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Sample records for concept node analysis

  1. Sentinel node concept in breast cancer

    International Nuclear Information System (INIS)

    Kiricuta, I.C.

    2000-01-01

    Background/purpose: It seems that there exists a specific lymph node center called sentinel node (SN) which appears to be the primary site of metastases. The sentinel node concept (SNC) is fundamentally based on the orderly progression of tumor cells within the lymphatic system. It is the most important new concept in surgical and radiation oncology. The purpose is to present the biological significance, the diagnostic and clinical basis of the sentinel node concept in breast cancer patients. Material and methods: Lymphoscintigraphy and gamma probe biopsy is necessary to show predictable lymph flow to the regional sentinel node, to multiple sentinel nodes or unpredictable lymph flow to extra-regional sentinel nodes and for performing sentinel node procedure. The standard protocol for the evaluation of the sentinel node metastases consists of extensive histopathological investigation including step Hematoxylin and Eosin (H and E) stained sections and immunohistochemistry. Results: A high rate of success of the identification of the sentinel node for breast cancer was reported. The presence or absence of metastasis in this node is a very accurate predictor of overall nodal status. The temptation to examine the sentinel node with the greatest possible degree of accuracy highlights one of the major problems related to sentinel node biopsy. The success of the sentinel node procedure depends primarily on the adequate functional capacity necessary for sufficient uptake to ensure the accurate identification. In negative sentinel-node patients a complete axillary lymph node dissection is avoidable. In sentinel-node positive patients and clinically negative patients a postoperative radiotherapy would permit an adequate tumor control. The last 2-procedures permit a low morbidity. In the actual TNM classification it was recently introduced a definition of a 'pN0' patient based on sentinel node biopsy. New target volumes are defined for adjuvant radiotherapy or lymphatic basins

  2. Sentinel node concept in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kiricuta, I.C. [St. Vincenz-Hospital, Limburg (Germany). Inst. for Radiation Oncology

    2000-07-01

    Background/purpose: It seems that there exists a specific lymph node center called sentinel node (SN) which appears to be the primary site of metastases. The sentinel node concept (SNC) is fundamentally based on the orderly progression of tumor cells within the lymphatic system. It is the most important new concept in surgical and radiation oncology. The purpose is to present the biological significance, the diagnostic and clinical basis of the sentinel node concept in breast cancer patients. Material and methods: Lymphoscintigraphy and gamma probe biopsy is necessary to show predictable lymph flow to the regional sentinel node, to multiple sentinel nodes or unpredictable lymph flow to extra-regional sentinel nodes and for performing sentinel node procedure. The standard protocol for the evaluation of the sentinel node metastases consists of extensive histopathological investigation including step Hematoxylin and Eosin (H and E) stained sections and immunohistochemistry. Results: A high rate of success of the identification of the sentinel node for breast cancer was reported. The presence or absence of metastasis in this node is a very accurate predictor of overall nodal status. The temptation to examine the sentinel node with the greatest possible degree of accuracy highlights one of the major problems related to sentinel node biopsy. The success of the sentinel node procedure depends primarily on the adequate functional capacity necessary for sufficient uptake to ensure the accurate identification. In negative sentinel-node patients a complete axillary lymph node dissection is avoidable. In sentinel-node positive patients and clinically negative patients a postoperative radiotherapy would permit an adequate tumor control. The last 2-procedures permit a low morbidity. In the actual TNM classification it was recently introduced a definition of a 'pN0' patient based on sentinel node biopsy. New target volumes are defined for adjuvant radiotherapy or

  3. SENTINEL LYMPH NODE CONCEPT IN DIFFERENTIATED THYROID CANCER

    Directory of Open Access Journals (Sweden)

    Markovic Ivan

    2014-12-01

    Full Text Available Introduction: Differentiated thyroid carcinoma (DTC account up to 90% of all thyroid malignacies, and represents the most common malignant tumors of endocrine system. The incidence of papillary thyroid carcinoma (PTC, especially small tumors is rapidly increasing during past three decades. At the time of diagnosis, the incidence of lymph node metastases (LNM ranges from 80 to 90%. During the last 15 years, LNM were recognized as bad prognostic factor for both local-regional relapse (LRR and cancer specific survival. There is general agreement that neck dissections are indicated in cases of clinically apparent LNM. The subject of the current controversy is the surgical treatment of occult LNM that remain unrecognized on preoperative diagnosis (cN0. The extent of operations of the lymph nodes ranges from “wait and see” so-called “Western school” principle substantiated the role of applying ablative I131therapy and frequency peroperative complications (recurrent laryngeal nerve injury and hypoparathyroidism, especially for less experienced teams to mutual prophylactic dissection of the central and lateral compartments so-called “Japanese school” due to the limited use of radioactive iodine therapy and significantly lower operating morbidity if dissetion was done during primary operation. Despite high prevalence of occult LNM, existing controversies regarding diagnosis, longterm prognostic impact and extent of lymph node surgery, motivated some authors to apply consept of sentinel lymph node biopsy (SLNb in DTC, taking into account excellent results of SLN concept in breast cancer and skin melanoma. This review presents the summarized results of relevant studies and three meta-analysis of accuracy and applicability of SLN concept in patients with differentiated thyroid carcinoma.

  4. Sentinel lymph node concept in oral cancer

    International Nuclear Information System (INIS)

    Hasegawa, Shogo; Omura, Ken; Harada, Hiroyuki; Shimamoto, Hiroaki; Yoshida, Yoshihiko; Uekusa, Masaru; Togawa, Takashi

    2005-01-01

    The cervical lymph node (CLN) status is one of the most important prognostic factors in oral cancer. However, the main method of addressing the CLN depends on diagnostic imaging. Sentinel lymph node (SN) biopsy combined with lymphoscintigraphy may be a minimally invasive technique that samples first-echelon lymph node to predict the need for neck dissection. Focused analysis of the SN is highly accurate in identifying metastases. In this study, we investigate the possibility of identifying the SN in oral cancer and the detection of metastases in SN by HE stain, cytokeratin IHC and cytokeratin 17 reverse transcription polymerase chain reaction (RT-PCR). Twenty-four consecutive patients who had clinically negative CLN underwent SN biopsy, followed by elective neck dissection. SNs were detected by means of mapping with isotope labeling 99m Tc-phytate. All lymph nodes were examined by conventional HE staining for evaluating metastasis. In addition, each SN was cut into multiple sections for cytokeratin IHC staining and for RT-PCR for cytokeratin 17. SNs were identified in 24 (100%) of 24 patients by lymphoscintigraphy and gamma probe. One to seven SNs were identified in each patient. Both HE and immunohistochemical staining of SN identified metastasis in 7 patients (29.2%), and the expression of cytokeratin 17 by RT-PCR of SN was positive in 8 patients (34.8%). No metastases were identified using HE, cytokeratin IHC staining in non-SNs. Neck failure has not developed in 23 (95.8%) of 24 patients. The results strongly suggest the usefulness of the SN concept in oral cancer and for better assessing the status of the CLN. (author)

  5. [The validity of the sentinel node concept in gastrointestinal cancers].

    Science.gov (United States)

    Kitagawa, Y; Fujii, H; Mukai, M; Ando, N; Kubota, T; Ikeda, T; Ohgami, M; Watanabe, M; Otani, Y; Ozawa, S; Hasegawa, H; Furukawa, T; Nakahara, T; Kubo, A; Kumai, K; Kitajima, M

    2000-03-01

    Although the sentinel node concept has been validated and clinically applied to breast cancer and malignant melanoma, its clinical significance in other solid tumors has not been thoroughly investigated. With regard to gastrointestinal (GI) cancers in particular, our surgeons have been cautious because of the high frequency of skip metastasis and the complicated lymphatic system in the GI tract. We would like to emphasize that so-called skip metastasis has been defined according to anatomic classification of regional lymph nodes and that the lymphatic drainage route must be patient or lesion specific. To test the validity and feasibility of this concept in GI cancers, we have established a radio-guided intraoperative sentinel node navigation system using preoperative endoscopic submucosal injection of radioactive tracer followed by intra-operative gamma-probing. In 131 patients with GI cancers (esophagus: 22, stomach: 71, colorectum: 38), the detection rate of sentinel nades was 91% and overall diagnostic accuracy of lymph node metastasis by sentinel node status was 97%. Initial results suggest further investigation of this procedure as an accurate staging and a minimally invasive approach to early GI cancers.

  6. Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines

    DEFF Research Database (Denmark)

    Girinsky, Theodore; van der Maazen, Richard; Specht, Lena

    2006-01-01

    are designed to irradiate the initially involved lymph nodes exclusively and to encompass their initial volume. In some cases, radiation fields are slightly modified to avoid unnecessary irradiation of muscles or organs at risk. CONCLUSIONS: The concept of involved-node radiotherapy (INRT) described here......BACKGROUND AND PURPOSE: To describe new concepts for radiation fields in patients with early stage Hodgkin lymphoma treated with a combined modality. PATIENTS AND MATERIALS: Patients receiving combined modality therapy with at least 2 or 3 cycles of chemotherapy prior to radiotherapy. Pre...

  7. Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: Concepts and guidelines

    International Nuclear Information System (INIS)

    Girinsky, Theodore; Maazen, Richard van der; Specht, Lena; Aleman, Berthe; Poortmans, Philip; Lievens, Yolande; Meijnders, Paul; Ghalibafian, Mithra; Meerwaldt, Jacobus; Noordijk, Evert

    2006-01-01

    Background and purpose: To describe new concepts for radiation fields in patients with early stage Hodgkin lymphoma treated with a combined modality. Patients and materials: Patients receiving combined modality therapy with at least 2 or 3 cycles of chemotherapy prior to radiotherapy. Pre- and postchemotherapy cervical and thoracic CT scans are mandatory and should be performed, whenever possible, in the treatment position with the use of image fusion capabilities. A pre-chemotherapy PET scan is strongly recommended to increase the detection of involved lymph nodes. Results: Radiation fields are designed to irradiate the initially involved lymph nodes exclusively and to encompass their initial volume. In some cases, radiation fields are slightly modified to avoid unnecessary irradiation of muscles or organs at risk. Conclusions: The concept of involved-node radiotherapy (INRT) described here is the first attempt to reduce the size of radiation fields compared to the classic involved fields used in adult patients. Proper implementation of INRT requires adequate training and an efficient prospective or early retrospective quality assurance program

  8. The 'Sentinel Node' Concept: More Questions Raised than Answers Provided?

    Science.gov (United States)

    Schlag

    1998-01-01

    preoperative lymph node staging. However, there is none. General criteria like size, shape, structure, or texture in variable imaging modalities are unreliable. While it is still too early to definitely evaluate in this context new diagnostic modalities like PET, immunoscintigraphy, or contrast-enhanced MRI, the initial results do not provoke clear enthusiasm toward the development of a sensitive and specific staging tool with regard to the nodal status. Adequate specificity may be obtained by external or endoluminal ultrasound-guided fine needle biopsies. However, uncertainty arises from eventually unrepresentative tissue sampling. The sentinel lymphonodectomy technique may remedy the dilemma, enabling a risk-adapted, individual indication for regional lymphatic dissection. This concept, first introduced in 1977 by Cabanas into the treatment of penis carcinoma, is based on the evidence of orderly and predictable lymphatic drainage pathways. Tumor cell progression within the lymphatic system seems to follow a sequential pattern. Primary draining lymph nodes possess the structural and functional capability to retain and to fight tumor cells efficiently. The 'sentinel node' is defined as the first tumor draining filter, and, if uninvolved, should thus adequately predict the nodal status of the disease. Skip metastases beyond an uninvolved sentinel node are supposed to be a very rare event. The reliability of the 'Cabanas approach', however, was limited by its relatively poor localization technique, and therefore failed to gain widespread acceptance. Unfortunately, the significance of the concept was not fully appreciated at the time. It is to Morton's credit that the procedure was reinstituted in malignant melanoma through a dye injection technique at the primary tumor site. This led to a rapid development and refinement of intraoperative lymphatic mapping. One major step in this process was to use radiolabeled colloids in conjunction with gamma-camera imaging or gamma probe

  9. Utilisation of Decision Tables for Proposal of Transfer Node Conception

    Directory of Open Access Journals (Sweden)

    Martin Jacura

    2012-09-01

    Full Text Available The key issue in improving the appeal of public mass transport is the optimal arrangement of transfer nodes. The objective is to propose a comfortable, simple and safe environment for both passengers and operators, and a solution which is economical to construct and operate. Although each transfer node is unique and specific, it is beneficial to have a general idea on the layout of a project to construct or reconstruct such a transfer node. This project should, in particular, stem from the traffic intensity of single transport modes, the volume of single transfer links, and the nature and significance of traffic routes. This article presents the methodology for determining the appropriate disposition of mass public transport nodes using modified decision tables (one of the tools of systems analysis with specific data particularly applicable in the Czech Republic.

  10. The sentinel node concept in breast cancer: A commentary

    International Nuclear Information System (INIS)

    Canizales, A.L. . E-mail A.L.Canizales@qmul.ac.uk; Al-Yasi, A.; Gambhir, S.; Morris, G.; Granowska, M.; Britton, K.E.

    2004-01-01

    As there are multiple lymphatic pathways from the breast to the axilla with multiple possible choices for a cancer cell or a colloid, it appears intuitively unusual that one node is preferentially 'chosen'. The intuitive response would be that there is an equal chance for a breast cancer cell to travel by any lymphatic pathway to any axillary node at level 1. If this were true, then after a colloid injection into the peritumoural lymphatics or the periareolar lymphatic plexus, such a colloid has a similar chance to travel to any level 1 axillary node, be it an involved node or an uninvolved node. We have tried to resolve this conflict between intuition and practice. It was tested by identifying and measuring the activity of the radiolabelled colloid in the nodes removed in an axillary clearance and in the sentinel node or nodes after applying a sentinel node technique similar to that of Veronesi et al. The histology of all the nodes that were counted was analysed so that the colloid activity in each node was able to be correlated with its histology, whether it was involved with cancer or not involved. Measurements were obtained in those patients, in whom there were both involved and uninvolved nodes in the axillae. The colloid counts in cpm/g of each node were compared with the related sentinel node findings either involved with cancer or not involved. These were calculated either as the involved to uninvolved that is a 'positive' to 'negative' ratio. The results were that the activity ratio of all involved axillary nodes to uninvolved axillary nodes was about 4:1. The involved Sentinel nodes had on average over 25 times the uptake of the uninvolved Sentinel nodes. P value was <0.009 for a significant difference between colloid uptake in sentinel nodes with positive histology and those with negative histology. It is a new observation that involved axillary nodes show greater uptake of the colloid than uninvolved nodes in all patients where there are both involved

  11. Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Rachna Ram

    2014-01-01

    Full Text Available Introduction. There has been recent interest in validity of completion axillary node dissection after a positive sentinel node. This systematic review aims to ascertain if sentinel lymph node dissection alone was noninferior to axillary lymph node dissection for breast cancer patients who have a positive sentinel node. Method. A systematic review of the electronic databases Embase, MEDLINE, and Cochrane Register of Controlled Trials was carried out. Only randomised trials that had patients with positive sentinel node as the study sample were included in the meta-analysis using the reported hazard ratios with a fixed effect model. Results. Three randomised controlled trials and five retrospective studies were identified. The pooled effect for overall survival was HR 0.94, 95% CI [0.79, 1.19], and for disease free survival was HR 0.83, 95% CI [0.60, 1.14]. The reported rates for locoregional recurrence were similar in both groups. The surgical morbidity was found to be significantly more in patients who had underwent axillary dissection. Conclusion. Amongst patients with micrometastasis in the sentinel node, no further axillary dissection is necessary. For patients with macrometastasis in the sentinel node, it is reasonable to consider omitting axillary dissection to avoid the morbidity of the procedure.

  12. A Stirling engine analysis method based upon moving gas nodes

    Science.gov (United States)

    Martini, W. R.

    1986-01-01

    A Lagrangian nodal analysis method for Stirling engines (SEs) is described, validated, and applied to a conventional SE and an isothermalized SE (with fins in the hot and cold spaces). The analysis employs a constant-mass gas node (which moves with respect to the solid nodes during each time step) instead of the fixed gas nodes of Eulerian analysis. The isothermalized SE is found to have efficiency only slightly greater than that of a conventional SE.

  13. Node-based analysis of species distributions

    DEFF Research Database (Denmark)

    Borregaard, Michael Krabbe; Rahbek, Carsten; Fjeldså, Jon

    2014-01-01

    overrepresentation score (SOS) and the geographic node divergence (GND) score, which together combine ecological and evolutionary patterns into a single framework and avoids many of the problems that characterize community phylogenetic methods in current use.This approach goes through each node in the phylogeny...... with case studies on two groups with well-described biogeographical histories: a local-scale community data set of hummingbirds in the North Andes, and a large-scale data set of the distribution of all species of New World flycatchers. The node-based analysis of these two groups generates a set...... of intuitively interpretable patterns that are consistent with current biogeographical knowledge.Importantly, the results are statistically tractable, opening many possibilities for their use in analyses of evolutionary, historical and spatial patterns of species diversity. The method is implemented...

  14. Simplified Dynamic Analysis of Grinders Spindle Node

    Science.gov (United States)

    Demec, Peter

    2014-12-01

    The contribution deals with the simplified dynamic analysis of surface grinding machine spindle node. Dynamic analysis is based on the use of the transfer matrix method, which is essentially a matrix form of method of initial parameters. The advantage of the described method, despite the seemingly complex mathematical apparatus, is primarily, that it does not require for solve the problem of costly commercial software using finite element method. All calculations can be made for example in MS Excel, which is advantageous especially in the initial stages of constructing of spindle node for the rapid assessment of the suitability its design. After detailing the entire structure of spindle node is then also necessary to perform the refined dynamic analysis in the environment of FEM, which it requires the necessary skills and experience and it is therefore economically difficult. This work was developed within grant project KEGA No. 023TUKE-4/2012 Creation of a comprehensive educational - teaching material for the article Production technique using a combination of traditional and modern information technology and e-learning.

  15. Concepts of formal concept analysis

    Science.gov (United States)

    Žáček, Martin; Homola, Dan; Miarka, Rostislav

    2017-07-01

    The aim of this article is apply of Formal Concept Analysis on concept of world. Formal concept analysis (FCA) as a methodology of data analysis, information management and knowledge representation has potential to be applied to a verity of linguistic problems. FCA is mathematical theory for concepts and concept hierarchies that reflects an understanding of concept. Formal concept analysis explicitly formalizes extension and intension of a concept, their mutual relationships. A distinguishing feature of FCA is an inherent integration of three components of conceptual processing of data and knowledge, namely, the discovery and reasoning with concepts in data, discovery and reasoning with dependencies in data, and visualization of data, concepts, and dependencies with folding/unfolding capabilities.

  16. Erasure code-based low storage blockchain node

    OpenAIRE

    Perard, Doriane; Lacan, Jérôme; Bachy, Yann; Detchart, Jonathan

    2018-01-01

    The concept of a decentralized ledger usually implies that each node of a blockchain network stores the entire blockchain. However, in the case of popular blockchains, which each weigh several hundreds of GB, the large amount of data to be stored can incite new or low-capacity nodes to run lightweight clients. Such nodes do not participate to the global storage effort and can result in a centralization of the blockchain by very few nodes, which is contrary to the basic concepts of a blockchai...

  17. Choosing a heuristic and root node for edge ordering in BDD-based network reliability analysis

    International Nuclear Information System (INIS)

    Mo, Yuchang; Xing, Liudong; Zhong, Farong; Pan, Zhusheng; Chen, Zhongyu

    2014-01-01

    In the Binary Decision Diagram (BDD)-based network reliability analysis, heuristics have been widely used to obtain a reasonably good ordering of edge variables. Orderings generated using different heuristics can lead to dramatically different sizes of BDDs, and thus dramatically different running times and memory usages for the analysis of the same network. Unfortunately, due to the nature of the ordering problem (i.e., being an NP-complete problem) no formal guidelines or rules are available for choosing a good heuristic or for choosing a high-performance root node to perform edge searching using a particular heuristic. In this work, we make novel contributions by proposing heuristic and root node selection methods based on the concept of boundary sets for the BDD-based network reliability analysis. Empirical studies show that the proposed selection methods can help to generate high-performance edge ordering for most of studied cases, enabling the efficient BDD-based reliability analysis of large-scale networks. The proposed methods are demonstrated on different types of networks, including square lattice networks, torus lattice networks and de Bruijn networks

  18. Long range node-strut analysis of trabecular bone microarchitecture

    DEFF Research Database (Denmark)

    Schmah, Tanya; Marwan, Norbert; Thomsen, Jesper Skovhus

    2011-01-01

    PURPOSE: We present a new morphometric measure of trabecular bone microarchitecture, called mean node strength (NdStr), which is part of a newly developed approach called long range node-strut analysis. Our general aim is to describe and quantify the apparent "latticelike" microarchitecture of th...

  19. A local-world node deleting evolving network model

    International Nuclear Information System (INIS)

    Gu Yuying; Sun Jitao

    2008-01-01

    A new type network growth rule which comprises node addition with the concept of local-world connectivity and node deleting is studied. A series of theoretical analysis and numerical simulation to the LWD network are conducted in this Letter. Firstly, the degree distribution p(k) of this network changes no longer pure scale free but truncates by an exponential tail and the truncation in p(k) increases as p a decreases. Secondly, the connectivity is tighter, as the local-world size M increases. Thirdly, the average path length L increases and the clustering coefficient decreases as generally node deleting increases. Finally, trends up when the local-world size M increases, so as to k max . Hence, the expanding local-world can compensate the infection of the node deleting

  20. A local-world node deleting evolving network model

    Energy Technology Data Exchange (ETDEWEB)

    Gu Yuying [Department of Mathematics, Tongji University, Shanghai 200092 (China); Sun Jitao [Department of Mathematics, Tongji University, Shanghai 200092 (China)], E-mail: sunjt@sh163.net

    2008-06-16

    A new type network growth rule which comprises node addition with the concept of local-world connectivity and node deleting is studied. A series of theoretical analysis and numerical simulation to the LWD network are conducted in this Letter. Firstly, the degree distribution p(k) of this network changes no longer pure scale free but truncates by an exponential tail and the truncation in p(k) increases as p{sub a} decreases. Secondly, the connectivity is tighter, as the local-world size M increases. Thirdly, the average path length L increases and the clustering coefficient decreases as generally node deleting increases. Finally, trends up when the local-world size M increases, so as to k{sub max}. Hence, the expanding local-world can compensate the infection of the node deleting.

  1. Network neighborhood analysis with the multi-node topological overlap measure.

    Science.gov (United States)

    Li, Ai; Horvath, Steve

    2007-01-15

    The goal of neighborhood analysis is to find a set of genes (the neighborhood) that is similar to an initial 'seed' set of genes. Neighborhood analysis methods for network data are important in systems biology. If individual network connections are susceptible to noise, it can be advantageous to define neighborhoods on the basis of a robust interconnectedness measure, e.g. the topological overlap measure. Since the use of multiple nodes in the seed set may lead to more informative neighborhoods, it can be advantageous to define multi-node similarity measures. The pairwise topological overlap measure is generalized to multiple network nodes and subsequently used in a recursive neighborhood construction method. A local permutation scheme is used to determine the neighborhood size. Using four network applications and a simulated example, we provide empirical evidence that the resulting neighborhoods are biologically meaningful, e.g. we use neighborhood analysis to identify brain cancer related genes. An executable Windows program and tutorial for multi-node topological overlap measure (MTOM) based analysis can be downloaded from the webpage (http://www.genetics.ucla.edu/labs/horvath/MTOM/).

  2. Clinical value of sentinel lymph node diagnostics in head and neck cancer; Klinische Wertigkeit der Sentinel-Lymph-Node-Diagnostik bei Kopf-Hals-Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Kampen, W.U. [Klinik fuer Nuklearmedizin am Universitaetsklinikum Schleswig-Holstein, Campus Kiel (Germany); Hoeft, S. [Klinik fuer Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie am Universitaetsklinikum Schleswig-Holstein, Campus Kiel (Germany); Maune, S. [Praxis fuer Hals-Nasen-Ohrenheilkunde, Kiel (Germany)

    2006-06-15

    The concept of the so-called sentinel lymph node (SLN), being the first node draining a malignant tumor and thus carrying the highest risk of metastatic disease, is already frequently applied in patients suffering from malignant melanoma and breast cancer. It is the aim of this concept, to reduce postoperative morbidity by omitting a conventional lymph node dissection if the SLN is proven to be free of any tumor cells. First clinical studies showed promising results also in patients with head and neck cancer. However, both the anatomical localization of the primary tumor and the very complex lymphatic, frequently bilateral drainage pattern may lead to significant methodological problems. Besides a skilful intraoperative usage of the gamma probe, the precise preoperative staging of the respective patient for determination of the N0 status and the assiduous histopathological analysis of the excised SLN are extremely important to reach a maximum of sensitivity in this clinical setting. This paper summarizes the data published on the SLN concept in patients with head and neck cancer, describes the several methodological aspects of labeling the SLN with radiocolloides and reviews the today's impact of the SLN method in clinical routine. (orig.)

  3. A 3D Two-node and One-node HCMFD Algorithm for Pin-wise Reactor Analysis

    International Nuclear Information System (INIS)

    Kim, Jaeha; Kim, Yonghee

    2016-01-01

    To maximize the parallel computational efficiency, an iterative local-global strategy is adopted in the HCMFD algorithm. The global eigenvalue problem is solved by one-node CMFD, and the local fixed-source problems are solved by two-node CMFD based on the pin-wise nodal solutions. In such local-global scheme, the computational cost is mostly concentrated in solving the local problems while they can be solved in parallel so that a parallel computing can effectively be applied. Previously, the feasibility of the HCMFD algorithm was evaluated only in a 2-D scheme. In this paper, the 3D HCMFD algorithm with some possible variations in treating the axial direction is introduced. The HCMFD algorithm was successfully extended to a 3-D core analysis without any numerical instability even though the axial mesh size in local problems is quite different from the x-y node size. We have shown that 3D pin-wise core analysis can be done very effectively with the HCMFD framework. Additionally, it was demonstrated that parallel efficiency of the new 3D HCMFD scheme can be quite high on a simple OpenMP parallel architecture. It is concluded that the 3D HCMFD will enable an efficient pin-wise 3D core analysis

  4. Sentinel lymph node detection in canine oncological patients

    International Nuclear Information System (INIS)

    Balogh, L.; Andocs, G.; Mathe, D.

    2002-01-01

    Sentinel lymph node detection was investigated in dogs with spontaneously occurring tumours. In this pilot study, 24 client-owned spontaneously tumorous dogs presented for sentinel lymph node detection. A multiple method was used with a nuclear medicine technique (injection of 99mT c human serum albumin colloid) with scintigraphy and intraoperative guidance, and blue dye injection. Of the 35 lymph nodes histologically demonstrated to contain metastases, 34 (97%) were found by radioguided surgery, which means that one would have been missed in the intraoperative localisation process; 31 nodes (89%) were clearly visualised in the gamma camera images; only 27 (77%) were blue-stained by vital dye; a mere 8 lymph nodes (23%) were enlarged and therefore easily detectable by palpation. Data obtained from the harmless application of the sentinel node concept are useful for the radiopharmaceutist. The sentinel lymph node concept is well applicable in the veterinary clinic. (author)

  5. A new centrality measure for identifying influential nodes in social networks

    Science.gov (United States)

    Rhouma, Delel; Ben Romdhane, Lotfi

    2018-04-01

    The identification of central nodes has been a key problem in the field of social network analysis. In fact, it is a measure that accounts the popularity or the visibility of an actor within a network. In order to capture this concept, various measures, either sample or more elaborate, has been developed. Nevertheless, many of "traditional" measures are not designed to be applicable to huge data. This paper sets out a new node centrality index suitable for large social network. It uses the amount of the neighbors of a node and connections between them to characterize a "pivot" node in the graph. We presented experimental results on real data sets which show the efficiency of our proposal.

  6. Exploring the evolution of node neighborhoods in Dynamic Networks

    Science.gov (United States)

    Orman, Günce Keziban; Labatut, Vincent; Naskali, Ahmet Teoman

    2017-09-01

    Dynamic Networks are a popular way of modeling and studying the behavior of evolving systems. However, their analysis constitutes a relatively recent subfield of Network Science, and the number of available tools is consequently much smaller than for static networks. In this work, we propose a method specifically designed to take advantage of the longitudinal nature of dynamic networks. It characterizes each individual node by studying the evolution of its direct neighborhood, based on the assumption that the way this neighborhood changes reflects the role and position of the node in the whole network. For this purpose, we define the concept of neighborhood event, which corresponds to the various transformations such groups of nodes can undergo, and describe an algorithm for detecting such events. We demonstrate the interest of our method on three real-world networks: DBLP, LastFM and Enron. We apply frequent pattern mining to extract meaningful information from temporal sequences of neighborhood events. This results in the identification of behavioral trends emerging in the whole network, as well as the individual characterization of specific nodes. We also perform a cluster analysis, which reveals that, in all three networks, one can distinguish two types of nodes exhibiting different behaviors: a very small group of active nodes, whose neighborhood undergo diverse and frequent events, and a very large group of stable nodes.

  7. phylo-node: A molecular phylogenetic toolkit using Node.js.

    Science.gov (United States)

    O'Halloran, Damien M

    2017-01-01

    Node.js is an open-source and cross-platform environment that provides a JavaScript codebase for back-end server-side applications. JavaScript has been used to develop very fast and user-friendly front-end tools for bioinformatic and phylogenetic analyses. However, no such toolkits are available using Node.js to conduct comprehensive molecular phylogenetic analysis. To address this problem, I have developed, phylo-node, which was developed using Node.js and provides a stable and scalable toolkit that allows the user to perform diverse molecular and phylogenetic tasks. phylo-node can execute the analysis and process the resulting outputs from a suite of software options that provides tools for read processing and genome alignment, sequence retrieval, multiple sequence alignment, primer design, evolutionary modeling, and phylogeny reconstruction. Furthermore, phylo-node enables the user to deploy server dependent applications, and also provides simple integration and interoperation with other Node modules and languages using Node inheritance patterns, and a customized piping module to support the production of diverse pipelines. phylo-node is open-source and freely available to all users without sign-up or login requirements. All source code and user guidelines are openly available at the GitHub repository: https://github.com/dohalloran/phylo-node.

  8. The Influence of Total Nodes Examined, Number of Positive Nodes, and Lymph Node Ratio on Survival After Surgical Resection and Adjuvant Chemoradiation for Pancreatic Cancer: A Secondary Analysis of RTOG 9704

    Energy Technology Data Exchange (ETDEWEB)

    Showalter, Timothy N. [Department of Radiation Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA (United States); Winter, Kathryn A. [Radiation Therapy Oncology Group, RTOG Statistical Center, Philadelphia, PA (United States); Berger, Adam C., E-mail: adam.berger@jefferson.edu [Department of Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA (United States); Regine, William F. [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (United States); Safran, Howard [Department of Medicine, Miriam Hospital, Brown University Oncology Group, Providence, RI (United States); Hoffman, John P. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Benson, Al B. [Division of Hematology-Oncology, Northwestern University, Chicago, IL (United States); MacDonald, John S. [St. Vincent' s Cancer Care Center, New York, NY (United States); Willett, Christopher G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2011-12-01

    Purpose: Lymph node status is an important predictor of survival in pancreatic cancer. We performed a secondary analysis of Radiation Therapy Oncology Group (RTOG) 9704, an adjuvant chemotherapy and chemoradiation trial, to determine the influence of lymph node factors-number of positive nodes (NPN), total nodes examined (TNE), and lymph node ratio (LNR ratio of NPN to TNE)-on OS and disease-free survival (DFS). Patient and Methods: Eligible patients from RTOG 9704 form the basis of this secondary analysis of lymph node parameters. Actuarial estimates for OS and DFS were calculated using Kaplan-Meier methods. Cox proportional hazards models were performed to evaluate associations of NPN, TNE, and LNR with OS and DFS. Multivariate Cox proportional hazards models were also performed. Results: There were 538 patients enrolled in the RTOG 9704 trial. Of these, 445 patients were eligible with lymph nodes removed. Overall median NPN was 1 (min-max, 0-18). Increased NPN was associated with worse OS (HR = 1.06, p = 0.001) and DFS (HR = 1.05, p = 0.01). In multivariate analyses, both NPN and TNE were associated with OS and DFS. TNE > 12, and >15 were associated with increased OS for all patients, but not for node-negative patients (n = 142). Increased LNR was associated with worse OS (HR = 1.01, p < 0.0001) and DFS (HR = 1.006, p = 0.002). Conclusion: In patients who undergo surgical resection followed by adjuvant chemoradiation, TNE, NPN, and LNR are associated with OS and DFS. This secondary analysis of a prospective, cooperative group trial supports the influence of these lymph node parameters on outcomes after surgery and adjuvant therapy using contemporary techniques.

  9. Semi-automated volumetric analysis of artificial lymph nodes in a phantom study

    International Nuclear Information System (INIS)

    Fabel, M.; Biederer, J.; Jochens, A.; Bornemann, L.; Soza, G.; Heller, M.; Bolte, H.

    2011-01-01

    Purpose: Quantification of tumour burden in oncology requires accurate and reproducible image evaluation. The current standard is one-dimensional measurement (e.g. RECIST) with inherent disadvantages. Volumetric analysis is discussed as an alternative for therapy monitoring of lung and liver metastases. The aim of this study was to investigate the accuracy of semi-automated volumetric analysis of artificial lymph node metastases in a phantom study. Materials and methods: Fifty artificial lymph nodes were produced in a size range from 10 to 55 mm; some of them enhanced using iodine contrast media. All nodules were placed in an artificial chest phantom (artiCHEST ® ) within different surrounding tissues. MDCT was performed using different collimations (1–5 mm) at varying reconstruction kernels (B20f, B40f, B60f). Volume and RECIST measurements were performed using Oncology Software (Siemens Healthcare, Forchheim, Germany) and were compared to reference volume and diameter by calculating absolute percentage errors. Results: The software performance allowed a robust volumetric analysis in a phantom setting. Unsatisfying segmentation results were frequently found for native nodules within surrounding muscle. The absolute percentage error (APE) for volumetric analysis varied between 0.01 and 225%. No significant differences were seen between different reconstruction kernels. The most unsatisfactory segmentation results occurred in higher slice thickness (4 and 5 mm). Contrast enhanced lymph nodes showed better segmentation results by trend. Conclusion: The semi-automated 3D-volumetric analysis software tool allows a reliable and convenient segmentation of artificial lymph nodes in a phantom setting. Lymph nodes adjacent to tissue of similar density cause segmentation problems. For volumetric analysis of lymph node metastases in clinical routine a slice thickness of ≤3 mm and a medium soft reconstruction kernel (e.g. B40f for Siemens scan systems) may be a suitable

  10. Node-making process in network meta-analysis of nonpharmacological treatment are poorly reported.

    Science.gov (United States)

    James, Arthur; Yavchitz, Amélie; Ravaud, Philippe; Boutron, Isabelle

    2018-05-01

    To identify methods to support the node-making process in network meta-analyses (NMAs) of nonpharmacological treatments. We proceeded in two stages. First, we conducted a literature review of guidelines and methodological articles about NMAs to identify methods proposed to lump interventions into nodes. Second, we conducted a systematic review of NMAs of nonpharmacological treatments to extract methods used by authors to support their node-making process. MEDLINE and Google Scholar were searched to identify articles assessing NMA guidelines or methodology intended for NMA authors. MEDLINE, CENTRAL, and EMBASE were searched to identify reports of NMAs including at least one nonpharmacological treatment. Both searches involved articles available from database inception to March 2016. From the methodological review, we identified and extracted methods proposed to lump interventions into nodes. From the systematic review, the reporting of the network was assessed as long as the method described supported the node-making process. Among the 116 articles retrieved in the literature review, 12 (10%) discussed the concept of lumping or splitting interventions in NMAs. No consensual method was identified during the methodological review, and expert consensus was the only method proposed to support the node-making process. Among 5187 references for the systematic review, we included 110 reports of NMAs published between 2007 and 2016. The nodes were described in the introduction section of 88 reports (80%), which suggested that the node content might have been a priori decided before the systematic review. Nine reports (8.1%) described a specific process or justification to build nodes for the network. Two methods were identified: (1) fit a previously published classification and (2) expert consensus. Despite the importance of NMA in the delivery of evidence when several interventions are available for a single indication, recommendations on the reporting of the node

  11. Clinical value of sentinel lymph node diagnostics in head and neck cancer

    International Nuclear Information System (INIS)

    Kampen, W.U.; Hoeft, S.; Maune, S.

    2006-01-01

    The concept of the so-called sentinel lymph node (SLN), being the first node draining a malignant tumor and thus carrying the highest risk of metastatic disease, is already frequently applied in patients suffering from malignant melanoma and breast cancer. It is the aim of this concept, to reduce postoperative morbidity by omitting a conventional lymph node dissection if the SLN is proven to be free of any tumor cells. First clinical studies showed promising results also in patients with head and neck cancer. However, both the anatomical localization of the primary tumor and the very complex lymphatic, frequently bilateral drainage pattern may lead to significant methodological problems. Besides a skilful intraoperative usage of the gamma probe, the precise preoperative staging of the respective patient for determination of the N0 status and the assiduous histopathological analysis of the excised SLN are extremely important to reach a maximum of sensitivity in this clinical setting. This paper summarizes the data published on the SLN concept in patients with head and neck cancer, describes the several methodological aspects of labeling the SLN with radiocolloides and reviews the today's impact of the SLN method in clinical routine. (orig.)

  12. Instant node package module

    CERN Document Server

    Ali, Juzer

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. A practical exploration of the lifecycle of creating node modules as well as learning all of the top features that npm has to offer.Intended for readers who want to create their first node.js modules. The programming paradigm of JavaScript is not covered so a foundation in these concepts would be beneficial.

  13. Clearance Analysis of Node 3 Aft CBM to the Stowed FGB Solar Array

    Science.gov (United States)

    Liddle, Donn

    2014-01-01

    In early 2011, the ISS Vehicle Configuration Office began considering the relocation of the Permanent Multipurpose Module (PMM) to the aft facing Common Berthing Mechanism (CBM) on Node 3 to open a berthing location for visiting vehicles on the Node 1 nadir CBM. In this position, computer-aided design (CAD) models indicated that the aft end of the PMM would be only a few inches from the stowed Functional Cargo Block (FGB) port solar array. To validate the CAD model clearance analysis, in the late summer of 2011 the Image Science and Analysis Group (ISAG) was asked to determine the true geometric relationship between the on-orbit aft facing Node 3 CBM and the FGB port solar array. The desired measurements could be computed easily by photogrammetric analysis if current imagery of the ISS hardware were obtained. Beginning in the fall of 2011, ISAG used the Dynamic Onboard Ubiquitous Graphics (DOUG) program to design a way to acquire imagery of the aft face of Node 3, the aft end-cone of Node 1, the port side of pressurized mating adapter 1 (PMA1), and the port side of the FGB out to the tip of the port solar array using cameras on the Space Station Remote Manipulator System (SSRMS). This was complicated by the need to thread the SSRMS under the truss, past Node 3 and the Cupola, and into the space between the aft side of Node 3 and the FGB solar array to acquire more than 100 images from multiple positions. To minimize the number of SSRMS movements, the Special Purpose Dexterous Manipulator (SPDM) would be attached to the SSRMS. This would make it possible to park the SPDM in one position and acquire multiple images by changing the viewing orientation of the SPDM body cameras using the pan/tilt units on which the cameras are mounted. Using this implementation concept, ISAG identified four SSRMS/SPDM positions from which all of the needed imagery could be acquired. Based on a photogrammetric simulation, it was estimated that the location of the FGB solar array could be

  14. Improving Smart Home Concept with the Internet of Things Concept Using RaspberryPi and NodeMCU

    Science.gov (United States)

    Amri, Yasirli; Andri Setiawan, Mukhammad

    2018-03-01

    The Internet of things (IoT) is getting more tractions in recent years. One of the usage scenario of IoT is smart home. Smart home basically provides home automation for installed devices at home such as thermostat, lighting, air conditioning, etc and allows devices connected to the Internet to be monitored and controlled remotely by user. However many studies on smart home concept focusing only on few main features. They still lack of important usage of IoT i.e. providing energy efficiency, energy monitoring, dealing with security, and managing privacy. This paper proposes a smart home system with RaspberryPi and NodeMCU as the backend that not only serves as home automation and merely a switch replacement, but to also record and report important things to the owner of the house e.g. when someone trespasses the house (security perimeter), or to report the calculation of how much money has been spent in consuming the electrical appliances. We successfully examine our proposed system in a real life working scenario. The communication between user and the system is done using Telegram Bot.

  15. Quantitative analysis and prediction of regional lymph node status in rectal cancer based on computed tomography imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Chunyan; Liu, Lizhi; Li, Li [Sun Yat-sen University, State Key Laboratory of Oncology in Southern China, Imaging Diagnosis and Interventional Center, Cancer Center, Guangzhou, Guangdong (China); Cai, Hongmin; Tian, Haiying [Sun Yat-Sen University, Department of Automation, School of Science Information and Technology, Guangzhou (China); Li, Liren [Sun Yat-sen University, State Key Laboratory of Oncology in Southern China, Department of Abdominal (colon and rectal) Surgery, Cancer Center, Guangzhou (China)

    2011-11-15

    To quantitatively evaluate regional lymph nodes in rectal cancer patients by using an automated, computer-aided approach, and to assess the accuracy of this approach in differentiating benign and malignant lymph nodes. Patients (228) with newly diagnosed rectal cancer, confirmed by biopsy, underwent enhanced computed tomography (CT). Patients were assigned to the benign node or malignant node group according to histopathological analysis of node samples. All CT-detected lymph nodes were segmented using the edge detection method, and seven quantitative parameters of each node were measured. To increase the prediction accuracy, a hierarchical model combining the merits of the support and relevance vector machines was proposed to achieve higher performance. Of the 220 lymph nodes evaluated, 125 were positive and 95 were negative for metastases. Fractal dimension obtained by the Minkowski box-counting approach was higher in malignant nodes than in benign nodes, and there was a significant difference in heterogeneity between metastatic and non-metastatic lymph nodes. The overall performance of the proposed model is shown to have accuracy as high as 88% using morphological characterisation of lymph nodes. Computer-aided quantitative analysis can improve the prediction of node status in rectal cancer. (orig.)

