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Sample records for computer-controlled treatment unit

  1. A computer controlled tele-cobalt unit

    International Nuclear Information System (INIS)

    Brace, J.A.

    1982-01-01

    A computer controlled cobalt treatment unit was commissioned for treating patients in January 1980. Initially the controlling computer was a minicomputer, but now the control of the therapy unit is by a microcomputer. The treatment files, which specify the movement and configurations necessary to deliver the prescribed dose, are produced on the minicomputer and then transferred to the microcomputer using minitape cartridges. The actual treatment unit is based on a standard cobalt unit with a few additional features e.g. the drive motors can be controlled either by the computer or manually. Since the treatment unit is used for both manual and automatic treatments, the operational procedure under computer control is made to closely follow the manual procedure for a single field treatment. The necessary safety features which protect against human, hardware and software errors as well as the advantages and disadvantages of computer controlled radiotherapy are discussed

  2. Application of an EPID for fast daily dosimetric quality control of a fully computer-controlled treatment unit

    International Nuclear Information System (INIS)

    Dirkx, M.L.P.; Kroonwijk, M.; De Boer, J.C.J.; Heijmen, B.J.M.

    1995-01-01

    The MM50 Racetrack Microtron, suited for sophisticated three-dimensional computer-controlled conformal radiotherapy techniques, is a complex treatment unit in various respects. Therefore, for a number of gantry angles, daily quality control of the absolute output and the profiles of the scanned photon beams in mandatory. A fast method for these daily checks, based on dosimetric measurements with the Philips SRI-100 Electronic Portal Imaging Device, has been developed and tested. Open beams are checked for four different gantry angles; for gantry angle 0, a wedged field is checked as well. The fields are set up one after another under full computer control. Performing and analyzing the measurements takes about ten minutes. The applied EPID has favourable characteristics for dosimetric quality control measurements: absolute measurements reproduce within 0.5% (1 SD) and the reproducibility of a relative (2-D) fluence profile is 0.2% (1 SD). The day-to-day sensitivity stability over a period of a month is 0.6% (1 SD). EPID-signals are within 0.2% linear with the applied dose. The 2-D fluence profile of the 25 MV photon beam of the MM50 is very stable in time: during a period of one year, a maximum fluctuation of 2.6% was observed. Once, a deviation in the cGy/MU-value of 6% was detected. Only because of the performed morning quality control checks with the EPID, erroneous dose delivery to patients could be avoided; there is no interlock in the MM50-system that would have prevented patient treatment. Based on our experiences and on clinical requirements regarding the acceptability of deviations of beam characteristics, a protocol has been developed including action levels for additional investigations. Studies on the application of the SRI-100 for in vivo dosimetry on the MM50 have been started

  3. Application of an EPID for fast daily dosimetric quality control of a fully computer-controlled treatment unit

    Energy Technology Data Exchange (ETDEWEB)

    Dirkx, M L.P.; Kroonwijk, M; De Boer, J C.J.; Heijmen, B J.M. [Nederlands Kanker Inst. ` Antoni van Leeuwenhoekhuis` , Amsterdam (Netherlands)

    1995-12-01

    The MM50 Racetrack Microtron, suited for sophisticated three-dimensional computer-controlled conformal radiotherapy techniques, is a complex treatment unit in various respects. Therefore, for a number of gantry angles, daily quality control of the absolute output and the profiles of the scanned photon beams in mandatory. A fast method for these daily checks, based on dosimetric measurements with the Philips SRI-100 Electronic Portal Imaging Device, has been developed and tested. Open beams are checked for four different gantry angles; for gantry angle 0, a wedged field is checked as well. The fields are set up one after another under full computer control. Performing and analyzing the measurements takes about ten minutes. The applied EPID has favourable characteristics for dosimetric quality control measurements: absolute measurements reproduce within 0.5% (1 SD) and the reproducibility of a relative (2-D) fluence profile is 0.2% (1 SD). The day-to-day sensitivity stability over a period of a month is 0.6% (1 SD). EPID-signals are within 0.2% linear with the applied dose. The 2-D fluence profile of the 25 MV photon beam of the MM50 is very stable in time: during a period of one year, a maximum fluctuation of 2.6% was observed. Once, a deviation in the cGy/MU-value of 6% was detected. Only because of the performed morning quality control checks with the EPID, erroneous dose delivery to patients could be avoided; there is no interlock in the MM50-system that would have prevented patient treatment. Based on our experiences and on clinical requirements regarding the acceptability of deviations of beam characteristics, a protocol has been developed including action levels for additional investigations. Studies on the application of the SRI-100 for in vivo dosimetry on the MM50 have been started.

  4. Computer-controlled 3-D treatment delivery

    International Nuclear Information System (INIS)

    Fraass, Benedick A.

    1995-01-01

    Purpose/Objective: This course will describe the use of computer-controlled treatment delivery techniques for treatment of patients with sophisticated conformal therapy. In particular, research and implementation issues related to clinical use of computer-controlled conformal radiation therapy (CCRT) techniques will be discussed. The possible/potential advantages of CCRT techniques will be highlighted using results from clinical 3-D planning studies. Materials and Methods: In recent years, 3-D treatment planning has been used to develop and implement 3-D conformal therapy treatment techniques, and studies based on these conformal treatments have begun to show the promise of conformal therapy. This work has been followed by the development of commercially-available multileaf collimator and computer control systems for treatment machines. Using these (and other) CCRT devices, various centers are beginning to clinically use complex computer-controlled treatments. Both research and clinical CCRT treatment techniques will be discussed in this presentation. General concepts and requirements for CCRT will be mentioned. Developmental and clinical experience with CCRT techniques from a number of centers will be utilized. Results: Treatment planning, treatment preparation and treatment delivery must be approached in an integrated fashion in order to clinically implement CCRT treatment techniques, and the entire process will be discussed. Various CCRT treatment methodologies will be reviewed from operational, dosimetric, and technical points of view. The discussion will concentrate on CCRT techniques which are likely to see rather wide dissemination over the next several years, including particularly the use of multileaf collimators (MLC), dynamic and segmental conformal therapy, conformal field shaping, and other related techniques. More advanced CCRT techniques, such as the use of individualized intensity modulation of beams or segments, and the use of computer-controlled

  5. Reduction of treatment delivery variances with a computer-controlled treatment delivery system

    International Nuclear Information System (INIS)

    Fraass, B.A.; Lash, K.L.; Matrone, G.M.; Lichter, A.S.

    1997-01-01

    Purpose: To analyze treatment delivery variances for 3-D conformal therapy performed at various levels of treatment delivery automation, ranging from manual field setup to virtually complete computer-controlled treatment delivery using a computer-controlled conformal radiotherapy system. Materials and Methods: All external beam treatments performed in our department during six months of 1996 were analyzed to study treatment delivery variances versus treatment complexity. Treatments for 505 patients (40,641 individual treatment ports) on four treatment machines were studied. All treatment variances noted by treatment therapists or quality assurance reviews (39 in all) were analyzed. Machines 'M1' (CLinac (6(100))) and 'M2' (CLinac 1800) were operated in a standard manual setup mode, with no record and verify system (R/V). Machines 'M3' (CLinac 2100CD/MLC) and ''M4'' (MM50 racetrack microtron system with MLC) treated patients under the control of a computer-controlled conformal radiotherapy system (CCRS) which 1) downloads the treatment delivery plan from the planning system, 2) performs some (or all) of the machine set-up and treatment delivery for each field, 3) monitors treatment delivery, 4) records all treatment parameters, and 5) notes exceptions to the electronically-prescribed plan. Complete external computer control is not available on M3, so it uses as many CCRS features as possible, while M4 operates completely under CCRS control and performs semi-automated and automated multi-segment intensity modulated treatments. Analysis of treatment complexity was based on numbers of fields, individual segments (ports), non-axial and non-coplanar plans, multi-segment intensity modulation, and pseudo-isocentric treatments (and other plans with computer-controlled table motions). Treatment delivery time was obtained from the computerized scheduling system (for manual treatments) or from CCRS system logs. Treatment therapists rotate among the machines, so this analysis

  6. The impact of treatment complexity and computer-control delivery technology on treatment delivery errors

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; Lash, Kathy L.; Matrone, Gwynne M.; Volkman, Susan K.; McShan, Daniel L.; Kessler, Marc L.; Lichter, Allen S.

    1998-01-01

    Purpose: To analyze treatment delivery errors for three-dimensional (3D) conformal therapy performed at various levels of treatment delivery automation and complexity, ranging from manual field setup to virtually complete computer-controlled treatment delivery using a computer-controlled conformal radiotherapy system (CCRS). Methods and Materials: All treatment delivery errors which occurred in our department during a 15-month period were analyzed. Approximately 34,000 treatment sessions (114,000 individual treatment segments [ports]) on four treatment machines were studied. All treatment delivery errors logged by treatment therapists or quality assurance reviews (152 in all) were analyzed. Machines 'M1' and 'M2' were operated in a standard manual setup mode, with no record and verify system (R/V). MLC machines 'M3' and 'M4' treated patients under the control of the CCRS system, which (1) downloads the treatment delivery plan from the planning system; (2) performs some (or all) of the machine set up and treatment delivery for each field; (3) monitors treatment delivery; (4) records all treatment parameters; and (5) notes exceptions to the electronically-prescribed plan. Complete external computer control is not available on M3; therefore, it uses as many CCRS features as possible, while M4 operates completely under CCRS control and performs semi-automated and automated multi-segment intensity modulated treatments. Analysis of treatment complexity was based on numbers of fields, individual segments, nonaxial and noncoplanar plans, multisegment intensity modulation, and pseudoisocentric treatments studied for a 6-month period (505 patients) concurrent with the period in which the delivery errors were obtained. Treatment delivery time was obtained from the computerized scheduling system (for manual treatments) or from CCRS system logs. Treatment therapists rotate among the machines; therefore, this analysis does not depend on fixed therapist staff on particular

  7. 3-D conformal radiation therapy - Part II: Computer-controlled 3-D treatment delivery

    International Nuclear Information System (INIS)

    Benedick, A.

    1997-01-01

    Purpose/Objective: This course will describe the use of computer-controlled treatment delivery techniques for treatment of patients with sophisticated conformal therapy. In particular, research and implementation issues related to clinical use of computer-controlled conformal radiation therapy (CCRT) techniques will be discussed. The possible/potential advantages of CCRT techniques will be highlighted using results from clinical 3-D planning studies. Materials and Methods: In recent years, 3-D treatment planning has been used to develop and implement 3-D conformal therapy treatment techniques, and studies based on these conformal treatments have begun to show the promise of conformal therapy. This work has been followed by the development of commercially-available multileaf collimator and computer control systems for treatment machines. Using these (and other) CCRT devices, various centers are beginning to clinically use complex computer-controlled treatments. Both research and clinical CCRT treatment techniques will be discussed in this presentation. General concepts and requirements for CCRT will be mentioned. Developmental and clinical experience with CCRT techniques from a number of centers will be utilized. Results: Treatment planning, treatment preparation and treatment delivery must be approached in an integrated fashion in order to clinically implement CCRT treatment techniques, and the entire process will be discussed. Various CCRT treatment methodologies will be reviewed from operational, dosimetric, and technical points of view. The discussion will concentrate on CCRT techniques which are likely to see rather wide dissemination over the next several years, including particularly the use of multileaf collimators (MLC), dynamic and segmental conformal therapy, conformal field shaping, and other related techniques. More advanced CCRT techniques, such as the use of individualized intensity modulation of beams or segments, and the use of computer-controlled

  8. A computer-controlled conformal radiotherapy system. III: graphical simulation and monitoring of treatment delivery

    International Nuclear Information System (INIS)

    Kessler, Marc L.; McShan, Daniel L.; Fraass, Benedick A.

    1995-01-01

    Purpose: Safe and efficient delivery of radiotherapy using computer-controlled machines requires new procedures to design and verify the actual delivery of these treatments. Graphical simulation and monitoring techniques for treatment delivery have been developed for this purpose. Methods and Materials: A graphics-based simulator of the treatment machine and a set of procedures for creating and manipulating treatment delivery scripts are used to simulate machine motions, detect collisions, and monitor machine positions during treatment. The treatment delivery simulator is composed of four components: a three-dimensional dynamic model of the treatment machine; a motion simulation and collision detection algorithm, user-interface widgets that mimic the treatment machine's control and readout devices; and an icon-based interface for creating and manipulating treatment delivery scripts. These components are used in a stand-alone fashion for interactive treatment delivery planning and integrated with a machine control system for treatment implementation and monitoring. Results: A graphics-based treatment delivery simulator and a set of procedures for planning and monitoring computer-controlled treatment delivery have been developed and implemented as part of a comprehensive computer-controlled conformal radiotherapy system. To date, these techniques have been used to design and help monitor computer-controlled treatments on a radiotherapy machine for more than 200 patients. Examples using these techniques for treatment delivery planning and on-line monitoring of machine motions during therapy are described. Conclusion: A system that provides interactive graphics-based tools for defining the sequence of machine motions, simulating treatment delivery including collision detection, and presenting the therapists with continual visual feedback from the treatment machine has been successfully implemented for routine clinical use as part of an overall system for computer-controlled

  9. QA Issues for Computer-Controlled Treatment Delivery: This Is Not Your Old R/V System Any More!

    International Nuclear Information System (INIS)

    Fraass, Benedick A.

    2008-01-01

    State-of-the-art radiotherapy treatment delivery has changed dramatically during the past decade, moving from manual individual field setup and treatment to automated computer-controlled delivery of complex treatments, including intensity-modulated radiotherapy and other similarly complex delivery strategies. However, the quality assurance methods typically used to ensure treatment is performed precisely and correctly have not evolved in a similarly dramatic way. This paper reviews the old manual treatment process and use of record-and-verify systems, and describes differences with modern computer-controlled treatment delivery. The process and technology used for computer-controlled treatment delivery are analyzed in terms of potential (and actual) problems, as well as relevant published guidance on quality assurance. The potential for improved quality assurance for computer-controlled delivery is discussed

  10. Comparison of the pain levels of computer-controlled and conventional anesthesia techniques in prosthodontic treatment

    Directory of Open Access Journals (Sweden)

    Murat Yenisey

    2009-10-01

    Full Text Available OBJECTIVE: The objective of this study was to compare the pain levels on opposite sides of the maxilla at needle insertion during delivery of local anesthetic solution and tooth preparation for both conventional and anterior middle superior alveolar (AMSA technique with the Wand computer-controlled local anesthesia application. MATERIAL AND METHODS: Pain scores of 16 patients were evaluated with a 5-point verbal rating scale (VRS and data were analyzed nonparametrically. Pain differences at needle insertion, during delivery of local anesthetic, and at tooth preparation, for conventional versus the Wand technique, were analyzed using the Mann-Whitney U test (p=0.01. RESULTS: The Wand technique had a lower pain level compared to conventional injection for needle insertion (p0.05. CONCLUSIONS: The AMSA technique using the Wand is recommended for prosthodontic treatment because it reduces pain during needle insertion and during delivery of local anaesthetic. However, these two techniques have the same pain levels for tooth preparation.

  11. Malaria Treatment (United States)

    Science.gov (United States)

    ... Providers, Emergency Consultations, and General Public. Contact Us Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  12. Novel diode-based laser system for combined transcutaneous monitoring and computer-controlled intermittent treatment of jaundiced neonates

    Science.gov (United States)

    Hamza, Mostafa; El-Ahl, Mohammad H. S.; Hamza, Ahmad M.

    2001-06-01

    The high efficacy of laser phototherapy combined with transcutaneous monitoring of serum bilirubin provides optimum safety for jaundiced infants from the risk of bilirubin encephalopathy. In this paper the authors introduce the design and operating principles of a new laser system that can provide simultaneous monitoring and treatment of several jaundiced babies at one time. The new system incorporates diode-based laser sources oscillating at selected wavelengths to achieve both transcutaneous differential absorption measurements of bilirubin concentration in addition to the computer controlled intermittent laser therapy through a network of optical fibers. The detailed description and operating characteristics of this system are presented.

  13. Waste Water Treatment Unit

    International Nuclear Information System (INIS)

    Ramadan, A.E.K.

    2004-01-01

    A wastewater treatment plant to treat both the sanitary and industrial effluent originated from process, utilities and off site units of the refinery is described. The purpose is to obtain at the end of the treatment plant, a water quality that is in compliance with contractual requirements and relevant environmental regulations. first treatment (pretreatment). Primary de-oiling, Equalization, Neutralization, Secondary de-oiling. Second treatment (Biological), The mechanism of BOD removal, Biological flocculation, Nutrient requirements, Nitrification, De-nitrification, Effect of temperature, Effect of ph, Toxicity

  14. Computer-controlled attenuator.

    Science.gov (United States)

    Mitov, D; Grozev, Z

    1991-01-01

    Various possibilities for applying electronic computer-controlled attenuators for the automation of physiological experiments are considered. A detailed description is given of the design of a 4-channel computer-controlled attenuator, in two of the channels of which the output signal can change by a linear step, in the other two channels--by a logarithmic step. This, together with the existence of additional programmable timers, allows to automate a wide range of studies in different spheres of physiology and psychophysics, including vision and hearing.

  15. Computer control applied to accelerators

    CERN Document Server

    Crowley-Milling, Michael C

    1974-01-01

    The differences that exist between control systems for accelerators and other types of control systems are outlined. It is further indicated that earlier accelerators had manual control systems to which computers were added, but that it is essential for the new, large accelerators to include computers in the control systems right from the beginning. Details of the computer control designed for the Super Proton Synchrotron are presented. The method of choosing the computers is described, as well as the reasons for CERN having to design the message transfer system. The items discussed include: CAMAC interface systems, a new multiplex system, operator-to-computer interaction (such as touch screen, computer-controlled knob, and non- linear track-ball), and high-level control languages. Brief mention is made of the contributions of other high-energy research laboratories as well as of some other computer control applications at CERN. (0 refs).

  16. Computer controlled high voltage system

    Energy Technology Data Exchange (ETDEWEB)

    Kunov, B; Georgiev, G; Dimitrov, L [and others

    1996-12-31

    A multichannel computer controlled high-voltage power supply system is developed. The basic technical parameters of the system are: output voltage -100-3000 V, output current - 0-3 mA, maximum number of channels in one crate - 78. 3 refs.

  17. A computer-controlled conformal radiotherapy system I: overview

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; McShan, Daniel L.; Kessler, Marc L.; Matrone, Gwynne M.; Lewis, James D.; Weaver, Tamar A.

    1995-01-01

    Purpose: Equipment developed for use with computer-controlled conformal radiotherapy (CCRT) treatment techniques, including multileaf collimators and/or computer-control systems for treatment machines, are now available. The purpose of this work is to develop a system that will allow the safe, efficient, and accurate delivery of CCRT treatments as routine clinical treatments, and permit modifications of the system so that the delivery process can be optimized. Methods and Materials: The needs and requirements for a system that can fully support modern computer-controlled treatment machines equipped with multileaf collimators and segmental or dynamic conformal therapy capabilities have been analyzed and evaluated. This analysis has been used to design and then implement a complete approach to the delivery of CCRT treatments. Results: The computer-controlled conformal radiotherapy system (CCRS) described here consists of a process for the delivery of CCRT treatments, and a complex software system that implements the treatment process. The CCRS system described here includes systems for plan transfer, treatment delivery planning, sequencing of the actual treatment delivery process, graphical simulation and verification tools, as well as an electronic chart that is an integral part of the system. The CCRS system has been implemented for use with a number of different treatment machines. The system has been used clinically for more than 2 years to perform CCRT treatments for more than 200 patients. Conclusions: A comprehensive system for the implementation and delivery of computer-controlled conformal radiation therapy (CCRT) plans has been designed and implemented for routine clinical use with multisegment, computer-controlled, multileaf-collimated conformal therapy. The CCRS system has been successfully implemented to perform these complex treatments, and is considered quite important to the clinical use of modern computer-controlled treatment techniques

  18. A computer-controlled conformal radiotherapy system. IV: Electronic chart

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; McShan, Daniel L.; Matrone, Gwynne M.; Weaver, Tamar A.; Lewis, James D.; Kessler, Marc L.

    1995-01-01

    Purpose: The design and implementation of a system for electronically tracking relevant plan, prescription, and treatment data for computer-controlled conformal radiation therapy is described. Methods and Materials: The electronic charting system is implemented on a computer cluster coupled by high-speed networks to computer-controlled therapy machines. A methodical approach to the specification and design of an integrated solution has been used in developing the system. The electronic chart system is designed to allow identification and access of patient-specific data including treatment-planning data, treatment prescription information, and charting of doses. An in-house developed database system is used to provide an integrated approach to the database requirements of the design. A hierarchy of databases is used for both centralization and distribution of the treatment data for specific treatment machines. Results: The basic electronic database system has been implemented and has been in use since July 1993. The system has been used to download and manage treatment data on all patients treated on our first fully computer-controlled treatment machine. To date, electronic dose charting functions have not been fully implemented clinically, requiring the continued use of paper charting for dose tracking. Conclusions: The routine clinical application of complex computer-controlled conformal treatment procedures requires the management of large quantities of information for describing and tracking treatments. An integrated and comprehensive approach to this problem has led to a full electronic chart for conformal radiation therapy treatments

  19. Adaptive remediation using portable treatment units

    International Nuclear Information System (INIS)

    Bahowick, S.; Folsom, E.; Pico, T.

    1996-01-01

    Lawrence Livermore National Laboratory (LLNL) is using adaptive remediation to optimize their environmental restoration strategy. Adaptive remediation uses hydrostratigraphic analysis to gain a better understanding of the subsurface characteristics, hydraulic tests to optimize contaminant transport models, and Portable Treatment Units (PTUs) as an alternative to fixed facilities. Hydrostratigraphic analysis is an optimization tool that improves the ability to identify and target contaminant migration pathways, identify the relationship between plumes and source areas, and better define hydraulic capture areas. Hydraulic tests, performed with PTUs, provide valuable data about subsurface characteristics. As clean up progresses, PTUs can be moved to the appropriate extraction wells to optimize contaminant mass removal. PTUs can also be placed to support innovative treatment technologies such as steam injection and microbial filters. Construction of PTUs will reduce by one-half the capital costs of building the rest of the fixed treatment system planned in the Record of Decision. Regulatory agencies are receptive to the use of the PTUs because the same treatment technology is being used and the PTUs will be able to clean up the plume cheaper and faster. Using adaptive remediation, LLNL is more effectively implementing remediation plans, improving cleanup time, and reducing project costs

  20. A computer control system for a research reactor

    International Nuclear Information System (INIS)

    Crawford, K.C.; Sandquist, G.M.

    1987-01-01

    Most reactor applications until now, have not required computer control of core output. Commercial reactors are generally operated at a constant power output to provide baseline power. However, if commercial reactor cores are to become load following over a wide range, then centralized digital computer control is required to make the entire facility respond as a single unit to continual changes in power demand. Navy and research reactors are much smaller and simpler and are operated at constant power levels as required, without concern for the number of operators required to operate the facility. For navy reactors, centralized digital computer control may provide space savings and reduced personnel requirements. Computer control offers research reactors versatility to efficiently change a system to develop new ideas. The operation of any reactor facility would be enhanced by a controller that does not panic and is continually monitoring all facility parameters. Eventually very sophisticated computer control systems may be developed which will sense operational problems, diagnose the problem, and depending on the severity of the problem, immediately activate safety systems or consult with operators before taking action

  1. Multiaxis, Lightweight, Computer-Controlled Exercise System

    Science.gov (United States)

    Haynes, Leonard; Bachrach, Benjamin; Harvey, William

    2006-01-01

    The multipurpose, multiaxial, isokinetic dynamometer (MMID) is a computer-controlled system of exercise machinery that can serve as a means for quantitatively assessing a subject s muscle coordination, range of motion, strength, and overall physical condition with respect to a wide variety of forces, motions, and exercise regimens. The MMID is easily reconfigurable and compactly stowable and, in comparison with prior computer-controlled exercise systems, it weighs less, costs less, and offers more capabilities. Whereas a typical prior isokinetic exercise machine is limited to operation in only one plane, the MMID can operate along any path. In addition, the MMID is not limited to the isokinetic (constant-speed) mode of operation. The MMID provides for control and/or measurement of position, force, and/or speed of exertion in as many as six degrees of freedom simultaneously; hence, it can accommodate more complex, more nearly natural combinations of motions and, in so doing, offers greater capabilities for physical conditioning and evaluation. The MMID (see figure) includes as many as eight active modules, each of which can be anchored to a floor, wall, ceiling, or other fixed object. A cable is payed out from a reel in each module to a bar or other suitable object that is gripped and manipulated by the subject. The reel is driven by a DC brushless motor or other suitable electric motor via a gear reduction unit. The motor can be made to function as either a driver or an electromagnetic brake, depending on the required nature of the interaction with the subject. The module includes a force and a displacement sensor for real-time monitoring of the tension in and displacement of the cable, respectively. In response to commands from a control computer, the motor can be operated to generate a required tension in the cable, to displace the cable a required distance, or to reel the cable in or out at a required speed. The computer can be programmed, either locally or via

  2. Distributed computer control system for reactor optimization

    International Nuclear Information System (INIS)

    Williams, A.H.

    1983-01-01

    At the Oldbury power station a prototype distributed computer control system has been installed. This system is designed to support research and development into improved reactor temperature control methods. This work will lead to the development and demonstration of new optimal control systems for improvement of plant efficiency and increase of generated output. The system can collect plant data from special test instrumentation connected to dedicated scanners and from the station's existing data processing system. The system can also, via distributed microprocessor-based interface units, make adjustments to the desired reactor channel gas exit temperatures. The existing control equipment will then adjust the height of control rods to maintain operation at these temperatures. The design of the distributed system is based on extensive experience with distributed systems for direct digital control, operator display and plant monitoring. The paper describes various aspects of this system, with particular emphasis on: (1) the hierarchal system structure; (2) the modular construction of the system to facilitate installation, commissioning and testing, and to reduce maintenance to module replacement; (3) the integration of the system into the station's existing data processing system; (4) distributed microprocessor-based interfaces to the reactor controls, with extensive security facilities implemented by hardware and software; (5) data transfer using point-to-point and bussed data links; (6) man-machine communication based on VDUs with computer input push-buttons and touch-sensitive screens; and (7) the use of a software system supporting a high-level engineer-orientated programming language, at all levels in the system, together with comprehensive data link management

  3. Design parameters for waste effluent treatment unit from beverages production

    OpenAIRE

    Mona A. Abdel-Fatah; H.O. Sherif; S.I. Hawash

    2017-01-01

    Based on a successful experimental result from laboratory and bench scale for treatment of wastewater from beverages industry, an industrial and efficient treatment unit is designed and constructed. The broad goal of this study was to design and construct effluent, cost effective and high quality treatment unit. The used technology is the activated sludge process of extended aeration type followed by rapid sand filters and chlorination as tertiary treatment. Experimental results have been con...

  4. Computer control of shielded cell operations

    International Nuclear Information System (INIS)

    Jeffords, W.R. III.

    1987-01-01

    This paper describes in detail a computer system to remotely control shielded cell operations. System hardware, software, and design criteria are discussed. We have designed a computer-controlled buret that provides a tenfold improvement over the buret currently in service. A computer also automatically controls cell analyses, calibrations, and maintenance. This system improves conditions for the operators by providing a safer, more efficient working environment and is expandable for future growth and development

  5. Configurating computer-controlled bar system

    OpenAIRE

    Šuštaršič, Nejc

    2010-01-01

    The principal goal of my diploma thesis is creating an application for configurating computer-controlled beverages dispensing systems. In the preamble of my thesis I present the theoretical platform for point of sale systems and beverages dispensing systems, which are required for the understanding of the target problematics. As with many other fields, computer tehnologies entered the field of managing bars and restaurants quite some time ago. Basic components of every bar or restaurant a...

  6. Design parameters for waste effluent treatment unit from beverages production

    Directory of Open Access Journals (Sweden)

    Mona A. Abdel-Fatah

    2017-09-01

    Full Text Available Based on a successful experimental result from laboratory and bench scale for treatment of wastewater from beverages industry, an industrial and efficient treatment unit is designed and constructed. The broad goal of this study was to design and construct effluent, cost effective and high quality treatment unit. The used technology is the activated sludge process of extended aeration type followed by rapid sand filters and chlorination as tertiary treatment. Experimental results have been considered as the basis for full scale design of the industrial capacity of 1600 m3/day treatment plant. Final effluent characteristics after treatment comply with Egyptian legalizations after reducing COD and BOD5 by about 97% and 95% respectively. So it is recommended to reuse treated effluent in textile industry in dyeing process.

  7. Computer-controlled radiation monitoring system

    International Nuclear Information System (INIS)

    Homann, S.G.

    1994-01-01

    A computer-controlled radiation monitoring system was designed and installed at the Lawrence Livermore National Laboratory's Multiuser Tandem Laboratory (10 MV tandem accelerator from High Voltage Engineering Corporation). The system continuously monitors the photon and neutron radiation environment associated with the facility and automatically suspends accelerator operation if preset radiation levels are exceeded. The system has proved reliable real-time radiation monitoring over the past five years, and has been a valuable tool for maintaining personnel exposure as low as reasonably achievable

  8. Present SLAC accelerator computer control system features

    International Nuclear Information System (INIS)

    Davidson, V.; Johnson, R.

    1981-02-01

    The current functional organization and state of software development of the computer control system of the Stanford Linear Accelerator is described. Included is a discussion of the distribution of functions throughout the system, the local controller features, and currently implemented features of the touch panel portion of the system. The functional use of our triplex of PDP11-34 computers sharing common memory is described. Also included is a description of the use of pseudopanel tables as data tables for closed loop control functions

  9. Data acquisition and treatment unit for use in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Annaix, C; Prieur, G; Vilayleck, S; Jallet, P [C.H.R., Angers (France)

    1981-01-01

    Here is below a one-channel data acquisition unit piloted through a minicomputer programmed by means of an advanced language of the Basic type. This unit allows, especially in nuclear medicine, pulse counts from a spectrometer according to a programmed sequence. Moreover, it provides treatment of measures as well as printing and filing of interpreted results. The acquisition unit is linked to the minicomputer through a RS 232 C serial mode, which ensures both easy operation and universal use of the system here described. Accuracy of measurement is also examined.

  10. Computer control for remote wind turbine operation

    Energy Technology Data Exchange (ETDEWEB)

    Manwell, J.F.; Rogers, A.L.; Abdulwahid, U.; Driscoll, J. [Univ. of Massachusetts, Amherst, MA (United States)

    1997-12-31

    Light weight wind turbines located in harsh, remote sites require particularly capable controllers. Based on extensive operation of the original ESI-807 moved to such a location, a much more sophisticated controller than the original one has been developed. This paper describes the design, development and testing of that new controller. The complete control and monitoring system consists of sensor and control inputs, the control computer, control outputs, and additional equipment. The control code was written in Microsoft Visual Basic on a PC type computer. The control code monitors potential faults and allows the turbine to operate in one of eight states: off, start, run, freewheel, low wind shut down, normal wind shutdown, emergency shutdown, and blade parking. The controller also incorporates two {open_quotes}virtual wind turbines,{close_quotes} including a dynamic model of the machine, for code testing. The controller can handle numerous situations for which the original controller was unequipped.

  11. Computer-controlled wall servicing robot

    Energy Technology Data Exchange (ETDEWEB)

    Lefkowitz, S. [Pentek, Inc., Corapolis, PA (United States)

    1995-03-01

    After four years of cooperative research, Pentek has unveiled a new robot with the capability to automatically deliver a variety of cleaning, painting, inspection, and surveillance devices to large vertical surfaces. The completely computer-controlled robot can position a working tool on a 50-foot tall by 50-foot wide vertical surface with a repeatability of 1/16 inch. The working end can literally {open_quotes}fly{close_quotes} across the face of a wall at speed of 60 per minute, and can handle working loads of 350 pounds. The robot was originally developed to decontaminate the walls of reactor fueling cavities at commercial nuclear power plants during fuel outages. If these cavities are left to dry after reactor refueling, contamination present in the residue could later become airborne and move throughout the containment building. Decontaminating the cavity during the refueling outage reduces the need for restrictive personal protective equipment during plant operations to limit the dose rates.

  12. Computer controls for the WITCH experiment

    CERN Document Server

    Tandecki, M; Van Gorp, S; Friedag, P; De Leebeeck, V; Beck, D; Brand, H; Weinheimer, C; Breitenfeldt, M; Traykov, E; Mader, J; Roccia, S; Severijns, N; Herlert, A; Wauters, F; Zakoucky, D; Kozlov, V; Soti, G

    2011-01-01

    The WITCH experiment is a medium-scale experimental set-up located at ISOLDE/CERN. It combines a double Penning trap system with,a retardation spectrometer for energy measurements of recoil ions from beta decay. For a correct operation of such a set-up a whole range of different devices is required. Along with the installation and optimization of the set-up a computer control system was developed to control these devices. The CS-Framework that is developed and maintained at GSI, was chosen as a basis for this control system as it is perfectly suited to handle the distributed nature of a control system.We report here on the required hardware for WITCH, along with the basis of this CS-Framework and the add-ons that were implemented for WITCH. (C) 2010 Elsevier B.V. All rights reserved.

  13. Computer controlled multi-leaf conformation radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, T [Tokyo Metropolitan Komagome Hospital (Japan); Inamura, K

    1981-10-01

    A conformation radiotherapy system with 5-split collimators of which openings can be controlled symmetrically by computerized techniques during rotational irradiation by a linear accelerator has been developed. Outline of the system performance and its clinical applications are described as follows. 1. Profile of the system: The hardware is composed of three parts, namely, the multi-split collimator, the electronic data processor, and the interface between those two parts. 1) The multi-leaf collimator is composed of 5 pairs (10 leaves) diaphragms. It can be mounted to the X-ray head of a linear accelerator when used, and can be dismounted after its use. 2) The electronic data processor sends control signal to the collimator according to the 5-leaf target volume data which can be stored into a minifloppy disc through the curve digitizer previously. This part is composed of a) dedicated micro processor, b) I/O expansion unit, c) color CRT display with key board, d) dual mini-floppy disc unit, e) curve digitizer and f) digital plotter for recording and verification of resulted accuracy. 2. Performance of the system: 1) Maximum field size: 15 cm x 15 cm at isocenter. 2) Maximum elongation ratio of the target volume: 3 : 1 when the longer diameter is 15 cm. 3) Control accuracy: Within +-3 mm deviation from planned beam focus at isocenter. 3. Clinical application: The method of treatment planning and clinical advantages of this irradiation method are explained by raising clinical experiences such as treating brain tumor and rectal cancer.

  14. Computer controlled multi-leaf conformation radiotherapy

    International Nuclear Information System (INIS)

    Matsuda, Tadayoshi; Inamura, Kiyonari.

    1981-01-01

    A conformation radiotherapy system with 5-split collimators of which openings can be controlled symmetrically by computerized techniques during rotational irradiation by a linear accelerator has been developed. Outline of the system performance and its clinical applications are described as follows. 1. Profile of the system: The hardware is composed of three parts, namely, the multi-split collimator, the electronic data processor, and the interface between those two parts. 1) The multi-leaf collimator is composed of 5 pairs (10 leaves) diaphragms. It can be mounted to the X-ray head of a linear accelerator when used, and can be dismounted after its use. 2) The electronic data processor sends control signal to the collimator according to the 5-leaf target volume data which can be stored into a minifloppy disc through the curve digitizer previously. This part is composed of a) dedicated micro processor, b) I/O expansion unit, c) color CRT display with key board, d) dual mini-floppy disc unit, e) curve digitizer and f) digital plotter for recording and verification of resulted accuracy. 2. Performance of the system: 1) Maximum field size: 15 cm x 15 cm at isocenter. 2) Maximum elongation ratio of the target volume: 3 : 1 when the longer diameter is 15 cm. 3) Control accuracy: Within +-3 mm deviation from planned beam focus at isocenter. 3. Clinical application: The method of treatment planning and clinical advantages of this irradiation method are explained by raising clinical experiences such as treating brain tumor and rectal cancer. (author)

  15. Who benefits from treatment and rehabilitation in a stroke Unit?

    DEFF Research Database (Denmark)

    Jorgensen, H S; Kammersgaard, L P; Houth, J

    2000-01-01

    The beneficial effects of treatment and rehabilitation of patients with acute stroke in a dedicated stroke unit (SU) are well established. We wanted to examine if these effects are limited to certain groups of patients or if they apply to all patients independent of age, sex, comorbidity......, and initial stroke severity....

  16. Accessibility of hypertensive users to health units and treatment adherence

    Directory of Open Access Journals (Sweden)

    Natasha Marques Frota

    2013-09-01

    Full Text Available We aimed to analyze the accessibility of hypertensive users to the health system with focus on treatment adherence. A cross-sectional study with quantitative approach was conducted in four Family Health Basic Units of Fortaleza-CE, Brazil. The sample consisted of 400 users. Data collection happened through a form applied from May to August 2011. About 97.5% of users were older than 40 years, and 67.2% were female. The accessibility to the referral service occurred in 47.2% of users to secondary care, of which 101 (25.2% were referred to Emergency Units, and 88 (22.0% were admitted to Inpatient Units. Most hypertensive patients adhered to healthy habits, except the use of dietetic sweeteners (36.0% and physical exercise (35.0%. The hypertensive patients had good treatment adherence and difficulty in accessibility regarding counter-referral services to secondary and tertiary care services.

  17. Stroke treatment outcomes in hospitals with and without Stroke Units.

    Science.gov (United States)

    Masjuan, J; Gállego Culleré, J; Ignacio García, E; Mira Solves, J J; Ollero Ortiz, A; Vidal de Francisco, D; López-Mesonero, L; Bestué, M; Albertí, O; Acebrón, F; Navarro Soler, I M

    2017-10-23

    Organisational capacity in terms of resources and care circuits to shorten response times in new stroke cases is key to obtaining positive outcomes. This study compares therapeutic approaches and treatment outcomes between traditional care centres (with stroke teams and no stroke unit) and centres with stroke units. We conducted a prospective, quasi-experimental study (without randomisation of the units analysed) to draw comparisons between 2 centres with stroke units and 4 centres providing traditional care through the neurology department, analysing a selection of agreed indicators for monitoring quality of stroke care. A total of 225 patients participated in the study. In addition, self-administered questionnaires were used to collect patients' evaluations of the service and healthcare received. Centres with stroke units showed shorter response times after symptom onset, both in the time taken to arrive at the centre and in the time elapsed from patient's arrival at the hospital to diagnostic imaging. Hospitals with stroke units had greater capacity to respond through the application of intravenous thrombolysis than centres delivering traditional neurological care. Centres with stroke units showed a better fit to the reference standards for stroke response time, as calculated in the Quick study, than centres providing traditional care through the neurology department. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Beyond Ebola treatment units: severe infection temporary treatment units as an essential element of Ebola case management during an outbreak.

    Science.gov (United States)

    Janke, Christian; Heim, Katrin Moira; Steiner, Florian; Massaquoi, Moses; Gbanya, Miatta Zenabu; Frey, Claudia; Froeschl, Guenter

    2017-02-06

    In the course of the Ebola outbreak in West Africa that was witnessed since early 2014, the response mechanisms showed deficits in terms of timeliness, volume and adequacy. The authors were deployed in the Ebola campaign in the West African country Liberia, where by September 2014 the changing epidemiological pattern made reconsiderations of guidelines and adopted procedures necessary. A temporary facility set up as a conventional Ebola Treatment Unit in the Liberian capital Monrovia was re-dedicated into a Severe Infections Temporary Treatment Unit. This facility allowed for stratification based on the nosocomial risk of exposure to Ebola virus for a growing subgroup of admitted patients that in the end would turn out as Ebola negative cases. At the same time, adequate diagnostic measures and treatment for the non-Ebola conditions of these patients could be provided without compromising work safety of the employed staff. The key elements of the new unit comprised a Suspect Cases Area similar to that of conventional Ebola treatment units for newly arriving patients, an Unlikely Cases Area for patients with a first negative Ebola PCR result, and a Confirmed Negative Cases Area for patients in whom Ebola could be ruled out. The authors, comprising representatives of the Liberian Ministry of Health and Social Welfare, as well as infectious disease specialists from the German Ebola Task Force are presenting key features of the adapted concept, and are highlighting its relevance in raising acceptance for outbreak counter-measures within the population at stake.

  19. Study on the Development of Household Wastewater Treatment Unit

    Directory of Open Access Journals (Sweden)

    Ali Hadi Ghawi

    2018-03-01

    Full Text Available The cities of Iraq in general and the city of Al Diwaniyah in particular are characterized by the fact that the majority of households use septic tank to dispose of sewage, leading to contamination of ground and surface water and a disturbance to the environment. The objective of this study is to protect the water and soil sources from the risk of pollution, eliminate the process of perfusion and thus, reduce costs, maintain public health, as well as design and implement the proposed purification unit for domestic wastewater treatment. A domestic wastewater treatment unit has been improved to meet the standard specifications for the quality of the effluent wastewater. In this study, a compact non-electric sewage treatment unit was improved and implemented. Treatment is based on an effective modern biological purification process. Experimental verification and analysis of results were performed to demonstrate the improvement of physical and chemical parameters. The performance of the septic tanks-bioreactor gave satisfactory results. The removal efficiencies of Total Biochemical Oxygen Demand (BOD, Total Chemical Oxygen Demand (COD, NH4-N, Total Nitrogen and Total Suspended Solid (TSS were 96.9%, 84.6%, 78.8%, 79.9% and 95.3%, respectively.

  20. National Ignition Facility integrated computer control system

    International Nuclear Information System (INIS)

    Van Arsdall, P.J. LLNL

    1998-01-01

    The NIF design team is developing the Integrated Computer Control System (ICCS), which is based on an object-oriented software framework applicable to event-driven control systems. The framework provides an open, extensible architecture that is sufficiently abstract to construct future mission-critical control systems. The ICCS will become operational when the first 8 out of 192 beams are activated in mid 2000. The ICCS consists of 300 front-end processors attached to 60,000 control points coordinated by a supervisory system. Computers running either Solaris or VxWorks are networked over a hybrid configuration of switched fast Ethernet and asynchronous transfer mode (ATM). ATM carries digital motion video from sensors to operator consoles. Supervisory software is constructed by extending the reusable framework components for each specific application. The framework incorporates services for database persistence, system configuration, graphical user interface, status monitoring, event logging, scripting language, alert management, and access control. More than twenty collaborating software applications are derived from the common framework. The framework is interoperable among different kinds of computers and functions as a plug-in software bus by leveraging a common object request brokering architecture (CORBA). CORBA transparently distributes the software objects across the network. Because of the pivotal role played, CORBA was tested to ensure adequate performance

  1. Integrated Computer Controlled Glow Discharge Tube

    Science.gov (United States)

    Kaiser, Erik; Post-Zwicker, Andrew

    2002-11-01

    An "Interactive Plasma Display" was created for the Princeton Plasma Physics Laboratory to demonstrate the characteristics of plasma to various science education outreach programs. From high school students and teachers, to undergraduate students and visitors to the lab, the plasma device will be a key component in advancing the public's basic knowledge of plasma physics. The device is fully computer controlled using LabVIEW, a touchscreen Graphical User Interface [GUI], and a GPIB interface. Utilizing a feedback loop, the display is fully autonomous in controlling pressure, as well as in monitoring the safety aspects of the apparatus. With a digital convectron gauge continuously monitoring pressure, the computer interface analyzes the input signals, while making changes to a digital flow controller. This function works independently of the GUI, allowing the user to simply input and receive a desired pressure; quickly, easily, and intuitively. The discharge tube is a 36" x 4"id glass cylinder with 3" side port. A 3000 volt, 10mA power supply, is used to breakdown the plasma. A 300 turn solenoid was created to demonstrate the magnetic pinching of a plasma. All primary functions of the device are controlled through the GUI digital controllers. This configuration allows for operators to safely control the pressure (100mTorr-1Torr), magnetic field (0-90Gauss, 7amps, 10volts), and finally, the voltage applied across the electrodes (0-3000v, 10mA).

  2. A Computer-Controlled Laser Bore Scanner

    Science.gov (United States)

    Cheng, Charles C.

    1980-08-01

    This paper describes the design and engineering of a laser scanning system for production applications. The laser scanning techniques, the timing control, the logic design of the pattern recognition subsystem, the digital computer servo control for the loading and un-loading of parts, and the laser probe rotation and its synchronization will be discussed. The laser inspection machine is designed to automatically inspect the surface of precision-bored holes, such as those in automobile master cylinders, without contacting the machined surface. Although the controls are relatively sophisticated, operation of the laser inspection machine is simple. A laser light beam from a commercially available gas laser, directed through a probe, scans the entire surface of the bore. Reflected light, picked up through optics by photoelectric sensors, generates signals that are fed to a mini-computer for processing. A pattern recognition techniques program in the computer determines acceptance or rejection of the part being inspected. The system's acceptance specifications are adjustable and are set to the user's established tolerances. However, the computer-controlled laser system is capable of defining from 10 to 75 rms surface finish, and voids or flaws from 0.0005 to 0.020 inch. Following the successful demonstration with an engineering prototype, the described laser machine has proved its capability to consistently ensure high-quality master brake cylinders. It thus provides a safety improvement for the automotive braking system. Flawless, smooth cylinder bores eliminate premature wearing of the rubber seals, resulting in a longer-lasting master brake cylinder and a safer and more reliable automobile. The results obtained from use of this system, which has been in operation about a year for replacement of a tedious, manual operation on one of the high-volume lines at the Bendix Hydraulics Division, have been very satisfactory.

  3. B Plant treatment, storage, and disposal (TSD) units inspection plan

    International Nuclear Information System (INIS)

    Beam, T.G.

    1996-01-01

    This inspection plan is written to meet the requirements of WAC 173-303 for operations of a TSD facility. Owners/operators of TSD facilities are required to inspection their facility and active waste management units to prevent and/or detect malfunctions, discharges and other conditions potentially hazardous to human health and the environment. A written plan detailing these inspection efforts must be maintained at the facility in accordance with Washington Administrative Code (WAC), Chapter 173-303, ''Dangerous Waste Regulations'' (WAC 173-303), a written inspection plan is required for the operation of a treatment, storage and disposal (TSD) facility and individual TSD units. B Plant is a permitted TSD facility currently operating under interim status with an approved Part A Permit. Various operational systems and locations within or under the control of B Plant have been permitted for waste management activities. Included are the following TSD units: Cell 4 Container Storage Area; B Plant Containment Building; Low Level Waste Tank System; Organic Waste Tank System; Neutralized Current Acid Waste (NCAW) Tank System; Low Level Waste Concentrator Tank System. This inspection plan complies with the requirements of WAC 173-303. It addresses both general TSD facility and TSD unit-specific inspection requirements. Sections on each of the TSD units provide a brief description of the system configuration and the permitted waste management activity, a summary of the inspection requirements, and details on the activities B Plant uses to maintain compliance with those requirements

  4. Operators manual for a computer controlled impedance measurement system

    Science.gov (United States)

    Gordon, J.

    1987-02-01

    Operating instructions of a computer controlled impedance measurement system based in Hewlett Packard instrumentation are given. Hardware details, program listings, flowcharts and a practical application are included.

  5. Organizational issues in stroke treatment: The Swiss paradigm - Stroke units

    Directory of Open Access Journals (Sweden)

    Georgios K Matis

    2013-01-01

    Full Text Available Stroke represents the leading cause of acquired disability in adults and poses a tremendous socioeconomic burden both on patients and the society. In this sense, prompt diagnosis and urgent treatment are needed in order to radically reduce the devastating consequences of this disease. Herein the authors present the new guidelines recently adopted by the Swiss Stroke Society concerning the establishment of stroke units. Standardized treatment and allocation protocols along with an acute rehabilitation concept seem to be the core of the Swiss stroke management system. Coordinated multidisciplinary care provided by specialized medical, nursing and therapy staff is of utmost importance for achieving a significant dependency and death reduction. It is believed that the implementation of these guidelines in the stroke care system would be beneficial not only for the stroke patients, but also for the health system.

  6. Reduction of energy consumption peaks in a greenhouse by computer control

    Energy Technology Data Exchange (ETDEWEB)

    Amsen, M.G.; Froesig Nielsen, O.; Jacobsen, L.H. (Danish Research Service for Plant and Soil Science, Research Centre for Horticulture, Department of Horticultural Engineering, Aarslev (DK))

    1990-01-01

    The results of using a computer for environmental control in one greenhouse is in this paper compared with using modified analogue control equipment in another one. Energy consumption peaks can be almost prevented by properly applying the computer control and strategy. Both treatments were based upon negative DIF, i.e. low day and high night minimum set points (14 deg. C/ 22 deg. C) for room temperature. No difference in production time and quality was observed in six different pot plant species. Only Kalanchoe showed significant increase in fresh weight and dry weight. By applying computer control, the lack of flexibility of analogue control can be avoided by applying computer control and a more accurate room temperature control can be obtained. (author).

  7. A Computer Controlled Precision High Pressure Measuring System

    Science.gov (United States)

    Sadana, S.; Yadav, S.; Jha, N.; Gupta, V. K.; Agarwal, R.; Bandyopadhyay, A. K.; Saxena, T. K.

    2011-01-01

    A microcontroller (AT89C51) based electronics has been designed and developed for high precision calibrator based on Digiquartz pressure transducer (DQPT) for the measurement of high hydrostatic pressure up to 275 MPa. The input signal from DQPT is converted into a square wave form and multiplied through frequency multiplier circuit over 10 times to input frequency. This input frequency is multiplied by a factor of ten using phased lock loop. Octal buffer is used to store the calculated frequency, which in turn is fed to microcontroller AT89C51 interfaced with a liquid crystal display for the display of frequency as well as corresponding pressure in user friendly units. The electronics developed is interfaced with a computer using RS232 for automatic data acquisition, computation and storage. The data is acquired by programming in Visual Basic 6.0. This system is interfaced with the PC to make it a computer controlled system. The system is capable of measuring the frequency up to 4 MHz with a resolution of 0.01 Hz and the pressure up to 275 MPa with a resolution of 0.001 MPa within measurement uncertainty of 0.025%. The details on the hardware of the pressure measuring system, associated electronics, software and calibration are discussed in this paper.

  8. Eye injury treatment in intensive care unit patients

    Directory of Open Access Journals (Sweden)

    L. K. Moshetova

    2015-01-01

    Full Text Available Aim. To describe eye injuries in intensive care unit (ICU patients with multitrauma, to study conjunctival microflora in these patients, and to develop etiologically and pathogenically targeted treatment and prevention of wound complications.Materials and methods. Study group included 50 patients (54 eyes with combined mechanical cerebral and eye injury. All patients underwent possible ophthalmological examination (biomicroscopy, ophthalmoscopy and ocular fundus photographing with portative fundus camera, tonometry, cranial CT and MRT, and bacteriological study of conjunctival smears. Results. Modern methods of ophthalmological examination of ICU patients provided correct diagnosis and prediction of wound healing. Eye injury treatment schedule provided maximum possible results in all ICU patients. Hospitalacquired infection results in asymptomatic dissemination of pathogenic microbes on ocular surface. Conclusions. 14-day topical treatment with antimicrobials, steroids, and NSAIDs reduces posttraumatic inflammation caused by mechanical eye injuries in ICU patients. Bacteriological studies of conjunctival smears demonstrate the presence of pathogenic flora in ICU patients. In these patients, the most effective antibacterial agents are third-generation fluoroquinolones. 

  9. Radiological emergency response in a medical waste treatment unit

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)

    2000-07-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  10. Radiological emergency response in a medical waste treatment unit

    International Nuclear Information System (INIS)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L.

    2000-01-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  11. Robotic Automation in Computer Controlled Polishing

    Science.gov (United States)

    Walker, D. D.; Yu, G.; Bibby, M.; Dunn, C.; Li, H.; Wu, Y.; Zheng, X.; Zhang, P.

    2016-02-01

    We first present a Case Study - the manufacture of 1.4 m prototype mirror-segments for the European Extremely Large Telescope, undertaken by the National Facility for Ultra Precision Surfaces, at the OpTIC facility operated by Glyndwr University. Scale-up to serial-manufacture demands delivery of a 1.4 m off-axis aspheric hexagonal segment with surface precision robots and computer numerically controlled ('CNC') polishing machines for optical fabrication. The objective was not to assess which is superior. Rather, it was to understand for the first time their complementary properties, leading us to operate them together as a unit, integrated in hardware and software. Three key areas are reported. First is the novel use of robots to automate currently-manual operations on CNC polishing machines, to improve work-throughput, mitigate risk of damage to parts, and reduce dependence on highly-skilled staff. Second is the use of robots to pre-process surfaces prior to CNC polishing, to reduce total process time. The third draws the threads together, describing our vision of the automated manufacturing cell, where the operator interacts at cell rather than machine level. This promises to deliver a step-change in end-to-end manufacturing times and costs, compared with either platform used on its own or, indeed, the state-of-the-art used elsewhere.

  12. EBR-II high-ramp transients under computer control

    International Nuclear Information System (INIS)

    Forrester, R.J.; Larson, H.A.; Christensen, L.J.; Booty, W.F.; Dean, E.M.

    1983-01-01

    During reactor run 122, EBR-II was subjected to 13 computer-controlled overpower transients at ramps of 4 MWt/s to qualify the facility and fuel for transient testing of LMFBR oxide fuels as part of the EBR-II operational-reliability-testing (ORT) program. A computer-controlled automatic control-rod drive system (ACRDS), designed by EBR-II personnel, permitted automatic control on demand power during the transients

  13. Computer Controlled Chemical Micro-Reactor

    International Nuclear Information System (INIS)

    Mechtilde, Schaefer; Eduard, Stach; Adreas, Foitzik

    2006-01-01

    Chemical reactions or chemical equilibria can be influenced and controlled by several parameters. The ratio of two liquid ingredients, the so called reactants or educts, plays an important role in determining the end product and its yield. The reactants must be weighed and accordingly mixed with the conventional batch mode. If the reaction is done in a microreactor or in several parallel working micro-reactors, units for allotting the educts in appropriate quantities are required. In this report we present a novel micro-reactor that allows the constant monitoring of the chemical reaction via Raman spectroscopy. Such monitoring enables an appropriate feedback on the steering parameters for the PC controlled micro-pumps for the appropriate educt flow rate of both liquids to get optimised ratios of ingredients at an optimised total flow rate. The micro-reactors are the core pieces of the design and are easily removable and can therefore be changed at any time to adapt the requirements of the chemical reaction. One type of reactor consists of a stainless steel base containing small scale milled channels covered with anodically bonded Pyrex glass. Another type of reactor has a base of anisotropically etched silicon, and is also covered with anodically bonded Pyrex glass. The glass window allows visual observation of the initial phase interface of the two educts in the reaction channels by optical microscopy and does not affect, in contrast to infrared spectroscopy, the Raman spectroscopic signal for detection of the reaction kinetics. On the basis of a test reaction, we present non-invasive and spatially highly resolved in-situ reaction analysis using Raman spectroscopy measured along the reaction channel at different locations

  14. Integrated Waste Treatment Unit GFSI Risk Management Plan

    International Nuclear Information System (INIS)

    W. A. Owca

    2007-01-01

    This GFSI Risk Management Plan (RMP) describes the strategy for assessing and managing project risks for the Integrated Waste Treatment Unit (IWTU) that are specifically within the control and purview of the U.S. Department of Energy (DOE), and identifies the risks that formed the basis for the DOE contingency included in the performance baseline. DOE-held contingency is required to cover cost and schedule impacts of DOE activities. Prior to approval of the performance baseline (Critical Decision-2) project cost contingency was evaluated during a joint meeting of the Contractor Management Team and the Integrated Project Team for both contractor and DOE risks to schedule and cost. At that time, the contractor cost and schedule risk value was $41.3M and the DOE cost and schedule risk contingency value is $39.0M. The contractor cost and schedule risk value of $41.3M was retained in the performance baseline as the contractor's management reserve for risk contingency. The DOE cost and schedule risk value of $39.0M has been retained in the performance baseline as the DOE Contingency. The performance baseline for the project was approved in December 2006 (Garman 2006). The project will continue to manage to the performance baseline and change control thresholds identified in PLN-1963, ''Idaho Cleanup Project Sodium-Bearing Waste Treatment Project Execution Plan'' (PEP)

  15. CE: Inside an Ebola Treatment Unit: A Nurse's Report.

    Science.gov (United States)

    Wilson, Deborah

    2015-12-01

    In December 2013, the first cases of the most recent outbreak of Ebola virus disease (formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Liberia for five weeks. This article describes her experiences there. It provides some background, outlines the practices and teams involved, and aims to convey a sense of what it's like to work during an Ebola outbreak and to put a human face on this devastating epidemic.

  16. THE ROLE OF FOLLICULAR UNIT GRAFTING IN TREATMENT ALOPECIA

    Directory of Open Access Journals (Sweden)

    Duhita Ayuningtyas

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Alopecia is usually treatable and self-limited, but it may be permanent. Careful diagnosis of the type of hair loss will aid in selecting effective treatment. Many drugs used to treat alopecia, but in many people not satisfied with the result. One of the treatment currently used to treat alopecia is hair transplantation with follicular unit grafting (FUG. The advantages of hair transplantation is to create a natural appearance, one that mimics natural hair growth both in terms of numbers and pattern /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  17. WASH activities at two Ebola treatment units in Sierra Leone.

    Directory of Open Access Journals (Sweden)

    Michaela Mallow

    Full Text Available The 2014 outbreak of Ebola virus disease (EVD in West Africa was the largest in history. Starting in September 2014, International Medical Corps (IMC operated five Ebola treatment units (ETUs in Sierra Leone and Liberia. This paper explores how future infectious disease outbreak facilities in resource-limited settings can be planned, organized, and managed by analyzing data collected on water, sanitation, and hygiene (WASH and infection prevention control (IPC protocols.We conducted a retrospective cohort study by analyzing WASH/IPC activity data routinely recorded on paper forms or white boards at ETUs during the outbreak and later merged into a database from two IMC-run ETUs in Sierra Leone between December 2014 and December 2015.The IMC WASH/IPC database contains data from over 369 days. Our results highlight parameters key to designing and maintaining an ETU. High concentration chlorine solution usage was highly correlated with both daily patient occupancy and high-risk zone staff entries; low concentration chlorine usage was less well explained by these measures. There is high demand for laundering and disinfecting of personal protective equipment (PPE on a daily basis and approximately 1 (0-4 piece of PPE is damaged each day.Lack of standardization in the type and format of data collected at ETUs made constructing the WASH/IPC database difficult. However, the data presented here may help inform humanitarian response operations in future epidemics.

  18. Transport of Pathogen Surrogates in Soil Treatment Units: Numerical Modeling

    Directory of Open Access Journals (Sweden)

    Ivan Morales

    2014-04-01

    Full Text Available Segmented mesocosms (n = 3 packed with sand, sandy loam or clay loam soil were used to determine the effect of soil texture and depth on transport of two septic tank effluent (STE-borne microbial pathogen surrogates—green fluorescent protein-labeled E. coli (GFPE and MS-2 coliphage—in soil treatment units. HYDRUS 2D/3D software was used to model the transport of these microbes from the infiltrative surface. Mesocosms were spiked with GFPE and MS-2 coliphage at 105 cfu/mL STE and 105–106 pfu/mL STE, respectively. In all soils, removal rates were >99.99% at 25 cm. The transport simulation compared (1 optimization; and (2 trial-and-error modeling approaches. Only slight differences between the transport parameters were observed between these approaches. Treating both the die-off rates and attachment/detachment rates as variables resulted in an overall better model fit, particularly for the tailing phase of the experiments. Independent of the fitting procedure, attachment rates computed by the model were higher in sandy and sandy loam soils than clay, which was attributed to unsaturated flow conditions at lower water content in the coarser-textured soils. Early breakthrough of the bacteria and virus indicated the presence of preferential flow in the system in the structured clay loam soil, resulting in faster movement of water and microbes through the soil relative to a conservative tracer (bromide.

  19. Clinical treatment planning optimization by Powell's method for gamma unit treatment system

    International Nuclear Information System (INIS)

    Yan Yulong; Shu Huazhong; Bao Xudong; Luo Limin; Bai Yi

    1997-01-01

    Purpose: This article presents a new optimization method for stereotactic radiosurgery treatment planning for gamma unit treatment system. Methods and Materials: The gamma unit has been utilized in stereotactic radiosurgery for about 30 years, but the usual procedure for a physician-physicist team to design a treatment plan is a trial-and-error approach. Isodose curves are viewed on two-dimensional computed tomography (CT) or magnetic resonance (MR) image planes, which is not only time consuming but also seldom achieves the optimal treatment plan, especially when the isocenter weights are regarded. We developed a treatment-planning system on a computer workstation in which Powell's optimization method is realized. The optimization process starts with the initial parameters (the number of iso centers as well as corresponding 3D iso centers' coordinates, collimator sizes, and weight factors) roughly determined by the physician-physicist team. The objective function can be changed to consider protection of sensitive tissues. Results: We use the plan parameters given by a well-trained physician-physicist team, or ones that the author give roughly as the initial parameters for the optimization procedure. Dosimetric results of optimization show a better high dose-volume conformation to the target volume compared to the doctor's plan. Conclusion: This method converges quickly and is not sensitive to the initial parameters. It achieves an excellent conformation of the estimated isodose curves with the contours of the target volume. If the initial parameters are varied, there will be a little difference in parameters' configuration, but the dosimetric results proved almost to be the same

  20. Computer control and monitoring of neutral beam injectors on the 2XIIB CTR experiment at LLL

    International Nuclear Information System (INIS)

    Pollock, G.G.

    1975-01-01

    The original manual control system for the 12 neutral beam injectors on the 2XIIB Machine is being integrated with a computer control system. This, in turn, is a part of a multiple computer network comprised of the three computers which are involved in the operation and instrumentation of the 2XIIB experiment. The computer control system simplifies neutral beam operation and centralizes it to a single operating position. A special purpose console utilizes computer generated graphics and interactive function entry buttons to optimize the human/machine interface. Through the facilities of the computer network, a high level control function will be implemented for the use of the experimenter in a remotely located experiment diagnositcs area. In addition to controlling the injectors in normal operation, the computer system provides automatic conditioning of the injectors, bringing rebuilt units back to full energy output with minimum loss of useful life. The computer system also provides detail archive data recording

  1. Computer control of fuel handling activities at FFTF

    International Nuclear Information System (INIS)

    Romrell, D.M.

    1985-03-01

    The Fast Flux Test Facility near Richland, Washington, utilizes computer control for reactor refueling and other related core component handling and processing tasks. The computer controlled tasks described in this paper include core component transfers within the reactor vessel, core component transfers into and out of the reactor vessel, remote duct measurements of irradiated core components, remote duct cutting, and finally, transferring irradiated components out of the reactor containment building for off-site shipments or to long term storage. 3 refs., 16 figs

  2. Invasive treatment of NSTEMI patients in German Chest Pain Units - Evidence for a treatment paradox.

    Science.gov (United States)

    Schmidt, Frank P; Schmitt, Claus; Hochadel, Matthias; Giannitsis, Evangelos; Darius, Harald; Maier, Lars S; Schmitt, Claus; Heusch, Gerd; Voigtländer, Thomas; Mudra, Harald; Gori, Tommaso; Senges, Jochen; Münzel, Thomas

    2018-03-15

    Patients with non ST-segment elevation myocardial infarction (NSTEMI) represent the largest fraction of patients with acute coronary syndrome in German Chest Pain units. Recent evidence on early vs. selective percutaneous coronary intervention (PCI) is ambiguous with respect to effects on mortality, myocardial infarction (MI) and recurrent angina. With the present study we sought to investigate the prognostic impact of PCI and its timing in German Chest Pain Unit (CPU) NSTEMI patients. Data from 1549 patients whose leading diagnosis was NSTEMI were retrieved from the German CPU registry for the interval between 3/2010 and 3/2014. Follow-up was available at median of 167days after discharge. The patients were grouped into a higher (Group A) and lower risk group (Group B) according to GRACE score and additional criteria on admission. Group A had higher Killip classes, higher BNP levels, reduced EF and significant more triple vessel disease (pGerman Chest Pain Units. This treatment paradox may worsen prognosis in patients who could derive the largest benefit from early revascularization. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Electron Gun for Computer-controlled Welding of Small Components

    Czech Academy of Sciences Publication Activity Database

    Dupák, Jan; Vlček, Ivan; Zobač, Martin

    2001-01-01

    Roč. 62, 2-3 (2001), s. 159-164 ISSN 0042-207X R&D Projects: GA AV ČR IBS2065015 Institutional research plan: CEZ:AV0Z2065902 Keywords : Electron beam-welding machine * Electron gun * Computer- control led beam Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 0.541, year: 2001

  4. An improved computer controlled triple-axis neutron spectrometer

    International Nuclear Information System (INIS)

    Cooper, M.J.; Hall, J.W.; Hutchings, M.T.

    1975-07-01

    A description is given of the computer-controlled triple-axis neutron spectrometer installed at the PLUTO reactor at Harwell. The reasons for an nature of recent major improvements are discussed. Following a general description of the spectrometer, details are then given of the new computerised control system, including the functions of the various programs which are now available to the user. (author)

  5. Isotopic analysis of plutonium by computer controlled mass spectrometry

    International Nuclear Information System (INIS)

    1974-01-01

    Isotopic analysis of plutonium chemically purified by ion exchange is achieved using a thermal ionization mass spectrometer. Data acquisition from and control of the instrument is done automatically with a dedicated system computer in real time with subsequent automatic data reduction and reporting. Separation of isotopes is achieved by varying the ion accelerating high voltage with accurate computer control

  6. Nuclear safety inspection in treatment process for SG heat exchange tubes deficiency of unit 1, TNPS

    International Nuclear Information System (INIS)

    Zhang Chunming; Song Chenxiu; Zhao Pengyu; Hou Wei

    2006-01-01

    This paper describes treatment process for SG heat exchange tubes deficiency of Unit 1, TNPS, nuclear safety inspection of Northern Regional Office during treatment process for deficiency and further inspection after deficiency had been treated. (authors)

  7. Present and Future Developments in Radiotherapy Treatment Units.

    Science.gov (United States)

    Boyer

    1995-04-01

    Technical advances in the design of medical accelerators are making possible the exploration of new treatment techniques. Technology currently available to the radiation oncologist allows the use of internal and dynamic wedges. Multileaf collimators can be used for static treatment ports, and dynamic field shaping and beam modulation using multileaf collimators has been shown to be feasible. Computer interfaces are necessary to transfer the complex treatment sequences that are possible with these devices. Such network interfaces also provide for more efficient conventional treatments. New machines such as X-band linear accelerators and advanced proton accelerators are being developed for applications such as boron neutron capture therapy and proton conformal therapy.

  8. Micro-computer control for super-critical He generation

    International Nuclear Information System (INIS)

    Tamada, Noriharu; Sekine, Takehiro; Tomiyama, Sakutaro

    1979-01-01

    The development of a large scale refrigeration system is being stimulated by new superconducting techniques representated by a superconducting power cable and a magnet. For the practical operation of such a large system, an automatic control system with a computer is required, because it can attain an effective and systematic operation. For this reason, we examined and developed micro-computer control techniques for supercritical He generation, as a simplified control model of the refrigeration system. The experimental results showed that the computer control system can attain fine controlability, even if the control element is only one magnetic valve, but a BASIK program language of micro-computer, which is convinient and generaly used, isn't enough one to control a more complicated system, because of its low calculating speed. Then we conclude that a more effective program language for micro-computer must be developed to realize practical refrigeration control. (author)

  9. A low cost computer-controlled electrochemical measurement system for education and research

    International Nuclear Information System (INIS)

    Cottis, R.A.

    1989-01-01

    With the advent of low cost computers of significant processing power, it has become economically attractive, as well as offering practical advantages, to replace conventional electrochemical instrumentation with computer-based equipment. For example, the equipment to be described can perform all of the functions required for the measurement of a potentiodynamic polarization curve, replacing the conventional arrangement of sweep generator, potentiostat and chart recorder at a cost (based on the purchase cost of parts) which is less than that of most chart recorders alone. Additionally the use of computer control at a relatively low level provides a versatility (assuming the development of suitable software) which cannot easily be matched by conventional instruments. As a result of these considerations a simple computer-controlled electrochemical measurement system has been developed, with a primary aim being its use in teaching an MSc class in corrosion science and engineering, with additional applications in MSc and PhD research. For education reasons the design of the user interface has tried to make the internal operation of the unit as obvious as possible, and thereby minimize the tendency for students to treat the unit as a 'black box' with incomprehensible inner workings. This has resulted in a unit in which the three main components of function generator, potentiostat and recorder are presented as independent areas on the front panel, and can be configured by the user in exactly the same way as conventional instruments. (author) 11 figs

  10. A low cost computer-controlled electrochemical measurement system for education and research

    Energy Technology Data Exchange (ETDEWEB)

    Cottis, R A [Manchester Univ. (UK). Inst. of Science and Technology

    1989-01-01

    With the advent of low cost computers of significant processing power, it has become economically attractive, as well as offering practical advantages, to replace conventional electrochemical instrumentation with computer-based equipment. For example, the equipment to be described can perform all of the functions required for the measurement of a potentiodynamic polarization curve, replacing the conventional arrangement of sweep generator, potentiostat and chart recorder at a cost (based on the purchase cost of parts) which is less than that of most chart recorders alone. Additionally the use of computer control at a relatively low level provides a versatility (assuming the development of suitable software) which cannot easily be matched by conventional instruments. As a result of these considerations a simple computer-controlled electrochemical measurement system has been developed, with a primary aim being its use in teaching an MSc class in corrosion science and engineering, with additional applications in MSc and PhD research. For education reasons the design of the user interface has tried to make the internal operation of the unit as obvious as possible, and thereby minimize the tendency for students to treat the unit as a 'black box' with incomprehensible inner workings. This has resulted in a unit in which the three main components of function generator, potentiostat and recorder are presented as independent areas on the front panel, and can be configured by the user in exactly the same way as conventional instruments. (author) 11 figs.

