费、仪器设备、实验教学档案、实验项目、实验室开放、环境与安全卫生等各项规章制度,采用信息化辅助管理,确保实验教学中心管理制度得到更好贯彻与执行.使实验教学中心管理科学化、制度化、规范化,为学生提供良好的实验室实践环境,为培养创新型人才奠定了扎实的基础.%A new administrating system was constructed in which the bylaws for managing experiment teacher,laboratory administrator, experiment outlay, instruments, experiment teaching files, experiment items, laboratory opening, environment and security were established and strengthen, and the computers were employed to manage the laboratory to male sure the effects, which make the administrating of experiment teaching center scientifically, institutionally and regularized, offering a good environment for experimental teaching and study,making contribute for training innovational students.

  14. Integration of Russian Tier-1 Grid Center with High Performance Computers at NRC-KI for LHC experiments and beyond HENP

    Science.gov (United States)

    Belyaev, A.; Berezhnaya, A.; Betev, L.; Buncic, P.; De, K.; Drizhuk, D.; Klimentov, A.; Lazin, Y.; Lyalin, I.; Mashinistov, R.; Novikov, A.; Oleynik, D.; Polyakov, A.; Poyda, A.; Ryabinkin, E.; Teslyuk, A.; Tkachenko, I.; Yasnopolskiy, L.

    2015-12-01

    The LHC experiments are preparing for the precision measurements and further discoveries that will be made possible by higher LHC energies from April 2015 (LHC Run2). The need for simulation, data processing and analysis would overwhelm the expected capacity of grid infrastructure computing facilities deployed by the Worldwide LHC Computing Grid (WLCG). To meet this challenge the integration of the opportunistic resources into LHC computing model is highly important. The Tier-1 facility at Kurchatov Institute (NRC-KI) in Moscow is a part of WLCG and it will process, simulate and store up to 10% of total data obtained from ALICE, ATLAS and LHCb experiments. In addition Kurchatov Institute has supercomputers with peak performance 0.12 PFLOPS. The delegation of even a fraction of supercomputing resources to the LHC Computing will notably increase total capacity. In 2014 the development a portal combining a Tier-1 and a supercomputer in Kurchatov Institute was started to provide common interfaces and storage. The portal will be used not only for HENP experiments, but also by other data- and compute-intensive sciences like biology with genome sequencing analysis; astrophysics with cosmic rays analysis, antimatter and dark matter search, etc.

  15. IRASM Center

    International Nuclear Information System (INIS)

    IRASM is a national center for radiation processing developed around an industrial Co60 gamma irradiator. Being a department in an R and D national institute, IRASM Center is dealing with radiation treatment, pre/post microbiological control, validation of irradiation sterilization, detection of irradiated foodstuffs. Training is available for operators of new irradiation facilities focused on radiation technologies, dosimetry, sterilization, food treatment, conservation by irradiation of cultural heritage, quality assurance. Expertise on proper choosing the plastics for packaging versus dose is offered to the potential clients. IRASM Center is also involved in interdisciplinary applied research like chitosan treatment, sterile male technique or implementation of irradiation step in production of pharmaceuticals. All important activities: irradiation treatment, dosimetry, microbiology, detection of irradiated food, radioprotection, nuclear safety, physical protection. are performed in accordance with the proper standards in the frame of a certified quality management system. In this way Co60 industrial sources, a byproduct of certain nuclear power plants like Candu type, appear to be the key of a large technical and R and D domain. (authors)

  16. Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

    Science.gov (United States)

    Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

    2016-03-01

    Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context. PMID:26535867

  17. Radiation Therapy Improves Survival Outcome in Pancreatic Adenocarcinoma: Comparison of a 15-Year Institutional Experience at the University of Nebraska Medical Center with SEER Data

    Directory of Open Access Journals (Sweden)

    Michael J. Baine

    2014-01-01

    Full Text Available Objectives. We examined the role of radiation therapy (RT in pancreatic adenocarcinoma (PA treatment through a 15-year retrospective analysis of patients treated at University of Nebraska Medical Center (UNMC as well as those from the SEER database. Methods. A total of 561 patients diagnosed with PA at UNMC between 1995 and 2011 and 60,587 patients diagnosed between 1995 and 2009 from the SEER were included. Examined prognostic factors for overall survival (OS were age, gender, race, stage, year of diagnosis, and treatment with surgery, chemotherapy (CT, or RT. Time to death was plotted by Kaplan-Meier method. A Cox proportional hazards model was used to evaluate prognostic factors for OS. Results. The median OS was 7.3 and 5 months for patients from UNMC and the SEER database, respectively. A Cox model of patients from UNMC showed that RT was associated with improved OS (HR 0.77, P=0.018 after adjusting for factors including age, race, gender, stage, year of diagnosis, having surgery, or having CT. Cox analysis of patients from the SEER showed similar results (HR 0.65, P<0.0001. Conclusions. RT confers an independent survival advantage in patients being treated for PA which is apparent both at UNMC and through SEER data.