  16. Sentinel lymph node detection with Tc-99m tin colloids in patients with esophagogastric cancer

    International Nuclear Information System (INIS)

    Yasuda, Seiei; Shimada, Hideo; Chino, Osamu

    2003-01-01

    The aim of this study was to determine by radioisotope use whether the sentinel lymph node concept is applicable to esophagogastric cancers. In addition, we examined radioactivities of hot nodes and compared them with the sensitivity of a gamma probe. The subjects were 44 patients, 23 with esophageal cancer and 21 with gastric cancer. The day before surgery, patients underwent endoscopic submucosal injection of 184 MBq of Tc-99m tin colloids into sites surrounding the tumor. Radioisotope activities of lymph nodes dissected at surgery were measured with a well-typed gamma detector and each lymph node was categorized as a hot or cold node. Histopathology of the lymph nodes was examined by hematoxylin and eosin staining. Radioisotope activities and histopathological results were compared to determine whether radioisotope flow reflects lymphatic flow to regional lymph nodes. The sensitivity of a gamma probe was measured in a laboratory study and the relation between the radioisotope activities of hot nodes and the detection sensitivity of the gamma probe was examined. Histopathological examination revealed lymph node metastasis in 18 of the 44 patients. In 15 of these 18 patients, metastatic foci were recognized in at least one hot node. Subsequent analysis was performed on the 36 patients in whom tumor invasion was confined to the muscle layer and in whom endoscopic clippings had not been applied. Lymph node metastases were observed in 12 of these 36 patients. In these 12 patients, at least one hot node was positive for metastasis. The laboratory study revealed that the gamma probe was able to detect radioisotope activities of ≥0.02μCi. Thirty-two of 63 (51%) esophageal cancer hot nodes and 16 of 86 (19%) gastric cancer hot nodes showed radioisotope activities below the detection sensitivity of the gamma probe. The sentinel lymph node concept is applicable to patients with esophageal and gastric cancers; however, further studies are necessary to identify hot nodes

  17. Related Drupal Nodes Block

    NARCIS (Netherlands)

    Van der Vegt, Wim

    2010-01-01

    Related Drupal Nodes Block This module exposes a block that uses Latent Semantic Analysis (Lsa) internally to suggest three nodes that are relevant to the node a user is viewing. This module performs three tasks. 1) It periodically indexes a Drupal site and generates a Lsa Term Document Matrix.

  18. System for Malicious Node Detection in IPv6-Based Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Kresimir Grgic

    2016-01-01

    Full Text Available The trend of implementing the IPv6 into wireless sensor networks (WSNs has recently occurred as a consequence of a tendency of their integration with other types of IP-based networks. The paper deals with the security aspects of these IPv6-based WSNs. A brief analysis of security threats and attacks which are present in the IPv6-based WSN is given. The solution to an adaptive distributed system for malicious node detection in the IPv6-based WSN is proposed. The proposed intrusion detection system is based on distributed algorithms and a collective decision-making process. It introduces an innovative concept of probability estimation for malicious behaviour of sensor nodes. The proposed system is implemented and tested through several different scenarios in three different network topologies. Finally, the performed analysis showed that the proposed system is energy efficient and has a good capability to detect malicious nodes.

  19. A mathematical prediction model incorporating molecular subtype for risk of non-sentinel lymph node metastasis in sentinel lymph node-positive breast cancer patients: a retrospective analysis and nomogram development.

    Science.gov (United States)

    Wang, Na-Na; Yang, Zheng-Jun; Wang, Xue; Chen, Li-Xuan; Zhao, Hong-Meng; Cao, Wen-Feng; Zhang, Bin

    2018-04-25

    Molecular subtype of breast cancer is associated with sentinel lymph node status. We sought to establish a mathematical prediction model that included breast cancer molecular subtype for risk of positive non-sentinel lymph nodes in breast cancer patients with sentinel lymph node metastasis and further validate the model in a separate validation cohort. We reviewed the clinicopathologic data of breast cancer patients with sentinel lymph node metastasis who underwent axillary lymph node dissection between June 16, 2014 and November 16, 2017 at our hospital. Sentinel lymph node biopsy was performed and patients with pathologically proven sentinel lymph node metastasis underwent axillary lymph node dissection. Independent risks for non-sentinel lymph node metastasis were assessed in a training cohort by multivariate analysis and incorporated into a mathematical prediction model. The model was further validated in a separate validation cohort, and a nomogram was developed and evaluated for diagnostic performance in predicting the risk of non-sentinel lymph node metastasis. Moreover, we assessed the performance of five different models in predicting non-sentinel lymph node metastasis in training cohort. Totally, 495 cases were eligible for the study, including 291 patients in the training cohort and 204 in the validation cohort. Non-sentinel lymph node metastasis was observed in 33.3% (97/291) patients in the training cohort. The AUC of MSKCC, Tenon, MDA, Ljubljana, and Louisville models in training cohort were 0.7613, 0.7142, 0.7076, 0.7483, and 0.671, respectively. Multivariate regression analysis indicated that tumor size (OR = 1.439; 95% CI 1.025-2.021; P = 0.036), sentinel lymph node macro-metastasis versus micro-metastasis (OR = 5.063; 95% CI 1.111-23.074; P = 0.036), the number of positive sentinel lymph nodes (OR = 2.583, 95% CI 1.714-3.892; P model based on the results of multivariate analysis was established to predict the risk of non

  20. Mathematical Analysis of Vehicle Delivery Scale of Bike-Sharing Rental Nodes

    Science.gov (United States)

    Zhai, Y.; Liu, J.; Liu, L.

    2018-04-01

    Aiming at the lack of scientific and reasonable judgment of vehicles delivery scale and insufficient optimization of scheduling decision, based on features of the bike-sharing usage, this paper analyses the applicability of the discrete time and state of the Markov chain, and proves its properties to be irreducible, aperiodic and positive recurrent. Based on above analysis, the paper has reached to the conclusion that limit state (steady state) probability of the bike-sharing Markov chain only exists and is independent of the initial probability distribution. Then this paper analyses the difficulty of the transition probability matrix parameter statistics and the linear equations group solution in the traditional solving algorithm of the bike-sharing Markov chain. In order to improve the feasibility, this paper proposes a "virtual two-node vehicle scale solution" algorithm which considered the all the nodes beside the node to be solved as a virtual node, offered the transition probability matrix, steady state linear equations group and the computational methods related to the steady state scale, steady state arrival time and scheduling decision of the node to be solved. Finally, the paper evaluates the rationality and accuracy of the steady state probability of the proposed algorithm by comparing with the traditional algorithm. By solving the steady state scale of the nodes one by one, the proposed algorithm is proved to have strong feasibility because it lowers the level of computational difficulty and reduces the number of statistic, which will help the bike-sharing companies to optimize the scale and scheduling of nodes.

  1. MATHEMATICAL ANALYSIS OF VEHICLE DELIVERY SCALE OF BIKE-SHARING RENTAL NODES

    Directory of Open Access Journals (Sweden)

    Y. Zhai

    2018-04-01

    Full Text Available Aiming at the lack of scientific and reasonable judgment of vehicles delivery scale and insufficient optimization of scheduling decision, based on features of the bike-sharing usage, this paper analyses the applicability of the discrete time and state of the Markov chain, and proves its properties to be irreducible, aperiodic and positive recurrent. Based on above analysis, the paper has reached to the conclusion that limit state (steady state probability of the bike-sharing Markov chain only exists and is independent of the initial probability distribution. Then this paper analyses the difficulty of the transition probability matrix parameter statistics and the linear equations group solution in the traditional solving algorithm of the bike-sharing Markov chain. In order to improve the feasibility, this paper proposes a "virtual two-node vehicle scale solution" algorithm which considered the all the nodes beside the node to be solved as a virtual node, offered the transition probability matrix, steady state linear equations group and the computational methods related to the steady state scale, steady state arrival time and scheduling decision of the node to be solved. Finally, the paper evaluates the rationality and accuracy of the steady state probability of the proposed algorithm by comparing with the traditional algorithm. By solving the steady state scale of the nodes one by one, the proposed algorithm is proved to have strong feasibility because it lowers the level of computational difficulty and reduces the number of statistic, which will help the bike-sharing companies to optimize the scale and scheduling of nodes.

  2. A fourteen-year review of radical cystectomy for transitional cell carcinoma demonstrating the usefulness of the concept of lymph node density

    Directory of Open Access Journals (Sweden)

    Chi W. Cheng

    2006-10-01

    Full Text Available OBJECTIVE: We studied the long-term outcome of radical cystectomy for transitional cell carcinoma and evaluated prognostic factors for disease specific survival. MATERIALS AND METHODS: A retrospective review was carried out for all cystectomies performed for transitional cell carcinoma between 1989 and 2002. Disease specific survival was correlated to patient, pathological and operative factors as well as to adjuvant therapy. RESULTS: Of the 133 cystectomies included, 100 were male and 33 were female patients. The median age was 69 years (range 43 to 86. The median follow up was 20 months (range 0 to 158. With univariate analysis, pT stage, N stage, lymph node density, carcinoma in-situ, surgical margin and post-operative radiotherapy to distant metastasis were predictive of disease specific survival. On the other hand, with multivariate analysis, only pT stage, lymph node density and post-operative radiotherapy to distant metastasis were predictive of disease specific survival. Within the group of node positive disease, lymph node density also predicted disease specific survival with both univariate and multivariate analyses. Patients with lymph node density 20% or below showed better disease specific survival. CONCLUSIONS: pT stage and lymph node density were found to be the most important predictive factors for disease specific survival after cystectomy in the Asian population.

  3. Sentinel lymph node biopsy in breast cancer and melanoma

    NARCIS (Netherlands)

    Doting, Meintje Hylkje Edwina

    2007-01-01

    Summary and conclusions In the introduction, a short overview of the development of the sentinel lymph node biopsy concept is presented. In addition to melanoma and breast cancer, the usefulness of sentinel lymph node biopsy as a surgical assessment method for squamous cell carcinoma of penis and

  4. Node-based finite element method for large-scale adaptive fluid analysis in parallel environments

    International Nuclear Information System (INIS)

    Toshimitsu, Fujisawa; Genki, Yagawa

    2003-01-01

    In this paper, a FEM-based (finite element method) mesh free method with a probabilistic node generation technique is presented. In the proposed method, all computational procedures, from the mesh generation to the solution of a system of equations, can be performed fluently in parallel in terms of nodes. Local finite element mesh is generated robustly around each node, even for harsh boundary shapes such as cracks. The algorithm and the data structure of finite element calculation are based on nodes, and parallel computing is realized by dividing a system of equations by the row of the global coefficient matrix. In addition, the node-based finite element method is accompanied by a probabilistic node generation technique, which generates good-natured points for nodes of finite element mesh. Furthermore, the probabilistic node generation technique can be performed in parallel environments. As a numerical example of the proposed method, we perform a compressible flow simulation containing strong shocks. Numerical simulations with frequent mesh refinement, which are required for such kind of analysis, can effectively be performed on parallel processors by using the proposed method. (authors)

  5. Node-based finite element method for large-scale adaptive fluid analysis in parallel environments

    Energy Technology Data Exchange (ETDEWEB)

    Toshimitsu, Fujisawa [Tokyo Univ., Collaborative Research Center of Frontier Simulation Software for Industrial Science, Institute of Industrial Science (Japan); Genki, Yagawa [Tokyo Univ., Department of Quantum Engineering and Systems Science (Japan)

    2003-07-01

    In this paper, a FEM-based (finite element method) mesh free method with a probabilistic node generation technique is presented. In the proposed method, all computational procedures, from the mesh generation to the solution of a system of equations, can be performed fluently in parallel in terms of nodes. Local finite element mesh is generated robustly around each node, even for harsh boundary shapes such as cracks. The algorithm and the data structure of finite element calculation are based on nodes, and parallel computing is realized by dividing a system of equations by the row of the global coefficient matrix. In addition, the node-based finite element method is accompanied by a probabilistic node generation technique, which generates good-natured points for nodes of finite element mesh. Furthermore, the probabilistic node generation technique can be performed in parallel environments. As a numerical example of the proposed method, we perform a compressible flow simulation containing strong shocks. Numerical simulations with frequent mesh refinement, which are required for such kind of analysis, can effectively be performed on parallel processors by using the proposed method. (authors)

  6. Search for all MCs in networks with unreliable nodes and arcs

    International Nuclear Information System (INIS)

    Yeh, W.-C.

    2003-01-01

    A simple method is proposed to search for all minimal cutsets (MCs ) for imperfect networks reliability subject to both arc and node failures under the condition that all of the MCs in the network with perfect nodes are given in advance. The proposed method does not require re-enumeration for all of the MCs for additional node failure consideration. All of the MC candidates found in the proposed algorithm are actual MCs without any need for further verification. This algorithm is more effective than the existing algorithm in which every MC candidate is not verified as a MC. No identical MCs are found using the proposed algorithm, which does not duplicate MCs and is more efficient than the existing methods. Only simple concepts are used to implement the proposed algorithm, which makes it easier to understand and implement. With considering unreliable nodes, the proposed method is also more realistic and valuable for reliability analysis in an existing network. The correctness of the proposed algorithm will be analyzed and proven. One example is used to illustrate how all MCs are generated in a network with arc and node failures solved using the proposed algorithm

  7. Quantitative Concept Analysis

    NARCIS (Netherlands)

    Pavlovic, Dusko; Domenach, Florent; Ignatov, Dmitry I.; Poelmans, Jonas

    2012-01-01

    Formal Concept Analysis (FCA) begins from a context, given as a binary relation between some objects and some attributes, and derives a lattice of concepts, where each concept is given as a set of objects and a set of attributes, such that the first set consists of all objects that satisfy all

  8. Differentiation of benign and malignant lymph nodes with ADC value on diffusion MR: a Meta-analysis

    International Nuclear Information System (INIS)

    Long Miaomiao; Liu Lihua; Gao Guangfeng; Chen Lihua; Shen Wen; Qi Ji

    2012-01-01

    Objective: To summarize the diagnostic efficacy of ADC value for differentiation of benign and malignant lymph nodes on diffusion MRI with Meta-analysis. Methods: Published papers on differentiation of benign and malignant lymph nodes with ADC value were searched and reviewed. Quality evaluation was performed for the eligible papers before data extraction.Test for heterogeneity was performed first, then appropriate model was selected to calculate the weighted mean difference, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio,pretest and posttest probability. The potential of ADC value for differentiation of benign and malignant lymph nodes was assessed qualitatively and quantitatively. Results: Fifteen papers including 735 cases and 1963 lymph nodes were selected. According to Meta-regression analysis, subgroup analysis and robust analysis, two studies with benign lymph nodes in patients with benign lesion and one study using chemical shift saturation technique were excluded because of their impact on the robustness of the pooled results. The weighted mean difference (WMD) between malignant and benign lymph nodes was -0.355 × 10 -3 mm 2 /s [95% confidence interval (CI):-0.423 ×10-3- -0.288 × 10 -3 mm 2 /s]. Although the cutoff of ADC value for differentiation in each study was different, the diagnostic efficacy was stable, the pooled sensitivity,specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under summarized receiver operator's curve were 0.87 (95% CI: 0.79-0.92), 0.87 (95% CI: 0.82-0.90), 6.5 (95% CI: 4.7-9.2), 0.15 (95% CI: 0.09-0.25), 43 (95% CI: 21-87), 0.93 (95% CI: 0.90-0.95). The posttest malignancy probability of benign lymph node indicated by ADC was 6%, while that of malignant lymph node was 72%. Conclusion: The ADC value can be used to differentiate benign and malignant lymph nodes with good sensitivity and specificity noninvasively. (authors)

  9. Methodology of sentinel node detection

    International Nuclear Information System (INIS)

    Maublant, J.

    2000-01-01

    The isotopic localisation of the sentinel node, i.e., the first functional lymph node in a tumor basin, is probably the fastest growing field ever experienced in nuclear medicine. Although based on the simple concept of the lymphatic migration of Tc-labeled colloids, the choice of the optimal technique remains controversial. We review and discuss the role of the colloids, of the site of injection, of the injected volume, of early imaging and of the colorimetric approach. Initially applied to melanoma and breast cancer, the sentinel node detection is now tested in other types of cancer such as lung, colon and prostate. It could become one of the leading tools in minimally invasive surgical oncology. The nuclear medicine physician has to remain aware of the rapid evolutions in this field in order to be able to answer to a rapidly growing demand. (author)

  10. Critical nodes in signalling pathways

    DEFF Research Database (Denmark)

    Taniguchi, Cullen M; Emanuelli, Brice; Kahn, C Ronald

    2006-01-01

    Physiologically important cell-signalling networks are complex, and contain several points of regulation, signal divergence and crosstalk with other signalling cascades. Here, we use the concept of 'critical nodes' to define the important junctions in these pathways and illustrate their unique role...... using insulin signalling as a model system....

  11. Sentinel lymph node imaging in breast cancer

    International Nuclear Information System (INIS)

    Kim, Byung Tae

    1999-01-01

    Currently, dissection of the axillary or regional lymph nodes is considered the standard staging procedure in breast cancer. However, accumulating evidence is becoming available that the sentinel node concept may provide the same or even better staging information. In the case of melanoma, it is proven that the histological characteristics of the sentinel node reflect the histological characteristics of the distal part of the lymphatic basin. Morbidity can be reduced significantly by the use of sentinel node dissection as several authors have reported successful introduction of this technique into clinical practice. But in breast cancer patients, there are significant differences in practice relating to the technology, such as radiopharmaceuticals, injection sites, volume of injectate, combination with vital blue dye, preoperative lymphoscintigraphy, etc. Valuable reports on these topics appeared in recent journals. This review is a summary of those reports for nuclear physicians interested in sentinel node detection by lymphoscintigraphy in breast cancer patients

  12. Sentinel lymph node dissection only versus complete axillary lymph node dissection in early invasive breast cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Glechner, Anna; Wöckel, Achim; Gartlehner, Gerald; Thaler, Kylie; Strobelberger, Michaela; Griebler, Ursula; Kreienberg, Rolf

    2013-03-01

    The Z0011-study, a landmark randomised controlled trial (RCT) challenged the benefits of complete axillary lymph node dissection (ALND) compared with sentinel lymph node dissection only (SLND) in breast cancer patients with positive sentinel nodes. The study, however, has been criticised for lack of power and low applicability. The aim of this review was to systematically assess the evidence on the comparative benefits and harms of ALND versus SLND for sentinel node positive breast cancer patients. We systematically searched PubMed, Embase, the Cochrane Library, and reference lists of pertinent review articles from January 2006 to August 2011. We dually reviewed the literature and rated the risk of bias of each study. For effectiveness, we included RCTs and observational studies of at least 1 year follow-up. In addition, we considered studies conducted in sentinel node-negative women to assess the risk of harms. If data were sufficient, we conducted random effects meta-analysis of outcomes of interest. Meta-analysis of three studies with 50,120 patients indicated similar 5-year survival and regional recurrence rates between patients treated with ALND or SLND, although prognostic tumour characteristics varied among the 3 study-populations. Results from 6 studies on more than 11,500 patients reported a higher risk for harms for ALND than SLND. Long-term evidence on pertinent health outcomes is missing. The available evidence indicates that for some women with early invasive breast cancer SLND appears to be a justifiable alternative to ALND. Surgeons need to discuss advantages and disadvantages of both approaches with their patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Clinical reasoning: concept analysis.

    Science.gov (United States)

    Simmons, Barbara

    2010-05-01

    This paper is a report of a concept analysis of clinical reasoning in nursing. Clinical reasoning is an ambiguous term that is often used synonymously with decision-making and clinical judgment. Clinical reasoning has not been clearly defined in the literature. Healthcare settings are increasingly filled with uncertainty, risk and complexity due to increased patient acuity, multiple comorbidities, and enhanced use of technology, all of which require clinical reasoning. Data sources. Literature for this concept analysis was retrieved from several databases, including CINAHL, PubMed, PsycINFO, ERIC and OvidMEDLINE, for the years 1980 to 2008. Rodgers's evolutionary method of concept analysis was used because of its applicability to concepts that are still evolving. Multiple terms have been used synonymously to describe the thinking skills that nurses use. Research in the past 20 years has elucidated differences among these terms and identified the cognitive processes that precede judgment and decision-making. Our concept analysis defines one of these terms, 'clinical reasoning,' as a complex process that uses cognition, metacognition, and discipline-specific knowledge to gather and analyse patient information, evaluate its significance, and weigh alternative actions. This concept analysis provides a middle-range descriptive theory of clinical reasoning in nursing that helps clarify meaning and gives direction for future research. Appropriate instruments to operationalize the concept need to be developed. Research is needed to identify additional variables that have an impact on clinical reasoning and what are the consequences of clinical reasoning in specific situations.

  14. A concept analysis of befriending.

    Science.gov (United States)

    Balaam, Marie-Clare

    2015-01-01

    To report an analysis of the concept of befriending. Befriending is an intervention used in a range of nursing, health and social care settings to provide support for individuals who are socially isolated or lack social support. However, in many cases befriending and its impact remains poorly understood and under researched. Concept analysis provides clarification of the concept and basis for further research and development. Concept analysis. AMED, Psyc Articles, Psych Info, Medline, MedlinePlus, Social Science Index and CINHAL databases were searched for literature published between 1993-2013 using the search term Befriending. Walker and Avant's method of concept analysis was chosen. This combined with insights from Risjord's work produced a theoretical concept analysis which focused on the concept in peer reviewed academic literature. There are currently several ways the mechanisms of befriending and its effects on individuals and communities are understood. It is possible however to identify key attributes which define the concept and differentiate it from related concepts, such as peer support and mentoring. Key attributes are that it is an organised intervention, involving the creation of an emotionally connected friend-like relationship, where there is a negotiation of power. This concept analysis has clarified current understandings and uses of befriending. It provides the basis for widening the focus of research into the effectiveness and impact of befriending on those who are befriended, those who befriend and the communities where befriending takes place. © 2014 John Wiley & Sons Ltd.

  15. Fractal dimension analysis of malignant and benign endobronchial ultrasound nodes

    International Nuclear Information System (INIS)

    Fiz, José Antonio; Monte-Moreno, Enrique; Andreo, Felipe; Auteri, Santiago José; Sanz-Santos, José; Serra, Pere; Bonet, Gloria; Castellà, Eva; Manzano, Juan Ruiz

    2014-01-01

    Endobronchial ultrasonography (EBUS) has been applied as a routine procedure for the diagnostic of hiliar and mediastinal nodes. The authors assessed the relationship between the echographic appearance of mediastinal nodes, based on endobronchial ultrasound images, and the likelihood of malignancy. The images of twelve malignant and eleven benign nodes were evaluated. A previous processing method was applied to improve the quality of the images and to enhance the details. Texture and morphology parameters analyzed were: the image texture of the echographies and a fractal dimension that expressed the relationship between area and perimeter of the structures that appear in the image, and characterizes the convoluted inner structure of the hiliar and mediastinal nodes. Processed images showed that relationship between log perimeter and log area of hilar nodes was lineal (i.e. perimeter vs. area follow a power law). Fractal dimension was lower in the malignant nodes compared with non-malignant nodes (1.47(0.09), 1.53(0.10) mean(SD), Mann–Whitney U test p < 0.05)). Fractal dimension of ultrasonographic images of mediastinal nodes obtained through endobronchial ultrasound differ in malignant nodes from non-malignant. This parameter could differentiate malignat and non-malignat mediastinic and hiliar nodes

  16. Self-care Concept Analysis in Cancer Patients: An Evolutionary Concept Analysis

    Science.gov (United States)

    Hasanpour-Dehkordi, Ali

    2016-01-01

    Background: Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. Materials and Methods: We used Rodgers’ evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis, and a PhD thesis were selected, examined, and analyzed in-depth. Two experts checked the process of analysis and monitored and reviewed the articles. Results: The analysis showed that self-care concept is determined by four attributes of education, interaction, self-control, and self-reliance. Three types of antecedents in the present study were client-related (self-efficacy, self-esteem), system-related (adequate sources, social networks, and cultural factors), and healthcare professionals-related (participation). Conclusion: The self-care concept has considerably evolved among patients with chronic diseases, particularly cancer, over the past 35 years, and nurses have managed to enhance their knowledge about self-care remarkably for the clients so that the nurses in healthcare teams have become highly efficient and able to assume the responsibility for self-care teams. PMID:27803559

  17. Self-care Concept Analysis in Cancer Patients: An Evolutionary Concept Analysis.

    Science.gov (United States)

    Hasanpour-Dehkordi, Ali

    2016-01-01

    Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. We used Rodgers' evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis, and a PhD thesis were selected, examined, and analyzed in-depth. Two experts checked the process of analysis and monitored and reviewed the articles. The analysis showed that self-care concept is determined by four attributes of education, interaction, self-control, and self-reliance. Three types of antecedents in the present study were client-related (self-efficacy, self-esteem), system-related (adequate sources, social networks, and cultural factors), and healthcare professionals-related (participation). The self-care concept has considerably evolved among patients with chronic diseases, particularly cancer, over the past 35 years, and nurses have managed to enhance their knowledge about self-care remarkably for the clients so that the nurses in healthcare teams have become highly efficient and able to assume the responsibility for self-care teams.

  18. Transaction processing in the common node of a distributed function laboratory computer system

    International Nuclear Information System (INIS)

    Stubblefield, F.W.; Dimmler, D.G.

    1975-01-01

    A computer network architecture consisting of a common node processor for managing peripherals and files and a number of private node processors for laboratory experiment control is briefly reviewed. Central to the problem of private node-common node communication is the concept of a transaction. The collection of procedures and the data structure associated with a transaction are described. The common node properties assigned to a transaction and procedures required for its complete processing are discussed. (U.S.)

  19. Lymph Node Micrometastases are Associated with Worse Survival in Patients with Otherwise Node-Negative Hilar Cholangiocarcinoma.

    Science.gov (United States)

    Mantel, Hendrik T J; Wiggers, Jim K; Verheij, Joanne; Doff, Jan J; Sieders, Egbert; van Gulik, Thomas M; Gouw, Annette S H; Porte, Robert J

    2015-12-01

    Lymph node metastases on routine histology are a strong negative predictor for survival after resection of hilar cholangiocarcinoma. Additional immunohistochemistry can detect lymph node micrometastases in patients who are otherwise node negative, but the prognostic value is unsure. The objective of this study was to assess the effect on survival of immunohistochemically detected lymph node micrometastases in patients with node-negative (pN0) hilar cholangiocarcinoma on routine histology. Between 1990 and 2010, a total of 146 patients underwent curative-intent resection of hilar cholangiocarcinoma with regional lymphadenectomy at two university medical centers in the Netherlands. Ninety-one patients (62 %) without lymph node metastases at routine histology were included. Micrometastases were identified by multiple sectioning of all lymph nodes and additional immunostaining with an antibody against cytokeratin 19 (K19). The association with overall survival was assessed in univariable and multivariable analysis. Median follow-up was 48 months. Micrometastases were identified in 16 (5 %) of 324 lymph nodes, corresponding to 11 (12 %) of 91 patients. There were no differences in clinical variables between K19 lymph node-positive and -negative patients. Five-year survival rates in patients with lymph node micrometastases were significantly lower compared to patients without micrometastases (27 vs. 54 %, P = 0.01). Multivariable analysis confirmed micrometastases as an independent prognostic factor for survival (adjusted Hazard ratio 2.4, P = 0.02). Lymph node micrometastases are associated with worse survival after resection of hilar cholangiocarcinoma. Immunohistochemical detection of lymph node micrometastases leads to better staging of patients who were initially diagnosed with node-negative (pN0) hilar cholangiocarcinoma on routine histology.

  20. Autonomous solutions for powering wireless sensor nodes in rivers

    Science.gov (United States)

    Kamenar, E.; Maćešić, S.; Gregov, G.; Blažević, D.; Zelenika, S.; Marković, K.; Glažar, V.

    2015-05-01

    There is an evident need for monitoring pollutants and/or other conditions in river flows via wireless sensor networks. In a typical wireless sensor network topography, a series of sensor nodes is to be deployed in the environment, all wirelessly connected to each other and/or their gateways. Each sensor node is composed of active electronic devices that have to be constantly powered. In general, batteries can be used for this purpose, but problems may occur when they have to be replaced. In the case of large networks, when sensor nodes can be placed in hardly accessible locations, energy harvesting can thus be a viable powering solution. The possibility to use three different small-scale river flow energy harvesting principles is hence thoroughly studied in this work: a miniaturized underwater turbine, a so-called `piezoelectric eel' and a hybrid turbine solution coupled with a rigid piezoelectric beam. The first two concepts are then validated experimentally in laboratory as well as in real river conditions. The concept of the miniaturised hydro-generator is finally embedded into the actual wireless sensor node system and its functionality is confirmed.

  1. Cognitive Scout Node for Communication in Disaster Scenarios

    Directory of Open Access Journals (Sweden)

    Rajesh K. Sharma

    2012-01-01

    highly desired to manage unexpected situations that may happen in a disaster scenario. The scout node proposed in this paper is an extended concept based on a powerful CR node in a heterogeneous nodes environment which takes a leading role for highly flexible, fast, and robust establishment of cooperative wireless links in a disaster situation. This node should have two components: one is a passive sensor unit that collects and stores the technical knowledge about the electromagnetic environment in a data processing unit so-called “radio environment map” in the form of a dynamically updated database, and other is an active transceiver unit which can automatically be configured either as a secondary node for opportunistic communication or as a cooperative base station or access point for primary network in emergency communications. Scout solution can be viable by taking advantage of the technologies used by existing radio surveillance systems in the context of CR.

  2. Concept similarity and related categories in information retrieval using formal concept analysis

    Science.gov (United States)

    Eklund, P.; Ducrou, J.; Dau, F.

    2012-11-01

    The application of formal concept analysis to the problem of information retrieval has been shown useful but has lacked any real analysis of the idea of relevance ranking of search results. SearchSleuth is a program developed to experiment with the automated local analysis of Web search using formal concept analysis. SearchSleuth extends a standard search interface to include a conceptual neighbourhood centred on a formal concept derived from the initial query. This neighbourhood of the concept derived from the search terms is decorated with its upper and lower neighbours representing more general and special concepts, respectively. SearchSleuth is in many ways an archetype of search engines based on formal concept analysis with some novel features. In SearchSleuth, the notion of related categories - which are themselves formal concepts - is also introduced. This allows the retrieval focus to shift to a new formal concept called a sibling. This movement across the concept lattice needs to relate one formal concept to another in a principled way. This paper presents the issues concerning exploring, searching, and ordering the space of related categories. The focus is on understanding the use and meaning of proximity and semantic distance in the context of information retrieval using formal concept analysis.

  3. [Clinical reasoning in nursing, concept analysis].

    Science.gov (United States)

    Côté, Sarah; St-Cyr Tribble, Denise

    2012-12-01

    Nurses work in situations of complex care requiring great clinical reasoning abilities. In literature, clinical reasoning is often confused with other concepts and it has no consensual definition. To conduct a concept analysis of a nurse's clinical reasoning in order to clarify, define and distinguish it from the other concepts as well as to better understand clinical reasoning. Rodgers's method of concept analysis was used, after literature was retrieved with the use of clinical reasoning, concept analysis, nurse, intensive care and decision making as key-words. The use of cognition, cognitive strategies, a systematic approach of analysis and data interpretation, generating hypothesis and alternatives are attributes of clinical reasoning. The antecedents are experience, knowledge, memory, cues, intuition and data collection. The consequences are decision making, action, clues and problem resolution. This concept analysis helped to define clinical reasoning, to distinguish it from other concepts used synonymously and to guide future research.

  4. Perceived parental efficacy: concept analysis.

    Science.gov (United States)

    Montigny, Francine; Lacharité, Carl

    2005-02-01

    This paper describes a concept analysis carried out to remove some of the ambiguity surrounding the conceptual meaning of perceived parental efficacy and to distinguish it from related concepts such as parental confidence and parental competence. Constructing parental efficacy is a crucial step for family members after the birth of their first child. For some authors, perceived parental efficacy is a motor for adequate parental practices. Confusion about the definition and measurement of this concept has hindered both psychology and nursing practice and research. Concept delineation and concept clarification are required in order to further the development of the concept of perceived parental efficacy. A literature search using a variety of online databases yielded 113 articles between the years 1980 and 2000. The final sample (n=60) consisted of 30 articles from two disciplines: nursing and psychology. A content analysis of the literature was done using Rodger's evolutionary concept analysis method. Content analysis of the literature yielded four contributors to perceived parental efficacy: positive enactive mastery experiences, vicarious experiences, verbal persuasion and an appropriate physiological and affective state. Perceived parental efficacy can thus be defined as 'beliefs or judgements a parent holds of their capabilities to organize and execute a set of tasks related to parenting a child'. This conceptual analysis has allowed perceived parental efficacy to be distinguished from parental confidence and parental competence. Both nursing and psychology research, practice and education will benefit from a more precise and delineated concept.

  5. Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients

    International Nuclear Information System (INIS)

    Katz, Angela; Niemierko, Andrzej; Gage, Irene; Evans, Sheila; Shaffer, Margaret; Smith, Frederick P.; Taghian, Alphonse; Magnant, Colette

    2006-01-01

    Purpose: Sentinel lymph node-positive (SLN+) patients who are unlikely to have 4 or more involved axillary nodes might be treated with less extensive regional nodal radiation. The purpose of this study was to define possible predictors of having 4 or more involved axillary nodes. Methods and Materials: The records of 224 patients with breast cancer and 1 to 3 involved SLNs, who underwent completion axillary dissection without neoadjuvant chemotherapy or hormonal therapy were reviewed. Factors associated with the presence of 4 or more involved axillary nodes (SLNs plus non-SLNs) were evaluated by Pearson chi-square test of association and by simple and multiple logistic-regression analysis. Results: Of 224 patients, 42 had involvement of 4 or more axillary nodes. On univariate analysis, the presence of 4 or more involved axillary nodes was positively associated with increased tumor size, lobular histology, lymphovascular space invasion (LVSI), increased number of involved SLNs, decreased number of uninvolved SLNs, and increased size of SLN metastasis. On multivariate analysis, the presence of 4 or more involved axillary nodes was associated with LVSI, increased number of involved SLNs, increased size of SLN metastasis, and lobular histology. Conclusions: Patients with 1 or more involved SLN, LVSI, or SLN macrometastasis should be treated to the supraclavicular fossa/axillary apex if they do not undergo completion axillary dissection. Other SLN+ patients might be adequately treated with less extensive radiation fields

  6. Sustained operation of sensor nodes with energy harvesters and supercapacitors

    Energy Technology Data Exchange (ETDEWEB)

    Renner, Bernd-Christian

    2013-06-01

    Sensor nodes powered by energy harvesters and supercapacitors open the door to unlimited and uninterrupted operation. This dissertation closes the persistent gap of system integration w.r.t. holistic online energy assessment, develops a new concept for harvest forecasting while assessing the behavior and quality of known approaches, and proposes a novel load adaptation scheme to achieve sustained and uniform sensor node operation with low complexity and computational overhead. For this purpose, a prototype of an energy harvester with a supercapacitor for off-the-shelf sensor nodes is developed and used for practical evaluation.

  7. Self-care Concept Analysis in Cancer Patients: An Evolutionary Concept Analysis

    OpenAIRE

    Hasanpour-Dehkordi, Ali

    2016-01-01

    Background: Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. Materials and Methods: We used Rodgers? evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis,...

  8. Simple fall criteria for MEMS sensors: Data analysis and sensor concept

    KAUST Repository

    Ibrahim, Alwathiqbellah; Younis, Mohammad I.

    2014-01-01

    This paper presents a new and simple fall detection concept based on detailed experimental data of human falling and the activities of daily living (ADLs). Establishing appropriate fall algorithms compatible with MEMS sensors requires detailed data on falls and ADLs that indicate clearly the variations of the kinematics at the possible sensor node location on the human body, such as hip, head, and chest. Currently, there is a lack of data on the exact direction and magnitude of each acceleration component associated with these node locations. This is crucial for MEMS structures, which have inertia elements very close to the substrate and are capacitively biased, and hence, are very sensitive to the direction of motion whether it is toward or away from the substrate. This work presents detailed data of the acceleration components on various locations on the human body during various kinds of falls and ADLs. A two-degree-of-freedom model is used to help interpret the experimental data. An algorithm for fall detection based on MEMS switches is then established. A new sensing concept based on the algorithm is proposed. The concept is based on employing several inertia sensors, which are triggered simultaneously, as electrical switches connected in series, upon receiving a true fall signal. In the case of everyday life activities, some or no switches will be triggered resulting in an open circuit configuration, thereby preventing false positive. Lumped-parameter model is presented for the device and preliminary simulation results are presented illustrating the new device concept. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

  9. Simple fall criteria for MEMS sensors: Data analysis and sensor concept

    KAUST Repository

    Ibrahim, Alwathiqbellah

    2014-07-08

    This paper presents a new and simple fall detection concept based on detailed experimental data of human falling and the activities of daily living (ADLs). Establishing appropriate fall algorithms compatible with MEMS sensors requires detailed data on falls and ADLs that indicate clearly the variations of the kinematics at the possible sensor node location on the human body, such as hip, head, and chest. Currently, there is a lack of data on the exact direction and magnitude of each acceleration component associated with these node locations. This is crucial for MEMS structures, which have inertia elements very close to the substrate and are capacitively biased, and hence, are very sensitive to the direction of motion whether it is toward or away from the substrate. This work presents detailed data of the acceleration components on various locations on the human body during various kinds of falls and ADLs. A two-degree-of-freedom model is used to help interpret the experimental data. An algorithm for fall detection based on MEMS switches is then established. A new sensing concept based on the algorithm is proposed. The concept is based on employing several inertia sensors, which are triggered simultaneously, as electrical switches connected in series, upon receiving a true fall signal. In the case of everyday life activities, some or no switches will be triggered resulting in an open circuit configuration, thereby preventing false positive. Lumped-parameter model is presented for the device and preliminary simulation results are presented illustrating the new device concept. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

  10. Sentinel node detection in pre-operative axillary staging.

    Science.gov (United States)

    Trifirò, Giuseppe; Viale, Giuseppe; Gentilini, Oreste; Travaini, Laura Lavinia; Paganelli, Giovanni

    2004-06-01

    The concept of sentinel lymph node biopsy in breast cancer surgery is based on the fact that the tumour drains in a logical way via the lymphatic system, from the first to upper levels. Since axillary node dissection does not improve the prognosis of patients with breast cancer, sentinel lymph node biopsy might replace complete axillary dissection for staging of the axilla in clinically N0 patients. Sentinel lymph node biopsy would represent a significant advantage as a minimally invasive procedure, considering that about 70% of patients are found to be free from metastatic disease, yet axillary node dissection can lead to significant morbidity. Subdermal or peritumoural injection of small aliquots (and very low activity) of radiotracer is preferred to intratumoural administration, and (99m)Tc-labelled colloids with most of the particles in the 100-200 nm size range would be ideal for radioguided sentinel node biopsy in breast cancer. The success rate of radioguidance in localising the sentinel lymph node in breast cancer surgery is about 97% in institutions where a high number of procedures are performed, and the success rate of lymphoscintigraphy in sentinel node detection is about 100%. The sentinel lymph node should be processed for intraoperative frozen section examination in its entirety, based on conventional histopathology and, when necessary, immune staining with anti-cytokeratin antibody. Nowadays, lymphoscintigraphy is a useful procedure in patients with different clinical evidence of breast cancer.

  11. Analysis of the movement of calcified lymph nodes during breathing

    International Nuclear Information System (INIS)

    Jenkins, Peter; Salmon, Clare; Mannion, Cathy

    2005-01-01

    Purpose: To identify and measure the respiratory-induced movement of calcified mediastinal lymph nodes. Methods and materials: Twenty-one patients receiving radiation therapy for primary lung or pleural tumors were noted to have calcification within one or more mediastinal lymph nodes. The breathing motion of 27 such nodes was measured with orthogonal fluoroscopic imaging during quiet respiration. Results: All 27 nodes showed some motion synchronous with breathing. The mean respiratory movement was 6.6 mm, 2.6 mm, and 1.4 mm in the craniocaudal, dorsoventral, and mediolateral planes, respectively. There was a significant difference in the amplitude of motion in the craniocaudal plane compared with movement in the other two directions (p < 0.001). No differences were seen in the movement of lymph nodes dependent on position within the mediastinum (supracarinal vs. infracarinal or hilar vs. mediastinal). Neither size of the primary tumor nor spirometric parameters were correlated with the amplitude of lymph node movement. Conclusions: Mediastinal lymph nodes move during breathing, and this needs to be accounted for when the internal margin component of the PTV is defined. The amplitude of this movement is anisotropic and seems to be less than that reported for primary lung tumors. This should permit a modest reduction in the margin allowed for breathing movement around involved mediastinal nodes, particularly in the mediolateral and dorsoventral planes

  12. Metastases in patients with malignant melanoma despite of negative sentinel lymph node: has the concept to be changed?

    International Nuclear Information System (INIS)

    Weiss, M.; Dresel, S.; Tatsch, K.; Hahn, K.; Konz, B.; Schmid-Wendtner, M.H.; Sander, C.; Volkenandt, M.

    2000-01-01

    The aim of the present study was to prove the prognostic value of the SLN-concept in these patients. Methods: So far the clinical follow-up of 162 patients with histologically proven malignant melanoma and metastatically uninvolved (negative) SLN was investigated. Histological examination included standard methods (HE-Test) and special histochemical techniques (S-100, HMB-45). All patients underwent clinical examination, ultrasonic diagnosis of the regional lymph nodes, and X-ray of the chest every 3 months. Results: Despite of negative SLN-findings in 8/162 patients metastases of the malignant melanoma were found after a time period of 5-27 months. Three patients presented with recurrence in the previously mapped (negative) SLN-basin. In another case the scintigraphically visualized SLN could not be identified intraoperatively by means of the hand-held gamma probe. One patient showed intransit-metastases or skin-metastases, respectively; another patient recurred in the scar area. One patient showed hematogenic dissemination (liver) which is not detectable by lymphoscintigraphy; in another patient metastases were found outside the primary lymphatic basin (cervical). Conclusion: In our patient group 4,9% presented with metastases despite negative SLN while published data report up to 11% (observation period 35 months), among them only 3 patients (1,9%) being real concept failures. Our results underline that there is no evidence to change this concept in patients with clinically early stage. (orig.) [de

  13. Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node-negative neck.