  11. Intelligent computational control of multi-fingered dexterous robotic hand

    OpenAIRE

    Chen, Disi; Li, Gongfa; Jiang, Guozhang; Fang, Yinfeng; Ju, Zhaojie; Liu, Honghai

    2015-01-01

    We discuss the intelligent computational control theory and introduce the hardware structure of HIT/DLR II dexterous robotic hand, which is the typical dexterous robotic hand. We show that how DSP or FPGA controller can be used in the dexterous robotic hand. A popular intelligent dexterous robotic hand control system, which named Electromyography (EMG) control is investigated. We introduced some mathematical algorithms in EMG controlling, such as Gauss mixture model (GMM), artificial neural n...

  12. Latent-failure risk estimates for computer control

    Science.gov (United States)

    Dunn, William R.; Folsom, Rolfe A.; Green, Owen R.

    1991-01-01

    It is shown that critical computer controls employing unmonitored safety circuits are unsafe. Analysis supporting this result leads to two additional, important conclusions: (1) annual maintenance checks of safety circuit function do not, as widely believed, eliminate latent failure risk; (2) safety risk remains even if multiple, series-connected protection circuits are employed. Finally, it is shown analytically that latent failure risk is eliminated when continuous monitoring is employed.

  13. Distributed computer control systems in future nuclear power plants

    International Nuclear Information System (INIS)

    Yan, G.; L'Archeveque, J.V.R.; Watkins, L.M.

    1978-09-01

    Good operating experience with computer control in CANDU reactors over the last decade justifies a broadening of the role of digital electronic and computer related technologies in future plants. Functions of electronic systems in the total plant context are reappraised to help evolve an appropriate match between technology and future applications. The systems research, development and demonstration program at CRNL is described, focusing on the projects pertinent to the real-time data acquisition and process control requirements. (author)

  14. Multilink manipulator computer control: experience in development and commissioning

    International Nuclear Information System (INIS)

    Holt, J.E.

    1988-11-01

    This report describes development which has been carried out on the multilink manipulator computer control system. The system allows the manipulator to be driven using only two joysticks. The leading link is controlled and the other links follow its path into the reactor, thus avoiding any potential obstacles. The system has been fully commissioned and used with the Sizewell ''A'' reactor 2 Multilink T.V. manipulator. Experience of the use of the system is presented, together with recommendations for future improvements. (author)

  15. Effluent treatment plant for pharmaceutical unit at Bahipheru - case study

    International Nuclear Information System (INIS)

    Hayat, A.

    1997-01-01

    This project has been awarded to environ (Pvt) Ltd., on turnkey basis, and is an integrated waste treatment facility for pharmaceuticals companies, manufacturing paracetamole, aspirin and various pharmaceuticals intermediates, from phenol as basic raw material. A highly toxic waste water, containing high concentrations of phenolics and sulfate ions is generated at this plant and has to be treatment before final disposal into an irrigation channel. (author)

  16. Infertility Evaluation and Treatment among Women in the United States

    Science.gov (United States)

    Kessler, Lawrence M.; Craig, Benjamin M.; Plosker, Shayne M.; Reed, Damon R.; Quinn, Gwendolyn P.

    2013-01-01

    Objective To examine the characteristics of women seeking infertility evaluation and treatment. Design Cross-sectional survey based on in-person interviews, followed by two-step hurdle analysis. Participants 4,558 married or cohabitating women ages 25–44 Setting U.S. household population of women based on the 2006–2010 National Survey of Family Growth Intervention None Main Outcome Measure(s) Likelihood of seeking preliminary infertility evaluation. Likelihood of seeking infertility treatment once evaluated. Treatment type provided. Results 623 women (13.7%) reported seeking infertility evaluation, of which 328 reported undergoing subsequent infertility treatment. Age at marriage, marital status, education, health insurance status, race/ethnicity, and religion were associated with the likelihood of seeking infertility evaluation. For example, the predicted probability that a non-White woman who married at 25 will seek evaluation was 12%. This probability increased to 34% for White women with a graduate degree who married at age 30. Among women who are evaluated, income, employment status, and ethnicity correlated strongly with the likelihood of seeking infertility treatment. Infertility drug therapy was the most frequent treatment used. Reproductive surgery and in vitro fertilization (IVF) were used the least. Conclusions The use of infertility services is not random and understanding the socio-demographic factors correlated with use may assist new couples with family planning. Roughly 50% of the women evaluated for infertility progressed to treatment, and only a small proportion were treated with more advanced assisted reproductive technologies (ARTs) such as IVF therapy. Future research aimed at improving access to effective healthcare treatments within the boundaries of affordability is warranted. PMID:23849845

  17. Comparison of monitor units calculated by radiotherapy treatment planning system and an independent monitor unit verification software.

    Science.gov (United States)

    Sellakumar, P; Arun, C; Sanjay, S S; Ramesh, S B

    2011-01-01

    In radiation therapy, the monitor units (MU) needed to deliver a treatment plan are calculated by treatment planning systems (TPS). The essential part of quality assurance is to verify the MU with independent monitor unit calculation to correct any potential errors prior to the start of treatment. In this study, we have compared the MU calculated by TPS and by independent MU verification software. The MU verification software was commissioned and tested for the data integrity to ensure that the correct beam data was considered for MU calculations. The accuracy of the calculations was tested by creating a series of test plans and comparing them with ion chamber measurements. The results show that there is good agreement between the two. The MU difference (MUdiff) between the monitor unit calculations of TPS and independent MU verification system was calculated for 623 fields from 245 patients and was analyzed by treatment site for head & neck, thorax, breast, abdomen and pelvis. The mean MUdiff of -0.838% with a standard deviation of 3.04% was observed for all 623 fields. The site specific standard deviation of MUdiff was as follows: abdomen and pelvis (<1.75%), head & neck (2.5%), thorax (2.32%) and breast (6.01%). The disparities were analyzed and different correction methods were used to reduce the disparity. © 2010 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Development of processing procedure preparing for digital computer controlled equipment on modular design base

    International Nuclear Information System (INIS)

    Starosel'tsev, O.P.; Khrundin, V.I.

    1982-01-01

    In order to reduce labour consumption of technological preparation of production for digital computer controlled machines during the treatment of steam turbines articles created is a system of modular design of technological processes and controlling programs. A set of typical modulas-transitions, being a number of surfaces of an articles treated with one cutting tool in optimum sequence, and a library of cutting tools are the base of the system. Introduction of such a system sharply enhaneces the efficiency of the equipment utilization [ru

  19. Future Communication, Computing, Control and Management Volume 2

    CERN Document Server

    2012-01-01

    This volume contains revised and extended research articles written by prominent researchers participating in the ICF4C 2011 conference. 2011 International Conference on Future Communication, Computing, Control and Management (ICF4C 2011) has been held on December 16-17, 2011, Phuket, Thailand. Topics covered include intelligent computing, network management, wireless networks, telecommunication, power engineering, control engineering, Signal and Image Processing, Machine Learning, Control Systems and Applications, The book will offer the states of arts of tremendous advances in Computing, Communication, Control, and Management and also serve as an excellent reference work for researchers and graduate students working on Computing, Communication, Control, and Management Research.

  20. New technique for determining unavailability of computer controlled safety systems

    International Nuclear Information System (INIS)

    Fryer, M.O.; Bruske, S.Z.

    1984-04-01

    The availability of a safety system for a fusion reactor is determined. A fusion reactor processes tritium and requires an Emergency Tritium Cleanup (ETC) system for accidental tritium releases. The ETC is computer controlled and because of its complexity, is an excellent candidate for this analysis. The ETC system unavailability, for preliminary untested software, is calculated based on different assumptions about operator response. These assumptions are: (a) the operator shuts down the system after the first indication of plant failure; (b) the operator shuts down the system after following optimized failure verification procedures; or (c) the operator is taken out of the decision process, and the computer uses the optimized failure verification procedures

  1. Towards full automation of accelerators through computer control

    CERN Document Server

    Gamble, J; Kemp, D; Keyser, R; Koutchouk, Jean-Pierre; Martucci, P P; Tausch, Lothar A; Vos, L

    1980-01-01

    The computer control system of the Intersecting Storage Rings (ISR) at CERN has always laid emphasis on two particular operational aspects, the first being the reproducibility of machine conditions and the second that of giving the operators the possibility to work in terms of machine parameters such as the tune. Already certain phases of the operation are optimized by the control system, whilst others are automated with a minimum of manual intervention. The authors describe this present control system with emphasis on the existing automated facilities and the features of the control system which make it possible. It then discusses the steps needed to completely automate the operational procedure of accelerators. (7 refs).

  2. Computer-controlled sampling system for airborne particulates

    International Nuclear Information System (INIS)

    Hall, C.F.; Anspaugh, L.R.; Koval, J.S.; Phelps, P.L.; Steinhaus, R.J.

    1975-01-01

    A self-contained, mobile, computer-controlled air-sampling system has been designed and fabricated that also collects and records the data from eight meteorological sensors. The air-samplers are activated automatically when the collected meteorological data meet the criteria specified at the beginning of the data-collection run. The filters from the samplers are intended to collect airborne 239 Pu for later radionuclide analysis and correlation with the meteorological data for the study of resuspended airborne radioactivity and for the development of a predictive model. This paper describes the system hardware, discusses the system and software concepts, and outlines the operational procedures for the system

  3. Towards full automation of accelerators through computer control

    International Nuclear Information System (INIS)

    Gamble, J.; Hemery, J.-Y.; Kemp, D.; Keyser, R.; Koutchouk, J.-P.; Martucci, P.; Tausch, L.; Vos, L.

    1980-01-01

    The computer control system of the Intersecting Storage Rings (ISR) at CERN has always laid emphasis on two particular operational aspects, the first being the reproducibility of machine conditions and the second that of giving the operators the possibility to work in terms of machine parameters such as the tune. Already certain phases of the operation are optimized by the control system, whilst others are automated with a minimum of manual intervention. The paper describes this present control system with emphasis on the existing automated facilities and the features of the control system which make it possible. It then discusses the steps needed to completely automate the operational procedure of accelerators. (Auth.)

  4. Future Communication, Computing, Control and Management Volume 1

    CERN Document Server

    2012-01-01

    This volume contains revised and extended research articles written by prominent researchers participating in the ICF4C 2011 conference. 2011 International Conference on Future Communication, Computing, Control and Management (ICF4C 2011) has been held on December 16-17, 2011, Phuket, Thailand. Topics covered include intelligent computing, network management, wireless networks, telecommunication, power engineering, control engineering, Signal and Image Processing, Machine Learning, Control Systems and Applications, The book will offer the states of arts of tremendous advances in Computing, Communication, Control, and Management and also serve as an excellent reference work for researchers and graduate students working on Computing, Communication, Control, and Management Research.

  5. Computer control of a multi-link manipulator

    International Nuclear Information System (INIS)

    Holt, J.E.; Thiruarooran, C.

    1988-01-01

    The Central Electricity Generating Board has a requirement for a manipulator which can deploy to its work location around obstacles. A multilink manipulator has been designed for this purpose. A computer control system designed to ease manipulator operation is described. Using the control program, the manipulator may be deployed using just 2 joysticks. Experience in the use of the program with an inspection manipulator at Sizewell 'A' Nuclear Power Station is discussed. When used to control a manipulator of 9 hydraulically actuated degrees of freedom, a control accuracy of about 1.5% of full extension has been achieved. (author)

  6. Computer controlled drifting of Si(Li) detectors

    International Nuclear Information System (INIS)

    Landis, D.A.; Wong, Y.K.; Walton, J.T.; Goulding, F.S.

    1989-01-01

    A relatively inexpensive computer-controlled system for performing the drift process used in fabricating Si(Li) detectors is described. The system employs a small computer to monitor the leakage current, applied voltage and temperature on eight individual drift stations. The associated computer program initializes the drift process, monitors the drift progress and then terminates the drift when an operator set drift time has elapsed. The improved control of the drift with this system has been well demonstrated over the past three years in the fabrication of a variety of Si(Li) detectors. A few representative system responses to detector behavior during the drift process are described

  7. Teleoperation and computer control of a backhoe/manipulator system

    International Nuclear Information System (INIS)

    Amazeen, C.A.; Bishop, S.S.

    1987-01-01

    Teleoperation of the U.S. Army's Small Emplacement Excavator (SEE) is now in the prototype stage of development. Initial work is directed towards remotely controlling the SEE backhoe attachment as well as a Belvoir Research, Development, and Engineering Center (BRDEC)-developed heavy-lift manipulator (HLM). The HLM is an alternate end effector for the backhoe. Primitive computer control of the backhoe, with a bucket as an end effector, has been achieved. This paper presents the current and planned system configurations and discusses system applications

  8. ENEA`s mobile treatment units for specific waters; Impianti mobili ENEA di trattamento / smaltimento rifiuti

    Energy Technology Data Exchange (ETDEWEB)

    Beone, G.; Barni, E.; Coronidi, M. [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dipt. Ambiente; Bortone, G.; Gambaro, L.; Zanetti, P. [ENEA, Centro Ricerche `Ezio Clementel, Bologna (Italy). Dipt. Ambiente; Liccione, G. [ENEA, Centro Ricerche Trisaia, Matera (Italy). Dipt. Ambiente; Zanin, E.

    1997-11-01

    Solid waste production in turistic places is characterized by a large increase, up to 80 % for few months during the year. Generally a waste treatment plant is designed for a mean production and can support increases that non exceed 10 %. Treatment plants with higher capacity are not economically convenient and the excedent production is landfilled. An answer to this problem are mobile treatment units that could be used to support resident plants when higher treatment capacity is requested. Mobile units are very useful for other uses like as treatment of specific wastes (agricultural plastic bags and sheets contaminated by antiparasitics and herbicides) infective wastes from hospital and laboratories and leaches from landfills. Mobile units flexibility is also important for environmental protection actions, either scheduled on in an emergency, like as reclamation of contaminated soils, asbestos contaminated site and every time when waste transport is characterized by high cost or safety and sanitary problems.

  9. Safety Metrics for Human-Computer Controlled Systems

    Science.gov (United States)

    Leveson, Nancy G; Hatanaka, Iwao

    2000-01-01

    The rapid growth of computer technology and innovation has played a significant role in the rise of computer automation of human tasks in modem production systems across all industries. Although the rationale for automation has been to eliminate "human error" or to relieve humans from manual repetitive tasks, various computer-related hazards and accidents have emerged as a direct result of increased system complexity attributed to computer automation. The risk assessment techniques utilized for electromechanical systems are not suitable for today's software-intensive systems or complex human-computer controlled systems.This thesis will propose a new systemic model-based framework for analyzing risk in safety-critical systems where both computers and humans are controlling safety-critical functions. A new systems accident model will be developed based upon modem systems theory and human cognitive processes to better characterize system accidents, the role of human operators, and the influence of software in its direct control of significant system functions Better risk assessments will then be achievable through the application of this new framework to complex human-computer controlled systems.

  10. Aspects of computer control from the human engineering standpoint

    International Nuclear Information System (INIS)

    Huang, T.V.

    1979-03-01

    A Computer Control System includes data acquisition, information display and output control signals. In order to design such a system effectively we must first determine the required operational mode: automatic control (closed loop), computer assisted (open loop), or hybrid control. The choice of operating mode will depend on the nature of the plant, the complexity of the operation, the funds available, and the technical expertise of the operating staff, among many other factors. Once the mode has been selected, consideration must be given to the method (man/machine interface) by which the operator interacts with this system. The human engineering factors are of prime importance to achieving high operating efficiency and very careful attention must be given to this aspect of the work, if full operator acceptance is to be achieved. This paper will discuss these topics and will draw on experience gained in setting up the computer control system in Main Control Center for Stanford University's Accelerator Center (a high energy physics research facility)

  11. A computer controlled potentiometric titrator for quantitative determination of uranium

    International Nuclear Information System (INIS)

    Verdingh, V.; Michiels, A.

    1988-01-01

    The modified Davies and Gray methods is frequently used for the potentiometric titration of uranium. It is based upon the reduction of U(VI) to U(IV) with a reductant (e.g. Fe ++ ) followed by a selective oxidation of the excess of reductant and subsequent titration of U(IV) with potassium dichromate (K 2 Cr 2 O 7 ). Interference from other elements is low, but the method is rather cumbersome due to the number of reactants to be added before the titration is started. The timing of these additions also plays a role. In order to render the titration less dependent on human factors and with the aim of reaching high reproducibility, a computer controlled system has been designed and set-up. Reagents are added by five computer controlled burettes. A program allows the choice of volumes and waiting times, and commands the start of the final titration which is followed by the microprocessor of the automatic potentiometric titrator. In this way a routine uranium titration can be completed in about twelve minutes. Reproducibilities of the order of ±15% are achievable in routine operation. For high precision work, the titrator is used as an end-point detector. Titrant is added manually by mass, so as to react with > 99% of the uranium. The residual uranium is then titrated automatically by colume with diluted titrant. The precision can be improved by a factor of approximately ten. (orig.)

  12. Measurement and reproduction accuracy of computer-controlled grand pianos

    Science.gov (United States)

    Goebl, Werner; Bresin, Roberto

    2003-10-01

    The recording and reproducing capabilities of a Yamaha Disklavier grand piano and a Bösendorfer SE290 computer-controlled grand piano were tested, with the goal of examining their reliability for performance research. An experimental setup consisting of accelerometers and a calibrated microphone was used to capture key and hammer movements, as well as the acoustic signal. Five selected keys were played by pianists with two types of touch (``staccato'' and ``legato''). Timing and dynamic differences between the original performance, the corresponding MIDI file recorded by the computer-controlled pianos, and its reproduction were analyzed. The two devices performed quite differently with respect to timing and dynamic accuracy. The Disklavier's onset capturing was slightly more precise (+/-10 ms) than its reproduction (-20 to +30 ms); the Bösendorfer performed generally better, but its timing accuracy was slightly less precise for recording (-10 to 3 ms) than for reproduction (+/-2 ms). Both devices exhibited a systematic (linear) error in recording over time. In the dynamic dimension, the Bösendorfer showed higher consistency over the whole dynamic range, while the Disklavier performed well only in a wide middle range. Neither device was able to capture or reproduce different types of touch.

  13. A computer-controlled high resolution micro-multi-leaf collimator for stereotactic conformal radio-therapy

    International Nuclear Information System (INIS)

    Schlegel, Wolfgang; Pastyr, Otto; Kubesch, Rudolf; Diemer, Torsten; Kuester, Gunnilla; Rhein, Bernhard; Hoever, Karl-Heinz

    1997-01-01

    Purpose/Objective In stereotactic conformal radiotherapy of irregularly shaped lesions, either multi-isocentric convergent beam treatment techniques with circular collimators or irregular shaped beams are being used. While the treatment technique with multiple isocenters has the disadvantage of producing inhomogeneous dose distributions, the use of irregular shaped fields is not yet satisfying from a technical point of view: Cerrobend blocking or the use of static micro MLCs need a long preparation time and only allow static treatment techniques, MLC collimators which are commercially available in connection with modern LINACs have leaf-thickness of at least 1 cm which is too coarse for stereotactic radiotherapy of lesions in the brain and head and neck area. For this reason, we developed a computer controlled micro-MLC with technical specifications matched to the needs of stereotactic radiotherapy and radiosurgery. Materials and Methods The mechanical specifications of the computer controlled micro-MLC were derived from our experience with stereotactic treatment techniques, from the requirement that the MLC has to be attachable as an external device to the accessory holders of standard LINACs, including cost considerations, dosimetric measurements as well as Monte Carlo calculations. The Micro-MLC is controlled by an electronic equipment consisting of a standard PC under Windows 95, an interface board, 14 Micro-controller boards, a verification system and 80 driving units equipped with DC motors and potentiometers. The control program has calibrating, operating, visualizing and test options. Irregular field data are transferred from the treatment planning computer to the control PC and distributed to the micro-controllers, which in parallel are driving three leaves each. Beside the special control unit, we are currently investigating whether the electronics of commercially available integrated large field MLCs can also be used for operating the Micro-MLC. Results

  14. Plutonium Finishing Plant (PFP) Treatment and Storage Unit Waste Analysis Plan

    International Nuclear Information System (INIS)

    PRIGNANO, A.L.

    2000-01-01

    The purpose of this waste analysis plan (WAP) is to document waste analysis activities associated with the Plutonium Finishing Plant Treatment and Storage Unit (PFP Treatment and Storage Unit) to comply with Washington Administrative Code (WAC) 173-303-300(1), (2), (4)(a) and (5). The PFP Treatment and Storage Unit is an interim status container management unit for plutonium bearing mixed waste radiologically managed as transuranic (TRU) waste. TRU mixed (TRUM) waste managed at the PFP Treatment and Storage Unit is destined for the Waste Isolation Pilot Plant (WIPP) and therefore is not subject to land disposal restrictions [WAC 173-303-140 and 40 CFR 268]. The PFP Treatment and Storage Unit is located in the 200 West Area of the Hanford Facility, Richland Washington (Figure 1). Because dangerous waste does not include source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of this documentation. The information on radionuclides is provided only for general knowledge

  15. Interim Status Closure Plan Open Burning Treatment Unit Technical Area 16-399 Burn Tray

    Energy Technology Data Exchange (ETDEWEB)

    Vigil-Holterman, Luciana R. [Los Alamos National Laboratory

    2012-05-07

    This closure plan describes the activities necessary to close one of the interim status hazardous waste open burning treatment units at Technical Area (TA) 16 at the Los Alamos National Laboratory (LANL or the Facility), hereinafter referred to as the 'TA-16-399 Burn Tray' or 'the unit'. The information provided in this closure plan addresses the closure requirements specified in the Code of Federal Regulations (CFR), Title 40, Part 265, Subparts G and P for the thermal treatment units operated at the Facility under the Resource Conservation and Recovery Act (RCRA) and the New Mexico Hazardous Waste Act. Closure of the open burning treatment unit will be completed in accordance with Section 4.1 of this closure plan.

  16. Introduction to computer control and future aspects in thermal ionisation mass spectrometry

    International Nuclear Information System (INIS)

    Hagemann, R.

    The author considers the computer control of the measurement program which is already available in modern mass spectrometers. Future areas for computer control are considered e.g. the heating program, ion optics and focusing, and sample changer control. (Auth.)

  17. Introduction to computer control and future aspects in thermal ionisation mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Hagemann, R. [CEA Centre d' Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France)

    1978-12-15

    The author considers the computer control of the measurement program which is already available in modern mass spectrometers. Future areas for computer control are considered e.g. the heating program, ion optics and focusing, and sample changer control.

  18. Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion.

    Science.gov (United States)

    2015-11-01

    In the United States, economic, racial, ethnic, geographic, and other disparities exist in access to fertility treatment and in treatment outcomes. This opinion examines the factors that contribute to these disparities and proposes actions to address them. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Production of custom beam profiles in computer-controlled radiation therapy

    International Nuclear Information System (INIS)

    Lane, R.G.; Loyd, M.D.; Chow, C.H.; Ekwelundu, E.; Rosen, I.I.

    1989-01-01

    This paper presents a study to produce custom beam profiles in patients that compensate for variations in patient anatomy and achieve uniform dose distributions in the treatment volume. A conventional treatment field is supplemented by a number of centered and/or offset smaller coincident fields of various sizes. The sizes and positions of these supplemental fields and the doses delivered by them are designed to compensate for variations in external patient contour, internal heterogeneities, and variation in tumor volume shape. A computer-controlled linear accelerator with four independent collimator jaws, a built-in motorized wedge filter, an automatic setup capability, and a patient prescription database is used to deliver these complex treatments automatically by means of multiple overlapping beams. Calculations, measurements, and dose distributions demonstrate the efficacy of this technique

  20. Improvement of Oil-Vapor Treatment Facility for Wolsong Unit 3,4

    International Nuclear Information System (INIS)

    Kim, Jeong Guk; Kwon, S. W.; Lee, H. S.

    2009-11-01

    With the purpose to minimize an oil-vapor discharge to the atmosphere and to be an environmentally friendly nuclear power plant by an improvement of mist eliminator for turbine lubricant system at Wolsong Nuclear Power Plant Unit 3,4, this project - project name : Improvement of Oil-vapor Treatment Facility for Wolsong Unit 3,4 - was conducted for six months (from Apr. 15, 2009 to Oct. 14, 2009). This Project contains Oil-vapor Source and Environmental Regulation, Analysis on the Present Oil-vapor Treatment Facility, Improvement of Oil-vapor Treatment Facility, Test Facility Design, Fabrication, Installation, Test Operation, Evaluation of the Facility

  1. Computer control of the TFTR tritium storage and delivery system

    International Nuclear Information System (INIS)

    Youssef, N.; Phillips, H.; Yemin, L.; Dong, J.; Pierce, C.

    1980-01-01

    The Tritium Storage and Delivery System (TSDS) will deliver to the torus the required tritium gas in precisely controlled injection profiles. This system will utilize advanced Central Instrumentation, Control and Data Acquisition (CICADA) computer-control techniques, in normal and malfunction-recovery modes of operation. The control scheme of the TSDS is built of three main control scenarios. An operating mode defines the permissives, sequence and path of a process during each scenario. The computerized control of the TSDS has four distinct advantages: (1) versatile control with fast response times both for tritium gas generation and for gas injection into the torus; (2) ease of selecting the proper operating modes of a control scenario, (3) ease of operation without disturbing the multiple levels of containment, and (4) simple fast trouble shooting of system malfunction utilizing programmed procedures and on-line diagnosis. The TSDS has both remote nd local control capability

  2. Gas analysis by computer-controlled microwave rotational spectrometry

    International Nuclear Information System (INIS)

    Hrubesh, L.W.

    1978-01-01

    Microwave rotational spectrometry has inherently high resolution and is thus nearly ideal for qualitative gas mixture analysis. Quantitative gas analysis is also possible by a simplified method which utilizes the ease with which molecular rotational transitions can be saturated at low microwave power densities. This article describes a computer-controlled microwave spectrometer which is used to demonstrate for the first time a totally automated analysis of a complex gas mixture. Examples are shown for a complete qualitative and quantitative analysis, in which a search of over 100 different compounds is made in less than 7 min, with sensitivity for most compounds in the 10 to 100 ppm range. This technique is expected to find increased use in view of the reduced complexity and increased reliabiity of microwave spectrometers and because of new energy-related applications for analysis of mixtures of small molecules

  3. Single cell adhesion assay using computer controlled micropipette.

    Directory of Open Access Journals (Sweden)

    Rita Salánki

    Full Text Available Cell adhesion is a fundamental phenomenon vital for all multicellular organisms. Recognition of and adhesion to specific macromolecules is a crucial task of leukocytes to initiate the immune response. To gain statistically reliable information of cell adhesion, large numbers of cells should be measured. However, direct measurement of the adhesion force of single cells is still challenging and today's techniques typically have an extremely low throughput (5-10 cells per day. Here, we introduce a computer controlled micropipette mounted onto a normal inverted microscope for probing single cell interactions with specific macromolecules. We calculated the estimated hydrodynamic lifting force acting on target cells by the numerical simulation of the flow at the micropipette tip. The adhesion force of surface attached cells could be accurately probed by repeating the pick-up process with increasing vacuum applied in the pipette positioned above the cell under investigation. Using the introduced methodology hundreds of cells adhered to specific macromolecules were measured one by one in a relatively short period of time (∼30 min. We blocked nonspecific cell adhesion by the protein non-adhesive PLL-g-PEG polymer. We found that human primary monocytes are less adherent to fibrinogen than their in vitro differentiated descendants: macrophages and dendritic cells, the latter producing the highest average adhesion force. Validation of the here introduced method was achieved by the hydrostatic step-pressure micropipette manipulation technique. Additionally the result was reinforced in standard microfluidic shear stress channels. Nevertheless, automated micropipette gave higher sensitivity and less side-effect than the shear stress channel. Using our technique, the probed single cells can be easily picked up and further investigated by other techniques; a definite advantage of the computer controlled micropipette. Our experiments revealed the existence of a

  4. Plutonium Finishing Plant Treatment and Storage Unit Dangerous Waste Training Plan

    International Nuclear Information System (INIS)

    ENTROP, G.E.

    2000-01-01

    The training program for personnel performing waste management duties pertaining to the Plutonium Finishing Plant (PFP) Treatment and Storage Unit is governed by the general requirements established in the Plutonium Finishing Plant Dangerous Waste Training Plan (PFP DWTP). The PFP Treatment and Storage Unit DWTP presented below incorporates all of the components of the PFP DWTP by reference. The discussion presented in this document identifies aspects of the training program specific to the PFP Treatment and Storage Unit. The training program includes specifications for personnel instruction through both classroom and on-the-job training. Training is developed specific to waste management duties. Hanford Facility personnel directly involved with the PFP Treatment and Storage Unit will receive training to container management practices, spill response, and emergency response. These will include, for example, training in the cementation process and training pertaining to applicable elements of WAC 173-303-330(1)(d). Applicable elements from WAC 173-303-330(1)(d) for the PFP Treatment and Storage Unit include: procedures for inspecting, repairing, and replacing facility emergency and monitoring equipment; communications and alarm systems; response to fires or explosions; and shutdown of operations

  5. Long-term trends in restoration and associated land treatments in the southwestern United States

    Science.gov (United States)

    Copeland, Stella M.; Munson, Seth M.; Pilliod, David S.; Welty, Justin L.; Bradford, John B.; Butterfield, Bradley J.

    2018-01-01

    Restoration treatments, such as revegetation with seeding or invasive species removal, have been applied on U.S. public lands for decades. Temporal trends in these management actions have not been extensively summarized previously, particularly in the southwestern United States where invasive plant species, drought, and fire have altered dryland ecosystems. We assessed long-term (1940–2010) trends in restoration using approximately 4,000 vegetation treatments conducted on Bureau of Land Management lands across the southwestern United States. We found that since 1940, the proportions of seeding and vegetation/soil manipulation (e.g. vegetation removal or plowing) treatments have declined, while the proportions of prescribed burn and invasive species treatments have increased. Treatments in pinyon-juniper and big sagebrush communities declined in comparison to treatments in desert scrub, creosote bush, and riparian woodland communities. Restoration-focused treatment objectives increased relative to resource extraction objectives. Species richness and proportion of native species used in seeding treatments also increased. Inflation-adjusted costs per area rose 750% for vegetation/soil manipulation, 600% for seeding, and 400% for prescribed burn treatments in the decades from 1981 to 2010. Seeding treatments were implemented in warmer and drier years when compared to the climate conditions of the entire study period and warmer and wetter years relative to several years before and after the treatment. These results suggest that treatments over a 70-year period on public lands in the southwestern United States are shifting toward restoration practices that are increasingly large, expensive, and related to fire and invasive species control.

  6. SensInDenT-Noncontact Sensors Integrated Into Dental Treatment Units.

    Science.gov (United States)

    Teichmann, Daniel; Teichmann, Maren; Weitz, Philippe; Wolfart, Stefan; Leonhardt, Steffen; Walter, Marian

    2017-02-01

    This paper presents the first system design (SensInDenT) for noncontact cardiorespiratory monitoring during dental treatment. The system is integrated into a dental treatment unit, and combines sensors based on electromagnetic, optical, and mechanical coupling at different sensor locations. The measurement principles and circuits are described and a system overview is presented. Furthermore, a first proof of concept is provided by taking measurements in healthy volunteers under laboratory conditions.

  7. MOBIL CONTAINER UNIT FOR SEWAGE SLUDGE UTILIZATION FROM SMALL AND MEDIUM WASTWATER TREATMENT PLANTS

    OpenAIRE

    Stanisław Ledakowicz; Paweł Stolarek; A. Malinowski

    2016-01-01

    The most wastewater treatment plants in Poland are small and medium plants of flow capacity below 1000 m3/d. These plants are not able to build sludge incineration plants and the transportation costs to the nearest plants increase the total costs of wastewater treatment. Polish company Metal Expert together with the French company ETIA and Lodz University of Technology proposed mobile unit for integrated drying and pyrolysis of sewage sludge in a pilot bench scale with capacity of 100 kg/h ...

  8. Scenario analysis of false indication in computer-control systems

    International Nuclear Information System (INIS)

    Tseng, Wan-Hui; Fan, Chin-Feng

    2013-01-01

    Highlights: ► A new failure mode and effect for safety-critical systems is proposed. ► False indication is the most dreadful kind of partial failures. ► A model-based simulation approach to generate failure scenarios is proposed. ► Simulation results showed that multiple errors may cause undesired consequences. ► An assertion-based method to detect false indication problems is provided. -- Abstract: Computer control may cause additional failure modes and effects that are new to analogue systems. False indication is one such failure mode that may bring unknown risks to a system. False indication refers to the problem when part of a system fails while other processes still work, and the failure is not revealed to operators. This paper presents a model-based simulation approach to systematically generate potential false indication and unintended consequences. Experiments showed that once a false indication occurs, it may have drastic effects on system safety. False indication can mislead the operator to perform adverse actions or no action. Therefore, we propose an assertion-based detection method to alleviate such failures. Our assertions contain process/device dependencies, timing relations and physical conservation rules. With these assertions, the operator may be alerted at run time. The proposed technique can reduce false indication problem. Moreover, it can also be used to assist the system design.

  9. An integrated computer control system for the ANU linac

    International Nuclear Information System (INIS)

    Davidson, P.M.; Foote, G.S.

    1996-01-01

    One facet of the installation of the superconducting linac at the ANU is the need for computer control of a variety of systems, such as beam transport, resonator RF, cryogenics and others. To accommodate this, a number of control interfaces (for example, analogue signals and RS232 serial lines) must be employed. Ideally, all of the systems should be able to be controlled from a central location, remote from the actual devices. To this end a system based around VAX computers and VME crates has been designed and is currently being developed and implemented. A VAXstation is used to issue control messages and perform high-level functions, while VME crates containing appropriate modules (primarily DACs, ADCs and digital I/O boards) control the devices. The controllers in the VME crates are AEON rtVAX modules running a real-time operating system. Communication with the VAXstation is via DECnet, on a private ethernet to allow communication rates unaffected by unrelated network activity and potentially increasing the security of the system by providing a possible network isolation point. Also on this ethernet are a number of terminal servers to control RS232 devices. A central database contains all device control and monitoring parameters. The main control process running on the VAXstation is responsible for maintaining the current values of the parameters in the database and for dispatching control messages to the appropriate VME crate or RS232 serial line

  10. Computer control of ET-RR-1 hot cell manipulators

    International Nuclear Information System (INIS)

    Effat, A.M.; Rahman, F.A.

    1990-01-01

    The hot cell designed for remote handling of radioactive materials are, in effect, integral systems of safety devices for attaining adequate radiological protection for the operating personnel. Their operation involve potential hazards that are sometimes of great magnitude. The effect of an incident or accident could thus be fatal. some of these incident are due to the collision of the manipulator slave side with the radioactive objectives. Therefore in order to minimize the probability of such type of incidents, the movement of the manipulators is suggested (in the present investigation) to be kept under computer control. A model have been developed to control the movement of the hot cell manipulators in the slave side for Egypt first research reactor ET-RR-1, specially in the hidden sectors. The model is based on the use of a microprocessor and some accessories fixed to the manipulators slave side in a special manner such that it prevents the manipulator from colliding with radioactive objects. This is achieved by a signal transmitted to a specially designed brake which controls the movement of the upper arm of the manipulator master side. The hardware design of the model as well as the software are presented in details

  11. A new generation drilling rig: hydraulically powered and computer controlled

    Energy Technology Data Exchange (ETDEWEB)

    Laurent, M.; Angman, P.; Oveson, D. [Tesco Corp., Calgary, AB, (Canada)

    1999-11-01

    Development, testing and operation of a new generation of hydraulically powered and computer controlled drilling rig that incorporates a number of features that enhance functionality and productivity, is described. The rig features modular construction, a large heated common drilling machinery room, permanently-mounted draw works which, along with the permanently installed top drive, significantly reduces rig-up/rig-down time. Also featured are closed and open hydraulic systems and a unique hydraulic distribution manifold. All functions are controlled through a programmable logic controller (PLC), providing almost unlimited interlocks and calculations to increase rig safety and efficiency. Simplified diagnostic routines, remote monitoring and troubleshooting are also part of the system. To date, two rigs are in operation. Performance of both rigs has been rated as `very good`. Little or no operational problems have been experienced; downtime has averaged 0.61 per cent since August 1998 when the the first of the two rigs went into operation. The most important future application for this rig is for use with the casing drilling process which eliminates the need for drill pipe and tripping. It also reduces the drilling time lost due to unscheduled events such as reaming, fishing and taking kicks while tripping. 1 tab., 6 figs.

  12. Plutonium Finishing Plan (PFP) Treatment and Storage Unit Interim Status Closure Plan

    International Nuclear Information System (INIS)

    PRIGNANO, A.L.

    2000-01-01

    This document describes the planned activities and performance standards for closing the Plutonium Finishing Plant (PFP) Treatment and Storage Unit. The PFP Treatment and Storage Unit is located within the 234-52 Building in the 200 West Area of the Hanford Facility. Although this document is prepared based upon Title 40 Code of Federal Regulations (CFR), Part 265, Subpart G requirements, closure of the unit will comply with Washington Administrative Code (WAC) 173-303-610 regulations pursuant to Section 5.3 of the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Action Plan (Ecology et al. 1996). Because the PFP Treatment and Storage Unit manages transuranic mixed (TRUM) waste, there are many controls placed on management of the waste. Based on the many controls placed on management of TRUM waste, releases of TRUM waste are not anticipated to occur in the PFP Treatment and Storage Unit. Because the intention is to clean close the PFP Treatment and Storage Unit, postclosure activities are not applicable to this closure plan. To clean close the unit, it will be demonstrated that dangerous waste has not been left onsite at levels above the closure performance standard for removal and decontamination. If it is determined that clean closure is not possible or is environmentally impractical, the closure plan will be modified to address required postclosure activities. The PFP Treatment and Storage Unit will be operated to immobilize and/or repackage plutonium-bearing waste in a glovebox process. The waste to be processed is in a solid physical state (chunks and coarse powder) and will be sealed into and out of the glovebox in closed containers. The containers of immobilized waste will be stored in the glovebox and in additional permitted storage locations at PFP. The waste will be managed to minimize the potential for spills outside the glovebox, and to preclude spills from reaching soil. Containment surfaces will be maintained to ensure

  13. Application for verification of monitor units of the treatment planning system

    International Nuclear Information System (INIS)

    Suero Rodrigo, M. A.; Marques Fraguela, E.

    2011-01-01

    Current estimates algorithms achieve acceptable degree of accuracy. However, operate on the basis of un intuitive models. It is therefore necessary to verify the calculation of monitor units of the treatment planning system (TPS) with those obtained by other independent formalisms. To this end, we have developed an application based on factorization formalism that automates the calculation of dose.

  14. Treatment and rehabilitation on a stroke unit improves 5-year survival. A community-based study

    DEFF Research Database (Denmark)

    Jørgensen, H S; Kammersgaard, L P; Nakayama, H

    1999-01-01

    We have previously reported a marked reduction in mortality up to 1 year after treatment and rehabilitation on a stroke unit versus on general neurological and medical wards in unselected stroke patients. In the present study we wanted to test the hypothesis that this mortality-reducing effect...

  15. Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States

    NARCIS (Netherlands)

    Perez, Marisol; Ohrt, Tara K.; Hoek, Hans W.

    Purpose of reviewWe reviewed the recent literature on prevalence rates, and application of evidence-based treatments for eating disorders among Hispanics/Latinos residing in the United States.Recent findingsLifetime prevalence rates of anorexia nervosa are lower among Hispanic/Latinos than

  16. Checks for quality control of wedge dynamics in treatment units and the planning system

    International Nuclear Information System (INIS)

    Mateos Salvador, P.; Rodriguez Lopez, B.; Font Gelabert, J.; Hernandez Rodriguez, J.; Arino Gil, A.

    2013-01-01

    The objective of this study is to verify the implementation of enhanced dynamic wedge (EDW) vary in the Eclipse planning system and the experimental determination of the parameters that define the dosimetry characteristics of enhanced dynamic wedge of our treatment units. (Author)

  17. [Technical aspects of treatments with single- and multi-unit fixed dental prostheses

    NARCIS (Netherlands)

    Wiersema, E.J.; Kreulen, C.M.; Latzke, P.; Witter, D.J.; Creugers, N.H.J.

    2014-01-01

    For the manufacture of single- and multi-unit fixed dental prostheses, effective communication between dentist and dental technician is required. Mutual insight concerning the (im)possibilities of available treatments and technical options is prerequisitefor this communication. The manufacture of

  18. Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States

    NARCIS (Netherlands)

    Perez, Marisol; Ohrt, Tara K.; Hoek, Hans W.

    2016-01-01

    Purpose of reviewWe reviewed the recent literature on prevalence rates, and application of evidence-based treatments for eating disorders among Hispanics/Latinos residing in the United States.Recent findingsLifetime prevalence rates of anorexia nervosa are lower among Hispanic/Latinos than

  19. The case for SAR as the major component of a hyperthermia treatment unit

    International Nuclear Information System (INIS)

    Scott, R.S.

    1985-01-01

    A major problem facing clinical hyperthermia is the lack of a useful unit of treatment. Most attempts at a treatment unit have utilized some function of temperature and time. Having accepted the validity of such a hypothetical units, one is faced with the formidable problem of obtaining a three dimensional temperature profile so that thermal dose can be determined. A corollary is the desirability of obtaining uniform temperature in the treatment volume. Various studies suggest that a uniform SAR is a more desirable goal when radiotherapy is to be used in combination with hyperthermia. The synergy between radiation and hyperthermia is maximized in low pH regions of tumor which are presumably also hypoxic. These regions are poorly perfused, likely to heat readily, and are resistant to the cytotoxic effects of radiation alone. On the other hand, well perfused regions of tumor are likely sensitive to radiation, and benefit less from the combination treatment. Other studies have definitely shown that tissue temperatures in the range normally associated with desirable hyperthermia treatment result in severe vascular damage. This damage could be expected to unnecessarily compromise the effectiveness of radiotherapy. Models in the literature can be combined to verify these observations

  20. Aspects regarding computer control of 15 N separation plant

    International Nuclear Information System (INIS)

    Kaucsar, M.; Cosma, V.; Axente, D.; Baldea, A.; Bendea, H.; Bunea, V

    2001-01-01

    In order to improve the efficiency of a separation plant the whole process must be automatically controlled. The plant has a single output - the isotopic product. This output is characterized by a complex function, which involves qualitative or/and quantitative properties of the product. There are two important inputs into the system, namely: the amount of the substances and compounds which supply the plant and the electric power consumption. Our first aim is to reduce the input/output ratio of the separation plant. On the other hand, by applying this automatic control system we can reduce the operating personnel also. The isotopic product is sampled and analyzed using a dedicated mass spectrometer. An overall closed loop through the separation plant including this mass spectrometer could be very efficient, but the theoretical analysis is too complex and it is very difficult to realize it in practice. Therefore, multiple local control loops are preferred to apply for each product correlated parameter. Between these parameters there are complex interdependencies, governed by differential equations. The computer is equipped with standard input/output hardware, but in order to use it in the complex feedback loops, extra input/output hardware must be added, namely, dedicated input/output module cards. Depending on the operating principle of the detectors and actuators the signals involved in the whole system are analog and digital. The majority of the sensors and transducers generates analog signals and only a few of them have digital output. The last case is typical for transducers specialized mainly for detecting the level of a parameter. Actuators also need analog or digital control signals, corresponding to their operating principles. The computer control of isotopic plant has a great advantage of being very flexible in implementing adequate control software with operator friendly interfacing routines. (authors)

  1. Home Hemodialysis (HHD Treatment as an Effective yet Underutilized Treatment Modality in the United States

    Directory of Open Access Journals (Sweden)

    Jihane J. Hajj

    2017-11-01

    Full Text Available End-stage renal disease (ESRD is a major health burden and its incidence has been increasing yearly reaching 120,000 cases in 2014. Home hemodialysis (HHD is a treatment modality option that has been shown to contribute to numerous clinical benefits but is largely underutilized due to many contributing factors. The purpose of this review paper is to analyze the advantages and disadvantages of HHD and the reasons for its low utilization with a special focus on its socioeconomic impact as compared to facility hemodialysis. Key factors contributing to HHD underutilization are related to the reimbursement system of the facility and nephrologists as well as the underutilization of the pre-dialysis educational benefit. Based on this comprehensive review of the literature, we propose several suggestions which may contribute to the expansion of HHD treatment modality.

  2. Septage unit treatment by sludge treatment reed beds for easy management and reuse: performance and design considerations.

    Science.gov (United States)

    Kim, Boram; Bel, Thomas; Bourdoncle, Pascal; Dimare, Jocelyne; Troesch, Stéphane; Molle, Pascal

    2018-01-01

    Sustainable treatment and management of fecal sludge in rural areas require adapted solutions. Rustic and simple operating processes such as sludge treatment reed beds (STRB) have been increasingly considered for this purpose. The biggest full scale (2,600 m 2 of STRB) septage treatment unit in France had been built in Nègrepelisse with the final objectives of reusing treated sludge and leachates for agriculture spreading and tree irrigation, respectively. The aim of this investigation was to validate the treatment chain of this installation. The obtained field data showed firstly that the overall removal efficiencies of STRB were satisfactory and stable. Removal rates higher than 98% for chemical oxygen demand and suspended solids and a 95% for Kjeldahl nitrogen represented so far a beneficial septage treatment by STRB. The highlighted necessity of a suitable complementary leachate treatment (before tree irrigation) justified the presence of the second stage of vertical flow constructed wetland. The sludge deposit drying and mineralization efficiencies were on the right track. According to hydrotextural diagram analysis, surface deposit was however found to have high deformability probably due to the youth of the installation. An in-depth understanding of STRB system needs continuous long-term studies.

  3. Treatment utilization among persons with opioid use disorder in the United States.

    Science.gov (United States)

    Wu, Li-Tzy; Zhu, He; Swartz, Marvin S

    2016-12-01

    The United States is experiencing an opioid overdose epidemic. Treatment use data from diverse racial/ethnic groups with opioid use disorder (OUD) are needed to inform treatment expansion efforts. We examined demographic characteristics and behavioral health of persons aged ≥12 years that met criteria for past-year OUD (n=6,125) in the 2005-2013 National Surveys on Drug Use and Health (N=503,101). We determined the prevalence and correlates of past-year use of alcohol/drug use treatment and opioid-specific treatment to inform efforts for improving OUD treatment. Among persons with OUD, 81.93% had prescription (Rx) OUD only, 9.75% had heroin use disorder (HUD) only, and 8.32% had Rx OUD+HUD. Persons with Rx OUD+HUD tended to be white, adults aged 18-49, males, or uninsured. The majority (80.09%) of persons with OUD had another substance use disorder (SUD), and major depressive episode (MDE) was common (28.74%). Of persons with OUD, 26.19% used any alcohol or drug use treatment, and 19.44% used opioid-specific treatment. Adolescents, the uninsured, blacks, native-Hawaiians/Pacific-Islanders/Asian-Americans, persons with Rx OUD only, and persons without MDE or SUD particularly underutilized opioid-specific treatment. Among alcohol/drug use treatment users, self-help group and outpatient rehabilitation treatment were commonly used services. Most people with OUD report no use of OUD treatment. Multifaceted interventions, including efforts to access insurance coverage, are required to change attitudes and knowledge towards addiction treatment in order to develop a supportive culture and infrastructure to enable treatment-seeking. Outreach efforts could target adolescents, minority groups, and the uninsured to improve access to treatment. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

  4. Population-level differences in revascularization treatment and outcomes among various United States subpopulations

    Institute of Scientific and Technical Information of China (English)

    Garth Graham; Yang-Yu Karen Xiao; Dan Rappoport; Saima Siddiqi

    2016-01-01

    Despite recent general improvements in health care, significant disparities persist in the cardiovascular care of women and racial/ethnic minorities. This is true even when income, education level, and site of care are taken into consideration. Possible explanations for these disparities include socioeconomic considerations, elements of discrimination and racism that affect socioeconomic status, and access to adequate medical care. Coronary revascularization has become the accepted and recommended treatment for myocardial infarction(MI) today and is one of the most common major medical interventions in the United States, with more than 1 million procedures each year. This review discusses recent data on disparities in co-morbidities and presentation symptoms, care and access to medical resources, and outcomes in revascularization as treatment for acute coronary syndrome, looking especially at women and minority populations in the United States. The data show that revascularization is used less in both female and minority patients. We summarize recent data on disparities in co-morbidities and presentation symptoms related to MI; access to care, medical resources, and treatments; and outcomes in women, blacks, and Hispanics. The picture is complicated among the last group by the many Hispanic/Latino subgroups in the United States. Some differences in outcomes are partially explained by presentation symptoms and co-morbidities and external conditions such as local hospital capacity. Of particular note is the striking differential in both presentation co-morbidities and mortality rates seen in women, compared to men, especially in women ≤ 55 years of age. Surveillance data on other groups in the United States such as American Indians/Alaska Natives and the many Asian subpopulations show disparities in risk factors and co-morbidities, but revascularization as treatment for MI in these populations has not been adequately studied. Significant research is required to

  5. An integrated computer control system for the ANU linac

    Science.gov (United States)

    Davidson, P. M.; Foote, G. S.

    1996-02-01

    One facet of the installation of the superconducting linac at the ANU is the need for computer control of a variety of systems, such as beam transport, resonator RF, cryogenics and others. To accommodate this, a number of control interfaces (for example, analogue signals and RS232 serial lines) must be employed. Ideally, all of the systems should be able to be controlled from a central location, remote from the actual devices. To this end a system based around VAX computers and VME crates has been designed and is currently being developed and implemented. A VAXstation is used to issue control messages and perform high-level functions, while VME crates containing appropriate modules (primarily DACs, ADCs and digital I/O boards) control the devices. The controllers in the VME crates are AEON rtVAX modules running a real-time operating system. Communication with the VAXstation is via DECnet, on a private ethernet to allow communication rates unaffected by unrelated network activity and potentially increasing the security of the system by providing a possible network isolation point. Also on this ethernet are a number of terminal servers to control RS232 devices. A central database contains all device control and monitoring parameters. The main control process running on the VAXstation is responsible for maintaining the current values of the parameters in the database and for dispatching control messages to the appropriate VME crate or RS232 serial line. Separate graphical interface processes allow the operator to interact with the control process, communicating through shared memory. Many graphics processes can be active simultaneously, displaying either on a single or on multiple terminals. Software running on the rtVAX controllers handles the low-level device-specific control by translating messages from the main control process to VME commands which set hardware outputs on VME modules. Similarly, requests for the value of a parameter result in the rtVAX program

  6. Computer Controlled Portable Greenhouse Climate Control System for Enhanced Energy Efficiency

    Science.gov (United States)

    Datsenko, Anthony; Myer, Steve; Petties, Albert; Hustek, Ryan; Thompson, Mark

    2010-04-01

    This paper discusses a student project at Kettering University focusing on the design and construction of an energy efficient greenhouse climate control system. In order to maintain acceptable temperatures and stabilize temperature fluctuations in a portable plastic greenhouse economically, a computer controlled climate control system was developed to capture and store thermal energy incident on the structure during daylight periods and release the stored thermal energy during dark periods. The thermal storage mass for the greenhouse system consisted of a water filled base unit. The heat exchanger consisted of a system of PVC tubing. The control system used a programmable LabView computer interface to meet functional specifications that minimized temperature fluctuations and recorded data during operation. The greenhouse was a portable sized unit with a 5' x 5' footprint. Control input sensors were temperature, water level, and humidity sensors and output control devices were fan actuating relays and water fill solenoid valves. A Graphical User Interface was developed to monitor the system, set control parameters, and to provide programmable data recording times and intervals.

  7. Outpatient Mental Health Treatment Utilization and Military Career Impact in the United States Marine Corps.

    Science.gov (United States)

    Ghahramanlou-Holloway, Marjan; LaCroix, Jessica M; Koss, Kari; Perera, Kanchana U; Rowan, Anderson; VanSickle, Marcus R; Novak, Laura A; Trieu, Theresa H

    2018-04-23

    Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines ( N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines ( N = 40) was matched to a non-treatment-seeking sample of Marines ( N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls ( p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed.

  8. Outcome predictors of smoking cessation treatment provided by an addiction care unit between 2007 and 2010

    Directory of Open Access Journals (Sweden)

    João Maurício Castaldelli-Maia

    2013-12-01

    Full Text Available Objective: To analyze the predictors of smoking cessation treatment outcomes in a sample with a high rate of medical and psychiatric disorders and addictions. Methods: Analysis of predictors of success of a 6-week treatment provided by an addiction care unit (CAPS-AD to 367 smokers in Brazil from 2007 to 2010. Forty variables were collected at baseline. Success was defined as abstinence from smoking for a period of at least 14 consecutive days, including the last day of treatment. Twenty variables were selected for the logistic regression model. Results: The only condition correlated with successful treatment after logistic regression was smoking one's first cigarette 5 minutes or more after waking (beta = 1.85, 95% confidence interval [95%CI] = 1.11-3.10, p = 0.018. Subjects with hypertension and alcohol use disorders and those who were undergoing psychiatric treatment showed success rates comparable to or greater than the average success rate of the sample (34.2-44.4%. Conclusions: These findings support the importance of the variable time to first cigarette in treatment outcomes for a sample with a high rate of clinical and psychiatric disorders. Good success rates were observed for pharmacological treatment, which was combined with group therapy based on cognitive-behavioral concepts and integrated into ongoing treatment of other addictions and psychiatric disorders.

  9. Doses in sensitive organs during prostate treatment with a 60Co unit

    International Nuclear Information System (INIS)

    Vega-Carrillo, H.R.; Navarro Becerra, J.A.; Pérez Arrieta, M.L.; Pérez-Landeros, L.H.

    2014-01-01

    Using thermoluminiscent dosimeters the absorbed dose in the bladder, rectum and thyroid have been evaluated when 200 cGy was applied to the prostate. The treatment was applied with a 60 Co unit. A water phantom was built and thermoluminiscent dosimeters were located in the position where the prostate, bladder, rectum and thyroid are located. The therapeutic beam was applied in 4 irradiations at 0, 90, 180 and 270° with the prostate at the isocenter. The TLDs readouts were used to evaluate the absorbed dose in each organ. The absorbed doses were used to estimate the effective doses and the probability of developing secondary malignacies in thyroid, rectum and bladder. - Highlights: • The absorbed doses in the bladder, rectum and thyroid were measured. • Measurements were done during prostate treatment with a 60 Co unit. • TLD100s in a water phantom were used. • The effective doses were also estimated

  10. Hanford facility dangerous waste permit application, 325 hazardous waste treatment units. Revision 1

    International Nuclear Information System (INIS)

    1997-07-01

    This report contains the Hanford Facility Dangerous Waste Permit Application for the 325 Hazardous Waste Treatment Units (325 HWTUs) which consist of the Shielded Analytical Laboratory, the 325 Building, and the 325 Collection/Loadout Station Tank. The 325 HWTUs receive, store, and treat dangerous waste generated by Hanford Facility programs. Routine dangerous and/or mixed waste treatment that will be conducted in the 325 HWTUs will include pH adjustment, ion exchange, carbon absorption, oxidation, reduction, waste concentration by evaporation, precipitation, filtration, solvent extraction, solids washing, phase separation, catalytic destruction, and solidification/stabilization

  11. Hanford facility dangerous waste permit application, 325 hazardous waste treatment units. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    This report contains the Hanford Facility Dangerous Waste Permit Application for the 325 Hazardous Waste Treatment Units (325 HWTUs) which consist of the Shielded Analytical Laboratory, the 325 Building, and the 325 Collection/Loadout Station Tank. The 325 HWTUs receive, store, and treat dangerous waste generated by Hanford Facility programs. Routine dangerous and/or mixed waste treatment that will be conducted in the 325 HWTUs will include pH adjustment, ion exchange, carbon absorption, oxidation, reduction, waste concentration by evaporation, precipitation, filtration, solvent extraction, solids washing, phase separation, catalytic destruction, and solidification/stabilization.

  12. Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States.

    Science.gov (United States)

    Perez, Marisol; Ohrt, Tara K; Hoek, Hans W

    2016-11-01

    We reviewed the recent literature on prevalence rates, and application of evidence-based treatments for eating disorders among Hispanics/Latinos residing in the United States. Lifetime prevalence rates of anorexia nervosa are lower among Hispanic/Latinos than non-Hispanic Whites. There are comparable rates of bulimia nervosa and binge eating disorder (BED) among Hispanic/Latinos and non-Hispanic Whites. BED is the most common eating disorder among Hispanic/Latinos. Evidence-based treatments have begun to be implemented with Hispanics/Latinos. The core concepts of cognitive behavioral therapy for bulimia nervosa and BED apply to this population. Culture-specific adaptations include strengthening the collectivistic framework within an individualistic treatment, psychoeducation of immediate and extended family, and adjustment of meal plans that incorporated cultural foods. There are more similarities than differences in the prevalence of eating disorders across Hispanics/Latinos and non-Hispanic Whites. However, the social context such as immigration status and acculturation is important to consider in the development of eating disorders. In addition, the Westernization of Latin America may change the future relationship of immigration status and development of eating disorder within the United States. Overall, cultural adaptations of evidence-based treatments involved the inclusion of family within treatment, acculturation-related issues, and managing family conflicts that arise because of the changes in eating patterns.

  13. Trends in the United States in the treatment of distal radial fractures in the elderly.

    Science.gov (United States)

    Chung, Kevin C; Shauver, Melissa J; Birkmeyer, John D

    2009-08-01

    Traditionally, distal radial fractures in the elderly have been treated nonoperatively with casting. However, since the introduction of the volar locking plating system in 2000, there has been an interest in the use of more aggressive treatment methods. The purpose of the present study was to assess changing trends in the treatment of distal radial fractures in elderly patients in the United States. We evaluated a 5% sample of Medicare data from 1996 to 1997 and a 20% sample from 1998 to 2005. Information on four treatment methods (closed treatment, percutaneous pin fixation, internal fixation, and external fixation) was extracted from the dataset. Other available data were diagnosis, physician specialty, and patient age, sex, and race. We calculated frequencies and rates to compare the utilization of different treatments over time. Over the ten-year time period examined, the rate of internal fixation of distal radial fractures in the elderly increased fivefold, from 3% in 1996 to 16% in 2005. Closed treatment, however, remained the predominant method (used for 82% of the fractures in 1996 and 70% in 2005). Fractures in patients with an age of eighty-five years or more were significantly more likely to be treated in a closed fashion (p < 0.0001). There was a large variation among physician specialties with regard to the fixation methods that were used. Orthopaedic surgeons were significantly more likely to use closed treatment than hand surgeons were, whereas hand surgeons were significantly more likely to use internal fixation than orthopaedic surgeons were. Since 2000, although the majority of distal radial fractures are still treated nonoperatively, there has been an increase in the use of internal fixation and a concurrent decrease in the rate of closed treatment of distal radial fractures in the elderly in the United States.

  14. CONCEPTUAL BASES OF THE ENERGY EFFICIENT SYSTEM OF MANAGEMENT OF COMBINED UNITS OF WASTEWATER TREATMENT

    Directory of Open Access Journals (Sweden)

    V. N. Shtepa

    2016-01-01

    Full Text Available A critical analysis of the shortcomings of the existing water purification systems is conducted. In order to ensure environmental safety and energy savings it is proposed to use the combined units, including physical, chemical, physical-and-chemical and biological methods. The attention is driven to the fact that the most effective way to maintain current water purification is an adaptive control system. The shortcomings of the management of water treatment units were revealed and it was proposed to produce their synthesis based on the mathematical apparatus of artificial intelligence systems. Taking into account the requirements of the environmental safety and the need in the energy savings, the energy efficiency criteria of combined system functioning has been developed. At an industrial plant (slaughterhouse wastewater treatment the compliance of the production conditions of the criterion has been undertaken that confirmed the criterion relevance and usefulness as applied to the synthesis of energy-efficient control systems. A synthetic control system combined the water treatment plants. Having based on the preliminary research and analysis of the current work in the subject area the architecture of a control system of combined water treatment units that use intelligent technology was developed. The key functional of the unit – information-analytical subsystem of the formation control actions including: multilayer perceptrons self-organization Kohonen network, fuzzy cognitive map. The basic difference between the developed design and its analogues is the ability to adjust the settings of equipment adaptively on the basis of processing sensor data, information on the price of consumables, volley discharges of pollutants, a sudden change in the flow and other force majeure. Adjustment of the parameters of the control system is carried out with the use of experimental and analytical data stored in the knowledge base of technological

  15. National Ignition Facility system design requirements NIF integrated computer controls SDR004

    International Nuclear Information System (INIS)

    Bliss, E.

    1996-01-01

    This System Design Requirement document establishes the performance, design, development, and test requirements for the NIF Integrated Computer Control System. The Integrated Computer Control System (ICCS) is covered in NIF WBS element 1.5. This document responds directly to the requirements detailed in the NIF Functional Requirements/Primary Criteria, and is supported by subsystem design requirements documents for each major ICCS Subsystem

  16. Cone beam computed tomography image guidance system for a dedicated intracranial radiosurgery treatment unit.

    Science.gov (United States)

    Ruschin, Mark; Komljenovic, Philip T; Ansell, Steve; Ménard, Cynthia; Bootsma, Gregory; Cho, Young-Bin; Chung, Caroline; Jaffray, David

    2013-01-01

    Image guidance has improved the precision of fractionated radiation treatment delivery on linear accelerators. Precise radiation delivery is particularly critical when high doses are delivered to complex shapes with steep dose gradients near critical structures, as is the case for intracranial radiosurgery. To reduce potential geometric uncertainties, a cone beam computed tomography (CT) image guidance system was developed in-house to generate high-resolution images of the head at the time of treatment, using a dedicated radiosurgery unit. The performance and initial clinical use of this imaging system are described. A kilovoltage cone beam CT system was integrated with a Leksell Gamma Knife Perfexion radiosurgery unit. The X-ray tube and flat-panel detector are mounted on a translational arm, which is parked above the treatment unit when not in use. Upon descent, a rotational axis provides 210° of rotation for cone beam CT scans. Mechanical integrity of the system was evaluated over a 6-month period. Subsequent clinical commissioning included end-to-end testing of targeting performance and subjective image quality performance in phantoms. The system has been used to image 2 patients, 1 of whom received single-fraction radiosurgery and 1 who received 3 fractions, using a relocatable head frame. Images of phantoms demonstrated soft tissue contrast visibility and submillimeter spatial resolution. A contrast difference of 35 HU was easily detected at a calibration dose of 1.2 cGy (center of head phantom). The shape of the mechanical flex vs scan angle was highly reproducible and exhibited cone beam CT image guidance system was successfully adapted to a radiosurgery unit. The system is capable of producing high-resolution images of bone and soft tissue. The system is in clinical use and provides excellent image guidance without invasive frames. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. MOBIL CONTAINER UNIT FOR SEWAGE SLUDGE UTILIZATION FROM SMALL AND MEDIUM WASTWATER TREATMENT PLANTS

    Directory of Open Access Journals (Sweden)

    Stanisław Ledakowicz

    2016-06-01

    Full Text Available The most wastewater treatment plants in Poland are small and medium plants of flow capacity below 1000 m3/d. These plants are not able to build sludge incineration plants and the transportation costs to the nearest plants increase the total costs of wastewater treatment. Polish company Metal Expert together with the French company ETIA and Lodz University of Technology proposed mobile unit for integrated drying and pyrolysis of sewage sludge in a pilot bench scale with capacity of 100 kg/h of dewatered sludge. The pilot plant was mounted in a typical mobile container which could provide service to small and medium wastewater treatment plants offering thermal processing of sewage sludge. This unit consists of KENKI contact dryer and „Spirajoule”® pyrolyser supplied with electricity utilizing the Joule effect, and a boiler, wherein the pyrolysis gases and volatile products are burned producing steam sent to the contact dryer. The bio-char produced during sludge pyrolysis could be utilized for agriculture purposes. During preliminary experiments and short-term exploitation of the unit at Elbląg Wastewater Treatment Plant the obtained results allowed us to make a mass and energy balance depended on the process conditions in the pyrolysis temperature range of 400÷800 °C. Based on the obtained results a calculator was created in the Excel , which enables assessment of pyrolysis products content and making mass and energy balances depended on process parameters such as initial moisture of sludge, pyrolysis temperature and installation output.

  18. Comparing Guidelines for Statin Treatment in Canada and the United States.

    Science.gov (United States)

    Hennessy, Deirdre A; Bushnik, Tracey; Manuel, Douglas G; Anderson, Todd J

    2015-07-14

    New guidelines for cardiovascular disease risk assessment and statin eligibility have recently been published in the United States by the American College of Cardiology and the American Heart Association (ACC-AHA). It is unknown how these guidelines compare with the Canadian Cardiovascular Society (CCS) recommendations. Using data from the Canadian Health Measures Survey 2007-2011, we estimated the cardiovascular disease risk and proportion of the Canadian population, aged 40 to 75 years without cardiovascular disease, who would theoretically be eligible for statin treatment under both the CCS and ACC-AHA guidelines. The survey sample used (n=1975) represented 13.1 million community dwelling Canadians between the ages of 40 and 75 years. In comparing the CVD risk assessment methods, we found that calculated CVD risk was higher based on the CCS guidelines compared with the ACC-AHA guidelines. Despite this, a similar proportion and number of Canadians would be eligible for statin treatment under the 2 sets of recommendations. Some discordance in recommendations was found within subgroups of the population, with the CCS guidelines recommending more treatment for individuals who are younger, with a family history of CVD, or with chronic kidney disease. The ACC-AHA recommend more treatment for people who are older (age 60+ years). These results likely overestimate the treatment rate under both guidelines because, in primary prevention, a clinician-patient discussion must occur before treatment and determines uptake. Implementing the ACC-AHA lipid treatment guidelines in Canada would not result in an increase in individuals eligible for statin treatment. In fact, the proportion of the population recommended for statin treatment would decrease slightly and be targeted at different subgroups of the population. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  19. Independent dose per monitor unit review of eight U.S.A. proton treatment facilities

    International Nuclear Information System (INIS)

    Moyers, M. F.; Ibbott, G. S.; Grant, R. L.; Summers, P. A.; Followill, D. S.

    2014-01-01

    Purpose: Compare the dose per monitor unit at different proton treatment facilities using three different dosimetry methods. Methods: Measurements of dose per monitor unit were performed by a single group at eight facilities using 11 test beams and up to six different clinical portal treatment sites. These measurements were compared to the facility reported dose per monitor unit values. Results: Agreement between the measured and reported doses was similar using any of the three dosimetry methods. Use of the ICRU 59 N D,w based method gave results approximately 3% higher than both the ICRU 59 N X and ICRU 78 (TRS-398) N D,w based methods. Conclusions: Any single dosimetry method could be used for multi-institution trials with similar conformity between facilities. A multi-institutional trial could support facilities using both the ICRU 59 N X based and ICRU 78 (TRS-398) N D,w based methods but use of the ICRU 59 N D,w based method should not be allowed simultaneously with the other two until the difference is resolved

  20. Design of chemical treatment unit for radioactive liquid wastes in Serpong nuclear facilities

    International Nuclear Information System (INIS)

    Salimin, Z.; Walman, E.; Santoso, P.; Purnomo, S.; Sugito; Suwardiyono; Wintono

    1996-01-01

    The chemical treatment unit for radioactive liquid wastes arising from nuclear fuel fabrication, radioisotopes production and radiometallurgy facility has been designed. The design of chemical processing unit is based on the characteristics of liquid wastes containing fluors from uranium fluoride conversion process to ammonium uranyl carbonate on the fuel fabrication. The chemical treatment has the following process steps: coagulation-precipitation of fluoride ion by calcium hydroxide coagulant, separation of supernatant solution from sludge, coagulation of remaining fluoride on the supernatant solution by alum, separation of supernatant from sludge, and than precipitation of fluors on the supernatant by polymer resin WWS 116. The processing unit is composed of 3 storage tanks for raw liquid wastes (capacity 1 m 3 per tank), 5 storage tanks for chemicals (capacity 0.5 m 3 per tank), 2 mixing reactors (capacity 0.5 m 3 per reactor), 1 storage tank for supernatant solution (capacity 1 m 3 ), and 1 storage tank for sludge (capacity 1 m 3 )

  1. Current trends in endodontic treatment by general dental practitioners: report of a United States national survey.

    Science.gov (United States)

    Savani, Gina M; Sabbah, Wael; Sedgley, Christine M; Whitten, Brian

    2014-05-01

    In the United States almost 70% of root canal treatment (RCT) is performed by general dentists (GPs), yet little is known about their treatment protocols. A paper survey was mailed to 2000 United States GPs with questions about the types of endodontic cases treated, routine treatment protocols, use of newer technologies, and endodontic continuing education (CE). Completed surveys were returned by 479 respondents (24%). GPs who perform RCT (84%) reported providing anterior (99%), bicuspid (95%), and molar (62%) RCT and retreatment (18%). Rubber dam was used always (60%), usually (16%), sometimes (13%), and never (11%). Newer technologies used by GPs included digital radiography (72%), magnification (80%), electronic apex locator (70%), and nickel-titanium rotary instrumentation (74%). Compared with GPs with >20 years of experience, those in practice for ≤10 years were more likely to use rubber dam (P 20 years were more likely to perform retreatments (P 5 hours of CE were more likely to use rotary instrumentation (P irrigant activation devices (P 20 years. More experienced GPs were more likely to take on complicated cases than those with fewer years of practice. There was no association between hours of CE and compliance with rubber dam usage. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Design of Biochemical Oxidation Process Engineering Unit for Treatment of Organic Radioactive Liquid Waste

    International Nuclear Information System (INIS)

    Zainus Salimin; Endang Nuraeni; Mirawaty; Tarigan, Cerdas

    2010-01-01

    Organic radioactive liquid waste from nuclear industry consist of detergent waste from nuclear laundry, 30% TBP-kerosene solvent waste from purification or recovery of uranium from process failure of nuclear fuel fabrication, and solvent waste containing D 2 EHPA, TOPO, and kerosene from purification of phosphoric acid. The waste is dangerous and toxic matter having low pH, high COD and BOD, and also low radioactivity. Biochemical oxidation process is the effective method for detoxification of organic waste and decontamination of radionuclide by bio sorption. The result process are sludges and non radioactive supernatant. The existing treatment facilities radioactive waste in Serpong can not use for treatment of that’s organics waste. Dio chemical oxidation process engineering unit for continuous treatment of organic radioactive liquid waste on the capacity of 1.6 L/h has been designed and constructed the equipment of process unit consist of storage tank of 100 L capacity for nutrition solution, 2 storage tanks of 100 L capacity per each for liquid waste, reactor oxidation of 120 L, settling tank of 50 L capacity storage tank of 55 L capacity for sludge, storage tank of 50 capacity for supernatant. Solution on the reactor R-01 are added by bacteria, nutrition and aeration using two difference aerators until biochemical oxidation occurs. The sludge from reactor of R-01 are recirculated to the settling tank of R-02 and on the its reverse operation biological sludge will be settled, and supernatant will be overflow. (author)

  3. Use of solidification/stabilization treatment technology for environmental remediation in the United States and Canada

    International Nuclear Information System (INIS)

    Wilk, C.M.