  18. Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

    Science.gov (United States)

    Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

    2016-03-01

    Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.

  19. A score model for predicting post-liver trans-plantation survival in HBV cirrhosis-related hepatocellular carcinoma recipients:a single center 5-year experience

    Institute of Scientific and Technical Information of China (English)

    Li-Ying Wang; Xin-Hua Chen; Tian-An Jiang; Fen Chen; Shu-Sen Zheng; Xiao Xu; Wei-Lin Wang; Jian Wu; Min Zhang; Yan Shen; Sheng Yan; Hai-Yang Xie

    2015-01-01

    BACKGROUND: The prognostic prediction of liver transplan-tation (LT) guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients' outcome, especially for the patients with HBV cirrhosis-re-lated hepatocellular carcinoma (HCC). The present study was to develop a quantitative assessment model for predicting the post-LT survival in HBV-related HCC patients. METHODS: Two hundred and thirty-eight LT recipients at the Liver Transplant Center, First Affiliated Hospital, Zhejiang University School of Medicine between 2008 and 2013 were included in this study. Their post-LT prognosis was recorded and multiple risk factors were analyzed using univariate and multivariate analyses in Cox regression. RESULTS: The score model was as follows: 0.114×(Child-Pugh score)-0.002×(positive HBV DNA detection time)+0.647× (number of tumor nodules)+0.055×(max diameter of tumor nodules)+0.231×lnAFP+0.437×(tumor differentiation grade). The receiver operating characteristic curve analysis showed that the area under the curve of the scoring model for predict-ing the post-LT survival was 0.887. The cut-off value was 1.27, which was associated with a sensitivity of 72.5% and a speci-ficity of 90.7%, respectively. CONCLUSION: The quantitative score model for predicting post-LT survival proved to be sensitive and specific.

  20. Prognostic Factors for Tumor Recurrence after a 12-Year, Single-Center Experience of Liver Transplantations in Patients with Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Matteo Cescon

    2010-01-01

    Full Text Available Background. Factors affecting outcomes after orthotopic liver transplantation (OLT for hepatocellular carcinoma (HCC have been extensively studied, but some of them have only recently been discovered or reassessed. Methods. We analyzed classical and more recently emerging variables with a hypothetical impact on recurrence-free survival (RFS in a single-center series of 283 patients transplanted for HCC between 1997 and 2009. Results. Five-year patient survival and RFS were 75% and 86%, respectively. Thirty-four (12% patients had HCC recurrence. Elevated preoperative alpha-fetoprotein (AFP levels, preoperative treatments of HCC, unfulfilled Milan and up-to-seven criteria at final histology, poor tumor differentiation, and tumor microvascular invasion negatively affected RFS by univariate analysis. Milan and up-to-seven criteria applied preoperatively, and the use of m-TOR inhibitors did not reach statistical significance. Cox's proportional hazard model showed that only elevated AFP levels (Odds Ratio=2.88; 95% C.I.=1.43–5.80; =.003, preoperative tumor treatments (Odds Ratio=4.84; 95% C.I.=1.42–16.42; =.01, and microvascular invasion (Odds Ratio=4.82; 95% C.I.=1.87–12.41; =.001 were predictors of lower RFS. Conclusions. Biological aggressiveness and preoperative tumor treatment, rather than traditional and expanded dimensional criteria, conditioned the outcomes in patients transplanted for HCC.

  1. Experience with the Wujciak-Opelz allocation system in a single center: an increase in HLA-DR mismatching and in early occurring acute rejection episodes.

    Science.gov (United States)

    Vereerstraeten, P; Abramowicz, D; De Pauw, L; Kinnaert, P

    1998-01-01

    The present single-center, retrospective study was undertaken to assess the impact of the Wujciak-Opelz allocation system (XCOMB), currently used within Eurotransplant for renal allografts, on the incidence of early occurring rejection episodes (RE). Implementation of the system resulted in an increase of HLA-DR mismatches (MM), while the incidence of HLA-A + B + DR MM remained unchanged. During the 1st post-transplant month, the total number of RE, expressed per patient-months, increased by 64% (0.326 vs 0.199, P = 0.007); when considering only severe and irreversible RE, the increase was 76% (0.158 vs 0.090, P = 0.011). In contrast, from the 2nd to the 12th post-transplant month, the incidence of RE, regardless of severity, was similar before and after implementation of XCOMB. As early occurring RE have detrimental effects on long-term graft outcome, these observations, if confirmed on a larger scale, would justify changes in the allocation algorithm. PMID:9787415

  2. Intraoperative frozen section analysis of margins in breast conserving surgery significantly decreases reoperative rates: one-year experience at an ambulatory surgical center.