    Science.gov (United States)

    Agarwal, Sangeet Kumar; Arora, Sowrabh Kumar; Kumar, Gopal; Sarin, Deepak

    2016-10-01

    The incidence of occult perifacial nodal disease in oral cavity squamous cell carcinoma is not well reported. The purpose of this study was to evaluate the incidence of isolated perifacial lymph node metastasis in patients with oral squamous cell carcinoma with a clinically node-negative neck. The study will shed light on current controversies and will provide valuable clinical and pathological information in the practice of routine comprehensive removal of these lymph node pads in selective neck dissection in the node-negative neck. Prospective analysis. This study was started in August 2011 when intraoperatively we routinely separated the lymph node levels from the main specimen for evaluation of the metastatic rate to different lymph node levels in 231 patients of oral squamous cell cancer with a clinically node-negative neck. The current study demonstrated that 19 (8.22%) out of 231 patients showed ipsilateral isolated perifacial lymph node involvement. The incidence of isolated perifacial nodes did not differ significantly between the oral tongue (7.14%) and buccal mucosa (7.75%). Incidence was statistically significant in cases with lower age group (oral squamous cell carcinoma with a clinically node-negative neck. The incidence of isolated perifacial involvement is high in cases of buccal mucosal and tongue cancers. A meticulous dissection of the perifacial nodes seems prudent when treating the neck in oral cavity squamous cell carcinoma. 4 Laryngoscope, 126:2252-2256, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Node and Regime: Interdisciplinary Analysis of Water-Energy-Food Nexus in the Mekong Region

    Directory of Open Access Journals (Sweden)

    Tira Foran

    2015-02-01

    Full Text Available Understanding complex phenomena such as the water-energy-food nexus (resource nexus requires a more holistic, interdisciplinary inquiry. Spurred by a sense of imbalance in approaches to the nexus dominated by integrated assessment/complex systems methodologies, I re-examine the findings and recommendations of a major 'nexus' research-for-development project in the Mekong region. The concept of 'regime of provisioning', a synthesis of social science concepts related to meso-level social order, allows essential political economy and discursive elements of the resource nexus to be analysed. I show that socio-political regimes constrain societal investment in three 'nodes' of the nexus previously identified as critical to manage sustainably: energy efficiency, wild-capture fisheries, and diversified smallholder agriculture. I discuss implications for the 'nexus' as a new policy agenda and offer three propositions for ongoing inquiry and inclusive practice.

  15. [Concept analysis "Competency-based education"].

    Science.gov (United States)

    Loosli, Clarence

    2016-03-01

    Competency-based education (CBE) stands out at global level as the best educational practice. Indeed, CBE is supposed to improve the quality of care provided by newly graduated nurses. Yet, there is a dearth of knowledge in nursing literature regarding CBE concept's definition. CBE is implemented differently in each entity even inside the same discipline in a single country. What accounts for CBE in nursing education ? to clarify CBE concept meaning according to literature review in order to propose a definition. Wilson concept analysis method framed our literature review through two databases: CINHAL and ERIC. following the 11 Wilson techniques analysis, we identified CBE concept as a multidimensional concept clustering three dimensions : learning, teaching and assessment. nurses educators are accountable for providing performants newly graduated professional to the society. Schools should struggle for the visibility and the transparency of means they are using to accomplish their educational activities. This first attempt to understand CBE concept opens a matter of debate concerning further development and clarification of the concept. This first description of CBE concept is a step toward its identification and assessment.

  16. Faith: a concept analysis.

    Science.gov (United States)

    Dyess, Susan Macleod

    2011-12-01

    This paper reports a concept analysis of faith. There are numerous scholars who consider spirituality and religiosity as they relate to health and nursing. Faith is often implied as linked to these concepts but deserves distinct exploration. In addition, as nursing practice conducted within communities of faith continues to emerge, concept clarification of faith is warranted. Qualitative analysis deliberately considered the concept of faith within the lens of Margaret Newman's health as expanding consciousness. Data sources used included a secondary analysis of stories collected within a study conducted in 2008, two specific reconstructed stories, the identification of attributes noted within these various stories and selected philosophical literature from 1950 to 2009.  A definition was identified from the analysis; faith is an evolving pattern of believing, that grounds and guides authentic living and gives meaning in the present moment of inter-relating. Four key attributes of faith were also identified as focusing on beliefs, foundational meaning for life, living authentically in accordance with beliefs, and interrelating with self, others and/or Divine. Although a seemingly universal concept, faith was defined individually. Faith appeared to be broader than spiritual practices and religious ritual and became the very foundation that enabled human beings to make sense of their world and circumstances. More work is needed to understand how faith community nursing can expand the traditional understanding of denominationally defined faith community practices and how nurses can support faith for individuals with whom they encounter within all nursing practice. © 2011 Blackwell Publishing Ltd.

  17. Partial axillary lymph node dissection inferior to the intercostobrachial nerves complements sentinel node biopsy in patients with clinically node-negative breast cancer.

    Science.gov (United States)

    Li, Jianyi; Jia, Shi; Zhang, Wenhai; Qiu, Fang; Zhang, Yang; Gu, Xi; Xue, Jinqi

    2015-06-30

    The practice of breast cancer diagnosis and treatment in China varies to that in western developed countries. With the unavailability of radioactive tracer technique for sentinel lymph nodes biopsy (SLNB), using blue dye alone has been the only option in China. Also, the diagnosis of breast malignant tumor in most Chinese centres heavily relies on intraoperative instant frozen histology which is normally followed by sentinel lymph nodes mapping, SLNB and the potential breast and axillary operations in one consecutive session. This practice appears to cause a high false negative rate (FNR) for SLNB. The present study aimed to investigate the impact of the current practice in China on the accuracy of SLNB, and whether partial axillary lymph node dissection (PALND), dissection of lymph nodes inferior to the intercostobrachial nerve (ICBN), was a good complementary procedure following SLNB using blue dye. 289 patients with clinically node-negative breast cancer were identified and recruited. Tumorectomy, intraoperative instant frozen histological diagnosis, SLNB using methylene blue dye, and PALND or complete axillary node dissection (ALND) were performed in one consecutive operative session. The choice of SLNB only, SLNB followed by PALND or by ALND was based on the pre-determined protocol and preoperative choice by the patient. Clinical parameters were analyzed and survival analysis was performed. 37% patients with clinically negative nodes were found nodes positive. 59 patients with positive SLN underwent ALND, including 47 patients with up to two positive nodes which were all located inferior to the ICBN. 9 patients had failed SLNB and underwent PALND. Among them, 3 (33.3%) patients were found to have one metastatic node. 149 patients showed negative SLNB but chose PALND. Among them, 30 (20.1%), 14 (9.4) and 1 (0.7%) patients were found to have one, two and three metastatic node(s), respectively. PALND detected 48 (30.4%) patients who had either failed SLNB or

  18. 20 kHz, 25 kVA node power transformer

    Science.gov (United States)

    Hussey, S.

    1989-01-01

    The electrical and mechanical design information and the electrical and thermal testing performed on the 440-208-V rms, 20-kHz, 25-kVa prototype node transformer are summarized. The calculated efficiency of the node transformer is 99.3 percent based on core loss and copper loss test data, and its maximum calculated load regulation is 0.7 percent. The node transformer has a weight of 19.7 lb and has a power density of 0.8 lb/kW. The hot-spot temperature rise is estimated to be 33 C above the cold plate mounting base. This proof-of-concept transformer design is a viable candidate for the space station Freedom application.

  19. Teaching concept analysis to graduate nursing students.

    Science.gov (United States)

    Schiller, Catharine J

    2018-04-01

    To provide guidance to educators who use the Wilson (1963) concept analysis method, as modified by Walker and Avant (2011), in their graduate nursing curriculum BACKGROUND: While graduate nursing curricula often include a concept analysis assignment, there is a paucity of literature to assist educators in guiding students through this challenging process. This article details one way for educators to assist graduate nursing students in learning how to undertake each step of the Wilson (1963) concept analysis method, as modified by Walker and Avant (2011). Wilson (1963) concept analysis method, as modified by Walker and Avant (2011). Using examples, this article walks the reader through the Walker and Avant (2011) concept analysis process and addresses those issues commonly encountered by educators during this process. This article presented one way of walking students through a Walker and Avant (2011) concept analysis. Having clear information about the steps involved in developing a concept analysis will make it easier for educators to incorporate it into their graduate nursing curriculum and to effectively guide students on their journey through this process. © 2018 Wiley Periodicals, Inc.

  20. Correlation of number and identification of sentinel nodes during radiographer led lymphoscintigraphy prior to sentinel lymph node biopsy in breast cancer patients

    International Nuclear Information System (INIS)

    Camilleri, Gail; Borg Grima, Karen; Zarb, Francis

    2012-01-01

    Purpose: The sentinel lymph node biopsy (SLNB) concept using the cutaneous (subdermal) peri-areolar approach is rapidly emerging as the technique for axillary staging in breast cancer. The procedure indicates whether axillary lymph node dissection (ALND) is necessary, therefore drastically minimising the invasiveness of surgical treatment. The SLNB concept is based on evidence suggesting that malignant disease primarily affects the sentinel node (SN) before being disseminated into the axillary lymph nodes (ALNs). Objective: This study was to define the role of lymphoscintigraphy in the visualisation of SNs during SLNB and to establish the correlation between the number of SNs identified on lymphoscintigraphy to the number of surgically identified SNs. Method: The study was a non-experimental, correlation study utilising quantitative data. Lymphoscintigraphy reports and histology results of 55 female breast cancer patients who underwent SLNB with partial or total back-up ALND, were retrospectively evaluated. Results: A maximum of 2 and a minimum of 0 sentinel nodes were visualised on lymphoscintigraphy in 52 out of 55 patients. Successful lymphoscintigraphy was highly predictive (p ≤ 0.001) of a successful SLNB as all 52 patients (94.5%) proceeded to have successful SN/s identification. There was a significant association (p ≤ 0.05) between the number of SN/s visualised on lymphoscintigraphy and the number of SN/s identified during SLNB. Lymphoscintigraphy accurately predicted the number of surgically identified SNs in 50.91% of cases (28/55). Conclusion: Considering that successful imaging effectively assures SN identification, the routine use of lymphoscintigraphy using the subdermal peri-areolar approach is fundamental in the reliable performance of SLNB.

  1. Using quantitative image analysis to classify axillary lymph nodes on breast MRI: A new application for the Z 0011 Era

    Energy Technology Data Exchange (ETDEWEB)

    Schacht, David V., E-mail: dschacht@radiology.bsd.uchicago.edu; Drukker, Karen, E-mail: kdrukker@uchicago.edu; Pak, Iris, E-mail: irisgpak@gmail.com; Abe, Hiroyuki, E-mail: habe@radiology.bsd.uchicago.edu; Giger, Maryellen L., E-mail: m-giger@uchicago.edu

    2015-03-15

    Highlights: •Quantitative image analysis showed promise in evaluating axillary lymph nodes. •13 of 28 features performed better than guessing at metastatic status. •When all features were used in together, a considerably higher AUC was obtained. -- Abstract: Purpose: To assess the performance of computer extracted feature analysis of dynamic contrast enhanced (DCE) magnetic resonance images (MRI) of axillary lymph nodes. To determine which quantitative features best predict nodal metastasis. Methods: This institutional board-approved HIPAA compliant study, in which informed patient consent was waived, collected enhanced T1 images of the axilla from patients with breast cancer. Lesion segmentation and feature analysis were performed on 192 nodes using a laboratory-developed quantitative image analysis (QIA) workstation. The importance of 28 features were assessed. Classification used the features as input to a neural net classifier in a leave-one-case-out cross-validation and evaluated with receiver operating characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) values for features in the task of distinguishing between positive and negative nodes ranged from just over 0.50 to 0.70. Five features yielded AUCs greater than 0.65: two morphological and three textural features. In cross-validation, the neural net classifier obtained an AUC of 0.88 (SE 0.03) for the task of distinguishing between positive and negative nodes. Conclusion: QIA of DCE MRI demonstrated promising performance in discriminating between positive and negative axillary nodes.

  2. Professional confidence: a concept analysis.

    Science.gov (United States)

    Holland, Kathlyn; Middleton, Lyn; Uys, Leana

    2012-03-01

    Professional confidence is a concept that is frequently used and or implied in occupational therapy literature, but often without specifying its meaning. Rodgers's Model of Concept Analysis was used to analyse the term "professional confidence". Published research obtained from a federated search in four health sciences databases was used to inform the concept analysis. The definitions, attributes, antecedents, and consequences of professional confidence as evidenced in the literature are discussed. Surrogate terms and related concepts are identified, and a model case of the concept provided. Based on the analysis, professional confidence can be described as a dynamic, maturing personal belief held by a professional or student. This includes an understanding of and a belief in the role, scope of practice, and significance of the profession, and is based on their capacity to competently fulfil these expectations, fostered through a process of affirming experiences. Developing and fostering professional confidence should be nurtured and valued to the same extent as professional competence, as the former underpins the latter, and both are linked to professional identity.

  3. Lymph Node Yield as a Predictor of Survival in Pathologically Node Negative Oral Cavity Carcinoma.

    Science.gov (United States)

    Lemieux, Aaron; Kedarisetty, Suraj; Raju, Sharat; Orosco, Ryan; Coffey, Charles

    2016-03-01

    Even after a pathologically node-negative (pN0) neck dissection for oral cavity squamous cell carcinoma (SCC), patients may develop regional recurrence. In this study, we (1) hypothesize that an increased number of lymph nodes removed (lymph node yield) in patients with pN0 oral SCC predicts improved survival and (2) explore predictors of survival in these patients using a multivariable model. Case series with chart review. Administrative database analysis. The SEER database was queried for patients diagnosed with all-stage oral cavity SCC between 1988 and 2009 who were determined to be pN0 after elective lymph node dissection. Demographic and treatment variables were extracted. The association of lymph node yield with 5-year all-cause survival was studied with multivariable survival analyses. A total of 4341 patients with pN0 oral SCC were included in this study. The 2 highest lymph node yield quartiles (representing >22 nodes removed) were found to be significant predictors of overall survival (22-35 nodes: hazard ratio [HR] = 0.854, P = .031; 36-98 nodes: HR = 0.827, P = .010). Each additional lymph node removed during neck dissection was associated with increased survival (HR = 0.995, P = .022). These data suggest that patients with oral SCC undergoing elective neck dissection may experience an overall survival benefit associated with greater lymph node yield. Mechanisms behind the demonstrated survival advantage are unknown. Larger nodal dissections may remove a greater burden of microscopic metastatic disease, diminishing the likelihood of recurrence. Lymph node yield may serve as an objective measure of the adequacy of lymphadenectomy. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  4. Concept Analysis: Music Therapy.

    Science.gov (United States)

    Murrock, Carolyn J; Bekhet, Abir K

    2016-01-01

    Down through the ages, music has been universally valued for its therapeutic properties based on the psychological and physiological responses in humans. However, the underlying mechanisms of the psychological and physiological responses to music have been poorly identified and defined. Without clarification, a concept can be misused, thereby diminishing its importance for application to nursing research and practice. The purpose of this article was for the clarification of the concept of music therapy based on Walker and Avant's concept analysis strategy. A review of recent nursing and health-related literature covering the years 2007-2014 was performed on the concepts of music, music therapy, preferred music, and individualized music. As a result of the search, the attributes, antecedents, and consequences of music therapy were identified, defined, and used to develop a conceptual model of music therapy. The conceptual model of music therapy provides direction for developing music interventions for nursing research and practice to be tested in various settings to improve various patient outcomes. Based on Walker and Avant's concept analysis strategy, model and contrary cases are included. Implications for future nursing research and practice to use the psychological and physiological responses to music therapy are discussed.

  5. Sensory overload: A concept analysis.

    Science.gov (United States)

    Scheydt, Stefan; Müller Staub, Maria; Frauenfelder, Fritz; Nielsen, Gunnar H; Behrens, Johann; Needham, Ian

    2017-04-01

    In the context of mental disorders sensory overload is a widely described phenomenon used in conjunction with psychiatric interventions such as removal from stimuli. However, the theoretical foundation of sensory overload as addressed in the literature can be described as insufficient and fragmentary. To date, the concept of sensory overload has not yet been sufficiently specified or analyzed. The aim of the study was to analyze the concept of sensory overload in mental health care. A literature search was undertaken using specific electronic databases, specific journals and websites, hand searches, specific library catalogues, and electronic publishing databases. Walker and Avant's method of concept analysis was used to analyze the sources included in the analysis. All aspects of the method of Walker and Avant were covered in this concept analysis. The conceptual understanding has become more focused, the defining attributes, influencing factors and consequences are described and empirical referents identified. The concept analysis is a first step in the development of a middle-range descriptive theory of sensory overload based on social scientific and stress-theoretical approaches. This specification may serve as a fundament for further research, for the development of a nursing diagnosis or for guidelines. © 2017 Australian College of Mental Health Nurses Inc.

  6. Teamwork: a concept analysis.

    Science.gov (United States)

    Xyrichis, Andreas; Ream, Emma

    2008-01-01

    This paper is a report of an analysis of the concept of teamwork. Teamwork is seen as an important facilitator in delivering quality healthcare services internationally. However, research studies of teamwork in health care are criticized for lacking a basic conceptual understanding of what this concept represents. A universal definition for healthcare settings and professionals is missing from published literature. Walker and Avant's approach was used to guide this concept analysis. Literature searches used bibliographic databases (Medline, CINAHL, Web of Science, Proquest CSA), internet search engines (GoogleScholar), and hand searches. Literature published between 1976 and 2006 was reviewed but only material in English was included. Based on the analysis undertaken, teamwork is proposed as a dynamic process involving two or more healthcare professionals with complementary backgrounds and skills, sharing common health goals and exercising concerted physical and mental effort in assessing, planning, or evaluating patient care. This is accomplished through interdependent collaboration, open communication and shared decision-making, and generates value-added patient, organizational and staff outcomes. Praising the value of teamwork without a common understanding of what this concept represents endangers both research into this way of working and its effective utilization in practice. The proposed definition helps reconcile discrepancies between how this concept is understood by nurses and doctors, as well as allied health professionals. A common understanding can facilitate communication in educational, research and clinical settings and is imperative for improving clarity and validity of future research.

  7. Secondary node analysis as an indicator for axillary lymphadenectomy in breast cancer patients.

    Science.gov (United States)

    Cremades, Manel; Torres, Mireia; Solà, Montse; Navinés, Jordi; Pascual, Icíar; Mariscal, Antonio; Caballero, Albert; Castellà, Eva; Luna, Miguel Ángel; Julián, Joan Francesc

    2017-11-01

    Currently, there is no agreement regarding if it would be necessary to perform an axillary lymph node dissection (ALND) in patients who have macrometastases in the sentinel lymph node (SLN). We studied the utility of the secondary node analysis (SN), defined as the following node after the SLN in an anatomical and lymphatic pathway, as a sign of malignant axillary involvement. An observational, retrospective and multicentre study was designed to assess the utility of the SN as a sign of axillary involvement. Among 2273 patients with breast cancer, a valid sample of 283 was obtained representing those who had the SN studied. Main endpoints of our study were: the SLN, the SN and the ALND histological pattern. Sensitivity, specificity and precision of the test were also calculated. SN test, in cases with positive SLN, has a sensitivity of 61.1%, a specificity of 78.7%, a positive predictive value of 45.8% and a negative predictive value of 87.3% with a precision of 74.7%. The study of the SN together with the technique of the SLN allows a more precise staging of the axillary involvement, in patients with breast cancer, than just the SLN technique. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Suicide Lethality: A Concept Analysis.

    Science.gov (United States)

    DeBastiani, Summer; De Santis, Joseph P

    2018-02-01

    Suicide is a significant health problem internationally. Those who complete suicide may have different behaviors and risk factors than those who attempt a non-fatal suicide. The purpose of this article is to analyze the concept of suicide lethality and propose a clear definition of the concept through the identification of antecedents, attributes, and consequences. A literature search for articles published in the English language between 1970 and 2016 was conducted using MEDLINE, the Cochrane Library, Pubmed, Psychlit, Ovid, PsycINFO, and Proquest. The bibliographies of all included studies were also reviewed to identify additional relevant citations. A concept analysis was conducted on the literature findings using six stages of Walker and Avant's method. The concept analysis differentiated between suicide, lethality, suicidal behavior, and suicide lethality. Presence of a suicide plan or a written suicide note was not found to be associated with the majority of completed suicides included in the definition of suicide lethality. There are a few scales that measure the lethality of a suicide attempt, but none that attempt to measure the concept of suicide lethality as described in this analysis. Clarifying the concept of suicide lethality encourages awareness of the possibility of different suicidal behaviors associated with different suicide outcomes and will inform the development of future nursing interventions. A clearer definition of the concept of suicide lethality will guide clinical practice, research, and policy development aimed at suicide prevention.

  9. The use of nodes attributes in social network analysis with an application to an international trade network

    Science.gov (United States)

    de Andrade, Ricardo Lopes; Rêgo, Leandro Chaves

    2018-02-01

    The social network analysis (SNA) studies the interactions among actors in a network formed through some relationship (friendship, cooperation, trade, among others). The SNA is constantly approached from a binary point of view, i.e., it is only observed if a link between two actors is present or not regardless of the strength of this link. It is known that different information can be obtained in weighted and unweighted networks and that the information extracted from weighted networks is more accurate and detailed. Another rarely discussed approach in the SNA is related to the individual attributes of the actors (nodes), because such analysis is usually focused on the topological structure of networks. Features of the nodes are not incorporated in the SNA what implies that there is some loss or misperception of information in those analyze. This paper aims at exploring more precisely the complexities of a social network, initially developing a method that inserts the individual attributes in the topological structure of the network and then analyzing the network in four different ways: unweighted, edge-weighted and two methods for using both edge-weights and nodes' attributes. The international trade network was chosen in the application of this approach, where the nodes represent the countries, the links represent the cash flow in the trade transactions and countries' GDP were chosen as nodes' attributes. As a result, it is possible to observe which countries are most connected in the world economy and with higher cash flows, to point out the countries that are central to the intermediation of the wealth flow and those that are most benefited from being included in this network. We also made a principal component analysis to study which metrics are more influential in describing the data variability, which turn out to be mostly the weighted metrics which include the nodes' attributes.

  10. Analysis of molecular markers as predictive factors of lymph node involvement in breast carcinoma.

    Science.gov (United States)

    Paula, Luciana Marques; De Moraes, Luis Henrique Ferreira; Do Canto, Abaeté Leite; Dos Santos, Laurita; Martin, Airton Abrahão; Rogatto, Silvia Regina; De Azevedo Canevari, Renata

    2017-01-01

    Nodal status is the most significant independent prognostic factor in breast cancer. Identification of molecular markers would allow stratification of patients who require surgical assessment of lymph nodes from the large numbers of patients for whom this surgical procedure is unnecessary, thus leading to a more accurate prognosis. However, up to now, the reported studies are preliminary and controversial, and although hundreds of markers have been assessed, few of them have been used in clinical practice for treatment or prognosis in breast cancer. The purpose of the present study was to determine whether protein phosphatase Mg2+/Mn2+ dependent 1D, β-1,3-N-acetylglucosaminyltransferase, neural precursor cell expressed, developmentally down-regulated 9, prohibitin, phosphoinositide-3-kinase regulatory subunit 5 (PIK3R5), phosphatidylinositol-5-phosphate 4-kinase type IIα, TRF1-interacting ankyrin-related ADP-ribose polymerase 2, BCL2 associated agonist of cell death, G2 and S-phase expressed 1 and PAX interacting protein 1 genes, described as prognostic markers in breast cancer in a previous microarray study, are also predictors of lymph node involvement in breast carcinoma Reverse transcription-quantitative polymerase chain reaction analysis was performed on primary breast tumor tissues from women with negative lymph node involvement (n=27) compared with primary tumor tissues from women with positive lymph node involvement (n=23), and was also performed on primary tumors and paired lymph node metastases (n=11). For all genes analyzed, only the PIK3R5 gene exhibited differential expression in samples of primary tumors with positive lymph node involvement compared with primary tumors with negative lymph node involvement (P=0.0347). These results demonstrate that the PIK3R5 gene may be considered predictive of lymph node involvement in breast carcinoma. Although the other genes evaluated in the present study have been previously characterized to be involved with

  11. Calling to Nursing: Concept Analysis.

    Science.gov (United States)

    Emerson, Christie

    The aims of this article are (a) to analyze the concept of a calling as it relates nursing and (b) to develop a definition of calling to nursing with the detail and clarity needed to guide reliable and valid research. The classic steps described by Walker and Avant are used for the analysis. Literature from several disciplines is reviewed including vocational psychology, Christian career counseling, sociology, organizational management, and nursing. The analysis provides an operational definition of a calling to nursing and establishes 3 defining attributes of the concept: (a) a passionate intrinsic motivation or desire (perhaps with a religious component), (b) an aspiration to engage in nursing practice, as a means of fulfilling one's purpose in life, and (c) the desire to help others as one's purpose in life. Antecedents to the concept are personal introspection and cognitive awareness. Positive consequences to the concept are improved work meaningfulness, work engagement, career commitment, personal well-being, and satisfaction. Negative consequences of having a calling might include willingness to sacrifice well-being for work and problems with work-life balance. Following the concept analysis, philosophical assumptions, contextual factors, interdisciplinary work, research opportunities, and practice implications are discussed.

  12. Operating Wireless Sensor Nodes without Energy Storage: Experimental Results with Transient Computing

    Directory of Open Access Journals (Sweden)

    Faisal Ahmed

    2016-12-01

    Full Text Available Energy harvesting is increasingly used for powering wireless sensor network nodes. Recently, it has been suggested to combine it with the concept of transient computing whereby the wireless sensor nodes operate without energy storage capabilities. This new combined approach brings benefits, for instance ultra-low power nodes and reduced maintenance, but also raises new challenges, foremost dealing with nodes that may be left without power for various time periods. Although transient computing has been demonstrated on microcontrollers, reports on experiments with wireless sensor nodes are still scarce in the literature. In this paper, we describe our experiments with solar, thermal, and RF energy harvesting sources that are used to power sensor nodes (including wireless ones without energy storage, but with transient computing capabilities. The results show that the selected solar and thermal energy sources can operate both the wired and wireless nodes without energy storage, whereas in our specific implementation, the developed RF energy source can only be used for the selected nodes without wireless connectivity.

  13. Concept analysis of nurses' happiness.

    Science.gov (United States)

    Ozkara San, Eda

    2015-01-01

    The purpose of this analysis is to examine and clarify the concept of nurses' happiness (NH), understand the different uses of the concept, explore the conditions that foster it, and consider the consequences of NH, including the phenomena that emerge as a result of NH occurrence. The author utilizes Walker and Avant's eight-stage concept analysis. Computer and manual searches were conducted of articles in the English language addressing NH from 1990 to present. EBSCO and PubMed are the electronic databases used to access literature for this paper. For both databases, the researcher has examined this new term by splitting the term nurses' happiness into its two root words, namely nurses and happiness. An inductive analysis of articles produced descriptive themes. Definitions of happiness and NH are analyzed. Antecedents, attributes, and consequences of NH are described. Model, borderline, contrary, and related cases for NH are also identified. This concept analysis helps in the understanding of the definition of NH, the attributes that contribute to the occurrence of NH in clinical practice, as well as the consequences of NH, and how it should be measured from a nursing perspective. Ozkara San. © 2014 Wiley Periodicals, Inc.

  14. Prediction Approach of Critical Node Based on Multiple Attribute Decision Making for Opportunistic Sensor Networks

    Directory of Open Access Journals (Sweden)

    Qifan Chen

    2016-01-01

    Full Text Available Predicting critical nodes of Opportunistic Sensor Network (OSN can help us not only to improve network performance but also to decrease the cost in network maintenance. However, existing ways of predicting critical nodes in static network are not suitable for OSN. In this paper, the conceptions of critical nodes, region contribution, and cut-vertex in multiregion OSN are defined. We propose an approach to predict critical node for OSN, which is based on multiple attribute decision making (MADM. It takes RC to present the dependence of regions on Ferry nodes. TOPSIS algorithm is employed to find out Ferry node with maximum comprehensive contribution, which is a critical node. The experimental results show that, in different scenarios, this approach can predict the critical nodes of OSN better.

  15. Automated generation of node-splitting models for assessment of inconsistency in network meta-analysis.

    Science.gov (United States)

    van Valkenhoef, Gert; Dias, Sofia; Ades, A E; Welton, Nicky J

    2016-03-01

    Network meta-analysis enables the simultaneous synthesis of a network of clinical trials comparing any number of treatments. Potential inconsistencies between estimates of relative treatment effects are an important concern, and several methods to detect inconsistency have been proposed. This paper is concerned with the node-splitting approach, which is particularly attractive because of its straightforward interpretation, contrasting estimates from both direct and indirect evidence. However, node-splitting analyses are labour-intensive because each comparison of interest requires a separate model. It would be advantageous if node-splitting models could be estimated automatically for all comparisons of interest. We present an unambiguous decision rule to choose which comparisons to split, and prove that it selects only comparisons in potentially inconsistent loops in the network, and that all potentially inconsistent loops in the network are investigated. Moreover, the decision rule circumvents problems with the parameterisation of multi-arm trials, ensuring that model generation is trivial in all cases. Thus, our methods eliminate most of the manual work involved in using the node-splitting approach, enabling the analyst to focus on interpreting the results. © 2015 The Authors Research Synthesis Methods Published by John Wiley & Sons Ltd.

  16. Health Habit: A Concept Analysis.

    Science.gov (United States)

    Opalinski, Andra S; Weglicki, Linda S; Gropper, Sareen S

    2018-01-01

    The aim of this article is to provide clarity of the concept of health habit. Using Walker and Avant's (1983; 2010) method for conducting a concept analysis, the authors identify the attributes and characteristics of health habit, its theoretical and practical application to nursing, and sample cases to further illustrate the concept. Empirical and conceptual literature was used to inform this concept analysis. Articles and one book from 1977 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing Health Literature (CINAHL), Science Direct, EBSCOhost and Web of Science. Offering a clear definition and conceptual model of health habit provide the foundation to identify/develop appropriate measures of the concept and guide further investigation of understanding the development and sustainability of healthy habits. Additional research is needed to test the conceptual relationships between health habits and outcome variables as they apply to different groups across the age continuum. © 2017 Wiley Periodicals, Inc.

  17. The One-node CMFD Computational Framework for Highly Parallel Reactor Analysis

    International Nuclear Information System (INIS)

    Kim, Yong Hee

    2016-01-01

    This paper presents one such possible approach named the One-Node and Two-Node Hybrid CMFD method; One-Node CMFD is used to solve the global problem, while Two-Node NEM (Nodal Expansion Method) CMFD replaces FMFD as the local problem. Rapid advancement in computing capabilities has enabled the pursuit for high-fidelity tools in analyzing the reactor configurations. One such tool that gains a lot of recent attention is the pin-by-pin core calculation via local-global iteration with nonlinear acceleration scheme. One-Node CMFD method uses two correction terms to preserve the interface current and flux, in contrast to one correction term employed by conventional nonlinear iterative method proposed. With two correction terms, One-Node CMFD can reduce computing time of local FMFD (Fine-Mesh Finite Difference) as it nonlinearly couples the CMFD and FMFD methods in global-local iterations. Nonetheless, retrieving the pinlevel information from the local FMFD is very time consuming. As such, a more flexible approach is needed to address this challenge.

  18. Comparative Analysis of Stability to Induced Deadlocks for Computing Grids with Various Node Architectures

    Directory of Open Access Journals (Sweden)

    Tatiana R. Shmeleva

    2018-01-01

    Full Text Available In this paper, we consider the classification and applications of switching methods, their advantages and disadvantages. A model of a computing grid was constructed in the form of a colored Petri net with a node which implements cut-through packet switching. The model consists of packet switching nodes, traffic generators and guns that form malicious traffic disguised as usual user traffic. The characteristics of the grid model were investigated under a working load with different intensities. The influence of malicious traffic such as traffic duel was estimated on the quality of service parameters of the grid. A comparative analysis of the computing grids stability was carried out with nodes which implement the store-and-forward and cut-through switching technologies. It is shown that the grids performance is approximately the same under work load conditions, and under peak load conditions the grid with the node implementing the store-and-forward technology is more stable. The grid with nodes implementing SAF technology comes to a complete deadlock through an additional load which is less than 10 percent. After a detailed study, it is shown that the traffic duel configuration does not affect the grid with cut-through nodes if the workload is increases to the peak load, at which the grid comes to a complete deadlock. The execution intensity of guns which generate a malicious traffic is determined by a random function with the Poisson distribution. The modeling system CPN Tools is used for constructing models and measuring parameters. Grid performance and average package delivery time are estimated in the grid on various load options.

  19. Comfort measures: a concept analysis.

    Science.gov (United States)

    Oliveira, Irene

    2013-01-01

    Reference to the concept of comfort measures is growing in the nursing and medical literature; however, the concept of comfort measures is rarely defined. For the comfort work of nurses to be recognized, nurses must be able to identify and delineate the key attributes of comfort measures. A concept analysis using Rodgers' evolutionary method (2000) was undertaken with the goal of identifying the core attributes of comfort measures and thereby clarifying this concept. Health care literature was accessed from the CINAHL and PubMed databases. No restrictions were placed on publication dates. Four main themes of attributes for comfort measures were identified during the analysis. Comfort measures involve an active, strategic process including elements of "stepping in" and "stepping back," are both simple and complex, move from a physical to a holistic perspective and are a part of supportive care. The antecedents to comfort measures are comfort needs and the most common consequence of comfort measures is enhanced comfort. Although the concept of comfort measures is often associated with end-of-life care, this analysis suggests that comfort measures are appropriate for nursing care in all settings and should be increasingly considered in the clinical management of patients who are living with multiple, chronic comorbidities.

  20. Maternal sensitivity: a concept analysis.

    Science.gov (United States)

    Shin, Hyunjeong; Park, Young-Joo; Ryu, Hosihn; Seomun, Gyeong-Ae

    2008-11-01

    The aim of this paper is to report a concept analysis of maternal sensitivity. Maternal sensitivity is a broad concept encompassing a variety of interrelated affective and behavioural caregiving attributes. It is used interchangeably with the terms maternal responsiveness or maternal competency, with no consistency of use. There is a need to clarify the concept of maternal sensitivity for research and practice. A search was performed on the CINAHL and Ovid MEDLINE databases using 'maternal sensitivity', 'maternal responsiveness' and 'sensitive mothering' as key words. The searches yielded 54 records for the years 1981-2007. Rodgers' method of evolutionary concept analysis was used to analyse the material. Four critical attributes of maternal sensitivity were identified: (a) dynamic process involving maternal abilities; (b) reciprocal give-and-take with the infant; (c) contingency on the infant's behaviour and (d) quality of maternal behaviours. Maternal identity and infant's needs and cues are antecedents for these attributes. The consequences are infant's comfort, mother-infant attachment and infant development. In addition, three positive affecting factors (social support, maternal-foetal attachment and high self-esteem) and three negative affecting factors (maternal depression, maternal stress and maternal anxiety) were identified. A clear understanding of the concept of maternal sensitivity could be useful for developing ways to enhance maternal sensitivity and to maximize the developmental potential of infants. Knowledge of the attributes of maternal sensitivity identified in this concept analysis may be helpful for constructing measuring items or dimensions.

  1. A Gene Expression Classifier of Node-Positive Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Paul F. Meeh

    2009-10-01

    Full Text Available We used digital long serial analysis of gene expression to discover gene expression differences between node-negative and node-positive colorectal tumors and developed a multigene classifier able to discriminate between these two tumor types. We prepared and sequenced long serial analysis of gene expression libraries from one node-negative and one node-positive colorectal tumor, sequenced to a depth of 26,060 unique tags, and identified 262 tags significantly differentially expressed between these two tumors (P < 2 x 10-6. We confirmed the tag-to-gene assignments and differential expression of 31 genes by quantitative real-time polymerase chain reaction, 12 of which were elevated in the node-positive tumor. We analyzed the expression levels of these 12 upregulated genes in a validation panel of 23 additional tumors and developed an optimized seven-gene logistic regression classifier. The classifier discriminated between node-negative and node-positive tumors with 86% sensitivity and 80% specificity. Receiver operating characteristic analysis of the classifier revealed an area under the curve of 0.86. Experimental manipulation of the function of one classification gene, Fibronectin, caused profound effects on invasion and migration of colorectal cancer cells in vitro. These results suggest that the development of node-positive colorectal cancer occurs in part through elevated epithelial FN1 expression and suggest novel strategies for the diagnosis and treatment of advanced disease.

  2. CT perfusion study of neck lymph nodes

    International Nuclear Information System (INIS)

    Zhong Jin; Liu Jun; Hua Rui; Qiao Hui; Gong Yi

    2011-01-01

    Objective: To study the CT perfusion features of various lymph nodes in the neck. Methods: Dynamic perfusion CT scanning was performed in 83 neck lymph nodes proved by pathology, including tuberculosis lymph nodes, lymphoma and metastatic lymph nodes. The shapes, blood flow modes, and perfusion parameters of these lymph nodes were compared among 3 groups. Statistical analysis of L/T and CT perfusion parameters was performed by one-way ANOVA and LSD test. Results: The values of MTT of tuberculosis lymph nodes, lymphoma and metastatic lymph nodes were (28.13±5.08), (31.08±5.82), and (11.24±5.31) s, respectively. The MTT of metastatic lymph nodes was statistically lower than that of tuberculosis lymph nodes and lymphoma (P -1 · 100 g -1 , respectively. The values of BV were (24.68±2.84), (25.30±3.16), and (25.15± 8.81) ml·100 g -1 respectively. The values of TTP were (40.90±8.85), (40.67±6.45), and (40.98±6.62) s, respectively. There were no significant differences in L/T, BF, BV and TTP among tuberculosis lymph nodes, lymphoma and metastatic lymph nodes (P>0.05). Conclusion: CT perfusion, especially combination functional imaging with perfusion images may be helpful in judging the nature of neck lymph nodes. (authors)

  3. Online Exhibits & Concept Maps

    Science.gov (United States)

    Douma, M.

    2009-12-01

    Presenting the complexity of geosciences to the public via the Internet poses a number of challenges. For example, utilizing various - and sometimes redundant - Web 2.0 tools can quickly devour limited time. Do you tweet? Do you write press releases? Do you create an exhibit or concept map? The presentation will provide participants with a context for utilizing Web 2.0 tools by briefly highlighting methods of online scientific communication across several dimensions. It will address issues of: * breadth and depth (e.g. from narrow topics to well-rounded views), * presentation methods (e.g. from text to multimedia, from momentary to enduring), * sources and audiences (e.g. for experts or for the public, content developed by producers to that developed by users), * content display (e.g. from linear to non-linear, from instructive to entertaining), * barriers to entry (e.g. from an incumbent advantage to neophyte accessible, from amateur to professional), * cost and reach (e.g. from cheap to expensive), and * impact (e.g. the amount learned, from anonymity to brand awareness). Against this backdrop, the presentation will provide an overview of two methods of online information dissemination, exhibits and concept maps, using the WebExhibits online museum (www.webexhibits.org) and SpicyNodes information visualization tool (www.spicynodes.org) as examples, with tips on how geoscientists can use either to communicate their science. Richly interactive online exhibits can serve to engage a large audience, appeal to visitors with multiple learning styles, prompt exploration and discovery, and present a topic’s breadth and depth. WebExhibits, which was among the first online museums, delivers interactive information, virtual experiments, and hands-on activities to the public. While large, multidisciplinary exhibits on topics like “Color Vision and Art” or “Calendars Through the Ages” require teams of scholars, user interface experts, professional writers and editors

  4. System based practice: a concept analysis

    Directory of Open Access Journals (Sweden)

    SHAHRAM YAZDANI

    2016-04-01

    Full Text Available Introduction: Systems-Based Practice (SBP is one of the six competencies introduced by the ACGME for physicians to provide high quality of care and also the most challenging of them in performance, training, and evaluation of medical students. This concept analysis clarifies the concept of SBP by identifying its components to make it possible to differentiate it from other similar concepts. For proper training of SBP and to ensure these competencies in physicians, it is necessary to have an operational definition, and SBP’s components must be precisely defined in order to provide valid and reliable assessment tools. Methods: Walker & Avant’s approach to concept analysis was performed in eight stages: choosing a concept, determining the purpose of analysis, identifying all uses of the concept, defining attributes, identifying a model case, identifying borderline, related, and contrary cases, identifying antecedents and consequences, and defining empirical referents. Results: Based on the analysis undertaken, the attributes of SBP includes knowledge of the system, balanced decision between patients’ need and system goals, effective role playing in interprofessional health care team, system level of health advocacy, and acting for system improvement. System thinking and a functional system are antecedents and system goals are consequences. A case model, as well as border, and contrary cases of SBP, has been introduced. Conclusion: The identification of SBP attributes in this study contributes to the body of knowledge in SBP and reduces the ambiguity of this concept to make it possible for applying it in training of different medical specialties. Also, it would be possible to develop and use more precise tools to evaluate SBP competency by using empirical referents of the analysis.

  5. RESTful web API design with Node.js

    CERN Document Server

    Bojinov, Valentin

    2015-01-01

    If you are a web developer wanting to enrich your development skills to create scalable, server-side, RESTful applications based on the Node.js platform, this book is for you. You also need to be aware of HTTP communication concepts and should have a working knowledge of JavaScript. Knowledge of REST would be an added advantage but is definitely not a necessity.