    2002-01-01

    In the United States (U.S.) Solidification/Stabilization (S/S) treatment is used to treat hazardous wastes for disposal, and in the remediation/site restoration of contaminated land. S/S is also an increasingly popular technology for Brownfields (industrial property) redevelopment since treated wastes can often be left on-site and to actually improve the site's soil for subsequent construction. The U.S. Environmental Protection Agency (EPA) considers S/S to be an established treatment technology. EPA has identified S/S treatment as Best Demonstrated Available Treatment Technology (BDAT) for at least 57 commonly produced industrial wastes (Resource Conservation and Recovery Act (RCRA)-listed hazardous wastes) and has selected S/S treatment for 25% of its Superfund (abandoned or uncontrolled) site remediation projects. S/S treatment involves mixing a binding reagent into the contaminated media or waste. Successful treatment is accomplished through physical changes to the waste form, and often, chemical changes to the hazardous constituents themselves. Commonly used S/S binding reagents in include portland cement, cement kiln dust, lime, lime kiln dust and fly ash. These materials are used alone or in combination. Proprietary reagents are also beginning to be marketed and used in the U.S. and Canada. This paper will discuss: (a) applicability of the technology to various wastes, (b) basic cement chemistry relating to S/S, (c) tests used to design treatability studies and to verify treatment, (d) basics on implementation of the technology in the field, and (e) examples of actual projects. (author)

  4. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  5. Increased trends in the use of treatment-limiting decisions in a regional neurosurgical unit.

    Science.gov (United States)

    Wilson, William T; McMillan, Tristan; Young, Adam M H; White, Mark A J

    2017-04-01

    Treatment-limiting decisions (TLDs) are employed to actively withhold treatment from patients whom clinicians feel would derive no benefit or suffer detrimental effects from further intervention. The use of such decisions has been heavily discussed in the media and clinicians in the past have been reluctant to institute them, even though it is in the best interests of the patients. Their use is influenced by several ethical, religious and social factors all of which have changed significantly over time. This study reports the trends in use of TLDs in a regional neurosurgical unit over 23 years. Patient archives were reviewed to identify the number of admissions and procedures performed at the Institute of Neurological Sciences, Glasgow, in the years 1988, 1997 and 2011. Death certificate records were used to identify mortality in the unit in the year 2011. Patient records were used to obtain details of diagnosis, time from admission to death, and the presence and timing of a TLD. The results show an increase in the use of TLDs, with decisions made for 89% of those who died in 2011, compared to 68% in 1997 and 51% in 1988. The number of admissions has increased substantially since 1988 as has the percentage of patients undergoing surgery (46, 67 and 72% in 1988, 1997 and 2011, respectively). There is a trending increase in the number of patients who have a TLD in our regional neurosurgical unit. This demonstrates an increased willingness of clinicians to recognise poor prognosis and to withdraw or withhold treatment in these cases. Continued appropriate use of the TLD is recommended but it is to only ever reflect the best interests of the patient.

  6. Enhancing the ecological and operational characteristics of water treatment units at TPPs based on baromembrane technologies

    Science.gov (United States)

    Chichirova, N. D.; Chichirov, A. A.; Filimonova, A. A.; Saitov, S. R.

    2017-12-01

    The innovative baromembrane technologies for water demineralization were introduced at Russian TPPs more than 25 years ago. While being used in the power engineering industry of Russia, these technologies demonstrated certain advantages over the traditional ion-exchange and thermal technologies of makeup water treatment for steam boilers. Water treatment units based on the baromembrane technology are compact, easy to operate, and highly automated. The experience gained from the use of these units shows that their reliability depends directly on preliminary water treatment. The popular water pretreatment technology with coagulation by aluminum oxychloride proved to be inefficient during the seasonal changes of source water quality that occurs at some stations. The use of aluminum coagulant at pH 8 and higher does not ensure the stable and qualitative pretreatment regime: soluble aluminum forms slip on membranes of the ultrafiltration unit, thereby causing pollution and intoxication as well as leading to structural damages or worsening of mechanical properties of the membranes. The problem of increased pH and seasonal changes of the source water quality can be solved by substitution of the traditional coagulant into a new one. To find the most successful coagulant for water pretreatment, experiments have been performed on both qualitative and quantitative analysis of the content of natural organic matters in the Volga water and their structure. We have developed a software program and measured the concentrations of soluble aluminum and iron salts at different pH values of the source water. The analysis of the obtained results has indicated that iron sulfate at pH 6.0-10.2, in contrast to aluminum oxychloride, is not characterized by increased solubility. Thus, the basic process diagrams of water pretreatment based on baromembrane technologies with pretreatment through coagulation by iron salts and wastewater amount reducing from 60-40 to 5-2% have been introduced for

  7. Computer-controlled environmental test systems - Criteria for selection, installation, and maintenance.

    Science.gov (United States)

    Chapman, C. P.

    1972-01-01

    Applications for presently marketed, new computer-controlled environmental test systems are suggested. It is shown that capital costs of these systems follow an exponential cost function curve that levels out as additional applications are implemented. Some test laboratory organization changes are recommended in terms of new personnel requirements, and facility modification are considered in support of a computer-controlled test system. Software for computer-controlled test systems are discussed, and control loop speed constraints are defined for real-time control functions. Suitable input and output devices and memory storage device tradeoffs are also considered.

  8. Resource Conservation and Recovery Act (RCRA) closure sumamry for the Uranium Treatment Unit

    International Nuclear Information System (INIS)

    1996-05-01

    This closure summary has been prepared for the Uranium Treatment Unit (UTU) located at the Y-12 Plant in Oak Ridge, Tennessee. The actions required to achieve closure of the UTU area are outlined in the Closure Plan, submitted to and approved by the Tennessee Department of Environmental and Conservation staff, respectively. The UTU was used to store and treat waste materials that are regulated by the Resource Conservation and Recovery Act. This closure summary details all steps that were performed to close the UTU in accordance with the approved plan

  9. Study of the uses of Information and Communication Technologies by Pain Treatment Unit Physicians.

    Science.gov (United States)

    Muriel Fernandez, Jorge; Sánchez Ledesma, María José; López Millan, Manuel; García Cenador, María Begoña

    2017-05-01

    Adequate use of Information and Communication Technologies (ICTs) in health has been shown to save the patient and caregiver time, improve access to the health system, improve diagnosis and control of disease or treatment. All this results in cost savings, and more importantly, they help improve the quality of service and the lives of patients. The purpose of this study is to analyse the differences in the uses of this ICTs between those physicians that belong to Pain Treatment Units (PU) and other physicians that work in pain not linked to these PUs. An online survey, generated by Netquest online survey tool, was sent to both groups of professionals and the data collected was statistical analysed through a logistic regression methodology which is the Logit binomial model. Our results show that those physicians that belong to PUs use ICTs more frequently and consider it more relevant to their clinical practice.

  10. Treatment of skin and soft tissue infections in a pediatric observation unit.

    Science.gov (United States)

    Lane, Roni D; Sandweiss, David R; Corneli, Howard M

    2014-05-01

    To report the success rate of observation unit (OU) treatment of pediatric skin and soft tissue infections (SSTIs) and to see if we could identify variables at the time of initial evaluation that predicted successful OU treatment. A retrospective review of children less than 18 years of age admitted for SSTI treatment to our OU from the emergency department between January 2003 and June 2009. On records review, 853 patients matched eligibility criteria; median age was 5.2 years (interquartile range = 2.5-9 years). Of the 853 patients, 597 (70.0%) met the primary outcome criteria of successful OU discharge within 26 hours. Secondary analysis revealed that 82% of the patients achieved successful discharge from the OU within 48 hours. Although some laboratory variables demonstrated statistical association with success, none achieved a combination of high sensitivity and specificity to predict OU failure. OU success rates varied by location. Dental and face infections and those of the extremities or multiple sites demonstrated OU success rates higher than 65%, while infection of the groin, buttocks, trunk, or neck had success rates between 24% (neck) and 60% (groin). In multivariate analysis, only 3 variables remained significant. Unfavorable location was most strongly associated with OU failure, followed by C-reactive protein > 4 and then by erythrocyte sedimentation rate > 20. Our findings suggest that successful OU treatment is possible in a large group of patients needing hospitalization for SSTIs. Consideration of infection location may assist the emergency department clinician in determining the most appropriate unit for admission.

  11. Development and status of the AL Mixed Waste Treatment Plan or I love that mobile unit of mine

    International Nuclear Information System (INIS)

    Bounini, L.; Williams, M.; Zygmunt, S.

    1995-01-01

    Nine Department of Energy (DOE) sites reporting to the Albuquerque Office (AL) have mixed waste that is chemically hazardous and radioactive. The hazardous waste regulations require the chemical portion of mixed waste to be to be treated to certain standards. The total volume of low-level mixed waste at the nine sites is equivalent to 7,000 drums, with individual site volumes ranging from 1 gallon of waste at the Pinellas Plant to 4,500 drums at Los Alamos National Laboratory. Nearly all the sites have a diversity of wastes requiring a diversity of treatment processes. Treatment capacity does not exist for much of this waste, and it would be expensive for each site to build the diversity of treatment processes needed to treat its own wastes. DOE-AL assembled a team that developed the AL Mixed Waste Treatment Plan that uses the resources of the nine sites to treat the waste at the sites. Work on the plan started in October 1993, and the plan was finalized in March 1994. The plan uses commercial treatment, treatability studies, and mobile treatment units. The plan specifies treatment technologies that will be built as mobile treatment units to be moved from site to site. Mobile units include bench-top units for very small volumes and treatability studies, drum-size units that treat one drum per day, and skid-size units that handle multiple drum volumes. After the tools needed to treat the wastes were determined, the sites were assigned to provide part of the treatment capacity using their own resources and expertise. The sites are making progress on treatability studies, commercial treatment, and mobile treatment design and fabrication. To date, this is the only plan for treating waste that brings the resources of several DOE sites together to treat mixed waste. It is the only program actively planning to use mobile treatment coordinated between DOE sites

  12. INFORMATION SYSTEMS: VA Computer Control Weaknesses Increase Risk of Fraud, Misuse, and Improper Disclosure

    National Research Council Canada - National Science Library

    1998-01-01

    This report discusses weaknesses that we identified during our assessment of general computer controls that support key financial management and benefit delivery operations of the department of Veterans Affairs...

  13. Lightweight and Compace Multifunction Computer-Controlled Strength and Aerobic Training Device, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — TDA Research proposes to develop a computer-controlled lightweight and compact device for aerobic and resistive training (DART) to counteract muscular atrophy and...

  14. Delivery Unit Costs for Antiretroviral Treatment and Prevention of Mother-to-Child-Transmission of HIV

    Science.gov (United States)

    Galárraga, Omar; Wirtz, Veronika J.; Figueroa-Lara, Alejandro; Santa-Ana-Tellez, Yared; Coulibaly, Ibrahima; Viisainen, Kirsi; Medina-Lara, Antonieta; Korenromp, Eline L.

    2013-01-01

    Background As antiretroviral treatment (ART) for HIV/AIDS is scaled-up globally, information on per-person costs is critical to improve efficiency in service delivery and maximize coverage and health impact. Objective To review studies on delivery unit costs for adult and pediatric ART provision per-patient-year, and prevention of mother-to-child transmission (PMTCT) interventions per mother-infant pair screened or treated, in low- and middle-income countries. Methods Systematic review of English, French and Spanish publications from 2001 to 2009, reporting empirical costing that accounted for at least antiretroviral (ARV) medicines, laboratory testing and personnel. Expenditures were analyzed by country income level and cost component. All costs were standardized to 2009 US dollars. Results Analyses covered 29 eligible, comprehensive costing studies. In the base case, in low-income countries (LIC), median, ART cost per patient-year was $792 (mean: $839, range: $682-$1089); for lower-middle-income countries (LMIC), the median was $932 (mean: $1246, range: $156-$3904); and for upper-middle-income countries (UMIC) the median was $1454 (mean: $2783, range: $1230-$5667). ARV drugs were largest component of overall ART cost in all settings (62%, 50% and 47% in LIC, LMIC and UMIC respectively). Out of 26 ART studies, 14 report which drug regimes were used, and only one study explicitly reported second line treatment costs. The second cost driver was laboratory cost in LIC and LMIC (14% and 19.5%) whereas it was personnel costs in UMIC (26%). Two studies specified the types of laboratory tests costed, and three studies specifically included above-facility-level personnel costs. Three studies reported detailed PMTCT costs, and two studies reported on pediatric ART. Conclusions There is a paucity of data on the full ART and PMTCT delivery unit costs, in particular for low-and middle-income countries. Heterogeneity in activities costed and insufficient detail regarding

  15. Grey water treatment by a continuous process of an electrocoagulation unit and a submerged membrane bioreactor system

    KAUST Repository

    Bani-Melhem, Khalid; Smith, Edward

    2012-01-01

    This paper presents the performance of an integrated process consisting of an electro-coagulation (EC) unit and a submerged membrane bioreactor (SMBR) technology for grey water treatment. For comparison purposes, another SMBR process without

  16. Treatment patterns in disease-modifying therapy for patients with multiple sclerosis in the United States.

    Science.gov (United States)

    Bonafede, Machaon M; Johnson, Barbara H; Wenten, Madé; Watson, Crystal

    2013-10-01

    Patients with multiple sclerosis (MS) whose disease activity is inadequately controlled with a platform therapy (interferon beta or glatiramer acetate [GA]) may switch to another platform therapy or escalate therapy to natalizumab or fingolimod, which were approved in the US in 2006 and 2010, respectively. The objective of this study was to describe treatment patterns in patients with multiple sclerosis (MS) in the United States who were followed for 2 years after initiating a disease-modifying therapy (DMT). A retrospective observational cohort study was conducted to examine treatment patterns of initial DMT use (on initial therapy for 2 years with and without gaps of ≥ 60 days, medication switching, and discontinuation) among patients with MS who initiated a platform therapy (interferon-β or glatiramer acetate) or natalizumab between January 1, 2007, and September 30, 2009; the first DMT claim was the index. Eligible patients were identified in the MarketScan Commercial and Medicare Supplemental databases based on continuous enrollment for 6 months before (preindex period) and 24 months after their index date, with a diagnosis of MS and no claim for a previous DMT in the 6-month preindex period. Demographics at index and clinical characteristics during the preindex period were also analyzed. A total of 6181 MS patients were included, with 5735 (92.8%) starting on platform therapy. Natalizumab initiators were more likely to stay on index therapy (32.3% vs 16.9%, P treatment gaps of ≥ 60 days (44.8% vs 55.3%, P treatment (13.9% vs 19.1%, P = 0.007) and took longer to switch (400.9 days vs 330.7 days, P treatment gaps, and switch less than platform initiators in the 2 years after treatment initiation. Switching between platform therapies is common despite evidence that MS patients on platform therapy may benefit from switching to natalizumab. © 2013 Elsevier HS Journals, Inc. All rights reserved.

  17. SU-E-P-45: An Analytical Formula for Deriving Mechanical Iso-Center of Rotational Gantry Treatment Unit Rotational Gantry Treatment Unit

    International Nuclear Information System (INIS)

    Ding, X; Bues, M

    2015-01-01

    Purpose: To present an analytical formula for deriving mechanical isocenter (MIC) of a rotational gantry treatment unit. The input data to the formula is obtained by a custom-made device. The formula has been implemented and used in an operational proton therapy facility since 2005. Methods: The custom made device consisted of 3 mutually perpendicular dial indicators and 5 clinometers, to obtain displacement data and gantry angle data simultaneously. During measurement, a steel sphere was affixed to the patient couch, and the device was attached to the snout rotating with the gantry. The displacement data and angle data were obtained simultaneously at angular increments of less than 1 degree. The analytical formula took the displacement and angle as input and derived the positions of dial indicator tips (DIT) position in room-fixed coordinate system. The formula derivation presupposes trigonometry and 3-dimentional coordinate transformations. Due to the symmetry properties of the defining equations, the DIT position can be solved for analytically without using mathematical approximations. We define the mean of all points in the DIT trajectory as the MIC. The formula was implemented in computer code, which has been employed during acceptance test, commissioning, as well as routine QA practice in an operational proton facility since 2005. Results: It took one minute for the custom-made device to acquire the measurement data for a full gantry rotation. The DIT trajectory and MIS are instantaneously available after the measurement. The MIC Result agrees well with vendor’s Result, which came from a different measurement setup, as well as different data analysis algorithm. Conclusion: An analytical formula for deriving mechanical isocenter was developed and validated. The formula is considered to be absolutely accurate mathematically. Be analyzing measured data of radial displacements as function of gantry angle, the formula calculates the MI position in room

  18. An Economic Evaluation of Tofacitinib Treatment in Rheumatoid Arthritis: Modeling the Cost of Treatment Strategies in the United States.

    Science.gov (United States)

    Claxton, Lindsay; Jenks, Michelle; Taylor, Matthew; Wallenstein, Gene; Mendelsohn, Alan M; Bourret, Jeffrey A; Singh, Amitabh; Moynagh, Dermot; Gerber, Robert A

    2016-09-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Tofacitinib is approved in the United States for use in adults with moderately to severely active RA and an inadequate response or intolerance to methotrexate. To (a) evaluate, using an economic model, the treatment costs of an RA strategy including tofacitinib, compared with adalimumab, etanercept, certolizumab and tocilizumab biologic RA treatment strategies, which are commonly prescribed in the United States, and (b) assess the economic impact of monotherapy and combination therapy in patients who had an inadequate response to methotrexate therapy (MTX-IR analysis) and to combination therapy in patients who had an inadequate response to a tumor necrosis factor inhibitor (TNF-IR analysis). A transparent, Excel-based economic model with a decision-tree approach was developed to evaluate costs over a 1- and 2-year time horizon. The model compared tofacitinib 5 mg twice a day (BID) either as monotherapy or in combination with MTX with similarly labeled biologic therapies. Response to treatment was modeled as American College of Rheumatology (ACR) 20/50/70 response. ACR20 represented clinical response and determined whether patients continued therapy. ACR response rates at 6-month intervals were sourced from prescribing information and safety event rates from a published meta-analysis. Following an adverse event or a lack of response to treatment, it was assumed that 75% of patients switched to the next line of treatment (first to abatacept and then to rituximab). The perspective was that of a U.S. payer. Costs were reported in 2015 U.S. dollars and included drug wholesale acquisition costs, monitoring, drug administration, and treatment for minor and serious adverse events. The patient population eligible for treatment was based on the total number of members (i.e., RA and non-RA) in a payer organization; members with RA treated with biologic therapies were estimated using

  19. Multibeam tomotherapy: A new treatment unit devised for multileaf collimation, intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Achterberg, Nils; Mueller, Reinhold G.

    2007-01-01

    A fully integrated system for treatment planning, application, and verification for automated multileaf collimator (MLC) based, intensity-modulated, image-guided, and adaptive radiation therapy (IMRT, IGRT and ART, respectively) is proposed. Patient comfort, which was the major development goal, will be achieved through a new unit design and short treatment times. Our device for photon beam therapy will consist of a new dual energy linac with five fixed treatment heads positioned evenly along one plane but one electron beam generator only. A minimum of moving parts increases technical reliability and reduces motion times to a minimum. Motion is allowed solely for the MLCs, the robotic patient table, and the small angle gantry rotation of ±36 deg. . Besides sophisticated electron beam guidance, this compact setup can be built using existing modules. The flattening-filter-free treatment heads are characterized by reduced beam-on time and contain apertures restricted in one dimension to the area of maximum primary fluence output. In the case of longer targets, this leads to a topographic intensity modulation, thanks to the combination of ''step and shoot'' MLC delivery and discrete patient couch motion. Owing to the limited number of beam directions, this multislice cone beam serial tomotherapy is referred to as ''multibeam tomotherapy.'' Every patient slice is irradiated by one treatment head at any given moment but for one subfield only. The electron beam is then guided to the next head ready for delivery, while the other heads are preparing their leaves for the next segment. The ''Multifocal MLC-positioning'' algorithm was programmed to enable treatment planning and optimize treatment time. We developed an overlap strategy for the longitudinally adjacent fields of every beam direction, in doing so minimizing the field match problem and the effects of possible table step errors. Clinical case studies show for the same or better planning target volume coverage

  20. Process engineering design of pathological waste incinerator with an integrated combustion gases treatment unit.

    Science.gov (United States)

    Shaaban, A F

    2007-06-25

    Management of medical wastes generated at different hospitals in Egypt is considered a highly serious problem. The sources and quantities of regulated medical wastes have been thoroughly surveyed and estimated (75t/day from governmental hospitals in Cairo). From the collected data it was concluded that the most appropriate incinerator capacity is 150kg/h. The objective of this work is to develop the process engineering design of an integrated unit, which is technically and economically capable for incinerating medical wastes and treatment of combustion gases. Such unit consists of (i) an incineration unit (INC-1) having an operating temperature of 1100 degrees C at 300% excess air, (ii) combustion-gases cooler (HE-1) generating 35m(3)/h hot water at 75 degrees C, (iii) dust filter (DF-1) capable of reducing particulates to 10-20mg/Nm(3), (iv) gas scrubbers (GS-1,2) for removing acidic gases, (v) a multi-tube fixed bed catalytic converter (CC-1) to maintain the level of dioxins and furans below 0.1ng/Nm(3), and (vi) an induced-draft suction fan system (SF-1) that can handle 6500Nm(3)/h at 250 degrees C. The residence time of combustion gases in the ignition, mixing and combustion chambers was found to be 2s, 0.25s and 0.75s, respectively. This will ensure both thorough homogenization of combustion gases and complete destruction of harmful constituents of the refuse. The adequate engineering design of individual process equipment results in competitive fixed and operating investments. The incineration unit has proved its high operating efficiency through the measurements of different pollutant-levels vented to the open atmosphere, which was found to be in conformity with the maximum allowable limits as specified in the law number 4/1994 issued by the Egyptian Environmental Affairs Agency (EEAA) and the European standards.

  1. The potential impact of increased treatment rates for alcohol dependence in the United Kingdom in 2004.

    Science.gov (United States)

    Shield, Kevin D; Rehm, Jürgen; Rehm, Maximilien X; Gmel, Gerrit; Drummond, Colin

    2014-02-05

    Alcohol consumption has been linked to a considerable burden of disease in the United Kingdom (UK), with most of this burden due to heavy drinking and Alcohol Dependence (AD). However, AD is undertreated in the UK, with only 8% of those individuals with AD being treated in England and only 6% of those individuals with AD being treated in Scotland. Thus, the objective of this paper is to quantify the deaths that would have been avoided in the UK in 2004 if the treatment rate for AD had been increased. Data on the prevalence of AD, alcohol consumption, and mortality were obtained from the Adult Psychiatric Morbidity Survey, the Global Information System on Alcohol and Health, and the 2004 Global Burden of Disease study respectively. Data on the effectiveness of pharmacological treatment and Motivational Interviewing/Cognitive Behavioural Therapy were obtained from Cochrane reviews and meta-analyses. Simulations were used to model the number of deaths under different treatment scenarios. Sensitivity analyses were performed to model the effects of Brief Interventions and to examine the effect of using AD prevalence data obtained from the National Institute for Health and Clinical Excellence. In the UK, 320 female and 1,385 male deaths would have been avoided if treatment coverage of pharmacological treatment had been increased to 20%. This decrease in the number of deaths represents 7.9% of all alcohol-attributable deaths (7.0% of all alcohol-attributable deaths for women and 8.1% of all alcohol-attributable deaths for men). If we used lower AD prevalence rates obtained from the National Institute for Health and Clinical Excellence, then treatment coverage of pharmacological treatment in hospitals for 20% of the population with AD would have resulted in the avoidance of 529 deaths in 2004 (99 deaths avoided for women and 430 deaths avoided for men). Increasing AD treatment in the UK would have led to a large number of deaths being avoided in 2004. Increased AD

  2. Independent calculation of the monitor units and times of treatment in radiotherapy

    International Nuclear Information System (INIS)

    Mueller, Marcio Rogerio

    2005-01-01

    In this work, an independent verification system of calculations in radiotherapy was developed and applied, using Visual Basic TM programming language. The computational program performs calculations of monitor units and treatment time, based on the algorithm of manual calculation. The calculations executed for the independent system had initially been compared with the manual calculations performed by the medical physicists of the Institute of Radiotherapy of the Hospital das Clinicas da Universidade de Sao Paulo. In this step, the results found for more than two hundred fields studied were similar to those found in the literature; deviations larger than +- 1% were found only in five cases involving errors in manual calculation. The application of the independent system, in this stage, could have identified errors up to +- 2,4%. Based on these data, the system was validated for use in clinical routine. In a second step, calculations were compared with calculations realized by the treatment computerized planning system CadPIan TM . When, again, the results were similar to those published in other works allowing to obtain levels of acceptance of the discrepancies between the calculations executed for the independent system and the calculations developed from the planning system, separated by anatomical region, as recommended according by the recent literature. For beams of 6 MV, the levels of acceptance for deviations between the calculations of monitor units, separated by treatment region were the following; breast +- 1.7%, head and neck +2%; hypophysis +- 2.2%; pelvis +- 4 . 1% and thorax +- 1.5%. For beams of 15 MV, the level suggested for pelvis was of +- 4.5%. (author)

  3. Study of the efficiency of some water treatment unit that present in houses in Erbil city-Iraq

    Science.gov (United States)

    Toma, Janan. Jabbar.; Hanna, Aveen. Matti.

    2017-09-01

    Many people in Erbil city started more than two decade to put special treatment units in their houses to purified water to become safer for drinking uses. The aim of this study was determine the efficiency of six kind water treatment units which include (two replicate of Crystal Water Purifier, So-Safe Water Filter, R O Water Purifier, Kontec Water Purified and Al-Kawther Purified Water). Water samples were collected in two sites one before and other after treatment unit. Each sample was collect with three replication during May to October-2016. Analyzed for Major cations concentration (calcium, magnesium, sodium and potassium), anions concentration (nitrate and chloride) and hydrogen ion concentration (pH), electrical conductivity (EC), total dissolved solids (TDS), alkalinity and total hardness by using standard methods. The water quality index values for all raw water sample befor and after treatment was good and excellent respectively for drinking purposes. Efficiency of So-Safe Water Filter was 66.32% it means was more efficiency than others special water treatment units while in RO Water Purifier was 27.14%, means less efficiency than other water purifier water under this study. Values for major cations, anions and others chemicals characteristics in the water samples after treatment became lower concentrations than befor treatment, likely an indication that these were removed by treatment. According to guideline of world health organization all of variables except total hardness befor treatment are safe and suitable for drinking purposes.

  4. Digital computer control of a research nuclear reactor

    International Nuclear Information System (INIS)

    Crawford, Kevan

    1986-01-01

    Currently, the use of digital computers in energy producing systems has been limited to data acquisition functions. These computers have greatly reduced human involvement in the moment to moment decision process and the crisis decision process, thereby improving the safety of the dynamic energy producing systems. However, in addition to data acquisition, control of energy producing systems also includes data comparison, decision making, and control actions. The majority of the later functions are accomplished through the use of analog computers in a distributed configuration. The lack of cooperation and hence, inefficiency in distributed control, and the extent of human interaction in critical phases of control have provided the incentive to improve the later three functions of energy systems control. Properly applied, centralized control by digital computers can increase efficiency by making the system react as a single unit and by implementing efficient power changes to match demand. Additionally, safety will be improved by further limiting human involvement to action only in the case of a failure of the centralized control system. This paper presents a hardware and software design for the centralized control of a research nuclear reactor by a digital computer. Current nuclear reactor control philosophies which include redundancy, inherent safety in failure, and conservative yet operational scram initiation were used as the bases of the design. The control philosophies were applied to the power monitoring system, the fuel temperature monitoring system, the area radiation monitoring system, and the overall system interaction. Unlike the single function analog computers that are currently used to control research and commercial reactors, this system will be driven by a multifunction digital computer. Specifically, the system will perform control rod movements to conform with operator requests, automatically log the required physical parameters during reactor

  5. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya

    Directory of Open Access Journals (Sweden)

    Yoshito Kawakatsu

    2017-02-01

    Full Text Available Abstract Background The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW. The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. Methods The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS. In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area’s CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Results Factors significantly associated with a lower prevalence of diarrhea among children under five were the child’s increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Conclusions Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate

  6. Impact of coronary intensive care unit in treatment of myocardial infarction

    Directory of Open Access Journals (Sweden)

    Marcia Cristina Todo

    Full Text Available Summary Introduction: The mortality rate attributed to ST-segment elevation myocardial infarction (STEMI has decreased in the world. However, this disease is still responsible for high costs for health systems. Several factors could decrease mortality in these patients, including implementation of cardiac intensive care units (CICU. The aim of this study was to evaluate the effect of CICU implementation on prescribed recommended treatments and mortality 30 days after STEMI. Method: We performed a retrospective study with patients admitted to CICU between 2005 and 2006 (after group and between 2000 and 2002, before CICU implementation (before group. Results: The after group had 101 patients, while the before group had 143 patients. There were no differences in general characteristics between groups. We observed an increase in angiotensin-converting enzyme inhibitors, clopidogrel and statin prescriptions after CICU implementation. We did not find differences regarding number of patients submitted to reperfusion therapy; however, there was an increase in primary percutaneous angioplasty compared with thrombolytic therapy in the after group. There was no difference in 30-day mortality (before: 10.5%; after: 8.9%; p=0.850, but prescription of recommended treatments was high in both groups. Prescription of angiotensin-converting enzyme inhibitors and beta-blocker decreased mortality risk by 4.4 and 4.9 times, respectively. Conclusion: CICU implementation did not reduce mortality after 30 days in patients with STEMI; however, it increased the prescription of standard treatment for these patients.

  7. Handover of patient information from the crisis assessment and treatment team to the inpatient psychiatric unit.

    Science.gov (United States)

    Waters, Amanda; Sands, Natisha; Keppich-Arnold, Sandra; Henderson, Kathryn

    2015-06-01

    Handover, or the communication of patient information between clinicians, is a fundamental component of health care. Psychiatric settings are dynamic environments relying on timely and accurate communication to plan care and manage risk. Crisis assessment and treatment teams are the primary interface between community and mental health services in many Australian and international health services, facilitating access to assessment, treatment, and admission to hospital. No previous research has investigated the handover between crisis assessment and treatment teams and inpatient psychiatric units, despite the importance of handover to care planning. The aim of the present study was to identify the nature and types of information transferred during these handovers, and to explore how these guides initial care planning. An observational, exploratory study design was used. A 20-item handover observation tool was used to observe 19 occasions of handover. A prospective audit was undertaken on clinical documentation arising from the admission. Clinical information, including psychiatric history and mental state, were handed over consistently; however, information about consumer preferences was reported less consistently. The present study identified a lack of attention to consumer preferences at handover, despite the current focus on recovery-oriented models for mental health care, and the centrality of respecting consumer preferences within the recovery paradigm. © 2014 Australian College of Mental Health Nurses Inc.

  8. Grand Junction projects office mixed-waste treatment program, VAC*TRAX mobile treatment unit process hazards analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, R.R.

    1996-04-01

    The objective of this report is to demonstrate that a thorough assessment of the risks associated with the operation of the Rust Geotech patented VAC*TRAX mobile treatment unit (MTU) has been performed and documented. The MTU was developed to treat mixed wastes at the US Department of Energy (DOE) Albuquerque Operations Office sites. The MTU uses an indirectly heated, batch vacuum dryer to thermally desorb organic compounds from mixed wastes. This process hazards analysis evaluated 102 potential hazards. The three significant hazards identified involved the inclusion of oxygen in a process that also included an ignition source and fuel. Changes to the design of the MTU were made concurrent with the hazard identification and analysis; all hazards with initial risk rankings of 1 or 2 were reduced to acceptable risk rankings of 3 or 4. The overall risk to any population group from operation of the MTU was determined to be very low; the MTU is classified as a Radiological Facility with low hazards.

  9. Grand Junction projects office mixed-waste treatment program, VAC*TRAX mobile treatment unit process hazards analysis

    International Nuclear Information System (INIS)

    Bloom, R.R.

    1996-04-01

    The objective of this report is to demonstrate that a thorough assessment of the risks associated with the operation of the Rust Geotech patented VAC*TRAX mobile treatment unit (MTU) has been performed and documented. The MTU was developed to treat mixed wastes at the US Department of Energy (DOE) Albuquerque Operations Office sites. The MTU uses an indirectly heated, batch vacuum dryer to thermally desorb organic compounds from mixed wastes. This process hazards analysis evaluated 102 potential hazards. The three significant hazards identified involved the inclusion of oxygen in a process that also included an ignition source and fuel. Changes to the design of the MTU were made concurrent with the hazard identification and analysis; all hazards with initial risk rankings of 1 or 2 were reduced to acceptable risk rankings of 3 or 4. The overall risk to any population group from operation of the MTU was determined to be very low; the MTU is classified as a Radiological Facility with low hazards

  10. Statistical Power and Optimum Sample Allocation Ratio for Treatment and Control Having Unequal Costs Per Unit of Randomization

    Science.gov (United States)

    Liu, Xiaofeng

    2003-01-01

    This article considers optimal sample allocation between the treatment and control condition in multilevel designs when the costs per sampling unit vary due to treatment assignment. Optimal unequal allocation may reduce the cost from that of a balanced design without sacrificing any power. The optimum sample allocation ratio depends only on the…

  11. A computer-controlled system for rapid soil analysis of 226Ra

    International Nuclear Information System (INIS)

    Doane, R.W.; Berven, B.A.; Blair, M.S.

    1984-01-01

    A computer-controlled multichannel analysis system has been developed by the Radiological Survey Activities (RASA) Group at Oak Ridge National Laboratory (ORNL) for the Department of Energy (DOE) in support of the DOE's remedial action programs. The purpose of this system is to provide a rapid estimate of the 226 Ra concentration in soil samples using a 6 x 9 inch NaI(T1) crystal containing a 3.25 inch deep by 3.5 inch diameter well. This gamma detection system is controlled by a minicomputer with a dual floppy disk storage medium, line printer, and optional X-Y plotter. A two-chip interface was also designed at ORNL which handles all control signals generated from the computer keyboard. These computer-generated control signals are processed in machine language for rapid data transfer and BASIC language is used for data processing. The computer system is a Commodore Business Machines (CBM) Model 8032 personal computer with CBM peripherals. Control and data signals are utilized via the parallel user's port to the interface unit. The analog-to-digital converter (ADC) is controlled in machine language, bootstrapped to high memory, and is addressed through the BASIC program. The BASIC program is designed to be ''user friendly'' and provides the operator with several modes of operation such as background and analysis acquisition. Any number of energy regions-of-interest (ROI) may be analyzed with automatic background substraction. Also employed in the BASIC program are the 226 Ra algorithms which utilize linear and polynomial regression equations for data conversion and look-up tables for radon equilibrating coefficients. The optional X-Y plotter may be used with two- or three-dimensional curve programs to enhance data analysis and presentation. A description of the system is presented and typical applications are discussed

  12. Case study: evaluation of the performance of water treatment units by the use of tracer techniques

    International Nuclear Information System (INIS)

    Sebastian, C.; Maghella, G.; Mamani, E.

    2000-12-01

    Very often, water treatment systems do not reach the expected performance due to disturbances of hydraulic order, which cause malfunctioning in the flow through such systems. Tracer techniques have proved to be very useful to obtain information on the system or a part of it, by means of observation of the released tracer or observation of the released tracer during its progress into the system or at the output of the same. This paper is a report of the behavior of a set of both sand settlement unit and hydraulic flocculators in a potable water plant, through the analysis of radiotracers response curves or residence time distribution curves. The tracers released into the system consists in an aqueous solution of Iodine-131 with very low activity, in order to get a dynamic behave similar to the one of the fluid under investigation

  13. Combining Follicular Unit Extraction and Scalp Micropigmentation for the Cosmetic Treatment of Alopecias

    Directory of Open Access Journals (Sweden)

    William Rassman, MD

    2017-11-01

    Full Text Available Two relatively new modalities, follicular unit extraction (FUE and scalp micropigmentation have changed the treatment of hair loss, to reduce the number of procedures and the total costs of the hair restoration process. These 2 modalities augment each other when treating patients with thinning hair and balding. The explosion of FUE procedures (which reflected 52.6% of the hair transplant procedures performed in 2016, up from 48.5% and the appearance of more and more new physicians offering hair restoration technologies employing FUE have caused a 20% annual growth in this industry over the past few years. This article reviews the use of FUE and scalp micropigmentation when used in combination.

  14. Radionuclides release to three rivers by ore treatment unit at Caldas, Minas Gerais - Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, W.S.; Carmo, R.F. do; Py Junior, D.A., E-mail: pereiraws@gmail.com [Industrias Nucleares do Brasil (INB), Pocos de Caldas, MG (Brazil). Unidade de Tratamento de Minerio. Grupo Multidisciplinar de Radioprotecao; Kelecom, A., E-mail: akelecom@id.uff.br [Universidade Federal Fluminense (LARARA-PLS/GETA/UFF), Niteroi, RJ (Brazil). Laboratorio de Radiobiologia e Radiometria Pedro Lopes dos Santos. Grupo de Estudos em Temas Ambientais; Pereira, J.R.S., E-mail: pereirarsj@gmail.com [Universidade Federal de Alfenas (UNIFAL), Pocos de Caldas, MG (Brazil)

    2013-07-01

    The Ore Treatment Unit (OTU) is a uranium mining and milling plant, situated at Caldas city, Minas Gerais, Brazil that was disabled in the mid 90's. This unit releases controlled effluents to three rivers: Ribeirao das Antas (at point 014, influenced by the waste pile), Ribeirao Soberbo (point 025, influenced by the waste pond) and Corrego da Consulta (at point 076, influenced by the open pit mine). Water samples collected at these points were analyzed for U{sub nat}, {sup 226}Ra, {sup 210}Pb, {sup 232}Th and {sup 228}Ra content in the particulate and soluble fractions, and the behavior of radionuclide releases and their fractions was investigated. U{sub nat} and {sup 228}Ra showed identical behaviors at these three points. U{sub nat} at point 014 (waste pile) behaved different from described in recent literature data. The isotopes of Ra should exhibit the same behavior at each point, but this was not observed at point 025 (waste pond). {sup 232}Th release showed equal activity concentration near the waste pile (point 014) and near the waste pond (point 025), whilst near the open pit mine (point 076) the soluble fraction showed a concentration of activity greater than the particulate fraction. Finally, {sup 210}Pb showed a different behavior at each point. Due to the great differences in behaviors of each radionuclide, it was not possible to establish a temporal pattern of release which requires assessment over a longer period of time. (author)

  15. Radionuclides release to three rivers by ore treatment unit at Caldas, Minas Gerais - Brazil

    International Nuclear Information System (INIS)

    Pereira, W.S.; Carmo, R.F. do; Py Junior, D.A.

    2013-01-01

    The Ore Treatment Unit (OTU) is a uranium mining and milling plant, situated at Caldas city, Minas Gerais, Brazil that was disabled in the mid 90's. This unit releases controlled effluents to three rivers: Ribeirao das Antas (at point 014, influenced by the waste pile), Ribeirao Soberbo (point 025, influenced by the waste pond) and Corrego da Consulta (at point 076, influenced by the open pit mine). Water samples collected at these points were analyzed for U nat , 226 Ra, 210 Pb, 232 Th and 228 Ra content in the particulate and soluble fractions, and the behavior of radionuclide releases and their fractions was investigated. U nat and 228 Ra showed identical behaviors at these three points. U nat at point 014 (waste pile) behaved different from described in recent literature data. The isotopes of Ra should exhibit the same behavior at each point, but this was not observed at point 025 (waste pond). 232 Th release showed equal activity concentration near the waste pile (point 014) and near the waste pond (point 025), whilst near the open pit mine (point 076) the soluble fraction showed a concentration of activity greater than the particulate fraction. Finally, 210 Pb showed a different behavior at each point. Due to the great differences in behaviors of each radionuclide, it was not possible to establish a temporal pattern of release which requires assessment over a longer period of time. (author)

  16. ICEMENERG technologies of water treatment applied at Cernavoda NPP Unit 1

    International Nuclear Information System (INIS)

    Stanca, Angela; Bolma, Aurelia; Serbanescu, Agnes; Raducanu, Alice

    2002-01-01

    The paper presents the ICEMENERG technologies for water treatment applied at Cernavoda Unit 1, the treatment of the additional water for power steam generators and the chemical treatment of cooling system water. The requirements for quality of water totally demineralized as imposed by the AECL-ANSALDO consortium are as following: electrical conductivity, < 0.2 mS/cm; total silicon, <0.02 mg/L; ionic silicon, <0.01 mg/L; sodium, < 0.05 mg/L; TOC, <0.300 mg/L. These requirements raise rather difficult problems to be solved because the raw water source in case of Cernavoda NPP is Danube River which presents a raising trend of organic and inorganic contamination. Accordingly, experiments at laboratory scale reproducing the entire technological flow were conducted. The following operations were studied: pretreatment with limewash, ferric chloride (with and without coagulation additives); demineralization with ion exchangers of Purolite and Amberlite types. The system consisted of a cationic stage, formed of an strongly acid step with countercurrent recovery and an anionic stage formed of two steps, namely, a weakly basic step and a strongly basic step with recovery inserted; finishing on mixed bed. The paper presents also the chemical treatment/conditioning of the cooling loop of turbine condenser. The Cernavoda NPP cooling system is an open system with a single flow of cooling water comprising two systems, namely, the circulation water system ensuring the steam condenser cooling and the servicing water system ensuring the cooling of heat exchangers in the recirculated water circuit (RCWS), the turbine oil coolants, the coolants of auxiliary steam as well as the emergency core cooling system. Studies were conducted to ensure the chemical conditioning of the raw water from Danube River, particularly, to destroy and remove the shells, the algae and other components. Finally, the following four steps of conditioning the water of the cooling system are summarized: 1

  17. Sorption-reagent treatment of brines produced by reverse osmosis unit for liquid radioactive waste management

    International Nuclear Information System (INIS)

    Avramenko, V. A.; Zheleznov, V. V.; Sergienko, V. I.; Chizhevsky, I. Yu

    2003-01-01

    The results of the pilot plant tests (2002-2003) of the sorption-reagent decontamination of high salinity radioactive waste (brines) remaining after the low-salinity liquid radioactive waste (LRW) treatment in the reverse-osmosis unit from long-lived radionuclides are presented. The sorption-reagent materials used in this work were developed in the Institute of Chemistry FEDRAS. They enable one to decontaminate brines with total salt content up to 50 g/l from long-lived radionuclides of Cs, Sr and Co. At joint application of the reverse-osmosis and sorption-reagent technologies total volume of solid radioactive waste (SRW) decreases up to 100-fold as compared to the technology of cementation of reverse osmosis brines. In this case total cost of LRW treatment and SRW disposal decreases more than 10-fold. Brines decontaminated from radionuclides are then diluted down to the ecologically safe total salts content in water to be disposed of. Tests were performed to compare the efficiency of technologies including evaporation of brines remaining after reverse osmosis process and their decontamination by means of the sorption-reagent method. It was shown that, as compared to evaporation, the sorption-reagent technology provides substantial advantages as in regard to radioactive waste total volume reduction as in view of total cost of the waste management

  18. An investigation of the air dispersion characteristics of refinery land treatment units

    International Nuclear Information System (INIS)

    Brewer, K.R.; Zaizhong Wang; Lupo, M.J.

    1991-01-01

    Numerical simulations of air emission and dispersion of volatile organic waste constituents from the land treatment units (LTU's) of four refineries were performed using the ISCST model. Particular attention was given to benzene. In order to realistically model the area pollutant source, each LTU had to be subdivided into smaller cells and the cell concentrations summed. The emission rate of the waste from the LTU's, one of the key inputs to the dispersion model, was periodically adjusted to reflect the rapid decay in rate following waste application. Meteorological conditions were found to be significant in determining boundary concentrations. The specific meteorological conditions most favorable for dispersion were investigated. The results of these simulations showed that mixing height is only minimally important in the dispersion of wastes from LTU's as currently regulated by EPA. Wind speed and variation of wind direction were both more important in atmospheric mixing of the volatile waste. It was found that care should be exercised in attempting to correlate any single meteorological parameter with favorable periods for land treatment. In comparisons of the cases, the results suggest that differences in LTU geometry may also be important in the modeling of long-term pollutant concentrations. Model simulations were performed to ascertain the impact of LTU geometry on boundary concentration

  19. Independent verification of monitor unit calculation for radiation treatment planning system.

    Science.gov (United States)

    Chen, Li; Chen, Li-Xin; Huang, Shao-Min; Sun, Wen-Zhao; Sun, Hong-Qiang; Deng, Xiao-Wu

    2010-02-01

    To ensure the accuracy of dose calculation for radiation treatment plans is an important part of quality assurance (QA) procedures for radiotherapy. This study evaluated the Monitor Units (MU) calculation accuracy of a third-party QA software and a 3-dimensional treatment planning system (3D TPS), to investigate the feasibility and reliability of independent verification for radiation treatment planning. Test plans in a homogenous phantom were designed with 3-D TPS, according to the International Atomic Energy Agency (IAEA) Technical Report No. 430, including open, blocked, wedge, and multileaf collimator (MLC) fields. Test plans were delivered and measured in the phantom. The delivered doses were input to the QA software and the independent calculated MUs were compared with delivery. All test plans were verified with independent calculation and phantom measurements separately, and the differences of the two kinds of verification were then compared. The deviation of the independent calculation to the measurements was (0.1 +/- 0.9)%, the biggest difference fell onto the plans that used block and wedge fields (2.0%). The mean MU difference between the TPS and the QA software was (0.6 +/- 1.0)%, ranging from -0.8% to 2.8%. The deviation in dose of the TPS calculation compared to the measurements was (-0.2 +/- 1.7)%, ranging from -3.9% to 2.9%. MU accuracy of the third-party QA software is clinically acceptable. Similar results were achieved with the independent calculations and the phantom measurements for all test plans. The tested independent calculation software can be used as an efficient tool for TPS plan verification.

  20. New Conceptual Model for Soil Treatment Units: Formation of Multiple Hydraulic Zones during Unsaturated Wastewater Infiltration.

    Science.gov (United States)

    Geza, Mengistu; Lowe, Kathryn S; Huntzinger, Deborah N; McCray, John E

    2013-07-01

    Onsite wastewater treatment systems are commonly used in the United States to reclaim domestic wastewater. A distinct biomat forms at the infiltrative surface, causing resistance to flow and decreasing soil moisture below the biomat. To simulate these conditions, previous modeling studies have used a two-layer approach: a thin biomat layer (1-5 cm thick) and the native soil layer below the biomat. However, the effect of wastewater application extends below the biomat layer. We used numerical modeling supported by experimental data to justify a new conceptual model that includes an intermediate zone (IZ) below the biomat. The conceptual model was set up using Hydrus 2D and calibrated against soil moisture and water flux measurements. The estimated hydraulic conductivity value for the IZ was between biomat and the native soil. The IZ has important implications for wastewater treatment. When the IZ was not considered, a loading rate of 5 cm d resulted in an 8.5-cm ponding. With the IZ, the same loading rate resulted in a 9.5-cm ponding. Without the IZ, up to 3.1 cm d of wastewater could be applied without ponding; with the IZ, only up to 2.8 cm d could be applied without ponding. The IZ also plays a significant role in soil moisture distribution. Without the IZ, near-saturation conditions were observed only within the biomat, whereas near-saturation conditions extended below the biomat with the IZ. Accurate prediction of ponding is important to prevent surfacing of wastewater. The degree of water and air saturation influences pollutant treatment efficiency through residence time, volatility, and biochemical reactions. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  1. Investigation of Accelerated Partial Breast Patient Alignment and Treatment With Helical Tomotherapy Unit

    International Nuclear Information System (INIS)

    Langen, Katja M.; Buchholz, Daniel J.; Burch, Doug R. C.; Burkavage, Rob C.; Limaye, Arti U.; Meeks, Sanford L.; Kupelian, Patrick A.; Ruchala, Kenneth J.; Haimerl, Jason; Henderson, Doug; Olivera, Gustavo H.

    2008-01-01

    Purpose: To determine the precision of megavoltage computed tomography (MVCT)-based alignment of the seroma cavity for patients undergoing partial breast irradiation; and to determine whether accelerated partial breast irradiation (APBI) plans can be generated for TomoTherapy deliveries that meet the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol guidelines for target coverage and normal tissue dose limitations. Methods and Materials: We obtained 50 MVCT images from 10 patients. An interuser study was designed to assess the alignment precision. Using a standard helical and a fixed beam prototype ('topotherapy') optimizer, two APBI plans for each patient were developed. Results: The precision of the MVCT-based seroma cavity alignment was better than 2 mm if averaged over the patient population. Both treatment techniques could be used to generate acceptable APBI plans for patients that fulfilled the recommended NSABP B-39/RTOG-0413 selection criteria. For plans of comparable treatment time, the conformation of the prescription dose to the target was greater for helical deliveries, while the ipsilateral lung dose was significantly reduced for the topotherapy plans. Conclusions: The inherent volumetric imaging capabilities of a TomoTherapy Hi-Art unit allow for alignment of patients undergoing partial breast irradiation that is determined from the visibility of the seroma cavity on the MVCT image. The precision of the MVCT-based alignment was better than 2 mm (± standard deviation) when averaged over the patient population. Using the NSABP B-39/RTOG-0413 guidelines, acceptable APBI treatment plans can be generated using helical- or topotherapy-based delivery techniques

  2. Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea - STD Surveillance Network, United States, 2016.

    Science.gov (United States)

    Weston, Emily J; Workowski, Kimberly; Torrone, Elizabeth; Weinstock, Hillard; Stenger, Mark R

    2018-04-27

    Gonorrhea, the sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, is the second most common notifiable disease in the United States after chlamydia; 468,514 cases were reported to state and local health departments in 2016, an increase of 18.5% from 2015 (1). N. gonorrhoeae has progressively developed resistance to most antimicrobials used to treat the infection (2). As a result, CDC recommends two antimicrobials (250 mg of ceftriaxone [IM] plus 1 g of azithromycin [PO]) for treating uncomplicated gonorrhea to improve treatment efficacy and, potentially, to slow the emergence and spread of antimicrobial resistance. To monitor adherence to the current CDC-recommended regimen for uncomplicated gonorrhea, CDC reviewed enhanced data collected on a random sample of reported cases of gonorrhea in seven jurisdictions participating in the STD Surveillance Network (SSuN) and estimated the proportion of patients who received the CDC-recommended regimen for uncomplicated gonorrhea, by patient characteristics and diagnosing facility type. In 2016, the majority of reported patients with gonorrhea (81%) received the recommended regimen. There were no differences in the proportion of patients receiving the recommended regimen by age or race/ethnicity; however, patients diagnosed with gonorrhea in STD (91%) or family planning/reproductive health (94%) clinics were more likely to receive this regimen than were patients diagnosed in other provider settings (80%). These data document high provider adherence to CDC gonorrhea treatment recommendations in specialty STD clinics, indicating high quality of care provided in those settings. Local and state health departments should monitor adherence with recommendations in their jurisdictions and consider implementing interventions to improve provider and patient compliance with gonorrhea treatment recommendations where indicated.

  3. Screening and treatment for short cervical length in pregnancy: a physician survey in the United States.

    Science.gov (United States)

    Martell, Bridget; DiBenedetti, Dana B; Weiss, Herman; Zhou, Xiaolei; Reynolds, Maria; Berghella, Vincenzo; Hassan, Sonia S

    2018-03-01

    To evaluate how physicians in the United States (US) screen for, define, and treat a short cervix to prevent preterm birth. This was a cross-sectional, web-based survey of 500 physicians treating pregnant patients with a short cervix in the US. Respondents' geographic region was monitored to ensure balance across the nine US Census divisions. Respondents were predominantly obstetrician/gynecologists (86%, 429/500; mean age 49 years). Physicians reported that a median of 90% of their pregnant patients undergo cervical length screening; 81% (407/500) use transvaginal ultrasound. Physicians consult multiple evidence sources to inform their patient care, most commonly clinical guidelines (83%; 413/500) and published research (70%; 349/500). Most physicians (98%; 490/500) reported treating pregnant patients with a short cervix; 95% (474/500) use synthetic and/or natural progestogen, alone or in combination with other treatment modalities. If reimbursement was not a concern, 47% of physicians (230/500) would choose vaginal progesterone as their preferred treatment to prevent preterm birth in all patients with a short cervix, and 45% (218/500) would choose a synthetic progestogen. US guidelines recommend transvaginal ultrasound for cervical length screening; 81% of physicians in this study reported using this method. Most physicians surveyed use progestogens to treat a short cervix, with approximately half choosing a synthetic progestin (45%) and half choosing natural progesterone (47%) as their preferred treatment, despite national guidelines recommending only vaginal natural progesterone for this indication. Additional physician education is required to implement current and best practices.

  4. Computer-controlled gamma-ray scanner for irradiated reactor fuel

    International Nuclear Information System (INIS)

    Mandler, J.W.; Coates, R.A.; Killian, E.W.

    1979-01-01

    Gamma-ray scanning of irradiated fuel is an important nondestructive technique used in the thermal fuels behavior program currently under way at the Idaho National Engineering Laboratory. This paper is concerned with the computer-controlled isotopic gamma-ray-scanning system developed for postirradiation examination of fuel and includes a brief discussion of some scan results obtained from fuel rods irradiated in the Power-Burst Facility to illustrate gamma-ray spectrometry for this application. Both burnup profiles and information concerning fission-product migration in irradiated fuel are routinely obtained with the computer-controlled system

  5. Knee temperatures measured in vivo after arthroscopic ACL reconstruction followed by cryotherapy with gel-packs or computer controlled heat extraction.

    Science.gov (United States)

    Rashkovska, Aleksandra; Trobec, Roman; Avbelj, Viktor; Veselko, Matjaž

    2014-09-01

    To obtain in vivo data about intra- and extra-articular knee temperatures to assess the effectiveness of two cryotherapeutic methods-conventional cooling with gel-packs and computer controlled cryotherapy following anterior cruciate ligament (ACL) reconstructive surgery. Twenty patients were arbitrarily assigned for cryotherapy after ACL reconstruction: 8 patients with frozen gel-packs and 12 patients with computer controlled cryotherapy with constant temperatures of the cooling liquid in the knee pads. The treatment was performed for 12 h. Temperatures were measured with two thermo sensors in catheters placed intraarticularly and subcutaneously, four sensors on the skin and one sensor under protective bandage, every second for 16 h after surgery. In the first 2 h of treatment, there were no significant differences (n.s.) between the groups in temperatures in the intracondylar notch. After 4 h of cryotherapy, the temperatures were significantly lower on the skin (24.6 ± 2.8 and 31.4 ± 1.3 °C, p cryotherapy group compared to the gel-pack group. The cooling effect of the arthroscopy irrigation fluid on the knee temperature is evident in the first 2 h of treatment. The energy extraction is significantly more effective and controllable by computer controlled cryotherapy than with frozen gel-packs. Prospective comparative study, Level II.

  6. Closure plan for the Test Area North-726 chromate water storage and Test Area North-726A chromate treatment units

    International Nuclear Information System (INIS)

    Smith, P.J.; Van Brunt, K.M.

    1992-11-01

    This document describes the proposed plan for closure of the Test Area North-726 chromate water storage and Test Area North-726A chromate treatment units at the Idaho National Engineering Laboratory in accordance with the Resource Conservation and Recovery Act interim status closure requirements. The location, size, capacity, and history of the units are described, and their current status is discussed. The units will be closed by treating remaining waste in storage, followed by thorough decontamination of the systems. Sufficient sampling and analysis, and documentation of all activities will be performed to demonstrate clean closure

  7. Evaluation of eleven years of area monitoring in ore treatment unit: I external exposure

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, W.S.; Py Junior, D.A.; Oliveira, S.Q. de; Dantas, M.V.A., E-mail: pereiraws@gmail.com [Industrias Nucleares do Brasil (INB), Pocos de Caldas, MG (Brazil). Unidade de Tratamento de Minerio. Grupo Multidisciplinar de Radioprotecao; Kelecom, A., E-mail: akelecom@id.uff.br [Universidade Federal Fluminense (LARARA-PLS/GETA/UFF), Niteroi, RJ (Brazil). Laboratorio de Radiobiologia e Radiometria Pedro Lopes dos Santos. Grupo de Estudos em Temas Ambientais; Pereira, J.R.S., E-mail: pereirarsj@gmail.com [Universidade Federal de Alfenas (UNIFAL), Pocos de Caldas, MG (Brazil)

    2013-07-01

    The Ore Treatment Unit (OTU) is an uranium mining and milling complex deactivated in 1995 that operated monazite during the years 2004 and 2005 in a plant used especially for that purpose called Chemical Treatment of Monazite (CTM). This study aims to analyze the monitoring of area to exposure rate from 2002 to 2012, comparing periods of suspended operation of OTU and identifying the influences of CTM and of the radioactive waste deposit, from other facilities of OTU. A total of 22,294 samples were analyzed for area dose rates; average values were obtained of 6.74 μSv h{sup -1} with an amplitude from 0 to 420 μSv h{sup -1}. 92% of the monitoring were below the derivative limit for workers, and 1,702 monitoring samples showed values above this limit. Ignoring the monitoring that was realized at CTM and at the deposit of radioactive waste, the number of monitoring samples were reduced to 1,341. In this case, the average reduces to 0.96 μSv h{sup -1}, going from 0 to 25 μSv h{sup -1}, only 15 samples remained above the threshold for workers and 675 samples were below the limit for individual public. It can be concluded that the OTU is an installation with nearly 99% of monitoring area safe for workers and 50% for individual public. The inclusion of new practices (CTM) and the deposit of radioactive waste coming from other facilities alter this picture dramatically, increased the dose rates. (author)

  8. Stroke treatment in Stroke Unit: from scientific evidences to clinical practice

    Directory of Open Access Journals (Sweden)

    Michele Stornello

    2013-04-01

    Full Text Available Background: In themanagement of stroke disease, evidences fromthe literature demonstrate that the introduction of stroke units, hospital wards with dedicated beds providing intensive care within 48 hours of symptoms’ onset, produced a real improvement in the outcome, reducing in-hospital fatality cases and increasing the proportion of patients independently living in long term follow-up. Discussion: The article focuses on stroke disease-management, suggesting a stroke integrated approach for the admission of patients on dedicated beds, in order to extend the ‘‘stroke care’’ approach outcomes to as many hospitals as possible in Italy. This approach implies the set up of a stroke network for an effective patients’ stratification according to the severity of the illness at debut; the set up of an integrated team of specialists in hospital management of the acute phase (first 48 hours and a timely rehabilitation treatment. Ultimately the hospital should be organized according to department’s semi-intensive areas in order to assure to the patients, in the early stage of the disease, a timely high intensity care aimed to improve the long term outcome.

  9. Firewater Storage, Treatment, Recycling and Management: New Perspectives Based on Experiences from the United Kingdom

    Directory of Open Access Journals (Sweden)

    Miklas Scholz

    2014-02-01

    Full Text Available Smart firewater management and recycling helps reduce water use and protect the environment from pollution. However, contamination of recycled water may pose a health risk to fire fighters. This review assesses international literature to identify best practices, and to recommend new technologies and methods on firewater management and recycling. The literature assessment indicates that this is a new research area where insufficient findings have been published in Web of Science-referenced journals. Therefore, informally published materials (a.k.a. grey literature were also assessed. Findings indicate the need for practical decision support tools to estimate consumption rates, predict “bottlenecks” and bund capacity, assess water quality and determine pump requirements. This article recommends that cost-efficient and rapid on-site treatment methods, such as compact and mobile filtration units for firewater recycling should be researched in the future. The filters should be based on compartments with different media. The empty pore space should decrease from inflow to outflow. A light plastic media should be positioned near the inflow to retain large particles, such as a grid. Activated carbon media could be placed near the outlet to remove fine suspended solids and dissolved contaminants. This should address concerns by fire fighters dealing with contaminated water, spray and foam.

  10. Dose in sensitive organs during the prostate treatment with a 60Co unit

    International Nuclear Information System (INIS)

    Vega C, H. R.; Navarro B, J. A.; Perez A, M. L.; Perez L, L. H.

    2012-10-01

    The absorbed dose by the bladder, the rectum and the gland thyroid was measured during a treatment applied for prostate cancer by means of a Cobalt 60 unit. The dose was measured using thermoluminescent dosimeters of the type TLD 100, with the values of the absorbed the values of the effective dose were calculated and was determined the probability of the development of a secondary cancer. Because these measurements cannot be made -in vivo- a phantom or mannequin was built with water that represents the hip and part of the torso of the human body and to represent the neck was used polyethylene. The study was carried out in the Instituto Zacatecano del Tumor that has a -cobalt bomb- which is used to treat oncology patients, during the phantom irradiation a dose of 200 c Gy was applied of this dose the bladder received 96.7%, the rectum 100.8% and the gland thyroid 0.3%. The dose received by the rectum and the bladder is due to the therapeutic beam while the dose received by the thyroid is due to the dispersed radiation by the phantom. The probability that in these organs a new neoplasm is developed is of 0.033% for the bladder, 0.157% for the rectum and 7.8 x 10 -5 % for the thyroid case. (Author)

  11. Neonatal circumcision in severe haemophilia: a survey of paediatric haematologists at United States Hemophilia Treatment Centers.

    Science.gov (United States)

    Kearney, S; Sharathkumar, A; Rodriguez, V; Chitlur, M; Valentino, L; Boggio, L; Gill, J

    2015-01-01

    Neonatal circumcision in patients with severe haemophilia has not been well studied. We performed a survey of paediatric haematologists from Hemophilia Treatment Centers (HTC) across the United States to better understand the attitudes toward and management of neonatal circumcision in haemophilia patients. Response rate to our survey was 40% (n = 64/159). Thirty-eight percent of respondents (n = 24) said that they would allow this procedure in the newborn period but in many cases this was against medical advice. The most reported concern regarding neonatal circumcision in haemophilia patients was the risk of development of an inhibitor (n = 25; 39%) followed by the concern for bleeding (n = 22; 34%) and issues related to vascular access in the neonate (n = 11; 17%). All respondents recommended at least one preprocedure dose of factor replacement. Twenty-two percent (n = 14) of respondents did not use more than one dose of factor replacement but 32% (n = 21) used 1-2 postoperative doses. The remainder of paediatric haematologists surveyed recommended between 3-5 (16%; n = 10) and 6-10 (3%, n = 2) additional days postoperatively. There was wide variation in both techniques of circumcision as well as adjuvant haemostatic agents used. Only 22% of respondents said that they had an established protocol for management of circumcision in the newborn haemophilia patient. These survey results highlight the need for evidence-based guidelines regarding the optimal management of circumcision in neonates with severe haemophilia. © 2014 John Wiley & Sons Ltd.

  12. Computer control system of the cooler-synchrotron TARN-II

    International Nuclear Information System (INIS)

    Watanabe, S.; Watanabe, T.; Yoshizawa, M.; Katayama, T.

    1993-11-01

    The client-server model enables us to develop the flexible control system such as a TARN-II computer control system. The system forms a single machine including a message bus to communicate between them. An auxiliary control path in the client-server model serves a high speed device control. The configuration and performance of that control system are described. (author)

  13. Computer control system for sup 6 sup 0 Co industrial DR nondestructive testing system

    CERN Document Server

    Chen Hai Jun

    2002-01-01

    The author presents the application of sup 6 sup 0 Co industrial DR nondestructive testing system, which including the control of step-motor, electrical protection, computer monitor program. The computer control system has good performance, high reliability and cheap expense

  14. Computer-controlled mechanical lung model for application in pulmonary function studies

    NARCIS (Netherlands)

    A.F.M. Verbraak (Anton); J.E.W. Beneken; J.M. Bogaard (Jan); A. Versprille (Adrian)

    1995-01-01

    textabstractA computer controlled mechanical lung model has been developed for testing lung function equipment, validation of computer programs and simulation of impaired pulmonary mechanics. The construction, function and some applications are described. The physical model is constructed from two

  15. In-line instrumentation and computer-controlled process supervision in reprocessing

    International Nuclear Information System (INIS)

    Mache, H.R.; Groll, P.

    Measuring equipment is needed for continuous monitoring of concentration in radioactive process solutions. A review is given of existing in-line apparatus and of computer-controlled data processing. A process control system is described for TAMARA, a model extraction facility for the U/HNO 3 /TBP system

  16. Computer control versus manual control of systemic hypertension during cardiac surgery

    NARCIS (Netherlands)

    Hoeksel, S.A.A.P.; Blom, J.A.; Jansen, J.R.C.; Maessen, J.G.; Schreuder, J.J.

    2001-01-01

    Keywords:Cardiac surgery;hypertension;closed-loop controlBackground: We recently demonstrated the feasibility of computer controlled infusion of vasoactive drugs for the control of systemic hypertension during cardiac surgery. The objective of the current study was to investigate the effects of

  17. Intraosseous anesthesia using a computer-controlled system during non-surgical periodontal therapy (root planing): Two case reports.

    Science.gov (United States)

    Han, Keumah; Kim, Jongbin

    2018-02-01

    Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.

  18. Status of the National Ignition Facility Integrated Computer Control System (ICCS) on the Path to Ignition

    International Nuclear Information System (INIS)

    Lagin, L J; Bettenhauasen, R C; Bowers, G A; Carey, R W; Edwards, O D; Estes, C M; Demaret, R D; Ferguson, S W; Fisher, J M; Ho, J C; Ludwigsen, A P; Mathisen, D G; Marshall, C D; Matone, J M; McGuigan, D L; Sanchez, R J; Shelton, R T; Stout, E A; Tekle, E; Townsend, S L; Van Arsdall, P J; Wilson, E F

    2007-01-01

    The National Ignition Facility (NIF) at the Lawrence Livermore National Laboratory is a stadium-sized facility under construction that will contain a 192-beam, 1.8-Megajoule, 500-Terawatt, ultraviolet laser system together with a 10-meter diameter target chamber with room for multiple experimental diagnostics. NIF is the world's largest and most energetic laser experimental system, providing a scientific center to study inertial confinement fusion (ICF) and matter at extreme energy densities and pressures. NIF's laser beams are designed to compress fusion targets to conditions required for thermonuclear burn, liberating more energy than required to initiate the fusion reactions. NIF is comprised of 24 independent bundles of 8 beams each using laser hardware that is modularized into more than 6,000 line replaceable units such as optical assemblies, laser amplifiers, and multifunction sensor packages containing 60,000 control and diagnostic points. NIF is operated by the large-scale Integrated Computer Control System (ICCS) in an architecture partitioned by bundle and distributed among over 800 front-end processors and 50 supervisory servers. NIF's automated control subsystems are built from a common object-oriented software framework based on CORBA distribution that deploys the software across the computer network and achieves interoperation between different languages and target architectures. A shot automation framework has been deployed during the past year to orchestrate and automate shots performed at the NIF using the ICCS. In December 2006, a full cluster of 48 beams of NIF was fired simultaneously, demonstrating that the independent bundle control system will scale to full scale of 192 beams. At present, 72 beams have been commissioned and have demonstrated 1.4-Megajoule capability of infrared light. During the next two years, the control system will be expanded to include automation of target area systems including final optics, target positioners and

  19. Status of the National Ignition Facility Integrated Computer Control System (ICCS) on the path to ignition

    International Nuclear Information System (INIS)

    Lagin, L.J.; Bettenhausen, R.C.; Bowers, G.A.; Carey, R.W.; Edwards, O.D.; Estes, C.M.; Demaret, R.D.; Ferguson, S.W.; Fisher, J.M.; Ho, J.C.; Ludwigsen, A.P.; Mathisen, D.G.; Marshall, C.D.; Matone, J.T.; McGuigan, D.L.; Sanchez, R.J.; Stout, E.A.; Tekle, E.A.; Townsend, S.L.; Van Arsdall, P.J.