    Science.gov (United States)

    Jorns, Julie M; Visscher, Daniel; Sabel, Michael; Breslin, Tara; Healy, Patrick; Daignaut, Stephanie; Myers, Jeffrey L; Wu, Angela J

    2012-11-01

    Intraoperative frozen section (FS) margin evaluation is not common practice for patients undergoing breast conservation therapy (BCT), but offers a significant reduction in reoperation. In this study, a technique to allow for more effective freezing of breast tissue was developed to perform FS evaluation of lumpectomy margins (FSM) for all patients undergoing BCT at an ambulatory surgery center. FS evaluation of sentinel lymph node biopsy specimens was performed concurrently. One hundred eighty-one study and 188 control patients, with and without FS evaluation, were compared. Reexcision was reduced 34% (from 48.9% to 14.9%) and reoperation was reduced 36% (from 55.3% to 19.3%) with FS evaluation. Most of the decrease in reoperative rate was because of a decrease in the need for margin reexcision. The number of patients requiring 1, 2, or 3 operations to complete therapy was 84, 92, and 12, respectively, in the control group, and 146, 33, and 2, respectively, in the study group. Lobular subtype, multifocal disease, and larger tumor size (≥2 cm) were significantly associated with failure of FSM to prevent reoperation, but reoperation rates were still significantly decreased in this subgroup of patients (from 75.5% to 43.8%) with FSM. This study highlights an innovative yet simple and adaptable FS approach that resulted in a nearly 3-fold reduction in reoperation for patients undergoing BCT.

  3. Radiation Therapy Improves Survival Outcome in Pancreatic Adenocarcinoma: Comparison of a 15-Year Institutional Experience at the University of Nebraska Medical Center with SEER Data

    International Nuclear Information System (INIS)

    Objectives. We examined the role of radiation therapy (RT) in pancreatic adenocarcinoma (PA) treatment through a 15-year retrospective analysis of patients treated at University of Nebraska Medical Center (UNMC) as well as those from the SEER database. Methods. A total of 561 patients diagnosed with PA at UNMC between 1995 and 2011 and 60,587 patients diagnosed between 1995 and 2009 from the SEER were included. Examined prognostic factors for overall survival (OS) were age, gender, race, stage, year of diagnosis, and treatment with surgery, chemotherapy (CT), or RT. Time to death was plotted by Kaplan-Meier method. A Cox proportional hazards model was used to evaluate prognostic factors for OS. Results. The median OS was 7.3 and 5 months for patients from UNMC and the SEER database, respectively. A Cox model of patients from UNMC showed that RT was associated with improved OS (HR 0.77,(Ρ =0.018) after adjusting for factors including age, race, gender, stage, year of diagnosis, having surgery, or having CT. Cox analysis of patients from the SEER showed similar results (HR 0.65, (Ρ0.0001). Conclusions. RT confers an independent survival advantage in patients being treated for PA which is apparent both at UNMC and through SEER data.

  4. Recent Experiences of the NASA Engineering and Safety Center (NESC) Guidance Navigation and Control (GN and C) Technical Discipline Team (TDT)

    Science.gov (United States)

    Dennehy, Cornelius J.

    2011-01-01

    The NASA Engineering and Safety Center (NESC) is an independently funded NASA Program whose dedicated team of technical experts provides objective engineering and safety assessments of critical, high risk projects. NESC's strength is rooted in the diverse perspectives and broad knowledge base that add value to its products, affording customers a responsive, alternate path for assessing and preventing technical problems while protecting vital human and national resources. The Guidance Navigation and Control (GN&C) Technical Discipline Team (TDT) is one of fifteen such discipline-focused teams within the NESC organization. The TDT membership is composed of GN&C specialists from across NASA and its partner organizations in other government agencies, industry, national laboratories, and universities. This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA.

  5. The rationale for and implementation of learner-centered education: experiences at the Ostrow School of Dentistry of the University of Southern California.

    Science.gov (United States)

    Navazesh, Mahvash; Rich, Sandra K; Tiber, Arnold

    2014-02-01

    This report describes the design, implementation, and function of integrated, learner-centered education at the Ostrow School of Dentistry of the University of Southern California. The 190 required courses of the previous curriculum have been condensed to forty-four courses. Four courses, presented for each of eleven trimesters of the four-year D.D.S. program, are entitled Human Structure, Human Function, Human Behavior, and Human Clinical Dentistry. An integrated biomedical sciences curriculum is supported by small-group, facilitator-based, problem-based learning (PBL) and an electronic PBL case library. Modules, rotations, and preclinical and clinical sessions make up remaining instructional units of the curriculum. Selected assessment outcomes measuring student knowledge, behavior, and skill development are discussed. As an external measure, first-attempt pass rates on the National Board Dental Examination (NBDE) Part I show a range of 87-96 percent over a ten-year period (for Classes 2005-14). First-attempt pass rates on the NBDE Part II for Classes 2005-12 ranged from 74 percent to 93 percent. Perceived barriers and opportunities for better performance on the NBDE Part II are addressed. Additionally, an exit survey, administered over the past four years, indicates a high level of student satisfaction with "depth and breadth" of their education (82-93 percent) and that graduates feel well prepared to enter the practice of dentistry (94-97 percent).