  6. The role of sentinel node detection techniques in vulvar and cervival cancer

    International Nuclear Information System (INIS)

    Wydra, D.; Sawicki, S.; Emerich, J.; Romanowicz, G.

    2002-01-01

    The sentinel node is the first lymph node that receives the lymph drainage from the primary tumour. The pathological status of the sentinel node should reflect the histopathology of the entire regional lymph drainage area - both vulvar and cervical cancer spread through the lymphatic system. In gynaecological oncology recent studies have confirmed the utility of the sentinel node concept in vulvar and cervical cancer. Three techniques for sentinel node localisation are available. The preoperative lymphoscintigraphy and intraoperative handheld gamma probe detection require the administration of the technetium-99m-labelled colloid around the tumour. The other method is based on the injection of the patent blue dye - during the surgery of the sentinel node because of the dye uptake becomes visible. Following detection, the sentinel lymph node can be removed separately and assessed with ultrastaging and immunohistochemical staining. In the early stages of vulvar and cervical cancer the lymph nodes metastases rate is relatively low - in most cases lymphadenectomy is not necessary. The determination of the regional lymph nodes' pathological status may limit the extent of the surgical treatment. The sentinel node detection rate is relatively high and depends on the applied technique. This technique may play an important role in the treatment of vulvar and cervical cancer. This paper describes the details of sentinel node identification and reviews the literature. (author)

  7. 3D inkjet printed disposable environmental monitoring wireless sensor node

    KAUST Repository

    Farooqui, Muhammad Fahad; Shamim, Atif

    2017-01-01

    We propose a disposable, miniaturized, moveable, fully integrated 3D inkjet-printed wireless sensor node for large area environmental monitoring applications. As a proof of concept, we show the wireless sensing of temperature, humidity and H2S

  8. Ethical competence: A concept analysis.

    Science.gov (United States)

    Kulju, Kati; Stolt, Minna; Suhonen, Riitta; Leino-Kilpi, Helena

    2016-06-01

    Exploring the concept of ethical competence in the context of healthcare is essential as it pertains to better quality of care. The concept still lacks a comprehensive definition covering the aspects of ethical expertise, ethical knowledge and action of a health professional. This article aims to report an analysis of the concept of ethical competence. A modified strategy suggested by Walker and Avant was used to analyse the concept. As a result, the concept of ethical competence can be defined in terms of character strength, ethical awareness, moral judgement skills and willingness to do good. Virtuous professional, experience of a professional, human communication, ethical knowledge and supporting surroundings in the organisation can be seen as prerequisites for ethical competence. Ethical competence results in the best possible solutions for the patient, reduced moral distress at work and development and democratisation of society. The results of the analysis establish a basis for an instrument to evaluate health professionals' ethical competence. It will guide educators, as well as managers in healthcare, to support the development of ethical conduct in healthcare. © The Author(s) 2015.

  9. Concept Analysis of Spirituality: An Evolutionary Approach.

    Science.gov (United States)

    Weathers, Elizabeth; McCarthy, Geraldine; Coffey, Alice

    2016-04-01

    The aim of this article is to clarify the concept of spirituality for future nursing research. Previous concept analyses of spirituality have mostly reviewed the conceptual literature with little consideration of the empirical literature. The literature reviewed in prior concept analyses extends from 1972 to 2005, with no analysis conducted in the past 9 years. Rodgers' evolutionary framework was used to review both the theoretical and empirical literature pertaining to spirituality. Evolutionary concept analysis is a formal method of philosophical inquiry, in which papers are analyzed to identify attributes, antecedents, and consequences of the concept. Empirical and conceptual literature. Three defining attributes of spirituality were identified: connectedness, transcendence, and meaning in life. A conceptual definition of spirituality was proposed based on the findings. Also, four antecedents and five primary consequences of spirituality were identified. Spirituality is a complex concept. This concept analysis adds some clarification by proposing a definition of spirituality that is underpinned by both conceptual and empirical research. Furthermore, exemplars of spirituality, based on prior qualitative research, are presented to support the findings. Hence, the findings of this analysis could guide future nursing research on spirituality. © 2015 Wiley Periodicals, Inc.

  10. Node cookbook

    CERN Document Server

    Clements, David Mark

    2014-01-01

    In Node Cookbook Second Edition, each chapter focuses on a different aspect of working with Node. Following a Cookbook structure, the recipes are written in an easy-to-understand language. Readers will find it easier to grasp even the complex recipes which are backed by lots of illustrations, tips, and hints.If you have some knowledge of JavaScript and want to build fast, efficient, scalable client-server solutions, then Node Cookbook Second Edition is for you. Knowledge of Node will be an advantage but is not required. Experienced users of Node will be able to improve their skills.

  11. An analysis of lymphographic signs for differentiating cancerous, lymphomatous, and normal lymph nodes

    International Nuclear Information System (INIS)

    Tatsuzaki, Hideo; Nakajima, Teiichi; Okumura, Toshiyuki; Akisada, Masayoshi

    1987-01-01

    Twenty-four lymphographic signs, obtained from a total of 204 cancerous (C), lymphomatous (L), and normal (N) lymph nodes, were analyzed based on the final diagnosis. Univariate analyses with correlation coefficient and multivariate regression analyses were employed to differentiate C, L, or N lymph nodes. Based on univariate analyses, lymphographic sings for C nodes were - enlarged node, irregular or deficient capsules or marginal sinuses, block of lymph vessels, extravasation, and defect in lymph-vascular and nodal phase (combination defect). The signs for L node were - enlarged node, elliptic shape from 2 projections, irregular or deficient capsules or marginal sinuses, and extravasation. Using multivariate analyses, the following signs were necessary for differentiating individual lymph nodes: (a) combination defect, specific pattern, granularity, nodal shape and stasis or preservation of lymph vessels for differentiating C from N nodes; (b) deficiencies of capsules, nodal shape, specific pattern, dislocation of lymph vessels, and nodal contrast for differentiating L from N nodes; and (c) character of defect, specific pattern, deformity, soft tissue shadow and nodal shape for differentiating C from L nodes. Should lymphography be used in the visualization of inside structure and lymphatic canal, it would even more increase the ability to diagnose cancer and malignant lymphomas. (Namekawa, K.)

  12. Cross-Disciplinary Analysis of Lymph Node Classification in Lung Cancer on CT Scanning.

    Science.gov (United States)

    El-Sherief, Ahmed H; Lau, Charles T; Obuchowski, Nancy A; Mehta, Atul C; Rice, Thomas W; Blackstone, Eugene H

    2017-04-01

    Accurate and consistent regional lymph node classification is an important element in the staging and multidisciplinary management of lung cancer. Regional lymph node definition sets-lymph node maps-have been created to standardize regional lymph node classification. In 2009, the International Association for the Study of Lung Cancer (IASLC) introduced a lymph node map to supersede all preexisting lymph node maps. Our aim was to study if and how lung cancer specialists apply the IASLC lymph node map when classifying thoracic lymph nodes encountered on CT scans during lung cancer staging. From April 2013 through July 2013, invitations were distributed to all members of the Fleischner Society, Society of Thoracic Radiology, General Thoracic Surgical Club, and the American Association of Bronchology and Interventional Pulmonology to participate in an anonymous online image-based and text-based 20-question survey regarding lymph node classification for lung cancer staging on CT imaging. Three hundred thirty-seven people responded (approximately 25% participation). Respondents consisted of self-reported thoracic radiologists (n = 158), thoracic surgeons (n = 102), and pulmonologists who perform endobronchial ultrasonography (n = 77). Half of the respondents (50%; 95% CI, 44%-55%) reported using the IASLC lymph node map in daily practice, with no significant differences between subspecialties. A disparity was observed between the IASLC definition sets and their interpretation and application on CT scans, in particular for lymph nodes near the thoracic inlet, anterior to the trachea, anterior to the tracheal bifurcation, near the ligamentum arteriosum, between the bronchus intermedius and esophagus, in the internal mammary space, and adjacent to the heart. Use of older lymph node maps and inconsistencies in interpretation and application of definitions in the IASLC lymph node map may potentially lead to misclassification of stage and suboptimal management of lung

  13. [Concept analysis of workplace bullying].

    Science.gov (United States)

    Ma, Shu-Ching; Wang, Hsiu-Hung; Chen, Jih-Yuan

    2011-08-01

    Workplace bullying is a complicated and imprecise concept. Research findings have highlighted it as an important issue in the nursing environment worldwide. Workplace bullying arises due to malfunctions in workplace organizational and cultural related antecedents and manifests in various forms. Many studies have reported that nurses experiencing workplace bullying face increased levels of physical, psychological and social distress, may adopt suicidal thoughts and negativity towards the nursing profession, and may even abandon the nursing profession completely. Although a large number of papers have discussed the antecedents, forms and interventions related to workplace bullying, there has yet been no systematic concept analysis of workplace bullying. This paper applied Walker and Avant's concept analysis process to verify concept definitions, identify defining attributes, antecedents, and consequences, and provide examples of model, borderline, and contrary cases. Findings can help nursing administrators understand and clarify the meaning of workplace bullying in order to take appropriate measures to improve the working environment for nursing professionals.

  14. Care partner: A concept analysis.

    Science.gov (United States)

    Bennett, Paul N; Wang, Wei; Moore, Mel; Nagle, Cate

    The use of the term care partner has increased, particularly in the chronic disease literature; however, the concept has not been well defined. The purpose of this concept analysis was to define and assist nurses to better understand the concept of care partner. The method by Walker and Avant was used for this literature-based concept analysis. Care partnering includes providing assistance to an individual with a health condition to meet their self-care deficits, the commitment to a care partner relationship, and the recognition that people with self-care deficits are care partners contributing to their own care. Emphasizing the care partner dyad in nursing may contribute to improved patient care outcomes both in the acute and chronic settings. It is recommended that nurses view the person with the condition as a contributor and partner in their own care in the context of a larger care partnership. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Team-Based Care: A Concept Analysis.

    Science.gov (United States)

    Baik, Dawon

    2017-10-01

    The purpose of this concept analysis is to clarify and analyze the concept of team-based care in clinical practice. Team-based care has garnered attention as a way to enhance healthcare delivery and patient care related to quality and safety. However, there is no consensus on the concept of team-based care; as a result, the lack of common definition impedes further studies on team-based care. This analysis was conducted using Walker and Avant's strategy. Literature searches were conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO, with a timeline from January 1985 to December 2015. The analysis demonstrates that the concept of team-based care has three core attributes: (a) interprofessional collaboration, (b) patient-centered approach, and (c) integrated care process. This is accomplished through understanding other team members' roles and responsibilities, a climate of mutual respect, and organizational support. Consequences of team-based care are identified with three aspects: (a) patient, (b) healthcare professional, and (c) healthcare organization. This concept analysis helps better understand the characteristics of team-based care in the clinical practice as well as promote the development of a theoretical definition of team-based care. © 2016 Wiley Periodicals, Inc.

  16. The Association between Abnormal Long Noncoding RNA MALAT-1 Expression and Cancer Lymph Node Metastasis: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jun Wang

    2016-01-01

    Full Text Available Previous studies have investigated that the expression levels of MALAT-1 were higher in cancerous tissues than matched histologically normal tissues. And, to some extent, overexpression of MALAT-1 was inclined to lymph node metastasis. This meta-analysis collected all relevant articles and explored the association between MALAT-1 expression levels and lymph node metastasis. We searched PubMed, EmBase, Web of Science, Cochrane Library, and OVID to address the level of MALAT-1 expression in cancer cases and noncancerous controls (accessed February 2015. And 8 studies comprising 696 multiple cancer patients were included to assess this association. The odds ratio (OR and its corresponding 95% confidence interval (CI were calculated to assess the strength of the association using Stata 12.0 version software. The results revealed there was a significant difference in the incidence of lymph node metastasis between high MALAT-1 expression group and low MALAT-1 expression group (OR = 1.94, 95% CI 1.15–3.28, P=0.013 random-effects model. Subgroup analysis indicated that MALAT-1 high expression had an unfavorable impact on lymph node metastasis in Chinese patients (OR = 1.87, 95% CI 1.01–2.46. This study demonstrated that the incidence of lymph node metastasis in patients detected with high MALAT-1 expression was higher than that in patients with low MALAT-1 expression in China.

  17. Allocating resources between network nodes for providing a network node function

    NARCIS (Netherlands)

    Strijkers, R.J.; Meulenhoff, P.J.

    2014-01-01

    The invention provides a method wherein a first network node advertises available resources that a second network node may use to offload network node functions transparently to the first network node. Examples of the first network node are a client device (e.g. PC, notebook, tablet, smart phone), a

  18. Concept analysis of culture applied to nursing.

    Science.gov (United States)

    Marzilli, Colleen

    2014-01-01

    Culture is an important concept, especially when applied to nursing. A concept analysis of culture is essential to understanding the meaning of the word. This article applies Rodgers' (2000) concept analysis template and provides a definition of the word culture as it applies to nursing practice. This article supplies examples of the concept of culture to aid the reader in understanding its application to nursing and includes a case study demonstrating components of culture that must be respected and included when providing health care.

  19. Preliminary evaluation of intraoperative gamma probe detection of the sentinel node

    Energy Technology Data Exchange (ETDEWEB)

    Sierralta, M P; Jofre, M J [Nuclear Medicine Department, Military Hospital, Santiago (Chile); Iglesis, R; Schwartz, R; Gomez, L; Velez, R [Surgery Department, Military Hospital, Santiago (Chile); Sandoval, R [Pathology Department, Military Hospital, Santiago (Chile)

    2002-09-01

    Introduction: The resurgence of the lymphoscintigraphy with the sentinel node concept and the availability of the intraoperative gamma probe have been proposed to avoid the morbidity of an unnecessary regional node dissection. The aim of the study was to evaluate the intraoperative gamma probe use after lymphoscintigraphy for the localization of the sentinel node. Material and methods: Twenty-nine patients were studied, 18 females (62%), mean age 60 {+-} 19 y.o. (range 24-86 y.o.) at the Military Hospital Nuclear Medicine Department. The reference diagnoses were 66% malignant melanoma, 21 % breast cancer, 10 % head and neck cancer and 3% vulvae cancer. Lymphoscintigraphs were performed with Tc99m-Dextran injected intradermally in four points around the primary lesion or around the biopsy site (for melanoma 500 microCi each one; for breast and head and neck 200 microCi each one). Afterwards, dynamic images were taken, followed by intraoperative gamma probe investigations in order to localize and remove the sentinel node. Additionally, isosulfan blue was injected before the surgery was made. Results: Lymphoscintigraphy was positive to detect sentinel node(s) in 20 patients (69%). During the surgery, 40 sentinel nodes were detected. In 33 cases, the intraoperative gamma probe was performed, of which 88 % were radioactives. In 35 nodes, the isosulfan blue was injected, of which 80 % were dyed. The correlation between both techniques was 75 %. The histology study of 37 samples demonstrated that 86% (n=32) were truly ganglionar nodes. Conclusion: The intraoperative gamma probe after lymphoscintigraphy is a useful technique for the localization of the sentinel node.

  20. Preliminary evaluation of intraoperative gamma probe detection of the sentinel node

    International Nuclear Information System (INIS)

    Sierralta, M.P.; Jofre, M.J.; Iglesis, R.; Schwartz, R.; Gomez, L.; Velez, R.; Sandoval, R.

    2002-01-01

    Introduction: The resurgence of the lymphoscintigraphy with the sentinel node concept and the availability of the intraoperative gamma probe have been proposed to avoid the morbidity of an unnecessary regional node dissection. The aim of the study was to evaluate the intraoperative gamma probe use after lymphoscintigraphy for the localization of the sentinel node. Material and methods: Twenty-nine patients were studied, 18 females (62%), mean age 60 ± 19 y.o. (range 24-86 y.o.) at the Military Hospital Nuclear Medicine Department. The reference diagnoses were 66% malignant melanoma, 21 % breast cancer, 10 % head and neck cancer and 3% vulvae cancer. Lymphoscintigraphs were performed with Tc99m-Dextran injected intradermally in four points around the primary lesion or around the biopsy site (for melanoma 500 microCi each one; for breast and head and neck 200 microCi each one). Afterwards, dynamic images were taken, followed by intraoperative gamma probe investigations in order to localize and remove the sentinel node. Additionally, isosulfan blue was injected before the surgery was made. Results: Lymphoscintigraphy was positive to detect sentinel node(s) in 20 patients (69%). During the surgery, 40 sentinel nodes were detected. In 33 cases, the intraoperative gamma probe was performed, of which 88 % were radioactives. In 35 nodes, the isosulfan blue was injected, of which 80 % were dyed. The correlation between both techniques was 75 %. The histology study of 37 samples demonstrated that 86% (n=32) were truly ganglionar nodes. Conclusion: The intraoperative gamma probe after lymphoscintigraphy is a useful technique for the localization of the sentinel node

  1. History, present status and future of sentinel node biopsy in breast cancer. The Mary Béves Lecture.

    Science.gov (United States)

    Mansel, R E; Khonji, N I; Clarke, D

    2000-01-01

    The word Sentinel' is defined in The Oxford English Dictionary as 'a guard, one who keeps watch or a sentry'. When translated to the concept of a tumour and its lymph node drainage, the sentinel node could be interpreted to mean the lymph node that guards or keeps watch over a tumour. The sentinel lymph node can thus be defined as the first lymph node that drains a primary tumour within the regional lymphatic basin of that tumour. We know that tumour progression in breast cancer often occurs in an orderly, progressive fashion. So in theory, if the sentinel node is tumour free then the rest of the nodes in the lymphatic basin should also be uninvolved by the tumour.

  2. Allocating resources between network nodes for providing a network node function

    OpenAIRE

    Strijkers, R.J.; Meulenhoff, P.J.

    2014-01-01

    The invention provides a method wherein a first network node advertises available resources that a second network node may use to offload network node functions transparently to the first network node. Examples of the first network node are a client device (e.g. PC, notebook, tablet, smart phone), a server (e.g. application server, a proxy server, cloud location, router). Examples of the second network node are an application server, a cloud location or a router. The available resources may b...

  3. The surgical treatment of failure in cervical lymph nodes after radiotherapy for nasopharyngeal carcinoma: an analysis of 83 patients

    International Nuclear Information System (INIS)

    Gu Wendong; Ji Qinghai; Lu Xueguan; Feng Yan

    2003-01-01

    Objective: To analyze the results of neck dissection in patients who failed in cervical lymph nodes after radiotherapy for nasopharyngeal carcinoma. Methods: Eighty-three patients who received neck dissection due to lymph node persistence or recurrence after definitive radiotherapy were analyzed retrospectively according to the following relevant factors: age, sex, the interval between completion of radiotherapy and surgery, rN stage, postoperative radiotherapy given or not, the adjacent tissues involved or not and the number of positive nodes. Kaplan-Meier method, Log-rank method and Cox method were used in the statistical analysis. Results: The 1-, 3- and 5-year overall survival rates were 80.7%, 47.1% and 34.9%. The interval between completion of radiotherapy and surgery, postoperative radiotherapy given or not, the adjacent tissues involved or not were significantly prognostic factors in statistic analysis. Conclusions: Neck dissection can be applied in the management of cervical lymph node failure in nasopharyngeal carcinoma after radiotherapy. Postoperative radiotherapy should be considered in patients with capsular invasion and/or adjacent tissue involvement

  4. Clinical Reasoning in Medicine: A Concept Analysis

    Directory of Open Access Journals (Sweden)

    Shahram Yazdani

    2018-01-01

    Full Text Available Background: Clinical reasoning plays an important role in the ability of physicians to make diagnoses and decisions. It is considered the physician’s most critical competence, but it is an ambiguous conceptin medicine that needs a clear analysis and definition. Our aim was to clarify the concept of clinical reasoning in medicine by identifying its components and to differentiate it from other similar concepts.It is necessary to have an operational definition of clinical reasoning, and its components must be precisely defined in order to design successful interventions and use it easily in future research.Methods: McKenna’s nine-step model was applied to facilitate the clarification of the concept of clinical reasoning. The literature for this concept analysis was retrieved from several databases, including Scopus, Elsevier, PubMed, ISI, ISC, Medline, and Google Scholar, for the years 1995– 2016 (until September 2016. An extensive search of the literature was conducted using the electronic database. Accordingly, 17 articles and one book were selected for the review. We applied McKenna’s method of concept analysis in studying clinical reasoning, so that definitional attributes, antecedents, and consequences of this concept were extracted.Results: Clinical reasoning has nine major attributes in medicine. These attributes include: (1 clinical reasoning as a cognitive process; (2 knowledge acquisition and application of different types of knowledge; (3 thinking as a part of the clinical reasoning process; (4 patient inputs; (5 contextdependent and domain-specific processes; (6 iterative and complex processes; (7 multi-modal cognitive processes; (8 professional principles; and (9 health system mandates. These attributes are influenced by the antecedents of workplace context, practice frames of reference, practice models of the practitioner, and clinical skills. The consequences of clinical reasoning are the metacognitive improvement of

  5. Concept Analysis: Alzheimer's Caregiver Stress.

    Science.gov (United States)

    Llanque, Sarah; Savage, Lynette; Rosenburg, Neal; Caserta, Michael

    2016-01-01

    The aim of this article was to analyze the concept of caregiver stress in the context of caring for a person with Alzheimer's disease and related dementias. Currently, there are more than 15 million unpaid caregivers for persons suffering from Alzheimer's disease and related dementias. This unpaid care can be stressful for caregivers due to the chronic nature of the disease process, as well as other factors. The paper incorporates the modified method of Wilson's concept analysis procedure to analyze the concept of caregiver stress. A review of the literature was undertaken using the Cumulative Index to Nursing and Allied Health Literature, Google Scholar, and PubMed. A theoretical definition of caregiver stress is provided, and the defining attributes, related concepts, antecedents, and consequences of caregiver stress are proposed, and case studies are presented. The analysis demonstrates that caregiver stress is the unequal exchange of assistance among people who stand in close relationship to one another, which results in emotional and physical stress on the caregiver. Implications for future nursing research and practice conclude the paper. © 2014 Wiley Periodicals, Inc.

  6. Node-pair reliability of network systems with small distances between adjacent nodes

    International Nuclear Information System (INIS)

    Malinowski, Jacek

    2007-01-01

    A new method for computing the node-pair reliability of network systems modeled by random graphs with nodes arranged in sequence is presented. It is based on a recursive algorithm using the 'sliding window' technique, the window being composed of several consecutive nodes. In a single step, the connectivity probabilities for all nodes included in the window are found. Subsequently, the window is moved one node forward. This process is repeated until, in the last step, the window reaches the terminal node. The connectivity probabilities found at that point are used to compute the node-pair reliability of the network system considered. The algorithm is designed especially for graphs with small distances between adjacent nodes, where the distance between two nodes is defined as the absolute value of the difference between the nodes' numbers. The maximal distance between any two adjacent nodes is denoted by Γ(G), where G symbolizes a random graph. If Γ(G)=2 then the method can be applied for directed as well as undirected graphs whose nodes and edges are subject to failure. This is important in view of the fact that many algorithms computing network reliability are designed for graphs with failure-prone edges and reliable nodes. If Γ(G)=3 then the method's applicability is limited to undirected graphs with reliable nodes. The main asset of the presented algorithms is their low numerical complexity-O(n), where n denotes the number of nodes

  7. A simple MC-based algorithm for evaluating reliability of stochastic-flow network with unreliable nodes

    International Nuclear Information System (INIS)

    Yeh, W.-C.

    2004-01-01

    A MP/minimal cutset (MC) is a path/cut set such that if any edge is removed from this path/cut set, then the remaining set is no longer a path/cut set. An intuitive method is proposed to evaluate the reliability in terms of MCs in a stochastic-flow network subject to both edge and node failures under the condition that all of the MCs are given in advance. This is an extension of the best of known algorithms for solving the d-MC (a special MC but formatted in a system-state vector, where d is the lower bound points of the system capacity level) problem from the stochastic-flow network without unreliable nodes to with unreliable nodes by introducing some simple concepts. These concepts were first developed in the literature to implement the proposed algorithm to reduce the number of d-MC candidates. This method is more efficient than the best of known existing algorithms regardless if the network has or does not have unreliable nodes. Two examples are illustrated to show how the reliability is determined using the proposed algorithm in the network with or without unreliable nodes. The computational complexity of the proposed algorithm is analyzed and compared with the existing methods

  8. Quantitative CT texture and shape analysis: Can it differentiate benign and malignant mediastinal lymph nodes in patients with primary lung cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Bayanati, Hamid; Thornhill, Rebecca E.; Souza, Carolina A.; Sethi-Virmani, Vineeta; Gupta, Ashish; Dennie, Carole [University of Ottawa, The Ottawa Hospital Research Institute, Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Box 232, Ottawa, ON (Canada); Maziak, Donna [University of Ottawa, The Ottawa Hospital Research Institute, Department of Surgery - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON (Canada); Amjadi, Kayvan [University of Ottawa, The Ottawa Hospital Research Institute, Department of Respiratory Medicine, The Ottawa Hospital, Ottawa, ON (Canada)

    2014-09-13

    To assess the accuracy of CT texture and shape analysis in the differentiation of benign and malignant mediastinal nodes in lung cancer. Forty-three patients with biopsy-proven primary lung malignancy with pathological mediastinal nodal staging and unenhanced CT of the thorax were studied retrospectively. Grey-level co-occurrence and run-length matrix textural features, as well as morphological features, were extracted from 72 nodes. Differences between benign and malignant features were assessed using Mann-Whitney U tests. Receiver operating characteristic (ROC) curves for each were constructed and the area under the curve (AUC) calculated with histopathology diagnosis as outcome. Combinations of features were also entered as predictors in logistic regression models and optimal threshold criteria were used to estimate sensitivity and specificity. Using optimum-threshold criteria, the combined textural and shape features identified malignant mediastinal nodes with 81 % sensitivity and 80 % specificity (AUC = 0.87, P < 0.0001). Using this combination, 84 % malignant and 71 % benign nodes were correctly classified. Quantitative CT texture and shape analysis has the potential to accurately differentiate malignant and benign mediastinal nodes in lung cancer. (orig.)

  9. Efficient Graph Computation for Node2Vec

    OpenAIRE

    Zhou, Dongyan; Niu, Songjie; Chen, Shimin

    2018-01-01

    Node2Vec is a state-of-the-art general-purpose feature learning method for network analysis. However, current solutions cannot run Node2Vec on large-scale graphs with billions of vertices and edges, which are common in real-world applications. The existing distributed Node2Vec on Spark incurs significant space and time overhead. It runs out of memory even for mid-sized graphs with millions of vertices. Moreover, it considers at most 30 edges for every vertex in generating random walks, causin...

  10. X-ray appearance of intrathoracic lymph nodes in lymphogranulomatosis

    International Nuclear Information System (INIS)

    Zagorodskaya, M.M.; Antonova, R.A.

    1980-01-01

    Analysis of clinico-roentgenological data obtained when examining 174 patients with lymphogranulomatosis is carried out. Roentgenological semiotics of the lesions of intrathoracic lymp nodes according to the Rouviere classification supplemented by Zhdanov has been specified. Technique of layer-by-layer examination with an account of roentgenotopography of intrathoracic lymph nodes promoting to their determination is developed. Dynamics of the lymph node changes under treatment is traced. Rarely occurring wide-spread decalcification of prevascular nodes after the radiotherapy is described

  11. Predictive Factors for Nonsentinel Lymph Node Metastasis in Patients With Positive Sentinel Lymph Nodes After Neoadjuvant Chemotherapy: Nomogram for Predicting Nonsentinel Lymph Node Metastasis.

    Science.gov (United States)

    Ryu, Jai Min; Lee, Se Kyung; Kim, Ji Young; Yu, Jonghan; Kim, Seok Won; Lee, Jeong Eon; Han, Se Hwan; Jung, Yong Sik; Nam, Seok Jin

    2017-11-01

    Axillary lymph node (ALN) status is an important prognostic factor for breast cancer patients. With increasing numbers of patients undergoing neoadjuvant chemotherapy (NAC), issues concerning sentinel lymph node biopsy (SLNB) after NAC have emerged. We analyzed the clinicopathologic features and developed a nomogram to predict the possibility of nonsentinel lymph node (NSLN) metastases in patients with positive SLNs after NAC. A retrospective medical record review was performed of 140 patients who had had clinically positive ALNs at presentation, had a positive SLN after NAC on subsequent SLNB, and undergone axillary lymph node dissection (ALND) from 2008 to 2014. On multivariate stepwise logistic regression analysis, pathologic T stage, lymphovascular invasion, SLN metastasis size, and number of positive SLN metastases were independent predictors for NSLN metastases (P Samsung Medical Center NAC nomogram was developed to predict the likelihood of additional positive NSLNs. The Samsung Medical Center NAC nomogram could provide information to surgeons regarding whether to perform additional ALND when the permanent biopsy revealed positive findings, although the intraoperative SLNB findings were negative. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Detection of sentinel nodes with radiopharmaceuticals

    International Nuclear Information System (INIS)

    Yokoyama, Kunihiko; Michigishi, Takatoshi; Kinuya, Seigo; Konishi, Shota; Nakajima, Kenichi; Tonami, Norihisa

    2000-01-01

    Sentinel lymph nodes have been found to be an indicator of lymph node metastasis in breast cancer. In Japan, the theory and concept of sentinel lymph nodes in breast cancer have begun to be applied to carcinomas of the digestive system. Based on clinical experience in the detection of sentinel lymph nodes with radiopharmaceuticals, differences and similarities between the radiopharmaceuticals, methods, and techniques used to detect sentinel lymph nodes have been assessed in relation to breast cancer and carcinomas of the digestive system (including carcinomas of the esophagus and large intestine). The greatest difference between the methods used for breast and digestive cancers is the site of administration of the radiopharmaceutical. In breast cancer, the radiopharmaceutical is administered into a superficial organ (i.e., the mammary gland), whereas in carcinomas of the digestive system, it is administered into a deep organ (i.e., digestive tract). Another obvious difference is in lymph flow, i.e., the flow of the mammary glands is subcutaneous whereas lymph flow in the digestive tract is submucosal. Two radionuclide diagnostic methods are available to detect sentinel lymph nodes: sentinel lymphoscintigraphy with a gamma camera and a method that involves the use of a gamma probe intraoperatively. Radiopharmaceuticals used to detect sentinel lymph nodes must be smoothly transferred from the site of administration into the lymph, and uptake by the sentinel lymph node must continue for a long time without excessive flowing to lower reaches. The optimal particle size remains a matter of controversy, and no radiopharmaceuticals appropriate for lymphoscintigraphy have ever been approved in Japan. The authors compared the pharmacokinetics of three different radiopharmaceuticals used for sentinel lymphoscintigraphy in breast cancer ( 99m Tc-labeled albumin, 99m Tc-labeled tin colloid, and 99m Tc-labeled phytic acid) and founded that the detection rate was lowest with

  13. [Self esteem : concept analysis.

    Science.gov (United States)

    Doré, Christina

    2017-06-01

    Self-esteem is an inner attitude at the base of the construction of personality and psychic balance in addition to be responsible of adaptive processes over the course of life. The concept of self-esteem is commonly used in several disciplines however, it seems that the consensus on its conceptualization and its operationalization is not yet reached. In this context, the concept analysis allows to address a phenomenon and to understand its use and its evolution from a unique disciplinary perspective. The aim of this article is therefore to analyze the concept of self esteem from a nursing perspective to identify : definitions of the term and related terms, attributes, model and limit cases proposed here within the community of mental health nurses, antecedents and consequents as well as the empirical references using the Walker and Avant method. The attributes identified allowing a deeper understanding of the concept are : the self-value, the self-acceptance, the self-efficacy, attitude towards oneself and finally, self-respect.

  14. Semen analysis and prediction of natural conception

    NARCIS (Netherlands)

    Leushuis, Esther; van der Steeg, Jan Willem; Steures, Pieternel; Repping, Sjoerd; Bossuyt, Patrick M. M.; Mol, Ben Willem J.; Hompes, Peter G. A.; van der Veen, Fulco

    2014-01-01

    Do two semen analyses predict natural conception better than a single semen analysis and will adding the results of repeated semen analyses to a prediction model for natural pregnancy improve predictions? A second semen analysis does not add helpful information for predicting natural conception

  15. Readiness for hospital discharge: A concept analysis.

    Science.gov (United States)

    Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice

    2017-11-01

    To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.

  16. Dying with dignity: a concept analysis.

    Science.gov (United States)

    Hemati, Zeinab; Ashouri, Elaheh; AllahBakhshian, Maryam; Pourfarzad, Zahra; Shirani, Farimah; Safazadeh, Shima; Ziyaei, Marziyeh; Varzeshnejad, Maryam; Hashemi, Maryam; Taleghani, Fariba

    2016-05-01

    This article is a report of an analysis of the concept of dying with dignity. Dignity is an important component of providing care for dying patients and their families. Nevertheless, given that this concept is poorly defined, concept analysis is one of the best ways to define and clarify the concept of death with dignity with the aim to enhance its application in clinical practice, research and education. A search of multiple nursing and social sciences databases was undertaken, including Academic Search Complete, Science Direct, ProQuest, Scopus, Medline, PubMed, EBSCO, Ovid, Noormage, Cinahl, Magiran, PsycINFO and SID. After an extensive review of the literature from 1998-2014, about 14 related articles were included in the study. Based on these articles, the applications, attributes and experimental results of and references to death with dignity were recorded. Based on this analysis, the most important attributes of this concept included respect for privacy, respect, spiritual peace and hope. The antecedents of this concept included consideration of moral values during caregiving, preservation of human dignity as a patient right and professional ethics, and belief in the dignity of self and others, consideration of culture in providing end-of-life care. The consequences of this concept included a sense of peace in the patient and their family, peaceful death and provision of patient privacy and comfort. The concept of patient dignity has been referred to in many contexts. However, considering the dignity of dying patients commensurate with their culture is the most important component of care provided by nurses to facilitate a peaceful death. Respecting the dignity of the patient results in the reduction of her/his suffering and prepares her/him for a comfortable death. © 2016 John Wiley & Sons Ltd.

  17. 3D inkjet printed disposable environmental monitoring wireless sensor node

    KAUST Repository

    Farooqui, Muhammad Fahad

    2017-10-24

    We propose a disposable, miniaturized, moveable, fully integrated 3D inkjet-printed wireless sensor node for large area environmental monitoring applications. As a proof of concept, we show the wireless sensing of temperature, humidity and H2S levels which are important for early warnings of two critical environmental conditions namely forest fires and industrial gas leaks. The temperature sensor has TCR of -0.018/°, the highest of any inkjet-printed sensor and the H2S sensor can detect as low as 3 ppm of gas. These sensors and an antenna have been realized on the walls of a 3D-printed cubic package which encloses the microelectronics developed on a 3D-printed circuit board. Hence, 3D printing and inkjet printing have been combined in order to realize a unique low-cost, fully integrated wireless sensor node. Field tests show that these sensor nodes can wirelessly communicate up to a distance of over 100m. Our proposed sensor node can be a part of internet of things with the aim of providing a better and safe living.

  18. Students’ conceptions analysis on several electricity concepts

    Science.gov (United States)

    Saputro, D. E.; Sarwanto, S.; Sukarmin, S.; Ratnasari, D.

    2018-05-01

    This research is aimed to analyse students’ conceptions on several electricity concept. This is a descriptive research with the subjects of new students of Sebelas Maret University. The numbers of the subject were 279 students that consisted of several departments such as science education, physics education, chemistry education, biology education and mathematics education in the academic year of 2017/2018. The instrument used in this research was the multiple-choice test with arguments. Based on the result of the research and analysis, it can be concluded that most of the students still find misconceptions and do not understand electricity concept on sub-topics such as electric current characteristic in the series and parallel arrangement, the value of capacitor capacitance, the influence of the capacitor charge and discharge towards the loads, and the amount of capacitor series arrangement. For the future research, it is suggested to improve students’ conceptual understanding with appropriate learning method and assessment instrument because electricity is one of physics material that closely related with students’ daily life.

  19. A concept analysis of professional commitment in nursing.

    Science.gov (United States)

    García-Moyano, Loreto; Altisent, Rogelio; Pellicer-García, Begoña; Guerrero-Portillo, Sandra; Arrazola-Alberdi, Oihana; Delgado-Marroquín, María Teresa

    2017-01-01

    The concept of professional commitment is being widely studied at present. However, although it is considered an indicator for the most human part of nursing care, there is no clear definition for it, and different descriptors are being used indiscriminately to reference it. The aim of this study is to clarify the concept of professional commitment in nursing through the Rodgers' evolutionary concept analysis process. Systematic search using English and Spanish descriptors and concept analysis. Studies published between 2009 and June 2015, front-to-back analysis of the Nursing Ethics journal and manual check of articles cited in studies related to the Nijmegen Professionalism Scale. The procedure of concept analysis developed by Rodgers was used. Ethical considerations: Although the topic was not labeled as sensitive and subject to ethical approval, its realization was approved by the Ethical Committee of Clinical Research of Aragon (CEICA) approved the study on 18 March 2015 and also careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. A total of 17 published studies. A clear definition of the concept was made, and surrogate terms, concept dimension, differential factors related to the concept, sociocultural variations and consequences for nursing practice were identified. There is a need for continuous advancement in the development of the concept, specific actions to encourage this and the improvement of evaluation methods for its study.

  20. The hidden sentinel node in breast cancer

    International Nuclear Information System (INIS)

    Tanis, P.J.; Sandick, J.W. van; Nieweg, O.E.; Rutgers, E.J.T.; Kroon, B.B.R.; Valdes Olmos, R.A.; Hoefnagel, C.A.

    2002-01-01

    The purpose of this study was to analyse the occurrence of non-visualisation during preoperative lymphoscintigraphy for sentinel node identification in breast cancer. Preoperative lymphoscintigraphy was performed in 495 clinically node-negative breast cancer patients (501 sentinel node procedures) after injection of technetium-99m nanocolloid. Anterior and prone lateral (hanging breast) planar images were obtained a few minutes and 4 h after injection. The sentinel node was intraoperatively identified with the aid of patent blue dye and a gamma-ray detection probe. A sentinel node was visualised on the 4-h images in 449 of 501 procedures (90%). This visualisation rate improved from 76% to 94% during the study period. Delayed imaging (5-23 h) in 19 patients whose sentinel nodes failed to show, resulted in visualisation in four of them. A repeat injection of radiocolloid in 11 patients revealed a sentinel node in six. In the end, the visualisation rate was 92%. The sentinel node was surgically retrieved in 24 of the remaining 42 patients with non-visualisation (57%). Sentinel nodes that were visualised were tumour-positive in 38% and non-visualised sentinel nodes were involved in 50% (χ 2 , P=0.17). In a multivariate regression analysis, scintigraphic non-visualisation was independently associated with increased patient age (P<0.001), decreased tracer dose (P<0.001) and increased number of tumour-positive lymph nodes (P=0.013). The use of a sufficient amount of radioactivity (at least 100 MBq) is recommended for lymphatic mapping in breast cancer, especially in elderly women. Delayed imaging and re-injection of the radioactive tracer increase the visualisation rate. The non-visualised sentinel node can be identified intraoperatively in more than half of the patients. (orig.)

  1. The hidden sentinel node in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tanis, P.J.; Sandick, J.W. van; Nieweg, O.E.; Rutgers, E.J.T.; Kroon, B.B.R. [Department of Surgery, Netherlands Cancer Institute, Amsterdam (Netherlands); Valdes Olmos, R.A.; Hoefnagel, C.A. [Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2002-03-01

    The purpose of this study was to analyse the occurrence of non-visualisation during preoperative lymphoscintigraphy for sentinel node identification in breast cancer. Preoperative lymphoscintigraphy was performed in 495 clinically node-negative breast cancer patients (501 sentinel node procedures) after injection of technetium-99m nanocolloid. Anterior and prone lateral (hanging breast) planar images were obtained a few minutes and 4 h after injection. The sentinel node was intraoperatively identified with the aid of patent blue dye and a gamma-ray detection probe. A sentinel node was visualised on the 4-h images in 449 of 501 procedures (90%). This visualisation rate improved from 76% to 94% during the study period. Delayed imaging (5-23 h) in 19 patients whose sentinel nodes failed to show, resulted in visualisation in four of them. A repeat injection of radiocolloid in 11 patients revealed a sentinel node in six. In the end, the visualisation rate was 92%. The sentinel node was surgically retrieved in 24 of the remaining 42 patients with non-visualisation (57%). Sentinel nodes that were visualised were tumour-positive in 38% and non-visualised sentinel nodes were involved in 50% ({chi}{sup 2}, P=0.17). In a multivariate regression analysis, scintigraphic non-visualisation was independently associated with increased patient age (P<0.001), decreased tracer dose (P<0.001) and increased number of tumour-positive lymph nodes (P=0.013). The use of a sufficient amount of radioactivity (at least 100 MBq) is recommended for lymphatic mapping in breast cancer, especially in elderly women. Delayed imaging and re-injection of the radioactive tracer increase the visualisation rate. The non-visualised sentinel node can be identified intraoperatively in more than half of the patients. (orig.)