    2008-01-01

    The National Ignition Facility (NIF) at the Lawrence Livermore National Laboratory is a stadium-sized facility under construction that will contain a 192-beam, 1.8-MJ, 500-TW, ultraviolet laser system together with a 10-m diameter target chamber with room for multiple experimental diagnostics. NIF is the world's largest and most energetic laser experimental system, providing a scientific center to study inertial confinement fusion (ICF) and matter at extreme energy densities and pressures. NIF's laser beams are designed to compress fusion targets to conditions required for thermonuclear burn, liberating more energy than required to initiate the fusion reactions. NIF is comprised of 24 independent bundles of eight beams each using laser hardware that is modularized into more than 6000 line replaceable units such as optical assemblies, laser amplifiers, and multi-function sensor packages containing 60,000 control and diagnostic points. NIF is operated by the large-scale Integrated Computer Control System (ICCS) in an architecture partitioned by bundle and distributed among over 800 front-end processors and 50 supervisory servers. NIF's automated control subsystems are built from a common object-oriented software framework based on CORBA distribution that deploys the software across the computer network and achieves interoperation between different languages and target architectures. A shot automation framework has been deployed during the past year to orchestrate and automate shots performed at the NIF using the ICCS. In December 2006, a full cluster of 48 beams of NIF was fired simultaneously, demonstrating that the independent bundle control system will scale to full scale of 192 beams. At present, 72 beams have been commissioned and have demonstrated 1.4-MJ capability of infrared light. During the next 2 years, the control system will be expanded in preparation for project completion in 2009 to include automation of target area systems including final optics

  20. Processes for CO2 capture. Context of thermal waste treatment units. State of the art. Extended abstract

    International Nuclear Information System (INIS)

    Lopez, A.; Roizard, D.; Favre, E.; Dufour, A.

    2013-01-01

    For most of industrial sectors, Greenhouse Gases (GHG) such as carbon dioxide (CO 2 ) are considered as serious pollutants and have to be controlled and treated. The thermal waste treatment units are part of industrial CO 2 emitters, even if they represent a small part of emissions (2,5 % of GHG emissions in France) compared to power plants (13 % of GHG emissions in France, one third of worldwide GHG emissions) or shaper industries (20 % of GHG emissions in France). Carbon Capture and Storage (CCS) can be a solution to reduce CO 2 emissions from industries (power plants, steel and cement industries...). The issues of CCS applied to thermal waste treatment units are quite similar to those related to power plants (CO 2 flow, flue gas temperature and pressure conditions). The problem is to know if the CO 2 produced by waste treatment plants can be captured thanks to the processes already available on the market or that should be available by 2020. It seems technically possible to adapt CCS post-combustion methods to the waste treatment sector. But on the whole, CCS is complex and costly for a waste treatment unit offering small economies of scale. However, regulations concerning impurities for CO 2 transport and storage are not clearly defined at the moment. Consequently, specific studies must be achieved in order to check the technical feasibility of CCS in waste treatment context and clearly define its cost. (authors)

  1. Supply of essential drugs in units specialized in the treatment of chronic diseases in Mexico in 2012

    Directory of Open Access Journals (Sweden)

    David Contreras-Loya

    2013-11-01

    Full Text Available Objective. To quantify the supply of essential drugs and the fully filled-in prescription level in the Units Specialized in the Treatment of Chronic Diseases (UNEMES-EC in Mexico. Materials and methods. The supply and prescription indicators were measured in 30 of the 86 existing UNEMES-EC. The supply of drugs was recorded using a list of 17 essential drugs related to the treatment of diabetes, hypertension, overweight and obesity. The information on fully filled-in prescriptions was obtained through a questionnaire applied to 1 200 health care users. Results. Only 13.3% of these units showed a complete supply of the 17 essential drugs: Supply levels were higher in units with external drugstore service. 35% of the interviewed patients reported out-of-pocket expenditures in medicines. Conclusion. UNEMES-EC should improve their levels of drug supply and fully filled-in prescriptions to reduce out-of-pocket expenditures.

  2. Predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime cannabis use disorder in the United States.

    Science.gov (United States)

    Kerridge, Bradley T; Mauro, Pia M; Chou, S Patricia; Saha, Tulshi D; Pickering, Roger P; Fan, Amy Z; Grant, Bridget F; Hasin, Deborah S

    2017-12-01

    To present information on predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime DSM-5 cannabis use disorder (CUD). Face-to-face survey of a representative sample of the adult US general population (n=36,309). Treatment rates for CUD were low in this general population survey (13.7%). Severity of CUD and comorbidity of other lifetime drug use disorders were significant predictors of lifetime treatment utilization for CUD. Preference for self-reliance, minimizing problems, fear of stigma, and financial and structural issues were among the most frequently endorsed reasons for respondents not seeking treatment when they perceived the need for treatment among individuals with lifetime CUD, regardless of whether they eventually utilized treatment at some time in their lives. Given the rising prevalence of CUD in the US over the past decade and currently low treatment rates for CUD, increased provision for services for CUD appears critically needed, especially those that screen for and treat, when present, other drug use disorders. Programs to reduce stigma and financial barriers are needed, as well as programs to increase awareness among the general public, health care professionals about the nature and seriousness of CUD, and the availability and effectiveness of treatment for this disorder. Copyright © 2017. Published by Elsevier B.V.

  3. Study of technical and economical feasibility for implementation of a movable unit for treatment of industrial effluents with electron beam

    International Nuclear Information System (INIS)

    Rela, Carolina Sciamarelli

    2006-01-01

    The treatment of industrial effluents is a practice that is disseminating in accelerated rhythm, of contributing to reinforce the public image, through the combat of the pollution, it brings economical advantages allowing the companies the reuse of the treated water in their own processes. The liquid effluent treatment technique studied in the present work is the one that uses the chemical oxidation/reduction standing out the use of the electron beam (e.b.) radiation. This technique uses an advanced oxidation process, generating radicals highly reagents that provoke the oxidation, reduction, dissociation and degradation in composed organic and exercising lethal effect in general in the microorganisms and parasites. In this work a conceptual and basic project of a movable unit of effluents treatment using electron beam radiation process was developed, in order that the unit moves until the treatment point, where the effluent is produced, facilitating the logistics. A technical and economical feasibility study was also elaborated allowing data on the capacity and cost of effluents processing to consolidate the values of the necessary investments to be presented to foundations organs for the construction of a movable unit. The results of the studies demonstrated that it is technically viable attending the pertinent legislation of Brazil, in the aspects of Radiation Protection and transport limit capacity. The unitary cost of the e.b. radiation processing in the movable unit was shown more expensive than in the fixed unit, the reason is the decrease of the efficiency of the interaction of the incident electrons in the effluent, due to the reduction of electron energy operation time of the unit. (author)

  4. Treatment of Young People With Antipsychotic Medications in the United States.

    Science.gov (United States)

    Olfson, Mark; King, Marissa; Schoenbaum, Michael

    2015-09-01

    Despite concerns about rising treatment of young people with antipsychotic medications, little is known about trends and patterns of their use in the United States. To describe antipsychotic prescription patterns among young people in the United States, focusing on age and sex. A retrospective descriptive analysis of antipsychotic prescriptions among patients aged 1 to 24 years was performed with data from calendar years 2006 (n = 765,829), 2008 (n = 858,216), and 2010 (n = 851,874), including a subset from calendar year 2009 with service claims data (n = 53,896). Data were retrieved from the IMS LifeLink LRx Longitudinal Prescription database, which includes approximately 60% of all retail pharmacies in the United States. Denominators were adjusted to generalize estimates to the US population. The percentage of young people filling 1 or more antipsychotic prescriptions during the study year by sex and age group (younger children, 1-6 years; older children, 7-12 years; adolescents, 13-18 years; and young adults, 19-24 years) was calculated. Among young people with antipsychotic use, percentages with specific clinical psychiatric diagnoses and 1 or more antipsychotic prescriptions from a psychiatrist and from a child and adolescent psychiatrist were also determined. The percentages of young people using antipsychotics in 2006 and 2010, respectively, were 0.14% and 0.11% for younger children, 0.85% and 0.80% for older children, 1.10% and 1.19% for adolescents, and 0.69% and 0.84% for young adults. In 2010, males were more likely than females to use antipsychotics, especially during childhood and adolescence: 0.16% vs 0.06% for younger children, 1.20% vs 0.44% for older children, 1.42% vs 0.95% for adolescents, and 0.88% vs 0.81% for young adults. Among young people treated with antipsychotics in 2010, receiving a prescription from a psychiatrist was less common among younger children (57.9%) than among other age groups (range, 70.4%-77.9%). Approximately 29.3% of

  5. Surface interactions between nanoscale iron and organic material: Potential uses in water treatment process units

    Science.gov (United States)

    Storms, Max

    Membrane systems are among the primary emergent technologies in water treatment process units due to their ease of use, small physical footprint, and high physical rejection. Membrane fouling, the phenomena by which membranes become clogged or generally soiled, is an inhibitor to optimal efficiency in membrane systems. Novel, composite, and modified surface materials must be investigated to determine their efficacy in improving fouling behavior. Ceramic membranes derived from iron oxide nanoparticles called ferroxanes were coated with a superhydrophillic, zwitterionic polymer called poly (sulfobetaine methacrylate) (polySBMA) to form a composite ceramic-polymeric membrane. Membrane samples with and without polySBMA coating were subjected to fouling with a bovine serum albumin solution and fouling was observed by measuring permeate flux at 10 mL intervals. Loss of polySBMA was measured using total organic carbon analysis, and membrane samples were characterized using x-ray diffraction, scanning electron microscopy, and optical profilometry. The coated membrane samples decreased initial fouling rate by 27% and secondary fouling rate by 24%. Similarly, they displayed a 30% decrease in irreversible fouling during the initial fouling stage, and a 27% decrease in irreversible fouling in the secondary fouling stage; however, retention of polySBMA sufficient for improved performance was not conclusive. The addition of chemical disinfectants into drinking water treatment processes results in the formation of compounds called disinfection by-products (DBPs). The formation of DBPs occurs when common chemical disinfectants (i.e. chlorine) react with organic material. The harmful effects of DBP exposure require that they be monitored and controlled for public safety. This work investigated the ability of nanostructured hematite derived from ferroxane nanoparticles to remove organic precursors to DBPs in the form of humic acid via adsorption processes. The results show that p

  6. Effectiveness of Ebola treatment units and community care centers - Liberia, September 23-October 31, 2014.

    Science.gov (United States)

    Washington, Michael L; Meltzer, Martin L

    2015-01-30

    Previous reports have shown that an Ebola outbreak can be slowed, and eventually stopped, by placing Ebola patients into settings where there is reduced risk for onward Ebola transmission, such as Ebola treatment units (ETUs) and community care centers (CCCs) or equivalent community settings that encourage changes in human behaviors to reduce transmission risk, such as making burials safe and reducing contact with Ebola patients. Using cumulative case count data from Liberia up to August 28, 2014, the EbolaResponse model previously estimated that without any additional interventions or further changes in human behavior, there would have been approximately 23,000 reported Ebola cases by October 31, 2014. In actuality, there were 6,525 reported cases by that date. To estimate the effectiveness of ETUs and CCCs or equivalent community settings in preventing greater Ebola transmission, CDC applied the EbolaResponse model to the period September 23-October 31, 2014, in Liberia. The results showed that admitting Ebola patients to ETUs alone prevented an estimated 2,244 Ebola cases. Having patients receive care in CCCs or equivalent community settings with a reduced risk for Ebola transmission prevented an estimated 4,487 cases. Having patients receive care in either ETUs or CCCs or in equivalent community settings, prevented an estimated 9,100 cases, apparently as the result of a synergistic effect in which the impact of the combined interventions was greater than the sum of the two interventions. Caring for patients in ETUs, CCCs, or in equivalent community settings with reduced risk for transmission can be important components of a successful public health response to an Ebola epidemic.

  7. Developing an efficient scheduling template of a chemotherapy treatment unit: A case study.

    Science.gov (United States)

    Ahmed, Z; Elmekkawy, Ty; Bates, S

    2011-01-01

    This study was undertaken to improve the performance of a Chemotherapy Treatment Unit by increasing the throughput and reducing the average patient's waiting time. In order to achieve this objective, a scheduling template has been built. The scheduling template is a simple tool that can be used to schedule patients' arrival to the clinic. A simulation model of this system was built and several scenarios, that target match the arrival pattern of the patients and resources availability, were designed and evaluated. After performing detailed analysis, one scenario provide the best system's performance. A scheduling template has been developed based on this scenario. After implementing the new scheduling template, 22.5% more patients can be served. 1. CancerCare Manitoba is a provincially mandated cancer care agency. It is dedicated to provide quality care to those who have been diagnosed and are living with cancer. MacCharles Chemotherapy unit is specially built to provide chemotherapy treatment to the cancer patients of Winnipeg. In order to maintain an excellent service, it tries to ensure that patients get their treatment in a timely manner. It is challenging to maintain that goal because of the lack of a proper roster, the workload distribution and inefficient resource allotment. In order to maintain the satisfaction of the patients and the healthcare providers, by serving the maximum number of patients in a timely manner, it is necessary to develop an efficient scheduling template that matches the required demand with the availability of resources. This goal can be reached using simulation modelling. Simulation has proven to be an excellent modelling tool. It can be defined as building computer models that represent real world or hypothetical systems, and hence experimenting with these models to study system behaviour under different scenarios.1, 2 A study was undertaken at the Children's Hospital of Eastern Ontario to identify the issues behind the long waiting

  8. Effects of lyric analysis interventions on treatment motivation in patients on a detoxification unit: a randomized effectiveness study.

    Science.gov (United States)

    Silverman, Michael J

    2015-01-01

    Treatment motivation is a key component in the early rehabilitative stages for people with substance use disorders. To date, no music therapy researcher has studied how lyric analysis interventions might affect motivation in a randomized controlled design. The primary purpose of this study was to determine the effect of lyric analysis interventions on treatment motivation in patients on a detoxification unit using a single-session wait-list control design. A secondary purpose was to determine if there were between-group differences concerning two contrasting songs used for the lyric analyses. Participants (N=104) were cluster randomized to a group lyric analysis condition or a wait-list control condition. Participants received either a "Hurt" or a "How to Save a Life" lyric analysis treatment. The Texas Christian University Treatment Motivation Scale-Client Evaluation of Self at Intake (CESI) (Simpson, 2008[2005]) was used to measure aspects of treatment motivation: problem recognition, desire for help, treatment readiness, pressures for treatment, and total motivation. Results indicated significant between-group differences in measures of problem recognition, desire for help, treatment readiness, and total motivation, with experimental participants having higher treatment motivation means than control participants. There was no difference between the two lyric analysis interventions. Although the song used for lyric analysis interventions did not affect outcome, a single group-based music therapy lyric analysis session can be an effective psychosocial treatment intervention to enhance treatment motivation in patients on a detoxification unit. Limitations, implications for clinical practice, and suggestions for future research are provided. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Treatment of severe insulin resistance in pregnancy with 500 units per milliliter of concentrated insulin.

    Science.gov (United States)

    Mendez-Figueroa, Hector; Maggio, Lindsay; Dahlke, Joshua D; Daley, Julie; Lopes, Vrishali V; Coustan, Donald R; Rouse, Dwight J

    2013-07-01

    To evaluate glycemic control and pregnancy outcomes among pregnant women with severe insulin resistance treated with 500 units/mL concentrated insulin. Retrospective analysis of gravid women with severe insulin resistance (need for greater than 100 units of insulin per injection or greater than 200 units/d) treated with either 500 units/mL concentrated insulin or conventional insulin therapy. We performed a two-part analysis: 1) between gravid women treated with and without 500 units/mL concentrated insulin; and 2) among gravid women treated with 500 units/mL concentrated insulin, comparing glycemic control before and after its initiation. Seventy-three pregnant women with severe insulin resistance were treated with 500 units/mL concentrated insulin and 78 with conventional insulin regimens. Patients treated with 500 units/mL concentrated insulin were older and more likely to have type 2 diabetes mellitus. Average body mass index was comparable between both groups (38.6 compared with 40.4, P=.11) as were obstetric and perinatal outcomes and glycemic control during the last week of gestation. Within the 500 units/mL concentrated insulin cohort, after initiation of this medication, fasting and postprandial blood glucose concentrations improved. However, the rates of blood glucose values less than 60 mg/dL and less than 50 mg/dL were higher in the 500 units/mL concentrated insulin group after initiation than before, 4.8% compared with 2.0% (Pinsulin in severely obese insulin-resistant pregnant women confers similar glycemic control compared with traditional insulin regimens but may increase the risk of hypoglycemia. II.

  10. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments - United States, 2015-2017.

    Science.gov (United States)

    DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Yembra, Debbie; Armour, Brian S

    2018-04-06

    Cigarette smoking prevalence among Medicaid enrollees (25.3%) is approximately twice that of privately insured Americans (11.8%), placing Medicaid enrollees at increased risk for smoking-related disease and death (1). Medicaid spends approximately $39 billion annually on treating smoking-related diseases (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications* are effective in helping tobacco users quit (3). Although state Medicaid coverage of tobacco cessation treatments improved during 2014-2015, coverage was still limited in most states (4). To monitor recent changes in state Medicaid cessation coverage for traditional (i.e., nonexpansion) Medicaid enrollees, the American Lung Association collected data on coverage of a total of nine cessation treatments: individual counseling, group counseling, and seven FDA-approved cessation medications † in state Medicaid programs during July 1, 2015-June 30, 2017. The American Lung Association also collected data on seven barriers to accessing covered treatments, such as copayments and prior authorization. As of June 30, 2017, 10 states covered all nine of these treatments for all enrollees, up from nine states as of June 30, 2015; of these 10 states, Missouri was the only state to have removed all seven barriers to accessing these cessation treatments. State Medicaid programs that cover all evidence-based cessation treatments, remove barriers to accessing these treatments, and promote covered treatments to Medicaid enrollees and health care providers would be expected to reduce smoking, smoking-related disease, and smoking-attributable federal and state health care expenditures (5-7).

  11. A rule-based computer control system for PBX-M neutral beams

    International Nuclear Information System (INIS)

    Frank, K.T.; Kozub, T.A.; Kugel, H.W.

    1987-01-01

    The Princeton Beta Experiment (PBX) neutral beams have been routinely operated under automatic computer control. A major upgrade of the computer configuration was undertaken to coincide with the PBX machine modification. The primary tasks included in the computer control system are data acquisition, waveform reduction, automatic control and data storage. The portion of the system which will remain intact is the rule-based approach to automatic control. Increased computational and storage capability will allow the expansion of the knowledge base previously used. The hardware configuration supported by the PBX Neutral Beam (XNB) software includes a dedicated Microvax with five CAMAC crates and four process controllers. The control algorithms are rule-based and goal-driven. The automatic control system raises ion source electrical parameters to selected energy goals and maintains these levels until new goals are requested or faults are detected

  12. The organizational structure of an intensive care unit influences treatment of hypotension among critically ill patients: A retrospective cohort study

    Science.gov (United States)

    Boone, M. Dustin; Massa, Jennifer; Mueller, Ariel; Jinadasa, Sayuri P; Lee, Joon; Kothari, Rishi; Scott, Daniel J.; Callahan, Julie; Celi, Leo Anthony; Hacker, Michele R.

    2016-01-01

    Purpose Prior studies report that weekend admission to an intensive care unit is associated with increased mortality, potentially attributed to the organizational structure of the unit. This study aims to determine whether treatment of hypotension, a risk factor for mortality, differs according to level of staffing. Methods Using the Multiparameter Intelligent Monitoring in Intensive Care database, we conducted a retrospective study of patients admitted to an intensive care unit at Beth Israel Deaconess Medical Center who experienced one or more episodes of hypotension. Episode(s) were categorized according to the staffing level, defined as high during weekday daytime (7am–7pm) and low during weekends or nighttime (7pm–7am). Results Patients with a hypotensive event on a weekend were less likely to be treated compared to those that occurred during the weekday daytime (p=0.02). No association between weekday daytime versus weekday nighttime staffing levels and treatment of hypotension was found (RR 1.02; 95% CI 0.98–1.07). Conclusion Patients with a hypotensive event on a weekend were less likely to be treated than patients with an event during high-staffing periods. No association between weekday nighttime staffing and hypotension treatment was observed. We conclude that treatment of a hypotensive episode relies on more than solely staffing levels. PMID:26975737

  13. Upgrading of Alum Preparation and Dosing Unit for Sharq Dijla Water Treatment Plant by Using Programmable Logic Controller System

    Directory of Open Access Journals (Sweden)

    Aumar Al-Nakeeb

    2018-02-01

    Full Text Available One of the important units in Sharq Dijla Water Treatment Plant (WTP first and second extensions are the alum solution preparation and dosing unit. The existing operation of this unit accomplished manually starting from unloading the powder alum in the preparation basin and ending by controlling the alum dosage addition through the dosing pumps to the flash mix chambers. Because of the modern trend of monitoring and control the automatic operation of WTPs due to the great benefits that could be gain from optimum equipment operation, reducing the operating costs and human errors. This study deals with how to transform the conventional operation to an automatic monitoring and controlling system depending on a Programmable Logic Controller (PLC and online sensors for alum preparation and dosing unit in Sharq Dijla WTP. PLC system will receive, analyze transmitting data, compare them with preset points then automatically orders the operational equipment (such as pumps, valves, and mixers in a way that guarantees the safe and appropriate operation of the unit. As a result of Process and Instrumentation Diagrams (PID that were prepared in this study, these units can be fully operating and manage by using Supervisory Control and Data Acquisition (SCADA system.

  14. A computer-controlled CAMAC system for the operation of a neutron diffractometer

    International Nuclear Information System (INIS)

    Zwoll, K.; Mueller, K.D.; Will, G.

    1976-01-01

    The paper describes a computer-controlled four-circle diffractometer for the investigation of single crystals by neutron diffraction. The hardware is based on the internationally standardised CAMAC system. This makes the system described here independent of the type of computer used and also largely independent of the mechanical equipment used. The software is written in the interpretative language FOCAL which is easy to learn and ensures high flexibility in programming and thus also in the use of the diffractometer. (orig.) [de

  15. Computer-controlled CAMAC system for the operation of a neutron diffractometer

    Energy Technology Data Exchange (ETDEWEB)

    Zwoll, K; Mueller, K D [Kernforschungsanlage Juelich G.m.b.H. (Germany, F.R.). Zentrallabor fuer Elektronik; Will, G [Bonn Univ. (Germany, F.R.). Mineralogisches Inst.

    1976-10-01

    The paper describes a computer-controlled four-circle diffractometer for the investigation of single crystals by neutron diffraction. The hardware is based on the internationally standardised CAMAC system. This makes the system described here independent of the type of computer used and also largely independent of the mechanical equipment used. The software is written in the interpretative language FOCAL which is easy to learn and ensures high flexibility in programming and thus also in the use of the diffractometer.

  16. Total reduction of distorted echelle spectrograms - An automatic procedure. [for computer controlled microdensitometer

    Science.gov (United States)

    Peterson, R. C.; Title, A. M.

    1975-01-01

    A total reduction procedure, notable for its use of a computer-controlled microdensitometer for semi-automatically tracing curved spectra, is applied to distorted high-dispersion echelle spectra recorded by an image tube. Microdensitometer specifications are presented and the FORTRAN, TRACEN and SPOTS programs are outlined. The intensity spectrum of the photographic or electrographic plate is plotted on a graphic display. The time requirements are discussed in detail.

  17. A computer-controlled electronic system for the ultrasonic NDT of components for nuclear power stations

    International Nuclear Information System (INIS)

    Rehrmann, M.; Harbecke, D.

    1987-01-01

    The paper describes an automatic ultrasonic testing system combined with a computer-controlled electronics system, called IMPULS I, for the non-destructive testing of components of nuclear reactors. The system can be used for both in-service inspection and for inspection during the manufacturing process. IMPUL I has more functions and less components than conventional ultrasonic systems, and the system gives good reproducible test results and is easy to operate. (U.K.)

  18. Intravenous dextrose administration reduces postoperative antiemetic rescue treatment requirements and postanesthesia care unit length of stay.

    Science.gov (United States)

    Dabu-Bondoc, Susan; Vadivelu, Nalini; Shimono, Chantelle; English, Annette; Kosarussavadi, Boonsri; Dai, Feng; Shelley, Kirk; Feinleib, Jessica

    2013-09-01

    Postoperative nausea and vomiting (PONV) remains the most common postoperative complication, and causes decreased patient satisfaction, prolonged postoperative hospital stays, and unanticipated admission. There are limited data that indicate that dextrose may reduce nausea and vomiting. In this trial, we attempted to determine whether the rate of PONV can be decreased by postoperative administration of IV dextrose bolus. To test the effect of postoperative dextrose administration on PONV rates, we conducted a double-blind, randomized, placebo-controlled trial. We enrolled 62 nondiabetic, ASA class I or II nonsmoking outpatients scheduled for gynecologic laparoscopic and hysteroscopic procedures. Patients were randomized into 2 groups: the treatment group received dextrose 5% in Ringer lactate solution, and the control (placebo) group received Ringer lactate solution given immediately after surgery. All patients underwent a standardized general anesthesia and received 1 dose of antiemetic a half hour before emergence from anesthesia. PONV scores, antiemetic rescue medications, narcotic consumption, and discharge time were recorded in the postanesthesia care unit (PACU) in half-hour intervals. The 2 groups were similar with regard to age, weight, anxiety scores, prior PONV, non per os status, presurgical glucose, anesthetic duration, intraoperative narcotic use, and total weight-based fluid volume received. Postoperative nausea scores were not significantly different in the dextrose group compared with the control group (P > 0.05) after Bonferroni correction for repeated measurements over time. However, patients who received dextrose 5% in Ringer lactate solution consumed less rescue antiemetic medications (ratio mean difference, 0.56; 95% confidence interval, 0.39-0.82; P = 0.02), and had a shorter length of stay in the PACU (ratio mean difference, 0.80; 95% confidence interval, 0.66-0.97; P = 0.03) compared with patients in the control group. In this trial

  19. Electronic-cigarette use by individuals in treatment for substance abuse: A survey of 24 treatment centers in the United States

    OpenAIRE

    Gubner, Noah R.; Andrews, K. Blakely; Mohammad-Zadeh, Ana; Lisha, Nadra E.; Guydish, Joseph

    2016-01-01

    Prevalence and reasons for using electronic cigarettes (e-cigarettes) was examined among patients enrolled in 24 substance abuse treatment centers in the United States (N=1,113). Prevalence of e-cigarette use was assessed for the full sample. Bivariate analyses and multivariate logistic regression were used to identify characteristics associated with e-cigarette use among current cigarette smokers (the majority of e-cigarette users). Overall 55.5% of the sample reported lifetime use of e-ciga...

  20. Verification of Monitor unit calculations for eclipse Treatment Planning System by in- house developed spreadsheet

    Directory of Open Access Journals (Sweden)

    Hemalatha Athiyaman

    2018-04-01

    Conclusion: The spreadsheet was tested for most of the routine treatment sites and geometries. It has good agreement with the Eclipse TPS version 13.8 for homogenous treatment sites such as head &and neck and carcinoma cervix.

  1. Neglected infections of poverty in Texas and the rest of the United States: management and treatment options.

    Science.gov (United States)

    Barry, M A; Bezek, S; Serpa, J A; Hotez, P J; Woc-Colburn, L

    2012-08-01

    In the poorest regions of the United States, especially along the Gulf Coast and in South Texas, are a group of endemic parasitic and related infections known as the neglected infections of poverty. Such infections are characterized by their chronicity, disabling features, and disproportionate impact on the estimated 46 million people who live below the U.S. poverty line. Today more Americans live in poverty than ever before in the half-century that the Census Bureau has been recording poverty rates. In association with that poverty, a group of major neglected infections of poverty have emerged in the United States. Here we describe the major neglected infections of poverty in the United States, with a brief overview of their significant epidemiological features, their links with poverty, and our approaches to their diagnosis, management, and treatment.

  2. Cost-effectiveness and budget impact of hepatitis C virus treatment with sofosbuvir and ledipasvir in the United States.

    Science.gov (United States)

    Chhatwal, Jagpreet; Kanwal, Fasiha; Roberts, Mark S; Dunn, Michael A

    2015-03-17

    Sofosbuvir and ledipasvir, which have recently been approved for treatment of chronic hepatitis C virus (HCV) infection, are more efficacious and safer than the old standard of care (oSOC) but are substantially more expensive. Whether and in which patients their improved efficacy justifies their increased cost is unclear. To evaluate the cost-effectiveness and budget impact of sofosbuvir and ledipasvir. Microsimulation model of the natural history of HCV infection. Published literature. Treatment-naive and treatment-experienced HCV population defined on the basis of HCV genotype, age, and fibrosis distribution in the United States. Lifetime. Third-party payer. Simulation of sofosbuvir-ledipasvir compared with the oSOC (interferon-based therapies). Quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and 5-year spending on antiviral drugs. Sofosbuvir-based therapies added 0.56 QALY relative to the oSOC at an ICER of $55 400 per additional QALY. The ICERs ranged from $9700 to $284 300 per QALY depending on the patient's status with respect to treatment history, HCV genotype, and presence of cirrhosis. At a willingness-to-pay threshold of $100 000 per QALY, sofosbuvir-based therapies were cost-effective in 83% of treatment-naive and 81% of treatment-experienced patients. Compared with the oSOC, treating eligible HCV-infected persons in the United States with the new drugs would cost an additional $65 billion in the next 5 years, whereas the resulting cost offsets would be $16 billion. Results were sensitive to drug price, drug efficacy, and quality of life after successful treatment. Data on real-world effectiveness of new antivirals are lacking. Treatment of HCV is cost-effective in most patients, but additional resources and value-based patient prioritization are needed to manage patients with HCV. National Institutes of Health.

  3. Cryptococcal Meningitis Treatment Strategies Affected by the Explosive Cost of Flucytosine in the United States: A Cost-effectiveness Analysis.

    Science.gov (United States)

    Merry, Matthew; Boulware, David R

    2016-06-15

    In the United States, cryptococcal meningitis causes approximately 3400 hospitalizations and approximately 330 deaths annually. The US guidelines recommend treatment with amphotericin B plus flucytosine for at least 2 weeks, followed by fluconazole for a minimum of 8 weeks. Due to generic drug manufacturer monopolization, flucytosine currently costs approximately $2000 per day in the United States, with a 2-week flucytosine treatment course costing approximately $28 000. The daily flucytosine treatment cost in the United Kingdom is approximately $22. Cost-effectiveness analysis was performed to determine the value of flucytosine relative to alternative regimens. We estimated the incremental cost-effectiveness ratio (ICER) of 3 cryptococcal induction regimens: (1) amphotericin B deoxycholate for 4 weeks; (2) amphotericin and flucytosine (100 mg/kg/day) for 2 weeks; and (3) amphotericin and fluconazole (800 mg/day) for 2 weeks. Costs of care were calculated using 2015 US prices and the medication costs. Survival estimates were derived from a randomized trial and scaled relative to published US survival data. Cost estimates were $83 227 for amphotericin monotherapy, $75 121 for amphotericin plus flucytosine, and $44 605 for amphotericin plus fluconazole. The ICER of amphotericin plus flucytosine was $23 842 per quality-adjusted life-year. Flucytosine is currently cost-effective in the United States despite a dramatic increase in price in recent years. Combination therapy with amphotericin and flucytosine is the most attractive treatment strategy for cryptococcal meningitis, though the rising price may be creating access issues that will exacerbate if the trend of profiteering continues. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  4. Difference in clinical presentation, immunology profile and treatment response of type 1 autoimmune hepatitis between United Kingdom and Singapore patients

    OpenAIRE

    Than, Nwe Ni; Ching, Doreen Koay Siew; Hodson, James; McDowell, Patrick; Mann, Jake; Gupta, Ravi; Salazar, Ennaliza; Ngu, Jing Hieng; Oo, Ye Htun

    2016-01-01

    Background Autoimmune hepatitis (AIH) is an immune-mediated liver disease of unknown etiology. Increasing incidence of AIH in Asian patients has been reported. However, the phenotypic difference of Asian patients in Europe and Asia has still not been explored. Aim To evaluate the clinical presentation, biochemical and immunological profiles, treatment response and survival outcome of type 1 AIH from two tertiary liver transplant centres (United Kingdom and Singapore). Method Patients who fulf...

  5. Effects of organ motion on IMRT treatments with segments of few monitor units

    International Nuclear Information System (INIS)

    Seco, J.; Sharp, G. C.; Turcotte, J.; Gierga, D.; Bortfeld, T.; Paganetti, H.

    2007-01-01

    Interplay between organ (breathing) motion and leaf motion has been shown in the literature to have a small dosimetric impact for clinical conditions (over a 30 fraction treatment). However, previous studies did not consider the case of treatment beams made up of many few-monitor-unit (MU) segments, where the segment delivery time (1-2 s) is of the order of the breathing period (3-5 s). In this study we assess if breathing compromises the radiotherapy treatment with IMRT segments of low number of MUs. We assess (i) how delivered dose varies, from patient to patient, with the number of MU per segment, (ii) if this delivered dose is identical to the average dose calculated without motion over the path of the motion, and (iii) the impact of the daily variation of the delivered dose as a function of MU per segment. The organ motion was studied along two orthogonal directions, representing the left-right and cranial-caudal directions of organ movement for a patient setup in the supine position. Breathing motion was modeled as sin(x), sin 4 (x), and sin 6 (x), based on functions used in the literature to represent organ motion. Measurements were performed with an ionization chamber and films. For a systematic study of motion effects, a MATLAB simulation was written to model organ movement and dose delivery. In the case of a single beam made up of one single segment, the dose delivered to point in a moving target over 30 fractions can vary up to 20% and 10% for segments of 10 MU and 20 MU, respectively. This dose error occurs because the tumor spends most of the time near the edges of the radiation beam. In the case of a single beam made of multiple segments with low MU, we observed 2.4%, 3.3%, and 4.3% differences, respectively, for sin(x), sin 4 (x), and sin 6 (x) motion, between delivered dose and motion-averaged dose for points in the penumbra region of the beam and over 30 fractions. In approximately 5-10% of the cases, differences between the motion-averaged dose

  6. Electronic remote blood issue combined with a computer-controlled, automated refrigerator for major surgery in operating theatres at a distance from the transfusion service.

    Science.gov (United States)

    Verlicchi, Franco; Pacilli, Pasqua; Bragliani, Arianna; Rapuano, Silvia; Dini, Daniele; Vincenzi, Daniele

    2018-02-01

    The difficulty of supplying red blood cells within an adequate time to patients undergoing surgery is a known problem for transfusion services, particularly if the operating theater is located at some distance from the blood bank. The consequences frequently are that more blood is ordered than required; several units are allocated and issued; and unused units must be returned to the blood bank. Some sparse reports have demonstrated that remote blood issue systems can improve the efficiency of issuing blood. This study describes a computer-controlled, self-service, remote blood-release system, combined with an automated refrigerator, installed in a hospital at which major surgery was performed, located 5 kilometers away from the transfusion service. With this system, red blood cell units were electronically allocated to patients immediately before release, when the units actually were needed. Two 2-year periods, before and after implementation of the system, were compared. After implementation of the system, the ratio of red blood cell units returned to the transfusion service was reduced from 48.9% to 1.6% of the issued units (8852 of 18,090 vs. 182 of 11,152 units; p blood cell units was observed, probably mainly due to changes in the number and complexity of surgical procedures. No transfusion errors occurred in the two periods. The current results demonstrate that the remote blood-release system is safe and useful for improving the efficiency of blood issue for patients in remote operating theatres. © 2017 AABB.

  7. A clinical-economic study of caspofungin use in the treatment of invasive candidiasis in intensive care units

    Directory of Open Access Journals (Sweden)

    A. S. Kolbin

    2010-01-01

    Full Text Available Candida spp. are the fourth on the list of sepsis pathogens in patients in intensive care units. Currently the physician’s armamentarium includes a whole range of antifungal medicines that have demonstrated high clinicalmycological effectiveness in clinical trials. The aim of this study to evaluate the clinical-economic usefulness of caspofungin therapy in the treatment of invasive candidiasis versus standard and alternative treatments in patients inintensive care units. The first time in the Russian clinical-economic analysis for targeted IC treatment in non-neutropenic patients in intensive care units who have not received primary prophylaxis with azole antimycotics, as well as in those with low (< 20% occurrence of in vitro Candida spp. resistance to fluconazole according to national or local study results, yielded the following findings: the best strategy is initial amphotericin B therapy with subsequent switching to caspofungin in patients with ineffective initial amphotericin B therapy or those with severe adverse events.

  8. Commercial waste treatment R and D needs in the United States

    International Nuclear Information System (INIS)

    Burkholder, H.C.

    1982-05-01

    The mission of the commercial waste treatment program is to establish treatment technology for safe and efficient management of high-level and transuranic wastes from reprocessing and fuel fabrication and special wastes from other fuel cycle activities. The four functional objectives that must be achieved to fulfill the mission are: (1) define waste product and treatment process performance requirements; (2) specify adequately safe waste products and verify their performance; (3) specify adequately efficient treatment processes and equipment and verify their performance; (4) solve existing waste treatment problems using verified products and processes. Although commercial waste treatment technology is in many respects highly advanced, there remains a number of areas where significant research and development is needed. These are: (1) technically-based performance requirements for both waste products and treatment processes; (2) pilot-scale radioactive demonstration of liquid-fed ceramic melting process and equipment for borosilicate glass; (3) non-glass TRU waste product and treatment process development; (4) waste product performance testing and predictive modeling; (5) quality verification for treatment processes

  9. Integrated Waste Treatment Unit (IWTU) Input Coal Analyses and Off-Gass Filter (OGF) Content Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Jantzen, Carol M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Missimer, David M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Guenther, Chris P. [National Energy Technology Lab. (NETL), Morgantown, WV (United States); Shekhawat, Dushyant [National Energy Technology Lab. (NETL), Morgantown, WV (United States); VanEssendelft, Dirk T. [National Energy Technology Lab. (NETL), Morgantown, WV (United States); Means, Nicholas C. [AECOM Technology Corp., Oak Ridge, TN (United States)

    2015-04-23

    A full engineering scale Fluidized Bed Steam Reformer (FBSR) system is being used at the Idaho Nuclear Technology and Engineering Center (INTEC) to stabilize acidic Low Activity Waste (LAW) known as Sodium Bearing Waste (SBW). The INTEC facility, known as the Integrated Waste Treatment Unit (IWTU), underwent an Operational Readiness Review (ORR) and a Technology Readiness Assessment (TRA) in March 2014. The IWTU began non-radioactive simulant processing in late 2014 and by January, 2015 ; the IWTU had processed 62,000 gallons of simulant. The facility is currently in a planned outage for inspection of the equipment and will resume processing simulated waste feed before commencing to process 900,000 gallons of radioactive SBW. The SBW acidic waste will be made into a granular FBSR product (carbonate based) for disposal in the Waste Isolation Pilot Plant (WIPP). In the FBSR process calcined coal is used to create a CO2 fugacity to force the waste species to convert to carbonate species. The quality of the coal, which is a feed input, is important because the reactivity, moisture, and volatiles (C,H,N,O, and S) in the coal impact the reactions and control of the mineralizing process in the primary steam reforming vessel, the Denitration and Mineralizing Reformer (DMR). Too much moisture in the coal can require that additional coal be used. However since moisture in the coal is only a small fraction of the moisture from the fluidizing steam this can be self-correcting. If the coal reactivity or heating value is too low then the coal feedrate needs to be adjusted to achieve the desired heat generation. Too little coal and autothermal heat generation in the DMR cannot be sustained and/or the carbon dioxide fugacity will be too low to create the desired carbonate mineral species. Too much coal and excess S and hydroxide species can form. Excess sulfur from coal that (1) is too rich in sulfur or (2) from overfeeding coal can promote wall scale and contribute to corrosion

  10. Structural Analysis of Treatment Cycles Representing Transitions between Nursing Organizational Units Inferred from Diabetes

    Science.gov (United States)

    Dehmer, Matthias; Kurt, Zeyneb; Emmert-Streib, Frank; Them, Christa; Schulc, Eva; Hofer, Sabine

    2015-01-01

    In this paper, we investigate treatment cycles inferred from diabetes data by means of graph theory. We define the term treatment cycles graph-theoretically and perform a descriptive as well as quantitative analysis thereof. Also, we interpret our findings in terms of nursing and clinical management. PMID:26030296

  11. 77 FR 58470 - Irradiation Treatment; Location of Facilities in the Southern United States; Technical Amendment

    Science.gov (United States)

    2012-09-21

    ... jointly by APHIS and the national plant protection organization (NPPO) of India as part of the required... standard \\2\\ of the International Plant Protection Convention, of which the United States is a contracting... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service 7 CFR Part 319 [Docket No...

  12. Aqueous treatment of water-sensitive paper objects: capillary unit, blotter wash or paraprint wash?

    NARCIS (Netherlands)

    Schalkx, H.; Iedema, P.; Reissland, B.; van Velzen, B.

    2011-01-01

    Blotter washing andwashing with the capillary unit are both methods used for aqueoustreatment of water-sensitive paper objects. The challenge of thistreatment is to remove water-soluble products while keeping thewater-sensitive medium in its place. In this article the two methodsare compared, along

  13. Life-sustaining treatment decisions in Portuguese intensive care units: a national survey of intensive care physicians.

    Science.gov (United States)

    Cardoso, Teresa; Fonseca, Teresa; Pereira, Sofia; Lencastre, Luís

    2003-12-01

    The objective of the present study was to evaluate the opinion of Portuguese intensive care physicians regarding 'do-not-resuscitate' (DNR) orders and decisions to withhold/withdraw treatment. A questionnaire was sent to all physicians working on a full-time basis in all intensive care units (ICUs) registered with the Portuguese Intensive Care Society. A total of 266 questionnaires were sent and 175 (66%) were returned. Physicians from 79% of the ICUs participated. All participants stated that DNR orders are applied in their units, and 98.3% stated that decisions to withhold treatment and 95.4% stated that decisions to withdraw treatment are also applied. About three quarters indicated that only the medical group makes these decisions. Fewer than 15% of the responders stated that they involve nurses, 9% involve patients and fewer than 11% involve patients' relatives in end-of-life decisions. Physicians with more than 10 years of clinical experience more frequently indicated that they involve nurses in these decisions (P atheist doctors more frequently involve patients' relatives in decisions to withhold/withdraw treatment (P religious beliefs of the respondents influences the way in which these decisions are made.

  14. On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

    Science.gov (United States)

    Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

    2013-01-01

    We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. Thermal treatment of solid residues from WtE units: A review

    Energy Technology Data Exchange (ETDEWEB)

    Lindberg, Daniel, E-mail: daniel.lindberg@abo.fi; Molin, Camilla, E-mail: camilla.molin@abo.fi; Hupa, Mikko, E-mail: mikko.hupa@abo.fi

    2015-03-15

    Highlights: • We review the thermal treatment methods for ashes and residues from WtE plants. • We review the results from extensive laboratory work on vitrification, melting and vaporization of ash. • We analyze the results from the extensive patent literature on thermal treatment. • We review industrial concepts for thermal treatment of ash. - Abstract: Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field.

  16. Thermal treatment of solid residues from WtE units: A review

    International Nuclear Information System (INIS)

    Lindberg, Daniel; Molin, Camilla; Hupa, Mikko

    2015-01-01

    Highlights: • We review the thermal treatment methods for ashes and residues from WtE plants. • We review the results from extensive laboratory work on vitrification, melting and vaporization of ash. • We analyze the results from the extensive patent literature on thermal treatment. • We review industrial concepts for thermal treatment of ash. - Abstract: Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field

  17. Prevalence and correlates of treatment utilization among adults with cannabis use disorder in the United States.

    Science.gov (United States)

    Wu, Li-Tzy; Zhu, He; Mannelli, Paolo; Swartz, Marvin S

    2017-08-01

    The increase in cannabis potency may have treatment implications for cannabis use disorder (CUD). Given the reported increase in prevalence of cannabis use among adults, there is a need to understand substance use treatment needs for CUD. We examined demographics and behavioral health indicators of adults aged ≥18 years that met criteria for past-year CUD (n=10,943) in the 2005-2013 National Surveys on Drug Use and Health. We determined prevalence and correlates of past-year treatment use for alcohol/drug, any drug, and cannabis use related problems, to inform treatment efforts for CUD. The majority of adults with past-year CUD were young adults aged 18-25 or men, had low income, and did not attend college. Two-thirds of adults with CUD met criteria for cannabis dependence, which was comparatively common among younger adults, women, low-income or publicly insured adults, and college-educated adults. Nicotine dependence (40.92%) and alcohol (44.07%) or other drug use disorder (19.70%) were prevalent among adults with CUD. Overall, less than 13% of adults with CUD had received alcohol/drug use treatment the past year; only 7.8% received cannabis-specific treatment. There was no significant yearly variation in treatment use prevalence over 9 years. In particular, Asian-Americans, women, and college-educated adults underutilized cannabis-specific treatment. This large sample of adults with CUD reveals pervasive underutilization of cannabis-related treatment, especially in women, married adults, and those with college education, despite a high proportion of comorbid behavioral health problems. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  18. Optimizing clinical trial supply requirements: simulation of computer-controlled supply chain management.

    Science.gov (United States)

    Peterson, Magnus; Byrom, Bill; Dowlman, Nikki; McEntegart, Damian

    2004-01-01

    Computer-controlled systems are commonly used in clinical trials to control dispensing and manage site inventories of trial supplies. Typically such systems are used with an interactive telephone or web system that provide an interface with the study site. Realizing the maximum savings in medication associated with this approach has, in the past, been problematic as it has been difficult to fully estimate medication requirements due to the complexities of these algorithms and the inherent variation in the clinical trial recruitment process. We describe the traditional and automated methods of supplying sites. We detail a simulation approach that models the automated system. We design a number of simulation experiments using this model to investigate the supply strategy properties that influence medication overage and other strategy performance metrics. The computer-controlled medication system gave superior performance to the traditional method. In one example, a 75% overage of wasted medication in the traditional system was associated with higher supply failure than an automated system strategy with an overage of 47%. In a further example, we demonstrate that the impact of using a country stratified as opposed to site stratified scheme affects the number of deliveries and probability of supply failures more than the amount of drug wasted with respective increases of 20, 2300 and 4%. Medication savings with automated systems are particularly significant in repeat dispensing designs. We show that the number of packs required can fall by as much as 50% if one uses a predictive medication algorithm. We conclude that a computer-controlled supply chain enables medication savings to be realized and that it is possible to quantify the distribution of these savings using a simulation model. The simulation model can be used to optimize the prestudy medication supply strategy and for midstudy monitoring using real-time data contained in the study database.

  19. Development of a totally computer-controlled triple quadrupole mass spectrometer system

    International Nuclear Information System (INIS)

    Wong, C.M.; Crawford, R.W.; Barton, V.C.; Brand, H.R.; Neufeld, K.W.; Bowman, J.E.

    1983-01-01

    A totally computer-controlled triple quadrupole mass spectrometer (TQMS) is described. It has a number of unique features not available on current commercial instruments, including: complete computer control of source and all ion axial potentials; use of dual computers for data acquisition and data processing; and capability for self-adaptive control of experiments. Furthermore, it has been possible to produce this instrument at a cost significantly below that of commercial instruments. This triple quadrupole mass spectrometer has been constructed using components commercially available from several different manufacturers. The source is a standard Hewlett-Packard 5985B GC/MS source. The two quadrupole analyzers and the quadrupole CAD region contain Balzers QMA 150 rods with Balzers QMG 511 rf controllers for the analyzers and a Balzers QHS-511 controller for the CAD region. The pulsed-positive-ion-negative-ion-chemical ionization (PPINICI) detector is made by Finnigan Corporation. The mechanical and electronics design were developed at LLNL for linking these diverse elements into a functional TQMS as described. The computer design for total control of the system is unique in that two separate LSI-11/23 minicomputers and assorted I/O peripherals and interfaces from several manufacturers are used. The evolution of this design concept from totally computer-controlled instrumentation into future self-adaptive or ''expert'' systems for instrumental analysis is described. Operational characteristics of the instrument and initial results from experiments involving the analysis of the high explosive HMX (1,3,5,7-Tetranitro-1,3,5,7-Tetrazacyclooctane) are presented

  20. How do physicians weigh benefits and risks associated with treatments in patients with osteoarthritis in the United Kingdom?

    Science.gov (United States)

    Arden, Nigel K; Hauber, A Brett; Mohamed, Ateesha F; Johnson, F Reed; Peloso, Paul M; Watson, Douglas J; Mavros, Panagiotis; Gammaitoni, Arnold; Sen, Shuvayu S; Taylor, Stephanie D

    2012-05-01

    To quantify the relative importance that UK physicians attach to the benefits and risks of current drugs when making treatment decisions for patients with osteoarthritis (OA). Physicians treating at least 10 patients with OA per month completed an online discrete-choice experiment survey and answered 12 treatment-choice questions comparing medication profiles. Medication profiles were defined by 4 benefits (reduction in ambulatory pain, resting pain, stiffness, and difficulty doing daily activities) and 3 treatment-related risks [bleeding ulcer, stroke, and myocardial infarction (MI)]. Each physician made medication choices for 3 of 9 hypothetical patients (varied by age, history of MI, hypertension, and history of gastrointestinal bleeding). Importance weights were estimated using a random-parameters logit model. Treatment-related risks physicians were willing to accept in exchange for various reductions in ambulatory and resting pain also were calculated. The final sample was 475. A reduction in ambulatory pain from 75 mm to 25 mm (1.6 units) was 1.1 times as important as an increase in MI risk from 0% to 1.5% (1.5 units). The greatest importance was for eliminating a 3% treatment-related risk of MI or stroke. On average, physicians were willing to accept an increase in bleeding ulcer risk of 0.7% (95% CI 0.4%-1.7%) for a reduction in ambulatory pain of 75 mm to 50 mm. When presented with well-known benefits and risks of OA treatments, physicians placed greater importance on the risks than on the analgesic properties of the drug. This has implications for the reporting of the results of clinical research to physicians.

  1. Computer-controlled back scattering and sputtering-experiment using a heavy-ion-accelerator

    International Nuclear Information System (INIS)

    Becker, H.; Birnbaum, M.; Degenhardt, K.H.; Mertens, P.; Tschammer, V.

    1978-12-01

    Control and data acquisition of a PDP 11/40 computer and CAMAC instrumentation are reported for an experiment that has been developed to measure sputtering in yields and energy losses for heavy 100 - 300 keV ions in thin metal foils. Besides a quadrupole mass filter or a bending magnet, a multichannel analyser is coupled to the computer, so that also pulse height analysis can be performed under computer control. CAMAC instrumentation and measuring programs are built in a modular form to enable an easy application to other experimental problems. (orig.) 891 KBE/orig. 892 BRE

  2. Computer-controlled system for plasma ion energy auto-analyzer

    International Nuclear Information System (INIS)

    Wu Xianqiu; Chen Junfang; Jiang Zhenmei; Zhong Qinghua; Xiong Yuying; Wu Kaihua

    2003-01-01

    A computer-controlled system for plasma ion energy auto-analyzer was technically studied for rapid and online measurement of plasma ion energy distribution. The system intelligently controls all the equipments via a RS-232 port, a printer port and a home-built circuit. The software designed by LabVIEW G language automatically fulfils all of the tasks such as system initializing, adjustment of scanning-voltage, measurement of weak-current, data processing, graphic export, etc. By using the system, a few minutes are taken to acquire the whole ion energy distribution, which rapidly provide important parameters of plasma process techniques based on semiconductor devices and microelectronics

  3. Software quality assurance plan for the National Ignition Facility integrated computer control system

    International Nuclear Information System (INIS)

    Woodruff, J.

    1996-11-01

    Quality achievement is the responsibility of the line organizations of the National Ignition Facility (NIF) Project. This Software Quality Assurance Plan (SQAP) applies to the activities of the Integrated Computer Control System (ICCS) organization and its subcontractors. The Plan describes the activities implemented by the ICCS section to achieve quality in the NIF Project's controls software and implements the NIF Quality Assurance Program Plan (QAPP, NIF-95-499, L-15958-2) and the Department of Energy's (DOE's) Order 5700.6C. This SQAP governs the quality affecting activities associated with developing and deploying all control system software during the life cycle of the NIF Project

  4. Digital computer control on Canadian nuclear power plants -experience to date and the future outlook

    International Nuclear Information System (INIS)

    Pearson, A.

    1977-10-01

    This paper discusses the performance of the digital computer control system at Pickering through the years 1973 to 1976. This evaluation is based on a study of the Pickering Generating Station operating records. The paper goes on to explore future computer architectures and the advantages that could accrue from a distributed system approach. Also outlined are the steps being taken to develop these ideas further in the context of two Chalk River projects - REDNET, an advanced data acquisition system being installed to process information from engineering experiments in NRX and NRU reactors, and CRIP, a prototype communications network using cable television technology. (author)

  5. Machine takeover the growing threat to human freedom in a computer-controlled society

    CERN Document Server

    George, Frank Honywill

    1977-01-01

    Machine Takeover: The Growing Threat to Human Freedom in a Computer-Controlled Society discusses the implications of technological advancement. The title identifies the changes in society that no one is aware of, along with what this changes entails. The text first covers the information science, particularly the aspect of an automated system for information processing. Next, the selection deals with social implications of information science, such as information pollution. The text also tackles the concerns in the utilization of technology in order to manipulate the lives of people without th

  6. Mobile unit for treatment of oil emulsions (taladrines); Unidad movil de tratamiento de taladrinas

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz, S.

    1995-06-01

    The environmental problems of water in oil emulsions (taladrines), produced because of an uncontrolled pouring in the sewage system, is the problem caused for the sewage sludge water treatment plants because they have oils, emulgents and heavy metals. (Author)

  7. Tuberculosis Treatment Completion in a United States/Mexico Binational Context

    Directory of Open Access Journals (Sweden)

    Celina I. Valencia

    2017-05-01

    Full Text Available BackgroundTuberculosis (TB remains a salient public health issue along the U.S./Mexico border. This study seeks to identify the social and structural factors, which are associated with TB disease burden in the binational geographic region. Identification of barriers of treatment completion provides the necessary framework for developing evidence-based interventions that are culturally relevant and context specific for the U.S./Mexico border region.MethodsRetrospective study of data extracted from medical charts (n = 439 from Yuma County Health Department (YCHD (n = 160 and Centro de Salud San Luis Río Colorado (n = 279. Patients currently accessing TB treatment at either facility were excluded from the study. Chi-square, unadjusted odds ratios, and logistic regression were utilized to identify characteristics associated with successful TB treatment in this population.FindingsThe study population was predominantly male (n = 327. Females were more likely to complete TB treatment (OR = 3.71. The absence of drug use and/or the absence of an HIV positive diagnosis were found to be predictors of TB treatment completion across both clinical sites. Forty-four percent (43.59% (n = 85 TB patients treated at CDS San Luis did not complete treatment versus 40.35% (n = 49 of TB patients who did not complete treatment at YCHD. Moving from the area or being deported was the highest category (20.78% for incomplete TB treatment in the population (n = 64 across both clinical sites.

  8. Analysis and relevant treatment of diametral tolerance of exciter shaft in unit 2

    International Nuclear Information System (INIS)

    Liu Qiang

    2012-01-01

    The generator and exciter unit has three support in Qinshan Nuclear Power Plant Phase Ⅱ, there are two bearings for the generator rotor and one for the exciter, this structure results in that it is difficult to achieve the standard when checking the exciter bearing's diametral tolerance. In the fifth outage of unit 2 in Qinshan Nuclear Power Plant Phase Ⅱ, the diametral tolerance failed to achieve the standard, there were several reasons for this, such as the alignment of generator and exciter coupling, the angular moment of generator and exciter coupling bolt. the end surface condition of generator and exciter coupling, the fitting dimension of the coupling bolt hole and the sleeve in it. After the analysis of all reasons one by one, it was confirmed that the radical reason was the abnormal condition of the generator coupling end surface, the problem was solved by machining it. (author)

  9. Automated treatment planning for a dedicated multi-source intracranial radiosurgery treatment unit using projected gradient and grassfire algorithms.

    Science.gov (United States)

    Ghobadi, Kimia; Ghaffari, Hamid R; Aleman, Dionne M; Jaffray, David A; Ruschin, Mark

    2012-06-01

    The purpose of this work is to develop a framework to the inverse problem for radiosurgery treatment planning on the Gamma Knife(®) Perfexion™ (PFX) for intracranial targets. The approach taken in the present study consists of two parts. First, a hybrid grassfire and sphere-packing algorithm is used to obtain shot positions (isocenters) based on the geometry of the target to be treated. For the selected isocenters, a sector duration optimization (SDO) model is used to optimize the duration of radiation delivery from each collimator size from each individual source bank. The SDO model is solved using a projected gradient algorithm. This approach has been retrospectively tested on seven manually planned clinical cases (comprising 11 lesions) including acoustic neuromas and brain metastases. In terms of conformity and organ-at-risk (OAR) sparing, the quality of plans achieved with the inverse planning approach were, on average, improved compared to the manually generated plans. The mean difference in conformity index between inverse and forward plans was -0.12 (range: -0.27 to +0.03) and +0.08 (range: 0.00-0.17) for classic and Paddick definitions, respectively, favoring the inverse plans. The mean difference in volume receiving the prescribed dose (V(100)) between forward and inverse plans was 0.2% (range: -2.4% to +2.0%). After plan renormalization for equivalent coverage (i.e., V(100)), the mean difference in dose to 1 mm(3) of brainstem between forward and inverse plans was -0.24 Gy (range: -2.40 to +2.02 Gy) favoring the inverse plans. Beam-on time varied with the number of isocenters but for the most optimal plans was on average 33 min longer than manual plans (range: -17 to +91 min) when normalized to a calibration dose rate of 3.5 Gy/min. In terms of algorithm performance, the isocenter selection for all the presented plans was performed in less than 3 s, while the SDO was performed in an average of 215 min. PFX inverse planning can be performed using

  10. Automated treatment planning for a dedicated multi-source intracranial radiosurgery treatment unit using projected gradient and grassfire algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Ghobadi, Kimia; Ghaffari, Hamid R.; Aleman, Dionne M.; Jaffray, David A.; Ruschin, Mark [Department of Mechanical and Industrial Engineering, University of Toronto, 5 King' s College Road, Toronto, Ontario M5S 3G8 (Canada); Department of Radiation Oncology, University of Toronto, Radiation Medicine Program, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada)

    2012-06-15

    Purpose: The purpose of this work is to develop a framework to the inverse problem for radiosurgery treatment planning on the Gamma Knife{sup Registered-Sign} Perfexion Trade-Mark-Sign (PFX) for intracranial targets. Methods: The approach taken in the present study consists of two parts. First, a hybrid grassfire and sphere-packing algorithm is used to obtain shot positions (isocenters) based on the geometry of the target to be treated. For the selected isocenters, a sector duration optimization (SDO) model is used to optimize the duration of radiation delivery from each collimator size from each individual source bank. The SDO model is solved using a projected gradient algorithm. This approach has been retrospectively tested on seven manually planned clinical cases (comprising 11 lesions) including acoustic neuromas and brain metastases. Results: In terms of conformity and organ-at-risk (OAR) sparing, the quality of plans achieved with the inverse planning approach were, on average, improved compared to the manually generated plans. The mean difference in conformity index between inverse and forward plans was -0.12 (range: -0.27 to +0.03) and +0.08 (range: 0.00-0.17) for classic and Paddick definitions, respectively, favoring the inverse plans. The mean difference in volume receiving the prescribed dose (V{sub 100}) between forward and inverse plans was 0.2% (range: -2.4% to +2.0%). After plan renormalization for equivalent coverage (i.e., V{sub 100}), the mean difference in dose to 1 mm{sup 3} of brainstem between forward and inverse plans was -0.24 Gy (range: -2.40 to +2.02 Gy) favoring the inverse plans. Beam-on time varied with the number of isocenters but for the most optimal plans was on average 33 min longer than manual plans (range: -17 to +91 min) when normalized to a calibration dose rate of 3.5 Gy/min. In terms of algorithm performance, the isocenter selection for all the presented plans was performed in less than 3 s, while the SDO was performed in an

  11. Automated treatment planning for a dedicated multi-source intracranial radiosurgery treatment unit using projected gradient and grassfire algorithms

    International Nuclear Information System (INIS)

    Ghobadi, Kimia; Ghaffari, Hamid R.; Aleman, Dionne M.; Jaffray, David A.; Ruschin, Mark

    2012-01-01

    Purpose: The purpose of this work is to develop a framework to the inverse problem for radiosurgery treatment planning on the Gamma Knife ® Perfexion™ (PFX) for intracranial targets. Methods: The approach taken in the present study consists of two parts. First, a hybrid grassfire and sphere-packing algorithm is used to obtain shot positions (isocenters) based on the geometry of the target to be treated. For the selected isocenters, a sector duration optimization (SDO) model is used to optimize the duration of radiation delivery from each collimator size from each individual source bank. The SDO model is solved using a projected gradient algorithm. This approach has been retrospectively tested on seven manually planned clinical cases (comprising 11 lesions) including acoustic neuromas and brain metastases. Results: In terms of conformity and organ-at-risk (OAR) sparing, the quality of plans achieved with the inverse planning approach were, on average, improved compared to the manually generated plans. The mean difference in conformity index between inverse and forward plans was −0.12 (range: −0.27 to +0.03) and +0.08 (range: 0.00–0.17) for classic and Paddick definitions, respectively, favoring the inverse plans. The mean difference in volume receiving the prescribed dose (V 100 ) between forward and inverse plans was 0.2% (range: −2.4% to +2.0%). After plan renormalization for equivalent coverage (i.e., V 100 ), the mean difference in dose to 1 mm 3 of brainstem between forward and inverse plans was −0.24 Gy (range: −2.40 to +2.02 Gy) favoring the inverse plans. Beam-on time varied with the number of isocenters but for the most optimal plans was on average 33 min longer than manual plans (range: −17 to +91 min) when normalized to a calibration dose rate of 3.5 Gy/min. In terms of algorithm performance, the isocenter selection for all the presented plans was performed in less than 3 s, while the SDO was performed in an average of 215 min

  12. [Preliminary study on detox in outpatient care units with 18 alcoholic patients in Directly Observed Treatment].

    Science.gov (United States)

    Lloréns Martínez, Ramón; Calatayud Francés, María; Morales Gallús, Esperanza; Añó Cervera, Consol; Adriá Caballero, Librada

    2008-01-01

    Directly Observed Treatment (TOD-DOT) has been tested in different conditions. The objective of this work is to check whether a UCA-CAB (Centre for Addictive Behaviour) can achieve detox and reduce the risk of early relapse (up to 12 weeks) in alcoholic patients. All patients had an established organic addiction and serious withdrawal syndrome, and had undergone multiple previous treatments. Furthermore, they had not managed to abstain for a 3-month consecutive period over the previous 2 years. The aim of the Directly Observed Treatment was to attain detox and reduce relapse by following a multi-method approach: medical, psychological and personal care, based on a brief daily consultation and pharmacological supervision. The results were as follows: Of the 18 patients included in the study, after 12 weeks, 13 (72 %) were still abstinent and 4 (22 %) had relapsed. Thus, 17 (94 %) were still following the treatment, with just one drop-out. We analysed the profiles of the patients abstaining, of those who relapsed (4) and of the one who dropped out. The average CIWA-Ar was 27.05 (21-36). Any value over 20 is considered to indicate serious withdrawal syndrome, though there were no negative events leading to hospitalization. Level of adherence to the treatment (94 %) meant that the most seriously affected patients and those with fewest financial resources could benefit, not only from any auxiliary social schemes, but also from basic health services, permitting them to improve the quality of their everyday life.

  13. The Effects of Silvicultural Treatment on Sirex noctilio Attacks and Tree Health in Northeastern United States

    Directory of Open Access Journals (Sweden)

    Kevin J. Dodds

    2014-11-01

    Full Text Available The invasive woodwasp Sirex noctilio (Hymenoptera: Siricidae is established in east-central North America. A replicated case study testing the effectiveness of silvicultural treatments for reducing the number of S. noctilio attacked trees in a stand was conducted in New York, USA. Silvicultural treatments reduced S. noctilio attacked trees by approximately 75% over the course of the study. There was no tree growth response to silvicultural treatments in the four years after thinning, but targeted removal of weakened trees removed potential S. noctilio habitat from treated stands. Two spectral vegetation indices were used to determine tree health in each treatment and potentially provide guidance for detection efforts. Silvicultural treatment significantly influenced the Red Edge Inflection Point, a strong indicator of chlorophyll content, and the Moisture Stress Index, a reflectance measurement sensitive to changes in foliar leaf water content, with the greatest differences occurring between control and treated blocks. Vegetation indices showed promise as a tool for aiding in stand prioritization for S. noctilio surveys or management activities.

  14. Effect of a community-based delivery of intermittent preventive treatment of malaria in pregnancy on treatment seeking for malaria at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, A K; Schultz Hansen, K; Bygbjerg, I C

    2008-01-01

    whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilizers can administer IPTp with sulphadoxine-pyrimethamine (SP) to pregnant women, reach those at greatest risk of malaria, and increase access and compliance with IPTp. STUDY DESIGN...... of the intervention on access to malaria treatment, antenatal care, other services and related costs. RESULTS: More women (67.5%) received two doses of SP through the community approach compared with health units (39.9%; P... in the community had sought malaria treatment (70.3%), suggesting the possibility that the novel approach had a positive impact on care seeking for malaria. Similarly, utilization of antenatal care, insecticide-treated nets and delivery care by women in the community was high. The total costs per woman receiving...

  15. Effect of a community-based delivery of intermittent preventive treatment of malaria in pregnancy on treatment seeking for malaria at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony; Hansen, Kristian Schultz; Bygbjerg, Ib

    2008-01-01

    whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilizers can administer IPTp with sulphadoxine-pyrimethamine (SP) to pregnant women, reach those at greatest risk of malaria, and increase access and compliance with IPTp. Study design...... of the intervention on access to malaria treatment, antenatal care, other services and related costs. Results: More women (67.5%) received two doses of SP through the community approach compared with health units (39.9%; P... in the community had sought malaria treatment (70.3%), suggesting the possibility that the novel approach had a positive impact on care seeking for malaria. Similarly, utilization of antenatal care, insecticide-treated nets and delivery care by women in the community was high. The total costs per woman receiving...

  16. A Model-based Framework for Risk Assessment in Human-Computer Controlled Systems

    Science.gov (United States)

    Hatanaka, Iwao

    2000-01-01

    The rapid growth of computer technology and innovation has played a significant role in the rise of computer automation of human tasks in modem production systems across all industries. Although the rationale for automation has been to eliminate "human error" or to relieve humans from manual repetitive tasks, various computer-related hazards and accidents have emerged as a direct result of increased system complexity attributed to computer automation. The risk assessment techniques utilized for electromechanical systems are not suitable for today's software-intensive systems or complex human-computer controlled systems. This thesis will propose a new systemic model-based framework for analyzing risk in safety-critical systems where both computers and humans are controlling safety-critical functions. A new systems accident model will be developed based upon modem systems theory and human cognitive processes to better characterize system accidents, the role of human operators, and the influence of software in its direct control of significant system functions. Better risk assessments will then be achievable through the application of this new framework to complex human-computer controlled systems.

  17. Development of a scanning proton microprobe - computer-control, elemental mapping and applications

    International Nuclear Information System (INIS)

    Loevestam, Goeran.

    1989-08-01

    A scanning proton microprobe set-up has been developed at the Pelletron accelerator in Lund. A magnetic beam scanning system and a computer-control system for beam scanning and data aquisition is described. The computer system consists of a VMEbus front-end computer and a μVax-II host-computer, interfaced by means of a high-speed data link. The VMEbus computer controls data acquisition, beam charge monitoring and beam scanning while the more sophisticated work of elemental mapping and spectrum evaluations is left to the μVax-II. The calibration of the set-up is described as well as several applications. Elemental micro patterns in tree rings and bark has been investigated by means of elemental mapping and quantitative analysis. Large variations of elemental concentrations have been found for several elements within a single tree ring. An external beam set-up has been developed in addition to the proton microprobe set-up. The external beam has been used for the analysis of antique papyrus documents. Using a scanning sample procedure and particle induced X-ray emission (PIXE) analysis, damaged and missing characters of the text could be made visible by means of multivariate statistical data evaluation and elemental mapping. Also aspects of elemental mapping by means of scanning μPIXE analysis are discussed. Spectrum background, target thickness variations and pile-up are shown to influence the structure of elemental maps considerably. In addition, a semi-quantification procedure has been developed. (author)

  18. Risk assessment analysis of the future technical unit dedicated to the evaluation and treatment of motor disabilities.