  6. Analysis of outcomes and prognostic factors of acute lymphoblastic leukemia patients treated by MCP841 protocol: A regional cancer center experience

    Directory of Open Access Journals (Sweden)

    Akhil Kapoor

    2016-01-01

    Full Text Available Background: A dramatic improvement in the survival of acute lymphoblastic leukemia (ALL patients in the last three decades has been observed. MCP 841 protocol is an old but effective tool with tolerable toxicities. The objective of this study was to estimate the relapse-free survival of ALL patients treated uniformly with MCP 841 protocol on the basis of various prognostic factors. Materials and Methods: The study design was retrospective and it was conducted in a regional cancer center of Northwest India. Three hundred and ten ALL patients who underwent treatment with MCP 841 protocol and regular follow-up for up to 5 years were selected for this study. Relapse-free survival was calculated by Kaplan-Meier analysis and Cox regression analysis was used to calculate the hazards ratio (HR using Statistical Package for the Social Sciences (SPSS software for windows version 20.0. Results: Fifty-four percent patients were 1 lakh/cmm had 41% survival [HR 2.14 (1.76-2.48 with, P < 0.001]. Conclusion: MCP 841 protocol is a useful tool for the treatment of ALL in children when more aggressive protocols can not be used.

  7. International Water Center

    Science.gov (United States)

    The urban district of Nancy and the Town of Nancy, France, have taken the initiative of creating an International Center of Water (Centre International de l'Eau à Nancy—NAN.C.I.E.) in association with two universities, six engineering colleges, the Research Centers of Nancy, the Rhine-Meuse Basin Agency, and the Chamber of Commerce and Industry. The aim of this center is to promote research and technology transfer in the areas of water and sanitation. In 1985 it will initiate a research program drawing on the experience of 350 researchers and engineers of various disciplines who have already been assigned to research in these fields. The research themes, the majority of which will be multidisciplinary, concern aspects of hygiene and health, the engineering of industrial processes, water resources, and the environment and agriculture. A specialist training program offering five types of training aimed at university graduates, graduates of engineering colleges, or experts, will start in October 1984.

  8. Fine Experiment and Finite Element Analysis for Static Stiffness of Vertical Machining Center%立式加工中心静刚度细化试验与有限元分析

    Institute of Scientific and Technical Information of China (English)

    李殿新; 赵沿民; 张建富; 冯平法

    2012-01-01

    采用细化试验和有限元方法对某立式加工中心静刚度进行了研究.通过细化试验不仅测得了机床的三向静刚度,而且测量了主要零件的变形;对主轴箱的变形进行了细化试验,对结果进行了详细分析;测量了主轴箱滑块与立柱导轨结合面的变形,结果表明该结合面y向是薄弱环节.在Workbench中建立了机床静刚度有限元模型,通过与试验数据的对比验证了有限元模型的准确性.%Static stiffness of a vertical machining center was researched based on fine experiment and finite element method. Static stiffness of three directions and deformation of the main parts were measured. Deformation of the spindle box was measured and detailed analysis was taken. Deformation of the joint between spindle box and column was measured. The results showed that weak leak of the joint is y direction. Finite element model of the machining center was established in Workbench and accuracy of the model was verified compared with experiments.

  9. Early subclinical rejection treated with low dose i.v. steroids is not associated to graft survival impairment: 13-years' experience at a single center.

    Science.gov (United States)

    Gigliotti, Paolo; Lofaro, Danilo; Leone, Francesca; Papalia, Teresa; Senatore, Massimino; Greco, Rosita; Perri, Anna; Vizza, Donatella; Lupinacci, Simona; Toteda, Giuseppina; La Russa, Antonella; De Stefano, Roberto; Romeo, Francesco; Bonofiglio, Renzo