  2. Cervical lymph node metastases in salivary gland adenoid cystic carcinoma: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ning C

    2018-06-01

    Full Text Available Chunliu Ning,1 Tengfei Zhao,1 Zechen Wang,1 Delong Li,1 Yurong Kou,2 Shaohui Huang1 1Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Department of Oral Biology, School of Stomatology, China Medical University, Shenyang, Liaoning, People’s Republic of China Background: The purpose of this research was to determine whether neck dissection is necessary for the adenoid cystic carcinoma (ACC of head and neck. Materials and methods: This article screened the abstract and full-text papers that investigated salivary gland primary ACC of head and neck. Two independent reviewers searched for articles published before October 2017 in three databases (Web of Science, PubMed, and Ovid, having no limits in date and language. Statistical data were analyzed statistically by Review Manager 5.3. Results: In total, 18 studies involving 2993 patients were included in the analysis. Of the 2993 patients, 473 patients had cervical lymph node metastasis, with a merge frequency of 16% (95% CI: 13–19. Among included articles, only 4 involved cervical lymph node occult metastases, with a merge frequency of 14% (95% CI: 9–20. There were 5 articles containing minor salivary glands (MiSGs involving 370 patients of which 92 patients had cervical lymph node metastases and the merge frequency was 25% (95% CI: 11–38. Moreover, there were 4 studies on major salivary glands involving 904 patients of which 158 patients had cervical lymph node metastases and the merge frequency was 17% (95% CI: 15–20. Conclusion: Elective neck dissection is unnecessary for all patients with salivary gland ACC of head and neck. Moreover, compared with major salivary glands, MiSGs have a higher cervical lymph node metastases rate in ACC. The overall cervical lymph node metastases rate of MiSGs is 25%, which is enough to attract our attention. Therefore, we suggest that neck dissection might be

  3. Elastography in the assessment of sentinel lymph nodes prior to dissection

    Energy Technology Data Exchange (ETDEWEB)

    Tourasse, Christophe, E-mail: christophe.tourasse@radiologie-lyon.com [Radiology Department, Hopital Prive Jean Mermoz, 55 avenue Jean Mermoz, 69008 Lyon (France); Denier, Jean Francois [Anatomopathology Department, Technipath, 41 allee des Cypres, 69760 Limonest (France); Awada, Azzam; Gratadour, Anne-Christel; Nessah-Bousquet, Karima [Gynaecological and Breast Surgery Department, Hopital Prive Jean Mermoz, 69008 Lyon (France); Gay, Joeel [SuperSonic Imagine, Les Jardins de la Duranne - Bat. F, 510, rue Rene Descartes, 13857 Aix-en-Provence Cedex (France)

    2012-11-15

    Objective: Breast cancer starts as a local tumor but can become metastatic and spread via the lymph nodes. When the pre-operative assessment of the axillary lymph nodes is negative patients generally undergo sentinel node biopsy (SNB), followed by a secondary surgical axillary lymph node dissection (ALND) if the SNB is positive. The extemporaneous anatomo-pathological analysis of the sentinel lymph node enables metastases to be detected and an ALND at the same time of the SNB. The goal of this study was to evaluate the added value of ShearWave Elastography (SWE), compared with the conventional pre-operative assessment, in the screening of sentinel lymph nodes with a high metastatic risk, which could then benefit from an extemporaneous anatomo-pathological analysis. Patients and methods: Women undergoing breast surgery with SNB were prospectively enrolled. Before surgery, they underwent ultrasound and elastography imaging of axillary lymph nodes using the SuperSonic Imagine device and its ShearWave Trade-Mark-Sign elastography mode (SWE Trade-Mark-Sign ). The results obtained were compared to the immunohistochemical results for the removed lymph nodes. Results: 65 patients were enrolled. From the 103 lymph nodes examined by elastography and the 185 lymph nodes removed we were able to pair 81; 70 were healthy and 11 were malignant. The stiffness measurements (mean and maximal values) were significantly different between the healthy and metastatic lymph nodes, (p < 0.05). The areas under the ROC curves were 0.76 (95% confidence interval (CI): 0.58-0.94) and 0.75 (95%CI: 0.55-0.95) for the mean and the maximal stiffness, respectively. Conclusion: These encouraging results show a correlation between the metastatic risk of lymph nodes and their increased mean stiffness. Elasticity variables and potential thresholds that seem to predict the metastatic status of axillary lymph nodes were identified. If confirmed by further larger studies, these results could be useful in

  4. Data acquisition remote node powered over the communications optical fiber

    International Nuclear Information System (INIS)

    Batista, Antonio J.N.; Sousa, Jorge; Gonçalves, Bruno

    2015-01-01

    Large nuclear fusion reactors, like ITER, will have harsh electromagnetic environments nearby the machine. Foreseeing the necessity for special data acquisition remote nodes, on difficult access locations and as close as possible to the experimental devices, motivated the system design. The architecture is based on the power-over-fiber technology recent advancements and respective implementation aim is to attain a proof of concept for the fusion technology field and others, e.g., high energy physics, industry, etc. The design intends the replacement of traditional copper cables and power supplies, vulnerable to electromagnetic interference, by the communications optical fiber of the data acquisition remote node. Optical fibers provide galvanic isolation, immunity to noisy electromagnetic environments and simultaneously can supply power to the remote node electronics. System architecture uses a laser power converter (array of photovoltaic cells) to convert the laser light, from the optical fiber, into electricity. The generated electrical power is enough for powering the remote node electronics and optoelectronics, such as an ADC, a low power FPGA and an optical transmitter. The laser power converter is also used as the communications receiver and from which the acquisition clock is recovered, providing synchronism between remote data acquisition nodes. Descriptions of the system architecture, tested implementations and future improvements are presented.

  5. How to Identify the Most Powerful Node in Complex Networks? A Novel Entropy Centrality Approach

    Directory of Open Access Journals (Sweden)

    Tong Qiao

    2017-11-01

    Full Text Available Centrality is one of the most studied concepts in network analysis. Despite an abundance of methods for measuring centrality in social networks has been proposed, each approach exclusively characterizes limited parts of what it implies for an actor to be “vital” to the network. In this paper, a novel mechanism is proposed to quantitatively measure centrality using the re-defined entropy centrality model, which is based on decompositions of a graph into subgraphs and analysis on the entropy of neighbor nodes. By design, the re-defined entropy centrality which describes associations among node pairs and captures the process of influence propagation can be interpreted explained as a measure of actor potential for communication activity. We evaluate the efficiency of the proposed model by using four real-world datasets with varied sizes and densities and three artificial networks constructed by models including Barabasi-Albert, Erdos-Renyi and Watts-Stroggatz. The four datasets are Zachary’s karate club, USAir97, Collaboration network and Email network URV respectively. Extensive experimental results prove the effectiveness of the proposed method.

  6. Contrast enhanced ultrasound of sentinel lymph nodes

    Directory of Open Access Journals (Sweden)

    XinWu Cui

    2013-03-01

    Full Text Available Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient’s prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and Definity®. This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.

  7. Analysis of a human phenomenon: self-concept.

    Science.gov (United States)

    LeMone, P

    1991-01-01

    This analysis of self-concept includes an examination of definitions, historical perspectives, theoretical basis, and closely related terms. Antecedents, consequences, defining attributes, and a definition were formulated based on the analysis. The purpose of the analysis was to provide support for the use of the label "self-concept" as a broad category that encompasses the self-esteem, identity, and body-image nursing diagnoses within Taxonomy I. This classification could allow the use of a broad diagnostic label to better describe conditions that necessitate nursing care. It may also further explain the relationships between and among those diagnoses that describe human responses to disturbance of any component of the self-concept.

  8. Nomogram for prediction of level 2 axillary lymph node metastasis in proven level 1 node-positive breast cancer patients.

    Science.gov (United States)

    Jiang, Yanlin; Xu, Hong; Zhang, Hao; Ou, Xunyan; Xu, Zhen; Ai, Liping; Sun, Lisha; Liu, Caigang

    2017-09-22

    The current management of the axilla in level 1 node-positive breast cancer patients is axillary lymph node dissection regardless of the status of the level 2 axillary lymph nodes. The goal of this study was to develop a nomogram predicting the probability of level 2 axillary lymph node metastasis (L-2-ALNM) in patients with level 1 axillary node-positive breast cancer. We reviewed the records of 974 patients with pathology-confirmed level 1 node-positive breast cancer between 2010 and 2014 at the Liaoning Cancer Hospital and Institute. The patients were randomized 1:1 and divided into a modeling group and a validation group. Clinical and pathological features of the patients were assessed with uni- and multivariate logistic regression. A nomogram based on independent predictors for the L-2-ALNM identified by multivariate logistic regression was constructed. Independent predictors of L-2-ALNM by the multivariate logistic regression analysis included tumor size, Ki-67 status, histological grade, and number of positive level 1 axillary lymph nodes. The areas under the receiver operating characteristic curve of the modeling set and the validation set were 0.828 and 0.816, respectively. The false-negative rates of the L-2-ALNM nomogram were 1.82% and 7.41% for the predicted probability cut-off points of level 1 axillary lymph node metastasis. Patients with a low probability of L-2-ALNM could be spared level 2 axillary lymph node dissection, thereby reducing postoperative morbidity.

  9. Cost Benefit Analysis of Utilising Mobile Nodes in Wireless Sensor Networks

    DEFF Research Database (Denmark)

    Mathur, Prateek; Nielsen, Rasmus Hjorth; Prasad, Neeli R.

    2015-01-01

    Mobile nodes have been found useful for improving performance of network parameters such as coverage, data latency and load balancing in wireless sensor networks (WSNs). In spite of the benets which mobile nodes could oer when used in WSNs, they have been often stated as infeasible for use...

  10. On node replication attack in wireless sensor networks

    International Nuclear Information System (INIS)

    Qabulio, M.; Malkani, Y.A.

    2015-01-01

    WSNs (Wireless Sensor Networks) comprise a large number of small, inexpensive, low power and memory constrained sensing devices (called sensor nodes) that are densely deployed to measure a given physical phenomenon. Since WSNs are commonly deployed in a hostile and unattended environment, it is easy for an adversary to physically capture one or more legitimate sensor nodes, re-program and redeploy them in the network. As a result, the adversary becomes able to deploy several identical copies of physically captured nodes in the network in order to perform illegitimate activities. This type of attack is referred to as Node Replication Attack or Clone Node Attack. By launching node replication attack, an adversary can easily get control on the network which consequently is the biggest threat to confidentiality, integrity and availability of data and services. Thus, detection and prevention of node replication attack in WSNs has become an active area of research and to date more than two dozen schemes have been proposed, which address this issue. In this paper, we present a comprehensive review, classification and comparative analysis of twenty five of these schemes which help to detect and/or prevent node replication attack in WSNs. (author)

  11. On Node Replication Attack in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Mumtaz Qabulio

    2016-04-01

    Full Text Available WSNs (Wireless Sensor Networks comprise a large number of small, inexpensive, low power and memory constrained sensing devices (called sensor nodes that are densely deployed to measure a given physical phenomenon. Since WSNs are commonly deployed in a hostile and unattended environment, it is easy for an adversary to physically capture one or more legitimate sensor nodes, re-program and redeploy them in the network. As a result, the adversary becomes able to deploy several identical copies of physically captured nodes in the network in order to perform illegitimate activities. This type of attack is referred to as Node Replication Attack or Clone Node Attack. By launching node replication attack, an adversary can easily get control on the network which consequently is the biggest threat to confidentiality, integrity and availability of data and services. Thus, detection and prevention of node replication attack in WSNs has become an active area of research and to date more than two dozen schemes have been proposed, which address this issue. In this paper, we present a comprehensive review, classification and comparative analysis of twenty five of these schemes which help to detect and/or prevent node replication attack in WSNs

  12. Patterns for election of active computing nodes in high availability distributed data acquisition systems

    International Nuclear Information System (INIS)

    Nair, Preetha; Padmini, S.; Diwakar, M.P.; Gohel, Nilesh

    2013-01-01

    Computer based systems for power plant and research reactors are expected to have high availability. Redundancy is a common approach to improve the availability of a system. In redundant configuration the challenge is to select one node as active, and in case of failure of current active node provide automatic fast switchover by electing another node to function as active and restore normal operation. Additional constraints include: exactly one node should be elected as active in an n-way redundant architecture. This paper discusses various high availability configurations developed by Electronics Division and deployed in power and research reactors and patterns followed to elect active nodes of distributed data acquisition systems. The systems are categorized into two: Active/Passive where changeover takes effect only on the failure of Active node, and Active/Active, where changeover is effective in alternate cycles. A novel concept of priority driven state based Active (Master) node election pattern is described for Active/Passive systems which allows multiple redundancy and dynamic election of single master. The paper also discusses the Active/Active pattern, which uncovers failure early by activating all the nodes alternatively in a redundant system. This pattern can be extended to multiple redundant nodes. (author)

  13. Formal concept analysis in knowledge discovery: A survey

    NARCIS (Netherlands)

    Poelmans, J.; Elzinga, P.; Viaene, S.; Dedene, G.; Croitoru, M.; Ferré, S.; Lukose, D.

    2010-01-01

    In this paper, we analyze the literature on Formal Concept Analysis (FCA) using FCA. We collected 702 papers published between 2003-2009 mentioning Formal Concept Analysis in the abstract. We developed a knowledge browsing environment to support our literature analysis process. The pdf-files

  14. Relativity concept inventory: Development, analysis, and results

    Directory of Open Access Journals (Sweden)

    J. S. Aslanides

    2013-05-01

    Full Text Available We report on a concept inventory for special relativity: the development process, data analysis methods, and results from an introductory relativity class. The Relativity Concept Inventory tests understanding of relativistic concepts. An unusual feature is confidence testing for each question. This can provide additional information; for example, high confidence correlated with incorrect answers suggests a misconception. A novel aspect of our data analysis is the use of Monte Carlo simulations to determine the significance of correlations. This approach is particularly useful for small sample sizes, such as ours. Our results show a gender bias that was not present in course assessment, similar to that reported for the Force Concept Inventory.

  15. Clinical and pathologic factors affecting lymph node yields in colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Ta-Wen Hsu

    Full Text Available OBJECTIVE: Lymph node yield is recommended as a benchmark of quality care in colorectal cancer. The objective of this study was to evaluate the impact of various factors upon lymph node yield and to identify independent factors associated with lymph node harvest. MATERIALS AND METHODS: The records of 162 patients with Stage I to Stage III colorectal cancers seen in one institution were reviewed. These patients underwent radical surgery as definitive therapy; high-risk patients then received adjuvant treatment. Pathologic and demographic data were recorded and analyzed. The subgroup analysis of lymph node yields was determined using a t-test and analysis of variants. Linear regression model and multivariable analysis were used to perform potential confounding and predicting variables. RESULTS: Five variables had significant association with lymph node yield after adjustment for other factors in a multiple linear regression model. These variables were: tumor size, surgical method, specimen length, and individual surgeon and pathologist. The model with these five significant variables interpreted 44.4% of the variation. CONCLUSIONS: Patients, tumor characteristics and surgical variables all influence the number of lymph nodes retrieved. Physicians are the main gatekeepers. Adequate training and optimized guidelines could greatly improve the quality of lymph node yields.

  16. Relativity Concept Inventory: Development, Analysis, and Results

    Science.gov (United States)

    Aslanides, J. S.; Savage, C. M.

    2013-01-01

    We report on a concept inventory for special relativity: the development process, data analysis methods, and results from an introductory relativity class. The Relativity Concept Inventory tests understanding of relativistic concepts. An unusual feature is confidence testing for each question. This can provide additional information; for example,…

  17. Stress: a concept analysis.

    Science.gov (United States)

    Goodnite, Patricia M

    2014-01-01

    To analyze the concept of stress and provide an operational definition of stress. Literature review revealed that stress is a commonly used, but often ambiguous, term. Findings supported a definition of stress entailing an individual's perception of a stimulus as overwhelming, which in turn elicits a measurable response resulting in a transformed state. This analysis adopts a dynamic definition of stress that may serve to encourage communication, promote reflection, and enhance concept understanding. This definition may provide direction for future work, as well as enhance efforts to serve patients affected by stress. © 2013 Wiley Periodicals, Inc.

  18. Modular sensor network node

    Science.gov (United States)

    Davis, Jesse Harper Zehring [Berkeley, CA; Stark, Jr., Douglas Paul; Kershaw, Christopher Patrick [Hayward, CA; Kyker, Ronald Dean [Livermore, CA

    2008-06-10

    A distributed wireless sensor network node is disclosed. The wireless sensor network node includes a plurality of sensor modules coupled to a system bus and configured to sense a parameter. The parameter may be an object, an event or any other parameter. The node collects data representative of the parameter. The node also includes a communication module coupled to the system bus and configured to allow the node to communicate with other nodes. The node also includes a processing module coupled to the system bus and adapted to receive the data from the sensor module and operable to analyze the data. The node also includes a power module connected to the system bus and operable to generate a regulated voltage.

  19. Importance of Metastatic Lymph Node Ratio in Non-Metastatic, Lymph Node-Invaded Colon Cancer: A Clinical Trial

    Science.gov (United States)

    Isik, Arda; Peker, Kemal; Firat, Deniz; Yilmaz, Bahri; Sayar, Ilyas; Idiz, Oguz; Cakir, Coskun; Demiryilmaz, Ismail; Yilmaz, Ismayil

    2014-01-01

    Background The aim of this study was to evaluate the prognostic importance of the metastatic lymph node ratio for stage III colon cancer patients and to find a cut-off value at which the overall survival and disease-free survival change. Material/Methods Patients with pathological stage III colon cancer were retrospectively evaluated for: age; preoperative values of Crp, Cea, Ca 19-9, and Afp; pathologic situation of vascular, perineural, lymphatic, and serosal involvement; and metastatic lymph node ratio values were calculated. Results The study included 58 stage III colon cancer patients: 20 (34.5%) females and 38 (65.5%) males were involved in the study. Multivariate analysis was applied to the following variables to evaluate significance for overall survival and disease-free survival: age, Crp, Cea, perineural invasion, and metastatic lymph node ratio. The metastatic lymph node ratio (<0.25 or ≥0.25) is the only independent variable significant for overall and disease-free survival. Conclusions Metastatic lymph node ratio is an ideal prognostic marker for stage III colon cancer patients, and 0.25 is the cut-off value for prognosis. PMID:25087904

  20. Target Control in Logical Models Using the Domain of Influence of Nodes.

    Science.gov (United States)

    Yang, Gang; Gómez Tejeda Zañudo, Jorge; Albert, Réka

    2018-01-01

    Dynamical models of biomolecular networks are successfully used to understand the mechanisms underlying complex diseases and to design therapeutic strategies. Network control and its special case of target control, is a promising avenue toward developing disease therapies. In target control it is assumed that a small subset of nodes is most relevant to the system's state and the goal is to drive the target nodes into their desired states. An example of target control would be driving a cell to commit to apoptosis (programmed cell death). From the experimental perspective, gene knockout, pharmacological inhibition of proteins, and providing sustained external signals are among practical intervention techniques. We identify methodologies to use the stabilizing effect of sustained interventions for target control in Boolean network models of biomolecular networks. Specifically, we define the domain of influence (DOI) of a node (in a certain state) to be the nodes (and their corresponding states) that will be ultimately stabilized by the sustained state of this node regardless of the initial state of the system. We also define the related concept of the logical domain of influence (LDOI) of a node, and develop an algorithm for its identification using an auxiliary network that incorporates the regulatory logic. This way a solution to the target control problem is a set of nodes whose DOI can cover the desired target node states. We perform greedy randomized adaptive search in node state space to find such solutions. We apply our strategy to in silico biological network models of real systems to demonstrate its effectiveness.

  1. Sentinel lymph node biopsy in endometrial cancer-Feasibility, safety and lymphatic complications.

    Science.gov (United States)

    Geppert, Barbara; Lönnerfors, Céline; Bollino, Michele; Persson, Jan

    2018-03-01

    To compare the rate of lymphatic complications in women with endometrial cancer undergoing sentinel lymph node biopsy versus a full pelvic and infrarenal paraaortic lymphadenectomy, and to examine the overall feasibility and safety of the former. A prospective study of 188 patients with endometrial cancer planned for robotic surgery. Indocyanine green was used to identify the sentinel lymph nodes. In low-risk patients the lymphadenectomy was restricted to removal of sentinel lymph nodes whereas in high-risk patients also a full lymphadenectomy was performed. The impact of the extent of the lymphadenectomy on the rate of complications was evaluated. The bilateral detection rate of sentinel lymph nodes was 96% after cervical tracer injection. No intraoperative complication was associated with the sentinel lymph node biopsy per se. Compared with hysterectomy alone, the additional average operative time for removal of sentinel lymph nodes was 33min whereas 91min were saved compared with a full pelvic and paraaortic lymphadenectomy. Sentinel lymph node biopsy alone resulted in a lower incidence of leg lymphedema than infrarenal paraaortic and pelvic lymphadenectomy (1.3% vs 18.1%, p=0.0003). The high feasibility, the absence of intraoperative complications and the low risk of lymphatic complications supports implementing detection of sentinel lymph nodes in low-risk endometrial cancer patients. Given that available preliminary data on sensitivity and false negative rates in high-risk patients are confirmed in further studies, we also believe that the reduction in lymphatic complications and operative time strongly motivates the sentinel lymph node concept in high-risk endometrial cancer. Copyright © 2017. Published by Elsevier Inc.

  2. Formal Modeling of Greedy Nodes in 802.15.4 WSN

    Directory of Open Access Journals (Sweden)

    Youcef Hammal

    2015-06-01

    Full Text Available This paper deals with formal specification of the non-slotted CSMA/CA protocol in wireless sensor networks(WSN whose some nodes own a greedy behavior. This protocol requires sensor nodes to wait some time before initiating a transmission, whereas greedy nodes may try to reduce their waiting duration, which may penalize other nodes. To analyze their impact on WSN mode in operation, we use timed automata of the model-checker UPPAAL to capture the abstract behavior of communication medium, sane, and greedy nodes in WSN. This enables the use of analysis tools to check whether these models satisfy intended properties.

  3. Flourishing: An Evolutionary Concept Analysis.

    Science.gov (United States)

    Agenor, Christine; Conner, Norma; Aroian, Karen

    2017-11-01

    Mental health is an important measure of public health (WHO, 2004); however, nursing practice and research continues to prioritize mental illness, rather than well-being (Wand, 2011). Flourishing is a recent concept in the field of well-being. The term has been used sparingly in nursing practice and research, and conceptual clarification is needed to promote comprehensive understanding of the phenomenon. The purpose of this study is to critically analyze flourishing, assess the maturity of the concept, and provide recommendations for future research, education, and practice. The concept of flourishing was analyzed using the evolutionary approach to concept analysis (Rodgers, 2000). A search for articles on flourishing within the context of well-being was conducted through CINAHL, MEDLINE, and PsycINFO. A sample of 32 articles and 1 book was reviewed. Data were reviewed for concept attributes, antecedents, consequences, surrogate terms and related concepts. Four models of flourishing were identified with six overlapping attributes: meaning, positive relationships, engagement, competence, positive emotion, and self-esteem. Limited longitudinal and predictive studies have been conducted, but there is evidence for several antecedents and outcomes of flourishing. Research is ongoing primarily in psychology and sociology and is lacking in other disciplines. The concept of flourishing is immature; however, evidence is building for related concepts. A lack of consistent terminology regarding flourishing prevents knowledge development of flourishing as a distinct concept. Further multidisciplinary research is needed to establish standard operational and conceptual definitions and develop effective interventions.

  4. A concept analysis of abductive reasoning.

    Science.gov (United States)

    Mirza, Noeman A; Akhtar-Danesh, Noori; Noesgaard, Charlotte; Martin, Lynn; Staples, Eric

    2014-09-01

    To describe an analysis of the concept of abductive reasoning. In the discipline of nursing, abductive reasoning has received only philosophical attention and remains a vague concept. In addition to deductive and inductive reasoning, abductive reasoning is not recognized even in prominent nursing knowledge development literature. Therefore, what abductive reasoning is and how it can inform nursing practice and education was explored. Concept analysis. Combinations of specific keywords were searched in Web of Science, CINAHL, PsychINFO, PubMed, Medline and EMBASE. The analysis was conducted in June 2012 and only literature before this period was included. No time limits were set. Rodger's evolutionary method for conducting concept analysis was used. Twelve records were included in the analysis. The most common surrogate term was retroduction, whereas related terms included intuition and pattern and similarity recognition. Antecedents consisted of a complex, puzzling situation and a clinician with creativity, experience and knowledge. Consequences included the formation of broad hypotheses that enhance understanding of care situations. Overall, abductive reasoning was described as the process of hypothesis or theory generation and evaluation. It was also viewed as inference to the best explanation. As a new approach, abductive reasoning could enhance reasoning abilities of novice clinicians. It can not only incorporate various ways of knowing but also its holistic approach to learning appears to be promising in problem-based learning. As nursing literature on abductive reasoning is predominantly philosophical, practical consequences of abductive reasoning warrant further research. © 2014 John Wiley & Sons Ltd.

  5. Application of carbon nanoparticles in lymph node dissection and parathyroid protection during thyroid cancer surgeries: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Wang L

    2017-02-01

    Full Text Available Lun Wang, Dong Yang, Jun-Yuan Lv, Dan Yu, Shi-Jie Xin Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, People’s Republic of China Purpose: To investigate whether carbon nanoparticles (CNs are helpful in identifying lymph nodes and metastatic lymph nodes and in parathyroid protection during thyroid cancer surgery. Methods: English and Chinese literature in PubMed, Cochrane Database of Systematic Reviews, EMBASE, ClinicalTrials.gov, China Biology Medicine Database, China National Knowledge Infrastructure, China Master’s and Doctoral Theses Full-Text Database, Wanfang database, and Cqvip database were searched (till March 22, 2016. Randomized controlled trials (RCTs that compared the use of CNs with a blank control in patients undergoing thyroid cancer surgery were included. Quality assessment and data extraction were performed, and a meta-analysis was conducted using RevMan 5.1 software. The primary outcomes were the number of retrieved central lymph nodes and metastatic lymph nodes, and the rate of accidental parathyroid removal. Results: We obtained 149 relevant studies, and only 47 RCTs with 4,605 patients (CN group: n=2,197; blank control group: n=2,408 met the inclusion criteria. Compared with the control group, the CN group was associated with more retrieved lymph nodes/patient (weighted mean difference [WMD]: 3.39, 95% confidence interval [CI]: 2.73–4.05, more retrieved metastatic lymph nodes (WMD: 0.98, 95% CI: 0.61–1.35, lower rate of accidental parathyroid removal, and lower rates of hypoparathyroidism and hypocalcemia. However, the total metastatic rate of the retrieved lymph nodes did not differ between the groups (odds ratio: 1.13, 95% CI: 0.87–1.47, P=0.35. Conclusion: CNs can improve the extent of neck dissection and protect the parathyroid glands during thyroid cancer surgery. And the number of identified metastatic lymph nodes can be simultaneously increased

  6. Intraoperative Sentinel Lymph Node Evaluation

    DEFF Research Database (Denmark)

    Shaw, Richard; Christensen, Anders; Java, Kapil

    2016-01-01

    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic......-ready" intraoperative diagnostic test (one step nucleic acid amplification-OSNA, sysmex). METHODS: Two cohorts were assembled: cohort 1, OSCC with stage and site that closely match cases suitable for sentinel lymph node biopsy (SLNB); cohort 2, HNSCC with sufficient fresh tumour tissue available for the OSNA assay (>50......% of tumours. Discordance between different techniques indicated that OSNA was more sensitive than qRT-PCR or RNA-ISH, which in turn were more sensitive than IHC. OSNA results showed CK19 expression in 80% of primary cases, so if used for diagnosis of lymph node metastasis would lead to a false-negative result...

  7. Food insecurity: A concept analysis

    Science.gov (United States)

    Schroeder, Krista; Smaldone, Arlene

    2015-01-01

    Aim To report an analysis of the concept of food insecurity, in order to 1) propose a theoretical model of food insecurity useful to nursing and 2) discuss its implications for nursing practice, nursing research, and health promotion. Background Forty eight million Americans are food insecure. As food insecurity is associated with multiple negative health effects, nursing intervention is warranted. Design Concept Analysis Data sources A literature search was conducted in May 2014 in Scopus and MEDLINE using the exploded term “food insecur*.” No year limit was placed. Government websites and popular media were searched to ensure a full understanding of the concept. Review Methods Iterative analysis, using the Walker and Avant method Results Food insecurity is defined by uncertain ability or inability to procure food, inability to procure enough food, being unable to live a healthy life, and feeling unsatisfied. A proposed theoretical model of food insecurity, adapted from the Socio-Ecological Model, identifies three layers of food insecurity (individual, community, society), with potential for nursing impact at each level. Conclusion Nurses must work to fight food insecurity. There exists a potential for nursing impact that is currently unrealized. Nursing impact can be guided by a new conceptual model, Food Insecurity within the Nursing Paradigm. PMID:25612146

  8. Healthcare Quality: A Concept Analysis.

    Science.gov (United States)

    Allen-Duck, Angela; Robinson, Jennifer C; Stewart, Mary W

    2017-10-01

    Worsening quality indicators of health care shake public trust. Although safety and quality of care in hospitals can be improved, healthcare quality remains conceptually and operationally vague. Therefore, the aim of this analysis is to clarify the concept of healthcare quality. Walker and Avant's method of concept analysis, the most commonly used in nursing literature, provided the framework. We searched general and medical dictionaries, public domain websites, and 5 academic literature databases. Search terms included health care and quality, as well as healthcare and quality. Peer-reviewed articles and government publications published in English from 2004 to 2016 were included. Exclusion criteria were related concepts, discussions about the need for quality care, gray literature, and conference proceedings. Similar attributes were grouped into themes during analysis. Forty-two relevant articles were analyzed after excluding duplicates and those that did not meet eligibility. Following thematic analysis, 4 defining attributes were identified: (1) effective, (2) safe, (3) culture of excellence, and (4) desired outcomes. Based on these attributes, the definition of healthcare quality is the assessment and provision of effective and safe care, reflected in a culture of excellence, resulting in the attainment of optimal or desired health. This analysis proposes a conceptualization of healthcare quality that defines its implied foundational components and has potential to improve the provision of quality care. Theoretical and practice implications presented promote a fuller, more consistent understanding of the components that are necessary to improve the provision of healthcare and steady public trust. © 2017 Wiley Periodicals, Inc.

  9. Analysis of Network Vulnerability Under Joint Node and Link Attacks

    Science.gov (United States)

    Li, Yongcheng; Liu, Shumei; Yu, Yao; Cao, Ting

    2018-03-01

    The security problem of computer network system is becoming more and more serious. The fundamental reason is that there are security vulnerabilities in the network system. Therefore, it’s very important to identify and reduce or eliminate these vulnerabilities before they are attacked. In this paper, we are interested in joint node and link attacks and propose a vulnerability evaluation method based on the overall connectivity of the network to defense this attack. Especially, we analyze the attack cost problem from the attackers’ perspective. The purpose is to find the set of least costs for joint links and nodes, and their deletion will lead to serious network connection damage. The simulation results show that the vulnerable elements obtained from the proposed method are more suitable for the attacking idea of the malicious persons in joint node and link attack. It is easy to find that the proposed method has more realistic protection significance.

  10. Evidence based practice readiness: A concept analysis.

    Science.gov (United States)

    Schaefer, Jessica D; Welton, John M

    2018-01-15

    To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.

  11. The Needs Analysis in Self-Concept Module Development

    Science.gov (United States)

    Yusop, Yusni Mohamad; Sumari, Melati; Mohamed, Fatanah; Said, Shahriza; Azeez, Mohd Ibrahim K.; Jamil, Mohd Ridhuan Mohd

    2015-01-01

    This research studies needs analyses conducted to examine the need for a self-concept module. Two types of analyses had been conducted; content analysis and experts' consensus. Content analysis was conducted to explore the issues of self-concept from the theory and literature perspective. Later, needs analysis had also been carried out to observe…

  12. Advanced Concept Architecture Design and Integrated Analysis (ACADIA)

    Science.gov (United States)

    2017-11-03

    1 Advanced Concept Architecture Design and Integrated Analysis (ACADIA) Submitted to the National Institute of Aerospace (NIA) on...Research Report 20161001 - 20161030 Advanced Concept Architecture Design and Integrated Analysis (ACADIA) W911NF-16-2-0229 8504Cedric Justin, Youngjun

  13. CONCEPT ANALYSIS: AGGRESSION

    OpenAIRE

    Liu, Jianghong

    2004-01-01

    The concept of aggression is important to nursing because further knowledge of aggression can help generate a better theoretical model to drive more effective intervention and prevention approaches. This paper outlines a conceptual analysis of aggression. First, the different forms of aggression are reviewed, including the clinical classification and the stimulus-based classification. Then the manifestations and measurement of aggression are described. Finally, the causes and consequences of ...

  14. Controlling data transfers from an origin compute node to a target compute node

    Science.gov (United States)

    Archer, Charles J [Rochester, MN; Blocksome, Michael A [Rochester, MN; Ratterman, Joseph D [Rochester, MN; Smith, Brian E [Rochester, MN

    2011-06-21

    Methods, apparatus, and products are disclosed for controlling data transfers from an origin compute node to a target compute node that include: receiving, by an application messaging module on the target compute node, an indication of a data transfer from an origin compute node to the target compute node; and administering, by the application messaging module on the target compute node, the data transfer using one or more messaging primitives of a system messaging module in dependence upon the indication.

  15. Spinal Schmorl's nodes: Sagittal sectional imaging and pathological examination

    International Nuclear Information System (INIS)

    Silberstein, M.; Opeskin, K.

    1999-01-01

    The presence, location and number of Schmorl's nodes was determined in the thoracolumbar spines of 70 motor vehicle accident victims using radiographic examination of a midline sagittal section and subsequent pathological examinations, including histology. In 28% of spines, a greater number of Schmorl's nodes were identified with radiography, while in 44%, pathological examination revealed a greater number of nodes. The visibility of Schmorl's nodes was enhanced by using a sagittal radiographic approach, and, in contrast to previous work, nodes below 0.5 cm 2 were readily detected. The results of the present study offer an additional imaging technique for postmortem analysis of the spine, and support the use of sagittal MR imaging for the evaluation of this condition. Copyright (1999) Blackwell Science Pty Ltd

  16. Defining nodes in complex brain networks

    Directory of Open Access Journals (Sweden)

    Matthew Lawrence Stanley

    2013-11-01

    Full Text Available Network science holds great promise for expanding our understanding of the human brain in health, disease, development, and aging. Network analyses are quickly becoming the method of choice for analyzing functional MRI data. However, many technical issues have yet to be confronted in order to optimize results. One particular issue that remains controversial in functional brain network analyses is the definition of a network node. In functional brain networks a node represents some predefined collection of brain tissue, and an edge measures the functional connectivity between pairs of nodes. The characteristics of a node, chosen by the researcher, vary considerably in the literature. This manuscript reviews the current state of the art based on published manuscripts and highlights the strengths and weaknesses of three main methods for defining nodes. Voxel-wise networks are constructed by assigning a node to each, equally sized brain area (voxel. The fMRI time-series recorded from each voxel is then used to create the functional network. Anatomical methods utilize atlases to define the nodes based on brain structure. The fMRI time-series from all voxels within the anatomical area are averaged and subsequently used to generate the network. Functional activation methods rely on data from traditional fMRI activation studies, often from databases, to identify network nodes. Such methods identify the peaks or centers of mass from activation maps to determine the location of the nodes. Small (~10-20 millimeter diameter spheres located at the coordinates of the activation foci are then applied to the data being used in the network analysis. The fMRI time-series from all voxels in the sphere are then averaged, and the resultant time series is used to generate the network. We attempt to clarify the discussion and move the study of complex brain networks forward. While the correct method to be used remains an open, possibly unsolvable question that

  17. Semi-automated volumetric analysis of lymph node metastases in patients with malignant melanoma stage III/IV-A feasibility study

    International Nuclear Information System (INIS)

    Fabel, M.; Tengg-Kobligk, H. von; Giesel, F.L.; Delorme, S.; Kauczor, H.-U.; Bornemann, L.; Dicken, V.; Kopp-Schneider, A.; Moser, C.

    2008-01-01

    Therapy monitoring in oncological patient care requires accurate and reliable imaging and post-processing methods. RECIST criteria are the current standard, with inherent disadvantages. The aim of this study was to investigate the feasibility of semi-automated volumetric analysis of lymph node metastases in patients with malignant melanoma compared to manual volumetric analysis and RECIST. Multislice CT was performed in 47 patients, covering the chest, abdomen and pelvis. In total, 227 suspicious, enlarged lymph nodes were evaluated retrospectively by two radiologists regarding diameters (RECIST), manually measured volume by placement of ROIs and semi-automated volumetric analysis. Volume (ml), quality of segmentation (++/-) and time effort (s) were evaluated in the study. The semi-automated volumetric analysis software tool was rated acceptable to excellent in 81% of all cases (reader 1) and 79% (reader 2). Median time for the entire segmentation process and necessary corrections was shorter with the semi-automated software than by manual segmentation. Bland-Altman plots showed a significantly lower interobserver variability for semi-automated volumetric than for RECIST measurements. The study demonstrated feasibility of volumetric analysis of lymph node metastases. The software allows a fast and robust segmentation in up to 80% of all cases. Ease of use and time needed are acceptable for application in the clinical routine. Variability and interuser bias were reduced to about one third of the values found for RECIST measurements. (orig.)

  18. Protocol for multiple node network

    Science.gov (United States)

    Kirkham, Harold (Inventor)

    1995-01-01

    The invention is a multiple interconnected network of intelligent message-repeating remote nodes which employs an antibody recognition message termination process performed by all remote nodes and a remote node polling process performed by other nodes which are master units controlling remote nodes in respective zones of the network assigned to respective master nodes. Each remote node repeats only those messages originated in the local zone, to provide isolation among the master nodes.

  19. Sentinel node biopsy before neoadjuvant chemotherapy spares breast cancer patients axillary lymph node dissection.

    Science.gov (United States)

    van Rijk, Maartje C; Nieweg, Omgo E; Rutgers, Emiel J T; Oldenburg, Hester S A; Olmos, Renato Valdés; Hoefnagel, Cornelis A; Kroon, Bin B R

    2006-04-01

    Neoadjuvant chemotherapy in breast cancer patients is a valuable method to determine the efficacy of chemotherapy and potentially downsize the primary tumor, which facilitates breast-conserving therapy. In 18 studies published about sentinel node biopsy after neoadjuvant chemotherapy, the sentinel node was identified in on average 89%, and the false-negative rate was on average 10%. Because of these mediocre results, no author dares to omit axillary clearance just yet. In our institute, sentinel lymph node biopsy is performed before neoadjuvant chemotherapy. The aim of this study was to evaluate our experience with this approach. Sentinel node biopsy was performed before neoadjuvant chemotherapy in 25 T2N0 patients by using lymphoscintigraphy, a gamma ray detection probe, and patent blue dye. Axillary lymph node dissection was performed after chemotherapy if the sentinel node contained metastases. Ten patients had a tumor-positive axillary sentinel node, and one patient had an involved lateral intramammary node. Four patients had additional involved nodes in the completion lymph node dissection specimen. The other 14 patients (56%) had a tumor-negative sentinel node and did not undergo axillary lymph node dissection. No recurrences have been observed after a median follow-up of 18 months. Fourteen (56%) of the 25 patients were spared axillary lymph node dissection when the sentinel node was found to be disease free. Performing sentinel node biopsy before neoadjuvant chemotherapy seems successful and reliable in patients with T2N0 breast cancer.

  20. Morphological analysis of lymph nodes in Odontocetes from north and northeast coast of Brazil.

    Science.gov (United States)

    De Oliveira e Silva, Fernanda Menezes; Guimarães, Juliana Plácido; Vergara-Parente, Jociery Einhardt; Carvalho, Vitor Luz; De Meirelles, Ana Carolina Oliveira; Marmontel, Miriam; Ferrão, Juliana Shimara Pires; Miglino, Maria Angelica

    2014-05-01

    The morphology and location of lymph nodes from seven species of Odontocetes, of both sexes and different age groups, were described. All animals were derived from stranding events along the North and Northeastern coasts of Brazil. After the identification of lymph nodes in situ, tissue samples were analyzed for light and electron microscopy. Vascular volume density (VVD) and vascular length density (VLD) were evaluated in the mesenteric lymph nodes. Lymph nodes occurred as solitary nodules or in groups, varying in shape and size. In addition to using the nomenclature recommended by Nomina Anatomica Veterinaria, new nomenclatures were suggested based on the lymph nodes topography. Lymph nodes were covered by a highly vascularized and innervated capsule of dense connective tissue, below which muscle fibers were observed, inconsistently, in all studied species. There was no difference in VLD among different age groups. However, VVD was higher in adults. Lymph nodes parenchyma was divided into an outer cortex, containing lymph nodules and germinal centers; a paracortical region, transition zone with dense lymphoid tissue; and an inner medulla, composed of small irregular cords of lymphatic tissue, blood vessels, and diffuse lymphoid tissue. Abundant collagen fibers were observed around arteries and arterioles. Germinal centers were more evident and developed in calves and young animals, being more discrete and sparse in adults. The morphology of lymph nodes in Odontocetes was typical of that observed in other terrestrial mammals. However, new groups of lymph nodes were described for seven species occurring in the Brazilian coast. Copyright © 2014 Wiley Periodicals, Inc.

  1. Translational research: a concept analysis.

    Science.gov (United States)

    Wendler, M Cecilia; Kirkbride, Geri; Wade, Kristen; Ferrell, Lynne

    2013-01-01

    BACKGROUND/CONCEPTUAL FRAMEWORK: Little is known about which approaches facilitate adoption and sustainment of evidence-based practice change in the highly complex care environments that constitute clinical practice today. The purpose of this article was to complete a concept analysis of translational research using a modified Walker and Avant approach. DESIGN/DATA COLLECTION: Using a rigorous and thorough review of the recent health care literature generated by a deep electronic search from 2004-2011, 85 appropriate documents were retrieved. Close reading of the articles by three coresearchers yielded an analysis of the emerging concept of translational research. Using the iterative process described by Walker and Avant, a tentative definition of the concept of translational research, along with antecedents and consequences were identified. Implications for health care professionals in education, practice, and research are offered. Further research is needed to determine the adequacy of the definition, to identify empirical referents, and to guide theory development. The study resulted in a theoretical definition of the concept of translational research, along with identification of antecedents and consequences and a description of an ideal or model case to illustrate the definition. Implications for practice and education include the importance of focusing on translational research approaches that may reduce the research-practice gap in health care, thereby improving patient care delivery. Research is needed to determine the usefulness of the definition in health care clinical practice.