    Science.gov (United States)

    Grelier, S; Thetio, M; Quentin, V; Achache, V; Sanchez, N; Leroux, V; Durand, E; Pequignot, R

    2011-03-01

    The National Hospital of Saint Maurice (HNSM) for Physical Medicine and Rehabilitation aims at strengthening its position as a pivot rehabilitation and physical therapy center. The opening in 2011 of a new unit for the evaluation and treatment of motor disabilities meets this objective. This project includes several parts: clinical, financial, architectural, organizational, applied clinical research as well as dealing with medical equipments and information system. This study focuses on the risk assessment of this future technical unit. This study was conducted by a group of professionals working for the hospital. It started with the design of a functional model to better comprehend the system to be analyzed. Risk assessment consists in confronting this functional model to a list of dangers in order to determine the vulnerable areas of the system. Then the team designed some scenarios to identify the causes, securities barriers and consequences in order to rank the risks. The analysis targeted various dangers, e.g. political, strategic, financial, economical, marketing, clinical and operational. The team identified more than 70 risky scenarios. For 75% of them the criticality level was deemed initially tolerable and under control or unacceptable. The implementation of an action plan for reducing the level of risks before opening this technical unit brought the system down to an acceptable level at 66%. A year prior to opening this technical unit for the evaluation and treatment of motor disabilities, conducting this preliminary risk assessment, with its exhaustive and rigorous methodology, enabled the concerned professionals to work together around an action plan for reducing the risks. 2011 Elsevier Masson SAS. All rights reserved.

  19. TITRATION: A Randomized Study to Assess 2 Treatment Algorithms with New Insulin Glargine 300 units/mL.

    Science.gov (United States)

    Yale, Jean-François; Berard, Lori; Groleau, Mélanie; Javadi, Pasha; Stewart, John; Harris, Stewart B

    2017-10-01

    It was uncertain whether an algorithm that involves increasing insulin dosages by 1 unit/day may cause more hypoglycemia with the longer-acting insulin glargine 300 units/mL (GLA-300). The objective of this study was to compare safety and efficacy of 2 titration algorithms, INSIGHT and EDITION, for GLA-300 in people with uncontrolled type 2 diabetes mellitus, mainly in a primary care setting. This was a 12-week, open-label, randomized, multicentre pilot study. Participants were randomly assigned to 1 of 2 algorithms: they either increased their dosage by 1 unit/day (INSIGHT, n=108) or the dose was adjusted by the investigator at least once weekly, but no more often than every 3 days (EDITION, n=104). The target fasting self-monitored blood glucose was in the range of 4.4 to 5.6 mmol/L. The percentages of participants reaching the primary endpoint of fasting self-monitored blood glucose ≤5.6 mmol/L without nocturnal hypoglycemia were 19.4% (INSIGHT) and 18.3% (EDITION). At week 12, 26.9% (INSIGHT) and 28.8% (EDITION) of participants achieved a glycated hemoglobin value of ≤7%. No differences in the incidence of hypoglycemia of any category were noted between algorithms. Participants in both arms of the study were much more satisfied with their new treatment as assessed by the Diabetes Treatment Satisfaction Questionnaire. Most health-care professionals (86%) preferred the INSIGHT over the EDITION algorithm. The frequency of adverse events was similar between algorithms. A patient-driven titration algorithm of 1 unit/day with GLA-300 is effective and comparable to the previously tested EDITION algorithm and is preferred by health-care professionals. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  20. Cancer treatment disparities in HIV-infected individuals in the United States.

    Science.gov (United States)

    Suneja, Gita; Shiels, Meredith S; Angulo, Rory; Copeland, Glenn E; Gonsalves, Lou; Hakenewerth, Anne M; Macomber, Kathryn E; Melville, Sharon K; Engels, Eric A

    2014-08-01

    HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this. We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin's lymphoma, Hodgkin's lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer. We evaluated 3,045 HIV-infected patients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin's lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non-small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage. HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates. © 2014 by American Society of Clinical

  1. Use of Transnational Services to Prevent Treatment Interruption in Tuberculosis-Infected Persons Who Leave the United States.

    Science.gov (United States)

    Tschampl, Cynthia A; Garnick, Deborah W; Zuroweste, Edward; Razavi, Moaven; Shepard, Donald S

    2016-03-01

    A major problem resulting from interrupted tuberculosis (TB) treatment is the development of drug-resistant TB, including multidrug-resistant TB (MDR TB), a more deadly and costly-to-treat form of the disease. Global health systems are not equipped to diagnose and treat the current burden of MDR TB. TB-infected foreign visitors and temporary US residents who leave the country during treatment can experience treatment interruption and, thus, are at greater risk for drug-resistant TB. Using epidemiologic and demographic data, we estimated TB incidence among this group, as well as the proportion of patients referred to transnational care-continuity and management services during relocation; each year, ≈2,827 visitors and temporary residents are at risk for TB treatment interruption, 222 (8%) of whom are referred for transnational services. Scale up of transnational services for persons at high risk for treatment interruption is possible and encouraged because of potential health gains and reductions in healthcare costs for the United States and receiving countries.

  2. State-level prevalence of cigarette smoking and treatment advice, by disability status, United States, 2004.

    Science.gov (United States)

    Armour, Brian S; Campbell, Vincent A; Crews, John E; Malarcher, Ann; Maurice, Emmanuel; Richard, Roland A

    2007-10-01

    To our knowledge, no study has determined whether smoking prevalence is higher among people with disabilities than among people without disabilities across all U.S. states. Neither do we know whether people with disabilities and people without disabilities receive the same quality of advice about tobacco-cessation treatment from medical providers. We analyzed data from the 2004 Behavioral Risk Factor Surveillance System to estimate differences between people with and people without disabilities in smoking prevalence and the receipt of tobacco-cessation treatment advice from medical providers. We found that smoking prevalence for people with disabilities was approximately 50% higher than for people without disabilities. Smokers with disabilities were more likely than smokers without disabilities to have visited a medical provider at least once in the previous 12 months and to have received medical advice to quit. More than 40% of smokers with disabilities who were advised to quit, however, reported not being told about the types of tobacco-cessation treatment available. Ensuring that people with disabilities are included in state-based smoking cessation programs gives states an opportunity to eliminate health disparities and to improve the health and wellness of this group. Ways to reduce unmet preventive health care needs of people with disabilities include provider adoption of the Public Health Service's clinical practice guideline for treating tobacco use and dependence and the provision of smoking cessation services that include counseling and effective pharmaceutical treatment.

  3. ASSESSMENT OF ESTROGENIC ACTIVITY IN EFFLUENTS FROM SEWAGE TREATMENT PLANTS IN THE UNITED STATES

    Science.gov (United States)

    Newly developed molecular biology methods have been used for the measurement of estrogenic activity in source-biased studies of sewage treatment plants. Studies in Texas and New Mexico have shown the utility of the measurement of changes in vitellogenin gene expression in fathea...

  4. Thermal treatment of solid residues from WtE units: a review.

    Science.gov (United States)

    Lindberg, Daniel; Molin, Camilla; Hupa, Mikko

    2015-03-01

    Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Incidence, treatment, and survival patterns for sacral chordoma in the United States, 1974-2011

    Directory of Open Access Journals (Sweden)

    Esther Yu

    2016-09-01

    Full Text Available IntroductionSacral chordomas represent one half of all chordomas, a rare neoplasm of notochordal remnants. Current NCCN guidelines recommend surgical resection with or without adjuvant radiotherapy, or definitive radiation for unresectable cases. Recent advances in radiation for chordomas include conformal photon and proton beam radiation. We investigated incidence, treatment, and survival outcomes to observe any trends in response to improvements in surgical and radiation techniques over a near 40 year time period.Materials and Methods345 microscopically confirmed cases of sacral chordoma were identified between 1974 and 2011 from the Surveillance, Epidemiology, and End Results (SEER program of the National Cancer Institute. Cases were divided into three cohorts by calendar year, 1974-1989, 1990-1999, and 2000-2011, as well as into two groups by age less than or equal to 65 versus greater than 65 to investigate trends over time and age via Chi-square analysis. Kaplan-Meier analyses were performed to determine effects of treatment on survival. Multivariate Cox regression analysis was performed to determine predictors of overall survival.Results5-year overall survival for the entire cohort was 60.0%. Overall survival correlated significantly with treatment modality, with 44% surviving at 5 years with no treatment, 52% with radiation alone, 82% surgery alone, and 78% surgery and radiation (p<.001. Age greater than 65 was significantly associated with non-surgical management with radiation alone or no treatment (p<.001. Relatively fewer patients received radiation between 2000 and 2011 compared to prior time periods (p=.03 versus surgery, for which rates which did not vary significantly over time (p=.55. However, 5-year overall survival was not significantly different by time period. Age group and treatment modality were predictive for overall survival on multivariate analysis (p<.001. ConclusionSurgery remains an important component in the

  6. Evaluation of Resource Utilization and Treatment Patterns in Patients with Actinic Keratosis in the United States.

    Science.gov (United States)

    Asche, Carl V; Zografos, Panagiotis; Norlin, Jenny M; Urbanek, Bill; Mamay, Carl; Makin, Charles; Erntoft, Sandra; Chen, Chi-Chang; Hines, Dionne M; Mark Siegel, Daniel

    2016-01-01

    To compare health care resource utilization and treatment patterns between patients with actinic keratosis (AK) treated with ingenol mebutate gel (IngMeb) and those treated with other field-directed AK therapies. A retrospective, propensity-score-matched, cohort study compared refill/repeat and adding-on/switching patterns and outpatient visits and prescriptions (health care resource utilization) over 6 months in patients receiving IngMeb versus those receiving imiquimod, 5-fluorouracil, diclofenac sodium, and methyl aminolevulinate or aminolevulinic acid photodynamic therapy (MAL/ALA-PDT). The final sample analyzed included four matched treatment cohort pairs (IngMeb and comparator; n = 790-971 per treatment arm). Refill rates were similar except for imiquimod (15% vs. 9% for imiquimod and IngMeb, respectively; P < 0.05). MAL/ALA-PDT treatment repetition rates were higher than IngMeb refill rates (20% vs. 10%; P < 0.05). Topical agent add-on/switch rates were comparable. PDT had higher switch rates than did IngMeb (5% vs. 2%; P < 0.05). The IngMeb cohort had a significantly lower proportion of patients with at least one AK-related outpatient visit during the 6-month follow-up than did any other cohort: versus imiquimod (50% vs. 66%; P < 0.0001), versus 5-fluorouracil (50% vs. 69%; P < 0.0001), versus diclofenac sodium (51% vs. 56%; P = 0.034), and versus MAL/ALA-PDT (50% vs. 100%; P < 0.0001). There were significantly fewer AK-related prescriptions among patients receiving IngMeb than among patients in other cohorts. Results based on the first 6 months after treatment initiation suggested that most field-directed AK therapies had clinically comparable treatment patterns except imiquimod, which was associated with higher refill rates, and PDT, which was associated with significantly more frequent treatment sessions and higher switching rates. IngMeb was also associated with significantly fewer outpatient visits than were other field-directed therapies. Copyright

  7. Treatment/Disposal Plan for Drummed Waste from the 300-FF-1 Operable Unit, 618-4 Burial Ground

    International Nuclear Information System (INIS)

    Lerch, J.A.

    1999-01-01

    The objective of this plan is to support selection of a safe, environmentally responsible, and cost-effective treatment and disposal method for drums containing depleted uranium metal chips submerged in oil that have been and will be excavated from the 618-4 Burial Ground. Remediation of the 300-FF-1 Operable Unit, 618-4 Burial Ground was initiated in fiscal year (FY) 1998 as an excavation and removal operation. Routine processes were established to excavate and ship contaminated soil and debris to the Environmental Restoration Disposal Facility (ERDF) for disposal

  8. Irradiation as a quarantine treatment and the status in the United States and Hawaii

    International Nuclear Information System (INIS)

    Moy, J.H.

    1998-01-01

    Finding an efficient and effective method to control fruit flies and other insect pests on tropical fruits is the prerequisite to sending fruits to international markets where fruit flies are unwanted. After ethylene dibromide was banned as a fumigant in the U.S. in 1984, papaya exports in Hawaii have been using two similar thermal treatments, either the vapor heat, or the high-temperature forced-air, as the disinfestation method. Time required for these thermal treatments is 5 to 6 hours and fruit quality problems are sometimes encountered. Other fruits would require different time-temperature regimes; yet not many fruits can tolerate the heat treatment. Irradiation, emerging as an alternative, efficacious disinfestation method, requires 15-20 min. in a commercial irradiator, and the quality of irradiated fruits is well preserved. Since April, 1995, more than 100,000 kg of untreated tropical fruits, mainly papaya, litchi, and starfruit, have been sent from Hawaii to the U.S. continent with a special permit by the Animal Plant Health Inspection Service (APHIS) of the U.S. Department of Agriculture (USDA), and irradiated at an irradiator near Chicago with a generic dose of 0.25 kGy. These fruits were test marketed with proper labeling in various supermarkets in the Midwest and other cities. Consumer acceptance of irradiated tropical fruits has been very favorable. In May, 1996, APHIS published a document describing policies, procedures, and regulations specifically related to irradiation as a phytosanitary treatment. In early July, 1998, USDA proposed a rule to allow more types of Hawaii-grown fruits to be shipped to the U.S. continent for radiation treatment. These include abiu, atemoya, longan, rambutan, sapodilla, green banana, and durian. To improve the export market potential, the Country of Hawaii is planning to build a small commercial irradiator in 1999 to treat various tropical fruits and possibly other products. (author)

  9. Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee Osteoarthritis in the United States

    Science.gov (United States)

    Bhadra, Arup K.; Altman, Roy; Dasa, Vinod; Myrick, Karen; Rosen, Jeffrey; Vad, Vijay; Vitanzo, Peter; Bruno, Michelle; Kleiner, Hillary; Just, Caryn

    2016-01-01

    Objective: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. Methods: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy. This workgroup utilized the results of a systematic review of evidence, expert clinical opinion, and current evidence-based clinical practice guidelines to develop appropriateness criteria for the use of intra-articular HA for knee OA in 17 real-world clinical scenarios. Results: The workgroup scored the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as appropriate (7-9), uncertain (4-6), or inappropriate (1-3). Six scenarios were scored as appropriate, 10 scenarios were scored as uncertain, and 1 scenario was scored as inappropriate. Conclusion: This article can assist clinicians in shared decision-making by providing best practices in considering HA injections for knee OA treatment. Moreover, this AUC article can aid payers and policy makers in determining reimbursement and preauthorization policies and more appropriately managing health care resources. It is clear that further research is still necessary—particularly in patient populations differentiated by OA severity—that may benefit the greatest from the use of HA injections for the treatment of knee OA. PMID:28618868

  10. Irradiation as a quarantine treatment and the status in the United States and Hawaii

    Energy Technology Data Exchange (ETDEWEB)

    Moy, J.H. [Dept. of Food Science and Human Nutrition, Univ. of Hawaii, Honolulu, HI (United States)

    1998-12-31

    Finding an efficient and effective method to control fruit flies and other insect pests on tropical fruits is the prerequisite to sending fruits to international markets where fruit flies are unwanted. After ethylene dibromide was banned as a fumigant in the U.S. in 1984, papaya exports in Hawaii have been using two similar thermal treatments, either the vapor heat, or the high-temperature forced-air, as the disinfestation method. Time required for these thermal treatments is 5 to 6 hours and fruit quality problems are sometimes encountered. Other fruits would require different time-temperature regimes; yet not many fruits can tolerate the heat treatment. Irradiation, emerging as an alternative, efficacious disinfestation method, requires 15-20 min. in a commercial irradiator, and the quality of irradiated fruits is well preserved. Since April, 1995, more than 100,000 kg of untreated tropical fruits, mainly papaya, litchi, and starfruit, have been sent from Hawaii to the U.S. continent with a special permit by the Animal Plant Health Inspection Service (APHIS) of the U.S. Department of Agriculture (USDA), and irradiated at an irradiator near Chicago with a generic dose of 0.25 kGy. These fruits were test marketed with proper labeling in various supermarkets in the Midwest and other cities. Consumer acceptance of irradiated tropical fruits has been very favorable. In May, 1996, APHIS published a document describing policies, procedures, and regulations specifically related to irradiation as a phytosanitary treatment. In early July, 1998, USDA proposed a rule to allow more types of Hawaii-grown fruits to be shipped to the U.S. continent for radiation treatment. These include abiu, atemoya, longan, rambutan, sapodilla, green banana, and durian. To improve the export market potential, the Country of Hawaii is planning to build a small commercial irradiator in 1999 to treat various tropical fruits and possibly other products. (author)

  11. Case Study of High-Dose Ketamine for Treatment of Complex Regional Pain Syndrome in the Pediatric Intensive Care Unit.

    Science.gov (United States)

    Pasek, Tracy Ann; Crowley, Kelli; Campese, Catherine; Lauer, Rachel; Yang, Charles

    2017-06-01

    Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient. The expertise of advanced practice nurses blended exquisitely to ensure patient and family-centered care and the coordination of care across the illness trajectory. The patient experienced positive outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. LITERATURE SURVEY FOR GROUNDWATER TREATMENT OPTIONS FOR NITRATE IODINE-129 AND URANIUM 200-ZP-1 OPERABLE UNIT HANFORD SITE

    Energy Technology Data Exchange (ETDEWEB)

    BYRNES ME

    2008-06-05

    This literature review presents treatment options for nitrate, iodine-129, and uranium, which are present in groundwater at the 200-ZP-I Groundwater Operable Unit (OU) within the 200 West Area of the Hanford Site. The objective of this review is to determine available methods to treat or sequester these contaminants in place (i.e., in situ) or to pump-and-treat the groundwater aboveground (i.e., ex situ). This review has been conducted with emphasis on commercially available or field-tested technologies, but theoretical studies have, in some cases, been considered when no published field data exist. The initial scope of this literature review included only nitrate and iodine-I 29, but it was later expanded to include uranium. The focus of the literature review was weighted toward researching methods for treatment of nitrate and iodine-129 over uranium because of the relatively greater impact of those compounds identified at the 200-ZP-I OU.

  13. LITERATURE SURVEY FOR GROUNDWATER TREATMENT OPTIONS FOR NITRATE, IODINE-129 AND URANIUM 200-ZP-1 OPERABLE UNIT, HANFORD SITE

    International Nuclear Information System (INIS)

    BYRNES ME

    2008-01-01

    This literature review presents treatment options for nitrate, iodine-129, and uranium, which are present in groundwater at the 200-ZP-I Groundwater Operable Unit (OU) within the 200 West Area of the Hanford Site. The objective of this review is to determine available methods to treat or sequester these contaminants in place (i.e., in situ) or to pump-and-treat the groundwater aboveground (i.e., ex situ). This review has been conducted with emphasis on commercially available or field-tested technologies, but theoretical studies have, in some cases, been considered when no published field data exist. The initial scope of this literature review included only nitrate and iodine-I 29, but it was later expanded to include uranium. The focus of the literature review was weighted toward researching methods for treatment of nitrate and iodine-129 over uranium because of the relatively greater impact of those compounds identified at the 200-ZP-I OU

  14. [Laser treatment for retinopathy of prematurity in neonatal intensive care units. Premature Eye Rescue Program].

    Science.gov (United States)

    Maka, Erika; Imre, László; Somogyvári, Zsolt; Németh, János

    2015-02-01

    Retinopathy of prematurity is a leading cause of childhood blindness around the world. The Department of Ophthalmology at the Semmelweis University and the Peter Cerny Neonatal Emergency and Ambulance Service started an innovative Premature Eye Rescue Program to reduce the non-essential transport of premature babies suffering from retinopathy of prematurity. During the first 5 years 186 eyes of 93 premature babies were treated at the bedside with stage 3 retinopathy of prematurity in the primary hospitals. In this first 5-years period the authors reduced the number of transports of premature babies for laser treatment; 93 children avoided the unnecessary transport, saving altogether a distance of 21,930 kilometers for children, as well as the ambulance service. The Premature Eye Rescue Program offers a good and effective alternative for treatment of retinopathy in the primary hospitals. The authors propose the national extension of this program.

  15. Characterization and constructive utilization of sludge produced in clari-flocculation unit of water treatment plant

    Science.gov (United States)

    Ahmad, Tarique; Ahmad, Kafeel; Alam, Mehtab

    2018-03-01

    All water treatment plants produce waste/residue amid the treatment of raw water. This study selectively investigates the clariflocculator sludge for its physicochemical characteristics and potential reuse options. Sieve analysis, XRF, SEM, XRD, FTIR, and TG-DTA instrumental techniques have been used to characterize the sludge sample. Results show that clariflocculator sludge contains about 78% fine sand having grain size range 150-75 μm. SiO2, Al2O3, Fe2O3 and CaO constitute the maximum percentage of chemical compounds present in the sludge and quartz is the main crystalline phase of the sludge. Recycling and reuse of this sludge, especially, as fine sand in preparing mortar, concrete mix and other civil engineering products would pave the way for constructive utilization with safe and sustainable sludge management strategies.

  16. Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems.

    Science.gov (United States)

    Ronzitti, Silvia; Soldini, Emiliano; Smith, Neil; Potenza, Marc N; Clerici, Massimo; Bowden-Jones, Henrietta

    2017-11-01

    Studies show higher lifetime prevalence of suicidality in individuals with pathological gambling. However, less is known about the relationship between pathological gambling and current suicidal ideation. We investigated socio-demographic, clinical and gambling-related variables associated with suicidality in treatment-seeking individuals. Bivariate analyses and logistic regression models were generated on data from 903 individuals to identify measures associated with aspects of suicidality. Forty-six percent of patients reported current suicidal ideation. People with current suicidal thoughts were more likely to report greater problem-gambling severity (psuicidality. Logistic regression models suggested that past suicidal ideation (psuicidality. Our findings suggest that the severity of anxiety disorder, along with a lifetime history of suicidal ideation, may help to identify treatment-seeking individuals with pathological gambling with a higher risk of suicidality, highlighting the importance of assessing suicidal ideation in clinical settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. [Non-pharmacological treatment of dementia in geriatric psychiatry care units : Scoping review].

    Science.gov (United States)

    Göhner, Anne; Hüll, Michael; Voigt-Radloff, Sebastian

    2018-02-01

    The number of persons suffering from dementia will continuously increase in the coming years; therefore, evidence-based interventions are needed in geriatric psychiatric care. When evidence is poor scoping reviews may help to identify knowledge gaps and needs for research. To present an overview of clinical trials on non-pharmacological treatment for elderly with dementia in hospitals, wards and nursing homes, specializing in gerontopsychiatric care. A systematic search was carried out by one of the authors for clinical trials (randomized controlled, controlled and single group pre-post design, English and German, 1998-2014) in PsycINFO, PubMED, PSYNDEX and the Cochrane Library as well as a manual search in two relevant German peer-reviewed journals. Two authors included studies according to a priori defined inclusion criteria. One author extracted data after consulting the second author in cases of ambiguity. The risk of bias of the studies was not assessed. A total of 77 studies were identified, 29 studies on restructured treatment pathways or settings, 14 trials on environmental changes and 34 studies on therapeutic single or group interventions. Both the methodological quality of the studies and the evidence for the efficacy of non-pharmacological treatment were limited. There are clear indications for an advantage of specialized environments and treatment settings for the elderly with dementia in hospitals, wards and nursing homes. There are consistent indications for positive effects of psychosocial activation alone or in combination with cognitive or physical activation, partly with high-quality study designs. This is consistent with the German S3 guidelines for dementia. For single interventions, such as electroconvulsive therapy or horticultural activities, the level of evidence remains limited.

  18. The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States.

    Science.gov (United States)

    Zero, Domenick T; Fontana, Margherita; Martínez-Mier, E Angeles; Ferreira-Zandoná, Andréa; Ando, Masatoshi; González-Cabezas, Carlos; Bayne, Stephen

    2009-09-01

    Scientific advances in cariology in the past 150 years have led to the understanding that dental caries is a chronic, dietomicrobial, site-specific disease caused by a shift from protective factors favoring tooth remineralization to destructive factors leading to demineralization. Epidemiologic data indicate that caries has changed in the last century; it now is distributed unequally in the U.S. population. People who are minorities, homeless, migrants, children with disabilities and of lower socioeconomic status suffer from the highest prevalence and severity of dental caries. Scientific advances have led to improvements in the prevention, diagnosis and treatment of dental caries, but there is a need for new diagnostic tools and treatment methods. and Future management of dental caries requires early detection and risk assessment if the profession is to achieve timely and cost-effective prevention and treatment for those who need it most. Dental professionals look forward to the day when people of all ages and backgrounds view dental caries as a disease of the past.

  19. Adequacy of depression treatment among college students in the United States.

    Science.gov (United States)

    Eisenberg, Daniel; Chung, Henry

    2012-01-01

    There is no published evidence on the adequacy of depression care among college students and how this varies by subpopulations and provider types. We estimated the prevalence of minimally adequate treatment among students with significant past-year depressive symptoms. Data were collected via a confidential online survey of a random sample of 8488 students from 15 colleges and universities in the 2009 Healthy Minds Study. Depressive symptoms were assessed by the Patient Health Questionnaire-2, adapted to a past-year time frame. Students with probable depression were coded as having received minimally adequate depression care based on the criteria from Wang and colleagues (2005). Minimally adequate treatment was received by only 22% of depressed students. The likelihood of minimally adequate treatment was similarly low for both psychiatric medication and psychotherapy. Minimally adequate care was lower for students prescribed medication by a primary care provider as compared to a psychiatrist (Pstudents were less likely to receive depression care (Pdepression care is a significant problem in the college population. Solutions will likely require greater availability of psychiatry care, better coordination between specialty and primary care using collaborative care models, and increased efforts to retain students in psychotherapy. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Treatment of chronic hepatitis C virus infection in the United States: some remaining obstacles.

    Science.gov (United States)

    Searson, Gloria; Engelson, Ellen S; Carriero, Damaris; Kotler, Donald P

    2014-05-01

    Hepatitis C infection is an important problem in inner city neighbourhoods, which suffer from multiple health disparities. Important factors in this population include alcoholism and substance abuse, mental illness and homelessness, which may be combined with mistrust, poor health literacy, limited access to healthcare and outright discrimination. Systemic barriers to effective care include a lack of capacity to provide comprehensive care, insufficient insurance coverage, poor coordination among caregivers and between caregivers and hospitals, as well as third party payers. These barriers affect real world treatment effectiveness as opposed to treatment efficacy, the latter reflecting the world of clinical trials. The components of effectiveness include efficacious medications, appropriate diagnosis and evaluation, recommendation for therapy, access to therapy, acceptance of the diagnosis and its implications by the patient and adherence to the recommended therapy. Very little attention has been given to assisting the patient to accept the diagnosis and adhere to therapy, i.e. care coordination. For this reason, care coordination is an area in which greater availability could lead to greater acceptance/adherence and greater treatment effectiveness. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Screening and treatment for heritable thrombophilia in pregnancy failure: inconsistencies among UK early pregnancy units.

    Science.gov (United States)

    Norrie, Gillian; Farquharson, Roy G; Greaves, Mike

    2009-01-01

    The significance of heritable thrombophilia in pregnancy failure is controversial. We surveyed all UK Early Pregnancy Units and 70% responded. The majority test routinely for heritable thrombophilias; 80%, 76% and 88% undertook at least one screening test in late miscarriage, recurrent miscarriage and placental abruption, respectively. The range of thrombophilias sought is inconsistent: testing for proteins C and S deficiency and F5 R506Q (factor V Leiden) is most prevalent. Detection of heritable thrombophilia frequently leads to administration of antithrombotics in subsequent pregnancies. Thus, thrombophilia testing and use of antithrombotics are widespread in the UK despite controversies regarding the role of heritable thrombophilia in the pathogenesis of pregnancy complications, and the lack of robust evidence for the efficacy of antithrombotic therapy.

  2. The issue of legal protection of the intensive care unit physician within the context of patient consent to treatment. Part I: conscious patient, refusing treatment.

    Science.gov (United States)

    Siewiera, Jacek; Trnka, Jakub; Kübler, Andrzej

    2014-01-01

    In daily clinical practice, physicians working in intensive care units (ICUs) face situations when their professional duty to protect the patient's life is in conflict with the obligation to respect the will of the patient and to assess his or her chances of treatment. Although the mere fact of conflict between these fundamental values for the ICU physician is a natural and obvious element in the chosen specialisation, many 'non-medical' circumstances make the given conflict not only very difficult but also dangerous for the physician. So far, the ethical and legal aspects of dying have been commented upon by a large group of lawyers and experts involved in the interpretation of the Polish regulations. The authors believe that a detailed analysis of the regulations should be carried out by persons of legal education, possessing a genuine medical experience associated with the specificity of end of life care in ICUs. In this paper, the authors have compared the current regulations of legislative acts of the common law relating to medical activities at anaesthesiology and intensive care units as well as based on the judgements of the common court of law over the past ten years. In the act of dissuading an ICU doctor from a medical procedure, all factors influencing the doctor's responsibility should be taken into account in accordance with the criminal law. In the case of a patient's death due to a refusal of treatment with the patient's full awareness, and given proper notification as to the consequences of refusing treatment, the doctor's responsibility lies under article 150 of the Polish penal code.

  3. Cognitive behaviour therapy for chronic fatigue syndrome: Differences in treatment outcome between a tertiary treatment centre in the United Kingdom and the Netherlands.

    Science.gov (United States)

    Worm-Smeitink, M; Nikolaus, S; Goldsmith, K; Wiborg, J; Ali, S; Knoop, H; Chalder, T

    2016-08-01

    Cognitive behaviour therapy (CBT) reduces fatigue and disability in chronic fatigue syndrome (CFS). However, outcomes vary between studies, possibly because of differences in patient characteristics, treatment protocols, diagnostic criteria and outcome measures. The objective was to compare outcomes after CBT in tertiary treatment centres in the Netherlands (NL) and the United Kingdom (UK), using different treatment protocols but identical outcome measures, while controlling for differences in patient characteristics and diagnostic criteria. Consecutively referred CFS patients who received CBT were included (NL: n=293, UK: n=163). Uncontrolled effect sizes for improvement in fatigue (Chalder Fatigue Questionnaire), physical functioning (SF-36 physical functioning subscale) and social functioning (Work and Social Adjustment Scale) were compared. Multiple regression analysis was used to examine whether patient differences explained outcome differences between centres. Effect sizes differed between centres for fatigue (Cohen's D NL=1.74, 95% CI=1.52-1.95; UK=0.99, CI=0.73-1.25), physical functioning (NL=0.99, CI=0.81-1.18; UK=0.33, CI=0.08-0.58) and social functioning (NL=1.47, CI=1.26-1.69; UK=0.61, CI=0.35-0.86). Patients in the UK had worse physical functioning at baseline and there were minor demographic differences. These could not explain differences in centre outcome. Effectiveness of CBT differed between treatment centres. Differences in treatment protocols may explain this and should be investigated to help further improve outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension Among Young Adults in the United States, 1999 to 2014.

    Science.gov (United States)

    Zhang, Yiyi; Moran, Andrew E

    2017-10-01

    Overall hypertension prevalence has not changed in the United States in recent decades although awareness, treatment, and control improved. However, hypertension epidemiology and its temporal trends may differ in younger adults compared with older adults. Our study included 41 331 participants ≥18 years of age from 8 National Health and Nutrition Examination Surveys (1999-2014) and estimated temporal trends of hypertension, awareness, treatment, and control among young adults (age, 18-39 years) compared with middle-age (age, 40-59 years) and older adults (age, ≥60 years). In 2013 to 2014, 7.3% of the US young adults had hypertension. During 1999 to 2014, young adults saw larger increases in hypertension awareness, treatment, and control than did older adults. However, all of these components of hypertension control were lower among young adults compared with middle-aged or older adults (74.7% younger versus 81.9% middle versus 88.4% older for awareness; 50.0% versus 70.3% versus 83.0% for treatment; and 40.2% versus 56.7% versus 54.4% for control). Worse hypertension awareness, treatment, and control in young adults overall were mostly driven by worse measures in young adult men compared with young adult women. More frequent healthcare visits by young adult women explained ≈28% of the sex-related difference in awareness, 60% of the difference in treatment, and 52% of the difference in control. These findings suggest that improved access to and engagement in medical care might improve hypertension control in young adults, particularly young adult men, and reduce life-time cardiovascular risk. © 2017 American Heart Association, Inc.

  5. Full Monte Carlo-Based Biologic Treatment Plan Optimization System for Intensity Modulated Carbon Ion Therapy on Graphics Processing Unit.

    Science.gov (United States)

    Qin, Nan; Shen, Chenyang; Tsai, Min-Yu; Pinto, Marco; Tian, Zhen; Dedes, Georgios; Pompos, Arnold; Jiang, Steve B; Parodi, Katia; Jia, Xun

    2018-01-01

    One of the major benefits of carbon ion therapy is enhanced biological effectiveness at the Bragg peak region. For intensity modulated carbon ion therapy (IMCT), it is desirable to use Monte Carlo (MC) methods to compute the properties of each pencil beam spot for treatment planning, because of their accuracy in modeling physics processes and estimating biological effects. We previously developed goCMC, a graphics processing unit (GPU)-oriented MC engine for carbon ion therapy. The purpose of the present study was to build a biological treatment plan optimization system using goCMC. The repair-misrepair-fixation model was implemented to compute the spatial distribution of linear-quadratic model parameters for each spot. A treatment plan optimization module was developed to minimize the difference between the prescribed and actual biological effect. We used a gradient-based algorithm to solve the optimization problem. The system was embedded in the Varian Eclipse treatment planning system under a client-server architecture to achieve a user-friendly planning environment. We tested the system with a 1-dimensional homogeneous water case and 3 3-dimensional patient cases. Our system generated treatment plans with biological spread-out Bragg peaks covering the targeted regions and sparing critical structures. Using 4 NVidia GTX 1080 GPUs, the total computation time, including spot simulation, optimization, and final dose calculation, was 0.6 hour for the prostate case (8282 spots), 0.2 hour for the pancreas case (3795 spots), and 0.3 hour for the brain case (6724 spots). The computation time was dominated by MC spot simulation. We built a biological treatment plan optimization system for IMCT that performs simulations using a fast MC engine, goCMC. To the best of our knowledge, this is the first time that full MC-based IMCT inverse planning has been achieved in a clinically viable time frame. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Effect on treatment planning based on properties of Cobalt-60 stereotactic radiosurgery units

    International Nuclear Information System (INIS)

    Nakazawa, Hisato; Komori, Masataka; Uchiyama, Yukio; Hagiwara, Masahiro; Hayashi, Naoki

    2014-01-01

    The brand-new version of gamma knife, Perfexion, is equipped with an automatic collimator arrangement system that does not require manual collimator exchange and a couch-traveling system that is approximately ten times faster than Model C, so treatment time with multiple shots is assumed to remain within a clinically acceptable range. In this study, the treatment plans for Model C and Perfexion were compared from the viewpoint of number of shots, coverage, selectivity, conformity, and gradient in planning target volume (PTV) coverage. We enrolled 187 and 89 patients with vestibular schwannomas treated by Model C and Perfexion in the study. Treatment planning was created on a Leksell GammaPlan workstation. The mean PTV was 5.2 ml (range 0.1-18.4 ml) in Model C and 4.1 ml (range 0.1-32.1 ml) in Perfexion. The mean shot number for Model C and Perfexion was 11 (range 2-27) and 16 (range 1-41) at the isodose contour of 40-60%, respectively. The mean PTV coverage was 94% (range 73-100%) and 98% (range 91-100%), and the mean PTV selectivity was 83% (range 46-98%) and 87% (range 63-97%) for Model C and Perfexion, respectively. The mean conformity index was 1.15 (range 0.81-2.02) and 1.14 (range 0.97-1.57), and the mean gradient index was 2.82 (range 2.37-3.35) and 2.91 (range 2.55-4.48) for Model C and Perfexion, respectively. In Perfexion, better PTV coverage and selectivity were achieved by using an excessively large number of shots. In addition, the use of a small collimator in Perfexion produced a steeper dose gradient. Our comparative research demonstrated the greater clinical usefulness of Perfexion. (author)

  7. The malleability of spatial ability under treatment of a FIRST LEGO League-based robotics unit

    Science.gov (United States)

    Coxon, Steven Vincent

    Spatial ability is important to science, technology, engineering, and math (STEM) success, but spatial talents are rarely developed in schools. Likewise, the gifted may become STEM innovators, but they are rarely provided with pedagogy appropriate to develop their abilities in schools. A stratified random sample of volunteer participants (n=75) ages 9-14 was drawn from 16 public school districts' gifted programs, including as many females (n=28) and children from groups traditionally underrepresented in gifted programs (n=18) as available. Participants were randomly divided into an experimental (n=38) and a control group (n=37) for an intervention study. All participants took the CogAT (form 6) Verbal Battery and the Project TALENT Spatial Ability Assessments. The experimental group participated in a simulation of the FIRST LEGO League (FLL) competition for 20 hours total over five consecutive days. All participants took the spatial measure another time. Experimental males evidenced significant and meaningful gains in measured spatial ability (Cohen's d = 0.87). Females did not evidence significant gains in measured spatial ability. This may be due to sampling error, gender differences in prior experience with LEGO, or differences in facets of spatial ability in the treatment or measurements. Further research studies with larger samples of females, other treatments and measurement tools, and longer treatment periods are recommended. The literature review revealed that FLL is beneficial for STEM engagement in both genders and its use in schools is recommended. The present study provides additional evidence for FLL's usefulness in increasing the number of individuals in the STEM pipeline. Keywords: spatial, gilled, talent, robotics, FIRST LEGO League, science

  8. Cholera in pregnancy: outcomes from a specialized cholera treatment unit for pregnant women in Léogâne, Haiti.

    Science.gov (United States)

    Ciglenecki, Iza; Bichet, Mathieu; Tena, Javier; Mondesir, Erneau; Bastard, Mathieu; Tran, Nguyen-Toan; Antierens, Annick; Staderini, Nelly

    2013-01-01

    The association between cholera in pregnancy and negative fetal outcome has been described since the 19(th) century. However, there is limited published literature on the subject. We describe pregnancy outcomes from a specialized multidisciplinary hospital unit at the onset of a large cholera outbreak in Haiti in 2010 and 2011. Pregnant women with cholera were hospitalized in a specialized unit within the MSF hospital compound in Léogâne and treated using standard cholera treatment guidelines but with earlier, more intense fluid replacement. All women had intravenous access established at admission regardless of their hydration status, and all received antibiotic treatment. Data were collected on patient demographics, pregnancy and cholera status, and pregnancy outcome. In this analysis we calculated risk ratios for fetal death and performed logistic regression analysis to control for confounding factors. 263 pregnant women with cholera were hospitalized between December 2010 and July 2011. None died during hospitalization, 226 (86%) were discharged with a preserved pregnancy and 16 (6%) had live fullterm singleton births, of whom 2 died within the first 5 days postpartum. The remaining 21 pregnancies (8%) resulted in intrauterine fetal death. The risk of fetal death was associated with factors reflecting severity of the cholera episode: after adjusting for confounding factors, the strongest risk factor for fetal death was severe maternal dehydration (adjusted risk ratio for severe vs. mild dehydration was 9.4, 95% CI 2.5-35.3, p = 0.005), followed by severe vomiting (adjusted risk ratio 5.1, 95% 1.1-23.8, p = 0.041). This is the largest cohort of pregnant women with cholera described to date. The main risk factor identified for fetal death was severity of dehydration. Our experience suggests that establishing specialized multidisciplinary units which facilitate close follow-up of both pregnancy and dehydration status due to cholera could be beneficial

  9. Surgical Treatment of Subungual Squamous Cell Carcinoma by Wide Excision of the Nail Unit and Skin Graft Reconstruction: An Evaluation of Treatment Efficiency and Outcomes.

    Science.gov (United States)

    Topin-Ruiz, Solène; Surinach, Catherine; Dalle, Stéphane; Duru, Gérard; Balme, Brigitte; Thomas, Luc

    2017-05-01

    The best surgical treatment modalities for subungual squamous cell carcinoma (SUSCC) without bone invasion need to be determined. The limited available data on Mohs micrographic surgery do not demonstrate its use as a standard procedure. A previous study in a limited series of patients has shown that wide surgical excision of the nail unit was associated with a low rate of recurrence. To confirm the efficiency of wide surgical excision of the nail unit with full-thickness skin graft reconstruction on a series of patients with SUSCC with an extended follow-up and to evaluate short- and long-term postoperative morbidity and patient satisfaction. A consecutive series of 55 patients with biopsy-proven SUSCC without bone invasion treated by wide surgical excision of the nail unit followed by full-thickness skin graft reconstruction from January 1, 2000, to August 31, 2012 were included. After a minimum follow-up of 5 years, the recurrences were collected from the referring physicians. Statistical analysis was conducted from January 1 to June 30, 2016. Demographic data, pathologic characteristics of tumors, postoperative follow-up, and recurrences were collected from medical records. Patients' satisfaction with surgery, quality of life, and delayed postoperative morbidity (functional outcome and sensory disorders) were assessed from a questionnaire mailed to patients and physicians. Among the 55 patients (23 women and 32 men; mean age, 64 years), the mean follow-up was 6.6 years (range, 5.0-11.2 years), with a minimum follow-up of 5 years. Fifty-two questionnaires (95%) were returned. Two recurrences were observed. Minor early postoperative complications, such as graft infection and delayed wound healing, were seen in 6 patients; 8 patients experienced severe pain. Late postoperative complications included hypersensitivity to mechanical shocks (39 of 51 patients [76%]), mildly increased sensitivity to cold (38 of 51 patients [75%]), loss of fine touch sensation (17 of 35

  10. Development of computer-controlled ultrasonic image processing system for severe accidents research

    International Nuclear Information System (INIS)

    Koo, Kil Mo; Kang, Kyung Ho; Kim, Jong Tai; Kim, Jong Whan; Cho, Young Ro; Ha, Kwang Soon; Park, Rae Jun; Kim, Sang Baik; Kim, Hee Dong; Sim, Chul Moo

    2000-07-01

    In order to verify in-vessel corium cooling mechanism, LAVA(Lower-plenum Arrested Vessel Attack) experiment is being performed as a first stage proof of principle test. The aims of this study are to find a gap formation between corium melt and reactor lower head vessel, to verify the principle of the gap formation and to analyze the effect of the gap formation on the thermal behavior of corium melt and the lower plenum. This report aims at developing a computer controlled image signal processing system which is able to improve visualization and to measure the gap distribution with 3-dimensional planar image using a time domain signal analysis method as a part of the ultrasonic pulse echo methods and a computerized position control system. An image signal processing system is developed by independently developing an ultrasonic image signal processing technique and a PC controlled position control system and then combining both systems

  11. An advanced computer-controlled automatic alpha-beta air sample counter

    International Nuclear Information System (INIS)

    Howell, W.P.; Bruinekool, D.J.; Stapleton, E.E.

    1984-01-01

    An improved computer-controlled automatic alpha-beta air sample counter was developed, based upon an earlier automatic air sample counter design. The system consists of an automatic sample changer, an electronic counting system utilizing a large silicon diode detector, a small desk-type microcomputer, a high-speed matrix printer and the necessary data interfaces. The system is operated by commands from the keyboard and programs stored on magnetic tape cassettes. The programs provide for background counting, Chi 2 test, radon subtraction and sample counting for sample periods of one day to one week. Output data are printed by the matrix printer on standard multifold paper. The data output includes gross beta, gross alpha and plutonium results. Data are automatically corrected for background, counter efficiency, and in the gross alpha and plutonium channels, for the presence of radon

  12. Computer-controlled system for rapid soil analysis of 226Ra

    International Nuclear Information System (INIS)

    Doane, R.W.; Berven, B.A.; Blair, M.S.

    1984-01-01

    A computer-controlled multichannel analysis system has been developed by the Radiological Survey Activities Group at Oak Ridge National Laboratory (ORNL) for the Department of Energy (DOE) in support of the DOE's remedial action programs. The purpose of this system is to provide a rapid estimate of the 226 Ra concentration in soil samples using a 6 x 9-in. NaI(Tl) crystal containing a 3.25-in. deep by 3.5-in. diameter well. This gamma detection system is controlled by a mini-computer with a dual floppy disk storage medium. A two-chip interface was also designed at ORNL which handles all control signals generated from the computer keyboard. These computer-generated control signals are processed in machine language for rapid data transfer and BASIC language is used for data processing

  13. Development of a computer control system for the RCNP ring cyclotron

    International Nuclear Information System (INIS)

    Ogata, H.; Yamazaki, T.; Ando, A.; Hosono, K.; Itahashi, T.; Katayama, I.; Kibayashi, M.; Kinjo, S.; Kondo, M.; Miura, I.; Nagayama, K.; Noro, T.; Saito, T.; Shimizu, A.; Uraki, M.; Maruyama, M.; Aoki, K.; Yamada, S.; Kodaira, K.

    1990-01-01

    A hierarchically distributed computer control system for the RCNP ring cyclotron is being developed. The control system consists of a central computer and four subcomputers which are linked together by an Ethernet, universal device controllers which control component devices, man-machine interfaces including an operator console and interlock systems. The universal device controller is a standard single-board computer with an 8344 microcontroller and parallel interfaces, and is usually integrated into a component device and connected to a subcomputer by means of an optical-fiber cable to achieve high-speed data transfer. Control sequences for subsystems are easily produced and improved by using an interpreter language named OPELA (OPEration Language for Accelerators). The control system will be installed in March 1990. (orig.)

  14. Risk assessment of computer-controlled safety systems for fusion reactors

    International Nuclear Information System (INIS)

    Fryer, M.O.; Bruske, S.Z.

    1983-01-01

    The complexity of fusion reactor systems and the need to display, analyze, and react promptly to large amounts of information during reactor operation will require a number of safety systems in the fusion facilities to be computer controlled. Computer software, therefore, must be included in the reactor safety analyses. Unfortunately, the science of integrating computer software into safety analyses is in its infancy. Combined plant hardware and computer software systems are often treated by making simple assumptions about software performance. This method is not acceptable for assessing risks in the complex fusion systems, and a new technique for risk assessment of combined plant hardware and computer software systems has been developed. This technique is an extension of the traditional fault tree analysis and uses structured flow charts of the software in a manner analogous to wiring or piping diagrams of hardware. The software logic determines the form of much of the fault trees

  15. Software quality assurance plan for the National Ignition Facility integrated computer control system

    Energy Technology Data Exchange (ETDEWEB)

    Woodruff, J.

    1996-11-01

    Quality achievement is the responsibility of the line organizations of the National Ignition Facility (NIF) Project. This Software Quality Assurance Plan (SQAP) applies to the activities of the Integrated Computer Control System (ICCS) organization and its subcontractors. The Plan describes the activities implemented by the ICCS section to achieve quality in the NIF Project`s controls software and implements the NIF Quality Assurance Program Plan (QAPP, NIF-95-499, L-15958-2) and the Department of Energy`s (DOE`s) Order 5700.6C. This SQAP governs the quality affecting activities associated with developing and deploying all control system software during the life cycle of the NIF Project.

  16. Simulation Analysis of Computer-Controlled pressurization for Mixture Ratio Control

    Science.gov (United States)

    Alexander, Leslie A.; Bishop-Behel, Karen; Benfield, Michael P. J.; Kelley, Anthony; Woodcock, Gordon R.

    2005-01-01

    A procedural code (C++) simulation was developed to investigate potentials for mixture ratio control of pressure-fed spacecraft rocket propulsion systems by measuring propellant flows, tank liquid quantities, or both, and using feedback from these measurements to adjust propellant tank pressures to set the correct operating mixture ratio for minimum propellant residuals. The pressurization system eliminated mechanical regulators in favor of a computer-controlled, servo- driven throttling valve. We found that a quasi-steady state simulation (pressure and flow transients in the pressurization systems resulting from changes in flow control valve position are ignored) is adequate for this purpose. Monte-Carlo methods are used to obtain simulated statistics on propellant depletion. Mixture ratio control algorithms based on proportional-integral-differential (PID) controller methods were developed. These algorithms actually set target tank pressures; the tank pressures are controlled by another PID controller. Simulation indicates this approach can provide reductions in residual propellants.

  17. Computer control system of the superconducting SR-light source ''Aurora''

    International Nuclear Information System (INIS)

    Yamada, H.

    1989-01-01

    The Aurora is a compact SR-light system optimized for x-ray lithography. The system includes a superconducting electron storage ring, a 150-MeV race track microtron as an injector, and light beamlines. The SR-ring features a single magnet body, in which the 650-MeV electron beam orbits a true circular trajectory of 1 m diameter. The computer control system developed for Aurora has a three-level hierarchical architecture. The top level is the Central Intelligence System, and the second an Autonomic Control System (ACS). The bottom is an assembly of distributed local controllers linked to the ACS level through optical fibers. This system provides fully automatic and remote operation, and a powerful machine study capability through the associated man--machine console and the interpretive operation language

  18. Computer control system of the superconducting SR-light source ``Aurora''

    Science.gov (United States)

    Yamada, Hironari

    1989-07-01

    The Aurora is a compact SR-light system optimized for x-ray lithography. The system includes a superconducting electron storage ring, a 150-MeV race track microtron as an injector, and light beamlines. The SR-ring features a single magnet body, in which the 650-MeV electron beam orbits a true circular trajectory of 1 m diameter. The computer control system developed for Aurora has a three-level hierarchical architecture. The top level is the Central Intelligence System, and the second an Autonomic Control System (ACS). The bottom is an assembly of distributed local controllers linked to the ACS level through optical fibers. This system provides fully automatic and remote operation, and a powerful machine study capability through the associated man-machine console and the interpretive operation language.

  19. LightLeaves: computer controlled kinetic reflection hologram installation and a brief discussion of earlier work

    International Nuclear Information System (INIS)

    Connors Chen, Betsy

    2013-01-01

    LightLeaves is an installation combining leaf shaped, white light reflection holograms of landscape images with a special kinetic lighting device that houses a lamp and moving leaf shaped masks. The masks are controlled by an Arduino microcontroller and servomotors that position the masks in front of the illumination source of the holograms. The work is the most recent in a long series of landscapes that combine multi-hologram installations with computer controlled devices that play with the motion of the holograms, the light, sound or other elements in the work. LightLeaves was first exhibited at the Peabody Essex Museum in Salem, Massachusetts in a show titled E ye Spy: Playing with Perception .

  20. A distributed, graphical user interface based, computer control system for atomic physics experiments.

    Science.gov (United States)

    Keshet, Aviv; Ketterle, Wolfgang

    2013-01-01

    Atomic physics experiments often require a complex sequence of precisely timed computer controlled events. This paper describes a distributed graphical user interface-based control system designed with such experiments in mind, which makes use of off-the-shelf output hardware from National Instruments. The software makes use of a client-server separation between a user interface for sequence design and a set of output hardware servers. Output hardware servers are designed to use standard National Instruments output cards, but the client-server nature should allow this to be extended to other output hardware. Output sequences running on multiple servers and output cards can be synchronized using a shared clock. By using a field programmable gate array-generated variable frequency clock, redundant buffers can be dramatically shortened, and a time resolution of 100 ns achieved over effectively arbitrary sequence lengths.

  1. Advanced computer-controlled automatic alpha-beta air sample counter

    International Nuclear Information System (INIS)

    Howell, W.P.; Bruinekool, D.J.; Stapleton, E.E.

    1983-01-01

    An improved computer controlled automatic alpha-beta air sample counter was developed, based upon an earlier automatic air sample counter design. The system consists of an automatic sample changer, an electronic counting system utilizing a large silicon diode detector, a small desk-type microcomputer, a high speed matrix printer, and the necessary data interfaces. The system is operated by commands from the keyboard and programs stored on magnetic tape cassettes. The programs provide for background counting, Chi 2 test, radon subtraction, and sample counting for sample periods of one day to one week. Output data are printed by the matrix printer on standard multifold paper. The data output includes gross beta, gross alpha, and plutonium results. Data are automatically corrected for background, counter efficiency, and in the gross alpha and plutonium channels, for the presence of radon

  2. Modeling of edge effect in subaperture tool influence functions of computer controlled optical surfacing.

    Science.gov (United States)

    Wan, Songlin; Zhang, Xiangchao; He, Xiaoying; Xu, Min

    2016-12-20

    Computer controlled optical surfacing requires an accurate tool influence function (TIF) for reliable path planning and deterministic fabrication. Near the edge of the workpieces, the TIF has a nonlinear removal behavior, which will cause a severe edge-roll phenomenon. In the present paper, a new edge pressure model is developed based on the finite element analysis results. The model is represented as the product of a basic pressure function and a correcting function. The basic pressure distribution is calculated according to the surface shape of the polishing pad, and the correcting function is used to compensate the errors caused by the edge effect. Practical experimental results demonstrate that the new model can accurately predict the edge TIFs with different overhang ratios. The relative error of the new edge model can be reduced to 15%.

  3. A distributed, graphical user interface based, computer control system for atomic physics experiments

    Science.gov (United States)

    Keshet, Aviv; Ketterle, Wolfgang

    2013-01-01

    Atomic physics experiments often require a complex sequence of precisely timed computer controlled events. This paper describes a distributed graphical user interface-based control system designed with such experiments in mind, which makes use of off-the-shelf output hardware from National Instruments. The software makes use of a client-server separation between a user interface for sequence design and a set of output hardware servers. Output hardware servers are designed to use standard National Instruments output cards, but the client-server nature should allow this to be extended to other output hardware. Output sequences running on multiple servers and output cards can be synchronized using a shared clock. By using a field programmable gate array-generated variable frequency clock, redundant buffers can be dramatically shortened, and a time resolution of 100 ns achieved over effectively arbitrary sequence lengths.

  4. Development of computer-controlled ultrasonic image processing system for severe accidents research

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Kil Mo; Kang, Kyung Ho; Kim, Jong Tai; Kim, Jong Whan; Cho, Young Ro; Ha, Kwang Soon; Park, Rae Jun; Kim, Sang Baik; Kim, Hee Dong; Sim, Chul Moo

    2000-07-01

    In order to verify in-vessel corium cooling mechanism, LAVA(Lower-plenum Arrested Vessel Attack) experiment is being performed as a first stage proof of principle test. The aims of this study are to find a gap formation between corium melt and reactor lower head vessel, to verify the principle of the gap formation and to analyze the effect of the gap formation on the thermal behavior of corium melt and the lower plenum. This report aims at developing a computer controlled image signal processing system which is able to improve visualization and to measure the gap distribution with 3-dimensional planar image using a time domain signal analysis method as a part of the ultrasonic pulse echo methods and a computerized position control system. An image signal processing system is developed by independently developing an ultrasonic image signal processing technique and a PC controlled position control system and then combining both systems.

  5. LightLeaves: computer controlled kinetic reflection hologram installation and a brief discussion of earlier work

    Energy Technology Data Exchange (ETDEWEB)

    Connors Chen, Betsy, E-mail: acmeholo@gmail.com [ACME Holography, Somerville, Massachusetts USA 02144 (United States)

    2013-02-22

    LightLeaves is an installation combining leaf shaped, white light reflection holograms of landscape images with a special kinetic lighting device that houses a lamp and moving leaf shaped masks. The masks are controlled by an Arduino microcontroller and servomotors that position the masks in front of the illumination source of the holograms. The work is the most recent in a long series of landscapes that combine multi-hologram installations with computer controlled devices that play with the motion of the holograms, the light, sound or other elements in the work. LightLeaves was first exhibited at the Peabody Essex Museum in Salem, Massachusetts in a show titled {sup E}ye Spy: Playing with Perception{sup .}.

  6. The LLNL Multiuser Tandem Laboratory computer-controlled radiation monitoring system

    International Nuclear Information System (INIS)

    Homann, S.G.

    1992-01-01

    The Physics Department of the Lawrence Livermore National Laboratory (LLNL) recently constructed a Multiuser Tandem Laboratory (MTL) to perform a variety of basic and applied measurement programs. The laboratory and its research equipment were constructed with support from a consortium of LLNL Divisions, Sandia National Laboratories Livermore, and the University of California. Primary design goals for the facility were inexpensive construction and operation, high beam quality at a large number of experimental stations, and versatility in adapting to new experimental needs. To accomplish these goals, our main design decisions were to place the accelerator in an unshielded structure, to make use of reconfigured cyclotrons as effective switching magnets, and to rely on computer control systems for both radiological protection and highly reproducible and well-characterized accelerator operation. This paper addresses the radiological control computer system

  7. Survey of neonatologists' attitudes toward limiting life-sustaining treatments in the neonatal intensive care unit.

    Science.gov (United States)

    Feltman, D M; Du, H; Leuthner, S R

    2012-11-01

    To understand neonatologists' attitudes toward end-of-life (EOL) management in clinical scenarios, EOL ethical concepts and resource utilization. American Academy of Pediatrics (AAP) Perinatal section members completed an anonymous online survey. Respondents indicated preferences in limiting life-sustaining treatments in four clinical scenarios, ranked agreement with EOL-care ethics statements, indicated outside resources previously used and provided demographic information. In all, 451 surveys were analyzed. Across clinical scenarios and as general ethical concepts, withdrawal of mechanical ventilation in severely affected patients was most accepted by respondents; withdrawal of artificial nutrition and hydration was least accepted. One-third of neonatologists did not agree that non-initiation of treatment is ethically equivalent to withdrawal. Around 20% of neonatologists would not defer care if uncomfortable with a parent's request. Respondents' resources included ethics committees, AAP guidelines and legal counsel/courts. Challenges to providing just, unified EOL care strategies are discussed, including deferring care, limiting artificial nutrition/hydration and conditions surrounding ventilator withdrawal.

  8. Current Capabilities and Capacity of Ebola Treatment Centers in the United States.

    Science.gov (United States)

    Herstein, Jocelyn J; Biddinger, Paul D; Kraft, Colleen S; Saiman, Lisa; Gibbs, Shawn G; Le, Aurora B; Smith, Philip W; Hewlett, Angela L; Lowe, John J

    2016-03-01

    To describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features. A 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet. The survey was sent to and completed by site representatives of each ETC. The survey was sent to all 55 ETCs; 47 (85%) responded. Of the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children's hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site. Facilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.

  9. Referral and Receipt of Treatment for Hepatocellular Carcinoma in United States Veterans: Effect of Patient and Non-Patient Factors

    Science.gov (United States)

    Davila, Jessica A.; Kramer, Jennifer R.; Duan, Zhigang; Richardson, Peter A.; Tyson, Gia L.; Sada, Yvonne H.; Kanwal, Fasiha; El-Serag, Hashem B.

    2014-01-01

    Background The delivery of treatment for hepatocellular carcinoma (HCC) could be influenced by place of HCC diagnosis (hospitalization vs. outpatient), subspecialty referral following diagnosis, as well as physician and facility factors. We conducted a study to examine the effect of patient and non-patient factors on the place of HCC diagnosis, referral, and treatment in Veterans Administration (VA) hospitals in the United States. Methods Using the VA Hepatitis C Clinical Case Registry, we identified HCV-infected patients who developed HCC during 1998–2006. All cases were verified and staged according to Barcelona Clinic Liver Cancer (BCLC) criteria. The main outcomes were place of HCC diagnosis, being seen by a surgeon or oncologist, and treatment. We examined factors related to these outcomes using hierarchical logistic regression. These factors included HCC stage, HCC surveillance, physician specialty, and facility factors, in addition to risk factors, co-morbidity, and liver disease indicators. Results Approximately 37.2% of the 1,296 patients with HCC were diagnosed during hospitalization, 31.0% were seen by a surgeon or oncologist, and 34.3% received treatment. Being seen by a surgeon or oncologist was associated with surveillance (adjusted odds ratio (aOR)=1.47;95%CI:1.20–1.80) and varied by geography (1.74;1.09–2.77). Seeing a surgeon or oncologist was predictive of treatment (aOR=1.43;95%CI:1.24–1.66). There was a significant increase in treatment among patients who received surveillance (aOR=1.37; 95%CI:1.02–1.71), were seen by gastroenterology (1.65;1.21–2.24) or were diagnosed at a transplant facility (1.48;1.15–1.90). Conclusions Approximately 40% of patients were diagnosed during hospitalization. Most patients were not seen by a surgeon or oncologist for treatment evaluation and only 34% received treatment. Only receipt of HCC surveillance was associated with increased likelihood of outpatient diagnosis, being seen by a surgeon or

  10. Anesthesiologists' practice patterns for treatment of postoperative nausea and vomiting in the ambulatory Post Anesthesia Care Unit

    Directory of Open Access Journals (Sweden)

    Claybon Louis

    2006-06-01

    Full Text Available Abstract Background When patients are asked what they find most anxiety provoking about having surgery, the top concerns almost always include postoperative nausea and vomiting (PONV. Only until recently have there been any published recommendations, mostly derived from expert opinion, as to which regimens to use once a patient develops PONV. The goal of this study was to assess the responses to a written survey to address the following questions: 1 If no prophylaxis is administered to an ambulatory patient, what agent do anesthesiologists use for treatment of PONV in the ambulatory Post-Anesthesia Care Unit (PACU?; 2 Do anesthesiologists use non-pharmacologic interventions for PONV treatment?; and 3 If a PONV prophylaxis agent is administered during the anesthetic, do anesthesiologists choose an antiemetic in a different class for treatment? Methods A questionnaire with five short hypothetical clinical vignettes was mailed to 300 randomly selected USA anesthesiologists. The types of pharmacological and nonpharmacological interventions for PONV treatment were analyzed. Results The questionnaire was completed by 106 anesthesiologists (38% response rate, who reported that on average 52% of their practice was ambulatory. If a patient develops PONV and received no prophylaxis, 67% (95% CI, 62% – 79% of anesthesiologists reported they would administer a 5-HT3-antagonist as first choice for treatment, with metoclopramide and dexamethasone being the next two most common choices. 65% (95% CI, 55% – 74% of anesthesiologists reported they would also use non-pharmacologic interventions to treat PONV in the PACU, with an IV fluid bolus or nasal cannula oxygen being the most common. When PONV prophylaxis was given during the anesthetic, the preferred PONV treatment choice changed. Whereas 3%–7% of anesthesiologists would repeat dose metoclopramide, dexamethasone, or droperidol, 26% (95% confidence intervals, 18% – 36% of practitioners would re

  11. ALTERNATIVE REMEDIATION TECHNOLOGY STUDY FOR GROUNDWATER TREATMENT AT 200-PO-1 OPERABLE UNIT AT HANFORD SITE

    Energy Technology Data Exchange (ETDEWEB)

    DADO MA

    2008-07-31

    This study focuses on the remediation methods and technologies applicable for use at 200-PO-I Groundwater Operable Unit (OU) at the Hanford Site. The 200-PO-I Groundwater au requires groundwater remediation because of the existence of contaminants of potential concern (COPC). A screening was conducted on alternative technologies and methods of remediation to determine which show the most potential for remediation of groundwater contaminants. The possible technologies were screened to determine which would be suggested for further study and which were not applicable for groundwater remediation. COPCs determined by the Hanford Site groundwater monitoring were grouped into categories based on properties linking them by remediation methods applicable to each COPC group. The screening considered the following criteria. (1) Determine if the suggested method or technology can be used for the specific contaminants found in groundwater and if the technology can be applied at the 200-PO-I Groundwater au, based on physical characteristics such as geology and depth to groundwater. (2) Evaluate screened technologies based on testing and development stages, effectiveness, implementability, cost, and time. This report documents the results of an intern research project conducted by Mathew Dado for Central Plateau Remediation in the Soil and Groundwater Remediation Project. The study was conducted under the technical supervision of Gloria Cummins and management supervision of Theresa Bergman and Becky Austin.

  12. Establishing a clinical pharmacy technician at a United States Army military treatment facility.

    Science.gov (United States)

    Evans, Jennifer L; Gladd, Ellen M; Gonzalez, Alicia C; Tranam, Salman; Larrabee, Joni M; Lipphardt, Sarah E; Chen, Tina T; Ronn, Michael D; Spain, John

    2016-01-01

    To describe the creation of a clinical pharmacy technician position within the U.S. Army and to identify the personal skills and characteristics required to meet the demands of this role. An outpatient military treatment facility located in Maryland. The clinical pharmacy technician position was designed to support clinical pharmacy services within a patient-centered medical home. Funding and a position description were established to hire a clinical pharmacy technician. Expected duties included administrative (45%), patient education (30%), and dispensing (25%). Local policy, in accordance with federal law and U.S. Army regulations, was developed to define the expanded technician responsibility to deliver patient medication education. In the initial 3 months, the clinical pharmacy technician spent 24 hours per week on clinical activities, affording an additional 10-15 hours per week for clinical pharmacists to provide patient care. Completed consults increased from 41% to 56%, and patient-pharmacist encounters increased from 240 to 290 per month. The technician, acting as a clinical pharmacist extender, also completed an average of 90 patient encounters independently each month. As a result of these improvements, the decision was made to hire a second technician. Currently, the technicians spend 28-40 hours per week on clinical activities, offsetting an average of 26 hours per week for the clinical pharmacists. A patient-centered medical home clinical pharmacy technician can reduce the administrative workload for clinical pharmacists, improve their efficiency, and enhance the use of clinical pharmacy services. Several characteristics, particularly medication knowledge, make pharmacy technicians particularly suited for this role. The results from the implementation of a clinical pharmacy technician at this military treatment facility resulted in an Army-wide expansion of the position and suggested applicability in other practice sites, particularly in federal

  13. The importance of early recognition and timely treatment of delirium in intensive care units

    Directory of Open Access Journals (Sweden)

    Stašević-Karličić Ivana

    2016-01-01

    Full Text Available Delirium is connected to bad short-term (the increase in hospital mortality rate and hospital days and long-term outcomes (disfunctionality, institutionalisation, cognitive damage and post hospital-release dementia. The objective of this study is to determine whether there are possible incompatibilities of treatment of delirium with the recommendations in the guides of good clinical practice from developed countries. The grounded method was used in the study. The so called principal sampling of 17 psychiatrists, anesthesiologists and registered nurses was conducted. Afterwards, the unstructured interviews with the selectees were conducted, transcribed and analyzed immediately through coding, category and concept detection. Having completed this, the theoretical sampling of new interview examinees was conducted. Their analysis enabled the concepts to be linked into a working theory and graphically displayed. The new sampling, the new interviews and their analysis were then continued interactively until the saturation of the working theory was achieved and the final version of the theory was formulated based on the findings reached through the interviews. Having completed the principal sampling and coding of the transcripts led the researches to the saturation of the theory through the separation of eight categories: A - Delirium as a sign of system infection, B - Therapy - Anaesthesiologists administer benzodiazepines, whereas psychiatrists administer antipsychotics, C - An inconspicuous onset of delirium is overlooked, D - Bleeding as the cause of delirium, E -Anticholinergics as a cause of delirium, F - Misunderstanding the nature of delirium by anaesthesiologists, G -Being aware that the patient is vitally endangered, and H - The nurses apply enhanced health care measures. Delirium is a syndrome which can be prevented in 30 -40% of cases (50. An etiological treatment would help avoid complicating delirium's clinical picture and would very much

  14. Case report of a near medical event in stereotactic radiotherapy due to improper units of measure from a treatment planning system

    International Nuclear Information System (INIS)

    Gladstone, D. J.; Li, S.; Jarvis, L. A.; Hartford, A. C.

    2011-01-01

    Purpose: The authors hereby notify the Radiation Oncology community of a potentially lethal error due to improper implementation of linear units of measure in a treatment planning system. The authors report an incident in which a patient was nearly mistreated during a stereotactic radiotherapy procedure due to inappropriate reporting of stereotactic coordinates by the radiation therapy treatment planning system in units of centimeter rather than in millimeter. The authors suggest a method to detect such errors during treatment planning so they are caught and corrected prior to the patient positioning for treatment on the treatment machine. Methods: Using pretreatment imaging, the authors found that stereotactic coordinates are reported with improper linear units by a treatment planning system. The authors have implemented a redundant, independent method of stereotactic coordinate calculation. Results: Implementation of a double check of stereotactic coordinates via redundant, independent calculation is simple and accurate. Use of this technique will avoid any future error in stereotactic treatment coordinates due to improper linear units, transcription, or other similar errors. Conclusions: The authors recommend an independent double check of stereotactic treatment coordinates during the treatment planning process in order to avoid potential mistreatment of patients.

  15. Case report of a near medical event in stereotactic radiotherapy due to improper units of measure from a treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Gladstone, D. J.; Li, S.; Jarvis, L. A.; Hartford, A. C. [Division of Radiation Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, New Hampshire 03756 (United States); Division of Radiation Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, New Hampshire 03756 and Department of Radiation Oncology, Temple University Hospital, Philadelphia, Pennsylvania 19104 (United States); Division of Radiation Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, New Hampshire 03756 (United States)

    2011-07-15

    Purpose: The authors hereby notify the Radiation Oncology community of a potentially lethal error due to improper implementation of linear units of measure in a treatment planning system. The authors report an incident in which a patient was nearly mistreated during a stereotactic radiotherapy procedure due to inappropriate reporting of stereotactic coordinates by the radiation therapy treatment planning system in units of centimeter rather than in millimeter. The authors suggest a method to detect such errors during treatment planning so they are caught and corrected prior to the patient positioning for treatment on the treatment machine. Methods: Using pretreatment imaging, the authors found that stereotactic coordinates are reported with improper linear units by a treatment planning system. The authors have implemented a redundant, independent method of stereotactic coordinate calculation. Results: Implementation of a double check of stereotactic coordinates via redundant, independent calculation is simple and accurate. Use of this technique will avoid any future error in stereotactic treatment coordinates due to improper linear units, transcription, or other similar errors. Conclusions: The authors recommend an independent double check of stereotactic treatment coordinates during the treatment planning process in order to avoid potential mistreatment of patients.

  16. Cost-effectiveness analysis evaluating fidaxomicin versus oral vancomycin for the treatment of Clostridium difficile infection in the United States.