    2016-06-01

    Subclinical rejection (SCR) has been variably associated with reduced graft survival, development and progression of interstitial fibrosis/tubular atrophy and chronic allograft nephropathy, but data are controversial concerning SCR treatment in terms of graft survival improvement. In this single-center retrospective study, we enrolled 174 adult kidney transplant recipients with a protocol biopsy performed at 30 days after transplantation to evaluate the incidence rate and risk factors for early SCR and its impact on 10-year graft survival. Five patients showed primary non function and were excluded. Among 159/169 (94.08 %) patients with stable graft function who underwent protocol biopsy, 17 (10.7 %) showed signs of SCR and were treated with low-dose intravenous (i.v.) steroids. Ten patients showed functional impairment, 8 (4.73 %) resulting as acute rejection. At multivariate analysis, donor age [odds ratio (OR) 1.04, 95 % confidence interval (CI) 1.01-1.09], and delayed graft function (DGF) (OR 1.08, 95 % CI 1.03-1.12) were significantly associated with SCR. The 10-year graft survival rate in the SCR group was similar to that in the normal-findings group (76.5 vs. 74.9 % respectively; p = 0.61). At multivariate Cox regression, acute [hazard ratio (HR) 5.22, 95 % CI 1.70-16.01], but not sub-clinical, rejection was independently associated with long-term graft failure. In conclusion, early protocol biopsy is a useful and safe tool to detect early SCR which seems not to affect the long-term survival. We suggest that this could be, probably, linked to early SCR treatment with low dose i.v. steroids.

  10. An evaluation of the robustness of organ-at-risk recommendations made by GEC/ESTRO according to interobserver variability: a single-center experience

    Science.gov (United States)

    Celada-Alvarez, Francisco; Roldán, Susana; Torregrosa, Asunción; Betancourt, Jesus; Bautista-Ballesteros, Juan; Farga, Dolores; Ibañez, Blanca; Tormo, Alejandro; Perez-Calatayud, Jose

    2016-01-01

    Purpose Groupe Européen de Curiethérapie (GEC) and European Society for Radiotherapy & Oncology (ESTRO) has proposed a rectal dose constraint of the most exposed 2-cc volume (D2cc of ≤ 75 Gy EQD2α/β = 3) during external-beam plus high-dose-rate brachytherapy (HDR-BT) in localized prostate cancer patients. This study aimed to evaluate D2cc for rectal contouring via interobserver variability. Material and methods Four blinded observers contoured rectums of 5 patients. Rectal contouring anatomical limits were determined through previous consensus. Dose-volume histogram (DVH) dosimetric parameters (D0.1cc, D1cc, and D2cc) were analyzed according to GEC/ESTRO recommendations and subjected to intra- and interobserver comparisons. Latter comparisons involved coefficients of variation. For each parameter, the mean, standard deviation (SD), and range were evaluated. The effect of interobserver variation on total dose was analyzed by estimating the biologically equivalent rectal dose (EQD2α/β = 3). Results Interobserver coefficients of variation for D0.1cc, D1cc, and D2cc were 5.7%, 4.5%, and 4%, respectively. The highest interobserver rectal delineation variation yielded a rectal dose difference up to 5.8 Gy EQD2. Estimated intraobserver variation for the reported D2cc was 5.5% in the worst-case scenario (non-significant). Conclusions We observed acceptable interobserver variability in EQD2 for D2cc, with strong impacts on clinical threshold levels (D2cc ≤ 75 Gy EQD2) in some cases. This small, single-center analysis will be extended in a multicenter study. PMID:27648090

  11. Prospective evaluation of complications using the modified Clavien grading system, and of success rates of percutaneous nephrolithotomy using Guy's Stone Score: A single-center experience

    Science.gov (United States)

    Mandal, Swarnendu; Goel, Apul; Kathpalia, Rohit; Sankhwar, Satyanarayan; Singh, Vishwajeet; Sinha, Rahul J.; Singh, Bhupender P.; Dalela, Divakar

    2012-01-01

    Introduction and Objectives: To prospectively document the perioperative complications of percutaneous nephrolithotomy (PCNL) using the modified Clavien grading system. Evaluation of complications and clearance rates according to stone complexity using the validated Guy's Stone Score (GSS) was also done. Materials and Methods: A total of 221 renal units underwent 278 PCNL procedures at a urology resident training center between September 2010 and September 2011 and data were recorded prospectively in our registry. Patients with co-morbidities like diabetes, renal failure, hypertension and cardiopulmonary diseases were excluded. Stone complexity was classified according to the GSS while peri-operative complications were recorded using the modified Clavien grading system. Results: Two hundred and forty-five complications were encountered in 278 PCNL procedures involving 116 renal units (41.72%). Complications of Grades 1, 2, 3a, 3b, 4a, 4b and 5 were seen in 52 (18.7%), 122 (43.8%), 42 (15.1%), 18 (6.4%), 6 (2.1%), 4 (1.4%) and 1 (0.3%) renal units respectively. There were 68, 98, 50 and 5 renal units in GSS I, II, III and IV groups, respectively. All grades of complications were more common in GSS III and IV (P<0.05). For GSS I, II, III and IV 100%, 74%, 56% and 0% of renal units, respectively, were stone-free after one session and 0%, 24%, 44% and 60% respectively needed two sessions to be stone-free. Conclusion: Although the complication rates were higher most were of low grade and self-limiting. Complications were significantly more common with higher GSS and the GSS effectively predicted stone-free rates. PMID:23450640

  12. Early subclinical rejection treated with low dose i.v. steroids is not associated to graft survival impairment: 13-years' experience at a single center.