  2. Professional nursing values: A concept analysis.

    Science.gov (United States)

    Schmidt, Bonnie J; McArthur, Erin C

    2018-01-01

    The aim of this concept analysis is to clarify the meaning of professional nursing values. In a time of increasing ethical dilemmas, it is essential that nurses internalize professional values to develop and maintain a professional identity. However, nursing organizations and researchers provide different conceptions of professional nursing values, leading to a lack of clarity as to the meaning and attributes of this construct. Walker and Avant's (2011) method was used to guide an analysis of this concept. Resources published from 1973 to 2016 were identified via electronic databases and hand-searching of reference lists. A review of the literature was completed and the data were analyzed to identify uses of the concept; the defining attributes of the concept; borderline, related, contrary, and illegitimate examples; antecedents and consequences; and empirical referents. Professional nursing values were defined as important professional nursing principles of human dignity, integrity, altruism, and justice that serve as a framework for standards, professional practice, and evaluation. Further research is needed in the development and testing of professional nursing values theory, and the reassessment of values instruments. Core professional values that are articulated may help unify the profession and demonstrate the value of nursing to the public. © 2017 Wiley Periodicals, Inc.

  3. The Prognostic Value of Lymph Nodes Dissection Number on Survival of Patients with Lymph Node-Negative Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Wu Song

    2014-01-01

    Full Text Available Objective. The study was designed to explore the prognostic value of examined lymph node (LN number on survival of gastric cancer patients without LN metastasis. Methods. Between August 1995 and January 2011, 300 patients who underwent gastrectomy with D2 lymphadenectomy for LN-negative gastric cancer were reviewed. Patients were assigned to various groups according to LN dissection number or tumor invasion depth. Some clinical outcomes, such as overall survival, operation time, length of stay, and postoperative complications, were compared among all groups. Results. The overall survival time of LN-negative GC patients was 50.2±30.5 months. Multivariate analysis indicated that LN dissection number (P30. Besides, it was not correlated with operation time, transfusion volume, length of postoperative stay, or postoperative complication incidence (P>0.05. Conclusions. The number of examined lymph nodes is an independent prognostic factor of survival for patients with lymph node-negative gastric cancer. Sufficient dissection of lymph nodes is recommended during surgery for such population.

  4. Concept analysis: Role ambiguity in senior nursing students.

    Science.gov (United States)

    Kalkman, Beth

    2018-04-01

    Role ambiguity is a lack of clarity or uncertainty related to one's position or role. Role ambiguity has been documented in the literature in relationship to athletics, industry, business, education, and nursing. However, a concept analysis has not been performed. Therefore, the process of concept analysis outlined by Walker and Avant is now used to look at the concept of role ambiguity and its relevance to senior nursing students' socialization and education into the profession of nursing. Attributes, antecedents, consequences, and empiric referents are discussed and theories commonly associated with role ambiguity are presented. At the end of the analysis, an operational definition is provided for use in exploring the concept of role ambiguity as it relates to senior nursing students' articulation of the role of the professional nurse. © 2017 Wiley Periodicals, Inc.

  5. Intentional learning: A concept analysis.

    Science.gov (United States)

    Mollman, Sarah; Candela, Lori

    2018-01-01

    To use a concept analysis to determine a clear definition of the term "intentional learning" for use in nursing. The term intentional learning has been used for years in educational, business, and even nursing literature. It has been used to denote processes leading to higher order thinking and the ability to use knowledge in new situations; both of which are important skills to develop in nursing students. But the lack of a common, accepted definition of the term makes it difficult for nurse educators to base instruction and learning experiences on or to evaluate its overall effectiveness in educating students for diverse, fast-paced clinical practices. A concept analysis following the eight-step method developed by Walker and Avant (2011). Empirical and descriptive literature.  Five defining attributes were identified: (1) self-efficacy for learning, (2) active, effortful, and engaged learning, (3) mastery of goals where learning is the goal, (4) self-directed learning, and (5) self-regulation of learning. Through this concept analysis, nursing will have a clear definition of intentional learning. This will enable nurse educators to generate, evaluate, and test learning experiences that promote further development of intentional learning in nursing students. Nurses in practice will also be able to evaluate if the stated benefits are demonstrated and how this impacts patient care and outcomes. © 2017 Wiley Periodicals, Inc.

  6. A Network Text Analysis of David Ayer’s Fury

    Directory of Open Access Journals (Sweden)

    Starling David Hunter

    2015-12-01

    Full Text Available Network Text Analysis (NTA involves the creation of networks of words and/or concepts from linguistic data. Its key insight is that the position of words and concepts in a text network provides vital clues to the central and underlying themes of the text as a whole. Recent research has relied on inductive approaches to identify these themes. In this study we demonstrate a deductive approach that we apply to the screenplay of the 2014 World War II-era film Fury. Specifically, we first use genre expectations theory to establish prior expectations as to the key themes associated with war films. We then empirically test whether words and concepts associated with the most influentially-positioned nodes are consistent with themes common to the war-film genre. As predicted, we find that words and concepts associated with the least constrained nodes in the text network were significantly more likely to be associated with the war, action, and biography genres and significantly less likely to be associated with the mystery, science-fiction, fantasy, and film-noir genres. Keywords: content analysis, text analysis, network text analysis, semantic network analysis, film studies, screenplay, screenwriting, war movies, World War II, tanks

  7. [The related factors of head and neck mocosal melanoma with lymph node metastasis].

    Science.gov (United States)

    Yin, G F; Guo, W; Chen, X H; Huang, Z G

    2017-12-05

    Objective: To investigate the related factors of mucosal melanoma of head and neck with lymph node metastasis for early diagnosis and further treatments. Method: A retrospective analysis of 117 cases of head and neck mucosal malignant melanoma patients which received surgical treatment was performed. Eleven cases of patients with pathologically confirmed lymph node metastasis and 33 cases without lymph node metastasis (1∶3) were randomly selected to analyze. The related factors of lymph node metastasis of head and neck mucosal melanoma patients including age, gender, whether the existence of recurrence, bone invasion, lesion location were analyzed. The single factor and logistic regression analysis were performed, P difference was statistically significant. Result: The lymph node metastasis rate of head and neck mucosal melanoma was 9.40%(11/117), the single factor analysis showed that there were 3 factors to be associated with lymph node metastasis, which was recurrence ( P =0.0000), bone invasion ( P =0.001), primary position ( P =0.007). Recurrence ( P =0.021) was a risk factor for lymph node metastasis according to the Logistic regression analysis, and the impact of bone invasion ( P =0.487) and primary location ( P =0.367) remained to be further explored. Conclusion: The patients of head and neck mucosal melanoma with the presence of recurrent usually accompanied by a further progression of the disease, such as lymph node metastasis, so for recurrent patients should pay special attention to the situation of lymph node and choose the reasonable treatment. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  8. High risk of non-sentinel node metastases in a group of breast cancer patients with micrometastases in the sentinel node.

    Science.gov (United States)

    Tvedskov, Tove Filtenborg; Jensen, Maj-Britt; Lisse, Ida Marie; Ejlertsen, Bent; Balslev, Eva; Kroman, Niels

    2012-11-15

    Axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel nodes is under debate. We aimed to establish two models to predict non-sentinel node (NSN) metastases in patients with micrometastases or isolated tumor cells (ITC) in sentinel nodes, to guide the decision for ALND. A total of 1,577 breast cancer patients with micrometastases and 304 with ITC in sentinel nodes, treated by sentinel lymph node dissection and ALND in 2002-2008 were identified in the Danish Breast Cancer Cooperative Group database. Risk of NSN metastases was calculated according to clinicopathological variables in a logistic regression analysis. We identified tumor size, proportion of positive sentinel nodes, lymphovascular invasion, hormone receptor status and location of tumor in upper lateral quadrant of the breast as risk factors for NSN metastases in patients with micrometastases. A model based on these risk factors identified 5% of patients with a risk of NSN metastases on nearly 40%. The model was however unable to identify a subgroup of patients with a very low risk of NSN metastases. Among patients with ITC, we identified tumor size, age and proportion of positive sentinel nodes as risk factors. A model based on these risk factors identified 32% of patients with risk of NSN metastases on only 2%. Omission of ALND would be acceptable in this group of patients. In contrast, ALND may still be beneficial in the subgroup of patients with micrometastases and a high risk of NSN metastases. Copyright © 2012 UICC.

  9. MSCT follow-up in malignant lymphoma. Comparison of manual linear measurements with semi-automated lymph node analysis for therapy response classification

    International Nuclear Information System (INIS)

    Wessling, J.; Puesken, M.; Kohlhase, N.; Persigehl, T.; Mesters, R.; Heindel, W.; Buerke, B.; Koch, R.

    2012-01-01

    Purpose: Assignment of semi-automated lymph node analysis compared to manual measurements for therapy response classification of malignant lymphoma in MSCT. Materials and Methods: MSCT scans of 63 malignant lymphoma patients before and after 2 cycles of chemotherapy (307 target lymph nodes) were evaluated. The long axis diameter (LAD), short axis diameter (SAD) and bi-dimensional WHO were determined manually and semi-automatically. The time for manual and semi-automatic segmentation was evaluated. The ref. standard response was defined as the mean relative change across all manual and semi-automatic measurements (mean manual/semi-automatic LAD, SAD, semi-automatic volume). Statistical analysis encompassed t-test and McNemar's test for clustered data. Results: Response classification per lymph node revealed semi-automated volumetry and bi-dimensional WHO to be significantly more accurate than manual linear metric measurements. Response classification per patient based on RECIST revealed more patients to be correctly classified by semi-automatic measurements, e.g. 96.0 %/92.9 % (WHO bi-dimensional/volume) compared to 85.7/84.1 % for manual LAD and SAD, respectively (mean reduction in misclassified patients of 9.95 %). Considering the use of correction tools, the time expenditure for lymph node segmentation (29.7 ± 17.4 sec) was the same as with the manual approach (29.1 ± 14.5 sec). Conclusion: Semi-automatically derived 'lymph node volume' and 'bi-dimensional WHO' significantly reduce the number of misclassified patients in the CT follow-up of malignant lymphoma by at least 10 %. However, lymph node volumetry does not outperform bi-dimensional WHO. (orig.)

  10. MSCT follow-up in malignant lymphoma. Comparison of manual linear measurements with semi-automated lymph node analysis for therapy response classification

    Energy Technology Data Exchange (ETDEWEB)

    Wessling, J.; Puesken, M.; Kohlhase, N.; Persigehl, T.; Mesters, R.; Heindel, W.; Buerke, B. [Muenster Univ. (Germany). Dept. of Clinical Radiology; Koch, R. [Muenster Univ. (Germany). Inst. of Biostatistics and Clinical Research

    2012-09-15

    Purpose: Assignment of semi-automated lymph node analysis compared to manual measurements for therapy response classification of malignant lymphoma in MSCT. Materials and Methods: MSCT scans of 63 malignant lymphoma patients before and after 2 cycles of chemotherapy (307 target lymph nodes) were evaluated. The long axis diameter (LAD), short axis diameter (SAD) and bi-dimensional WHO were determined manually and semi-automatically. The time for manual and semi-automatic segmentation was evaluated. The ref. standard response was defined as the mean relative change across all manual and semi-automatic measurements (mean manual/semi-automatic LAD, SAD, semi-automatic volume). Statistical analysis encompassed t-test and McNemar's test for clustered data. Results: Response classification per lymph node revealed semi-automated volumetry and bi-dimensional WHO to be significantly more accurate than manual linear metric measurements. Response classification per patient based on RECIST revealed more patients to be correctly classified by semi-automatic measurements, e.g. 96.0 %/92.9 % (WHO bi-dimensional/volume) compared to 85.7/84.1 % for manual LAD and SAD, respectively (mean reduction in misclassified patients of 9.95 %). Considering the use of correction tools, the time expenditure for lymph node segmentation (29.7 {+-} 17.4 sec) was the same as with the manual approach (29.1 {+-} 14.5 sec). Conclusion: Semi-automatically derived 'lymph node volume' and 'bi-dimensional WHO' significantly reduce the number of misclassified patients in the CT follow-up of malignant lymphoma by at least 10 %. However, lymph node volumetry does not outperform bi-dimensional WHO. (orig.)

  11. RootJS: Node.js Bindings for ROOT 6

    Science.gov (United States)

    Beffart, Theo; Früh, Maximilian; Haas, Christoph; Rajgopal, Sachin; Schwabe, Jonas; Wolff, Christoph; Szuba, Marek

    2017-10-01

    We present rootJS, an interface making it possible to seamlessly integrate ROOT 6 into applications written for Node.js, the JavaScript runtime platform increasingly commonly used to create high-performance Web applications. ROOT features can be called both directly from Node.js code and by JIT-compiling C++ macros. All rootJS methods are invoked asynchronously and support callback functions, allowing non-blocking operation of Node.js applications using them. Last but not least, our bindings have been designed to platform-independent and should therefore work on all systems supporting both ROOT 6 and Node.js. Thanks to rootJS it is now possible to create ROOT-aware Web applications taking full advantage of the high performance and extensive capabilities of Node.js. Examples include platforms for the quality assurance of acquired, reconstructed or simulated data, book-keeping and e-log systems, and even Web browser-based data visualisation and analysis.

  12. Mediastinal lymph node dissection versus mediastinal lymph node sampling for early stage non-small cell lung cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Huang, Xiongfeng; Wang, Jianmin; Chen, Qiao; Jiang, Jielin

    2014-01-01

    This systematic review and meta-analysis aimed to evaluate the overall survival, local recurrence, distant metastasis, and complications of mediastinal lymph node dissection (MLND) versus mediastinal lymph node sampling (MLNS) in stage I-IIIA non-small cell lung cancer (NSCLC) patients. A systematic search of published literature was conducted using the main databases (MEDLINE, PubMed, EMBASE, and Cochrane databases) to identify relevant randomized controlled trials that compared MLND vs. MLNS in NSCLC patients. Methodological quality of included randomized controlled trials was assessed according to the criteria from the Cochrane Handbook for Systematic Review of Interventions (Version 5.1.0). Meta-analysis was performed using The Cochrane Collaboration's Review Manager 5.3. The results of the meta-analysis were expressed as hazard ratio (HR) or risk ratio (RR), with their corresponding 95% confidence interval (CI). We included results reported from six randomized controlled trials, with a total of 1,791 patients included in the primary meta-analysis. Compared to MLNS in NSCLC patients, there was no statistically significant difference in MLND on overall survival (HR = 0.77, 95% CI 0.55 to 1.08; P = 0.13). In addition, the results indicated that local recurrence rate (RR = 0.93, 95% CI 0.68 to 1.28; P = 0.67), distant metastasis rate (RR = 0.88, 95% CI 0.74 to 1.04; P = 0.15), and total complications rate (RR = 1.10, 95% CI 0.67 to 1.79; P = 0.72) were similar, no significant difference found between the two groups. Results for overall survival, local recurrence rate, and distant metastasis rate were similar between MLND and MLNS in early stage NSCLC patients. There was no evidence that MLND increased complications compared with MLNS. Whether or not MLND is superior to MLNS for stage II-IIIA remains to be determined.

  13. Visualizing weighted networks: a performance comparison of adjacency matrices versus node-link diagrams

    Science.gov (United States)

    McIntire, John P.; Osesina, O. Isaac; Bartley, Cecilia; Tudoreanu, M. Eduard; Havig, Paul R.; Geiselman, Eric E.

    2012-06-01

    Ensuring the proper and effective ways to visualize network data is important for many areas of academia, applied sciences, the military, and the public. Fields such as social network analysis, genetics, biochemistry, intelligence, cybersecurity, neural network modeling, transit systems, communications, etc. often deal with large, complex network datasets that can be difficult to interact with, study, and use. There have been surprisingly few human factors performance studies on the relative effectiveness of different graph drawings or network diagram techniques to convey information to a viewer. This is particularly true for weighted networks which include the strength of connections between nodes, not just information about which nodes are linked to other nodes. We describe a human factors study in which participants performed four separate network analysis tasks (finding a direct link between given nodes, finding an interconnected node between given nodes, estimating link strengths, and estimating the most densely interconnected nodes) on two different network visualizations: an adjacency matrix with a heat-map versus a node-link diagram. The results should help shed light on effective methods of visualizing network data for some representative analysis tasks, with the ultimate goal of improving usability and performance for viewers of network data displays.

  14. Ranking important nodes in complex networks by simulated annealing

    International Nuclear Information System (INIS)

    Sun Yu; Yao Pei-Yang; Shen Jian; Zhong Yun; Wan Lu-Jun

    2017-01-01

    In this paper, based on simulated annealing a new method to rank important nodes in complex networks is presented. First, the concept of an importance sequence (IS) to describe the relative importance of nodes in complex networks is defined. Then, a measure used to evaluate the reasonability of an IS is designed. By comparing an IS and the measure of its reasonability to a state of complex networks and the energy of the state, respectively, the method finds the ground state of complex networks by simulated annealing. In other words, the method can construct a most reasonable IS. The results of experiments on real and artificial networks show that this ranking method not only is effective but also can be applied to different kinds of complex networks. (paper)

  15. Pattern of Colon Cancer Lymph Node Metastases in Patients Undergoing Central Mesocolic Lymph Node Excision

    DEFF Research Database (Denmark)

    Bertelsen, Claus A; Kirkegaard-Klitbo, Anders; Nielsen, Mingyuan

    2016-01-01

    BACKGROUND: Extended mesocolic lymph node dissection in colon cancer surgery seems to improve oncological outcome. A possible reason might be related to metastases in the central mesocolic lymph nodes. OBJECTIVE: The purpose of this study was to describe the pattern of mesocolic lymph node...... metastases, particularly in central lymph nodes, and the risk of skip, aberrant, and gastrocolic ligament metastases as the argument for performing extended lymph node dissection. DATA SOURCES: EMBASE and PubMed were searched using the terms colon or colorectal with sentinel node, lymph node mapping, or skip...... node; lymph node resection colon; and complete or total and mesocolic excision. STUDY SELECTION: Studies describing the risk of metastases in central, skip, aberrant, and gastrocolic ligament lymph node metastases from colon adenocarcinomas in 10 or more patients were included. No languages were...

  16. An evolutionary concept analysis of futility in health care.

    Science.gov (United States)

    Morata, Lauren

    2018-06-01

    To report a concept analysis of futility in health care. Each member of the healthcare team: the physician, the nurse, the patient, the family and all others involved perceive futility differently. The current evidence and knowledge in regard to futility in health care manifest a plethora of definitions, meanings and interpretations without consensus. Concept analysis. Databases searched included Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Premier, Cochrane Database of Systematic Reviews and PsycINFO. Search terms included "futil*," "concept analysis," "concept," "inefficacious," "non-beneficial," "ineffective" and "fruitless" from 1935-2016 to ensure a historical perspective of the concept. A total of 106 articles were retained to develop the concept. Rogers' evolutionary concept analysis was used to evaluate the concept of futility from ancient medicine to the present. Seven antecedents (the patient/family autonomy, surrogate decision-making movement, the patient-family/physician relationship, physician authority, legislation and court rulings, catastrophic events and advancing medical technology) lead to four major attributes (quantitative, physiologic, qualitative, and disease-specific). Ultimately, futile care could lead to consequences such as litigation, advancing technology, increasing healthcare costs, rationing, moral distress and ethical dilemmas. Futility in health care demonstrates components of a cyclical process and a consensus definition is proposed. A framework is developed to clarify the concept and articulate relationships among attributes, antecedents and consequences. Further testing of the proposed definition and framework are needed. © 2018 John Wiley & Sons Ltd.

  17. A time reference distribution concept for a time division communication network

    Science.gov (United States)

    Stover, H. A.

    1973-01-01

    Starting with an assumed ideal network having perfect clocks at every node and known fixed transmission delays between nodes, the effects of adding tolerances to both transmission delays and nodal clocks is described. The advantages of controlling tolerances on time rather than frequency are discussed. Then a concept is presented for maintaining these tolerances on time throughout the network. This concept, called time reference distribution, is a systematic technique for distributing time reference to all nodes of the network. It is reliable, survivable and possesses many other desirable characteristics. Some of its features such as an excellent self monitoring capability will be pointed out. Some preliminary estimates of the accuracy that might be expected are developed and there is a brief discussion of the impact upon communication system costs. Time reference distribution is a concept that appears very attractive. It has not had experimental evaluation and has not yet been endorsed for use in any communication network.

  18. Cultural Capital: A Concept Analysis.

    Science.gov (United States)

    Ohashi, Yuki; Taguchi, Atsuko; Omori, Junko; Ozaki, Akiko

    2017-07-01

    Harnessing community assets may help public health nurses address health inequalities. Cultural factor is one such asset, which is assumed to be capital in a community. Cultural capital is a key concept for understanding the causes of public health issues. This paper provided an in-depth analysis of "cultural capital" as a concept. Rodgers' evolutionary methodology was used for concept analysis. Forty-two studies published in English between 1998 and 2015 were retrieved from MEDLINE by searching for "cultural capital" in the title field. Antecedents of cultural capital included "educational environment," "belongingness in one's social group," "existing health/social inequalities," and "daily behavior." Cultural capital's identified attributes were "social cultivation," "reproductive rubric," "practical knowledge," and "autogenic ability." Cultural capital's consequences were "improving productivity," "reducing health/social inequality," and "enhancing well-being." Cultural capital is defined as capital characterized by cultivation, rubric, knowledge, and ability. These aspects of cultural capital are typically autogenic, and accumulate and reproduce through lifelong community membership. Cultural capital reduces inequality and ultimately enhances the well-being of individuals and the community through bonding, bridging, and linking economic and social capital. © 2017 Wiley Periodicals, Inc.

  19. CT in the staging of bronchogenic carcinoma: Analysis by correlative lymph node mapping and sampling

    International Nuclear Information System (INIS)

    McLoud, T.C.; Woldenberg, R.; Mathisen, D.J.; Grillo, H.C.; Bourgoulin, P.M.; Shepard, J.O.; Moore, E.H.

    1987-01-01

    Although previous studies have evaluated the accuracy of CT in staging the mediastinum in bronchogenic carcinoma, none has determined the sensitivity and specificity of CT in the assessment of individual lymph node groups by correlative nodal sampling at surgery. CT scans were performed on 84 patients with bronchogenic carcinoma. Abnormal nodes (≥ 1 cm) were localized according to the ATS classification of regional lymph node mapping. Seventy-nine patients had mediastinoscopy and 64 patients underwent thoracotomy. In each case, biopsies of lymph node groups 2R, 4R, 2L, 4L (paratracheal), 7 (subcarinal), and 5 (aorticopulmonary) were performed on the appropriate side. Hilar nodes (10R and 11R, 10L and 11L) were resected with the surgical specimen. A total of 292 nodes were sampled. Overall sensitivity for all lymph node groups was 40%, and specificity, 81%. Sensitivity was highest for the 4R (paratracheal) group (82%) and lowest for the subcarinal area (20%). Specificity ranged from 71% for 11R nodes (right hilar) to 94% for 10L (left peribronchial). The positive predictive value was 34%, and the negative predictive value, 84%. This study suggests that the more optimistic results previously reported may have resulted from lack of correlation of individual lymph node groups identified on CT with those sampled at surgery

  20. Holistic Nursing Simulation: A Concept Analysis.

    Science.gov (United States)

    Cohen, Bonni S; Boni, Rebecca

    2018-03-01

    Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

  1. Concept Analysis: Alzheimer’s Caregiver Stress

    Science.gov (United States)

    Llanque, Sarah; Savage, Lynette; Rosenburg, Neal; Honor’s, BA; Caserta, Michael

    2015-01-01

    AIM The aim of this article was to analyze the concept of caregiver stress in the context of caring for a person with Alzheimer’s disease and related dementias. BACKGROUND Currently, there are more than 15 million unpaid care-givers for persons suffering from Alzheimer’s disease and related dementias. This unpaid care can be stressful for caregivers due to the chronic nature of the disease process, as well as other factors. METHOD The paper incorporates the modified method of Wilson’s concept analysis procedure to analyze the concept of caregiver stress. DATA SOURCES A review of the literature was undertaken using the Cumulative Index to Nursing and Allied Health Literature, Google Scholar, and PubMed. RESULTS A theoretical definition of caregiver stress is provided, and the defining attributes, related concepts, antecedents, and consequences of caregiver stress are proposed, and case studies are presented. CONCLUSIONS The analysis demonstrates that caregiver stress is the unequal exchange of assistance among people who stand in close relationship to one another, which results in emotional and physical stress on the caregiver. Implications for future nursing research and practice conclude the paper. PMID:24787468

  2. Validation and structural analysis of the kinematics concept test

    Directory of Open Access Journals (Sweden)

    A. Lichtenberger

    2017-04-01

    Full Text Available The kinematics concept test (KCT is a multiple-choice test designed to evaluate students’ conceptual understanding of kinematics at the high school level. The test comprises 49 multiple-choice items about velocity and acceleration, which are based on seven kinematic concepts and which make use of three different representations. In the first part of this article we describe the development and the validation process of the KCT. We applied the KCT to 338 Swiss high school students who attended traditional teaching in kinematics. We analyzed the response data to provide the psychometric properties of the test. In the second part we present the results of a structural analysis of the test. An exploratory factor analysis of 664 student answers finally uncovered the seven kinematics concepts as factors. However, the analysis revealed a hierarchical structure of concepts. At the higher level, mathematical concepts group together, and then split up into physics concepts at the lower level. Furthermore, students who seem to understand a concept in one representation have difficulties transferring the concept to similar problems in another representation. Both results have implications for teaching kinematics. First, teaching mathematical concepts beforehand might be beneficial for learning kinematics. Second, instructions have to be designed to teach students the change between different representations.

  3. Validation and structural analysis of the kinematics concept test

    Science.gov (United States)

    Lichtenberger, A.; Wagner, C.; Hofer, S. I.; Stern, E.; Vaterlaus, A.

    2017-06-01

    The kinematics concept test (KCT) is a multiple-choice test designed to evaluate students' conceptual understanding of kinematics at the high school level. The test comprises 49 multiple-choice items about velocity and acceleration, which are based on seven kinematic concepts and which make use of three different representations. In the first part of this article we describe the development and the validation process of the KCT. We applied the KCT to 338 Swiss high school students who attended traditional teaching in kinematics. We analyzed the response data to provide the psychometric properties of the test. In the second part we present the results of a structural analysis of the test. An exploratory factor analysis of 664 student answers finally uncovered the seven kinematics concepts as factors. However, the analysis revealed a hierarchical structure of concepts. At the higher level, mathematical concepts group together, and then split up into physics concepts at the lower level. Furthermore, students who seem to understand a concept in one representation have difficulties transferring the concept to similar problems in another representation. Both results have implications for teaching kinematics. First, teaching mathematical concepts beforehand might be beneficial for learning kinematics. Second, instructions have to be designed to teach students the change between different representations.

  4. The effects of node exclusion on the centrality measures in graph models of interacting economic agents

    Science.gov (United States)

    Caetano, Marco Antonio Leonel; Yoneyama, Takashi

    2015-07-01

    This work concerns the study of the effects felt by a network as a whole when a specific node is perturbed. Many real world systems can be described by network models in which the interactions of the various agents can be represented as an edge of a graph. With a graph model in hand, it is possible to evaluate the effect of deleting some of its edges on the architecture and values of nodes of the network. Eventually a node may end up isolated from the rest of the network and an interesting problem is to have a quantitative measure of the impact of such an event. For instance, in the field of finance, the network models are very popular and the proposed methodology allows to carry out "what if" tests in terms of weakening the links between the economic agents, represented as nodes. The two main concepts employed in the proposed methodology are (i) the vibrational IC-Information Centrality, which can provide a measure of the relative importance of a particular node in a network and (ii) autocatalytic networks that can indicate the evolutionary trends of the network. Although these concepts were originally proposed in the context of other fields of knowledge, they were also found to be useful in analyzing financial networks. In order to illustrate the applicability of the proposed methodology, a case of study using the actual data comprising stock market indices of 12 countries is presented.

  5. Enablement in health care context: a concept analysis.

    Science.gov (United States)

    Hudon, Catherine; St-Cyr Tribble, Denise; Bravo, Gina; Poitras, Marie-Eve

    2011-02-01

    The enablement process is defined as a professional intervention aiming to recognize, support and emphasize the patient's capacity to have control over her or his health and life. The purpose of this article was to study the enablement concept through a concept analysis in the health care context to identify: (1) its attributes and (2) its antecedents and consequents. A concept analysis was performed according to the method of Rodgers. The literature was reviewed from 1980 to June 2008, using search strategies adapted to the databases Cinahl, Medline, Embase, PsycInfo and Social Works Abstract, and hand searching. All articles contributing to a deeper understanding of the concept were included. The analysis was carried out according to a thematic analysis procedure, as described by Miles & Huberman. The search identified 1305 citations. After in-depth assessment of 148 potentially eligible citations, 61 articles were included in the review. Five articles were added with hand searching. Sixty-seven per cent of these articles were related to nursing. The attributes of the enablement concept included: contribution to the therapeutic relationship; consideration of the person as a whole; facilitation of learning; valorization of the person's strengths; implication and support to decision making; and broadening of the possibilities. These attributes could be used as a basis for other studies on enablement. Conceptual and empirical work is still needed to better position this concept among others such as patient-centred care, shared decision making and patient's participation. © 2010 Blackwell Publishing Ltd.

  6. Sentinel Lymph Node Biopsy in Breast Cancer: Predictors of Axillary and Non-Sentinel Lymph Node Involvement

    Directory of Open Access Journals (Sweden)

    Hakan Postacı

    2013-12-01

    Full Text Available Background: Sentinel lymph node biopsy is a standard method for the evaluation of axillary status in patients with T1-2N0M0 breast cancers. Aims: To determine the prognostic significance of primary tumour-related clinico-histopathological factors on axillary and non-sentinel lymph node involvement of patients who underwent sentinel lymph node biopsy. Study design: Retrospective clinical study. Methods: In the present study, 157 sentinel lymph node biopsies were performed in 151 consecutive patients with early stage breast cancer between June 2008 and December 2011. Results: Successful lymphatic mapping was obtained in 157 of 158 procedures (99.4%. The incidence of larger tumour size (2.543±1.21 vs. 1.974±1.04, lymphatic vessel invasion (70.6% vs. 29.4%, blood vessel invasion (84.2% vs. 15.8%, and invasive lobular carcinoma subtype (72.7% vs. 27.3% were statistically significantly higher in patients with positive SLNs. Logistic stepwise regression analysis disclosed tumour size (odds ratio: 1.51, p=0.0021 and lymphatic vessel invasion (odds ratio: 4.68, p=0.001 as significant primary tumour-related prognostic determinants of SLN metastasis. Conclusion: A close relationship was identified between tumour size and lymphatic vessel invasion of the primary tumour and axillary lymph node involvement. However, the positive predictive value of these two independent variables is low and there is no compelling evidence to recommend their use in routine clinical practice.

  7. Social Accountable Medical Education: A concept analysis.

    Science.gov (United States)

    Abdolmaleki, Mohammadreza; Yazdani, Shahram; Momeni, Sedigheh; Momtazmanesh, Nader

    2017-07-01

    Considering the pervasiveness of social accountable medical education concept around the world and the growing trend of literature in this regard as well as various interpretations made about this concept, we found it necessary to analyze the concept of social accountable medical education. In this study, the modified version of McKenna's approach to concept analysis was used to determine the concept, explain structures and substructures and determine the border concepts neighboring and against social accountability in medical education. By studying the selected sources,the components of the concept were obtained to identify it and express an analytic definition of social accountability in medical education system. Then, a model case with all attributes of the given concept and the contrary and related concepts were mentioned to determine the boundary between the main concept and auxiliary ones. According to the results of this study in the field of social accountability, the detailed and transparent analytical definition of social accountable medical education can be used in future studies as well as the function and evaluation of medical education system.

  8. Cost-analysis of staging methods for lymph nodes in patients with prostate cancer: MRI with a lymph node-specific contrast agent compared to pelvic lymph node dissection or CT

    International Nuclear Information System (INIS)

    Hoevels, Anke M.; Adang, Eddy M.; Heesakkers, Roel A.M.; Jager, Gerrit J.; Barentsz, Jelle O.

    2004-01-01

    The aim of this study was to compare the costs of three strategies in patients with prostate cancer in a specific setting: firstly, a strategy including MR lymphography (MRL) in which pelvic lymph node dissection (PLND) is foregone in case of a negative result. The second strategy involves computed tomography (CT) followed by a biopsy or PLND. The third strategy consists of PLND without imaging beforehand. A decision analytic model was constructed. This model represented the diagnostic process for patients with prostate cancer and intermediate or high risk for nodal metastases, comparing the costs of the three strategies. Cost analysis was done from the health care perspective. The model indicated that the expected costs for the MRL strategy were □2,527. The expected costs for the strategy using CT were □3,837 and for PLND □3,994. These results show that potential savings performing MRL instead of CT were □1,310 and □1,467 for PLND. Sensitivity analyses show that variation in costs of PLND was most influential on the costs of all strategies. However, the overall savings pattern did not alter. Average costs of MRL staging in our institution are less than for CT and PLND in staging lymph nodes of patients with prostate cancer and who are intermediate or high risk for nodal metastases. (orig.)

  9. Context and Natural Language in Formal Concept Analysis

    DEFF Research Database (Denmark)

    Wray, Tim; Eklund, Peter

    2017-01-01

    perspectives that emphasise the importance of the human, social and cultural contexts that are associated with objects. This paper presents an application of these museological concepts as related to the principles of Formal Concept Analysis along with a description of how the CollectionWeb framework generates......CollectionWeb is a framework that uses Formal Concept Analysis (FCA) to link contextually related objects within museum collections. These connections are used to drive a number of user interactions that are intended to promote exploration and discovery. The idea is based on museological...

  10. Implementation of Multiple Host Nodes in Wireless Sensing Node Network System for Landslide Monitoring

    International Nuclear Information System (INIS)

    Bin Abas, Faizulsalihin; Takayama, Shigeru

    2015-01-01

    This paper proposes multiple host nodes in Wireless Sensing Node Network System (WSNNS) for landslide monitoring. As landslide disasters damage monitoring system easily, one major demand in landslide monitoring is the flexibility and robustness of the system to evaluate the current situation in the monitored area. For various reasons WSNNS can provide an important contribution to reach that aim. In this system, acceleration sensors and GPS are deployed in sensing nodes. Location information by GPS, enable the system to estimate network topology and enable the system to perceive the location in emergency by monitoring the node mode. Acceleration sensors deployment, capacitate this system to detect slow mass movement that can lead to landslide occurrence. Once deployed, sensing nodes self-organize into an autonomous wireless ad hoc network. The measurement parameter data from sensing nodes is transmitted to Host System via host node and ''Cloud'' System. The implementation of multiple host nodes in Local Sensing Node Network System (LSNNS), improve risk- management of the WSNNS for real-time monitoring of landslide disaster

  11. Implementation of Multiple Host Nodes in Wireless Sensing Node Network System for Landslide Monitoring

    Science.gov (United States)

    Abas, Faizulsalihin bin; Takayama, Shigeru

    2015-02-01

    This paper proposes multiple host nodes in Wireless Sensing Node Network System (WSNNS) for landslide monitoring. As landslide disasters damage monitoring system easily, one major demand in landslide monitoring is the flexibility and robustness of the system to evaluate the current situation in the monitored area. For various reasons WSNNS can provide an important contribution to reach that aim. In this system, acceleration sensors and GPS are deployed in sensing nodes. Location information by GPS, enable the system to estimate network topology and enable the system to perceive the location in emergency by monitoring the node mode. Acceleration sensors deployment, capacitate this system to detect slow mass movement that can lead to landslide occurrence. Once deployed, sensing nodes self-organize into an autonomous wireless ad hoc network. The measurement parameter data from sensing nodes is transmitted to Host System via host node and "Cloud" System. The implementation of multiple host nodes in Local Sensing Node Network System (LSNNS), improve risk- management of the WSNNS for real-time monitoring of landslide disaster.

  12. Dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job

    Science.gov (United States)

    Budnik, Thomas A [Rochester, MN; Knudson, Brant L [Rochester, MN; Megerian, Mark G [Rochester, MN; Miller, Samuel J [Rochester, MN; Stockdell, William M [Byron, MN

    2012-03-20

    Methods, systems, and products for dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job that include: identifying that a job failed to execute on the block of compute nodes because connectivity failed between a compute node assigned as at least one of the connected nodes for the block of compute nodes and its supporting I/O node; and re-launching the job, including selecting an alternative connected node that is actively coupled for data communications with an active I/O node; and assigning the alternative connected node as the connected node for the block of compute nodes running the re-launched job.

  13. Value of irradiation of neck nodes metastases. Pt. 1. Treatment of palpable nodes

    International Nuclear Information System (INIS)

    Bujko, K.

    1993-01-01

    Medical records of 222 patients with neck nodes metastases from squamous cell carcinoma of supraglottic larynx, tonsil and base of tongue were analyzed. All cases were treated with definitive irradiation. 110 patients were treated with orthovoltage technique with total doses of 5000-6000 rads, 150-10 rads per fraction; 112 patients with Co-60 with total doses 6000-7000 rads, 180-230 rads per fraction. Local-regional control was achieved in 28% of cases. Failures in the neck nodes with primary tumor controlled, were recorded in 10% of patients. Failures in a primary tumor alone were observed in 26% of patients, in primary tumor and neck nodes in 36%. Radiocurability of primary tumor and involved neck nodes was similar. In cases with primary tumor controlled, the probability of eradication of neck nodes metastases is high, even in N3 stage patients. Residual neck nodes palpable 1 to 3 months after irradiation were unfavorable prognostic factor indicated 50% risk of neck recurrence. In patients with complete regression of primary and nodal disease, failure in neck nodes was recorded in 5% of cases. The role of surgery following irradiation in patients with cervical nodes metastases is discussed. (author)

  14. Lymph Node Metastases and Prognosis in Left Upper Division Non-Small Cell Lung Cancers: The Impact of Interlobar Lymph Node Metastasis.

    Directory of Open Access Journals (Sweden)

    Hiroaki Kuroda

    Full Text Available Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC located in the left upper division.We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako's method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station.We enrolled 417 patients (237 men, 180 women. Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC.Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC.

  15. Network structure exploration in networks with node attributes

    Science.gov (United States)

    Chen, Yi; Wang, Xiaolong; Bu, Junzhao; Tang, Buzhou; Xiang, Xin

    2016-05-01

    Complex networks provide a powerful way to represent complex systems and have been widely studied during the past several years. One of the most important tasks of network analysis is to detect structures (also called structural regularities) embedded in networks by determining group number and group partition. Most of network structure exploration models only consider network links. However, in real world networks, nodes may have attributes that are useful for network structure exploration. In this paper, we propose a novel Bayesian nonparametric (BNP) model to explore structural regularities in networks with node attributes, called Bayesian nonparametric attribute (BNPA) model. This model does not only take full advantage of both links between nodes and node attributes for group partition via shared hidden variables, but also determine group number automatically via the Bayesian nonparametric theory. Experiments conducted on a number of real and synthetic networks show that our BNPA model is able to automatically explore structural regularities in networks with node attributes and is competitive with other state-of-the-art models.

  16. Radio(chemo)therapy in the management of squamous cell carcinoma of cervical lymph nodes from an unknown primary site. A retrospective analysis

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrian, K.; Thamm, R.; Knapp, S.; Molls, M.; Pigorsch, S.; Geinitz, H. [Technische Univ. Muenchen (Germany). Dept. of Radiation Oncology; Haller, B. [Technische Univ. Muenchen (Germany). Inst. of Medical Statistics and Epidemiology

    2012-01-15

    The goal was to retrospectively review the outcome of patients with cervical lymph node metastases of squamuos cell carcinoma of unknown primary site (CUP) treated with radio(chemo)therapy. Patients and methods A total of 65 patients with CUP N1-3, M0, treated between 1988 and 2009 were evaluated: 61 patients underwent surgical resection followed by postoperative radio(chemo)therapy, 4 patients received definitive radiochemotherapy. Radiotherapy of bilateral neck nodes + the parapharyngeal region (COMP-RT) was performed in 48 patients (80%) and a unilateral radiotherapy of lymph nodes (UL-RT) in 17 patients (20%). Results After a median follow-up time of 64 months (range 3-219 months), the estimated 2- and 5-year overall survival (OS) rates were 71 {+-} 6% and 48 {+-} 7%, respectively. The recurrent free survival (RFS) rate at 2- and 5-years was 58 {+-} 6% and 48% {+-} 7%, respectively. Extracapsular spread, resection status (R0 vs. R1/R2), neck lymph node level (I-III vs. IV-V), and Karnofsky index (60-70 vs. 80-100) were significant prognostic factors for OS and RFS in the univariate analysis. Lower nodal stage (N1/N2a vs. N2b/N2c/N3) was significantly associated with a better OS. Resection status and involvement of lymph node level IV significantly affected the OS and RFS in the multivariate analysis. COMP-RT or concurrent chemotherapy was not associated with a better OS or RFS. Conclusion An advantage of comprehensive radiotherapy or radiochemotherapy compared with unilateral radiotherapy of lymph nodes was not observed. (orig.)