    Science.gov (United States)

    Stranges, Paul M; Hutton, David W; Collins, Curtis D

    2013-01-01

    Fidaxomicin is a novel treatment for Clostridium difficile infections (CDIs). This new treatment, however, is associated with a higher acquisition cost compared with alternatives. The objective of this study was to evaluate the cost-effectiveness of fidaxomicin or oral vancomycin for the treatment of CDIs. We performed a cost-utility analysis comparing fidaxomicin with oral vancomycin for the treatment of CDIs in the United States by creating a decision analytic model from the third-party payer perspective. The incremental cost-effectiveness ratio with fidaxomicin compared with oral vancomycin was $67,576/quality-adjusted life-year. A probabilistic Monte Carlo sensitivity analysis showed that fidaxomicin had an 80.2% chance of being cost-effective at a willingness-to-pay threshold of $100,000/quality-adjusted life-year. Fidaxomicin remained cost-effective under all fluctuations of both fidaxomicin and oral vancomycin costs. The decision analytic model was sensitive to variations in clinical cure and recurrence rates. Secondary analyses revealed that fidaxomicin was cost-effective in patients receiving concominant antimicrobials, in patients with mild to moderate CDIs, and when compared with oral metronidazole in patients with mild to moderate disease. Fidaxomicin was dominated by oral vancomycin if CDI was caused by the NAP1/Bl/027 Clostridium difficile strain and was dominant in institutions that did not compound oral vancomycin. Results of our model showed that fidaxomicin may be a more cost-effective option for the treatment of CDIs when compared with oral vancomycin under most scenarios tested. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Clinical Presentation and Care of Patients with Ebola Virus Disease in the China Ebola Treatment Unit, Liberia.

    Science.gov (United States)

    Shao, Xiaoping; Ren, Weizheng; Zhou, Feihu

    2017-01-24

    In order to evaluate the clinical characteristics of confirmed Ebola Virus Disease (EVD) patients admitted to the China Ebola Treatment Unit (China ETU) between January 2015 and March 2015, we retrospectively analyzed clinical symptoms, treatment, and epidemiologic features of 5 patients with confirmed EVD, and reviewed the relevant medical literature. Of these, 3 patients survived, and 2 died. The time interval from the onset of symptoms to the negative PCR test for Ebola virus in the 3 survivors was 14-18 days. All survivors reported direct contact with confirmed EVD patients up to 21 days prior to admission. All patients developed a fever, fatigue, and anorexia. Fever was generally the first symptom to develop, followed by a gastrointestinal phase characterized by vomiting/nausea (3 cases, 60%), diarrhea (3 cases), and abdominal pain (4 cases, 80%). Three patients (60%) reported joint pain, muscle pain, and conjunctival hemorrhage, respectively, and 2 patients (40%) developed a headache. We concluded that strict isolation and interruption of the route of transmission were required for suspected or confirmed EVD patients. The main treatment strategies were supportive care, maintenance of blood volume and electrolyte balance, and the prevention of complications.

  18. Quantifying direct carbon dioxide emissions from wastewater treatment units by nondispersive infrared sensor (NDIR) - A pilot study.

    Science.gov (United States)

    Kosse, Pascal; Kleeberg, Tasja; Lübken, Manfred; Matschullat, Jörg; Wichern, Marc

    2018-08-15

    Treatment of nutrient-rich wastewater potentially results in direct release of greenhouse gases (GHGs) such as CO 2 , N 2 O or CH 4 - and thus affects Waste Water Treatment Plant's carbon footprint. Accurate CO 2 quantification is challenging due to various chemical, physical and operational conditions. A floating chamber equipped with a nondispersive infrared, single beam, dual wavelength sensor has been evaluated for a pilot approach to quantify fugitive CO 2 emissions above different wastewater treatment units. Total average CO 2 flux was 1182gCO 2 ·m -2 ·d -1 with minimum and maximum fluxes of 829gCO 2 ·m -2 ·d -1 and 1493gCO 2 ·m -2 ·d -1 , respectively. Total observed CO 2 emissions were in 7 to 17kgCO 2 ·PE -1 ·a -1 (average 12kgCO 2 ·PE -1 ·a -1 ). The nitrification tank accounted for about 94.3% of the emissions, followed by secondary clarification (ca. 4.3%) and denitrification (ca. 1.4%), based on those average annual CO 2 emissions per population equivalent (PE). Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Grey water treatment by a continuous process of an electrocoagulation unit and a submerged membrane bioreactor system

    KAUST Repository

    Bani-Melhem, Khalid

    2012-08-01

    This paper presents the performance of an integrated process consisting of an electro-coagulation (EC) unit and a submerged membrane bioreactor (SMBR) technology for grey water treatment. For comparison purposes, another SMBR process without electrocoagulation (EC) was operated in parallel with both processes operated under constant transmembrane pressure for 24. days in continuous operation mode. It was found that integrating EC process with SMBR (EC-SMBR) was not only an effective method for grey water treatment but also for improving the overall performance of the membrane filtration process. EC-SMBR process achieved up to 13% reduction in membrane fouling compared to SMBR without electrocoagulation. High average percent removals were attained by both processes for most wastewater parameters studied. The results demonstrated that EC-SMBR performance slightly exceeded that of SMBR for COD, turbidity, and colour. Both processes produced effluent free of suspended solids, and faecal coliforms were nearly (100%) removed in both processes. A substantial improvement was achieved in removal of phosphate in the EC-SMBR process. However, ammonia nitrogen was removed more effectively by the SMBR only. Accordingly, the electrolysis condition in the EC-SMBR process should be optimized so as not to impede biological treatment. © 2012 Elsevier B.V.

  20. Handling and treatment of low-level radioactive wastes from gaseous diffusion plants in the United States of America

    International Nuclear Information System (INIS)

    Wing, J.F.; Behrend, J.E.

    1984-01-01

    Gaseous diffusion plants in the United States of America currently generate very small quantities of low-level radioactive wastes. These wastes consist primarily of airborne effluent solid trapping media and liquid scrubber solutions, liquid effluent treatment sludges, waste oils and solvents, scrap metals and conventional combustible wastes such as floor sweepings, cleaning rags and shoe covers. In addition to waste emanating from current operations, large quantities of scrap metal generated during the Cascade Improvement Program are stored above ground at each of the diffusion plants. The radionuclides of primary concern are uranium and 99 Tc. Current radioactive waste treatment consists of uranium dissolution in weak acids followed by chemical precipitation and/or solvent extraction for uranium recovery. Current disposal operations consist of above ground storage of scrap metals, shallow land burial of inorganic solids and incineration of combustible wastes. With increased emphasis on reducing the potential for off-site radiological dose, several new treatment and disposal options are being studied and new projects are being planned. One project of particular interest involves the installation of a high temperature incinerator to thermally degrade hazardous organic wastes contaminated with low-level radioactive wastes. Other technologies being studied include fixation of uranium-bearing sludges in concrete before burial, decontamination of scrap metals by smelting and use of specially engineered centralized burial grounds. (author)

  1. Occurrence of disinfection byproducts in United States wastewater treatment plant effluents

    KAUST Repository

    Krasner, Stuart W.

    2009-11-01

    Effluents from wastewater treatment plants (WWTPs) contain disinfection byproducts (DBPs) of health concern when the water is utilized downstream as a potable water supply. The pattern of DBP formation was strongly affected by whether or not the WWTP achieved good nitrification. Chlorine addition to poorly nitrified effluents formed low levels of halogenated DBPs, except for (in some cases) dihalogenated acetic acids, but often substantial amounts of N-nitrosodimethyamine (NDMA). Chlorination of well-nitrified effluent typically resulted in substantial formation of halogenated DBPs but much less NDMA. For example, on a median basis after chlorine addition, the well-nitrified effluents had 57 μg/L of trihalomethanes [THMs] and 3 ng/L of NDMA, while the poorly nitrified effluents had 2 μg/L of THMs and 11 ng/L of NDMA. DBPs with amino acid precursors (haloacetonitriles, haloacetaldehydes) formed at substantial levels after chlorination of well-nitrified effluent. The formation of halogenated DBPs but not that of NDMA correlated with the formation of THMs in WWTP effluents disinfected with free chlorine. However, THM formation did not correlate with the formation of other DBPs in effluents disinfected with chloramines. Because of the relatively high levels of bromide in treated wastewater, bromine incorporation was observed in various classes of DBPs. © 2009 American Chemical Society.

  2. Occurrence of disinfection byproducts in United States wastewater treatment plant effluents

    KAUST Repository

    Krasner, Stuart W.; Westerhoff, Paul K.; Chen, Baiyang; Rittmann, Bruce E.; Amy, Gary L.

    2009-01-01

    Effluents from wastewater treatment plants (WWTPs) contain disinfection byproducts (DBPs) of health concern when the water is utilized downstream as a potable water supply. The pattern of DBP formation was strongly affected by whether or not the WWTP achieved good nitrification. Chlorine addition to poorly nitrified effluents formed low levels of halogenated DBPs, except for (in some cases) dihalogenated acetic acids, but often substantial amounts of N-nitrosodimethyamine (NDMA). Chlorination of well-nitrified effluent typically resulted in substantial formation of halogenated DBPs but much less NDMA. For example, on a median basis after chlorine addition, the well-nitrified effluents had 57 μg/L of trihalomethanes [THMs] and 3 ng/L of NDMA, while the poorly nitrified effluents had 2 μg/L of THMs and 11 ng/L of NDMA. DBPs with amino acid precursors (haloacetonitriles, haloacetaldehydes) formed at substantial levels after chlorination of well-nitrified effluent. The formation of halogenated DBPs but not that of NDMA correlated with the formation of THMs in WWTP effluents disinfected with free chlorine. However, THM formation did not correlate with the formation of other DBPs in effluents disinfected with chloramines. Because of the relatively high levels of bromide in treated wastewater, bromine incorporation was observed in various classes of DBPs. © 2009 American Chemical Society.

  3. Comparison of treatment seeking compulsive buyers in Germany and the United States.

    Science.gov (United States)

    Mueller, Astrid; Mitchell, James E; Mertens, Christian; Mueller, Ulrike; Silbermann, Andrea; Burgard, Melissa; de Zwaan, Martina

    2007-07-01

    The aim of this pilot study was to compare a German (Bavaria) and an American (North Dakota) sample of women suffering from compulsive buying. Thirty-eight German and 39 American female compulsive buyers were screened with the Compulsive Buying Scale (CBS), and the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV) prior to entering a group treatment study. Psychiatric co-morbidity was assessed with the Structured Clinical Interview for DSM-IV Axis I disorders (SCID). There were no statistically significant differences between the German sample and the American sample with regard to age (mean 43.7 and 45 years, respectively), and with regard to the scores on the CBS and the Y-BOCS-SV. A high lifetime co-morbidity rate with Axis I disorders, especially mood disorders, anxiety disorders, substance use disorders, OCD, and binge eating disorder was detected in both samples. Almost all participants met criteria for at least one lifetime Axis I disorder. However, German compulsive buyers showed significantly higher current prevalence rates of any affective disorder, and higher current and lifetime prevalence rates of any anxiety disorder and somatoform disorder. In addition, German compulsive buyers were significantly more likely to have more than one Axis I disorder. The groups did not differ with regard to age and with regard to the severity of compulsive buying and showed a high co-morbidity with Axis I disorders. However, the German compulsive buying sample presented with significantly more psychiatric co-morbidity compared to the American sample. Further research is needed to provide a better understanding of this disorder in general and cross-culturally.

  4. A Cross-National Review of Evidence-Based Psychosocial Treatments for Children and Adolescents with Autistic Spectrum Disorders in the United Kingdom, Ireland, and United States

    Science.gov (United States)

    Robinson, Lee; Bond, Caroline

    2017-01-01

    The most thoroughly researched topic in relation to autistic spectrum disorders (ASDs) is the evaluation of interventions. Educational psychology in the United Kingdom and Ireland is the most closely allied profession to school psychology in the United States. In considering what is published by and for the profession, it is important to include…

  5. Treatment Recommendations for Single-Unit Crowns: Findings from The National Dental Practice-Based Research Network

    Science.gov (United States)

    McCracken, Michael S.; Louis, David R.; Litaker, Mark S.; Minyé, Helena M.; Mungia, Rahma; Gordan, Valeria V.; Marshall, Don G.; Gilbert, Gregg H.

    2016-01-01

    Background Objectives were to: (1) quantify practitioner variation in likelihood to recommend a crown; and (2) test whether certain dentist, practice, and clinical factors are significantly associated with this likelihood. Methods Dentists in the National Dental Practice-Based Research Network completed a questionnaire about indications for single-unit crowns. In four clinical scenarios, practitioners ranked their likelihood of recommending a single-unit crown. These responses were used to calculate a dentist-specific “Crown Factor” (CF; range 0–12). A higher score implies a higher likelihood to recommend a crown. Certain characteristics were tested for statistically significant associations with the CF. Results 1,777 of 2,132 eligible dentists responded (83%). Practitioners were most likely to recommend crowns for teeth that were fractured, cracked, endodontically-treated, or had a broken restoration. Practitioners overwhelmingly recommended crowns for posterior teeth treated endodontically (94%). Practice owners, Southwest practitioners, and practitioners with a balanced work load were more likely to recommend crowns, as were practitioners who use optical scanners for digital impressions. Conclusions There is substantial variation in the likelihood of recommending a crown. While consensus exists in some areas (posterior endodontic treatment), variation dominates in others (size of an existing restoration). Recommendations varied by type of practice, network region, practice busyness, patient insurance status, and use of optical scanners. Practical Implications Recommendations for crowns may be influenced by factors unrelated to tooth and patient variables. A concern for tooth fracture -- whether from endodontic treatment, fractured teeth, or large restorations -- prompted many clinicians to recommend crowns. PMID:27492046

  6. Electronic-cigarette use by individuals in treatment for substance abuse: A survey of 24 treatment centers in the United States.

    Science.gov (United States)

    Gubner, Noah R; Andrews, K Blakely; Mohammad-Zadeh, Ana; Lisha, Nadra E; Guydish, Joseph

    2016-12-01

    Prevalence and reasons for using electronic cigarettes (e-cigarettes) was examined among patients enrolled in 24 substance abuse treatment centers in the United States (N=1113). Prevalence of e-cigarette use was assessed for the full sample. Bivariate analyses and multivariate logistic regression were used to identify characteristics associated with e-cigarette use among current cigarette smokers (the majority of e-cigarette users). Overall 55.5% of the sample reported lifetime use of e-cigarettes, and 30.5% reported using e-cigarettes in the past 30days (current users). The main reasons for using e-cigarettes were (a) at times/places when smoking was prohibited (53.5%), and (b) as a way to quit/reduce cigarette smoking (50.3%). Daily vs non-daily e-cigarette users were more likely to use e-cigarettes both as a way to reduce health risks, and as a way to quit/reduce cigarette smoking. A majority of e-cigarette users (87.1%) reported dual use of e-cigarettes and tobacco cigarettes during the past month. Among current cigarette smokers, those that also used e-cigarettes smoked more cigarettes per day, were more likely to have made a past year cigarette quit attempt, and to have tried nicotine replacement therapy compared to cigarette only smokers. There was a high rate of dual e-cigarette and cigarette use by persons enrolled in addiction treatment. E-cigarette users may be heavier cigarette smokers trying to quit or reduce their cigarette smoking. However, e-cigarettes were also used at times when individuals could not smoke cigarettes. Substance abuse treatment centers developing tobacco policies need to consider these potentially conflicting reasons for using e-cigarettes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. A pharmacoeconomic evaluation of escitalopram versus citalopram in the treatment of severe depression in the United Kingdom.

    Science.gov (United States)

    Wade, Alan G; Toumi, Idris; Hemels, Michiel E H

    2005-04-01

    perspectives at all ranges of probabilities tested. A sensitivity analysis on the acquisition cost of citalopram verified that, from the societal perspective, escitalopram remained the dominant strategy, even at a cost of 0.00 British pounds for citalopram. These results suggest that escitalopram is a cost-saving alternative to citalopram for the treatment of severe depression in the United Kingdom from the perspectives of both the NHS and society. Therefore, a possible advantage may exist at the population level in the treatment of severe depression with escitalopram in the United Kingdom.

  8. Severe depression with Cotard’s phenomenon: treatment of a capacitated patient within the United Kingdom’s Mental Health Act 2007

    Directory of Open Access Journals (Sweden)

    Simon B. Menezes

    2013-02-01

    Full Text Available Treatment of Cotard’s syndrome with electroconvulsive therapy (ECT has been seen to be an effective treatment option when pharmacological options are not successful. Recent changes in the Mental Health Act 2007 used within the United Kingdom has resulted in clinicians unable to prescribe treatment for patients who have capacity but are not providing consent for treatment. We report a case of a patient in the UK with Cotard’s phenomenon and severe depression, where the only effective treatment of ECT was restricted due to changes in mental health law. The role of maintenance ECT as well as the ethical dilemma faced is discussed.

  9. Two-unit cantilevered resin-bonded fixed partial denture as a substitute for a prosthodontic-orthodontic treatment plan: a 5-year case report.

    Science.gov (United States)

    Emami, Elham; St-Georges, Annie; de Grandmont, Pierre

    2012-01-01

    In this case report, we describe the successful long-term treatment of a patient with dental agenesis. The initial treatment plan included an orthodontic phase to provide adequate space for replacing missing lateral incisors with implants. However, because of some complications encountered after 2 years of orthodontic treatment, a revised treatment plan was considered to achieve functional and esthetic goals. The patient was completely satisfied 5 years after being treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost.

  10. Zero Health Worker Infection: Experiences From the China Ebola Treatment Unit During the Ebola Epidemic in Liberia.

    Science.gov (United States)

    Liu, Lei; Yin, Huahua; Liu, Ding

    2017-04-01

    In November 2014, a total of 164 health care workers were dispatched by the Chinese government as the first medical assistance team to Liberia. The tasks of this team were to establish a China Ebola treatment unit (ETU), to commence the initial admission and treatment of suspected and confirmed Ebola patients, and to provide public health and infection control training for relevant local personnel. Overall, during the 2-month stay of this first medical assistance team in Liberia, 112 Ebola-suspected patients presented to the ETU, 65 patients were admitted, including 5 confirmed cases, and 3 confirmed cases were cured. Furthermore, 1520 local people were trained, including health care workers, military health care workers, staff members employed by the ETU, and community residents. Most importantly, as the first Chinese medical assistance team deployed to Liberia fighting the Ebola virus on the frontline, not a single member of this team or the hired local staff were infected by Ebola virus. This highly successful outcome was due to the meticulous infection control initiatives developed by the team, thereby making a significant contribution to China's ETU "zero infection" of health workers in Liberia. The major infection control initiatives conducted in the China ETU that contributed to achieving "zero infection" of all health workers in the ETU are introduced in this report. (Disaster Med Public Health Preparedness. 2017;11:262-266).

  11. Remifentanil analgesia during laser treatment for retinopathy of prematurity: a practical approach in neonatal intensive care unit.

    Science.gov (United States)

    Demirel, Nihal; Bas, Ahmet Y; Kavurt, Sumru; Celik, Istemi H; Yucel, Husniye; Turkbay, Dursun; Hekimoğlu, Emre; Koc, Orhan

    2014-11-01

    Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. The aim of this study is to determine the feasibility of remifentanil analgesia during laser treatment of ROP performed in the neonatal intensive care unit (NICU). Remifentanil was infused continuously during the procedure starting with a dose of 0.2 µg/kg/min and increased gradually to 0.6 µg/kg/min to provide an adequate level of analgesia. We enrolled 64 infants. Remifentanil was infused continuously at a mean rate of 0.4 ± 0.1 μg/kg/min. No major adverse effects were observed except in two patients with reversible bradycardia and hypotension. Premature infant pain profile (PIPP) scores revealed no pain. Patients with bronchopulmonary dysplasia had similar remifentanil dosage, intubation duration, and extubation time. Remifentanil analgesia for ROP treatment performed in the NICU by pediatricians is a safe and effective modality. This modality offers a practical solution in hospitals without readily available pediatric anesthetists. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Portable, remotely operated, computer-controlled, quadrupole mass spectrometer for field use

    International Nuclear Information System (INIS)

    Friesen, R.D.; Newton, J.C.; Smith, C.F.

    1982-04-01

    A portable, remote-controlled mass spectrometer was required at the Nevada Test Site to analyze prompt post-event gas from the nuclear cavity in support of the underground testing program. A Balzers QMG-511 quadrupole was chosen for its ability to be interfaced to a DEC LSI-11 computer and to withstand the ground movement caused by this field environment. The inlet system valves, the pumps, the pressure and temperature transducers, and the quadrupole mass spectrometer are controlled by a read-only-memory-based DEC LSI-11/2 with a high-speed microwave link to the control point which is typically 30 miles away. The computer at the control point is a DEC LSI-11/23 running the RSX-11 operating system. The instrument was automated as much as possible because the system is run by inexperienced operators at times. The mass spectrometer has been used on an initial field event with excellent performance. The gas analysis system is described, including automation by a novel computer control method which reduces operator errors and allows dynamic access to the system parameters

  13. Behavioral response and pain perception to computer controlled local anesthetic delivery system and cartridge syringe

    Directory of Open Access Journals (Sweden)

    T D Yogesh Kumar

    2015-01-01

    Full Text Available Aim: The present study evaluated and compared the pain perception, behavioral response, physiological parameters, and the role of topical anesthetic administration during local anesthetic administration with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD. Design: A randomized controlled crossover study was carried out with 120 children aged 7-11 years. They were randomly divided into Group A: Receiving injection with CCLAD during first visit; Group B: Receiving injection with cartridge syringe during first visit. They were further subdivided into three subgroups based on the topical application used: (a 20% benzocaine; (b pressure with cotton applicator; (c no topical application. Pulse rate and blood pressure were recorded before and during injection procedure. Objective evaluation of disruptive behavior and subjective evaluation of pain were done using face legs activity cry consolability scale and modified facial image scale, respectively. The washout period between the two visits was 1-week. Results: Injections with CCLAD produced significantly lesser pain response, disruptive behavior (P < 0.001, and pulse rate (P < 0.05 when compared to cartridge syringe injections. Application of benzocaine produced lesser pain response and disruptive behavior when compared to the other two subgroups, although the result was not significant. Conclusion: Usage of techniques which enhance behavioral response in children like injections with CCLAD can be considered as a possible step toward achieving a pain-free pediatric dental practice.

  14. A computer-controlled automated test system for fatigue and fracture testing

    International Nuclear Information System (INIS)

    Nanstad, R.K.; Alexander, D.J.; Swain, R.L.; Hutton, J.T.; Thomas, D.L.

    1989-01-01

    A computer-controlled system consisting of a servohydraulic test machine, an in-house designed test controller, and a desktop computer has been developed for performing automated fracture toughness and fatigue crack growth testing both in the laboratory and in hot cells for remote testing of irradiated specimens. Both unloading compliance and dc-potential drop can be used to monitor crack growth. The test controller includes a dc-current supply programmer, a function generator for driving the servohydraulic test machine to required test outputs, five measurement channels (each consisting of low-pass filter, track/hold amplifier, and 16-bit analog-to-digital converter), and digital logic for various control and data multiplexing functions. The test controller connects to the computer via a 16-bit wide photo-isolated bidirectional bus. The computer, a Hewlett-Packard series 200/300, inputs specimen and test parameters from the operator, configures the test controller, stores test data from the test controller in memory, does preliminary analysis during the test, and records sensor calibrations, specimen and test parameters, and test data on flexible diskette for later recall and analysis with measured initial and final crack length information. During the test, the operator can change test parameters as necessary. 24 refs., 6 figs

  15. Implementation of a computer-controlled monitoring system at the Princeton AVF Cyclotron

    International Nuclear Information System (INIS)

    Moore, W.H.

    1984-01-01

    Stability in the parameters of the beams from cyclotrons is often crucial to the experiments laboratories perform. For example, when running a high-resolution experiment with Princeton's QDDD Spectrograph, there are 42 magnetic elements between the ion source and the detector. Instability or drift in any of these elements can easily nullify the sophisticated dispersion matching and kinematic correction that make such experiments possible with machines. At the Princeton Cyclotron they have purchased a commercial computer-controlled measurement system and interfaced it to 20 elements of their beamline. While this project is still far from complete, the authors have satisfied two of the conditions that must be met for such a system to be useful. These are, firstly, that measurements can be made under the conditions of a working laboratory to 1 part in 100,000, and secondly that the results can be presented in a form useful both to the experimenter concerned with the quality of his data and to the technical staff who must maintain and develop the equipment

  16. Advanced digital computers, controls, and automation technologies for power plants: Proceedings

    International Nuclear Information System (INIS)

    Bhatt, S.C.

    1992-08-01

    This document is a compilation of the papers that were presented at an EPRI workshop on Advances in Computers, Controls, and Automation Technologies for Power Plants. The workshop, sponsored by EPRI's Nuclear Power Division, took place February 1992. It was attended by 157 representatives from electric utilities, equipment manufacturers, engineering consulting organizations, universities, national laboratories, government agencies and international utilities. More than 40% of the attendees were from utilities representing the majority group. There were 30% attendees from equipment manufacturers and the engineering consulting organizations. The participants from government agencies, universities, and national laboratories were about 10% each. The workshop included a keynote address, 35 technical papers, and vendor's equipment demonstrations. The technical papers described the state-of-the-art in the areas of recent utility digital upgrades such as digital feedwater controllers, steam generator level controllers, integrated plant computer systems, computer aided diagnostics, automated testing and surveillance and other applications. A group of technical papers presented the ongoing B ampersand W PWR integrated plant control system prototype developments with the triple redundant advanced digital control system. Several international papers from France, Japan and U.K. presented their programs on advance power plant design and applications. Significant advances in the control and automation technologies such as adaptive controls, self-tuning methods, neural networks and expert systems were presented by developers, universities, and national laboratories. Individual papers are indexed separately

  17. A Computer-Controlled SEM-EDX Routine for Characterizing Respirable Coal Mine Dust

    Directory of Open Access Journals (Sweden)

    Victoria Johann-Essex

    2017-01-01

    Full Text Available A recent resurgence in coal workers’ pneumoconiosis (or “black lung” and concerns over other related respiratory illnesses have highlighted the need to elucidate characteristics of airborne particulates in occupational environments. A better understanding of particle size, aspect ratio, or chemical composition may offer new insights regarding causal factors of such illnesses. Scanning electron microscopy analysis using energy dispersive X-ray (SEM-EDX can be used to estimate these particle characteristics. If conducted manually, such work can be very time intensive, limiting the number of particles that can be analyzed. Moreover, potential exists for user bias in interpretation of EDX spectra. A computer-controlled (CC routine, on the other hand, can allow similar analysis at a much faster rate, increasing total particle counts and reproducibility of results. This paper describes a CCSEM-EDX routine specifically developed for analysis of respirable dust samples from coal mines. The routine is verified based on reliability of results obtained on samples of known materials, and reproducibility of results obtained on a set of 10 dust samples collected in the field. The characteristics of the field samples are also discussed with respect to mine occupational environments.

  18. The Overview of the National Ignition Facility Distributed Computer Control System

    International Nuclear Information System (INIS)

    Lagin, L.J.; Bettenhausen, R.C.; Carey, R.A.; Estes, C.M.; Fisher, J.M.; Krammen, J.E.; Reed, R.K.; VanArsdall, P.J.; Woodruff, J.P.

    2001-01-01

    The Integrated Computer Control System (ICCS) for the National Ignition Facility (NIF) is a layered architecture of 300 front-end processors (FEP) coordinated by supervisor subsystems including automatic beam alignment and wavefront control, laser and target diagnostics, pulse power, and shot control timed to 30 ps. FEP computers incorporate either VxWorks on PowerPC or Solaris on UltraSPARC processors that interface to over 45,000 control points attached to VME-bus or PCI-bus crates respectively. Typical devices are stepping motors, transient digitizers, calorimeters, and photodiodes. The front-end layer is divided into another segment comprised of an additional 14,000 control points for industrial controls including vacuum, argon, synthetic air, and safety interlocks implemented with Allen-Bradley programmable logic controllers (PLCs). The computer network is augmented asynchronous transfer mode (ATM) that delivers video streams from 500 sensor cameras monitoring the 192 laser beams to operator workstations. Software is based on an object-oriented framework using CORBA distribution that incorporates services for archiving, machine configuration, graphical user interface, monitoring, event logging, scripting, alert management, and access control. Software coding using a mixed language environment of Ada95 and Java is one-third complete at over 300 thousand source lines. Control system installation is currently under way for the first 8 beams, with project completion scheduled for 2008

  19. A computer control system for the PNC high power cw electron linac. Concept and hardware

    Energy Technology Data Exchange (ETDEWEB)

    Emoto, T.; Hirano, K.; Takei, Hayanori; Nomura, Masahiro; Tani, S. [Power Reactor and Nuclear Fuel Development Corp., Oarai, Ibaraki (Japan). Oarai Engineering Center; Kato, Y.; Ishikawa, Y.

    1998-06-01

    Design and construction of a high power cw (Continuous Wave) electron linac for studying feasibility of nuclear waste transmutation was started in 1989 at PNC. The PNC accelerator (10 MeV, 20 mA average current, 4 ms pulse width, 50 Hz repetition) is dedicated machine for development of the high current acceleration technology in future need. The computer control system is responsible for accelerator control and supporting the experiment for high power operation. The feature of the system is the measurements of accelerator status simultaneously and modularity of software and hardware for easily implemented for modification or expansion. The high speed network (SCRAM Net {approx} 15 MB/s), Ethernet, and front end processors (Digital Signal Processor) were employed for the high speed data taking and control. The system was designed to be standard modules and software implemented man machine interface. Due to graphical-user-interface and object-oriented-programming, the software development environment is effortless programming and maintenance. (author)

  20. Incidence and Treatment Patterns in Hospitalizations for Malignant Spinal Cord Compression in the United States, 1998-2006

    International Nuclear Information System (INIS)

    Mak, Kimberley S.; Lee, Leslie K.; Mak, Raymond H.; Wang, Shuang; Pile-Spellman, John; Abrahm, Janet L.; Prigerson, Holly G.; Balboni, Tracy A.

    2011-01-01

    Purpose: To characterize patterns in incidence, management, and costs of malignant spinal cord compression (MSCC) hospitalizations in the United States, using population-based data. Methods and Materials: Using the Nationwide Inpatient Sample, an all-payer healthcare database representative of all U.S. hospitalizations, MSCC-related hospitalizations were identified for the period 1998-2006. Cases were combined with age-adjusted Surveillance, Epidemiology and End Results cancer death data to estimate annual incidence. Linear regression characterized trends in patient, treatment, and hospital characteristics, costs, and outcomes. Logistic regression was used to examine inpatient treatment (radiotherapy [RT], surgery, or neither) by hospital characteristics and year, adjusting for confounding. Results: We identified 15,367 MSCC-related cases, representing 75,876 hospitalizations. Lung cancer (24.9%), prostate cancer (16.2%), and multiple myeloma (11.1%) were the most prevalent underlying cancer diagnoses. The annual incidence of MSCC hospitalization among patients dying of cancer was 3.4%; multiple myeloma (15.0%), Hodgkin and non-Hodgkin lymphomas (13.9%), and prostate cancer (5.5%) exhibited the highest cancer-specific incidence. Over the study period, inpatient RT for MSCC decreased (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.61-0.81), whereas surgery increased (OR 1.48, 95% CI 1.17-1.84). Hospitalization costs for MSCC increased (5.3% per year, p < 0.001). Odds of inpatient RT were greater at teaching hospitals (OR 1.41, 95% CI 1.19-1.67), whereas odds of surgery were greater at urban institutions (OR 1.82, 95% CI 1.29-2.58). Conclusions: In the United States, patients dying of cancer have an estimated 3.4% annual incidence of MSCC requiring hospitalization. Inpatient management of MSCC varied over time and by hospital characteristics, with hospitalization costs increasing. Future studies are required to determine the impact of treatment patterns on MSCC

  1. A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh

    Directory of Open Access Journals (Sweden)

    Naheed Rukhsana

    2011-07-01

    Full Text Available Purpose: The report presents an extraordinary synthesis of customer acceptance procedures (CAP, quality assurance tests (QA in the treatment of cervical cancer patients, using the first Co-60 Multisource Unit® in Bangladesh. The QA and commissioning required measurements and emergency tests verifying the functional limits of parameters acceptable for the new HDR afterloader. Acceptable limits were: 1 the deviation between specified and measured source strength: ± 3%; 2 the positional accuracy and uniformity: ± 1 mm; 3 the temporal accuracy (i.e. timer error and linearity and end error: ± 1% or 30 sec.; 4 treatment planning system (digitizer and localization software: ± 3% or 1 mm; 5 the distance from line to first dwell position and all the others: 5 mm and 10 mm (± 1 mm. Material and methods: Till February 2011, 47 patients were treated with HDR with more than 140 insertions applied. Amongst them, 12 patients were in stage IIB and IIIB, 22 were postoperative (IA and IB while the remaining 13 patients were with unknown stage. All the cases with stage IIB and IIIB received concurrent chemo-radiation and brachytherapy. Postoperative patients received EBRT (50 Gy and HDR according to the institutional protocol. CT scans were completed before HDR-plus planning with a good reproducibility (± 2% and were documented in repeating the plan for the same set up of a patient. Absorbed dose (Gy to a point P, at a distance of “r” in centimeters from a source of the Reference Air Kerma Rate (RAKR has been utilized for the QA of the source, where source strength measurement was accomplished. Results: All methods and analysis applicable to the QA and commissioning of Co-60 have been investigated and systematically analyzed, measured and documented before the treatment of a patient. Studies and safety requirements of this HDR remote afterloader were carried out. Acceptance and the QA were imperative to justify functionality and dependability in

  2. A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh.

    Science.gov (United States)

    Malik, Sadiq R; Banu, Parvin A; Rukhsana, Naheed

    2011-06-01

    The report presents an extraordinary synthesis of customer acceptance procedures (CAP), quality assurance tests (QA) in the treatment of cervical cancer patients, using the first Co-60 Multisource Unit ® in Bangladesh. The QA and commissioning required measurements and emergency tests verifying the functional limits of parameters acceptable for the new HDR afterloader. Acceptable limits were: 1) the deviation between specified and measured source strength: ± 3%; 2) the positional accuracy and uniformity: ± 1 mm; 3) the temporal accuracy (i.e. timer error and linearity and end error): ± 1% or 30 sec.; 4) treatment planning system (digitizer and localization software): ± 3% or 1 mm; 5) the distance from line to first dwell position and all the others: 5 mm and 10 mm (± 1 mm). Till February 2011, 47 patients were treated with HDR with more than 140 insertions applied. Amongst them, 12 patients were in stage IIB and IIIB, 22 were postoperative (IA and IB) while the remaining 13 patients were with unknown stage. All the cases with stage IIB and IIIB received concurrent chemo-radiation and brachytherapy. Postoperative patients received EBRT (50 Gy and HDR) according to the institutional protocol. CT scans were completed before HDR-plus planning with a good reproducibility (± 2%) and were documented in repeating the plan for the same set up of a patient. Absorbed dose (Gy) to a point P, at a distance of "r" in centimeters from a source of the Reference Air Kerma Rate (RAKR) has been utilized for the QA of the source, where source strength measurement was accomplished. All methods and analysis applicable to the QA and commissioning of Co-60 have been investigated and systematically analyzed, measured and documented before the treatment of a patient. Studies and safety requirements of this HDR remote afterloader were carried out. Acceptance and the QA were imperative to justify functionality and dependability in delivering the treatment. Implications of these studies

  3. Restrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Virus Infection in the United States.

    Science.gov (United States)

    Barua, Soumitri; Greenwald, Robert; Grebely, Jason; Dore, Gregory J; Swan, Tracy; Taylor, Lynn E

    2015-08-04

    The aim of this study was to systematically evaluate state Medicaid policies for the treatment of hepatitis C virus (HCV) infection with sofosbuvir in the United States. Medicaid reimbursement criteria for sofosbuvir were evaluated in all 50 states and the District of Columbia. The authors searched state Medicaid Web sites between 23 June and 7 December 2014 and extracted data in duplicate. Any differences were resolved by consensus. Data were extracted on whether sofosbuvir was covered and the criteria for coverage based on the following categories: liver disease stage, HIV co-infection, prescriber type, and drug or alcohol use. Of the 42 states with known Medicaid reimbursement criteria for sofosbuvir, 74% limit sofosbuvir access to persons with advanced fibrosis (Meta-Analysis of Histologic Data in Viral Hepatitis [METAVIR] fibrosis stage F3) or cirrhosis (F4). One quarter of states require persons co-infected with HCV and HIV to be receiving antiretroviral therapy or to have suppressed HIV RNA levels. Two thirds of states have restrictions based on prescriber type, and 88% include drug or alcohol use in their sofosbuvir eligibility criteria, with 50% requiring a period of abstinence and 64% requiring urine drug screening. Heterogeneity is present in Medicaid reimbursement criteria for sofosbuvir with respect to liver disease staging, HIV co-infection, prescriber type, and drug or alcohol use across the United States. Restrictions do not seem to conform with recommendations from professional organizations, such as the Infectious Diseases Society of America and the American Association for the Study of Liver Diseases. Current restrictions seem to violate federal Medicaid law, which requires states to cover drugs consistent with their U.S. Food and Drug Administration labels.

  4. A Low-Cost Computer-Controlled Arduino-Based Educational Laboratory System for Teaching the Fundamentals of Photovoltaic Cells

    Science.gov (United States)

    Zachariadou, K.; Yiasemides, K.; Trougkakos, N.

    2012-01-01

    We present a low-cost, fully computer-controlled, Arduino-based, educational laboratory (SolarInsight) to be used in undergraduate university courses concerned with electrical engineering and physics. The major goal of the system is to provide students with the necessary instrumentation, software tools and methodology in order to learn fundamental…

  5. Proceedings of the meeting on the planning of the computer control and data processing system in the photon factory project

    International Nuclear Information System (INIS)

    Ando, Masami; Ohta, Toshiaki

    1978-07-01

    In the photon factory for synchrotron radiation experiments, a computer control and data processing system is required for efficient utilization of the factory. Reports made in the meeting oriented as above are presented individually, reflecting various aspects of joint-use computer system and its technological advances. (Mori, K.)

  6. Guide to improving the performance of a manipulator system for nuclear fuel handling through computer controls. Final report

    International Nuclear Information System (INIS)

    Evans, J.M. Jr.; Albus, J.S.; Barbera, A.J.; Rosenthal, R.; Truitt, W.B.

    1975-11-01

    The Office of Developmental Automation and Control Technology of the Institute for Computer Sciences and Technology of the National Bureau of Standards provides advising services, standards and guidelines on interface and computer control systems, and performance specifications for the procurement and use of computer controlled manipulators and other computer based automation systems. These outputs help other agencies and industry apply this technology to increase productivity and improve work quality by removing men from hazardous environments. In FY 74 personnel from the Oak Ridge National Laboratory visited NBS to discuss the feasibility of using computer control techniques to improve the operation of remote control manipulators in nuclear fuel reprocessing. Subsequent discussions led to an agreement for NBS to develop a conceptual design for such a computer control system for the PaR Model 3000 manipulator in the Thorium Uranium Recycle Facility (TURF) at ORNL. This report provides the required analysis and conceptual design. Complete computer programs are included for testing of computer interfaces and for actual robot control in both point-to-point and continuous path modes

  7. Migrating songbirds tested in computer-controlled Emlen funnels use stellar cuesfor a time-independent compass

    DEFF Research Database (Denmark)

    Mouritsen, Henrik Østergaard; Larsen, Ole Næsbye

    2001-01-01

    This paper investigates how young pied flycatchers, Ficedula hypoleuca, and blackcaps, Sylvia atricapilla, , and blackcaps, Sylvia atricapilla, interpret and use celestial cues. In order to record these data, we developed a computer-controlled version of the Emlen funnel, which enabled us to make...

  8. A comparative evaluation of pain and anxiety levels in 2 different anesthesia techniques: locoregional anesthesia using conventional syringe versus intraosseous anesthesia using a computer-controlled system (Quicksleeper).

    Science.gov (United States)

    Özer, Senem; Yaltirik, Mehmet; Kirli, Irem; Yargic, Ilhan

    2012-11-01

    The aim of this study was to compare anxiety and pain levels during anesthesia and efficacy of Quicksleeper intraosseous (IO) injection system, which delivers computer-controlled IO anesthesia and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molars. Forty subjects with bilateral impacted mandibular third molars randomly received IO injection or conventional IANB at 2 successive appointments. The subjects received 1.8 mL 2% articaine. IO injection has many advantages, such as enabling painless anesthesia with less soft tissue numbness and quick onset of anesthesia as well as lingual and palatal anesthesia with single needle penetration. Although IO injection is a useful technique commonly used during various treatments in dentistry, the duration of injection takes longer than conventional techniques, there is a possibility of obstruction at the needle tip, and, the duration of the anesthetic effect is inadequate for prolonged surgical procedures. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Back to the future: extended dialysis for treatment of acute kidney injury in the intensive care unit.

    Science.gov (United States)

    Kielstein, Jan T; Schiffer, Mario; Hafer, Carsten

    2010-01-01

    On September 11, 1945, Maria Schafstaat was the first patient who successfully underwent a dialysis treatment for acute kidney injury (AKI). The ingenious design of the first dialysis machine, made of cellophane tubing wrapped around a cylinder that rotated in a bath of fluid, together with the brave determination to treat patients with AKI, enabled the Dutch physician W.J. Kolff to save the life of the 67-year-old woman. By treating her for 690 minutes (i.e., 11.5 hours) with a blood flow rate of 116 ml/min, Kolff also set the coordinates of a renal replacement therapy that has enjoyed an unsurpassed renaissance over the last decade for treatment of severely ill patients with AKI in the intensive care unit (ICU). Prolonged dialysis time with low flow rates - these days, called extended dialysis (ED) - combines several advantages of both intermittent and continuous techniques, which makes it an ideal treatment method for ICU patients with AKI. This review summarizes our knowledge of this method, which is increasingly used in many centers worldwide. We reflect on prospective controlled studies in critically ill patients that have documented that small-solute clearance with ED is comparable with that of intermittent hemodialysis and continuous venovenous hemofiltration, as well as on studies showing that patients' cardiovascular stability during ED is similar to that with continuous renal replacement therapy. Furthermore, we report on logistic and economic advantages of this method. We share our view on how extended dialysis offers ample opportunity for a collaborative interaction between nephrologists and intensivists as the nephrology staff, enabling optimal treatment of complex critically ill patients by using the skill and knowledge of 2 indispensable specialties in the ICU. Lastly, we address the problem of ED intensity, which does not seem to have an impact on survival at higher doses, a finding that might be caused by the fact that we still adhere to dosing

  10. Computer-Controlled Cylindrical Polishing Process for Large X-Ray Mirror Mandrels

    Science.gov (United States)

    Khan, Gufran S.; Gubarev, Mikhail; Speegle, Chet; Ramsey, Brian

    2010-01-01

    We are developing high-energy grazing incidence shell optics for hard-x-ray telescopes. The resolution of a mirror shells depends on the quality of cylindrical mandrel from which they are being replicated. Mid-spatial-frequency axial figure error is a dominant contributor in the error budget of the mandrel. This paper presents our efforts to develop a deterministic cylindrical polishing process in order to keep the mid-spatial-frequency axial figure errors to a minimum. Simulation software is developed to model the residual surface figure errors of a mandrel due to the polishing process parameters and the tools used, as well as to compute the optical performance of the optics. The study carried out using the developed software was focused on establishing a relationship between the polishing process parameters and the mid-spatial-frequency error generation. The process parameters modeled are the speeds of the lap and the mandrel, the tool s influence function, the contour path (dwell) of the tools, their shape and the distribution of the tools on the polishing lap. Using the inputs from the mathematical model, a mandrel having conical approximated Wolter-1 geometry, has been polished on a newly developed computer-controlled cylindrical polishing machine. The preliminary results of a series of polishing experiments demonstrate a qualitative agreement with the developed model. We report our first experimental results and discuss plans for further improvements in the polishing process. The ability to simulate the polishing process is critical to optimize the polishing process, improve the mandrel quality and significantly reduce the cost of mandrel production

  11. Computer-controlled pneumatic pressure algometry--a new technique for quantitative sensory testing.

    Science.gov (United States)

    Polianskis, R; Graven-Nielsen, T; Arendt-Nielsen, L

    2001-01-01

    Hand-held pressure algometry usually assesses pressure-pain detection thresholds and provides little information on pressure-pain stimulus-response function. In this article, a cuff pressure algometry for advanced pressure-pain function evaluation is proposed. The experimental set-up consisted of a pneumatic tourniquet cuff, a computer-controlled air compressor and an electronic visual analogue scale (VAS) for constant pain intensity rating. Twelve healthy volunteers were included in the study. In the first part, hand-held algometry and cuff algometry were performed over the gastrocnemius muscle with constant compression rate. In the second part, the cuff algometry was performed with different compression rates to evaluate the influence of the compression rate on pain thresholds and other psychophysical data. Pressure-pain detection threshold (PDT), pain tolerance threshold (PTT), pain intensity, PDT-PTT time and other psychophysical variables were evaluated.Pressure-pain detection thresholds recorded over the gastrocnemius muscle with a hand-held and with a cuff algometer, were 482 +/- 19 kPa and 26 +/- 1.6 kPa, respectively. Pressure and pain intensities were correlated during cuff algometry. During increasing cuff compression, the subjective pain tolerance limit on VAS was 5.6 +/- 0.95 cm. There was a direct correlation between the number of compressions, the compression rate and pain thresholds. The cuff algometry technique is appropriate for pressure-pain stimulus-response studies. Cuff algometry allowed quantification of psychophysical response to the change of stimulus configuration. Copyright 2001 European Federation of Chapters of the International Association for the Study of Pain.

  12. Treatment Patterns and Associated Health Care Costs Before and After Treatment Initiation Among Pulmonary Arterial Hypertension Patients in the United States.

    Science.gov (United States)

    Burger, Charles D; Ozbay, A Burak; Lazarus, Howard M; Riehle, Ellen; Montejano, Leslie B; Lenhart, Gregory; White, R James

    2018-02-13

    -month post-index period with any inpatient admission decreased, 42% versus 30% (P < 0.001). In addition, PAH-related inpatient admissions decreased in the 6-month post-index period from 7% to 3% (P < 0.001). After treatment initiation, patients' nonpharmacy medical costs decreased from $48,200 (SD = $117,686) to $33,962 (SD = $90,294; P < 0.001), mainly attributable to reduced inpatient costs. However, total average medical costs including pharmacy costs remained comparable after treatment initiation (pre-index period = $51,455 vs. post-index period = $53,923; P = 0.213). This study found that while patients' PAH-related pharmacy costs increased after treatment initiation, the increase was offset by reduced inpatient utilization; therefore, total health care costs remained constant. While the majority of patients in this study were treated with monotherapy, the recently completed AMBITION study indicated that initial combination therapy with ambrisentan plus tadalafil reduced PAH-related hospitalizations compared with initial monotherapy with either of these agents. Future cost analyses of patients treated with combination therapy will be required to determine the economic effect of initial combination therapy. This study was sponsored and funded by Gilead Sciences. Ozbay is an employee of Gilead Sciences. At the time that this project and manuscript were developed, Lazarus was an employee of Gilead Sciences and may own stock/stock options. Riehle, Montejano, and Lenhart are employees of Truven Health Analytics, an IBM company, which received funding from Gilead Sciences to conduct this study. Burger and White do research with, and are paid consultants for, Gilead Sciences; they do not own equity and received no personal compensation for the work here. Burger also reports consultancy and advisory board work for Actelion Pharmaceuticals and grants from Gilead Sciences, Actelion Pharmaceuticals, Bayer, and United Therapeutics. Study concept and design were contributed by

  13. Carbapenem-resistant Klebsiella pneumoniae infections in a Greek intensive care unit: Molecular characterisation and treatment challenges.

    Science.gov (United States)

    Katsiari, Maria; Panagiota, Giakkoupi; Likousi, Sophia; Roussou, Zoi; Polemis, Michalis; Alkiviadis Vatopoulos, C; Evangelia Platsouka, D; Maguina, Asimina

    2015-06-01

    Acquisition of carbapenemase-producing Klebsiella pneumoniae (CP-Kp) strains poses a major threat to critically ill patients. The objectives of this study were to describe the epidemiology of CP-Kp isolates as well as the clinical outcome associated with the corresponding infections and to identify risk factors for mortality of intensive care unit (ICU) patients in a Greek hospital. A prospective, observational study was conducted in a nine-bed general ICU over a 2-year period (April 2010-March 2012). Imipenem-resistant K. pneumoniae isolates recovered from clinical samples of ICU patients were prospectively collected and studied for the presence of carbapenemases. Isolates were submitted to molecular typing using pulsed-field gel electrophoresis (PFGE). In total, 61 CP-Kp isolates (48 KPC-producers and 13 VIM-producers) were recovered from 58 ICU patients. The majority of KPC-producers were classified into a single PFGE type, indicating potent clonal dissemination. Among the 32 infected patients, bacteraemia was diagnosed in 16. Tigecycline+colistin was the most common combination antimicrobial regimen. Infection-attributable mortality was 43.8%. Regarding mortality risk factors, non-survivors were older (P=0.080), all of them presented with septic shock (P=0.010) and they had higher Sepsis-related Organ Failure Assessment (SOFA) scores at infection onset (P=0.004) compared with survivors. Appropriate definitive treatment and combination regimens were not associated with patient survival. In conclusion, CP-Kp infections are associated with limited treatment options and high in-hospital mortality. Effective measures for preventing dissemination of respective isolates in the hospital setting are required. Copyright © 2015 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  14. Using simulated historical time series to prioritize fuel treatments on landscapes across the United States: The LANDFIRE prototype project

    Science.gov (United States)

    Keane, Robert E.; Rollins, Matthew; Zhu, Zhi-Liang

    2007-01-01

    Canopy and surface fuels in many fire-prone forests of the United States have increased over the last 70 years as a result of modern fire exclusion policies, grazing, and other land management activities. The Healthy Forest Restoration Act and National Fire Plan establish a national commitment to reduce fire hazard and restore fire-adapted ecosystems across the USA. The primary index used to prioritize treatment areas across the nation is Fire Regime Condition Class (FRCC) computed as departures of current conditions from the historical fire and landscape conditions. This paper describes a process that uses an extensive set of ecological models to map FRCC from a departure statistic computed from simulated time series of historical landscape composition. This mapping process uses a data-driven, biophysical approach where georeferenced field data, biogeochemical simulation models, and spatial data libraries are integrated using spatial statistical modeling to map environmental gradients that are then used to predict vegetation and fuels characteristics over space. These characteristics are then fed into a landscape fire and succession simulation model to simulate a time series of historical landscape compositions that are then compared to the composition of current landscapes to compute departure, and the FRCC values. Intermediate products from this process are then used to create ancillary vegetation, fuels, and fire regime layers that are useful in the eventual planning and implementation of fuel and restoration treatments at local scales. The complex integration of varied ecological models at different scales is described and problems encountered during the implementation of this process in the LANDFIRE prototype project are addressed.

  15. Recommendations for the use of eliglustat in the treatment of adults with Gaucher disease type 1 in the United States.

    Science.gov (United States)

    Balwani, Manisha; Burrow, Thomas Andrew; Charrow, Joel; Goker-Alpan, Ozlem; Kaplan, Paige; Kishnani, Priya S; Mistry, Pramod; Ruskin, Jeremy; Weinreb, Neal

    2016-02-01

    In Gaucher disease, deficient activity of acid β-glucosidase results in accumulation of its substrates, glucosylceramide and glucosylsphingosine, within the lysosomes of cells primarily in the spleen, liver, bone marrow, and occasionally the lung. The multisystem disease is predominantly characterized by hepatosplenomegaly, anemia, thrombocytopenia, and skeletal disease. Enzyme replacement therapy with recombinant human acid β-glucosidase has been the first-line therapy for Gaucher disease type 1 for more than two decades. Eliglustat, a novel oral substrate reduction therapy, was recently approved in the United States and the European Union as a first-line treatment for adults with Gaucher disease type 1. Eliglustat inhibits glucosylceramide synthase, thereby decreasing production of the substrate glucosylceramide and reducing its accumulation. Although existing recommendations for the care of patients with Gaucher disease remain in effect, unique characteristics of eliglustat require additional investigation and monitoring. A panel of physicians with expertise in Gaucher disease and experience with eliglustat in the clinical trials provide guidance regarding the use of eliglustat, including considerations before starting therapy and monitoring of patients on eliglustat therapy. Copyright © 2015 Shire Development LLC. Published by Elsevier Inc. All rights reserved.

  16. Polycystic ovary syndrome and combined oral contraceptive use: a comparison of clinical practice in the United States to treatment guidelines.

    Science.gov (United States)

    Bird, Steven T; Hartzema, Abraham G; Etminan, Mahyar; Brophy, James M; Delaney, Joseph A C

    2013-04-01

    The October 2010 ESHRE/ASRM polycystic ovary syndrome (PCOS) workshop concluded: (1) all combined oral contraceptives (COC) appear to have equal efficacy for PCOS, (2) addition of antiandrogens (spironolactone) to COCs has little treatment benefit and (3) metformin does not improve the live-birth rate and should only be used with impaired glucose tolerance. We compared these guidelines to current practice in the United States IMS claims-database. Time-series analyses were conducted by calendar-year in women with PCOS to evaluate prescribing preferences for COCs, concomitant use of spironolactone, and utilization of metformin. Trends were analyzed with linear regression. Our cohort included 1.6 million women taking COCs, 46 780 with a PCOS claim. Drospirenone utilization increased by 1.52% (SE:0.48%, p = 0.007) per-year more in women with PCOS (4.16%, SE:0.45%, p medication management of PCOS to bridge the gap between guidelines and practice.

  17. Historical assessment of uranium release by the ore treatment unit - at Caldas, Minas Gerais, Brazil from 1999 to 2011

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, W.S.; Carmo, R.F.; Py Junior, D.A., E-mail: pereiraws@gmail.com [Industrias Nucleares do Brasil (INB), Pocos de Caldas, MG (Brazil). Unidade de Tratamento de Minerio. Grupo Multidisciplinar de Radioprotecao; Kelecom, A., E-mail: akelecom@id.uff.br [Universidade Federal Fluminense (LARARA-PLS/GETA/UFF), Niteroi, RJ (Brazil). Laboratorio de Radiobiologia e Radiometria Pedro Lopes dos Santos. Grupo de Estudos em Temas Ambientais; Pereira, J.R.S., E-mail: pereirarsj@gmail.com [Universidade Federal de Alfenas, Pocos de Caldas, MG (Brazil)

    2013-07-01

    The Ore Treatment Unit (OTU) is located at the source of three rivers: Ribeirao das Antas, Ribeirao do Soberbo and Corrego da Consulta. Each interface of installation with the environment, at the tree rivers, has been monitored for the release of radionuclides. At Ribeirao das Antas a weekly sample collection was made at point 014. At Ribeirao Soberbo there was a weekly sample collection at point 025, and at Corrego da Consulta a monthly collection was carried out at point 076. This work analyses the average annual releases of uranium from the historical series started in 1999 and ended in 2011. Points 014 and 025 showed average release of 0.12 Bq L{sup -1}. Point 076 showed somewhat higher average release, 1.27 Bq L{sup -1}. An Analysis Of Variance test (ANOVA) has been carried out to verify the existence of different means between these collecting points. The averages were considered statistically different. As a complementary analysis, the Student's t test was performed between the averages at considered points. Between points 014 and 025, the averages were considered identical. Between points 014 and 076, the average release at point 076 was considered higher than that at point 014. The same behavior was observed between points 025 and 076. The releases at point 076 were considered higher than those at point 025. Thus it can be concluded that releases at points 014 and 025 are identical and both are lower than releases at point 076. (author)

  18. Modified septic tank-anaerobic filter unit as a two-stage onsite domestic wastewater treatment system.

    Science.gov (United States)

    Sharma, Meena Kumari; Khursheed, Anwar; Kazmi, Absar Ahmad

    2014-01-01

    This study demonstrates the performance evaluation of a uniquely designed two-stage system for onsite treatment of domestic wastewater. The system consisted of two upflow anaerobic bioreactors, a modified septic tank followed by an upflow anaerobic filter, accommodated within a single cylindrical unit. The system was started up without inoculation at 24 h hydraulic retention time (HRT). It achieved a steady-state condition after 120 days. The system was observed to be remarkably efficient in removing pollutants during steady-state condition with the average removal efficiency of 88.6 +/- 3.7% for chemical oxygen demand, 86.3 +/- 4.9% for biochemical oxygen demand and 91.2 +/- 9.7% for total suspended solids. The microbial analysis revealed a high reduction (>90%) capacity of the system for indicator organism and pathogens. It also showed a very good endurance against imposed hydraulic shock load. Tracer study showed that the flow pattern was close to plug flow reactor. Mean HRT was also found to be close to the designed value.

  19. Assessment of pattern and treatment outcome of patients admitted to pediatric intensive care unit, Ayder Referral Hospital, Tigray, Ethiopia, 2015.

    Science.gov (United States)

    Haftu, Hansa; Hailu, Tedrose; Medhaniye, Araya; G/Tsadik, Teklit

    2018-05-24

    To describe admission pattern and outcome with its predictor variable on the mortality of children admitted to pediatric intensive care unit (PICU), Ayder Referral Hospital, Northern Ethiopia, from September 2012 to August 2014. From 680 admitted patients, 400 patients were analyzed. Average age at admission was 62.99 ± 60.94 months, with F:M ratio of 1:1.2. Overall (from infectious and non-infectious) the most commonly affected systems were respiratory (90/400 pts., 22.5%) and central nervous system (83/400 pts., 20.75%). Most were admitted due to meningitis (44/400 pts., 11%), post-operative (43/400 pts., 10.8%) and acute glomerulonephritis (41/400 pts., 10.3%). The overall mortality rate was 8.5%. Multivariable logistic regression shows, use of inotropes (p = 0.000), need for mechanical ventilator (p = 0.007) and presence of comorbid illness (p = 0.002), infectious cause (p = 0.015) and low level of Glasgow coma scale less than eight (p = 0.04) were independent predictors of mortality. From this study, common cause of PICU admission and death was meningitis. This highlights the importance of focusing on the preventable methods in the public such as vaccine, creating awareness about hygiene, and expanding ICU for early detection and for treatment acutely ill children.

  20. Historical assessment of uranium release by the ore treatment unit - at Caldas, Minas Gerais, Brazil from 1999 to 2011

    International Nuclear Information System (INIS)

    Pereira, W.S.; Carmo, R.F.; Py Junior, D.A.

    2013-01-01

    The Ore Treatment Unit (OTU) is located at the source of three rivers: Ribeirao das Antas, Ribeirao do Soberbo and Corrego da Consulta. Each interface of installation with the environment, at the tree rivers, has been monitored for the release of radionuclides. At Ribeirao das Antas a weekly sample collection was made at point 014. At Ribeirao Soberbo there was a weekly sample collection at point 025, and at Corrego da Consulta a monthly collection was carried out at point 076. This work analyses the average annual releases of uranium from the historical series started in 1999 and ended in 2011. Points 014 and 025 showed average release of 0.12 Bq L -1 . Point 076 showed somewhat higher average release, 1.27 Bq L -1 . An Analysis Of Variance test (ANOVA) has been carried out to verify the existence of different means between these collecting points. The averages were considered statistically different. As a complementary analysis, the Student's t test was performed between the averages at considered points. Between points 014 and 025, the averages were considered identical. Between points 014 and 076, the average release at point 076 was considered higher than that at point 014. The same behavior was observed between points 025 and 076. The releases at point 076 were considered higher than those at point 025. Thus it can be concluded that releases at points 014 and 025 are identical and both are lower than releases at point 076. (author)

  1. Education and Criminal Justice: The Educational Approach to Prison Administration. The United Nations Standard Minimum Rules for the Treatment of Prisoners.

    Science.gov (United States)

    Morin, Lucien; Cosman, J. W.

    The United Nations Standard Minimum Rules for the Treatment of Prisoners do not express the basic principle that would support a serious educational approach to prison administration. The crucial missing rationale is the concept of the inherent dignity of the individual human prisoner. This concept has certain basic educational implications,…

  2. A community-based delivery system of intermittent preventive treatment of malaria in pregnancy and its effect on use of essential maternity care at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, I C; Magnussen, Pascal

    2007-01-01

    Community delivery of intermittent preventive treatment of malaria in pregnancy (IPTp) is one potential option that could mitigate malaria in pregnancy. However, there is concern that this approach may lead to complacency among women with low access to essential care at health units. A non-random...

  3. Simulating fuel treatment effects in dry forests of the western United States: testing the principles of a fire-safe forest

    Science.gov (United States)

    Morris C. Johnson; Maureen C Kennedy; David L. Peterson

    2011-01-01

    We used the Fire and Fuels Extension to the Forest Vegetation Simulator (FFE-FVS) to simulate fuel treatment effects on stands in low- to midelevation dry forests (e.g., ponderosa pine (Pinus ponderosa Dougl. ex. P. & C. Laws.) and Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) of the western United States. We...

  4. 19 CFR 7.3 - Duty-free treatment of goods imported from insular possessions of the United States other than...

    Science.gov (United States)

    2010-04-01

    ... INSULAR POSSESSIONS AND GUANTANAMO BAY NAVAL STATION § 7.3 Duty-free treatment of goods imported from...) The goods became a new and different article of commerce as a result of production or manufacture... possession or the United States results from the original commercial transaction between the importer and the...

  5. Microbial pathogens in source and treated waters from drinking water treatment plants in the United States and implications for human health

    Science.gov (United States)

    An occurrence survey was conducted on selected pathogens in source and treated drinking water collected from 25 drinking water treatment plants (DWTPs) in the United States. Water samples were analyzed for the protozoa Giardia and Cryptosporidium (EPA Method 1623); the fungi Aspe...

  6. Application for verification of monitor units of the treatment planning system; Aplicacion para la verificacion de unidades monitor del sistema de planificacion de tratamientos

    Energy Technology Data Exchange (ETDEWEB)

    Suero Rodrigo, M. A.; Marques Fraguela, E.

    2011-07-01

    Current estimates algorithms achieve acceptable degree of accuracy. However, operate on the basis of un intuitive models. It is therefore necessary to verify the calculation of monitor units of the treatment planning system (PTS) with those obtained by other independent formalisms. To this end, we have developed an application based on factorization formalism that automates the calculation of dose.

  7. Treatment Dosing Patterns and Clinical Outcomes for Patients with Type 2 Diabetes Starting or Switching to Treatment with Insulin Glargine (300 Units per Milliliter) in a Real-World Setting: A Retrospective Observational Study.

    Science.gov (United States)

    Gupta, Shaloo; Wang, Hongwei; Skolnik, Neil; Tong, Liyue; Liebert, Ryan M; Lee, Lulu K; Stella, Peter; Cali, Anna; Preblick, Ronald

    2018-01-01

    Usage patterns and effectiveness of a longer-acting formulation of insulin glargine at a strength of 300 units per milliliter (Gla-300) have not been studied in real-world clinical practice. This study evaluated differences in dosing and clinical outcomes before and after Gla-300 treatment initiation in patients with type 2 diabetes starting or switching to treatment with Gla-300 to assess whether the benefits observed in clinical trials translate into real-world settings. This was a retrospective observational study using medical record data obtained by physician survey for patients starting treatment with insulin glargine at a strength of 100 units per milliliter (Gla-100) or Gla-300, or switching to treatment with Gla-300 from treatment with another basal insulin (BI). Differences in dosing and clinical outcomes before versus after treatment initiation or switching were examined by generalized linear mixed-effects models. Among insulin-naive patients starting BI treatment, no difference in the final titrated dose was observed in patients starting Gla-300 treatment versus those starting Gla-100 treatment [least-squares (LS) mean 0.43 units per kilogram vs 0.44 units per kilogram; P = 0.77]. Both groups had significant hemoglobin A 1c level reductions (LS mean 1.21 percentage points for Gla-300 and 1.12 percentage points for Gla-100 ; both P per kilogram before switch vs 0.58 units per kilogram after switch; P = 0.02). The mean hemoglobin A 1c level was significantly lower after switching than before switching (adjusted difference - 0.95 percentage points, 95% CI - 1.13 to - 0.78 percentage points ; P per patient-year were significantly lower (relative risk 0.17, 95% CI 0.11-0.26; P < 0.0001). Insulin-naive patients starting Gla-300 treatment had fewer hypoglycemic events, a similar hemoglobin A 1c level reduction, and no difference in insulin dose versus patients starting Gla-100 treatment. Patients switching to Gla-300 treatment from treatment with

  8. New therapy strategies for treatment of severe sepsis and septic shock in Intensive care unit of Clinical centre in Kragujevac

    Directory of Open Access Journals (Sweden)

    Jevđić Jasna

    2008-01-01

    Full Text Available INTRODUCTION Despite numerous advances in medicine, the mortality rate of severe sepsis and septic shock remains high, 30-50%. New therapy strategies include: early goaldirected therapy, fluid replacement, early and appropriate antimicrobials, source of infection control, use of corticosteroids, vasopressors and inotropic therapy, use of recombinant activated protein C, tight glucose control, low-tidal-volume mechanical ventilation. They have been shown to improve the outcomes. The adequacy and speed of treatment influence the outcome, too. OBJECTIVE The objective was to evaluate if new therapy strategies had been integrated in our routine practice. METOD Patients with severe sepsis or septic shock, who were treated in the Intensive Care Unit (ICU over a ten-month period, were analyzed retrospectively. The descriptive epidemiological method was applied. Central venous catheterization, central venous pressure, antibiotics, fluid resuscitation, mechanical ventilation, vasopressors, corticosteroids, blood administration, deep vein thrombosis prophylaxis, stress ulcer prophylaxis, glucose control, were evaluated. RESULTS 27 patients were analyzed. Patient characteristics were: age, 49.9 years (18-77 with 30-day in-hospital mortality rate of 48.1%. All patients received broad-spectrum antibiotics. Blood cultures were obtained in 85.2% patients. Adequate antimicrobial treatment was applied to 59.3% and 74.1% patients had central venous pressure monitoring. Average central venous pressure was 8.47±5.6 mm Hg (-2- 20. Aggressive fluid therapy was given to 33.3% of the cases and 66.7% of the patients with septic shock received vasoactive drugs while 29.6% received corticosteroids. Red blood cell transfusions were applied in 59.3% of patients. All patients received stress ulcer prophylaxis, and 37% of them deep vein thrombosis prophylaxis. The average value of morning glucose was 9.11±5.03 mmol/l (3.7-22.0. 63% of patients were mechanically ventilated

  9. A two-step crushed lava rock filter unit for grey water treatment at household level in an urban slum.

    Science.gov (United States)

    Katukiza, A Y; Ronteltap, M; Niwagaba, C B; Kansiime, F; Lens, P N L

    2014-01-15

    Decentralised grey water treatment in urban slums using low-cost and robust technologies offers opportunities to minimise public health risks and to reduce environmental pollution caused by the highly polluted grey water i.e. with a COD and N concentration of 3000-6000 mg L(-1) and 30-40 mg L(-1), respectively. However, there has been very limited action research to reduce the pollution load from uncontrolled grey water discharge by households in urban slums. This study was therefore carried out to investigate the potential of a two-step filtration process to reduce the grey water pollution load in an urban slum using a crushed lava rock filter, to determine the main filter design and operation parameters and the effect of intermittent flow on the grey water effluent quality. A two-step crushed lava rock filter unit was designed and implemented for use by a household in the Bwaise III slum in Kampala city (Uganda). It was monitored at a varying hydraulic loading rate (HLR) of 0.5-1.1 m d(-1) as well as at a constant HLR of 0.39 m d(-1). The removal efficiencies of COD, TP and TKN were, respectively, 85.9%, 58% and 65.5% under a varying HLR and 90.5%, 59.5% and 69%, when operating at a constant HLR regime. In addition, the log removal of Escherichia coli, Salmonella spp. and total coliforms was, respectively, 3.8, 3.2 and 3.9 under the varying HLR and 3.9, 3.5 and 3.9 at a constant HLR. The results show that the use of a two-step filtration process as well as a lower constant HLR increased the pollutant removal efficiencies. Further research is needed to investigate the feasibility of adding a tertiary treatment step to increase the nutrients and microorganisms removal from grey water. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. A new approach to the prevention and treatment of delirium in elderly patients in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Andrew B. Rosenzweig

    2015-09-01

    Full Text Available The pronounced prevalence of delirium in geriatric patients admitted to the intensive care unit (ICU and its increased morbidity and mortality is a well-established phenomenon. The purpose of this review is to explore the potential use of dexmedetomidine in preventing or managing ICU delirium in older patients. Articles used were identified and selected through multiple search engines, including Google Scholar, PubMed, and MEDLINE. Keywords such as dexmedetomidine, delirium, geriatric, ICU delirium, delirium in elderly, and palliative were used to obtain the specific articles used for this paper and restricted to articles published in 1990 or later. Articles specifically looking at the use of dexmedetomidine as compared to a study drug and its potential for use in ICU patients, as opposed to overall reviews of dexmedetomidine, were compared. When compared to benzodiazepines for the prevention or treatment of ICU delirium in the elderly, dexmedetomidine was associated with a reduction in delirium, as well as decreased morbidity and mortality. Dexmedetomidine has also been shown to be effective in limiting risk factors associated with ICU delirium such as length and depth of sedation. As opposed to benzodiazepines or opiates, dexmedetomidine provides effective analgesia, sympatholysis, and anxiolysis without causing respiratory depression and allows a patient to more effectively interact with practitioners. The review of these nine articles indicates that these favorable attributes and overall decreased duration and incidence of delirium make dexmedetomidine a viable option in preventing or reducing ICU delirium in high-risk geriatric patients and as a palliative adjunct to help control symptoms and stressors.