    Science.gov (United States)

    Gigliotti, Paolo; Lofaro, Danilo; Leone, Francesca; Papalia, Teresa; Senatore, Massimino; Greco, Rosita; Perri, Anna; Vizza, Donatella; Lupinacci, Simona; Toteda, Giuseppina; La Russa, Antonella; De Stefano, Roberto; Romeo, Francesco; Bonofiglio, Renzo

    2016-06-01

    Subclinical rejection (SCR) has been variably associated with reduced graft survival, development and progression of interstitial fibrosis/tubular atrophy and chronic allograft nephropathy, but data are controversial concerning SCR treatment in terms of graft survival improvement. In this single-center retrospective study, we enrolled 174 adult kidney transplant recipients with a protocol biopsy performed at 30 days after transplantation to evaluate the incidence rate and risk factors for early SCR and its impact on 10-year graft survival. Five patients showed primary non function and were excluded. Among 159/169 (94.08 %) patients with stable graft function who underwent protocol biopsy, 17 (10.7 %) showed signs of SCR and were treated with low-dose intravenous (i.v.) steroids. Ten patients showed functional impairment, 8 (4.73 %) resulting as acute rejection. At multivariate analysis, donor age [odds ratio (OR) 1.04, 95 % confidence interval (CI) 1.01-1.09], and delayed graft function (DGF) (OR 1.08, 95 % CI 1.03-1.12) were significantly associated with SCR. The 10-year graft survival rate in the SCR group was similar to that in the normal-findings group (76.5 vs. 74.9 % respectively; p = 0.61). At multivariate Cox regression, acute [hazard ratio (HR) 5.22, 95 % CI 1.70-16.01], but not sub-clinical, rejection was independently associated with long-term graft failure. In conclusion, early protocol biopsy is a useful and safe tool to detect early SCR which seems not to affect the long-term survival. We suggest that this could be, probably, linked to early SCR treatment with low dose i.v. steroids. PMID:25966801

  13. Percutaneous Lung Thermal Ablation of Non-surgical Clinical N0 Non-small Cell Lung Cancer: Results of Eight Years’ Experience in 87 Patients from Two Centers

    International Nuclear Information System (INIS)

    PurposeTo evaluate the survival outcomes of percutaneous thermal ablation (RFA + microwaves) for patients presenting N0 non-small-cell lung cancer (NSCLC) ineligible for surgery.Materials and MethodsEighty-seven patients from two comprehensive cancer centers were included. Eighty-two patients were treated with RFA electrodes and five with microwave antenna. Overall survival (OS) and disease-free survival (DFS) were estimated and predictive factors of local tumor progression, OS and DFS identified and compared by univariate and multivariate analysesResultsMedian follow-up was 30.5 months (interquartile range 16.7–51) and tumor size was 21 mm (range 10–54 mm). Treatment was incomplete for 14 patients with a local tumor progression of 11.5, 18.3, and 21.1 % at 1, 2, and 3 years, respectively. Two patients presented with neurological (grade III or IV) complications, and one died of respiratory and multivisceral failure as a result of the procedure at 29 days. In univariate analysis, increasing tumor size (P = 0.003) was the only predictive factor related to risk of local tumor progression. 5-year OS and DFS were 58.1 and 27.9 %, respectively. Sex (P = 0.044), pathology (P = 0.032), and tumor size >2 cm (P = 0.046) were prognostic factors for DFS. In multivariate analysis, pathology (P = 0.033) and tumor size >2 cm (P = 0.032) were independent prognostic factors for DFS.ConclusionsOversized and overlapping ablation of N0 NSCLC was well tolerated, effective, with few local tumor progressions, even over long-term follow-up. Increasing tumor size was the main prognostic factor linked to OS, DFS, and local tumor progression

  14. Percutaneous Lung Thermal Ablation of Non-surgical Clinical N0 Non-small Cell Lung Cancer: Results of Eight Years’ Experience in 87 Patients from Two Centers

    Energy Technology Data Exchange (ETDEWEB)

    Palussiere, Jean, E-mail: J.Palussiere@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Interventional Radiology (France); Lagarde, Philippe, E-mail: P.Lagarde@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Center, Radiation Oncology Department (France); Aupérin, Anne, E-mail: auperin@igr.fr [Institut Gustave-Roussy, Unit of Biostatistics and Epidemiology (France); Deschamps, Frédéric, E-mail: frederic.deschamps@igr.fr [Institut Gustave-Roussy, Department of Interventional Radiology (France); Chomy, François, E-mail: F.Chomy@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Center, Department of medical oncology (France); Baere, Thierry de, E-mail: debaere@igr.fr [Institut Gustave-Roussy, Department of Interventional Radiology (France)