  17. Responsibility among bachelor degree nursing students: A concept analysis.

    Science.gov (United States)

    Ghasemi, Saeed; Ahmadi, Fazlollah; Kazemnejad, Anoshirvan

    2018-01-01

    Responsibility is an important component of the professional values and core competencies for bachelor degree nursing students and has relationships with nursing education and professionalization. It is important for providing safe and high-quality care to the clients for the present and future performance of student. But there is no clear and operational definition of this concept for bachelor degree nursing students; however, there are extensive contents and debates about the definitions, attributes, domains and boundaries of responsibility in nursing and non-nursing literature. To examine the concept of responsibility among bachelor degree nursing students using the evolutionary approach to concept analysis. A total of 75 articles published between 1990 and 2016 and related to the concept of responsibility were selected from seven databases and considered for concept analysis based on Rogers' evolutionary approach. Ethical considerations: Throughout all stages of data collection, analysis and reporting, accuracy and bailment were respected. Responsibility is a procedural, spectral, dynamic and complex concept. The attributes of the concept are smart thinking, appropriate managerial behaviours, appropriate communicational behaviours, situational self-mandatory and task-orientation behaviours. Personal, educational and professional factors lead to the emergence of the responsible behaviours among bachelor degree nursing students. The emergence of such behaviours facilitates the learning and education process, ensures nursing profession life and promotes clients and community health level. Responsibility has some effects on nursing students. This concept had been changed over time since 1990-2016. There are similarities and differences in the elements of this concept in disciplines of nursing and other educational disciplines. Conclusion The analysis of this concept can help to develop educational or managerial theories, design instruments for better identification

  18. Ontological Analysis of the Project Risk Management Concept ‘Risk’

    Directory of Open Access Journals (Sweden)

    Uzulāns Juris

    2018-02-01

    Full Text Available The aim of the current research series is to examine the definitions of the concept ‘risk’ and analyze the concepts used in the definitions of ‘risk’ in the sources of these definitions in order to perform the ontological analysis of the concept of ‘risk’. Ontological and epistemological analysis of the concepts in the definition of the concept ‘risk’ was used to answer the question what ‘risk’ means in project management. This investigation represents a part of the research series where the ontological, epistemological and methodological analysis of project risk is performed with the aim to improve risk registers and risk management as a whole. In the previous studies the author analyzed the concept of ‘event’ that defines the content of the concept ‘risk’. The use of ‘event’ was analyzed in different sources to find out how the concept should be used. The ontological, epistemological and methodological analysis of the definitions of the concept ‘risk’ is the theoretical foundation for risk register creation because it is possible to create complete and understandable register for the participants of the project risk management process. The author believes that the conducted research helps establish confidence that ontological analysis is the method that together with the epistemological and methodological analysis provides opportunity to perform analysis of risk management sources aimed at improving risk management. The results of the study cannot be considered sufficient for deriving valid conclusions about project risk management and developing recommendations for improving risk management with regard to the content of the risk register. For valid conclusions and recommendations, a deeper research is needed which, first of all, would analyze a larger number of sources.

  19. Radiation Protection Considerations about gamma probe-guided intraoperative sentinel lymph node surgery

    International Nuclear Information System (INIS)

    Rodriguez, C.; Jimenez-Hoyuela Garcia, J. L.; Rebollo Aguirre, J. M.; Custodio, A.

    2002-01-01

    The sentinel node concept is based on the sequential dissemination hypothesis. According to it, there's a lymph node (named sentinel node) which is the first receiving cancer cells metastasizing from a primary tumor. Further, others nodes sequentially located might be affected. Surgical performance for several types of cancer includes the complete removal of the tumor and a complete local lymph node dissection (LND). so removing and analyzing the sentinel node may avoid the complete LND. To locate the sentinel node, it's usual the local administration (intradermal injection) of a radiopharmaceutical Tc-99, sulfur colloid (activity about 1 mCi( several hours prior to surgery, and using an intraoperative gamma probe very sensitive to the gamma radiation. Although the activity is injected by the Nuclear Medicine staff, and be exposed to the gamma radiation. In this study we estimated maximum possible doses that would be received by personnel (surgical staff during surgery and pathologists during lumpectomy of the sentinel node). For the surgical staff, to avoid dose errors due to the very low residual activities and not to interfere with the personnel in the surgery room, we estimated doses by taking into account only the physical decay of Tc99m injected. for the pathologists, we estimated the residual activity in the sentinel node with the gamma probe. The highest effective dose rate found was to the surgeon (o,44 μSv/h, respectively. so a surgeon could perform 407 hours/yr, and a pathologist 1717 hours/yr, dedicated exclusively to sentinel node biopsy, before being classified as professionally exposed to radiation, and 4070 and 17170 hours per year, respectively, to surpass the annual limits (national regulations of the European Communities). In short, radiation doses to clinical staff involved in the technique are low, and in normal conditions, by establishing appropriate procedures (precautions during surgery, during manipulation surgical specimen...) control

  20. Social Accountable Medical Education: A concept analysis

    Science.gov (United States)

    ABDOLMALEKI, MOHAMMADREZA; YAZDANI, SHAHRAM; MOMENI, SEDIGHEH; MOMTAZMANESH, NADER

    2017-01-01

    Introduction: Considering the pervasiveness of social accountable medical education concept around the world and the growing trend of literature in this regard as well as various interpretations made about this concept, we found it necessary to analyze the concept of social accountable medical education. Methods: In this study, the modified version of McKenna’s approach to concept analysis was used to determine the concept, explain structures and substructures and determine the border concepts neighboring and against social accountability in medical education. Results: By studying the selected sources,the components of the concept were obtained to identify it and express an analytic definition of social accountability in medical education system. Then, a model case with all attributes of the given concept and the contrary and related concepts were mentioned to determine the boundary between the main concept and auxiliary ones. Conclusion: According to the results of this study in the field of social accountability, the detailed and transparent analytical definition of social accountable medical education can be used in future studies as well as the function and evaluation of medical education system. PMID:28761884

  1. Measure of Node Similarity in Multilayer Networks

    DEFF Research Database (Denmark)

    Møllgaard, Anders; Zettler, Ingo; Dammeyer, Jesper

    2016-01-01

    The weight of links in a network is often related to the similarity of thenodes. Here, we introduce a simple tunable measure for analysing the similarityof nodes across different link weights. In particular, we use the measure toanalyze homophily in a group of 659 freshman students at a large...... university.Our analysis is based on data obtained using smartphones equipped with customdata collection software, complemented by questionnaire-based data. The networkof social contacts is represented as a weighted multilayer network constructedfrom different channels of telecommunication as well as data...... might bepresent in one layer of the multilayer network and simultaneously be absent inthe other layers. For a variable such as gender, our measure reveals atransition from similarity between nodes connected with links of relatively lowweight to dis-similarity for the nodes connected by the strongest...

  2. On Prolonging Network Lifetime through Load-Similar Node Deployment in Wireless Sensor Networks

    Science.gov (United States)

    Li, Qiao-Qin; Gong, Haigang; Liu, Ming; Yang, Mei; Zheng, Jun

    2011-01-01

    This paper is focused on the study of the energy hole problem in the Progressive Multi-hop Rotational Clustered (PMRC)-structure, a highly scalable wireless sensor network (WSN) architecture. Based on an analysis on the traffic load distribution in PMRC-based WSNs, we propose a novel load-similar node distribution strategy combined with the Minimum Overlapping Layers (MOL) scheme to address the energy hole problem in PMRC-based WSNs. In this strategy, sensor nodes are deployed in the network area according to the load distribution. That is, more nodes shall be deployed in the range where the average load is higher, and then the loads among different areas in the sensor network tend to be balanced. Simulation results demonstrate that the load-similar node distribution strategy prolongs network lifetime and reduces the average packet latency in comparison with existing nonuniform node distribution and uniform node distribution strategies. Note that, besides the PMRC structure, the analysis model and the proposed load-similar node distribution strategy are also applicable to other multi-hop WSN structures. PMID:22163809

  3. Sentinel nodes outside lymph node basins in patients with melanoma

    NARCIS (Netherlands)

    Roozendaal, GK; de Vries, JDH; van Poll, D; Jansen, L; Nieweg, OE; Kroon, BBR; Schraffordt Koops, H.

    Background: Lymphoscintigraphy occasionally reveals hot spots outside lymph node basins in patients with melanoma. The aim of this study was to evaluate such abnormally located hot spots. Methods: Sentinel node biopsy was studied prospectively in 379 patients with clinically localized cutaneous

  4. A concept analysis of voluntary active euthanasia.

    Science.gov (United States)

    Guo, Fenglin

    2006-01-01

    Euthanasia has a wide range of classifications. Confusion exists in the application of specific concepts to various studies. To analyze the concept of voluntary active euthanasia using Walker and Avant's concept analysis method. A comprehensive literature review from various published literature and bibliographies. Clinical, ethical, and policy differences and similarities of euthanasia need to be debated openly, both within the medical profession and publicly. Awareness of the classifications about euthanasia may help nurses dealing with "end of life issues" properly.

  5. Measure of Node Similarity in Multilayer Networks

    DEFF Research Database (Denmark)

    Møllgaard, Anders; Zettler, Ingo; Dammeyer, Jesper

    2016-01-01

    university.Our analysis is based on data obtained using smartphones equipped with customdata collection software, complemented by questionnaire-based data. The networkof social contacts is represented as a weighted multilayer network constructedfrom different channels of telecommunication as well as data...... might bepresent in one layer of the multilayer network and simultaneously be absent inthe other layers. For a variable such as gender, our measure reveals atransition from similarity between nodes connected with links of relatively lowweight to dis-similarity for the nodes connected by the strongest...

  6. Node Detection and Internode Length Estimation of Tomato Seedlings Based on Image Analysis and Machine Learning

    Directory of Open Access Journals (Sweden)

    Kyosuke Yamamoto

    2016-07-01

    Full Text Available Seedling vigor in tomatoes determines the quality and growth of fruits and total plant productivity. It is well known that the salient effects of environmental stresses appear on the internode length; the length between adjoining main stem node (henceforth called node. In this study, we develop a method for internode length estimation using image processing technology. The proposed method consists of three steps: node detection, node order estimation, and internode length estimation. This method has two main advantages: (i as it uses machine learning approaches for node detection, it does not require adjustment of threshold values even though seedlings are imaged under varying timings and lighting conditions with complex backgrounds; and (ii as it uses affinity propagation for node order estimation, it can be applied to seedlings with different numbers of nodes without prior provision of the node number as a parameter. Our node detection results show that the proposed method can detect 72% of the 358 nodes in time-series imaging of three seedlings (recall = 0.72, precision = 0.78. In particular, the application of a general object recognition approach, Bag of Visual Words (BoVWs, enabled the elimination of many false positives on leaves occurring in the image segmentation based on pixel color, significantly improving the precision. The internode length estimation results had a relative error of below 15.4%. These results demonstrate that our method has the ability to evaluate the vigor of tomato seedlings quickly and accurately.

  7. Identification of hybrid node and link communities in complex networks.

    Science.gov (United States)

    He, Dongxiao; Jin, Di; Chen, Zheng; Zhang, Weixiong

    2015-03-02

    Identifying communities in complex networks is an effective means for analyzing complex systems, with applications in diverse areas such as social science, engineering, biology and medicine. Finding communities of nodes and finding communities of links are two popular schemes for network analysis. These schemes, however, have inherent drawbacks and are inadequate to capture complex organizational structures in real networks. We introduce a new scheme and an effective approach for identifying complex mixture structures of node and link communities, called hybrid node-link communities. A central piece of our approach is a probabilistic model that accommodates node, link and hybrid node-link communities. Our extensive experiments on various real-world networks, including a large protein-protein interaction network and a large network of semantically associated words, illustrated that the scheme for hybrid communities is superior in revealing network characteristics. Moreover, the new approach outperformed the existing methods for finding node or link communities separately.

  8. Identification of hybrid node and link communities in complex networks

    Science.gov (United States)

    He, Dongxiao; Jin, Di; Chen, Zheng; Zhang, Weixiong

    2015-03-01

    Identifying communities in complex networks is an effective means for analyzing complex systems, with applications in diverse areas such as social science, engineering, biology and medicine. Finding communities of nodes and finding communities of links are two popular schemes for network analysis. These schemes, however, have inherent drawbacks and are inadequate to capture complex organizational structures in real networks. We introduce a new scheme and an effective approach for identifying complex mixture structures of node and link communities, called hybrid node-link communities. A central piece of our approach is a probabilistic model that accommodates node, link and hybrid node-link communities. Our extensive experiments on various real-world networks, including a large protein-protein interaction network and a large network of semantically associated words, illustrated that the scheme for hybrid communities is superior in revealing network characteristics. Moreover, the new approach outperformed the existing methods for finding node or link communities separately.

  9. Family-centred care of children in hospital - a concept analysis

    DEFF Research Database (Denmark)

    Mikkelsen, Gitte; Frederiksen, Kirsten

    2011-01-01

    from 1951 to 2009 resulted in a sample of 25 research articles. Review methods.  A theoretical concept analysis influenced by Risjord's distinction between theoretical and colloquial analyses and based on the principles developed by Morse, Hupcey and Penrod was used to examine the structure...... of professionals and families, mostly represented by mothers. Few attempts have been made to operationalize the concept. Conclusion.  Family-centred care is a partially mature and highly abstract concept. Developing a theory of family-centred care could position the concept in a theoretical context and should also......mikkelsen g. & frederiksen k. (2011) Family-centred care of children in hospital - a concept analysis. Journal of Advanced Nursing67(5), 1152-1162. ABSTRACT: Aim.  This paper reports a concept analysis of family-centred nursing care of hospitalized children. Background.  Family-centred care...

  10. A Concept Analysis of Personalized Health Care in Nursing.

    Science.gov (United States)

    Han, Claire Jungyoun

    2016-01-01

    The purpose of the study is to identify the concept of personalized health care in nursing and to address future direction in person-centered nursing care. Personalized health care has attracted increased attention in the twenty-first century. As more and more preclinical studies are focusing on cost-effective and patient-centered care, there also has been an identified need for a personalized health care in nursing. Yet the term lacks clear definition and interests among healthcare professionals. Rodgers' strategy for concept analysis was used in this analysis. A literature review for 1960-2014 was conducted for the following keywords: nursing care, personalized, and health care. The analysis demonstrates that personalized health care in nursing is an intangible asset, including explicit attributes (interprofessional collaboration and individualized care approach) and implicit attributes (managing personal vulnerabilities: molecular-based health information and self-health-seeking behaviors). The result of this analysis provides a guide for further conceptual and empirical research and clinical practice in the personalized healthcare era. This concept analysis represents an effort to describe the attributes of a concept regarded as representing an important feature of nursing care and to promote discourse that will enhance maturation of the concept into one that is established with clearly delineated characteristics. © 2015 Wiley Periodicals, Inc.

  11. [A concept analysis of assertiveness].

    Science.gov (United States)

    Park, Hyoung-Sook; Yang, Young-Ok

    2006-06-01

    The purpose of this study was to analyze and clarify the meaning of the concept, assertiveness. This study used Walker and Avant's process of concept analysis. 1. Attributes of assertiveness were defined as 1) Self-esteem 2) Comprehension to others 3) Clarification of the subject 4) Verbal communication 5) Non-verbal communication. 2. The antecedents of assertiveness consist of these facts 1) The occurrence of a conflict situation 2) The occurrence of will to stick to one's opinions. 3. There are consequences occurring as a result of assertiveness 1) Positive self-confidence 2) Increased comprehension or consideration to others 3) Expand of mutual respect 4) Maintenance of continuously cooperative relationship with each other 5) Output of acceptable results to each other. Assertiveness is a core human behavior and is key to interpersonal relationships. Using the components of the concept of assertiveness, many conflicts in a nursing situation can be effectively prevented.

  12. Live and Dead Nodes

    DEFF Research Database (Denmark)

    Jørgensen, Sune Lehman; Jackson, A. D.

    2005-01-01

    In this paper, we explore the consequences of a distinction between `live' and `dead' network nodes; `live' nodes are able to acquire new links whereas `dead' nodes are static. We develop an analytically soluble growing network model incorporating this distinction and show that it can provide...

  13. Prognostic relevance of lymph node ratio and total lymph node count for small bowel adenocarcinoma.

    Science.gov (United States)

    Tran, Thuy B; Qadan, Motaz; Dua, Monica M; Norton, Jeffrey A; Poultsides, George A; Visser, Brendan C

    2015-08-01

    Nodal metastasis is a known prognostic factor for small bowel adenocarcinoma. The goals of this study were to evaluate the number of lymph nodes (LNs) that should be retrieved and the impact of lymph node ratio (LNR) on survival. Surveillance, Epidemiology, and End Results was queried to identify patients with small bowel adenocarcinoma who underwent resection from 1988 to 2010. Survival was calculated with the Kaplan-Meier method. Multivariate analysis identified predictors of survival. A total of 2,772 patients underwent resection with at least one node retrieved, and this sample included equal numbers of duodenal (n = 1,387) and jejunoileal (n = 1,386) adenocarcinomas. There were 1,371 patients with no nodal metastasis (N0, 49.4%), 928 N1 (33.5%), and 474 N2 (17.1%). The median numbers of LNs examined for duodenal and jejunoileal cancers were 9 and 8, respectively. Cut-point analysis demonstrated that harvesting at least 9 for jejunoileal and 5 LN for duodenal cancers resulted in the greatest survival difference. Increasing LNR at both sites was associated with decreased overall median survival (LNR = 0, 71 months; LNR 0-0.02, 35 months; LNR 0.21-0.4, 25 months; and LNR >0.4, 16 months; P < .001). Multivariate analysis confirmed number of LNs examined, T-stage, LN positivity, and LNR were independent predictors of survival. LNR has a profound impact on survival in patients with small bowel adenocarcinoma. To achieve adequate staging, we recommend retrieving a minimum of 5 LN for duodenal and 9 LN for jejunoileal adenocarcinomas. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Sustainability in nursing: a concept analysis

    Science.gov (United States)

    Anåker, Anna; Elf, Marie

    2014-01-01

    Aim The aim of this study was to describe, explore and explain the concept of sustainability in nursing. Background Although researchers in nursing and medicine have emphasised the issue of sustainability and health, the concept of sustainability in nursing is undefined and poorly researched. A need exists for theoretical and empirical studies of sustainability in nursing. Design Concept analysis as developed by Walker and Avant. Method Data were derived from dictionaries, international healthcare organisations and literature searches in the CINAHL and MEDLINE databases. Inclusive years for the search ranged from 1990 to 2012. A total of fourteen articles were found that referred to sustainability in nursing. Results Sustainability in nursing involves six defining attributes: ecology, environment, future, globalism, holism and maintenance. Antecedents of sustainability require climate change, environmental impact and awareness, confidence in the future, responsibility and a willingness to change. Consequences of sustainability in nursing include education in the areas of ecology, environment and sustainable development as well as sustainability as a part of nursing academic programs and in the description of the academic subject of nursing. Sustainability should also be part of national and international healthcare organisations. The concept was clarified herein by giving it a definition. Conclusion Sustainability in nursing was explored and found to contribute to sustainable development, with the ultimate goal of maintaining an environment that does not harm current and future generations′ opportunities for good health. This concept analysis provides recommendations for the healthcare sector to incorporate sustainability and provides recommendations for future research. PMID:24602178

  15. Transforming care in nursing: a concept analysis.

    Science.gov (United States)

    Vázquez-Calatayud, Mónica; Oroviogoicoechea, Cristina; Saracibar, Maribel; Pumar-Méndez, María J

    2017-04-01

    Although the concept of 'Transforming care' is promising for improving health care, there is no consensus in the field as to its definition. The aim of this concept analysis is to develop a deeper understanding of the term 'Transforming care' within the nursing discipline, in order to facilitate its comprehension, implementation, and evaluation. We performed a comprehensive literature review on electronic databases such as Medline (PubMed), Cinahl (Ebsco), Cochrane Library, PsycINFO (Ovid), Web of Science, Wiley-Blackwell, ScienceDirect, and SpringerLink and used Walker and Avant's approach to analyse the concept. From the 20 studies selected for this analysis, 3 main attributes of 'Transforming care' were identified: patient-centredness, evidence-based change, and transformational leadership driven. We suggest an operational definition to facilitate the implementation of the concept in practice. Furthermore, we propose that implementation is guided by the following key ideas: (1) fostering a culture of continuous improvement; (2) encouraging bottom-up initiatives; (3) promoting patient-centred care; and (4) using transformational leadership. Lastly, the evaluation of 'Transforming care' initiatives should assess care processes and professionals' and patients' outcomes.

  16. Screening analysis of solar thermochemical hydrogen concepts.

    Energy Technology Data Exchange (ETDEWEB)

    Diver, Richard B., Jr.; Kolb, Gregory J.

    2008-03-01

    A screening analysis was performed to identify concentrating solar power (CSP) concepts that produce hydrogen with the highest efficiency. Several CSP concepts were identified that have the potential to be much more efficient than today's low-temperature electrolysis technology. They combine a central receiver or dish with either a thermochemical cycle or high-temperature electrolyzer that operate at temperatures >600 C. The solar-to-hydrogen efficiencies of the best central receiver concepts exceed 20%, significantly better than the 14% value predicted for low-temperature electrolysis.

  17. Self-determination and older people--a concept analysis.

    Science.gov (United States)

    Ekelund, Christina; Dahlin-Ivanoff, Synneve; Eklund, Kajsa

    2014-03-01

    Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural. To define and clarify the concept of self-determination in relation to community-dwelling frail older people. Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes. Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice. This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

  18. Radio(chemo)therapy in the management of squamous cell carcinoma of cervical lymph nodes from an unknown primary site. A retrospective analysis

    International Nuclear Information System (INIS)

    Fakhrian, K.; Thamm, R.; Knapp, S.; Molls, M.; Pigorsch, S.; Geinitz, H.; Haller, B.

    2012-01-01

    The goal was to retrospectively review the outcome of patients with cervical lymph node metastases of squamuos cell carcinoma of unknown primary site (CUP) treated with radio(chemo)therapy. Patients and methods A total of 65 patients with CUP N1-3, M0, treated between 1988 and 2009 were evaluated: 61 patients underwent surgical resection followed by postoperative radio(chemo)therapy, 4 patients received definitive radiochemotherapy. Radiotherapy of bilateral neck nodes + the parapharyngeal region (COMP-RT) was performed in 48 patients (80%) and a unilateral radiotherapy of lymph nodes (UL-RT) in 17 patients (20%). Results After a median follow-up time of 64 months (range 3-219 months), the estimated 2- and 5-year overall survival (OS) rates were 71 ± 6% and 48 ± 7%, respectively. The recurrent free survival (RFS) rate at 2- and 5-years was 58 ± 6% and 48% ± 7%, respectively. Extracapsular spread, resection status (R0 vs. R1/R2), neck lymph node level (I-III vs. IV-V), and Karnofsky index (60-70 vs. 80-100) were significant prognostic factors for OS and RFS in the univariate analysis. Lower nodal stage (N1/N2a vs. N2b/N2c/N3) was significantly associated with a better OS. Resection status and involvement of lymph node level IV significantly affected the OS and RFS in the multivariate analysis. COMP-RT or concurrent chemotherapy was not associated with a better OS or RFS. Conclusion An advantage of comprehensive radiotherapy or radiochemotherapy compared with unilateral radiotherapy of lymph nodes was not observed. (orig.)

  19. Source and sink nodes in absence seizures.

    Science.gov (United States)

    Rodrigues, Abner C; Machado, Birajara S; Caboclo, Luis Otavio S F; Fujita, Andre; Baccala, Luiz A; Sameshima, Koichi

    2016-08-01

    As opposed to focal epilepsy, absence seizures do not exhibit a clear seizure onset zone or focus since its ictal activity rapidly engages both brain hemispheres. Yet recent graph theoretical analysis applied to absence seizures EEG suggests the cortical focal presence, an unexpected feature for this type of epilepsy. In this study, we explore the characteristics of absence seizure by classifying the nodes as to their source/sink natures via weighted directed graph analysis based on connectivity direction and strength estimation using information partial directed coherence (iPDC). By segmenting the EEG signals into relatively short 5-sec-long time windows we studied the evolution of coupling strengths from both sink and source nodes, and the network dynamics of absence seizures in eight patients.

  20. Contribution of the sentinel lymph node detection in oral cavity and oropharynx cancer

    International Nuclear Information System (INIS)

    Comte, F.; Barge, M.L.; Chevalier, J.; Rossi, M.; Zanca, M.; Alovisetti, C.; Garrel, R.; Guerrier, B.; Costes, V.

    2004-01-01

    The histopathological features of lymph nodes removal in head and neck cancer bring major prognostic information. Molecular biology or immuno histological techniques allow a far better detection sensitivity while underlining micrometastases. However, due to the great number of removed lymph nodes, an exhaustive histological analysis is impossible and an efficient targeting is desirable. The aim of this study was to establish the feasibility of the gamma probe directed biopsy of the sentinel lymph node in oral and oropharyngeal carcinoma. Up to date, 13 patients with oral and oropharyngeal cancers (T1pNO) were included. The sentinel lymph node was detected during surgery and selectively resected before traditional neck lymph dissection. The sentinel lymph node (SLN) was detected in 92 % of patients. In one case, the immunohistochemical analysis of the SLN showed a micro-metastatic involvement while the classical histological analysis remained negative.The preliminary analysis of our study attests the SLN radio-localization efficiency in head and neck cancers and allows the systematic detection of micro-metastatic involvement. The pursuit of this study will continue to confirm these results from a larger population and to precise the prognostic value of the micro-metastatic stage. (author)

  1. Concept analysis: patient autonomy in a caring context.

    Science.gov (United States)

    Lindberg, Catharina; Fagerström, Cecilia; Sivberg, Bengt; Willman, Ania

    2014-10-01

    This paper is a report of an analysis of the concept of patient autonomy Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Concept analysis. Medline, CINAHL, The Cochrane Library and PsycINFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved. The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context. © 2014 John Wiley & Sons Ltd.

  2. Predicting Likelihood of Having Four or More Positive Nodes in Patient With Sentinel Lymph Node-Positive Breast Cancer: A Nomogram Validation Study

    International Nuclear Information System (INIS)

    Unal, Bulent; Gur, Akif Serhat; Beriwal, Sushil; Tang Gong; Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Soran, Atilla

    2009-01-01

    Purpose: Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. Methods and Materials: We reviewed the records of 309 patients with breast cancer who had undergone completion axillary lymph node dissection. The factors associated with the likelihood of having four or more positive axillary nodes were evaluated in patients with one to three positive SLNs. The nomogram developed by Katz was applied to our data set. The area under the curve of the corresponding receiver operating characteristics curve was calculated for the nomogram. Results: Of the 309 patients, 80 (25.9%) had four or more positive axillary lymph nodes. On multivariate analysis, the number of positive SLNs (p < .0001), overall metastasis size (p = .019), primary tumor size (p = .0001), and extracapsular extension (p = .01) were significant factors predicting for four or more positive nodes. For patients with <5% probability, 90.3% had fewer than four positive nodes and 9.7% had four or more positive nodes. The negative predictive value was 91.7%, and sensitivity was 80%. The nomogram was accurate and discriminating (area under the curve, .801). Conclusion: The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.

  3. Glial membranes at the node of Ranvier prevent neurite outgrowth

    DEFF Research Database (Denmark)

    Huang, Jeffrey K; Phillips, Greg R; Roth, Alejandro D

    2005-01-01

    of neurite outgrowth, including the oligodendrocyte myelin glycoprotein (OMgp). In rat spinal cord, OMgp was not localized to compact myelin, as previously thought, but to oligodendroglia-like cells, whose processes converge to form a ring that completely encircles the nodes. In OMgp-null mice, CNS nodes......Nodes of Ranvier are regularly placed, nonmyelinated axon segments along myelinated nerves. Here we show that nodal membranes isolated from the central nervous system (CNS) of mammals restricted neurite outgrowth of cultured neurons. Proteomic analysis of these membranes revealed several inhibitors...

  4. Community landscapes: an integrative approach to determine overlapping network module hierarchy, identify key nodes and predict network dynamics.

    Directory of Open Access Journals (Sweden)

    István A Kovács

    Full Text Available BACKGROUND: Network communities help the functional organization and evolution of complex networks. However, the development of a method, which is both fast and accurate, provides modular overlaps and partitions of a heterogeneous network, has proven to be rather difficult. METHODOLOGY/PRINCIPAL FINDINGS: Here we introduce the novel concept of ModuLand, an integrative method family determining overlapping network modules as hills of an influence function-based, centrality-type community landscape, and including several widely used modularization methods as special cases. As various adaptations of the method family, we developed several algorithms, which provide an efficient analysis of weighted and directed networks, and (1 determine persvasively overlapping modules with high resolution; (2 uncover a detailed hierarchical network structure allowing an efficient, zoom-in analysis of large networks; (3 allow the determination of key network nodes and (4 help to predict network dynamics. CONCLUSIONS/SIGNIFICANCE: The concept opens a wide range of possibilities to develop new approaches and applications including network routing, classification, comparison and prediction.

  5. Modified methylene blue injection improves lymph node harvest in rectal cancer.

    Science.gov (United States)

    Liu, Jianpei; Huang, Pinjie; Zheng, Zongheng; Chen, Tufeng; Wei, Hongbo

    2017-04-01

    The presence of nodal metastases in rectal cancer plays an important role in accurate staging and prognosis, which depends on adequate lymph node harvest. The aim of this prospective study is to investigate the feasibility and survival benefit of improving lymph node harvest by a modified method with methylene blue injection in rectal cancer specimens. One hundred and thirty-one patients with rectal cancer were randomly assigned to the control group in which lymph nodes were harvested by palpation and sight, or to the methylene blue group using a modified method of injection into the superior rectal artery with methylene blue. Analysis of clinicopathologic records, including a long-term follow-up, was performed. In the methylene blue group, 678 lymph nodes were harvested by simple palpation and sight. Methylene blue injection added 853 lymph nodes to the total harvest as well as 32 additional metastatic lymph nodes, causing a shift to node-positive stage in four patients. The average number of lymph nodes harvested was 11.7 ± 3.4 in the control group and 23.2 ± 4.7 in the methylene blue group, respectively. The harvest of small lymph nodes (rectal cancer, especially small node and metastatic node retrieval, which provided more accurate staging. However, it was not associated with overall survival. © 2014 Royal Australasian College of Surgeons.

  6. Distinct Ezrin Truncations Differentiate Metastases in Sentinel Lymph Nodes from Unaffected Lymph Node Tissues, from Primary Breast Tumors, and from Healthy Glandular Breast Tissues

    Directory of Open Access Journals (Sweden)

    Claudia Röwer

    2018-02-01

    Full Text Available BACKGROUND: Lymph node metastasis status is a prognostic factor for further lymph node involvement and for patient survival in breast cancer patients. Frozen section analysis of lymph nodes is a reliable method for detection of macro-metastases. However, this method is far less effective in detecting micro-metastases, requesting improved diagnostic procedures. METHODS: We investigated expression and truncation of ezrin in (i sentinel lymph node metastases, (ii unaffected axillary lymph nodes, (iii primary breast tumors, and (iv healthy glandular breast tissues using 2D gel electrophoresis, SDS-PAGE, and mass spectrometry in addition to Western blotting. RESULTS: Full-length ezrin (E1; amino acids 1–586 is present in all four investigated tissues. Two truncated ezrin forms, one missing about the first hundred amino acids (E2a and the other lacking about 150 C-terminal amino acids (E2b were detectable in primary tumor tissues and in sentinel lymph node metastases but not in glandular tissues. Strikingly, an ezrin truncation (E3 which consists approximately of amino acids 238–586 was found strongly expressed in all sentinel lymph node metastases. Moreover, an N-terminal ezrin fragment (E4 that consists approximately of amino acids 1–273 was identified in sentinel lymph node metastases as well. CONCLUSIONS: We show for the first time the existence of tissue-dependent specific ezrin truncations. The distinguished strong Western blot staining of ezrin E3 in sentinel lymph node metastases underlines its capability to substantiate the occurrence of lymph node (micrometastases in breast cancer patients.

  7. Tone as a health concept: An analysis.

    Science.gov (United States)

    McDowall, Donald; Emmanuel, Elizabeth; Grace, Sandra; Chaseling, Marilyn

    2017-11-01

    Concept analysis. This paper is a report on the analysis of the concept of tone in chiropractic. The purpose of this paper is to clarify the concept of tone as originally understood by Daniel David Palmer from 1895 to 1914 and to monitor its evolution over time. Data was sourced from Palmer's original work, published between 1895 and 1914. A literature search from 1980 to 2016 was also performed on the online databases CINHAL, PubMed and Scopus with key terms including 'tone', 'chiropractic', 'Palmer', 'vitalism', 'health', 'homeostasis', 'holism' and 'wellness'. Finally hand-searches were conducted through chiropractic books and professional literature from 1906 to 1980 for any references to 'tone'. Rodgers' evolutionary method of analysis was used to categorise the data in relation to the surrogates, attributes, references, antecedents and consequences of tone. A total of 49 references were found: five from publications by Palmer; three from the database searches, and; the remaining 41 from professional books, trade journals and websites. There is no clear interpretation of tone in the contemporary chiropractic literature. Tone is closely aligned with functional neurology and can be understood as an interface between the metaphysical and the biomedical. Using the concept of tone as a foundation for practice could strengthen the identity of the chiropractic profession. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Effects of Concept Mapping on Creativity in Photo Stories

    Science.gov (United States)

    Simper, Natalie; Reeve, Richard; Kirby, J. R.

    2016-01-01

    This research tested the use of concept map planning to support the development of creativity in photo stories, hypothesizing that skills taught to support organization would improve creativity. Concept maps are a type of graphic organizer, used to represent an ordering of ideas with nodes and linking words that form propositional statements. They…

  9. Prognostic factors in patients with node-negative gastric cancer: an Indian experience

    Directory of Open Access Journals (Sweden)

    Ranganathan Rama

    2011-05-01

    Full Text Available Abstract Background The status of the regional nodes is the most important prognostic factor in gastric cancer. There are subgroups of patients with different prognosis even in node-negative patients of gastric cancer. The aim of this study is to analyze the factors influencing the prognosis in Indian patients with node-negative gastric cancer. Methods This was a retrospective analysis of patients who underwent radical gastrectomy in a tertiary cancer centre in India between1991 and 2007. The study group included only patients with histologically node-negative disease. Various clinical, pathological and treatment related factors in this group of patients were analyzed to determine their prognostic ability by univariate and multivariate analyses. Results Among the 417 patients who underwent gastrectomy during this period, 122 patients had node-negative disease. A major proportion of the patients had advanced gastric cancer. The 5-year overall survival and disease-free survival in all node-negative gastric cancer patients was 68.2% and 67.5% respectively. The overall recurrence rate in this group was 27.3%. On univariate analysis, the factors found to significantly influence the disease-free survival were the size, location and presence or absence of serosal invasion of the primary tumor. However, on multivariate analysis, only tumor size more than 3 cm and serosal invasion were found to be independently associated with an inferior survival. Conclusion Serosal invasion and primary tumor size more than 3 cm independently predict a poor outcome in patients with node-negative gastric cancer.

  10. The Value of Nursing Care: A Concept Analysis.

    Science.gov (United States)

    Dick, Tracey K; Patrician, Patricia A; Loan, Lori A

    2017-10-01

    To report an analysis of the concept of value of nursing care. Value-based health care delivery and reimbursement models are focused on value as a product of quality and cost. Nursing care provides tangible and intangible contributions to patient and organizational outcomes. The nursing profession must be able to proactively and effectively communicate the value of nursing care. Concept analysis. Thirty-five separate sources were chosen from database searches of CINAHL Complete and ABI/INFORM Complete. Key terms utilized for the search were "nursing value" OR "nursing care value" OR "value of nursing". Caron and Bowers' (2000) dimensional analysis method was used as a guide for the project. Dimensions identified from this concept analysis included: (a) economic, (b) relational, and (c) societal. Direct care nurses experience the relational and societal dimensions of the value of nursing care. Patients and/or families experience the relational dimension of value in nursing care. Health care administrators, third-party payers, and nurse researchers interpret value from the economic dimension. Future nursing research should better quantify the economic value of nursing care. Qualitative research which focuses on how patients and families experience the value of nursing care would also contribute to further refinement of this concept. © 2017 Wiley Periodicals, Inc.

  11. Lymph Node Metastases and Prognosis in Left Upper Division Non-Small Cell Lung Cancers: The Impact of Interlobar Lymph Node Metastasis

    Science.gov (United States)

    Kuroda, Hiroaki; Sakao, Yukinori; Mun, Mingyon; Uehara, Hirofumi; Nakao, Masayuki; Matsuura, Yousuke; Mizuno, Tetsuya; Sakakura, Noriaki; Motoi, Noriko; Ishikawa, Yuichi; Yatabe, Yasushi; Nakagawa, Ken; Okumura, Sakae

    2015-01-01

    Background Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC) located in the left upper division. Methods We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy) with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako’s method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station. Results We enrolled 417 patients (237 men, 180 women). Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC. Conclusions Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC. PMID:26247881

  12. Lay Worker Health Literacy: A Concept Analysis and Operational Definition.

    Science.gov (United States)

    Cadman, Kathleen Paco

    2017-10-01

    The concept of lay worker health literacy is created by concurrently analyzing and synthesizing two intersecting concepts, lay workers and health literacy. Articulation of this unique intersection is the result of implementing a simplified Wilson's Concept Analysis Procedure. This process incorporates the following components: a) selecting a concept, b) determining the aims/purposes of analysis, c) identifying all uses of the concept, d) determining defining attributes, e) identifying a model case, f) identifying borderline, related, contrary, and illegitimate cases, g) identifying antecedents and consequences, and h) defining empirical referents. Furthermore, as current literature provides no operational definition for lay worker health literacy, one is created to contribute cohesion to the concept. © 2017 Wiley Periodicals, Inc.

  13. Joy and happiness: a simultaneous and evolutionary concept analysis.

    Science.gov (United States)

    Cottrell, Laura

    2016-07-01

    To report a simultaneous and evolutionary analysis of the concepts of joy and long-term happiness. Joy and happiness are underrepresented in the nursing literature, though negative concepts are well represented. When mentioned in the literature, neither joy nor happiness is adequately defined, explained, or clearly understood. To promote further investigation of these concepts in nursing and to explore their relationship with health and healing, conceptual clarity is an essential first step. Concept analysis. The following databases were searched, without time restrictions, for articles in English: Academic Search Complete, Anthropology Plus; ATLA Religious Database with ATLASerials; Cumulative Index of Nursing and Allied Health Literature (CINAHL); Education Research Complete; Humanities International Complete; Psych EXTRA; and SocINDEX with Full Text. The final sample size consists of 61 articles and one book, published between 1978-2014. An adapted combination of Rodgers' Evolutionary Model and Haase et al.'s Simultaneous Concept Analysis (SCA) method. Though both are positive concepts, joy and happiness have significant differences. Attributes of joy describe a spontaneous, sudden and transient concept associated with connection, awareness, and freedom. Attributes of happiness describe a pursued, long-lasting, stable mental state associated with virtue and self-control. Further exploration of joy and happiness is necessary to ascertain their relationship with health and their value to nursing practice and theory development. Nurses are encouraged to consider the value of positive concepts to all areas of nursing. © 2016 John Wiley & Sons Ltd.

  14. Concept Analysis and the Advance of Nursing Knowledge: State of the Science.

    Science.gov (United States)

    Rodgers, Beth L; Jacelon, Cynthia S; Knafl, Kathleen A

    2018-04-24

    Despite an overwhelming increase in the number of concept analyses published since the early 1970s, there are significant limitations to the impact of this work in promoting progress in nursing science. We conducted an extensive review of concept analyses published between 1972 and 2017 to identify patterns in analysis and followed this with exploration of an exemplar related to the concept of normalization to demonstrate the capabilities of analysis for promoting concept development and progress. Scoping review of peer-reviewed literature published in the Cumulative Index to Nursing and Allied Health Literature (CINAHL) in which the terms "concept analysis," "concept clarification," and "concept derivation" appeared in any part of the reference. The original search returned 3,489 articles. This initial pool was refined to a final sample of 958 articles published in 223 journals and addressing 604 concepts. A review of citations of the original analysis of the concept of normalization resulted in 75 articles selected for closer examination of the process of concept development. Review showed a clear pattern of repetition of analysis of the same concept, growth in number of published analyses, preponderance of first authors with master's degrees, and 43 distinct descriptions of methods. Review of the 75 citations to the normalization analysis identified multiple ways concept analysis can inform subsequent research and theory development. Conceptual work needs to move beyond the level of "concept analysis" involving clear linkage to the resolution of problems in the discipline. Conceptual work is an important component of progress in the knowledge base of a discipline, and more effective use of concept development activities are needed to maximize the potential of this important work. It is important to the discipline that we facilitate progress in nursing science on a theoretical and conceptual level as a part of cohesive and systematic development of the discipline

  15. Ethical sensitivity in professional practice: concept analysis.

    Science.gov (United States)

    Weaver, Kathryn; Morse, Janice; Mitcham, Carl

    2008-06-01

    This paper is a report of a concept analysis of ethical sensitivity. Ethical sensitivity enables nurses and other professionals to respond morally to the suffering and vulnerability of those receiving professional care and services. Because of its significance to nursing and other professional practices, ethical sensitivity deserves more focused analysis. A criteria-based method oriented toward pragmatic utility guided the analysis of 200 papers and books from the fields of nursing, medicine, psychology, dentistry, clinical ethics, theology, education, law, accounting or business, journalism, philosophy, political and social sciences and women's studies. This literature spanned 1970 to 2006 and was sorted by discipline and concept dimensions and examined for concept structure and use across various contexts. The analysis was completed in September 2007. Ethical sensitivity in professional practice develops in contexts of uncertainty, client suffering and vulnerability, and through relationships characterized by receptivity, responsiveness and courage on the part of professionals. Essential attributes of ethical sensitivity are identified as moral perception, affectivity and dividing loyalties. Outcomes include integrity preserving decision-making, comfort and well-being, learning and professional transcendence. Our findings promote ethical sensitivity as a type of practical wisdom that pursues client comfort and professional satisfaction with care delivery. The analysis and resulting model offers an inclusive view of ethical sensitivity that addresses some of the limitations with prior conceptualizations.