  11. Ebola Virus Disease and Pregnancy: A Retrospective Cohort Study of Patients Managed at 5 Ebola Treatment Units in West Africa.

    Science.gov (United States)

    Henwood, Patricia C; Bebell, Lisa M; Roshania, Reshma; Wolfman, Vanessa; Mallow, Michaela; Kalyanpur, Anushka; Levine, Adam C

    2017-07-15

    Reliable data are lacking on pregnancy outcomes during Ebola virus disease (EVD) epidemics. We aimed to characterize symptoms and outcomes among pregnant women admitted to Ebola treatment units (ETUs) with suspected and confirmed EVD to better inform obstetric management. We analyzed a retrospective cohort of reproductive-aged women presenting to 5 West African ETUs from September 2014 to September 2015. We compared clinical symptoms, risk of EVD diagnosis, and mortality between pregnant and nonpregnant women. Of 729 reproductive-aged women admitted to study ETUs, 44 (6%) reported pregnancy. Thirteen of 44 pregnant women (30%) tested EVD positive; 6 of 13 (46%) died. Pregnant women were less likely than nonpregnant women to report anorexia, asthenia, diarrhea, fever, myalgias/arthralgias, nausea, or vomiting (P Ebola viral loads on presentation to nonpregnant women, as measured by initial cycle threshold (26.4 vs 23.2, P = .16), they were less likely to have myalgias/arthralgias (P< .001) and vomiting (P = .02). Both all-cause mortality (14% vs 19%, P = .39) and EVD-specific mortality (46% vs 54%, P = .60) were not significantly different between pregnant and nonpregnant women. Two neonates born live in the ETU died within 8 days. We find no evidence to support a difference in the risk of death between pregnant women with suspected or confirmed EVD compared to nonpregnant women. Limited data suggest poor fetal and neonatal outcomes in EVD-affected pregnancies. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  12. An independent monitor unit calculation by commercial software as a part of a radiotherapy treatment planning system quality control

    International Nuclear Information System (INIS)

    Nechvil, K.; Mynarik, J.

    2014-01-01

    For the independent calculation of the monitored unit (MU) the commercial software RadCalc (Lifeline Software Inc., Tyler TX) was used as the choice of some available similar programs. The program was configured and used to verify the doses calculated by commercially accessible planning system Eclipse version 8.6.17 (Varian Medical System Inc., Palo Alto). This system is being used during the clinical running for the creation of the treatment plans. The results of each plan were compared to the dose phantom measurements by the ionization chamber at the same point in which the calculation were done (Eclipse, RadCalc) - in the izocentre. TPS is configured by the beam data (PDD and OAR). Those beam data were exported and afterwards the same data were imported to the program RadCalc. The consistent and independent data between TPS and RadCalc were gained by this process. The reference conditions were set the identical in RadCalc as in TPS, so the consistency between TPS and RadCalc output factors has been achieved (Collimator Scatter Factor: Sc, Phantom Scatter Factor: Sp). Those output factors were also measured by the ionizing chamber in the water phantom and compared with the TPS. Based on the clinical data of the response to the doses, ICRU recommends ensuring the ability of dosimetric systems to deliver the doses with accuracy of at least 5%. Many factors, such as layout of anatomic structures, positioning of a patient, factors related to an accelerator (a dose calibration and mechanic parameters) cause random and systematic failures in a dose delivery. The source of some problems can be also caused by the system databases and relating information transfer; and the TPS containing besides other things other dose calculation algorithms. (authors)

  13. Effectiveness of osteopathic manipulative treatment in neonatal intensive care units: protocol for a multicentre randomised clinical trial

    Science.gov (United States)

    Cerritelli, Francesco; Pizzolorusso, Gianfranco; Renzetti, Cinzia; D'Incecco, Carmine; Fusilli, Paola; Perri, Paolo Francesco; Tubaldi, Lucia; Barlafante, Gina

    2013-01-01

    Introduction Neonatal care has been considered as one of the first priorities for improving quality of life in children. In 2010, 10% of babies were born prematurely influencing national healthcare policies, economic action plans and political decisions. The use of complementary medicine has been applied to the care of newborns. One previous study documented the positive effect of osteopathic manipulative treatment (OMT) in reducing newborns’ length of stay (LOS). Aim of this multicentre randomised controlled trial is to examine the association between OMT and LOS across three neonatal intensive care units (NICUs). Methods and analysis 690 preterm infants will be recruited from three secondary and tertiary NICUs from north and central Italy and allocated into two groups, using permuted-block randomisation. The two groups will receive standard medical care and OMT will be applied, twice a week, to the experimental group only. Outcome assessors will be blinded of study design and group allocation. The primary outcome is the mean difference in days between discharge and entry. Secondary outcomes are difference in daily weight gain, number of episodes of vomit, regurgitation, stooling, use of enema, time to full enteral feeding and NICU costs. Statistical analyses will take into account the intention-to-treat method. Missing data will be handled using last observation carried forward (LOCF) imputation technique. Ethics and dissemination Written informed consent will be obtained from parents or legal guardians at study enrolment. The trial has been approved by the ethical committee of Macerata hospital (n°22/int./CEI/27239) and it is under review by the other regional ethics committees. Results Dissemination of results from this trial will be through scientific medical journals and conferences. Trial registration This trial has been registered at http://www.clinicaltrials.org (identifier NCT01645137). PMID:23430598

  14. Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

    Science.gov (United States)

    Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

    2008-07-01

    To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

  15. Integrated computer control system CORBA-based simulator FY98 LDRD project final summary report

    International Nuclear Information System (INIS)

    Bryant, R M; Holloway, F W; Van Arsdall, P J.

    1999-01-01

    The CORBA-based Simulator was a Laboratory Directed Research and Development (LDRD) project that applied simulation techniques to explore critical questions about distributed control architecture. The simulator project used a three-prong approach comprised of a study of object-oriented distribution tools, computer network modeling, and simulation of key control system scenarios. This summary report highlights the findings of the team and provides the architectural context of the study. For the last several years LLNL has been developing the Integrated Computer Control System (ICCS), which is an abstract object-oriented software framework for constructing distributed systems. The framework is capable of implementing large event-driven control systems for mission-critical facilities such as the National Ignition Facility (NIF). Tools developed in this project were applied to the NIF example architecture in order to gain experience with a complex system and derive immediate benefits from this LDRD. The ICCS integrates data acquisition and control hardware with a supervisory system, and reduces the amount of new coding and testing necessary by providing prebuilt components that can be reused and extended to accommodate specific additional requirements. The framework integrates control point hardware with a supervisory system by providing the services needed for distributed control such as database persistence, system start-up and configuration, graphical user interface, status monitoring, event logging, scripting language, alert management, and access control. The design is interoperable among computers of different kinds and provides plug-in software connections by leveraging a common object request brokering architecture (CORBA) to transparently distribute software objects across the network of computers. Because object broker distribution applied to control systems is relatively new and its inherent performance is roughly threefold less than traditional point

  16. Timber product implications of a program of mechanical fuel treatments applied on public timberland in the Western United States

    Science.gov (United States)

    Barbour R. James.; Xiaoping Zhou; Jeffrey P. Prestemon

    2008-01-01

    This study reports the results from a 5 year simulation of forest thinning intended to reduce fire hazard on publicly managed lands in the western United States. A state simulation model of interrelated timber markets was used to evaluate the timber product outputs. Approximately 84 million acres (34 million hectares), or 66% of total timberland in the western United...

  17. An Analysis of Horizontal Flow Treatment Well Applicability for the Treatment of Chlorinated Solvent Contaminated Groundwater at United States Forces Korea Installations

    National Research Council Canada - National Science Library

    Staples, Michael

    2002-01-01

    ...). As Korean government and public interest in the environment grow, there is likely to be increased pressure to remediate environmental contamination at United States Department of Defense (DoD...

  18. Real-World Characteristics and Treatment Patterns in Patients with Urticaria Initiating Omalizumab in the United States.

    Science.gov (United States)

    Ke, Xuehua; Kavati, Abhishek; Wertz, Debra; Huang, Qing; Wang, Liya; Willey, Vincent J; Stephenson, Judith J; Ortiz, Benjamin; Paknis, Brandee; Bernstein, Jonathan A; Beck, Lisa A

    2017-12-19

    Omalizumab is indicated for the management of chronic idiopathic urticaria (CIU) in patients aged 12 years or older with persistent hives that are not adequately controlled by H1 antihistamines. While its safety and efficacy in CIU patients have been evaluated in multiple clinical trials, real-world use of omalizaumab in CIU has not been well characterized. To assess demographics, clinical characteristics, and treatment patterns of CIU patients who initiated omalizumab to better understand the usage of this agent in CIU management in the real world. This retrospective cohort study used medical and pharmacy claims data in the United States from the HealthCore Integrated Database to identify patients with CIU newly treated with omalizumab (≥ 4 omalizumab claims within 6 months of the initial claim) between March 21, 2014, and October 31, 2015 (study intake period). The index date was defined as the date of the first claim for omalizumab during the study intake period. Demographic and clinical characteristics were described for patients treated with omalizumab, as were treatment patterns associated with omalizumab and concomitant medications associated with CIU treatment. Descriptive and inferential statistics were reported. The Kaplan-Meier method was used to examine omalizumab treatment patterns. This study included 298 omalizumab-treated patients (mean [SD] age of 43.5 [13.64] years; 70.8% female); approximately 84% were seen by an allergist/immunologist. All patients had ≥ 12 months of continuous enrolment and a subset of 138 patients had ≥ 18 months of follow-up. For patients with ≥ 12 months of post-index follow-up, 12.1% (n = 36), 28.5% (n = 85), and 32.9% (n = 98) discontinued omalizumab within the 6-month, 12-month, and the entire post-index periods (mean 530 days), respectively; the mean number of days patients were continuously treated with omalizumab was 443.1 (95% CI = 425.0-461.3); the probabilities of continuous treatment (95% CI) were 0.879 (0

  19. Likelihood of treatment in a coronary care unit for a first-time myocardial infarction in relation to sex, country of birth and socioeconomic position in Sweden.

    Science.gov (United States)

    Yang, Dong; James, Stefan; de Faire, Ulf; Alfredsson, Lars; Jernberg, Tomas; Moradi, Tahereh

    2013-01-01

    To examine the relationship between sex, country of birth, level of education as an indicator of socioeconomic position, and the likelihood of treatment in a coronary care unit (CCU) for a first-time myocardial infarction. Nationwide register based study. Sweden. 199 906 patients (114 387 men and 85,519 women) of all ages who were admitted to hospital for first-time myocardial infarction between 2001 and 2009. Admission to a coronary care unit due to myocardial infarction. Despite the observed increasing access to coronary care units over time, the proportion of women treated in a coronary care unit was 13% less than for men. As compared with men, the multivariable adjusted odds ratio among women was 0.80 (95% confidence interval 0.77 to 0.82). This lower proportion of women treated in a CCU varied by age and year of diagnosis and country of birth. Overall, there was no evidence of a difference in likelihood of treatment in a coronary care unit between Sweden-born and foreign-born patients. As compared with patients with high education, the adjusted odds ratio among patients with a low level of education was 0.93 (95% confidence interval 0.89 to 0.96). Foreign-born and Sweden-born first-time myocardial infarction patients had equal opportunity of being treated in a coronary care unit in Sweden; this is in contrast to the situation in many other countries with large immigrant populations. However, the apparent lower rate of coronary care unit admission after first-time myocardial infarction among women and patients with low socioeconomic position warrants further investigation.

  20. Patterns and Predictors of Depression Treatment among Older Adults with Parkinson’s Disease and Depression in Ambulatory Care Settings in the United States

    Directory of Open Access Journals (Sweden)

    Sandipan Bhattacharjee

    2018-01-01

    Full Text Available Little is known regarding depression treatment patterns and predictors among older adults with comorbid Parkinson's disease and depression (dPD in the United States (US. The objective of this study was to assess the patterns and predictors of depression treatment among older adults with dPD in the US. We adopted a cross-sectional study design by pooling multiple-year data (2005–2011 from the National Ambulatory Medical Care Survey (NAMCS and the outpatient department of the National Hospital Ambulatory Medical Care Survey (NHAMCS. The final study sample consisted of visits by older adults with dPD. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariate logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Individuals with dPD and polypharmacy were 74% more likely to receive depression treatment (odds ratio = 1.743, 95% CI 1.376–2.209, while dPD subjects with comorbid chronic conditions were 44% less likely (odds ratio = 0.559, 95% CI 0.396–0.790 to receive depression treatment. Approximately six out of ten older adults with PD and depression received depression treatment. Treatment options for dPD are underutilized in routine clinical practice, and further research should explore how overall medical complexity presents a barrier to depression treatment.

  1. Racial Disparities in Treatment Rates for Chronic Hepatitis C: Analysis of a Population-Based Cohort of 73,665 Patients in the United States.

    Science.gov (United States)

    Vutien, Philip; Hoang, Joseph; Brooks, Louis; Nguyen, Nghia H; Nguyen, Mindie H

    2016-05-01

    Chronic hepatitis C (CHC) disproportionately affects racial minorities in the United States (US). Although prior studies have reported lower treatment rates in Blacks than in Caucasians, the rates of other minorities remain understudied. We aimed to examine antiviral treatment rates by race and to evaluate the effect of other demographic, medical, and psychiatric factors on treatment rates. We performed a population-based study of adult CHC patients identified via ICD-9CM query from OptumInsight's Data Mart from January 2009 to December 2013. Antiviral treatment was defined by pharmaceutical claims for interferon and/or pegylated-interferon. A total of 73,665 insured patients were included: 51,282 Caucasians, 10,493 Blacks, 8679 Hispanics, and 3211 Asians. Caucasians had the highest treatment rate (10.7%) followed by Blacks (8.8%), Hispanics (8.8%), and Asians (7.9%, P 73 (CI: 0.62-0.86) for Asians versus Caucasians. Racial minorities had lower treatment rates than Caucasians. Despite fewer medical and psychiatric comorbidities and higher incomes and educational levels, Asians had the lowest treatment rates. Hispanics also had lower treatment rates than Caucasians despite having higher rates of cirrhosis. Future studies should aim to identify underlying racial-related barriers to hepatitis C virus treatment besides socioeconomic status and medical or psychiatric comorbidities.

  2. Correlates of Initiation of Treatment for Chronic Hepatitis C Infection in United States Veterans, 2004-2009.

    Directory of Open Access Journals (Sweden)

    Adi V Gundlapalli

    Full Text Available We describe the rates and predictors of initiation of treatment for chronic hepatitis C (HCV infection in a large cohort of HCV positive Veterans seen in U.S. Department of Veterans Affairs (VA facilities between January 1, 2004 and December 31, 2009. In addition, we identify the relationship between homelessness among these Veterans and treatment initiation. Univariate and multivariable Cox Proportional Hazards regression models with time-varying covariates were used to identify predictors of initiation of treatment with pegylated interferon alpha plus ribavirin. Of the 101,444 HCV treatment-naïve Veterans during the study period, rates of initiation of treatment among homeless and non-homeless Veterans with HCV were low and clinically similar (6.2% vs. 7.4%, p<0.0001. For all U.S. Veterans, being diagnosed with genotype 2 or 3, black or other/unknown race, having Medicare or other insurance increased the risk of treatment. Veterans with age ≥50 years, drug abuse, diabetes, and hemoglobin < 10 g/dL showed lower rates of treatment. Initiation of treatment for HCV in homeless Veterans is low; similar factors predicted initiation of treatment. Additionally, exposure to treatment with medications for diabetes predicted lower rates of treatment. As newer therapies become available for HCV, these results may inform further studies and guide strategies to increase treatment rates in all U.S. Veterans and those who experience homelessness.

  3. Adherence to Tuberculosis Therapy among Patients Receiving Home-Based Directly Observed Treatment: Evidence from the United Republic of Tanzania

    NARCIS (Netherlands)

    Mkopi, Abdallah; Range, Nyagosya; Lwilla, Fred; Egwaga, Saidi; Schulze, Alexander; Geubbels, Eveline; van Leth, Frank

    2012-01-01

    Background: Non-adherence to tuberculosis (TB) treatment is the leading contributor to the selection of drug-resistant strains of Mycobacterium tuberculosis and subsequent treatment failure. Tanzania introduced a TB Patient Centred Treatment (PCT) approach which gives new TB patients the choice

  4. Cholera in Pregnancy: Outcomes from a Specialized Cholera Treatment Unit for Pregnant Women in L?og?ne, Haiti

    OpenAIRE

    Ciglenecki, Iza; Bichet, Mathieu; Tena, Javier; Mondesir, Erneau; Bastard, Mathieu; Tran, Nguyen-Toan; Antierens, Annick; Staderini, Nelly

    2013-01-01

    BACKGROUND: The association between cholera in pregnancy and negative fetal outcome has been described since the 19(th) century. However, there is limited published literature on the subject. We describe pregnancy outcomes from a specialized multidisciplinary hospital unit at the onset of a large cholera outbreak in Haiti in 2010 and 2011. METHODS: Pregnant women with cholera were hospitalized in a specialized unit within the MSF hospital compound in Léogâne and treated using standard cholera...

  5. Patterns and Predictors of Depression Treatment among Older Adults with Parkinson’s Disease and Depression in Ambulatory Care Settings in the United States

    OpenAIRE

    Bhattacharjee, Sandipan; Vadiei, Nina; Goldstone, Lisa; Alrabiah, Ziyad; Sherman, Scott J.

    2018-01-01

    Little is known regarding depression treatment patterns and predictors among older adults with comorbid Parkinson's disease and depression (dPD) in the United States (US). The objective of this study was to assess the patterns and predictors of depression treatment among older adults with dPD in the US. We adopted a cross-sectional study design by pooling multiple-year data (2005–2011) from the National Ambulatory Medical Care Survey (NAMCS) and the outpatient department of the National Hospi...

  6. Predictors of pharmacological treatment outcomes with atomoxetine or methylphenidate in patients with attention-deficit/hyperactivity disorder from China, Egypt, Lebanon, Russian Federation, Taiwan, and United Arab Emirates.

    Science.gov (United States)

    Treuer, T; Feng, Q; Desaiah, D; Altin, M; Wu, S; El-Shafei, A; Serebryakova, E; Gado, M; Faries, D

    2014-09-01

    The reduced availability of data from non-Western countries limits our ability to understand attention-deficit/hyperactivity disorder (ADHD) treatment outcomes, specifically, adherence and persistence of ADHD in children and adolescents. This analysis assessed predictors of treatment outcomes in a non-Western cohort of patients with ADHD treated with atomoxetine or methylphenidate. Data from a 12-month, prospective, observational study in outpatients aged 6-17 years treated with atomoxetine (N = 234) or methylphenidate (N = 221) were analysed post hoc to determine potential predictors of treatment outcomes. Participating countries included the Russian Federation, China, Taiwan, Egypt, United Arab Emirates and Lebanon. Factors associated with remission were analysed with stepwise multiple logistic regression and classification and regression trees (CART). Cox proportional hazards models with propensity score adjustment assessed differences in atomoxetine persistence among initial-dose cohorts. In patients treated with atomoxetine who had available dosing information (N = 134), Cox proportional hazards revealed lower (atomoxetine-treated patients were associated with age (older), country (United Arab Emirates) and gender (female) (all p atomoxetine) and prior atomoxetine use were associated with greater remission rates. These findings may help clinicians assess factors upon initiation of ADHD treatment to improve course prediction, proper dosing and treatment adherence and persistence. Observational study, therefore no registration. © 2014 John Wiley & Sons Ltd.

  7. The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study

    Directory of Open Access Journals (Sweden)

    Cho Yeoungjee

    2012-06-01

    Full Text Available Abstract Background The aim of the study was to determine whether distance between residence and peritoneal dialysis (PD unit influenced peritonitis occurrence, microbiology, treatment and outcomes. Methods The study included all patients receiving PD between 1/10/2003 and 31/12/2008, using ANZDATA Registry data. Results 365 (6% patients lived ≥100 km from their nearest PD unit (distant group, while 6183 (94% lived S. aureus peritonitis (adjusted odds ratio [OR] 1.64, 95% CI 1.09-2.47. Distant patients with first peritonitis episodes were less likely to be hospitalised (64% vs 73%, p = 0.008 and receive antifungal prophylaxis (4% vs 10%, p = 0.01, but more likely to receive vancomycin-based antibiotic regimens (52% vs 42%, p  Conclusions Living ≥100 km away from a PD unit was associated with increased risk of S. aureus peritonitis, modified approaches to peritonitis treatment and peritonitis outcomes that were comparable to, or better than patients living closer to a PD unit. Staphylococcal decolonisation should receive particular consideration in remote living patients.

  8. One-session treatment of specific phobias in youth: a randomized clinical trial in the United States and Sweden.

    Science.gov (United States)

    Ollendick, Thomas H; Ost, Lars-Göran; Reuterskiöld, Lena; Costa, Natalie; Cederlund, Rio; Sirbu, Cristian; Davis, Thompson E; Jarrett, Matthew A

    2009-06-01

    One hundred and ninety-six youth, ages 7-16, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for various specific phobias were randomized to a one-session exposure treatment, education support treatment, or a wait list control group. After the waiting period, the wait list participants were offered treatment and, if interested, rerandomized to 1 of the 2 active treatments. The phobias were assessed with semistructured diagnostic interviews, clinician severity ratings, and behavioral avoidance tests, whereas fears, general anxiety, depression, and behavior problems were assessed with self- and parent report measures. Assessments were completed pretreatment, posttreatment, and at 6 months following treatment. Results showed that both treatment conditions were superior to the wait list control condition and that 1-session exposure treatment was superior to education support treatment on clinician ratings of phobic severity, percentage of participants who were diagnosis free, child ratings of anxiety during the behavioral avoidance test, and treatment satisfaction as reported by the youth and their parents. There were no differences on self-report measures. Treatment effects were maintained at follow-up. Implications of these findings are discussed. Copyright 2009 APA

  9. Catheter-related Saccharomyces cerevisiae Fungemia Following Saccharomyces boulardii Probiotic Treatment: In a child in intensive care unit and review of the literature

    Directory of Open Access Journals (Sweden)

    Serkan Atıcı

    2017-03-01

    Full Text Available Although Saccharomyces boulardii is usually a non-pathogenic fungus, in rare occasions it can cause invasive infection in children. We present the case of an 8-year-old patient in pediatric surgical intensive care unit who developed S. cerevisiae fungemia following probiotic treatment containing S. boulardii. Caspofungin was not effective in this case and he was treated with amphotericin B. We want to emphasize that physicians should be careful about probiotic usage in critically ill patients.

  10. Catheter-related Saccharomyces cerevisiae Fungemia Following Saccharomyces boulardii Probiotic Treatment: In a child in intensive care unit and review of the literature.

    Science.gov (United States)

    Atıcı, Serkan; Soysal, Ahmet; Karadeniz Cerit, Kıvılcım; Yılmaz, Şerife; Aksu, Burak; Kıyan, Gürsu; Bakır, Mustafa

    2017-03-01

    Although Saccharomyces boulardii is usually a non-pathogenic fungus, in rare occasions it can cause invasive infection in children. We present the case of an 8-year-old patient in pediatric surgical intensive care unit who developed S. cerevisiae fungemia following probiotic treatment containing S. boulardii . Caspofungin was not effective in this case and he was treated with amphotericin B. We want to emphasize that physicians should be careful about probiotic usage in critically ill patients.

  11. Group program procedure for machining seal rings of steam turbines on digital computer controlled machines

    International Nuclear Information System (INIS)

    Glukhikh, V.K.; Skvortsov, S.B.; Sidorov, V.A.

    1982-01-01

    Developed is a group program procedure for turning machining of seal rings, including the use of new progressive high-accuracy equipment, universal device for securing of all nomenclature of treated seal rings, necessary cutting tools and program control of the process of treatment. Introduction of a new technological process permitted to improve the quality of treated seal rings; to reduce the labour consumption in 30...40% [ru

  12. Updated CDC Recommendations for Using Artemether-Lumefantrine for the Treatment of Uncomplicated Malaria in Pregnant Women in the United States.

    Science.gov (United States)

    Ballard, Sarah-Blythe; Salinger, Allison; Arguin, Paul M; Desai, Meghna; Tan, Kathrine R

    2018-04-13

    Malaria infection during pregnancy is associated with an increased risk for maternal and fetal complications. In the United States, treatment options for uncomplicated, chloroquine-resistant Plasmodium falciparum and P. vivax malaria in pregnant women are limited to mefloquine or quinine plus clindamycin (1). However, limited availability of quinine and increasing resistance to mefloquine restrict these options. Strong evidence now demonstrates that artemether-lumefantrine (AL) (Coartem) is effective and safe in the treatment of malaria in pregnancy. The World Health Organization (WHO) has endorsed artemisinin-based combination therapies (ACTs), such as AL, for treatment of uncomplicated malaria during the second and third trimesters of pregnancy and is currently considering whether to add ACTs, including AL, as an option for malaria treatment during the first trimester (2,3). This policy note reviews the evidence and updates CDC recommendations to include AL as a treatment option for uncomplicated malaria during the second and third trimesters of pregnancy and during the first trimester of pregnancy when other treatment options are unavailable. These updated recommendations reflect current evidence and are consistent with WHO treatment guidelines.

  13. Laser color recording unit

    Science.gov (United States)

    Jung, E.

    1984-05-01

    A color recording unit was designed for output and control of digitized picture data within computer controlled reproduction and picture processing systems. In order to get a color proof picture of high quality similar to a color print, together with reduced time and material consumption, a photographic color film material was exposed pixelwise by modulated laser beams of three wavelengths for red, green and blue light. Components of different manufacturers for lasers, acousto-optic modulators and polygon mirrors were tested, also different recording methods as (continuous tone mode or screened mode and with a drum or flatbed recording principle). Besides the application for the graphic arts - the proof recorder CPR 403 with continuous tone color recording with a drum scanner - such a color hardcopy peripheral unit with large picture formats and high resolution can be used in medicine, communication, and satellite picture processing.

  14. The treatment of ‘difficult’ patients in a secure unit of a specialized psychiatric hospital: the patient's perspective

    NARCIS (Netherlands)

    C.J. Gamel; B. Koekkoek; prof Berno van Meijel; M. Bos; Nienke Kool

    2011-01-01

    The aim of this study is to obtain insight, from a patient's perspective, into the results and essential components of treatment in specialist settings for so-called ‘difficult’ patients in mental health care. In cases where usual hospital treatment is not successful, a temporary transfer to

  15. The treatment of 'difficult' patients in a secure unit of a specialized psychiatric hospital : The patient's perspective

    NARCIS (Netherlands)

    N. Kool-Goudzwaard; Bauke van Koekkoek; C.J. Gamel; M. Bos; B. Meijel

    2012-01-01

    The aim of this study is to obtain insight, from a patient's perspective, into the results and essential components of treatment in specialist settings for so-called 'difficult' patients in mental health care. In cases where usual hospital treatment is not successful, a temporary transfer to

  16. Laser Doppler imaging of cutaneous blood flow through transparent face masks: a necessary preamble to computer-controlled rapid prototyping fabrication with submillimeter precision.

    Science.gov (United States)

    Allely, Rebekah R; Van-Buendia, Lan B; Jeng, James C; White, Patricia; Wu, Jingshu; Niszczak, Jonathan; Jordan, Marion H

    2008-01-01

    A paradigm shift in management of postburn facial scarring is lurking "just beneath the waves" with the widespread availability of two recent technologies: precise three-dimensional scanning/digitizing of complex surfaces and computer-controlled rapid prototyping three-dimensional "printers". Laser Doppler imaging may be the sensible method to track the scar hyperemia that should form the basis of assessing progress and directing incremental changes in the digitized topographical face mask "prescription". The purpose of this study was to establish feasibility of detecting perfusion through transparent face masks using the Laser Doppler Imaging scanner. Laser Doppler images of perfusion were obtained at multiple facial regions on five uninjured staff members. Images were obtained without a mask, followed by images with a loose fitting mask with and without a silicone liner, and then with a tight fitting mask with and without a silicone liner. Right and left oblique images, in addition to the frontal images, were used to overcome unobtainable measurements at the extremes of face mask curvature. General linear model, mixed model, and t tests were used for data analysis. Three hundred seventy-five measurements were used for analysis, with a mean perfusion unit of 299 and pixel validity of 97%. The effect of face mask pressure with and without the silicone liner was readily quantified with significant changes in mean cutaneous blood flow (P face masks. Perfusion decreases with the application of pressure and with silicone. Every participant measured differently in perfusion units; however, consistent perfusion patterns in the face were observed.

  17. Using simulated historical time series to prioritize fuel treatments on landscapes across the United States: The LANDFIRE prototype project

    Science.gov (United States)

    Robert E. Keane; Matthew Rollins; Zhi-Liang Zhu

    2007-01-01

    Canopy and surface fuels in many fire-prone forests of the United States have increased over the last 70 years as a result of modern fire exclusion policies, grazing, and other land management activities. The Healthy Forest Restoration Act and National Fire Plan establish a national commitment to reduce fire hazard and restore fire-adapted ecosystems across the USA....

  18. Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment.

    NARCIS (Netherlands)

    Guery, B.P.; Arendrup, M.C.; Auzinger, G.; Azoulay, E.; Borges Sa, M.; Johnson, E.M.; Muller, E.; Putensen, C.; Rotstein, C.; Sganga, G.; Venditti, M.; Zaragoza Crespo, R.; Kullberg, B.J.

    2009-01-01

    BACKGROUND: Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). OBJECTIVE AND METHODS: To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review

  19. The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study

    Science.gov (United States)

    2012-01-01

    Background The aim of the study was to determine whether distance between residence and peritoneal dialysis (PD) unit influenced peritonitis occurrence, microbiology, treatment and outcomes. Methods The study included all patients receiving PD between 1/10/2003 and 31/12/2008, using ANZDATA Registry data. Results 365 (6%) patients lived ≥100 km from their nearest PD unit (distant group), while 6183 (94%) lived peritonitis in distant patients (1.34 years, 95% CI 1.07-1.61) was significantly shorter than in local patients (1.68 years, 95% CI 1.59-1.77, p = 0.001), whilst overall peritonitis rates were higher in distant patients (incidence rate ratio 1.32, 95% CI 1.20-1.46). Living ≥100 km away from a PD unit was independently associated with a higher risk of S. aureus peritonitis (adjusted odds ratio [OR] 1.64, 95% CI 1.09-2.47). Distant patients with first peritonitis episodes were less likely to be hospitalised (64% vs 73%, p = 0.008) and receive antifungal prophylaxis (4% vs 10%, p = 0.01), but more likely to receive vancomycin-based antibiotic regimens (52% vs 42%, p peritonitis outcomes, distant patients were more likely to be cured with antibiotics alone (OR 1.55, 95% CI 1.03-2.24). All other outcomes were comparable between the two groups. Conclusions Living ≥100 km away from a PD unit was associated with increased risk of S. aureus peritonitis, modified approaches to peritonitis treatment and peritonitis outcomes that were comparable to, or better than patients living closer to a PD unit. Staphylococcal decolonisation should receive particular consideration in remote living patients. PMID:22702659

  20. Simulation of nuclear fuel rods by using process computer-controlled power for indirect electrically heated rods

    International Nuclear Information System (INIS)

    Malang, S.

    1975-11-01

    An investigation was carried out to determine how the simulation of nuclear fuel rods with indirect electrically heated rods could be improved by use of a computer to control the electrical power during a loss-of-coolant accident (LOCA). To aid in the experiment, a new version of the HETRAP code was developed which simulates a LOCA with heater rod power controlled by a computer that adjusts rod power during a blowdown to minimize the difference in heat flux of the fuel and heater rods. Results show that without computer control of heater rod power, only the part of a blowdown up to the time when the heat transfer mode changes from nucleate boiling to transition or film boiling can be simulated well and then only for short times. With computer control, the surface heat flux and temperature of an electrically heated rod can be made nearly identical to that of a reactor fuel rod with the same cooling conditions during much of the LOCA. A small process control computer can be used to achieve close simulation of a nuclear fuel rod with an indirect electrically heated rod

  1. Trends in the Quality of Treatment for Patients With Intact Cervical Cancer in the United States, 1999 Through 2011

    International Nuclear Information System (INIS)

    Smith, Grace L.; Jiang, Jing; Giordano, Sharon H.; Meyer, Larissa A.; Eifel, Patricia J.

    2015-01-01

    Purpose: High-quality treatment for intact cervical cancer requires external radiation therapy, brachytherapy, and chemotherapy, carefully sequenced and completed without delays. We sought to determine how frequently current treatment meets quality benchmarks and whether new technologies have influenced patterns of care. Methods and Materials: By searching diagnosis and procedure claims in MarketScan, an employment-based health care claims database, we identified 1508 patients with nonmetastatic, intact cervical cancer treated from 1999 to 2011, who were <65 years of age and received >10 fractions of radiation. Treatments received were identified using procedure codes and compared with 3 quality benchmarks: receipt of brachytherapy, receipt of chemotherapy, and radiation treatment duration not exceeding 63 days. The Cochran-Armitage test was used to evaluate temporal trends. Results: Seventy-eight percent of patients (n=1182) received brachytherapy, with brachytherapy receipt stable over time (Cochran-Armitage P trend =.15). Among patients who received brachytherapy, 66% had high–dose rate and 34% had low–dose rate treatment, although use of high–dose rate brachytherapy steadily increased to 75% by 2011 (P trend <.001). Eighteen percent of patients (n=278) received intensity modulated radiation therapy (IMRT), and IMRT receipt increased to 37% by 2011 (P trend <.001). Only 2.5% of patients (n=38) received IMRT in the setting of brachytherapy omission. Overall, 79% of patients (n=1185) received chemotherapy, and chemotherapy receipt increased to 84% by 2011 (P trend <.001). Median radiation treatment duration was 56 days (interquartile range, 47-65 days); however, duration exceeded 63 days in 36% of patients (n=543). Although 98% of patients received at least 1 benchmark treatment, only 44% received treatment that met all 3 benchmarks. With more stringent indicators (brachytherapy, ≥4 chemotherapy cycles, and duration not exceeding 56 days), only 25

  2. Feasibility of replacing patient specific cutouts with a computer-controlled electron multileaf collimator

    International Nuclear Information System (INIS)

    Eldib, Ahmed; Jin Lihui; Li Jinsheng; Ma, C-M Charlie

    2013-01-01

    A motorized electron multileaf collimator (eMLC) was developed as an add-on device to the Varian linac for delivery of advanced electron beam therapy. It has previously been shown that electron beams collimated by an eMLC have very similar penumbra to those collimated by applicators and cutouts. Thus, manufacturing patient specific cutouts would no longer be necessary, resulting in the reduction of time taken in the cutout fabrication process. Moreover, cutout construction involves handling of toxic materials and exposure to toxic fumes that are usually generated during the process, while the eMLC will be a pollution-free device. However, undulation of the isodose lines is expected due to the finite size of the eMLC. Hence, the provided planned target volume (PTV) shape will not exactly follow the beam's-eye-view of the PTV, but instead will make a stepped approximation to the PTV shape. This may be a problem when the field edge is close to a critical structure. Therefore, in this study the capability of the eMLC to achieve the same clinical outcome as an applicator/cutout combination was investigated based on real patient computed tomographies (CTs). An in-house Monte Carlo based treatment planning system was used for dose calculation using ten patient CTs. For each patient, two plans were generated; one with electron beams collimated using the applicator/cutout combination; and the other plan with beams collimated by the eMLC. Treatment plan quality was compared for each patient based on dose distribution and dose–volume histogram. In order to determine the optimal position of the leaves, the impact of the different leaf positioning strategies was investigated. All plans with both eMLC and cutouts were generated such that 100% of the target volume receives at least 90% of the prescribed dose. Then the percentage difference in dose between both delivery techniques was calculated for all the cases. The difference in the dose received by 10% of the volume of the

  3. Feasibility of replacing patient specific cutouts with a computer-controlled electron multileaf collimator

    Science.gov (United States)

    Eldib, Ahmed; Jin, Lihui; Li, Jinsheng; Ma, C.-M. Charlie

    2013-08-01

    A motorized electron multileaf collimator (eMLC) was developed as an add-on device to the Varian linac for delivery of advanced electron beam therapy. It has previously been shown that electron beams collimated by an eMLC have very similar penumbra to those collimated by applicators and cutouts. Thus, manufacturing patient specific cutouts would no longer be necessary, resulting in the reduction of time taken in the cutout fabrication process. Moreover, cutout construction involves handling of toxic materials and exposure to toxic fumes that are usually generated during the process, while the eMLC will be a pollution-free device. However, undulation of the isodose lines is expected due to the finite size of the eMLC. Hence, the provided planned target volume (PTV) shape will not exactly follow the beam's-eye-view of the PTV, but instead will make a stepped approximation to the PTV shape. This may be a problem when the field edge is close to a critical structure. Therefore, in this study the capability of the eMLC to achieve the same clinical outcome as an applicator/cutout combination was investigated based on real patient computed tomographies (CTs). An in-house Monte Carlo based treatment planning system was used for dose calculation using ten patient CTs. For each patient, two plans were generated; one with electron beams collimated using the applicator/cutout combination; and the other plan with beams collimated by the eMLC. Treatment plan quality was compared for each patient based on dose distribution and dose-volume histogram. In order to determine the optimal position of the leaves, the impact of the different leaf positioning strategies was investigated. All plans with both eMLC and cutouts were generated such that 100% of the target volume receives at least 90% of the prescribed dose. Then the percentage difference in dose between both delivery techniques was calculated for all the cases. The difference in the dose received by 10% of the volume of the

  4. The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study

    Directory of Open Access Journals (Sweden)

    Gillian M. Craig

    2015-03-01

    Conclusions: There is a need for integrated care across drug, alcohol, HIV, and homeless services in order to address the complex clinical co-morbidities and social needs that impact on the patient's ability to sustain a course of treatment.

  5. Trends and disparities in receipt of pharmacotherapy among pregnant women in publically funded treatment programs for opioid use disorder in the United States.

    Science.gov (United States)

    Short, Vanessa L; Hand, Dennis J; MacAfee, Lauren; Abatemarco, Diane J; Terplan, Mishka

    2018-06-01

    To describe differences in geographic, demographic, treatment, and substance use characteristics by pharmacotherapy receipt among pregnant women entering publically funded treatment for opioid use disorder (OUD) in the United States. 1996 to 2014 Treatment Episode Data Set-Admissions data from pregnant admissions with OUD, defined as reporting opioids as the primary substance of use leading to the treatment episode, were analyzed for this cross-sectional study. The proportion of all pregnant admissions with OUD who received pharmacotherapy was calculated by year and U.S. census region. Trends across time were assessed using the Cochrane-Armitage Trend test. Associations between demographic, substance use, and treatment characteristics and pharmacotherapy receipt were assessed using Chi-square tests and multivariable logistic regression. The proportion of pregnant admissions where opioids were the primary substance of use increased from 16.9% to 41.6% during the study period, while the proportion of pregnant admissions with OUD who received pharmacotherapy remained relatively unchanged at around 50%. Overall, pharmacotherapy recipients were generally older and white, more likely to receive treatment in an outpatient setting, be self-referred, and report heroin as the primary substance, daily substance use, and intravenous drug use, and less likely to have a co-occurring psychiatric problem compared to those who did not receive pharmacotherapy. Regional differences in pharmacotherapy utilization exist; the South consistently had the fewest pregnant admissions with OUD receiving pharmacotherapy. Although the proportion of pregnant admissions to substance use treatment centers with OUD has increased since the mid-1990s, the proportion receiving pharmacotherapy has not changed. Significant variations in pharmacotherapy utilization exist by geography and demographic, substance use and treatment characteristics. Utilization of pharmacotherapy at publically funded

  6. Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop

    Directory of Open Access Journals (Sweden)

    Kerns William P

    2011-02-01

    Full Text Available Abstract Background Envenomation by crotaline snakes (rattlesnake, cottonmouth, copperhead is a complex, potentially lethal condition affecting thousands of people in the United States each year. Treatment of crotaline envenomation is not standardized, and significant variation in practice exists. Methods A geographically diverse panel of experts was convened for the purpose of deriving an evidence-informed unified treatment algorithm. Research staff analyzed the extant medical literature and performed targeted analyses of existing databases to inform specific clinical decisions. A trained external facilitator used modified Delphi and structured consensus methodology to achieve consensus on the final treatment algorithm. Results A unified treatment algorithm was produced and endorsed by all nine expert panel members. This algorithm provides guidance about clinical and laboratory observations, indications for and dosing of antivenom, adjunctive therapies, post-stabilization care, and management of complications from envenomation and therapy. Conclusions Clinical manifestations and ideal treatment of crotaline snakebite differ greatly, and can result in severe complications. Using a modified Delphi method, we provide evidence-informed treatment guidelines in an attempt to reduce variation in care and possibly improve clinical outcomes.

  7. Computer systems for the control of teletherapy units

    International Nuclear Information System (INIS)

    Brace, J.A.

    1985-01-01

    This paper describes a computer-controlled tracking cobalt unit installed at the Royal Free Hospital. It is based on a standard TEM MS90 unit and operates at 90-cm source-axis distance with a geometric field size of 45 x 45 cm at that distance. It has been modified so that it can be used either manually or under computer control. There are nine parameters that can be controlled positionally and two that can be controlled in rate mode; these are presented in a table

  8. An artificial-vision responsive to patient motions during computer controlled radiation therapy

    International Nuclear Information System (INIS)

    Kalend, A.M.; Shimoga, K.; Kanade, T.; Greenberger, J.S.

    1997-01-01

    Purpose/Objectives: Automated precision radiotherapy using multiple conformal and modulated beams, requires monitoring of patient movements during irradiation. Immobilizers relying on patient cooperating in cradles have somewhat reduced positional uncertainties, but others including breathing are largely unknown. We built an artificial vision (AV) device for real-time vision of patient movements, their tracking and quantification. Method and Materials: The Artificial Vision System's 'acuity' and 'reflex' were evaluated in terms of imaged skin spatial resolutions and temporal dispersions measured using a mannequin and a fiduciated harmonic oscillator placed at 100cm isocenter. The device traced skin motion even in poorly lighted rooms without use of explicit skin fiduciation, or using standard radiotherapy skin tattoos. Results: The AV system tracked human skin at vision rates approaching 30Hz and sensitivity of 2mm. It successfully identified and tracked independent skin marks, either natural tattoos or artificial fiducials. Three alert levels triggered when patient movement exceeded preset displacements (2mm/30Hz), motion velocities (5m/sec) or acceleration (2m/sec 2 ). Conclusion: The AV system trigger should suit for patient ventilatory gating and safety interlocking of treatment accelerators, in order to modulate, interrupt, or abort radiation during dynamic therapy

  9. Electronic gaming machines and gambling disorder: A cross-cultural comparison between treatment-seeking subjects from Brazil and the United States.

    Science.gov (United States)

    Medeiros, Gustavo C; Leppink, Eric W; Yaemi, Ana; Mariani, Mirella; Tavares, Hermano; Grant, Jon E

    2015-12-15

    The objective of this paper is to perform a cross-cultural comparison of gambling disorder (GD) due to electronic gaming machines (EGM), a form of gambling that may have a high addictive potential. Our goal is to investigate two treatment-seeking samples of adults collected in Brazil and the United States, countries with different socio-cultural backgrounds. This comparison may lead to a better understanding of cultural influences on GD. The total studied sample involved 733 treatment-seeking subjects: 353 men and 380 women (average age=45.80, standard deviation ±10.9). The Brazilian sample had 517 individuals and the American sample 216. Subjects were recruited by analogous strategies. We found that the Brazilian sample was younger, predominantly male, less likely to be Caucasian, more likely to be partnered, tended to have a faster progression from recreational gambling to GD, and were more likely to endorse chasing losses. This study demonstrated that there are significant differences between treatment-seeking samples of adults presenting GD due to EGM in Brazil and in the United States. These findings suggest that cultural aspects may have a relevant role in GD due to EGM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Sleep quality in treatment-seeking veterans of Operations Enduring Freedom and Iraqi Freedom: the role of cognitive coping strategies and unit cohesion.

    Science.gov (United States)

    Pietrzak, Robert H; Morgan, Charles A; Southwick, Steven M

    2010-11-01

    Sleep difficulties are common in individuals exposed to stress or trauma, and maladaptive cognitive coping strategies, such as worry and fear of losing vigilance, as well as low social support, may further impair sleep quality. This study examined the severity and correlates of sleep difficulties in a sample of treatment-seeking veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). A total of 167 OEF-OIF veterans seeking behavioral or primary care services completed a questionnaire containing measures of sleep quality, combat exposure, psychopathology, fear of loss of vigilance, cognitive coping strategies, and unit and postdeployment social support within 1 year of returning from deployment. Mean Pittsburgh Sleep Quality Inventory scores in the full sample were indicative of severely impaired sleep. Posttraumatic stress disorder (PTSD) was associated with increased sleep difficulties, most notably sleep disturbances, daytime dysfunction, and sleep quality. Hierarchical regression analysis in the full sample revealed that PTSD symptoms and scores on measures of worry and fear of loss of vigilance were positively associated with sleep difficulties and that scores on a measure of unit member support were negatively associated with sleep difficulties. Among veterans with PTSD, fear of loss of vigilance was positively associated with sleep difficulties and cognitive distraction and unit member support were negatively associated with sleep difficulties. Treatment-seeking OEF-OIF veterans report severe sleep difficulties, with more pronounced impairment in veterans with PTSD. The results of this study suggest that interventions to mitigate worry and fear of loss of vigilance and to enhance perceived unit member support may be helpful in reducing sleep difficulties following return from deployment in this population. Copyright © 2010 Elsevier Inc. All rights reserved.

  11. Fuels planning: science synthesis and integration; forest structure and fire hazard fact sheet 06: Guide to fuel treatments in dry forests of the Western United States: assessing forest structure and fire hazard

    Science.gov (United States)

    Rocky Mountain Research Station USDA Forest Service

    2005-01-01

    The Guide to Fuel Treatments analyzes a range of potential silvicultural thinnings and surface fuel treatments for 25 representative dry-forest stands in the Western United States. The guide provides quantitative guidelines and visualization for treatment based on scientific principles identified for reducing potential crown fires. This fact sheet identifies the...

  12. SU-E-T-572: Beam Characteristics and Treatment Planning Commissioning for a New Proton Therapy Unit

    International Nuclear Information System (INIS)

    Zhao, T; Sun, B; Grantham, K; Santanam, L; Goddu, S; Klein, E

    2014-01-01

    Purpose: A single-room proton system, the Mevion S250, was introduced into the arena of proton radiotherapy by Mevion Medical Systems. The first unit was installed and operates at the S. Lee Kling Proton Therapy Center at Barnes-Jewish Hospital. The objective of this abstract is to report the system's beam characteristics and Eclipse commissioning. Methods: Commissioning data were acquired for modelling longitudinal fluence, virtual source position, effective source position, source size and Bragg peaks in Eclipse. Stoichiometric CT calibration was generated via ICRU44 human. Spread-out Bragg peaks (SOBP) were measured with Parallel Plate Chamber and profiles with solid state detector for model validation. Heterogeneity effects were measured with bone and lung inserts in the beam line. RT dose was computed in a virtual water phantom, and exported from Eclipse to compare with measurements at various depths and axis. SOBPs were fine-tuned with partial shining correction and entry correction to match measurements. Output factor was measured for each individual field with an ADCL ion chamber in a water tank and fitted to a polynomial function to cross-check the monitor unit verification. Results: Ranges of all 24 options were measured within ±1mm tolerance. Modulations met a ±1mm or ±2% tolerance. SOBP flatness met a ±3% tolerance. Distal fall off (80%-20%) were measured between 6mm and 7mm for all options. Virtual source positions varied between 177cm and 195cm, decreasing with field size and range. SOBP generated by Eclipse agreed with measurements within ±3% in the entry region, and ±1%/±1mm in other regions. Sanity check for output achieved 5% accuracy in 98% of cases. Conclusion: The commissioning of the first Mevions S250 proton therapy system met specifications. The unit has been put in clinical operation since 12/17/2013

  13. A Point Source of a Different Color: Identifying a Gap in United States Regulatory Policy for “Green” CSO Treatment Using Constructed Wetlands

    Directory of Open Access Journals (Sweden)

    Zeno F. Levy

    2014-04-01

    Full Text Available Up to 850 billion gallons of untreated combined sewer overflow (CSO is discharged into waters of the United States each year. Recent changes in CSO management policy support green infrastructure (GI technologies as “front of the pipe” approaches to discharge mitigation by detention/reduction of urban stormwater runoff. Constructed wetlands for CSO treatment have been considered among suites of GI solutions. However, these wetlands differ fundamentally from other GI technologies in that they are “end of the pipe” treatment systems that discharge from a point source, and are therefore regulated in the U.S. under the National Pollution Discharge Elimination System (NPDES. We use a comparative regulatory analysis to examine the U.S. policy framework for CSO treatment wetlands. We find in all cases that permitting authorities have used best professional judgment to determine effluent limits and compliance monitoring requirements, referencing technology and water quality-based standards originally developed for traditional “grey” treatment systems. A qualitative comparison with Europe shows less stringent regulatory requirements, perhaps due to institutionalized design parameters. We recommend that permitting authorities develop technical guidance documents for evaluation of “green” CSO treatment systems that account for their unique operational concerns and benefits with respect to sustainable development.

  14. On the computer control of the Eindhoven A.V.F. cyclotron

    International Nuclear Information System (INIS)

    Heusden, G.C.L. van

    1976-01-01

    In this thesis, the design and the results are described of the computerized control system of the Eindhoven AVF cyclotron and the beam guiding system. The beam diagnostic equipment is reviewed. At 13 radii in the cyclotron fase, probes are installed to measure the HF-phase angle of the accelerated particles. At an internal beam current of 10 μA the accuracy is, depending on the method used, 0.5deg or 0.06deg; at an interval current of 50 nA, the accuracy is 9deg and 1deg respectively. At an external beam current of more than 30 nA a decrease of the extraction efficiency, due to erroneous parameter settings, still can be measured. The accuracy of the determination of the position and width of the external beam equals 0.2 mm for beam currents larger than 30 nA. The emittance of the external beam can be determined at a number of locations in the beam guiding system with an accuracy of about 5%. In chapter 3 the data handling system is described consisting of a CAMAC system and a PDP-9 computer. The coupling between the CAMAC system and the PDP-9 is briefly discussed. Further, the software performing the various control tasks is given. The control schemes used are given along with a geometrical treatment of the least squares method. Thus a good inside can be obtained concerning the control parameters to be used. The results of the control system are given in chapter 5. The HF-phase angle of the accelerated particles can be kept within 1deg of the desired value at all radii. The extraction efficiency can be kept within 1% of the maximum value. In chapter 6, preliminary results are given on HF-phase selection, using radial and axial selecting slits. Further an acial deflection system is described which selects one out of 28 beam pulses. The axial phase selection slits together with the deflection system are used to obtain single turn extraction

  15. Treatment of Moderately Intellectually Disabled Delinquent Youth in a Dutch Juvenile Justice Facility with Closed and Open Units

    Science.gov (United States)

    Lodewijks, Henny P. B.

    2011-01-01

    This article will focus on a juvenile justice facility in the Netherlands, targeted at moderately intellectually disabled juveniles, who are sentenced because of serious crimes. All of the juveniles have a disruptive disorder (conduct disorder or oppositional defiant disorder) and 70% have comorbid psychiatric classifications. Treatment amounts to…

  16. Efficacy of Elimination of Pasteurella pneumotropica from a Mouse Specific Pathogen-Free Barrier Breeding Unit through Treatment with Enrofloxacin

    DEFF Research Database (Denmark)

    Østergaard, Grete; Arnorsdottir, Stefania Embla; Schumacher-Petersen, Camilla

    2010-01-01

    , and enrofloxacin (EF) was chosen as the most appropriate antibiotic to treat this infection. Various doses of EF were tested for toxic effects on NMRI-mice prior to the treatment, and since no negative effects of EF, regardlessof dose tested, were observed, the highest dose of 150 mg/kg body weight was chosen...

  17. Evaluation and diffusion of excimer laser treatment of myopia in the United States and in the Netherlands

    NARCIS (Netherlands)

    Vondeling, H.; Rosendal, H.; Banta, D.

    1995-01-01

    Excimer laser photorefractive keratectomy (PRK) is an experimental treatment to correct myopia (short-sightedness) that is diffusing into use without convincing evidence of safety and efficacy. It has been claimed that PRK may render conventional methods of correcting myopia, such as wearing glasses

  18. The Management of Pemphigus Vulgaris in a Burn Intensive Care Unit: A Case Report and Treatment Review

    Science.gov (United States)

    2014-10-01

    achieving com- plete remission. J Am Acad Dermatol 2011;64:490–4. 10. Martin LK, Werth VP, Villaneuva EV, Murrell DF. A system- atic review of randomized...Cavacini LA, Posner MR. Treatment of pemphigus vulgaris with rituximab and intra- venous immune globulin. N Engl J Med 2006;355:1772–9. 29. Joly P

  19. Electroconvulsive therapy as a treatment for protracted refractory delirium in the intensive care unit--five cases and a review

    DEFF Research Database (Denmark)

    Nielsen, R M; Olsen, K S; Lauritsen, Anne Øberg

    2014-01-01

    of stress, and able to cooperate with the ventilator but remained in a state of posttraumatic amnesia after a head trauma. CONCLUSION: Although controversial, ECT is nevertheless recognized as an efficient and safe treatment for various psychiatric illnesses including delirium. Considering the significantly...

  20. An Internet treatment with weekly e-mail contacts used in a tobacco unit: clinical utility and predictors of outcome

    NARCIS (Netherlands)

    Gallego, M.J.; Modesto, M.; Muñoz, M.A.; Almajano, M.J.; Modolell, E.; Peris, C.P.; Emmelkamp, P.M.G.

    2014-01-01

    This work presents preliminary data on the clinical utility and outcome predictors of The San Francisco Stop Smoking Internet Site (SFSSIS) (Lenert et al., 2003) used with weekly e-mail contacts and the usual pharmacological treatment. Fifty smokers participated in the current series of cases, 24

  1. Treatment Patterns Associated with ACR-Recommended Medications in the Management of Fibromyalgia in the United States.

    Science.gov (United States)

    Liu, Yifei; Qian, Chunlin; Yang, Mei

    2016-03-01

    Fibromyalgia (FM) affects up to 6% of U.S. adults, resulting in a significant burden on the health care system and poor quality of life for patients. Duloxetine, pregabalin, and milnacipran are approved for management of FM; however, consensus is lacking regarding optimal therapy. Patients with FM taking approved medications often do not experience meaningful symptom relief, and many experience intolerable adverse events. To assess treatment patterns associated with available and commonly used medications for the management of FM using U.S. health insurance claims. This retrospective analysis used the MarketScan claims database to identify adults with a first diagnosis of FM (ICD-9-CM code 729.1) between 2009 and 2011 with continuous health plan enrollment for 12 months pre- and post-index. Medications of interest were pregabalin, gabapentin, duloxetine, milnacipran, cyclobenzaprine, and tramadol. These are 6 of the 8 medications recommended by the American College of Rheumatology (ACR) for treating FM; the other 2 (amitriptyline and venlafaxine) were only included in some initial assessments. The Charlson Comorbidity Index (CCI) was used to assess overall comorbidity burden. Endpoints included proportion of patients treated within 1 year after first diagnosis; initial treatment pattern; adherence over the first-year follow-up period for the medications of interest; and discontinuation, switching, and combination therapy patterns among pain medications of interest at different time points. Proportion of days covered (PDC; defined as number of days in the period when the patient had drug supply divided by the number of days in the period) was used to define adherence, which was categorized as low (PDC time to discontinuation (defined as the first drug supply gap ≥ 90 days) was estimated using Kaplan-Meier analysis. Overall, 240,144 patients met the inclusion criteria. Patients were predominantly women (68%), had preferred provider organization insurance coverage

  2. Computer-Controlled Cylindrical Polishing Process for Development of Grazing Incidence Optics for Hard X-Ray Region

    Science.gov (United States)

    Khan, Gufran Sayeed; Gubarev, Mikhail; Speegle, Chet; Ramsey, Brian

    2010-01-01

    The presentation includes grazing incidence X-ray optics, motivation and challenges, mid spatial frequency generation in cylindrical polishing, design considerations for polishing lap, simulation studies and experimental results, future scope, and summary. Topics include current status of replication optics technology, cylindrical polishing process using large size polishing lap, non-conformance of polishin lap to the optics, development of software and polishing machine, deterministic prediction of polishing, polishing experiment under optimum conditions, and polishing experiment based on known error profile. Future plans include determination of non-uniformity in the polishing lap compliance, development of a polishing sequence based on a known error profile of the specimen, software for generating a mandrel polishing sequence, design an development of a flexible polishing lap, and computer controlled localized polishing process.

  3. Representation, testing and assessment of the 'Estelle' formal description technique from a computer-controlled neutron scatter experiment

    International Nuclear Information System (INIS)

    Wolschke, U.

    1986-08-01

    Estelle is a formal method of description, which was developed based on an extended state transition model for the specification of communication records and services. Regardless of the field of application, there are problems common to all systems in distributed systems, i.e. in communication systems as in process computer systems, which are to be specified. These include real time problems, such as waiting for events, reactions to expected events and those occurring at the correct time, reacting to unexpected events or those not occurring at the correct time, transmitting and receiving data and the synchronisation of process going on simultaneously. This work examines, using the example of a process computer-controlled neutron scatter experiment, whether Estelle is suitable for the specification of distributed real time systems in this field of application. (orig.) [de

  4. Facilitating the design and operation of computer-controlled radiochemistry synthesizers with an open-quotes Electronic Toolboxclose quotes

    International Nuclear Information System (INIS)

    Feliu, A.L.

    1991-01-01

    Positron emission tomography (PET) is a non-invasive diagnostic imaging technique requiring rapid and reliable radiopharmaceutical production. Automated systems offer a host of potential advantages over manually or remotely operated apparatus, including reduced personnel requirements, lower radiation exposure to personel, reliable yields, and reproducible product purity. However, the burden of routine radiopharmaceutical production most often remains a labor-intensive responsibility of highly trained radiochemists. In order to ease the transition between manual, remote-controlled, and computer-controlled radiochemical synthesis, an electronic toolbox with graphical user interface was developed as a generic process control system compatible with a variety of common radiochemical operations. This work is specifically aimed to make automated techniques more accessible by emphasizing the similarities between manual and automated chemistry and by minimizing the computer programming effort required. This paper discusses the structural elements of the electronic toolbox approach to radiochemistry process control, and its ramifications for the designers and end-users of automated synthesizers

  5. Energy Recovery from Wastewater Treatment Plants in the United States: A Case Study of the Energy-Water Nexus

    OpenAIRE

    Ashlynn S. Stillwell; David C. Hoppock; Michael E. Webber

    2010-01-01

    This manuscript uses data from the U.S. Environmental Protection Agency to analyze the potential for energy recovery from wastewater treatment plants via anaerobic digestion with biogas utilization and biosolids incineration with electricity generation. These energy recovery strategies could help offset the electricity consumption of the wastewater sector and represent possible areas for sustainable energy policy implementation. We estimate that anaerobic digestion could save 628 to 4,940 mil...

  6. Condensate treatment in BWR circuits by filter demineralizer units using powdered ion exchange resin at medium and high temperature

    International Nuclear Information System (INIS)

    De Martino, R.

    1983-01-01

    Considering the radiation build-up in some BWR reactors, we make a correlation between this phenomenon and the condensate purification system applied and the point of its utilization into the circuits. The application temperature of such a plant seems to have a very important role on the equilibria of metals contained in the reactor water and on the oxide composition. The efficiency of the condensate polishing system and the corrosion control are the most interesting objectives to achieve and to maintain, to control and regulate the physical and chemical process in the feedwater and in the reactor water. Up to date the technology owns major knowledge and a consistent know-how on using chemical products in order to increase the condensate polishing system efficiency. It is also considered a typical parallel case of a conventional power station and a secondary system of BWR units. (author)

  7. Treatment and follow-up results of children with electrical burn who observed in burn intensive care unit

    Directory of Open Access Journals (Sweden)

    Çiğdem Aliosmanoğlu

    2011-06-01

    Full Text Available Electrical burns are infrequent relative to other injuries, but they are associated with high morbidity and mortality. The aim of this study was to assess management and follow-up results of pediatric patients’ who observed in intensive care unit and also review the precautions for preventing electrical burns.Materials and methods: Totally 22 patients aged under 17 years who were observed in the burn intensive care unit of Şanlıurfa Education and Research Hospital during the period between July 2009-October 2010. Cases were investigated retrospectively. The patients’ age, gender, total burn surface area, length of stay in hospital, musculo-skeletal system complication, cardiovascular system complication, kidney damage and attempts were recorded.Results: Of the 22 cases, 19 (86.3% were male and 3 (13.7% were female. The mean age of the patients was 11.5 years. In 10 (45.4% children burns were occurred in workplace and working area and 12 (54.6% were occurred in the home environment. Depth of burns were third degree in 10 (45.4% children and second degree in 12 (54.6%. The mean percentage of burn surface area was 25.9%. The mean length of stay in hospital was 17 days. Debridement and grafting were performed to 12 (54.6% cases and 10 (45.4% children were treated with dressings. No patient had increased creatinine kinase levels, oliguria, myoglobuinuria and arrhythmia. The mean hospitalization time was 17 days.Conclusion: Nearly half of patients underwent debridement plus grafting. None of our patients developed renal failure other severe system dysfunction.

  8. Extracorporeal shock wave lithotripsy in the treatment of ureteric stones: Experience from Twam Hospital, United Arab Emirates

    International Nuclear Information System (INIS)

    Ghafoor, M.; Halim, A.

    2002-01-01

    The optimal treatment of ureteric stones, especially the lower ureteric stone, remains controversial. The purpose of this study was to evaluate the role of extracorporeal shock wave lithotripsy (ESWL) in the management of ureteric stones. A total of 99 patients with ureteric stones at different levels were treated with ESWL from 1994 through 1998 at our hospital. All patients were treated using Siemen Lithostar-II Plus Lithotripter. Of 99 patients, 22 were excluded from the study because they had no follow-up records of their stone-free status. The clearance rates for ureteric stones of the other 79 patients treated were stratified according to the site, size and the number of treatment sessions required per stone. The stone size was determined by the widest diameters. Based on stone size, the patients were divided into two groups: A ( 1 0 mm) and B (11-20 mm). The overall all clearance rate for ureteric stones treated with ESWL, irrespective of its site and size, was 78.5%. The overall clearance rate for size A (<-10 mm) stone was 82% and size B (11-20 mm) was 58% regardless of the site of the stone in the ureter. A total of 17 upper ureteric stones were treated with ESWL. The overall clearance rate for upper ureteric stones was 94%. Thirteen patients with mid-ureteric stones were treated with ESWL. The overall clearance rate for the lower ureteric stones was 69.3%. ESWL is safe, effective, noninvasive and a convenient way of treatment for all ureteric stones. The clearance rate for stones in the upper and mid-ureter is above 90%. ESWL being an outpatient procedure without ant need for anesthesia or any pretreatment intervention. It should be considered as the first line of treatment for all stones in the upper and mid-ureter. The clearance for small stones (<1 mm) in the lower third of ureter was 73.8% in our study and for these, ESWL may be considered as a primary therapy. For stones larger than 10 mm in the distal third of ureter, the clearance rate was low

  9. Development of a Faith-Based Mental Health Literacy Program to Improve Treatment Engagement Among Caribbean Latinos in the Northeastern United States of America.

    Science.gov (United States)

    Caplan, Susan; Cordero, Carolyn

    2015-01-01

    Depression is one of the leading causes of years lived with disability (YLDs) worldwide. Although depression can be successfully treated, 75% of Americans do not receive care. Treatment rates among Latinos immigrants are significantly lower than non-immigrant Latinos and non-Hispanic Whites. Known factors for mental health-care disparities such as poverty, insurance coverage, language barriers, and access to specialty mental health services in Latino neighborhoods do not fully explain the differences in treatment rates. Significant, but poorly understood factors influencing depression treatment among Latinos in the United States are lack of culturally congruent care, low mental health literacy, and stigma. Even though churches are a major source of health information, social and spiritual support for Latinos, the conceptualization of culturally congruent care rarely addresses religious beliefs. Therefore, one strategy to reduce disparities in depression treatment is to partner with churches to address faith-based stigma. Community-based participatory research is recognized as a methodology particularly well suited for creating successful culturally targeted interventions. The purpose of this article is to describe the process of creating a faith-based mental health literacy intervention in the Caribbean Latino community using the principles of community-based participatory research. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. Influence of timber harvesting costs on the layout of cuttings and economic return in forest planning based on dynamic treatment units

    Directory of Open Access Journals (Sweden)

    Adrián Pascual

    2018-05-01

    Full Text Available Aim of study: To analyze the influence of harvesting costs on the distribution and type of cuttings when forest management planning is based on the dynamic treatment units (DTUs approach. Area of study: A Mediterranean pine forest in Central Spain. Materials and methods: Airborne laser scanning data were used in area-based approach to predict stand attributes and delineate segments that were used as calculation units. Predicted stand attributes and existing models for diameter distribution and individual-tree growth were used to simulate alternative management schedules for each segment for a 60-year planning horizon divided into three 20-year periods. Three alternative forest planning problems were formulated. They aimed to maximize or minimize net income, or maximize timber production with a constant flow of harvested timber. Spatial goals were used in all cases to enhance the clustering of treatments. Main results: Maxizing timber production without considering harvesting costs can be costly, even close to the plan that minimized net incomes. Maximizing net incomes led to frequent use of final felling instead of thinnings, placing cuttings near forest roads and creating more compact DTUs than obtained in the plan that maximized timber production. Research highlights: Compared to previous studies on DTUs, this study integrated felling and forwarding costs, which depended on distance to road and stand attributes, in the process of creating DTUs by means of spatial optimization.

  11. Modeling the fiscal costs and benefits of alternative treatment strategies in the United Kingdom for chronic hepatitis C.

    Science.gov (United States)

    Connolly, Mark P; Kotsopoulos, Nikos; Ustianowski, Andrew

    2018-01-01

    Hepatitis C (HCV) infection causes substantial direct health costs, but also impacts broader societal and governmental costs, such as tax revenue and social protection benefits. This study investigated the broader fiscal costs and benefits of curative interventions for chronic Hepatitis C (CHC) that allow individuals to avoid long-term HCV attributed health conditions. A prospective cohort model, assessing the long-term fiscal consequences of policy decisions, was developed for HCV infected individuals, following the generational accounting analytic framework that combines age-specific lifetime gross taxes paid and governmental transfers received (i.e. healthcare and social support costs). The analysis assessed the burden of a theoretical cohort of untreated HCV infected patients with the alternative of treating these patients with a highly efficacious curative intervention (ledipasvir/sofosbuvir [LDV/SOF]). It also compared treating patients at all fibrosis stages (Stages F0-F4) compared to late treatment (Stage F4). Based on projected lifetime work activity and taxes paid, the treated cohort paid an additional £5,900 per patient compared to the untreated cohort. Lifetime government disability costs of £97,555 and £125,359 per patient for treated cohort vs no treatment cohort were estimated, respectively. Lifetime direct healthcare costs in the treated cohort were £32,235, compared to non-treated cohort of £26,424, with an incremental healthcare costs increase of £5,901 per patient. The benefit cost ratio (BCR) of total government benefits and savings relative to government treatment costs (including LDV/SOF) ranged from 1.8-5.6. Treating patients early resulted in 77% less disability costs, 43% lower healthcare costs, and 33% higher tax revenue. The ability to cure Hepatitis C offers considerable fiscal benefits beyond direct medical costs and savings attributed to reduced disability costs, public allowances, and improved tax revenue. Changes in parameters

  12. [Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?].