    2015-02-15

    PurposeTo evaluate the survival outcomes of percutaneous thermal ablation (RFA + microwaves) for patients presenting N0 non-small-cell lung cancer (NSCLC) ineligible for surgery.Materials and MethodsEighty-seven patients from two comprehensive cancer centers were included. Eighty-two patients were treated with RFA electrodes and five with microwave antenna. Overall survival (OS) and disease-free survival (DFS) were estimated and predictive factors of local tumor progression, OS and DFS identified and compared by univariate and multivariate analysesResultsMedian follow-up was 30.5 months (interquartile range 16.7–51) and tumor size was 21 mm (range 10–54 mm). Treatment was incomplete for 14 patients with a local tumor progression of 11.5, 18.3, and 21.1 % at 1, 2, and 3 years, respectively. Two patients presented with neurological (grade III or IV) complications, and one died of respiratory and multivisceral failure as a result of the procedure at 29 days. In univariate analysis, increasing tumor size (P = 0.003) was the only predictive factor related to risk of local tumor progression. 5-year OS and DFS were 58.1 and 27.9 %, respectively. Sex (P = 0.044), pathology (P = 0.032), and tumor size >2 cm (P = 0.046) were prognostic factors for DFS. In multivariate analysis, pathology (P = 0.033) and tumor size >2 cm (P = 0.032) were independent prognostic factors for DFS.ConclusionsOversized and overlapping ablation of N0 NSCLC was well tolerated, effective, with few local tumor progressions, even over long-term follow-up. Increasing tumor size was the main prognostic factor linked to OS, DFS, and local tumor progression.

  15. Epidemiological and Clinical Features of Cervical Column and Cord Injuries; A 2-Year Experience from a Large Trauma Center in Southern Iran

    Directory of Open Access Journals (Sweden)

    Hamid Reza Kamravan

    2014-01-01

    Full Text Available Objective: To describe the epidemiological characteristics of patients with cervical spine injury admitted to Rajaee hospital, Shiraz, Iran. Methods: This cross-sectional study includes all patients admitted with impression of cervical column injury with or without cervical cord injury from October 2009 to March 2012 to our level I trauma center in Shiraz. We recorded the patients’ characteristics including age, sex, marital status, mechanism of injury, level of injury, concomitant injury, treatment(non-operative or operative and clinical outcome. The data were described and compared with the international literature. Results: Among 261 patients referred with impression of spinal cord injury, the diagnosis of spinal column injury (with or without spine cord injury was confirmed in 206 patients. The mean age of patients was 37.2±15.9 years with Male/Female ratio of 3:1. Car turn-over and car-collisions were the leading causes of injury. The most common spine fracture was C6 vertebra involving 60 (29.1% patients. Fracture of upper and lower extremities were the most concomitant fractures observed in 31(15.1% patients. Open surgery was performed in 65(31.6%.Mortality rate was 7.3% (15 patients.Patients with brain, lung and cord injuries had increased risk of death, among 15 deaths,9 patients had brain injury, 5 individuals had lung injury and 10 patients suffered from cord injury. Conclusion: Cervical spine injuries mostly affect young males, and comprise 206 (10% cases out of 2100 spine injuries in our country. Preventive measures should be taken to reduce cervical spine injuries especially in young age group.

  16. Radiofrequency Thermoablation of HCC Larger Than 3 cm and Less Than 5 cm Proximal to the Gallbladder without Gallbladder Isolation: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Antonio Orlacchio

    2014-01-01

    Full Text Available Radiofrequency ablation (RFA is an effective minimally invasive treatment for nonsurgical hepatocellular carcinoma (HCC, but ablation of tumors close to the gallbladder could be associated with several complications. We report our experience on the treatment of HCC close to the gallbladder with RFA. Eight RFA procedures were performed in eight patients with HCC larger than 3 cm and less than 5 cm close to the gallbladder. In all cases, a percutaneous approach was used. There were no major complications. Only in two patients a minimal wall thickening of the gallbladder was observed. Contrast enhanced computed tomography carried out after 30 days from the first procedure showed complete necrosis in seven patients (87%. Only one patient had local recurrence at 11 months of followup. Although limited, our experience suggests that, after careful preprocedural planning, in experienced hands and with appropriate technology, percutaneous RFA could be safely performed even for lesions larger than 3 cm located in close adjacency to the gallbladder.

  17. A Review of and Recommendations for the Management of Patients With Life-Threatening Dabigatran-Associated Hemorrhage: A Single-Center University Hospital Experience.

    Science.gov (United States)

    Kumar, Rohit; Smith, Roy E; Henry, Brian L

    2015-12-01

    Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Dabigatran has several advantages over warfarin including predictable pharmacokinetics and pharmacodynamics which eliminates the need for routine laboratory monitoring, superiority over warfarin in preventing stroke, or systemic embolism without having an increased risk of bleeding. However, as with any anticoagulant, there remains a real chance of bleeding, including major or life-threatening hemorrhage. Many physicians feel comfortable managing bleeding complications on older anticoagulants like warfarin and heparin, due to extensive experience with the medications along with antidotes to reverse their effects as well as established protocols for treating anticoagulant-associated hemorrhage. However, most physicians have limited clinical experience with dabigatran, there is no specific antidote for dabigatran reversal and there is a paucity of protocols, guidelines, and recommendations for how to manage dabigatran-associated hemorrhage. In this review, we present a case series of patients admitted to our institution for management of bleeding while receiving dabigatran. We retrospectively reviewed these cases to evaluate the efficacy and rationale of the various anticoagulation reversal strategies employed in the context of the existing evidence found in the literature. Specific focus is placed on the therapies utilized and the coagulation studies used to manage these patients. PMID:24668159

  18. A Review of and Recommendations for the Management of Patients With Life-Threatening Dabigatran-Associated Hemorrhage: A Single-Center University Hospital Experience.

    Science.gov (United States)

    Kumar, Rohit; Smith, Roy E; Henry, Brian L

    2015-12-01

    Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Dabigatran has several advantages over warfarin including predictable pharmacokinetics and pharmacodynamics which eliminates the need for routine laboratory monitoring, superiority over warfarin in preventing stroke, or systemic embolism without having an increased risk of bleeding. However, as with any anticoagulant, there remains a real chance of bleeding, including major or life-threatening hemorrhage. Many physicians feel comfortable managing bleeding complications on older anticoagulants like warfarin and heparin, due to extensive experience with the medications along with antidotes to reverse their effects as well as established protocols for treating anticoagulant-associated hemorrhage. However, most physicians have limited clinical experience with dabigatran, there is no specific antidote for dabigatran reversal and there is a paucity of protocols, guidelines, and recommendations for how to manage dabigatran-associated hemorrhage. In this review, we present a case series of patients admitted to our institution for management of bleeding while receiving dabigatran. We retrospectively reviewed these cases to evaluate the efficacy and rationale of the various anticoagulation reversal strategies employed in the context of the existing evidence found in the literature. Specific focus is placed on the therapies utilized and the coagulation studies used to manage these patients.

  19. The Extended-OPQ Method for User-Centered Quality of Experience Evaluation: A Study for Mobile 3D Video Broadcasting over DVB-H

    Directory of Open Access Journals (Sweden)

    Jumisko-Pyykkö Satu

    2011-01-01

    Full Text Available Abstract The Open Profiling of Quality (OPQ is a mixed methods approach combining a conventional quantitative psychoperceptual evaluation and qualitative descriptive quality evaluation based on naïve participants' individual vocabulary. The method targets evaluation of heterogeneous and multimodal stimulus material. The current OPQ data collection procedure provides a rich pool of data, but full benefit of it has neither been taken in the analysis to build up completeness in understanding the phenomenon under the study nor has the procedure in the analysis been probed with alternative methods. The goal of this paper is to extend the original OPQ method with advanced research methods that have become popular in related research and the component model to be able to generalize individual attributes into a terminology of Quality of Experience. We conduct an extensive subjective quality evaluation study for 3D video on mobile device with heterogeneous stimuli. We vary factors on content, media (coding, concealments, and slice modes, and transmission levels (channel loss rate. The results showed that advanced procedures in the analysis cannot only complement each other but also draw deeper understanding on Quality of Experience.

  20. Implementation of Environmental Monitors for NIFFTE and SeaQuest Experiments

    Science.gov (United States)

    Isenhower, Donald; Niffte Collaboration; Seaquest Collaboration

    2011-10-01

    The implementation of environmental monitors for the LANSCE NIFFTE and Fermilab SeaQuest experiments will be discussed. The emphasis will be on the use of a single, low cost, general purpose instrument, as opposed to a system of specialized, multiple subsystems. The implementation uses a Keithley™ 2701 Multimeter/Data Acquisition System with a Keithley™ 7710 solid state multiplexer. The system will be set up to work with MIDAS or CODA as the DAQ interface. It can have multiple types of sensors hooked up, as each channel is independent and can measure any parameter ordinarily associated with a DMM. The inputs can be a mixed composition of thermocouples, thermistors, LVDTs, pressure, humidity, and other sensors. The Keithley™ 2701 is easily controlled via the ``Standard Commands for Programmable Instrumentation'' (SCPI) Ethernet interface in a Linux environment. The different ways in which such a system can be configured as part of the LANSCE NIFFTE and Fermilab SeaQuest slow control systems will be demonstrated. Funding for this work was provided in part by the U.S. Department of Energy Office of Science.