    Science.gov (United States)

    Rosa Salazar, V; Bernal Martínez, L; García Pino, M J; Hernández Contreras, M E; García Méndez, M M; García Pérez, B; Marras Fernández-Cid, C

    2016-01-01

    To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). A total of 113patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85days. In 2007, there were 70patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate. Copyright © 2015 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Automated treatment planning for a dedicated multi-source intra-cranial radiosurgery treatment unit accounting for overlapping structures and dose homogeneity

    Energy Technology Data Exchange (ETDEWEB)

    Ghobadi, Kimia; Ghaffari, Hamid R. [Department of Mechanical and Industrial Engineering, University of Toronto, Ontario M5S 3G8 (Canada); Aleman, Dionne M. [Department of Mechanical and Industrial Engineering, University of Toronto, Ontario M5S 3G8 (Canada); Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario M5T 3M6 (Canada); Techna Institute, University Health Network, Ontario M5G 1P5 (Canada); Jaffray, David A. [Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Ontario M5T 2M9 (Canada); Department of Radiation Oncology, University of Toronto, Ontario M5S 3E2 (Canada); Department of Medical Biophysics, University of Toronto, Ontario M5G 2M9 (Canada); Institute of Biomaterial and Biomedical Engineering, University of Toronto, Ontario M5S 2J7 (Canada); Techna Institute, University Health Network, Ontario M5G 1P5 (Canada); Ontario Cancer Institute, Ontario M5G 0A3 (Canada); Ruschin, Mark [Department of Medical Physics, Odette Cancer Centre, Toronto, Ontario M4N 3M5 (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario M5S 3E2 (Canada)

    2013-09-15

    Purpose: The purpose of this work is to advance the two-step approach for Gamma Knife{sup ®} Perfexion™ (PFX) optimization to account for dose homogeneity and overlap between the planning target volume (PTV) and organs-at-risk (OARs).Methods: In the first step, a geometry-based algorithm is used to quickly select isocentre locations while explicitly accounting for PTV-OARs overlaps. In this approach, the PTV is divided into subvolumes based on the PTV-OARs overlaps and the distance of voxels to the overlaps. Only a few isocentres are selected in the overlap volume, and a higher number of isocentres are carefully selected among voxels that are immediately close to the overlap volume. In the second step, a convex optimization is solved to find the optimal combination of collimator sizes and their radiation duration for each isocentre location.Results: This two-step approach is tested on seven clinical cases (comprising 11 targets) for which the authors assess coverage, OARs dose, and homogeneity index and relate these parameters to the overlap fraction for each case. In terms of coverage, the mean V{sub 99} for the gross target volume (GTV) was 99.8% while the V{sub 95} for the PTV averaged at 94.6%, thus satisfying the clinical objectives of 99% for GTV and 95% for PTV, respectively. The mean relative dose to the brainstem was 87.7% of the prescription dose (with maximum 108%), while on average, 11.3% of the PTV overlapped with the brainstem. The mean beam-on time per fraction per dose was 8.6 min with calibration dose rate of 3.5 Gy/min, and the computational time averaged at 205 min. Compared with previous work involving single-fraction radiosurgery, the resulting plans were more homogeneous with average homogeneity index of 1.18 compared to 1.47.Conclusions: PFX treatment plans with homogeneous dose distribution can be achieved by inverse planning using geometric isocentre selection and mathematical modeling and optimization techniques. The quality of the

  14. Physician experiences and preferences in the treatment of HR+/HER2− metastatic breast cancer in the United States: a physician survey

    International Nuclear Information System (INIS)

    Lin, Peggy L.; Hao, Yanni; Xie, Jipan; Li, Nanxin; Zhong, Yichen; Zhou, Zhou; Signorovitch, James E.; Wu, Eric Q.

    2015-01-01

    Sequential endocrine therapy (ET) is recommended for postmenopausal women with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (mBC) and without visceral symptoms. Chemotherapy (CT) can be considered after sequential ETs, but is associated with adverse side effects. We assessed physicians' preferences and self-reported prescribing patterns for ET and CT in the treatment of HR+/HER2− mBC at community practices in the United States. Community-based oncologists/hematologists from a nationwide online panel who treated postmenopausal women with HR+/HER2− mBC were invited to complete a survey, blinded to the identity of study sponsor. Treatment preferences were collected by treatment class of ET-based regimens versus CT and by agent for postmenopausal HR+/HER2− mBC patients after prior nonsteroidal aromatase inhibitor use in the adjuvant or mBC setting. Among 213 physicians who completed the survey, 78% were male, 71% were based in small/intermediate practices (2–9 oncologists/subspecialists), 55% had >10 years of experience, and 58% referred to the National Comprehensive Cancer Network Guidelines when treating mBC. Among first-line ETs, anastrozole was the most frequently used treatment (35%), followed by everolimus-based (EVE, 34%) and fulvestrant-based (FUL, 15%) therapy. After first-line ET, the most preferred second- and third-line treatments were ET monotherapy (48% and 39%), ET combination therapy (31% and 19%), and CT monotherapy (13% and 30%). Comparing EVE versus FUL, physicians preferred EVE in all lines but first line. Efficacy was the most important consideration for treatment choice. Physicians prescribed CT in early lines mainly because of visceral symptoms. This survey of treatment patterns for HR+/HER2− mBC in community practice suggested that after first-line ET, ET mono- or combination therapy was commonly used for the second- and third-line treatments and CT

  15. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

    The main goal of this study is to utilize a natural low cost material “as an accelerator additive to enhance the chemical treatment process using Alum coagulant and the accelerator substances were Perlite and Bentonite. The performance of the chemical treatment was enhanced using the accelerator substances with 90 mg/l Alum as a constant dose. Perlite gave better performance than the Bentonite effluent. The removal ratio for conductivity, turbidity, BOD and COD for Perlite was 86.7%, 87.4%, 89.9% and 92.8% respectively, and for Bentonite was 83.5%, 85.0%, 86.5% and 85.0% respectively at the same concentration of 40 mg/l for each.

  16. Increase in white cell and neutrophil counts during the first eighteen weeks of treatment with clozapine in patients admitted to a long-term psychiatric care inpatient unit.

    Science.gov (United States)

    Capllonch, Adrián; de Pablo, Silvia; de la Torre, Alberto; Morales, Ignacio

    Clozapine is an antipsychotic drug that has shown to be more effective than other antipsychotics in the treatment of schizophrenia, but its use is limited due to its side effects, particularly by the risk of causing agranulocytosis. A study was made on the variations in white cell and neutrophil counts in patients treated with clozapine in a Long-term Psychiatric Unit. A retrospective observational study was conducted with a sample of women of our long-term psychiatric care unit who had been treated with clozapine. A study was made on the variations in white cell and neutrophil counts during the first 18 weeks of treatment, as well as the onset of leukopenia, neutropenia, agranulocytosis, and the influence of concomitant drugs. The study included 55 patients on treatment with clozapine. The incidence rate of neutropenia was 1.82% (95% CI; 0.05-10.13). The incidence rate of leukopenia and agranulocytosis was 0%. An increase in white cell and neutrophil counts from baseline to week 3-4 was observed. Only small variations were observed after this time, but the counts remained higher than the initial values. These changes were statistically significant in the white cell count: One-way repeated ANOVA with Greenhouse-Geisser correction F (11.47, 37) = 2.114 (P= .011); and in neutrophils: One-way repeated ANOVA with Greenhouse-Geisser correction F (10.3, 37)=3.312 (P=.0002), and MANOVA F (18, 37)=2.693 (P=.005), ŋ 2 P =0.567. The influence of concomitant drugs (lithium, valproic and biperiden) was not significant on the overall increase found in white cells or neutrophils (MANOVA). Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Wireless infrared computer control

    Science.gov (United States)

    Chen, George C.; He, Xiaofei

    2004-04-01

    Wireless mouse is not restricted by cable"s length and has advantage over its wired counterpart. However, all the mice available in the market have detection range less than 2 meters and angular coverage less than 180 degrees. Furthermore, commercial infrared mice are based on track ball and rollers to detect movements. This restricts them to be used in those occasions where users want to have dynamic movement, such as presentations and meetings etc. This paper presents our newly developed infrared wireless mouse, which has a detection range of 6 meters and angular coverage of 180 degrees. This new mouse uses buttons instead of traditional track ball and is developed to be a hand-held device like remote controller. It enables users to control cursor with a distance closed to computer and the mouse to be free from computer operation.

  18. PEP computer control system

    International Nuclear Information System (INIS)

    1979-03-01

    This paper describes the design and performance of the computer system that will be used to control and monitor the PEP storage ring. Since the design is essentially complete and much of the system is operational, the system is described as it is expected to 1979. Section 1 of the paper describes the system hardware which includes the computer network, the CAMAC data I/O system, and the operator control consoles. Section 2 describes a collection of routines that provide general services to applications programs. These services include a graphics package, data base and data I/O programs, and a director programm for use in operator communication. Section 3 describes a collection of automatic and semi-automatic control programs, known as SCORE, that contain mathematical models of the ring lattice and are used to determine in real-time stable paths for changing beam configuration and energy and for orbit correction. Section 4 describes a collection of programs, known as CALI, that are used for calibration of ring elements

  19. An ecological study of skin biopsies and skin cancer treatment procedures in the United States Medicare population, 2000 to 2015.

    Science.gov (United States)

    Wang, David M; Morgan, Frederick C; Besaw, Robert J; Schmults, Chrysalyne D

    2018-01-01

    Analyses of skin cancer procedures adjusted for population changes are needed. To describe trends in skin cancer-related biopsies and procedures in Medicare beneficiaries. An ecological study of Medicare claims for skin biopsies and skin cancer procedures in 2000 to 2015. Biopsies increased 142%, and skin cancer procedures increased 56%. Mohs micrographic surgery (MMS) utilization increased on the head/neck, hands/feet, and genitalia (increasing from 11% to 27% of all treatment procedures) but was low on the trunk/extremities (increasing from 1% to 4%). Adjusted for increased Medicare enrollment (+36%) between 2000 and 2015, the number of biopsies and MMS procedures performed per 1000 beneficiaries increased (from 56 to 99 and from 5 to 15, respectively), whereas the number of excisions and destructions changed minimally (from 18 to 16 and from 19 to 18, respectively). Growth in biopsies and MMS procedures slowed between each time period studied: 4.3 additional biopsies per year and 0.9 additional MMS procedures per year per 1000 beneficiaries between 2000 and 2007, 2.2 and 0.5 more between 2008 and 2011, and 0.5 and 0.3 more between 2012 and 2015, respectively. Medicare claims-level data do not provide patient-level or nonsurgical treatment information. The increased number of skin cancer procedures performed was largely the result of Medicare population growth over time. MMS utilization increased primarily on high- and medium-risk and functionally and cosmetically significant locations where tissue sparing and maximizing cure are critical. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Treatment Patterns and Antipsychotic Medication Adherence Among Commercially Insured Patients With Schizoaffective Disorder in the United States

    Science.gov (United States)

    Joshi, Kruti; Lin, Jay; Lingohr-Smith, Melissa; Fu, Dong-Jing; Muser, Erik

    2016-01-01

    Abstract This study assessed real-world treatment patterns and antipsychotic (AP) medication adherence among commercially insured US patients with schizoaffective disorder (SCA). Continuously insured adults aged 18 years or older with a diagnosis of SCA from January 1, 2009, to December 31, 2012, were identified from the Clinformatics Data Mart database. Patients were categorized into 2 cohorts: incident or prevalent SCA. Demographics and clinical characteristics were evaluated during the baseline period. Use of psychiatric medications and adherence to AP medications were evaluated during a 12-month follow-up period after index diagnosis of SCA. Of the overall study population (N = 2713; mean age, 40.2 y; 52.7% female), 1961 patients (72.3%) (mean age, 38.7 y; 51.3% female) had incident SCA, and 752 patients (27.7%) (mean age, 43.9 y; 56.5% female) had prevalent SCA. Antipsychotics were used by 74.8% of patients in the overall study population during the follow-up period. The most commonly prescribed oral AP was risperidone (23.9%), followed by quetiapine (21.4%) and aripiprazole (20.4%). Use of any long-acting injectable APs in the overall study population during the follow-up period was less than 3%. A total of 49.0% and 38.0% of the overall study population had medication possession ratios and proportion of days covered for APs of 80% or greater, respectively. Overall use of long-acting injectable APs for the treatment of SCA is low, and adherence to AP medications, measured by both medication possession ratio and proportion of days covered, is suboptimal among patients with SCA in the real-world setting. PMID:27525965

  1. SU-E-J-70: Feasibility Study of Dynamic Arc and IMRT Treatment Plans Utilizing Vero Treatment Unit and IPlan Planning Computer for SRS/FSRT Brain Cancer Patients

    International Nuclear Information System (INIS)

    Huh, S; Lee, S; Dagan, R; Malyapa, R; Mendenhall, N; Mendenhall, W; Ho, M; Hough, D; Yam, M; Li, Z

    2014-01-01

    Purpose: To investigate the feasibility of utilizing Dynamic Arc (DA) and IMRT with 5mm MLC leaf of VERO treatment unit for SRS/FSRT brain cancer patients with non-invasive stereotactic treatments. The DA and IMRT plans using the VERO unit (BrainLab Inc, USA) are compared with cone-based planning and proton plans to evaluate their dosimetric advantages. Methods: The Vero treatment has unique features like no rotational or translational movements of the table during treatments, Dynamic Arc/IMRT, tracking of IR markers, limitation of Ring rotation. Accuracies of the image fusions using CBCT, orthogonal x-rays, and CT are evaluated less than ∼ 0.7mm with a custom-made target phantom with 18 hidden targets. 1mm margin is given to GTV to determine PTV for planning constraints considering all the uncertainties of planning computer and mechanical uncertainties of the treatment unit. Also, double-scattering proton plans with 6F to 9F beams and typical clinical parameters, multiple isocenter plans with 6 to 21 isocenters, and DA/IMRT plans are evaluated to investigate the dosimetric advantages of the DA/IMRT for complex shape of targets. Results: 3 Groups of the patients are divided: (1) Group A (complex target shape), CI's are same for IMRT, and DGI of the proton plan are better by 9.5% than that of the IMRT, (2) Group B, CI of the DA plans (1.91+/−0.4) are better than cone-based plan, while DGI of the DA plan is 4.60+/−1.1 is better than cone-based plan (5.32+/−1.4), (3) Group C (small spherical targets), CI of the DA and cone-based plans are almost the same. Conclusion: For small spherical targets, cone-based plans are superior to other 2 plans: DS proton and DA plans. For complex or irregular plans, dynamic and IMRT plans are comparable to cone-based and proton plans for complex targets

  2. Cost-effectiveness of combination daclatasvir-sofosbuvir for treatment of genotype 3 chronic hepatitis C infection in the United States.

    Science.gov (United States)

    Saint-Laurent Thibault, Catherine; Moorjaney, Divya; Ganz, Michael L; Sill, Bruce; Hede, Shalini; Yuan, Yong; Gorsh, Boris

    2017-07-01

    A phase III trial evaluated the efficacy and safety of Daklinza (daclatasvir or DCV) in combination with sofosbuvir (SOF) for treatment of genotype (GT) 3 hepatitis C virus (HCV) patients. This study evaluated the cost-effectiveness of DCV + SOF vs SOF in combination with ribavirin (RBV) over a 20-year time horizon from the perspective of a United States (US) payer. A published Markov model was adapted to reflect US demographic characteristics, treatment patterns, costs of drug acquisition, monitoring, disease and adverse event management, and mortality risks. Clinical inputs came from the ALLY-3 and VALENCE trials. The primary outcome was the incremental cost-utility ratio. Life-years, incidence of complications, number of patients achieving sustained virological response (SVR), and the total cost per SVR were secondary outcomes. Costs (2014 USD) and quality-adjusted life years (QALYs) were discounted at 3% per year. Deterministic, probabilistic, and scenario sensitivity analyses were conducted. DCV + SOF was associated with lower costs and better effectiveness than SOF + RBV in the base case and in almost all scenarios (i.e. treatment-experienced, non-cirrhotic, time horizons of 5, 10, and 80 years). DCV + SOF was less costly, but also slightly less effective than SOF + RBV in the cirrhotic and treatment-naïve population scenarios. Results were sensitive to variations in the probability of achieving SVR for both treatment arms. DCV + SOF costs less than $50,000 per QALY gained in 79% of all probabilistic iterations compared with SOF + RBV. DCV + SOF is a dominant option compared with SOF + RBV in the US for the overall GT 3 HCV patient population.

  3. Racial discrimination, response to unfair treatment, and depressive symptoms among pregnant black and African American women in the United States.

    Science.gov (United States)

    Ertel, Karen A; James-Todd, Tamarra; Kleinman, Kenneth; Krieger, Nancy; Gillman, Matthew; Wright, Rosalind; Rich-Edwards, Janet

    2012-12-01

    To assess the association between self-reported racial discrimination and prenatal depressive symptoms among black women. Our study population consisted of two cohorts of pregnant women: the Asthma Coalition on Community, Environment, and Social Stress project (ACCESS) and Project Viva. We measured self-reported racial discrimination among black women using a modified Experiences of Discrimination scale (score 0-8). We assessed elevated depressive symptoms (EDS) with the Edinburgh Postnatal Depression Scale (≥13 on a 0-30 scale). Fifty-four percent of ACCESS and 78% of Viva participants reported experiencing racial discrimination. After adjusting for age, marital status, income, education, and nativity, a 1-U increment in Experiences of Discrimination score was associated with 48% increased odds of EDS (odds ratio, 1.48; 95% confidence interval, 1.24-1.76) for ACCESS participants but was not significantly associated among Viva participants (odds ratio, 1.12; 95% confidence interval, 0.92-1.37). In both cohorts, responding to unfair treatment by talking to others was associated with the lowest odds of EDS. Our findings suggest that higher levels of perceived racial discrimination may increase depressive symptoms during pregnancy among U.S. black women. Interventions involving talking to others may aid in reducing the risk of depressive symptoms among black women experiencing higher levels of racial discrimination. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Experience of the posterior lip augmentation device in a regional hip arthroplasty unit as a treatment for recurrent dislocation.

    Science.gov (United States)

    Hoggett, L; Cross, C; Helm, T

    2017-12-01

    Dislocation after total hip arthroplasty (THA) remains a significant complication of the procedure and is the third leading cause for revision THA. One technique for treatment of this complication is the use of the posterior lip augmentation device (PLAD). We describe our experience using the PLAD including complication rates. A retrospective review of 55 PLADs (54 patients) was carried out following identification from electronic theatre records. Basic patient demographics, operative records and radiographs were collected and reviewed and data was analysed using Microsoft Excel. Failure of the PLAD was defined as further operative intervention after PLAD insertion and included: dislocation, implant breakage, infection and revision of the THA for loosening of either component. 55 PLADs were implanted in 54 patients with an average age of 77 years. There was a significant preponderance of females and a variety of surgical approaches had been used for the original hip replacement, including trochanteric osteotomy, posterior and antero-lateral. 9 (16%) patients had recurrent dislocations,1 (2%) failed secondary to screw breakage, 3 (5%) had and infection requiring intervention and 2 (4%) underwent further revision for aseptic loosening of the femoral component. The overall failure rate was 25% with 14 patients requiring intervention post PLAD. Our results are inferior to other published results and indicate that the PLAD should be used with caution for recurrent dislocations of the Charnley hip replacement.

  5. Use of indium and rare-earths activable tracers for the evaluation of the hydraulic performance of wastewater treatment units

    Energy Technology Data Exchange (ETDEWEB)

    Alvarenga, Gilmara Lucia Souza; Barreto, Alberto Avelar; Pinto, Amenonia Maria Ferreira; Moreira, Rubens Martins, E-mail: gil_lsa@yahoo.com.br, E-mail: aab@cdtn.br, E-mail: amfp@cdtn.br, E-mail: rubens@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Silva, Lauris Lucia da, E-mail: laurislsilva@yahoo.com.br [Universidade Federal de Minas Gerais (DQ/UFMG), Minas Gerais, MG (Brazil). Dept. de Quimica

    2013-07-01

    Efforts aimed at going deeper into the understanding of the purification processes of contaminated waters and at the optimization of both the technological and economic performance of such processes have been developed following the introduction of innovative wastewater treatment processes. Among the several wastewater depuration processes, this study focuses physical aspects of systems known as artificial wetlands and a special version of the anaerobic biological reactor. This biological reactor is of the upflow anaerobic sludge blanket (UASB) type, which is increasingly being utilized for the processing of urban wastewater. However, its effluent eventually needs some polishing to be performed at an artificial wetland stage. The hydrodynamic performances of both a special version of the UASB and a vegetated wetland have been studied using the tracer methodology, based on the impulse response of these systems. Both radioactive and activable tracers have been employed and had their information analyzed by appropriate software. Comments are presented on the advantages of the activable tracers. The results thus obtained have demonstrated the potential of the application of activable tracers in the experimental research of either natural or artificial hydraulic systems. (author)

  6. Use of indium and rare-earths activable tracers for the evaluation of the hydraulic performance of wastewater treatment units

    International Nuclear Information System (INIS)

    Alvarenga, Gilmara Lucia Souza; Barreto, Alberto Avelar; Pinto, Amenonia Maria Ferreira; Moreira, Rubens Martins; Silva, Lauris Lucia da

    2013-01-01

    Efforts aimed at going deeper into the understanding of the purification processes of contaminated waters and at the optimization of both the technological and economic performance of such processes have been developed following the introduction of innovative wastewater treatment processes. Among the several wastewater depuration processes, this study focuses physical aspects of systems known as artificial wetlands and a special version of the anaerobic biological reactor. This biological reactor is of the upflow anaerobic sludge blanket (UASB) type, which is increasingly being utilized for the processing of urban wastewater. However, its effluent eventually needs some polishing to be performed at an artificial wetland stage. The hydrodynamic performances of both a special version of the UASB and a vegetated wetland have been studied using the tracer methodology, based on the impulse response of these systems. Both radioactive and activable tracers have been employed and had their information analyzed by appropriate software. Comments are presented on the advantages of the activable tracers. The results thus obtained have demonstrated the potential of the application of activable tracers in the experimental research of either natural or artificial hydraulic systems. (author)

  7. Cost-effectiveness of elbasvir/grazoprevir use in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and chronic kidney disease in the United States.

    Science.gov (United States)

    Elbasha, E; Greaves, W; Roth, D; Nwankwo, C

    2017-04-01

    Among patients with chronic kidney disease (CKD) in the United States, HCV infection causes significant morbidity and mortality and results in substantial healthcare costs. A once-daily oral regimen of elbasvir/grazoprevir (EBR/GZR) for 12 weeks was found to be a safe and efficacious treatment for HCV in patients with CKD. We evaluated the cost-effectiveness of EBR/GZR in treatment-naïve and treatment-experienced CKD patients compared with no treatment (NoTx) and pegylated interferon plus ribavirin (peg-IFN/RBV) using a computer-based model of the natural history of chronic HCV genotype 1 infection, CKD and liver disease. Data on baseline characteristics of the simulated patients were obtained from NHANES, 2000-2010. Model inputs were estimated from published studies. Cost of treatment with EBR/GZR and peg-INF/RBV were based on wholesale acquisition cost. All costs were from a third-party payer perspective and were expressed in 2015 U.S. dollars. We estimated lifetime incidence of liver-related complications, liver transplantation, kidney transplantation, end-stage live disease mortality and end-stage renal disease mortality; lifetime quality-adjusted life years (QALY); and incremental cost-utility ratios (ICUR). The model predicted that EBR/GZR will significantly reduce the incidence of liver-related complications and prolong life in patients with chronic HCV genotype 1 infection and CKD compared with NoTx or use of peg-IFN/RBV. EBR/GZR-based regimens resulted in higher average remaining QALYs and higher costs (11.5716, $191 242) compared with NoTx (8.9199, $156 236) or peg-INF/RBV (10.2857, $186 701). Peg-IFN/RBV is not cost-effective, and the ICUR of EBR/GZR compared with NoTx was $13 200/QALY. Treatment of a patient on haemodialysis with EBR/GZR resulted in a higher ICUR ($217 000/QALY). Assuming a threshold of $100 000 per QALY gained for cost-effectiveness, use of elbasvir/grazoprevir to treat an average patient with CKD can be considered cost

  8. Analysis of print news media framing of ketamine treatment in the United States and Canada from 2000 to 2015.

    Directory of Open Access Journals (Sweden)

    Melvyn W B Zhang

    Full Text Available There are multifaceted views on the use of ketamine, a potentially addictive substance, to treat mental health problems. The past 15 years have seen growing media coverage of ketamine for medical and other purposes. This study examined the print news media coverage of medical and other uses of ketamine in North America to determine orientations and trends over time.Print newspaper coverage of ketamine from 2000 to 2015 was reviewed, resulting in 43 print news articles from 28 North American newspapers. A 55-item structured coding instrument was applied to assess news reports of ketamine. Items captured negative and positive aspects, therapeutic use of ketamine, and adverse side effects. Chi-squares tested for changes in trends over time.In the 15-year reviewed period, the three most frequent themes related to ketamine were: abuse (68.2%, legal status (34.1%, and clinical use in anesthesia (31.8%. There was significant change in trends during two periods (2000-2007 and 2008-2015. In 2008-2015, print news media articles were significantly more likely to encourage clinical use of ketamine to treat depression (p = 0.002, to treat treatment resistant depression (p = 0.043, and to claim that ketamine is more effective than conventional antidepressants (p = 0.043.Our review found consistent positive changes in the portrayals of ketamine by the print news media as a therapeutic antidepressant that mirror the recent scientific publications. These changes in news media reporting might influence the popularity of ketamine use to treat clinical depression. Guidance is required for journalists on objective reporting of medical research findings, including limitations of current research evidence and potential risks of ketamine.

  9. Functionally relevant microorganisms to enhanced biological phosphorus removal performance at full-scale wastewater treatment plants in the United States.

    Science.gov (United States)

    Gu, April Z; Saunders, A; Neethling, J B; Stensel, H D; Blackall, L L

    2008-08-01

    The abundance and relevance ofAccumulibacter phosphatis (presumed to be polyphosphate-accumulating organisms [PAOs]), Competibacter phosphatis (presumed to be glycogen-accumulating organisms [GAOs]), and tetrad-forming organisms (TFOs) to phosphorus removal performance at six full-scale enhanced biological phosphorus removal (EBPR) wastewater treatment plants were investigated. Coexistence of various levels of candidate PAOs and GAOs were found at these facilities. Accumulibacter were found to be 5 to 20% of the total bacterial population, and Competibacter were 0 to 20% of the total bacteria population. The TFO abundance varied from nondetectable to dominant. Anaerobic phosphorus (P) release to acetate uptake ratios (P(rel)/HAc(up)) obtained from bench tests were correlated positively with the abundance ratio of Accumulibacter/(Competibacter +TFOs) and negatively with the abundance of (Competibacter +TFOs) for all plants except one, suggesting the relevance of these candidate organisms to EBPR processes. However, effluent phosphorus concentration, amount of phosphorus removed, and process stability in an EBPR system were not directly related to high PAO abundance or mutually exclusive with a high GAO fraction. The plant that had the lowest average effluent phosphorus and highest stability rating had the lowest P(rel)/HAc(up) and the most TFOs. Evaluation of full-scale EBPR performance data indicated that low effluent phosphorus concentration and high process stability are positively correlated with the influent readily biodegradable chemical oxygen demand-to-phosphorus ratio. A system-level carbon-distribution-based conceptual model is proposed for capturing the dynamic competition between PAOs and GAOs and their effect on an EBPR process, and the results from this study seem to support the model hypothesis.

  10. Analysis of print news media framing of ketamine treatment in the United States and Canada from 2000 to 2015.

    Science.gov (United States)

    Zhang, Melvyn W B; Hong, Ying X; Husain, Syeda F; Harris, Keith M; Ho, Roger C M

    2017-01-01

    There are multifaceted views on the use of ketamine, a potentially addictive substance, to treat mental health problems. The past 15 years have seen growing media coverage of ketamine for medical and other purposes. This study examined the print news media coverage of medical and other uses of ketamine in North America to determine orientations and trends over time. Print newspaper coverage of ketamine from 2000 to 2015 was reviewed, resulting in 43 print news articles from 28 North American newspapers. A 55-item structured coding instrument was applied to assess news reports of ketamine. Items captured negative and positive aspects, therapeutic use of ketamine, and adverse side effects. Chi-squares tested for changes in trends over time. In the 15-year reviewed period, the three most frequent themes related to ketamine were: abuse (68.2%), legal status (34.1%), and clinical use in anesthesia (31.8%). There was significant change in trends during two periods (2000-2007 and 2008-2015). In 2008-2015, print news media articles were significantly more likely to encourage clinical use of ketamine to treat depression (p = 0.002), to treat treatment resistant depression (p = 0.043), and to claim that ketamine is more effective than conventional antidepressants (p = 0.043). Our review found consistent positive changes in the portrayals of ketamine by the print news media as a therapeutic antidepressant that mirror the recent scientific publications. These changes in news media reporting might influence the popularity of ketamine use to treat clinical depression. Guidance is required for journalists on objective reporting of medical research findings, including limitations of current research evidence and potential risks of ketamine.

  11. Current Status of Spent Fast Reactor Fuel Reprocessing and Waste Treatment in Various Countries: United States of America

    International Nuclear Information System (INIS)

    2011-01-01

    Due to the previous strategic US decision on treating SNF as waste and not pursuing the reprocessing option, development work for the FR fuel cycle was only performed in a few laboratories, although interest is now increasing again. ORNL together with ANL have been influential in promoting the wider use of centrifugal contactors (favoured due to the high fissile content and decay power of FR fuel materials), associated remote handling systems and hardware prototypes for most unit operations in the reprocessing conceptual designs in the context of their development of the Consolidated Fuel Reprocessing Program. There is limited experience with reprocessing tests on the Fast Flux Text Facility (FFTF) MOX fuel. ORNL has undertaken small tests on laboratory scale dissolution and solvent extraction of MOX fuel irradiated to 220 GW/t HM burnup at around 2 kg batch scale [180-186]. The initiative called the breeder reprocessing engineering test (BRET) was started in the 1980s with a focus on the developmental activity of the US DOE to demonstrate breeder fuel reprocessing technology while closing the fuel cycle for the FFTF. The process was supposed to be installed at the existing Fuels and Materials Examination Facility (FMEF) at the Hanford Site, Richland, Washington. The major objectives of BRET were to: - Develop and demonstrate reprocessing technology and systems for breeder fuel; - Close the fuel cycle for the FFTF; - Provide an integrated test of breeder reactor fuel cycle technology - reprocessing, safeguards and waste management. The quest for pyrochemical alternatives to aqueous reprocessing has been under way in the USA since the late 1950s. Approaches examined at various levels of development and for a variety of fuels include alloy melting, FP volatilization and adsorption, fluoride and chloride volatility methods, redox solvent extractions between liquid salt and metal phases, precipitation and fractional crystallization, and electrowinning and electro

  12. Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Muthukumar M

    2017-04-01

    Full Text Available Madhusubramanian Muthukumar,1 Kamal Desai,1 Seye Abogunrin,2 Timothy Harrower,3 Sylvie Gabriel,4 Jerome Dinet5 1Modelling and Simulation, 2Meta Research, Evidera, London, 3Royal Devon and Exeter NHS Foundation Trust, Exeter, UK; 4Global Market Access and Pricing, 5Health Economics and Outcomes Research (Global, Ipsen Pharma, Boulogne-Billancourt, France Background: Cervical dystonia (CD involves painful involuntary contraction of the neck and shoulder muscles and abnormal posture in middle-aged adults. Botulinum neurotoxin type A (BoNT-A is effective in treating CD but little is known about its associated cost-effectiveness.Objective: To evaluate the cost-effectiveness of abobotulinumtoxinA for treating CD from the UK payer perspective.Methods: A Markov model was developed to evaluate the cost-effectiveness of abobotulinumtoxinA versus best supportive care (BSC in CD, with a lifetime horizon and health states for response, nonresponse, secondary nonresponse, and BSC in patients with CD (mean age: 53 years; 37% male. Clinical improvement measured using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS was mapped to utility using data from a randomized trial of abobotulinumtoxinA. Health care resource use, costs, and other inputs were from the British National Formulary, Personal Social Services Research Unit, published literature, or expert opinion. Costs and outcomes were discounted at 3.5% per annum.Results: In the base case, the incremental lifetime quality-adjusted life-years (QALYs gained from abobotulinumtoxinA arm versus BSC was 0.253 per patient, whereas the incremental cost was £7,160, leading to an incremental cost-effectiveness ratio (ICER of £30,468 per QALY. One-way sensitivity analyses showed that these results were sensitive to the proportion of responders to abobotulinumtoxinA at first injection, duration between injections, the number of reinjections allowed among primary nonresponders, and any difference in

  13. Food irradiation in the United States: irradiation as a phytosanitary treatment for fresh fruits and vegetables and for the control of microorganisms in meat and poultry

    International Nuclear Information System (INIS)

    Ross, Ralph T.; Engeljohn, Dan

    2000-01-01

    Recently there has been a renewed focus on food irradiation in the United States (US) for the disinfestation of fresh fruits and vegetables to eliminate pests from imported agricultural commodities that could threaten the economic viability of American agriculture and for the control of bacterium E. coli 0157:H7 in beef, a pathogen that threatens the safety of the US domestic food supply. In January 1999 USDA/APHIS published in the Federal Register a rule which authorized irradiation as a guarantee treatment for papayas for movement from Hawaii to the US mainland. This treatment was never used for a number of reasons. However, in December, 1993, the US Environmental Protection Agency (EPA) published its final rule to terminate production and consumption of methyl bromide, the only remaining broad spectrum fumigant for disinfesting agricultural commodities for pests of quarantine significance on imported and exported commodities. With increased global trade pressures and the possible loss of methyl bromide as a fumigant for regulatory pests treatment made it imperative that practical treatment options be explored including irradiation. In May 1996, USDA/APHIS published a Notice of Policy which sets forth a policy statement that share positions and policies of USDA concerning the use of irradiation as a phytosanitary treatment. Subsequently in July, 1997, USDA/APHIS amended its Hawaiian regulation by increasing the dose required for papayas intended for interstate movement and by allowing carambolas and litchis also to move interstate as well. Fruits from Hawaii to the US mainland are currently being irradiated and distributed in commerce throughout the US Irradiation treatments now afford movement of many exotic fruits to the US mainland that could not be done earlier due to the lack of available treatment methods. To help combat this potential public health problem, the US Food and Drug Administration (FDA) approved treating red meat products. This process has been

  14. Development and validation of a new dynamic computer-controlled model of the human stomach and small intestine.

    Science.gov (United States)

    Guerra, Aurélie; Denis, Sylvain; le Goff, Olivier; Sicardi, Vincent; François, Olivier; Yao, Anne-Françoise; Garrait, Ghislain; Manzi, Aimé Pacifique; Beyssac, Eric; Alric, Monique; Blanquet-Diot, Stéphanie

    2016-06-01

    For ethical, regulatory, and economic reasons, in vitro human digestion models are increasingly used as an alternative to in vivo assays. This study aims to present the new Engineered Stomach and small INtestine (ESIN) model and its validation for pharmaceutical applications. This dynamic computer-controlled system reproduces, according to in vivo data, the complex physiology of the human stomach and small intestine, including pH, transit times, chyme mixing, digestive secretions, and passive absorption of digestion products. Its innovative design allows a progressive meal intake and the differential gastric emptying of solids and liquids. The pharmaceutical behavior of two model drugs (paracetamol immediate release form and theophylline sustained release tablet) was studied in ESIN during liquid digestion. The results were compared to those found with a classical compendial method (paddle apparatus) and in human volunteers. Paracetamol and theophylline tablets showed similar absorption profiles in ESIN and in healthy subjects. For theophylline, a level A in vitro-in vivo correlation could be established between the results obtained in ESIN and in humans. Interestingly, using a pharmaceutical basket, the swelling and erosion of the theophylline sustained release form was followed during transit throughout ESIN. ESIN emerges as a relevant tool for pharmaceutical studies but once further validated may find many other applications in nutritional, toxicological, and microbiological fields. Biotechnol. Bioeng. 2016;113: 1325-1335. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  15. Development of a computer-controlled tensiometer for real-time measurements of tension in tubular organs.

    Science.gov (United States)

    Gregersen, H; Barlow, J; Thompson, D

    1999-04-01

    A computer-controlled tensiometer for studying wall tension in tubular organs has been developed. The system consisted of a probe with an inflatable balloon, an impedance planimeter, pressure transducer and amplifier, a pump with RS232 interface and a PC with dedicated software. Circumferential wall tension was computed in real time from pressure and cross-sectional area measurements (tension measurement mode). Wall tension can be maintained on a preset level or be changed as a step or ramp function by a feedback control of the infusion/withdrawal pump (tension control mode). A software regulator adjusted the volume rate (low volume rate when the computed tension was close to the preset value) to minimize overshoot and oscillation. Validation tests were performed and the technique was applied in the human oesophagus. Volume- and tension-controlled balloon distensions elicited secondary peristalsis of increasing intensity that was decreased significantly by the antimuscarinic agent Hyoscine butyl bromide. In tension control mode Hyoscine butyl bromide caused oesophageal relaxation, i.e. CSA to increase and pressure to decay. Furthermore, pronounced pressure relaxation and tension relaxation were observed during volume-controlled distension after administration of Hyoscine butyl bromide.

  16. Reconstruction of a whole-body counter into a process computer-controlled low-level whole-body scanner

    International Nuclear Information System (INIS)

    Hamann, C.

    1975-01-01

    A report is given on the state of the research project to reconstruct our whole-body counter with solid geometries into a scanning type one. The object is to develop a process computer controlled 'adaptive system'. The self-built scan mechanics are explained and the advantages and problems of applying stepping motors are gone into. A stepping motor coordinates control is presented. As the planned scanner and the process computer form a digital controlled system, all theoretical and actual values as well as the control orders from the process computer must be directly controllable. A CAMAC system was not used for economical reasons, the process periphery was made controllable by self building of interfaces to and from the computer. As example, the available multi-channel analyzers were converted to external controlling. The price-moderate and relatively simple self-built set-up are outlined and an example is given of how a TELETYPE version is reconstructed into a fast electronic interface. A BUS-MULTIPLEX system was developed which generates all necessary DI/DO interfaces out of one DI and DO address of the process computer only. The essential part of this system is given. (orig./LH) [de

  17. Human versus Computer Controlled Selection of Ventilator Settings: An Evaluation of Adaptive Support Ventilation and Mid-Frequency Ventilation

    Directory of Open Access Journals (Sweden)

    Eduardo Mireles-Cabodevila

    2012-01-01

    Full Text Available Background. There are modes of mechanical ventilation that can select ventilator settings with computer controlled algorithms (targeting schemes. Two examples are adaptive support ventilation (ASV and mid-frequency ventilation (MFV. We studied how different clinician-chosen ventilator settings are from these computer algorithms under different scenarios. Methods. A survey of critical care clinicians provided reference ventilator settings for a 70 kg paralyzed patient in five clinical/physiological scenarios. The survey-derived values for minute ventilation and minute alveolar ventilation were used as goals for ASV and MFV, respectively. A lung simulator programmed with each scenario’s respiratory system characteristics was ventilated using the clinician, ASV, and MFV settings. Results. Tidal volumes ranged from 6.1 to 8.3 mL/kg for the clinician, 6.7 to 11.9 mL/kg for ASV, and 3.5 to 9.9 mL/kg for MFV. Inspiratory pressures were lower for ASV and MFV. Clinician-selected tidal volumes were similar to the ASV settings for all scenarios except for asthma, in which the tidal volumes were larger for ASV and MFV. MFV delivered the same alveolar minute ventilation with higher end expiratory and lower end inspiratory volumes. Conclusions. There are differences and similarities among initial ventilator settings selected by humans and computers for various clinical scenarios. The ventilation outcomes are the result of the lung physiological characteristics and their interaction with the targeting scheme.

  18. A low-cost computer-controlled Arduino-based educational laboratory system for teaching the fundamentals of photovoltaic cells

    International Nuclear Information System (INIS)

    Zachariadou, K; Yiasemides, K; Trougkakos, N

    2012-01-01

    We present a low-cost, fully computer-controlled, Arduino-based, educational laboratory (SolarInsight) to be used in undergraduate university courses concerned with electrical engineering and physics. The major goal of the system is to provide students with the necessary instrumentation, software tools and methodology in order to learn fundamental concepts of semiconductor physics by exploring the process of an experimental physics inquiry. The system runs under the Windows operating system and is composed of a data acquisition/control board, a power supply and processing boards, sensing elements, a graphical user interface and data analysis software. The data acquisition/control board is based on the Arduino open source electronics prototyping platform. The graphical user interface and communication with the Arduino are developed in C number sign and C++ programming languages respectively, by using IDE Microsoft Visual Studio 2010 Professional, which is freely available to students. Finally, the data analysis is performed by using the open source, object-oriented framework ROOT. Currently the system supports five teaching activities, each one corresponding to an independent tab in the user interface. SolarInsight has been partially developed in the context of a diploma thesis conducted within the Technological Educational Institute of Piraeus under the co-supervision of the Physics and Electronic Computer Systems departments’ academic staff. (paper)

  19. Computer control and data acquisition system for the Mirror Fusion Test Facility Ion Cyclotron Resonant Heating System (ICRH)

    International Nuclear Information System (INIS)

    Cheshire, D.L.; Thomas, R.A.

    1985-01-01

    The Lawrence Livermore National Laboratory (LLNL) large Mirror Fusion Test Facility (MFTF-B) will employ an Ion Cyclotron Resonant Heating (ICRH) system for plasma startup. As the MFTF-B Industrial Participant, TRW has responsibility for the ICRH system, including development of the data acquisition and control system. During the MFTF-B Supervisory Control and Diagnostic System (SCDS). For subsystem development and checkout at TRW, and for verification and acceptance testing at LLNL, the system will be run from a stand-alone computer system designed to simulate the functions of SCDS. The ''SCDS Simulator'' was developed originally for the MFTF-B ECRH System; descriptions of the hardware and software are updated in this paper. The computer control and data acquisition functions implemented for ICRH are described, including development status, and test schedule at TRW and at LLNL. The application software is written for the SCDS Simulator, but it is programmed in PASCAL and designed to facilitate conversion for use on the SCDS computers

  20. Short communication: Milk meal pattern of dairy calves is affected by computer-controlled milk feeder set-up

    DEFF Research Database (Denmark)

    Jensen, Margit Bak

    2009-01-01

    for a minimum of 2 and 4 portions, respectively, whereas low-fed calves ingested their milk in 2.4 and 4.4 meals for a minimum of 2 and 4 portions, respectively. Calves on a high milk allowance had fewer milk meals over time, whereas calves on a low milk allowance had the same number of milk meals throughout...... milk portions, whereas the other half could ingest the milk in 4 or more daily portions. Data were collected during 3 successive 14-d periods, the first period starting the day after introduction to the feeder at minimum 12 d of age. High-fed calves ingested their milk in 4.0 and 4.9 meals....... Thus, the development from small and frequent milk meals to fewer and larger meals reported by studies of natural suckling was also found among high-fed calves on a computer-controlled milk feeder. Irrespectively of minimum number of milk portions, the low-fed calves had more unrewarded visits...

  1. A low-cost computer-controlled Arduino-based educational laboratory system for teaching the fundamentals of photovoltaic cells

    Energy Technology Data Exchange (ETDEWEB)

    Zachariadou, K; Yiasemides, K; Trougkakos, N [Technological Educational Institute of Piraeus, P Ralli and Thivon 250, 12244 Egaleo (Greece)

    2012-11-15

    We present a low-cost, fully computer-controlled, Arduino-based, educational laboratory (SolarInsight) to be used in undergraduate university courses concerned with electrical engineering and physics. The major goal of the system is to provide students with the necessary instrumentation, software tools and methodology in order to learn fundamental concepts of semiconductor physics by exploring the process of an experimental physics inquiry. The system runs under the Windows operating system and is composed of a data acquisition/control board, a power supply and processing boards, sensing elements, a graphical user interface and data analysis software. The data acquisition/control board is based on the Arduino open source electronics prototyping platform. The graphical user interface and communication with the Arduino are developed in C number sign and C++ programming languages respectively, by using IDE Microsoft Visual Studio 2010 Professional, which is freely available to students. Finally, the data analysis is performed by using the open source, object-oriented framework ROOT. Currently the system supports five teaching activities, each one corresponding to an independent tab in the user interface. SolarInsight has been partially developed in the context of a diploma thesis conducted within the Technological Educational Institute of Piraeus under the co-supervision of the Physics and Electronic Computer Systems departments' academic staff. (paper)

  2. Resource Conservation and Recovery Act (RCRA) general contingency plan for hazardous waste treatment, storage, and disposal units at the Oak Ridge Y-12 Plant

    International Nuclear Information System (INIS)

    Skaggs, B.E.

    1993-11-01

    The Y-12 RCRA Contingency Plan will be continually reviewed and revised if any of the following occur: the facility permit is revised, the plan is inadequate in an emergency, the procedures herein can be improved, the operations of the facility change in a way that alters the plan, the emergency coordinator changes, or the emergency equipment list changes. Copies of the Y-12 Emergency Management Plan are available at the Plant Shift Superintendent's Office and the Emergency Management Office. This document serves to supplement the Y-12 Emergency Management Plan to be appropriate for all RCRA hazardous waste treatment, storage, or disposal units. The 90-day accumulation areas at the Y-12 Plant have a separate contingency supplement as required by RCRA and are separate from this supplement

  3. Resource Conservation and Recovery Act (RCRA) contingency plan for hazardous waste treatment, storage, and disposal units at the Oak Ridge Y-12 Plant

    International Nuclear Information System (INIS)

    1994-08-01

    The Y-12 RCRA Contingency Plan will be continually reviewed and revised if any of the following occur: the facility permit is revised, the plan is inadequate in an emergency, the procedures can be improved, the operations of the facility change in a way that alters the plan, the emergency coordinator changes, or the emergency equipment list changes. Copies of the Y-12 Emergency Management Plan are available at the Plant Shift Superintendent's Office and the Emergency Management Office. This document serves to supplement the Y-12 Emergency Management Plan to be appropriate for all RCRA hazardous waste treatment, storage, or disposal units. The 90-day accumulation areas at the Y-12 Plant have a separate contingency supplement as required by RCRA and are separate from this supplement

  4. Trends in the incidence, treatment, and outcomes of acute lower extremity ischemia in the United States Medicare population.

    Science.gov (United States)

    Baril, Donald T; Ghosh, Kaushik; Rosen, Allison B

    2014-09-01

    Acute lower extremity ischemia (ALI) is a common vascular surgery emergency associated with high rates of morbidity and mortality. The purpose of this study was to assess contemporary trends in the incidence of ALI, the methods of treatment, and the associated mortality and amputation rates in the U.S. Medicare population. This was an observational study using Medicare claims data between 1998 and 2009. Outcomes examined included trends in the incidence of ALI; trends in interventions for ALI; and trends in amputation, mortality, and amputation-free survival rates. Between 1998 and 2009, the incidence of hospitalization for ALI decreased from 45.7 per 100,000 to 26.0 per 100,000 (P for trend < .001). The percentage of patients undergoing surgical intervention decreased from 57.1% to 51.6% (P for trend < .001), whereas the percentage of patients undergoing endovascular interventions increased from 15.0% to 33.1% (P for trend < .001). In-hospital mortality rates decreased from 12.0% to 9.0% (P for trend < .001), whereas 1-year mortality rates remained stable at 41.0% and 42.5% (P for trend not significant). In-hospital amputation rates remained stable at 8.1% and 6.4% (P for trend not significant), whereas 1-year amputation rates decreased from 14.8% to 11.0% (P for trend < .001). In-hospital amputation-free survival after hospitalization for ALI increased from 81.2% to 85.4% (P for trend < .001); however, 1-year amputation-free survival remained unchanged. Between 1998 and 2009, the incidence of ALI among the U.S. Medicare population declined significantly, and the percentage of patients treated with endovascular techniques markedly increased. During this time, 1-year amputation rates declined. Furthermore, although in-hospital mortality rates declined after presentation with ALI, 1-year mortality rates remained unchanged. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  5. Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States.

    Science.gov (United States)

    Sun, Shawn X; Liu, Gordon G; Christensen, Dale B; Fu, Alex Z

    2007-10-01

    To review the literature addressing the economic outcomes of nonadherence in the treatment of schizophrenia, and to utilize the review results to provide an update on the economic impact of hospitalizations among schizophrenia patients related to antipsychotic nonadherence. A structured search of EMBASE, Ovid MEDLINE, PubMed and PsycINFO for years 1995-2007 was conducted to identify published English-language articles addressing the economic impact of antipsychotic nonadherence in schizophrenia. The following key words were used in the search: compliance, noncompliance, adherence, nonadherence, relapse, economic, cost, and schizophrenia. A bibliographic search of retrieved articles was performed to identify additional studies. For a study to be included, the date of publication had to be from 1/1/1995 to 6/1/2007, and the impact of nonadherence had to be measured in terms of direct healthcare costs or inpatient days. Subsequently, an estimate of incremental hospitalization costs related to antipsychotic non adherence was extrapolated at the US national level based on the reviewed studies (nonadherence rate and hospitalization rate) and the National Inpatient Sample of Healthcare Cost and Utilization Project (average daily hospitalization costs). Seven studies were identified and reviewed based on the study design, measurement of medication nonadherence, study setting, and cost outcome results. Despite the varied adherence measures across studies, all articles reviewed showed that antipsychotic nonadherence was related to an increase in hospitalization rate, hospital days or hospital costs. We also estimated that the national rehospitalization costs related to antipsychotic nonadherence was $1479 million, ranging from $1392 million to $1826 million in the US in 2005. The estimate of rehospitalization costs was restricted to schizophrenia patients from the Medicaid program. Additionally, the studies we reviewed did not capture the newer antipsychotic drugs

  6. Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States.

    Science.gov (United States)

    Padula, William V; Larson, Richard A; Dusetzina, Stacie B; Apperley, Jane F; Hehlmann, Rudiger; Baccarani, Michele; Eigendorff, Ekkehard; Guilhot, Joelle; Guilhot, Francois; Hehlmann, Rudiger; Mahon, Francois-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C; Niederwieser, Dietger; Saussele, Susanne; Schiffer, Charles A; Silver, Richard T; Simonsson, Bengt; Conti, Rena M

    2016-07-01

    We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib's price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness ("imatinib-first") would be cost-effective compared with the current standard of care: "physicians' choice" of initiating treatment with any one of the three TKIs. We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician's choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models' clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven's MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study's conduct. Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician's choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses. When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP. © The Author 2016. Published by Oxford University Press.

  7. SU-E-T-161: Characterization and Validation of CT Simulator Hounsfield Units to Relative Stopping Power Values for Proton Treatment Planning

    International Nuclear Information System (INIS)

    Schnell, E; Ahmad, S; De La Fuente Herman, T

    2015-01-01

    Purpose: To develop a calibration curve that includes and minimizes the variations of Hounsfield Unit (HU) from a CT scanner to Relative Stopping Power (RSP) of tissues along the proton beam path. The variations are due to scanner and proton energy, technique, phantom size and placement, and tissue arrangement. Methods: A CIRS 062 M phantom with 10 plugs of known relative electron density (RED) was scanned through a 16 slice GE Discovery CT Simulator scanner. Three setup combinations of plug distributions and techniques clinically implemented for five treatment regions were scanned with energies of 100, 120, and 140 kV. Volumetric HU values were measured for each plug and scan. The RSP values derived through the Bethe-Bloch formula are currently being verified with parallel-plate ionization chamber measurements in water using 80, 150, and 225 MeV proton beam. Typical treatment plans for treatment regions of brain, head-&-neck, chest, abdomen, and pelvis are being planned and dose delivered will be compared with film and Optically Stimulated Luminescence (OSL) measurements. Results: Percentage variations were determined for each variable. For tissues close to water, variations were <1% from any given parameter. Tissues far from water equivalence (lung and bone) showed the greatest sensitivity to change (7.4% maximum) with scanner energy and up to 5.3% with positioning of the phantom. No major variations were observed for proton energies within the treatment range. Conclusion: When deriving a calibration curve, attention should be placed to low and high HU values. A thorough verification process of calculated vs. water-phantom measured RSP values at different proton energies, followed by dose validation of planned vs. measured doses in phantom with film and OSL detectors are currently being undertaken

  8. The effect of plasma rich in growth factors combined with follicular unit extraction surgery for the treatment of hair loss: A pilot study.

    Science.gov (United States)

    Navarro, Roge M; Pino, Ander; Martinez-Andres, Asunción; Molina, Consuelo; Martinez, Ana María; Martinez, Nahikari; Orive, Gorka; Anitua, Eduardo

    2017-10-26

    Hair transplant surgery using follicular unit extraction technique (FUE) is a common surgical procedure for the treatment of severe hair loss. Blood-derived autologous growth factors have also proved to promote hair regeneration in patients with different types of alopecia. The aim of this study was to evaluate the safety and clinical efficacy of plasma rich in growth factors (PRGF) technology as an adjuvant therapy for FUE surgery in hair loss affected patients. The biologic potential of PRGF was firstly in vitro evaluated over follicular germinal matrix and dermal papilla cells. Afterward, fifteen patients were subjected to routine FUE procedure while 15 patients underwent FUE+PRGF therapy. PRGF group included intradermal injections of growth factors and follicular transfer unit (FTU) preservation in an autologous fibrin clot. Postsurgical patient satisfaction and clinical improvement were evaluated, and PRGF or saline-preserved hair grafts were histomorphometrically analyzed. Follicular cell proliferation and migration was induced after autologous growth factors treatment. PRGF-preserved FTUs presented higher bioactivity signals and improved integrity of perifollicular structures and extracellular matrix proteins such as collagen and elastic fibers. PRGF not only reduced the postsurgical crust healing and hair fixation period, but also decreased the inflammatory pain and itching sensation. This preliminary data demonstrate that PRGF is able to minimize the postsurgical follicle loss and potentiate the performance of grafted hairs. The fibrin clot not only acts as a protective barrier against environmental factors, but also provides a biologically active scaffold that induces resident cell proliferation and maintains an optimal integrity of the grafted hair. © 2017 Wiley Periodicals, Inc.

  9. Fabrication of optical fiber micro(and nano)-optical and photonic devices and components, using computer controlled spark thermo-pulling system

    International Nuclear Information System (INIS)

    Fatemi, H.; Mosleh, A.; Pashmkar, M.; Khaksar Kalati, A.

    2007-01-01

    Fabrication of optical fiber Micro (and Nano)-Optical component and devices, as well as, those applicable for photonic purposes are described. It is to demonstrate the practical capabilities and characterization of the previously reported Computer controlled spark thermo-pulling fabrication system.

  10. A stepwise approach to the etiologic diagnosis of pleural effusion in respiratory intensive care unit and short-term evaluation of treatment

    Directory of Open Access Journals (Sweden)

    Nilesh J Chinchkar

    2015-01-01

    Full Text Available Background: Pleural effusions in respiratory intensive care unit (RICU are associated with diseases of varied etiologies and often carry a grave prognosis. This prospective study was conducted to establish an etiologic diagnosis in a series of such patients before starting treatment. Materials and Methods: Fifty consecutive patients, diagnosed with pleural effusion on admission or during their stay in RICU, were further investigated by a two-step approach. (1 Etiologic diagnosis was established by sequential clinical history and findings on physical examination, laboratory tests, chest radiograph, CECT/HRCT/PET-CT and pleural fluid analysis. (2 Patients who remained undiagnosed were subjected to fiber-optic bronchoscopy, video-assisted thoracoscopic pleural biopsy, and histopathology. Results: Etiologic diagnosis of pleural effusion was established in 44 (88% Metastases (24%; para-pneumonia (22%; congestive cardiac failure (18%; tuberculosis (14%; hemothorax (4%; trapped lung, renal failure, and liver cirrhosis (2% each. Six patients (12% remained undiagnosed, as the final diagnostic thoracoscopic biopsy could not be performed in five and tissue histopathology findings were inconclusive in one. Out of the 50 patients, 10 died in the hospital; 2 left against medical advice; and 2 were referred to oncology center for further treatment. The remaining 36 patients were clinically stabilized and discharged. During a 3-month follow-up, eight of them were re-hospitalized, of which four died. Conclusions: Pleural effusion in RICU carries a high risk of mortality. Etiologic diagnosis can be established in most cases.

  11. Report on the International Workshop on Drug Prevention and Treatment in Rural Settings Organized by United Nation Office on Drugs and Crime (UNODC) and World Health Organization (WHO).

    Science.gov (United States)

    Milano, Giulia; Saenz, Elizabeth; Clark, Nicolas; Busse, Anja; Gale, John; Campello, Giovanna; Mattfeld, Elizabeth; Maalouf, Wadih; Heikkila, Hanna; Martelli, Antonietta; Morales, Brian; Gerra, Gilberto

    2017-11-10

    Very little evidence has been reported in literature regarding the misuse of substances in rural areas. Despite the common perception of rural communities as a protective and risk-mitigating environment, the scientific literature demonstrated the existence of many risk factors in rural communities. The Drug Prevention and Health Branch (DHB) of the United Nations Office on Drugs and Crime (UNODC), and the World Health Organization (WHO), in June 2016, organized a meeting of experts in treatment and prevention of SUDs in rural settings. The content presented during the meeting and the related discussion have provided materials for the preparation of an outline document, which is the basis to create a technical tool on SUDs prevention and treatment in rural settings. The UNODC framework for interventions in rural settings is a technical tool aimed to assist policy makers and managers at the national level. This paper is a report on UNODC/WHO efforts to improve the clinical conditions of people affected by SUDs and living in rural areas. The purpose of this article is to draw attention on a severe clinical and social problem in a reality forgotten by everyone.

  12. A stepwise approach to the etiologic diagnosis of pleural effusion in respiratory intensive care unit and short-term evaluation of treatment

    Science.gov (United States)

    Chinchkar, Nilesh J; Talwar, Deepak; Jain, Sushil K

    2015-01-01

    Background: Pleural effusions in respiratory intensive care unit (RICU) are associated with diseases of varied etiologies and often carry a grave prognosis. This prospective study was conducted to establish an etiologic diagnosis in a series of such patients before starting treatment. Materials and Methods: Fifty consecutive patients, diagnosed with pleural effusion on admission or during their stay in RICU, were further investigated by a two-step approach. (1) Etiologic diagnosis was established by sequential clinical history and findings on physical examination, laboratory tests, chest radiograph, CECT/HRCT/PET-CT and pleural fluid analysis. (2) Patients who remained undiagnosed were subjected to fiber-optic bronchoscopy, video-assisted thoracoscopic pleural biopsy, and histopathology. Results: Etiologic diagnosis of pleural effusion was established in 44 (88%) Metastases (24%); para-pneumonia (22%); congestive cardiac failure (18%); tuberculosis (14%); hemothorax (4%); trapped lung, renal failure, and liver cirrhosis (2% each). Six patients (12%) remained undiagnosed, as the final diagnostic thoracoscopic biopsy could not be performed in five and tissue histopathology findings were inconclusive in one. Out of the 50 patients, 10 died in the hospital; 2 left against medical advice; and 2 were referred to oncology center for further treatment. The remaining 36 patients were clinically stabilized and discharged. During a 3-month follow-up, eight of them were re-hospitalized, of which four died. Conclusions: Pleural effusion in RICU carries a high risk of mortality. Etiologic diagnosis can be established in most cases. PMID:25814793

  13. Effects of probiotics and antibiotics on the intestinal homeostasis in a computer controlled model of the large intestine

    Directory of Open Access Journals (Sweden)

    Rehman Ateequr

    2012-03-01

    Full Text Available Abstract Background Antibiotic associated diarrhea and Clostridium difficile infection are frequent complications of broad spectrum antibiotic therapy. Probiotic bacteria are used as therapeutic and preventive agents in these disorders, but the exact functional mechanisms and the mode of action are poorly understood. The effects of clindamycin and the probiotic mixture VSL#3 (containing the 8 bacterial strains Streptococcus thermophilus, Bifidobacterium breve, Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus paracasei and Lactobacillus delbrueckii subsp. Bulgaricus consecutively or in combination were investigated and compared to controls without therapy using a standardized human fecal microbiota in a computer-controlled in vitro model of large intestine. Microbial metabolites (short chain fatty acids, lactate, branched chain fatty acids, and ammonia and the intestinal microbiota were analyzed. Results Compared to controls and combination therapy, short chain fatty acids and lactate, but also ammonia and branched chain fatty acids, were increased under probiotic therapy. The metabolic pattern under combined therapy with antibiotics and probiotics had the most beneficial and consistent effect on intestinal metabolic profiles. The intestinal microbiota showed a decrease in several indigenous bacterial groups under antibiotic therapy, there was no significant recovery of these groups when the antibiotic therapy was followed by administration of probiotics. Simultaneous application of anti- and probiotics had a stabilizing effect on the intestinal microbiota with increased bifidobacteria and lactobacilli. Conclusions Administration of VSL#3 parallel with the clindamycin therapy had a beneficial and stabilizing effect on the intestinal metabolic homeostasis by decreasing toxic metabolites and protecting the endogenic microbiota from destruction. Probiotics could be a reasonable

  14. Approaches to brain stress testing: BOLD magnetic resonance imaging with computer-controlled delivery of carbon dioxide.

    Directory of Open Access Journals (Sweden)

    W Alan C Mutch

    Full Text Available BACKGROUND: An impaired vascular response in the brain regionally may indicate reduced vascular reserve and vulnerability to ischemic injury. Changing the carbon dioxide (CO(2 tension in arterial blood is commonly used as a cerebral vasoactive stimulus to assess the cerebral vascular response, changing cerebral blood flow (CBF by up to 5-11 percent/mmHg in normal adults. Here we describe two approaches to generating the CO(2 challenge using a computer-controlled gas blender to administer: i a square wave change in CO(2 and, ii a ramp stimulus, consisting of a continuously graded change in CO(2 over a range. Responses were assessed regionally by blood oxygen level dependent (BOLD magnetic resonance imaging (MRI. METHODOLOGY/PRINCIPAL FINDINGS: We studied 8 patients with known cerebrovascular disease (carotid stenosis or occlusion and 2 healthy subjects. The square wave stimulus was used to study the dynamics of the vascular response, while the ramp stimulus assessed the steady-state response to CO(2. Cerebrovascular reactivity (CVR maps were registered by color coding and overlaid on the anatomical scans generated with 3 Tesla MRI to assess the corresponding BOLD signal change/mmHg change in CO(2, voxel-by-voxel. Using a fractal temporal approach, detrended fluctuation analysis (DFA maps of the processed raw BOLD signal per voxel over the same CO(2 range were generated. Regions of BOLD signal decrease with increased CO(2 (coded blue were seen in all of these high-risk patients, indicating regions of impaired CVR. All patients also demonstrated regions of altered signal structure on DFA maps (Hurst exponents less than 0.5; coded blue indicative of anti-persistent noise. While 'blue' CVR maps remained essentially stable over the time of analysis, 'blue' DFA maps improved. CONCLUSIONS/SIGNIFICANCE: This combined dual stimulus and dual analysis approach may be complementary in identifying vulnerable brain regions and thus constitute a regional as

  15. Cost Effectiveness of Candida Polymerase Chain Reaction Detection and Empirical Antifungal Treatment among Patients with Suspected Fungal Peritonitis in the Intensive Care Unit.

    Science.gov (United States)

    Pagès, Arnaud; Iriart, Xavier; Molinier, Laurent; Georges, Bernard; Berry, Antoine; Massip, Patrice; Juillard-Condat, Blandine

    2017-12-01

    Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture. To perform a cost-effectiveness analysis of the combination of several diagnostic and therapeutic strategies to manage Candida peritonitis in non-neutropenic adult patients in ICUs. We constructed a decision tree model to evaluate the cost effectiveness. Cost and effectiveness were taken into account in a 1-year time horizon and from the French National Health Insurance perspective. Six strategies were compared: fluconazole or echinocandin as an empirical therapy, plus diagnosis by fungal culture or detection by PCR of all Candida species, or use of PCR to detect most fluconazole-resistant Candida species (i.e., Candida krusei and Candida glabrata). The use of fluconazole empirical treatment and PCR to detect all Candida species is more cost effective than using fluconazole empirical treatment without PCR (incremental cost-effectiveness ratio of €40,055/quality-adjusted life-year). Empirical treatment with echinocandin plus PCR to detect C. krusei and C. glabrata is the most effective strategy, but has an incremental cost-effectiveness ratio of €93,776/quality-adjusted life-year. If the cost of echinocandin decreases, then strategies involving PCR plus empirical echinocandin become more cost-effective. Detection by PCR of all Candida species and of most fluconazole-resistant Candida species could improve the cost-effectiveness of fluconazole and echinocandin given to non-neutropenic patients with suspected peritoneal candidiasis in ICUs. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. Midodrine as adjunctive support for treatment of refractory hypotension in the intensive care unit: a multicenter, randomized, placebo controlled trial (the MIDAS trial).

    Science.gov (United States)

    Anstey, Matthew H; Wibrow, Bradley; Thevathasan, Tharusan; Roberts, Brigit; Chhangani, Khushi; Ng, Pauline Yeung; Levine, Alexander; DiBiasio, Alan; Sarge, Todd; Eikermann, Matthias

    2017-03-21

    Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. This trial aims to evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV vasopressor treatment, and allow earlier discharge from ICU and hospital. The MIDAS trial is an international, multicenter, randomized, double-blind, placebo-controlled clinical trial being conducted in the USA and Australia. We are targeting 120 patients. Adult patients admitted to the ICU who are resuscitated and otherwise stable on low dose IV vasopressors for at least 24 h will be considered for recruitment. Participants will be randomized to receive midodrine (20 mg) or placebo three times a day, in addition to standard care. The primary outcome is time (hours) from initiation of midodrine or placebo to discontinuation of IV vasopressors. Secondary outcomes include time (hours) from ICU admission to discharge readiness, ICU length of stay (LOS) (days), hospital LOS (days), rates of ICU readmission, and rates of adverse events related to midodrine administration. Midodrine is approved by the Food and Drug Administration (FDA) for the treatment of symptomatic orthostatic hypotension. In August 2010, FDA proposed to withdraw approval of midodrine because of lack of studies that verify the clinical benefit of the drug. We obtained Investigational New Drug (IND 113,330) approval to study its effects in critically ill patients who require IV vasopressors but are otherwise ready for discharge from the ICU. A pilot observational study in a cohort of surgical ICU patients showed that the rate of decline in vasopressor requirements increased after initiation of midodrine treatment. We

  17. Developing a computer-controlled simulated digestion system to predict the concentration of metabolizable energy of feedstuffs for rooster.

    Science.gov (United States)

    Zhao, F; Ren, L Q; Mi, B M; Tan, H Z; Zhao, J T; Li, H; Zhang, H F; Zhang, Z Y

    2014-04-01

    Four experiments were conducted to evaluate the effectiveness of a computer-controlled simulated digestion system (CCSDS) for predicting apparent metabolizable energy (AME) and true metabolizable energy (TME) using in vitro digestible energy (IVDE) content of feeds for roosters. In Exp. 1, the repeatability of the IVDE assay was tested in corn, wheat, rapeseed meal, and cottonseed meal with 3 assays of each sample and each with 5 replicates of the same sample. In Exp. 2, the additivity of IVDE concentration in corn, soybean meal, and cottonseed meal was tested by comparing determined IVDE values of the complete diet with values predicted from measurements on individual ingredients. In Exp. 3, linear models to predict AME and TME based on IVDE were developed with 16 calibration samples. In Exp. 4, the accuracy of prediction models was tested by the differences between predicted and determined values for AME or TME of 6 ingredients and 4 diets. In Exp. 1, the mean CV of IVDE was 0.88% (range = 0.20 to 2.14%) for corn, wheat, rapeseed meal, and cottonseed meal. No difference in IVDE was observed between 3 assays of an ingredient, indicating that the IVDE assay is repeatable under these conditions. In Exp. 2, minimal differences (<21 kcal/kg) were observed between determined and calculated IVDE of 3 complete diets formulated with corn, soybean meal, and cottonseed meal, demonstrating that the IVDE values are additive in a complete diet. In Exp. 3, linear relationships between AME and IVDE and between TME and IVDE were observed in 16 calibration samples: AME = 1.062 × IVDE - 530 (R(2) = 0.97, residual standard deviation [RSD] = 146 kcal/kg, P < 0.001) and TME = 1.050 × IVDE - 16 (R(2) = 0.97, RSD = 148 kcal/kg, P < 0.001). Differences of less than 100 kcal/kg were observed between determined and predicted values in 10 and 9 of the 16 calibration samples for AME and TME, respectively. In Exp. 4, differences of less than 100 kcal/kg between determined and predicted

  18. Cost-Benefit Analysis of Nanoparticle Albumin-Bound Paclitaxel versus Solvent-Based Paclitaxel for the Treatment of Metastatic Breast Cancer in the United States

    Science.gov (United States)

    Vichansavakul, Kittaya

    Breast cancer is the second leading cause of death among women in the US. Although early detection and treatment help to increase survival rates, some unfortunate patients develop metastatic breast cancer that has no cure. Palliative treatment is the main objective in this group of patients in order to prolong life and reduce toxicities from interventions. In the advancement of treatment for metastatic breast cancer, solvent-based paclitaxel has been widely used. However, solvent-based paclitaxel often causes adverse reactions. Therefore, researchers have developed a new chemotherapy based on nanotechnology. One of these drugs is the Nanoparticle albumin-bound Paclitaxel. This nanodrug aims to increase therapeutic index by reducing adverse reactions from solvents and to improve efficacy of conventional cytotoxic chemotherapy. Breast cancer is a disease with high epidemiological and economic burden. The treatment of metastatic breast cancer has not only high direct costs but also high indirect costs. Breast cancer affects mass populations, especially women younger than 50 years of age. It relates to high indirect costs due to lost productivity and premature death because the majority of these patients are in the workforce. Because of the high cost of breast cancer therapies and short survival rates, the question is raised whether the costs and benefits are worth paying or not. Due to the rising costs in healthcare and new financing policies that have been developed to address this issue, economic evaluation is an important aspect of the development and use of any new interventions. To guide policy makers on how to allocate limited healthcare resources in the most efficient and effective manner, many economic evaluation methods can be used to measure the costs, benefits, and impacts of healthcare innovations. Currently, economic evaluation and health outcomes studies have focused greatly on cost-effectiveness and cost-utility analysis. However, the previous studies

  19. Evaluation of the distribution of rare earths elements in fluvial sediments, rocks and wastes correlated to the Caldas Ore Treatment Unit (UTM-Caldas), Minas Gerais State, Brazil

    International Nuclear Information System (INIS)

    Possas, Clara R.; Moura, Rodrigo R. de; Carvalho Filho, Carlos A. de; Menezes, Maria Ângela de B.C.

    2017-01-01

    The Caldas Ore Treatment Unit (UTM-Caldas), located at the municipality of Caldas (Minas Gerais-Brazil), was a site