  16. Pregnancy-related anxiety: A concept analysis.

    Science.gov (United States)

    Bayrampour, Hamideh; Ali, Elena; McNeil, Deborah A; Benzies, Karen; MacQueen, Glenda; Tough, Suzanne

    2016-03-01

    Evidence suggests that pregnancy-related anxiety is more strongly associated with maternal and child outcomes than general anxiety and depression are and that pregnancy-related anxiety may constitute a distinct concept. However, because of its poor conceptualization, the measurement and assessment of pregnancy-related anxiety have been limited. Efforts to analyze this concept can significantly contribute to its theoretical development. The first objective of this paper was to clarify the concept of pregnancy-related anxiety and identify its characteristics and dimensions. The second aim was to examine the items of current pregnancy-related anxiety measures to determine the dimensions and attributes that each scale addresses, noting any gaps between the current assessment and the construct of the concept. A concept analysis was conducted to examine the concept of pregnancy-related anxiety. To obtain the relevant evidence, several databases were searched including MEDLINE, PsycINFO, EBSCO's SocINDEX, Psychological and Behavioral Sciences Collection, CINAHL, SCOPUS, and EMBASE. A modified approach based on Walker and Avant (Strategies for theory construction in nursing. 5th ed; 2011) was used. Qualitative or quantitative studies published in English that explored or examined anxiety during pregnancy or its dimensions prospectively or retrospectively were included. Thirty eight studies provided data for the concept analysis. Three critical attributes (i.e., affective responses, cognitions, and somatic symptoms), three antecedents (i.e., a real or anticipated threat to pregnancy or its outcomes, low perceived control, and excessive cognitive activity, and four consequences (i.e., negative attitudes, difficulty concentrating, excessive reassurance-seeking behavior, and avoidance behaviors) were identified. Nine dimensions for pregnancy-related anxiety were determined, and a definition of the concept was proposed. The most frequently reported dimensions included anxiety

  17. Sustainability in nursing: a concept analysis.

    Science.gov (United States)

    Anåker, Anna; Elf, Marie

    2014-06-01

    The aim of this study was to describe, explore and explain the concept of sustainability in nursing. Although researchers in nursing and medicine have emphasised the issue of sustainability and health, the concept of sustainability in nursing is undefined and poorly researched. A need exists for theoretical and empirical studies of sustainability in nursing. Concept analysis as developed by Walker and Avant. Data were derived from dictionaries, international healthcare organisations and literature searches in the CINAHL and MEDLINE databases. Inclusive years for the search ranged from 1990 to 2012. A total of fourteen articles were found that referred to sustainability in nursing. Sustainability in nursing involves six defining attributes: ecology, environment, future, globalism, holism and maintenance. Antecedents of sustainability require climate change, environmental impact and awareness, confidence in the future, responsibility and a willingness to change. Consequences of sustainability in nursing include education in the areas of ecology, environment and sustainable development as well as sustainability as a part of nursing academic programs and in the description of the academic subject of nursing. Sustainability should also be part of national and international healthcare organisations. The concept was clarified herein by giving it a definition. Sustainability in nursing was explored and found to contribute to sustainable development, with the ultimate goal of maintaining an environment that does not harm current and future generations' opportunities for good health. This concept analysis provides recommendations for the healthcare sector to incorporate sustainability and provides recommendations for future research. © 2014 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

  18. Sentinel nodes are identifiable in formalin-fixed specimens after surgeon-performed ex vivo sentinel lymph node mapping in colorectal cancer.

    LENUS (Irish Health Repository)

    Smith, Fraser McLean

    2012-02-03

    BACKGROUND: In recent years, the technique of sentinel lymph node (SLN) mapping has been applied to colorectal cancer. One aim was to ultrastage patients who were deemed node negative by routine pathologic processing but who went on to develop systemic disease. Such a group may benefit from adjuvant chemotherapy. METHODS: With fully informed consent and ethical approval, 37 patients with primary colorectal cancer and 3 patients with large adenomas were prospectively mapped. Isosulfan blue dye (1 to 2 mL) was injected around tumors within 5 to 10 minutes of resection. After gentle massage to recreate in vivo lymph flow, specimens were placed directly into formalin. During routine pathologic analysis, all nodes were bivalved, and blue-staining nodes were noted. These later underwent multilevel step sectioning with hematoxylin and eosin and cytokeratin staining. RESULTS: SLNs were found in 39 of 40 patients (98% sensitivity), with an average of 4.1 SLNs per patient (range, 1-8). In 14 of 16 (88% specificity) patients with nodal metastases on routine reporting, SLN status was in accordance. Focused examination of SLNs identified occult tumor deposits in 6 (29%) of 21 node-negative patients. No metastatic cells were found in SLNs draining the three adenomas. CONCLUSIONS: The ability to identify SLNs after formalin fixation increases the ease and applicability of SLN mapping in colorectal cancer. Furthermore, the sensitivity and specificity of this simple ex vivo method for establishing regional lymph node status were directly comparable to those in previously published reports.

  19. Ultrasound detection of abdominal lymph nodes in chronic liver diseases. A retrospective analysis

    Energy Technology Data Exchange (ETDEWEB)

    Soresi, M.; Bonfissuto, G.; Magliarisi, C.; Riili, A.; Terranova, A.; Di Giovanni, G.; Bascone, F.; Carroccio, A.; Tripi, S.; Montalto, G. E-mail: gmontal@unipa.it

    2003-05-01

    AIM: To retrospectively evaluate the prevalence of lymph nodes of the hepato-duodenal ligament in a group of patients with chronic liver disease of various aetiologies and to investigate what clinical, aetiological and laboratory data may lead to their appearance. MATERIALS AND METHODS: One thousand and three patients (554 men, 449 women) were studied, including 557 with chronic hepatitis and 446 with liver cirrhosis. The presence of lymph nodes near the trunk of the portal vein, hepatic artery, celiac axis, superior mesenteric vein and pancreas head was investigated using ultrasound. RESULTS: Lymph nodes were detected in 394 out of the 1003 study patients (39.3%); their number ranged from one to four, with a diameter ranging between 0.8 and 4 cm. The highest prevalence was in the subgroup of patients with primary biliary cirrhosis (87.5%), followed by patients with hepatitis C virus (HCV; 42%), patients with HCV and hepatitis B virus (HBV; 41.3%), autoimmune hepatitis (40%), and HBV alone (21.2%). In the alcoholic and idiopathic subgroups prevalence was 9.5%, while in the non-alcoholic steatohepatitis and haemochromatosis subgroups it was 0%. HCV RNA was present in 97 out of 103 lymph node-positive patients and in 141 out of 168 lymph node-negative HCV-negative patients (p<0.003). Lymphadenopathy frequency increased as the liver disease worsened ({chi}{sup 2} MH=74.3; p<0.0001). CONCLUSION: Despite the limitations of a retrospective study, our data indicate a high prevalence of lymphadenopathy in liver disease patients; ultrasound evidence of lymph nodes of the hepato-duodenal ligament in a given liver disease may most likely suggest a HCV or an autoimmune aetiology and a more severe histological picture.

  20. Clinicopathologic risk factors for right paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Yu, Q A; Ma, D K; Liu, K P; Wang, P; Xie, C M; Wu, Y H; Dai, W J; Jiang, H C

    2018-03-17

    To investigate risk factors associated with right paraesophageal lymph node (RPELN) metastasis in patients with papillary thyroid carcinoma (PTC) and to determine the indications for right lymph node dissection. Clinicopathologic data from 829 patients (104 men and 725 women) with PTC, operated on by the same thyroid surgery team at the First Affiliated Hospital of Harbin Medical University from January 2013 to May 2017, were analyzed. Overall, 309 patients underwent total thyroidectomy with bilateral lymph node dissection, 488 underwent right thyroid lobe and isthmic resection with right central compartment lymph node dissection, and 32 underwent near-total thyroidectomy (ipsilateral thyroid lobectomy with contralateral near-total lobectomy) with bilateral lymph node dissection. The overall rate of central compartment lymph node metastasis was 43.5% (361/829), with right central compartment lymph node and RPELN metastasis rates of 35.5% (294/829) and 19.1% (158/829), respectively. Tumor size, number, invasion, and location, lymph node metastasis, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis were associated with RPELN in the univariate analysis, whereas age and sex were not. Multivariate analysis identified tumors with a diameter ≥ 1 cm, multiple tumors, tumors located in the right lobe, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis as independent risk factors for RPELN metastasis. Lymph node dissection, including RPELN dissection, should be performed for patients with PTC with a tumor diameter ≥ 1 cm, multiple tumors, right-lobe tumors, right central compartment lymph node metastasis, or suspected lateral compartment lymph node metastasis.

  1. Comparative analysis of multi-slice spiral CT and positron emission tomography-CT in evaluation of axillary lymph nodes in breast cancer patients

    International Nuclear Information System (INIS)

    Sun Xianchang; Zhang Ruyi; Liu Qingwei; Zhao Suhong; Zu Degui; Li Xin

    2008-01-01

    Objective: To evaluate and compare spiral CT and positron emission tomography-CT (PET-CT) in characterization of of axillary lymph nodes in breast cancer patients. Methods: Forty patients with pathologically proven breast cancer underwent contrast-enhanced spiral CT of the breast and axilla, 13 of them also underwent PET-CT examination. One hundred and fifty-eight axillary lymph nodes were found in the 40 patients through contrast enhanced spiral CT, while 57 lymph nodes were found in the 13 patients through PET-CT. Three radiologists rated the lymph nodes found in CT images on a five-point scale. If the score was equal to or greater than 3, it was defined as positive (metastatic), otherwise negative. Visual observation and semiquantitative analysis were used to classify lymph nodes in PET-CT images. The results of spiral CT observation and PET-CT observation of lymph nodes were compared with pathological results. The relative value of CT and PET-CT was analyzed. Exact probability statistics were employed. Results: One hundred and fifty eight lymph nodes of 40 patients were detected by spiral CT, 91 of them were diagnosed as positive and 67 as negative Among the lymph nodes found in spiral CT, 99 were positive and 59 were negative pathologicall. A total of 57 lymph nodes were found by PET-CT. Thirty-nine of them were defined as positive and 18 as negative. Among the lymph nodes found in PET-CT, 39 were positive and 18 were negative pathologically. The sensitivity, specificity, accuracy, positive and negative predictive values in CT prediction in axillary lymph nodes metastases were 88.89%, 94.91%, 91.14%, 96.70%, and 83.58%, respectively. The sensitivity, specificity, accuracy, positive and negative predictive values in PET-CT prediction in axillary lymph nodes metastases were 97.44%, 94.44%, 96.49%, 97.44%, and 94.44%, respectively. PET-CT had no significant difference with spiral CT in sensitivity, accuracy, positive and negative predictive values for detection

  2. Chemical shift effect predicting lymph node status in rectal cancer using high-resolution MR imaging with node-for-node matched histopathological validation

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hongmei; Zhang, Chongda; Ye, Feng; Liu, Yuan; Zhou, Chunwu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zheng, Zhaoxu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Colorectal Oncology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zou, Shuangmei [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Pathology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China)

    2017-09-15

    To evaluate the value of the chemical shift effect (CSE) as well as other criteria for the prediction of lymph node status. Twenty-nine patients who underwent radical surgery of rectal cancers were studied with pre- and postoperative specimen MRI. Lymph nodes were harvested from transverse whole-mount specimens and compared with in vivo and ex vivo images to obtain a precise slice-for-section match. Preoperative MR characteristics including CSE, as well as other predictors, were evaluated by two readers independently between benign and metastatic nodes. A total of 255 benign and 35 metastatic nodes were obtained; 71.4% and 69.4% of benign nodes were detected with regular CSE for two readers, whereas 80.0% and 74.3% of metastatic nodes with absence of CSE. The CSE rendered areas under the ROC curve (AUC) of 0.879 and 0.845 for predicting nodal status for two readers. The criteria of nodal location, border, signal intensity and minimum distance to the rectal wall were also useful but with AUCs (0.629-0.743) lower than those of CSE. CSE is a reliable predictor for differentiating benign from metastatic nodes. Additional criteria should be taken into account when it is difficult to determine the nodal status by using only a single predictor. (orig.)

  3. Formal Concept Analysis for Information Retrieval

    OpenAIRE

    Qadi, Abderrahim El; Aboutajedine, Driss; Ennouary, Yassine

    2010-01-01

    In this paper we describe a mechanism to improve Information Retrieval (IR) on the web. The method is based on Formal Concepts Analysis (FCA) that it is makes semantical relations during the queries, and allows a reorganizing, in the shape of a lattice of concepts, the answers provided by a search engine. We proposed for the IR an incremental algorithm based on Galois lattice. This algorithm allows a formal clustering of the data sources, and the results which it turns over are classified by ...

  4. Feeling safe during an inpatient hospitalization: a concept analysis.

    Science.gov (United States)

    Mollon, Deene

    2014-08-01

    This paper aims to explore the critical attributes of the concept feeling safe. The safe delivery of care is a high priority; however; it is not really known what it means to the patient to 'feel safe' during an inpatient hospitalization. This analysis explores the topic of safety from the patient's perspective. Concept analysis. The data bases of CINAHL, Medline, PsychInfo and Google Scholar for the years 1995-2012 were searched using the terms safe and feeling safe. The eight-step concept analysis method of Walker and Avant was used to analyse the concept of feeling safe. Uses and defining attributes, as well as identified antecedents, consequences and empirical referents, are presented. Case examples are provided to assist in the understanding of defining attributes. Feeling safe is defined as an emotional state where perceptions of care contribute to a sense of security and freedom from harm. Four attributes were identified: trust, cared for, presence and knowledge. Relationship, environment and suffering are the antecedents of feeling safe, while control, hope and relaxed or calm are the consequences. Empirical referents and early development of a theory of feeling safe are explored. This analysis begins the work of synthesizing qualitative research already completed around the concept of feeling safe by defining the key attributes of the concept. Support for the importance of developing patient-centred models of care and creating positive environments where patients receive high-quality care and feel safe is provided. © 2014 John Wiley & Sons Ltd.

  5. Seawifs Technical Report Series. Volume 2: Analysis of Orbit Selection for Seawifs: Ascending Versus Descending Node

    Science.gov (United States)

    Hooker, Stanford B. (Editor); Firestone, Elaine R. (Editor); Gregg, Watson W.

    1992-01-01

    Due to range safety considerations, the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) ocean color instrument may be required to be launched into a near-noon descending node, as opposed to the ascending node used by the predecessor sensor, the Coastal Zone Color Scanner (CZCS). The relative importance of ascending versus descending near-noon orbits was assessed here to determine if descending node will meet the scientific requirements of SeaWiFS. Analyses focused on ground coverage, local times of coverage, solar and viewing geometries (zenith and azimuth angles), and sun glint. Differences were found in the areas covered by individual orbits, but were not important when taken over a 16 day repeat time. Local time of coverage was also different: for ascending node orbits the Northern Hemisphere was observed in the morning and the Southern Hemisphere in the afternoon, while for descending node orbits the Northern Hemisphere was observed in the afternoon and the Southern in the morning. There were substantial differences in solar azimuth and spacecraft azimuth angles both at equinox and at the Northern Hemisphere summer solstice. Negligible differences in solar and spacecraft zenith angles, relative azimuth angles, and sun glint were obtained at the equinox. However, large differences were found in solar zenith angles, relative azimuths, and sun glint for the solstice. These differences appeared to compensate across the scan, however, an increase in sun glint in descending node over that in ascending node on the western part of the scan was compensated by a decrease on the eastern part of the scan. Thus, no advantage or disadvantage could be conferred upon either ascending node or descending node for noon orbits. Analyses were also performed for ascending and descending node orbits that deviated from a noon equator crossing time. For ascending node, afternoon orbits produced the lowest mean solar zenith angles in the Northern Hemisphere, and morning orbits produced

  6. Role stress amongst nurses at the workplace: concept analysis.

    Science.gov (United States)

    Riahi, Sanaz

    2011-09-01

    The present study explicates the concept of role stress amongst nurses through an analysis adopted from Walker and Avant; Strategies for Theory Construction in Nursing, 4th edn, Prentice Hall, New Jersey, NY. Role stress has become a significant problem amongst nurses and has created much distress leading to burnout among many in the nursing profession. It is significant to analyse the concept of role stress and its relative attributes and consequences, in order to recognize the necessary antecedents needed to create better conditions for nurses at the workplace. A modified method developed by Walker and Avant was used for this concept analysis. A model representing the concept of role stress was developed through careful consideration of the attributes, consequences, antecedents and empirical referents of role stress. The concept analysis of role stress among nurses at the workplace recognized the vulnerability of the nursing discipline towards burnout and distress in general. It is critical to be aware of the current state of health care and note the increased workload created for nurses. Nurses are at a greater vulnerability for role stress, making it imperative for health care organizations to critically evaluate and establish preventative measures for the concept of role stress. 2011 Blackwell Publishing Ltd.

  7. Deaf: A Concept Analysis From a Cultural Perspective Using the Wilson Method of Concept Analysis Development.

    Science.gov (United States)

    Pendergrass, Kathy M; Newman, Susan D; Jones, Elaine; Jenkins, Carolyn H

    2017-07-01

    The purpose of this article is to provide an analysis of the concept Deaf to increase health care provider (HCP) understanding from a cultural perspective. Deaf signers, people with hearing loss who communicate primarily in American Sign Language (ASL), generally define the term Deaf as a cultural heritage. In the health care setting, the term deaf is most often defined as a pathological condition requiring medical intervention. When HCPs are unaware that there are both cultural and pathological views of hearing loss, significant barriers may exist between the HCP and the Deaf individual. The concept of Deaf is analyzed using the Wilsonian method. Essential elements of the concept "Deaf" from a cultural perspective include a personal choice to communicate primarily in ASL and identify with the Deaf community. Resources for HCPs are needed to quickly identify Deaf signers and provide appropriate communication.

  8. Integrated Circuit Conception: A Wire Optimization Technic Reducing Interconnection Delay in Advanced Technology Nodes

    Directory of Open Access Journals (Sweden)

    Mohammed Darmi

    2017-10-01

    Full Text Available As we increasingly use advanced technology nodes to design integrated circuits (ICs, physical designers and electronic design automation (EDA providers are facing multiple challenges, firstly, to honor all physical constraints coming with cutting-edge technologies and, secondly, to achieve expected quality of results (QoR. An advanced technology should be able to bring better performances with minimum cost whatever the complexity. A high effort to develop out-of-the-box optimization techniques is more than needed. In this paper, we will introduce a new routing technique, with the objective to optimize timing, by only acting on routing topology, and without impacting the IC Area. In fact, the self-aligned double patterning (SADP technology offers an important difference on layer resistance between SADP and No-SADP layers; this property will be taken as an advantage to drive the global router to use No-SADP less resistive layers for critical nets. To prove the benefit on real test cases, we will use Mentor Graphics’ physical design EDA tool Nitro-SoC™ and several 7 nm technology node designs. The experiments show that worst negative slack (WNS and total negative slack (TNS improved up to 13% and 56%, respectively, compared to the baseline flow.

  9. Differential Gene Expression in Primary Breast Tumors Associated with Lymph Node Metastasis

    International Nuclear Information System (INIS)

    Ellsworth, R.E.; Field, L.A.; Kane, J.L.; Love, B.; Hooke, J.A.; Shriver, C.D.

    2011-01-01

    Lymph node status remains one of the most useful prognostic indicators in breast cancer; however, current methods to assess nodal status disrupt the lymphatic system and may lead to secondary complications. Identification of molecular signatures discriminating lymph node-positive from lymph node-negative primary tumors would allow for stratification of patients requiring surgical assesment of lymph nodes. Primary breast tumors from women with negative (n=41) and positive (n=35) lymph node status matched for possible confounding factors were subjected to laser micro dissection and gene expression data generated. Although ANOVA analysis (P 1.5) revealed 13 differentially expressed genes, hierarchical clustering classified 90% of node-negative but only 66% of node-positive tumors correctly. The inability to derive molecular profiles of metastasis in primary tumors may reflect tumor heterogeneity, paucity of cells within the primary tumor with metastatic potential, influence of the microenvironment, or inherited host susceptibility to metastasis

  10. Differential Gene Expression in Primary Breast Tumors Associated with Lymph Node Metastasis

    Science.gov (United States)

    Ellsworth, Rachel E.; Field, Lori A.; Love, Brad; Kane, Jennifer L.; Hooke, Jeffrey A.; Shriver, Craig D.

    2011-01-01

    Lymph node status remains one of the most useful prognostic indicators in breast cancer; however, current methods to assess nodal status disrupt the lymphatic system and may lead to secondary complications. Identification of molecular signatures discriminating lymph node-positive from lymph node-negative primary tumors would allow for stratification of patients requiring surgical assesment of lymph nodes. Primary breast tumors from women with negative (n = 41) and positive (n = 35) lymph node status matched for possible confounding factors were subjected to laser microdissection and gene expression data generated. Although ANOVA analysis (P 1.5) revealed 13 differentially expressed genes, hierarchical clustering classified 90% of node-negative but only 66% of node-positive tumors correctly. The inability to derive molecular profiles of metastasis in primary tumors may reflect tumor heterogeneity, paucity of cells within the primary tumor with metastatic potential, influence of the microenvironment, or inherited host susceptibility to metastasis. PMID:22295210

  11. Differential Gene Expression in Primary Breast Tumors Associated with Lymph Node Metastasis

    Directory of Open Access Journals (Sweden)

    Rachel E. Ellsworth

    2011-01-01

    Full Text Available Lymph node status remains one of the most useful prognostic indicators in breast cancer; however, current methods to assess nodal status disrupt the lymphatic system and may lead to secondary complications. Identification of molecular signatures discriminating lymph node-positive from lymph node-negative primary tumors would allow for stratification of patients requiring surgical assesment of lymph nodes. Primary breast tumors from women with negative (=41 and positive (=35 lymph node status matched for possible confounding factors were subjected to laser microdissection and gene expression data generated. Although ANOVA analysis (1.5 revealed 13 differentially expressed genes, hierarchical clustering classified 90% of node-negative but only 66% of node-positive tumors correctly. The inability to derive molecular profiles of metastasis in primary tumors may reflect tumor heterogeneity, paucity of cells within the primary tumor with metastatic potential, influence of the microenvironment, or inherited host susceptibility to metastasis.

  12. Workplace incivility: a concept analysis.

    Science.gov (United States)

    Abolfazl Vagharseyyedin, Seyyed

    2015-01-01

    This study aimed to describe the meaning of the concept 'workplace incivility' and promote consistency in its application in nursing research and practice. The methodology introduced by Walker and Avant was used to analyze this concept. A total number of 50 studies that had essentially addressed the concept of incivility in employees' work environment was selected. Ambiguous intent, violation of mutual respect, low intensity and lack of physical assault were identified as the defining attributes of workplace incivility. The necessary antecedent of workplace incivility consisted of the presence of two or more people, with one or more as the source of the incivility, and another or others as its target in the workplace. Moreover, certain individual and organisational factors were the potential antecedents of workplace incivility. Possible negative outcomes for victims, witnesses, organisations, society and perpetrators of such behaviours, such as increased cost for the organisation, reduced citizenship performance, psychological distress and anxiety were identified as outcomes of workplace incivility. Results of the current concept analysis can guide nurse managers to design interventions so that the occurrence of workplace incivility can be reduced. Further studies can focus on testing the psychometric properties of the existing workplace incivility scales, especially uncivil behaviours experienced by nurses across different societies or cultures.

  13. Is the benefit of postmastectomy irradiation limited to patients with four or more positive nodes, as recommended in international consensus reports? A subgroup analysis of the DBCG 82 b & c randomized trials

    DEFF Research Database (Denmark)

    Overgaard, Marie; Nielsen, Hanne Melgaard; Overgaard, Jens

    2007-01-01

    % to 10% (p4% (p...BACKGROUND AND AIM: Numerous consensus reports recommend that postmastectomy radiotherapy (RT) in addition to systemic therapy is indicated in high-risk patients with 4+ positive nodes, but not in patients with 1-3 positive nodes. A subgroup analysis of the DBCG 82 b&c trials was performed...... lymph nodes removed (median 7), the present analysis was limited to 1152 node positive patients with 8 or more nodes removed. RESULTS: The overall 15-year survival rate in the subgroup was 39% and 29% (p=0.015) after RT and no RT, respectively. RT reduced the 15-year loco-regional failure rate from 51...

  14. Involved Node Radiation Therapy

    DEFF Research Database (Denmark)

    Maraldo, Maja V; Aznar, Marianne C; Vogelius, Ivan R

    2012-01-01

    PURPOSE: The involved node radiation therapy (INRT) strategy was introduced for patients with Hodgkin lymphoma (HL) to reduce the risk of late effects. With INRT, only the originally involved lymph nodes are irradiated. We present treatment outcome in a retrospective analysis using this strategy...... to 36 Gy). Patients attended regular follow-up visits until 5 years after therapy. RESULTS: The 4-year freedom from disease progression was 96.4% (95% confidence interval: 92.4%-100.4%), median follow-up of 50 months (range: 4-71 months). Three relapses occurred: 2 within the previous radiation field......, and 1 in a previously uninvolved region. The 4-year overall survival was 94% (95% confidence interval: 88.8%-99.1%), median follow-up of 58 months (range: 4-91 months). Early radiation therapy toxicity was limited to grade 1 (23.4%) and grade 2 (13.8%). During follow-up, 8 patients died, none from HL, 7...

  15. Coupling effect of nodes popularity and similarity on social network persistence.

    Science.gov (United States)

    Jin, Xiaogang; Jin, Cheng; Huang, Jiaxuan; Min, Yong

    2017-02-21

    Network robustness represents the ability of networks to withstand failures and perturbations. In social networks, maintenance of individual activities, also called persistence, is significant towards understanding robustness. Previous works usually consider persistence on pre-generated network structures; while in social networks, the network structure is growing with the cascading inactivity of existed individuals. Here, we address this challenge through analysis for nodes under a coevolution model, which characterizes individual activity changes under three network growth modes: following the descending order of nodes' popularity, similarity or uniform random. We show that when nodes possess high spontaneous activities, a popularity-first growth mode obtains highly persistent networks; otherwise, with low spontaneous activities, a similarity-first mode does better. Moreover, a compound growth mode, with the consecutive joining of similar nodes in a short period and mixing a few high popularity nodes, obtains the highest persistence. Therefore, nodes similarity is essential for persistent social networks, while properly coupling popularity with similarity further optimizes the persistence. This demonstrates the evolution of nodes activity not only depends on network topology, but also their connective typology.

  16. Spiritual nursing care: A concept analysis.

    Science.gov (United States)

    Monareng, Lydia V

    2012-10-08

    Although the concept 'spiritual nursing care' has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech's eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result 'caring presence' was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.

  17. Managerial coaching: a concept analysis.

    Science.gov (United States)

    Batson, Vicki D; Yoder, Linda H

    2012-07-01

    This article presents a report of a concept analysis of managerial coaching. Managerial coaching has been identified as a means for managers to give support to staff nurses, however, no clear delineation of what behaviours and attributes constitute managerial coaching or differentiate it from other career development relationships is provided in the current nursing literature. The CINAHL, ProQuest, Business Source Complete and PscyhIFNO databases were searched for articles published between 1980-2009 using the keywords coaching, managerial coaching, nurse manager support, nursing leadership, self-efficacy, work environment and empowerment. A hybrid approach was used, incorporating both Walker and Avant's method of concept analysis and King's conceptual system and Theory of Goal Attainment to explore the meaning of managerial coaching. Inclusive years of search ranged from 1980-2009. Managerial coaching is a specific dyadic relationship between the nurse manager and staff nurse intended to improve skills and knowledge as they relate to expected job performance. Antecedents and consequences are categorized at the individual and organizational level. Defining attributes, empirical referents and a model case are presented. The theoretical definition for this concept helps to differentiate it from other types of career development relationships and will give a basis for nurse managers to understand what skills and attributes are necessary to establish an effective managerial coaching relationship with staff nurses. Conceptualization will also assist in developing empirical studies examining managerial coaching behaviours in the work environment. © 2012 Blackwell Publishing Ltd.

  18. Analysis of digester design concepts

    Energy Technology Data Exchange (ETDEWEB)

    Ashare, E.; Wilson, E. H.

    1979-01-29

    Engineering economic analyses were performed on various digester design concepts to determine the relative performance for various biomass feedstocks. A comprehensive literature survey describing the state-of-the-art of the various digestion designs is included. The digester designs included in the analyses are CSTR, plug flow, batch, CSTR in series, multi-stage digestion and biomethanation. Other process options investigated included pretreatment processes such as shredding, degritting, and chemical pretreatment, and post-digestion processes, such as dewatering and gas purification. The biomass sources considered include feedlot manure, rice straw, and bagasse. The results of the analysis indicate that the most economical (on a unit gas cost basis) digester design concept is the plug flow reactor. This conclusion results from this system providing a high gas production rate combined with a low capital hole-in-the-ground digester design concept. The costs determined in this analysis do not include any credits or penalties for feedstock or by-products, but present the costs only for conversion of biomass to methane. The batch land-fill type digester design was shown to have a unit gas cost comparable to that for a conventional stirred tank digester, with the potential of reducing the cost if a land-fill site were available for a lower cost per unit volume. The use of chemical pretreatment resulted in a higher unit gas cost, primarily due to the cost of pretreatment chemical. A sensitivity analysis indicated that the use of chemical pretreatment could improve the economics provided a process could be developed which utilized either less pretreatment chemical or a less costly chemical. The use of other process options resulted in higher unit gas costs. These options should only be used when necessary for proper process performance, or to result in production of a valuable by-product.

  19. Monitoring Traffic Information with a Developed Acceleration Sensing Node

    Directory of Open Access Journals (Sweden)

    Zhoujing Ye

    2017-12-01

    Full Text Available In this paper, an acceleration sensing node for pavement vibration was developed to monitor traffic information, including vehicle speed, vehicle types, and traffic flow, where a hardware design with low energy consumption and node encapsulation could be accomplished. The service performance of the sensing node was evaluated, by methods including waterproof test, compression test, sensing performance analysis, and comparison test. The results demonstrate that the sensing node is low in energy consumption, high in strength, IPX8 waterproof, and high in sensitivity and resolution. These characteristics can be applied to practical road environments. Two sensing nodes were spaced apart in the direction of travelling. In the experiment, three types of vehicles passed by the monitoring points at several different speeds and values of d (the distance between the sensor and the nearest tire center line. Based on cross-correlation with kernel pre-smoothing, a calculation method was applied to process the raw data. New algorithms for traffic flow, speed, and axle length were proposed. Finally, the effects of vehicle speed, vehicle weight, and d value on acceleration amplitude were statistically evaluated. It was found that the acceleration sensing node can be used for traffic flow, vehicle speed, and other types of monitoring.

  20. Monitoring Traffic Information with a Developed Acceleration Sensing Node.

    Science.gov (United States)

    Ye, Zhoujing; Wang, Linbing; Xu, Wen; Gao, Zhifei; Yan, Guannan

    2017-12-05

    In this paper, an acceleration sensing node for pavement vibration was developed to monitor traffic information, including vehicle speed, vehicle types, and traffic flow, where a hardware design with low energy consumption and node encapsulation could be accomplished. The service performance of the sensing node was evaluated, by methods including waterproof test, compression test, sensing performance analysis, and comparison test. The results demonstrate that the sensing node is low in energy consumption, high in strength, IPX8 waterproof, and high in sensitivity and resolution. These characteristics can be applied to practical road environments. Two sensing nodes were spaced apart in the direction of travelling. In the experiment, three types of vehicles passed by the monitoring points at several different speeds and values of d (the distance between the sensor and the nearest tire center line). Based on cross-correlation with kernel pre-smoothing, a calculation method was applied to process the raw data. New algorithms for traffic flow, speed, and axle length were proposed. Finally, the effects of vehicle speed, vehicle weight, and d value on acceleration amplitude were statistically evaluated. It was found that the acceleration sensing node can be used for traffic flow, vehicle speed, and other types of monitoring.

  1. Deploying Node.js

    CERN Document Server

    Pasquali, Sandro

    2015-01-01

    If you are an intermediate or advanced developer deploying your Node.js applications, then this book is for you. If you have already built a Node application or module and want to take your knowledge to the next level, this book will help you find your way.

  2. Identification of important nodes in directed biological networks: a network motif approach.

    Directory of Open Access Journals (Sweden)

    Pei Wang

    Full Text Available Identification of important nodes in complex networks has attracted an increasing attention over the last decade. Various measures have been proposed to characterize the importance of nodes in complex networks, such as the degree, betweenness and PageRank. Different measures consider different aspects of complex networks. Although there are numerous results reported on undirected complex networks, few results have been reported on directed biological networks. Based on network motifs and principal component analysis (PCA, this paper aims at introducing a new measure to characterize node importance in directed biological networks. Investigations on five real-world biological networks indicate that the proposed method can robustly identify actually important nodes in different networks, such as finding command interneurons, global regulators and non-hub but evolutionary conserved actually important nodes in biological networks. Receiver Operating Characteristic (ROC curves for the five networks indicate remarkable prediction accuracy of the proposed measure. The proposed index provides an alternative complex network metric. Potential implications of the related investigations include identifying network control and regulation targets, biological networks modeling and analysis, as well as networked medicine.

  3. Presenteeism in nursing: An evolutionary concept analysis.

    Science.gov (United States)

    Rainbow, Jessica G; Steege, Linsey M

    Presenteeism is an emerging concept in nursing that has been linked to increased health care costs, patient medication errors and falls, and negative nurse well-being. However, prior work has utilized various definitions and antecedents. Clarity on the significance, development, and consequences of presenteeism in nursing is needed. This concept analysis seeks to understand the application of presenteeism within nursing workforce literature and in the broader workforce context. Rodgers' evolutionary concept analysis method was used. The proposed definition of presenteeism as the act of being physically present at work with reduced performance can be attributed to multiple antecedents. These include nurse health, professional identity, work-life balance, and work environment. The prevalence of these antecedents with high rates of presenteeism among nurses and consequences point to the need for interventions. These findings can guide development of future interventions and policies that address the broader context of factors leading to presenteeism. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Advanced midwifery practice: An evolutionary concept analysis.

    Science.gov (United States)

    Goemaes, Régine; Beeckman, Dimitri; Goossens, Joline; Shawe, Jill; Verhaeghe, Sofie; Van Hecke, Ann

    2016-11-01

    the concept of 'advanced midwifery practice' is explored to a limited extent in the international literature. However, a clear conception of advanced midwifery practice is vital to advance the discipline and to achieve both internal and external legitimacy. This concept analysis aims to clarify advanced midwifery practice and identify its components. a review of the literature was executed using Rodgers' evolutionary method of concept analysis to analyze the attributes, references, related terms, antecedents and consequences of advanced midwifery practice. an international consensus definition of advanced midwifery practice is currently lacking. Four major attributes of advanced midwife practitioners (AMPs) are identified: autonomy in practice, leadership, expertise, and research skills. A consensus was found on the need of preparation at master's level for AMPs. Such midwives have a broad and internationally varied scope of practice, fulfilling different roles such as clinicians, clinical and professional leaders, educators, consultants, managers, change agents, researchers, and auditors. Evidence illustrating the important part AMPs play on a clinical and strategic level is mounting. the findings of this concept analysis support a wide variety in the emergence, titles, roles, and scope of practice of AMPs. Research on clinical and strategic outcomes of care provided by AMPs supports further implementation of these roles. As the indistinctness of AMPs' titles and roles is one of the barriers for implementation, a clear conceptualization of advanced midwifery practice seems essential for successful implementation. an international debate and consensus on the defining elements of advanced midwifery practice could enhance the further development of midwifery as a profession and is a prerequisite for its successful implementation. Due to rising numbers of AMPs, extension of practice and elevated quality requirements in healthcare, more outcomes research exclusively

  5. Sentinel node biopsy in penile cancer

    DEFF Research Database (Denmark)

    Jakobsen, J. K.; Krarup, K. P.; Sommer, P.

    2015-01-01

    INTRODUCTION & OBJECTIVES: Nodal involvement is a strong prognosticator in penile cancer and lymph node staging is crucial. Sentinel node biopsy (SNB) has proven a useful staging tool with few complications, but evidence rely mostly on single institution publications with a short follow-up. In th......INTRODUCTION & OBJECTIVES: Nodal involvement is a strong prognosticator in penile cancer and lymph node staging is crucial. Sentinel node biopsy (SNB) has proven a useful staging tool with few complications, but evidence rely mostly on single institution publications with a short follow...... died from complications. CONCLUSIONS: To our knowledge, this is the first complete national study on sentinel node biopsy. Penile cancer sentinel node biopsy with a close follow-up is a reliable lymph node staging and has few complications in a national multicentre setting. Inguinal lymph node...

  6. Pacing: a concept analysis of the chronic pain intervention.

    Science.gov (United States)

    Jamieson-Lega, Kathryn; Berry, Robyn; Brown, Cary A

    2013-01-01

    The intervention of pacing is regularly recommended for chronic pain patients. However, pacing is poorly defined and appears to be interpreted in varying, potentially contradictory manners within the field of chronic pain. This conceptual lack of clarity has implications for effective service delivery and for researchers' ability to conduct rigorous study. An examination of the background literature demonstrates that while pacing is often one part of a multidisciplinary pain management program, outcome research is hindered by a lack of a clear and shared definition of this currently ill-defined construct. To conduct a formal concept analysis of the term 'pacing'. A standardized concept analysis process (including literature scoping to identify all uses of the concept, analysis to determine defining attributes of the concept and identification of model, borderline and contrary cases) was used to determine what the concept of pacing does and does not represent within the current evidence base. A conceptual model including the core attributes of action, time, balance, learning and self-management emerged. From these attributes, an evidence-based definition for pacing was composed and distributed to stakeholders for review. After consideration of stakeholder feedback, the emergent definition of pacing was finalized as follows: "Pacing is an active self-management strategy whereby individuals learn to balance time spent on activity and rest for the purpose of achieving increased function and participation in meaningful activities". The findings of the present concept analysis will help to standardize the use and definition of the term pacing across disciplines for the purposes of both pain management and research.

  7. Sentinel node biopsy performance after neoadjuvant chemotherapy in locally advanced breast cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Mocellin, Simone; Goldin, Elena; Marchet, Alberto; Nitti, Donato

    2016-01-15

    The use of sentinel node biopsy (SNB) after neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer is debated. Our aim was to quantitatively review the available evidence on the performance of SNB after NAC in patients with locally advanced breast cancer. We performed a systematic review (by searching the PubMed, Cochrane and Scopus databases) and random effects meta-analysis to investigate on the feasibility and accuracy of SNB in these patients. The two outcomes of interest were the sentinel node identification rate (SIR) and the false negative rate (FNR). Sensitivity analysis and meta-regression were used to investigate the potential sources of between-study heterogeneity. We retrieved 72 eligible studies enrolling 7,451 patients. Upon meta-analysis, summary SIR resulted 89.6% [95% confidence interval (CI): 87.8-91.2; heterogeneity I(2): 76.9%], which poorly compares with the 95% SIR observed in some recent series of early breast cancer. The summary FNR resulted 14.2% (CI: 12.5-16.0; heterogeneity I(2): 29.1%), which was significantly higher than the 8-10% reference value. Considering an average post-NAC lymph node positivity rate of 50%, the downstaging due to false negative SNB would occur in 7/100 patients (with an excess error rate of 2-3/100 as compared to the early-stage setting). No plausible source of between-study heterogeneity was found. Based on the largest series of studies ever meta-analyzed, our findings highlight the limits of SNB performance in this population, where the impact of SNB on patient survival is still to be defined. © 2015 UICC.

  8. Sentinel Lymph Node Biopsy (SLNB) for Breast Cancer (BC) - Validation Protocol of the Technique

    International Nuclear Information System (INIS)

    Blidaru, A.; Bordea, C.I.; Condrea, Ileana; Albert, Paul

    2006-01-01

    Full text: The sentinel ganglion concept originates in the assumption according to which the primary tumor drains into a specific ganglionar area and then runs through the lymphatic nodes in an orderly, sequential mode. When neoplastic dissemination along the lymphatic pathway occurs, there is an initial invasion of a specific lymph node (rarely more than one) located on the drainage route. That firstly lymph node has been identified as the sentinel node, which mirrors the regional ganglionar status. In order to establish the indication for lymphadenectomy and avoid the situations in which such a surgical procedure would be of no use (N-), the only correct method consists in the identification and biopsy of the sentinel node. Radioactive tracing and/or use of vital staining enable the identification of the regional ganglionar group towards which the primary lesion is draining. The technique of sentinel lymph node identification and biopsy by means of radioactive tracing includes: - pre-surgical lymphoscintigraphy, - identification of the sentinel lymph node and its excisional biopsy, - intra-operative histopathological examination and immunohistochemical stains of the sentinel lymph node. Regional lymphadenectomy serves two major purposes: - diagnosis (axillary lymph node invasion represents an important prognostic factor) and therapeutic (to ensure local control of the disease). Regional lymph node invasion in breast cancer is directly related to the primary tumour size. In the less advanced stages (T1), as there is rarely invasion of the axillary lymph nodes, lymphadenectomy can be avoided in most cases. The paper presents the refinement of the technique, the validation of the method for the identification and biopsy of the sentinel lymph node in breast cancer using Tc99 and the intra-operative use of NEOPROBE 2000 gamma camera at the 'Prof. Dr. Alexandru Trestioreanu' Oncological Institute in Bucharest. 93 patients with primary breast cancer (T1, T2, N0

  9. (18F)-fluorodeoxyglucose PET/CT in cervix cancer: Lymph node assessment and prognostic/predictive value of primary tumour analysis

    International Nuclear Information System (INIS)

    Leseur, J.; Williaume, D.; Le Prise, E.; De Crevoisier, R.; Devillers, A.; Garin, E.; Fougerou, C.; Bouriel, C.; Leveque, J.; Monpetit, E.; Blanchot, J.

    2011-01-01

    Purpose. - In cervix carcinoma: (a) to evaluate the ability of ( 18 F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the lymph node detection; (b) to investigate the prognostic and predictive value of the primary cervical PET parameters. Patients and methods. - Ninety patients treated for cervix carcinoma and evaluated initially by MRI and FDG PET were included. The performances of FDG-PET for lymph node detection (relatively to the lymph node dissection) have been described (sensitivity, specificity, positive predictive value and negative predictive value). PET tumour parameters analyzed were: maximum standard uptake value (SUV max ), the volume and the maximum diameter. The prognostic and predictive values of these parameters were investigated. The tumour response was evaluated on surgical specimens. Results. - PET detected the cervical tumour with a sensitivity of 97% (mean values: SUV max = 15.8, volume = 27 mm 3 , maximum diameter = 47). For the detection of the lymph nodes, the values of sensibility, specificity, positive predictive value and negative predictive value were: 86, 56, 69 and 78% in the pelvic, and 90, 67, 50 and 95% for the para-aortic area, respectively. The SUV max was correlated with histologic response (P = 0.04). The frequency of partial histological response was significantly higher for tumour SUV max > 10.9 (P = 0.017). The maximum PET diameter and pathologic response had an impact on disease-free survival and overall survival in multivariate analysis (P < 0.05). Conclusion. - PET has high sensitivity in detecting pelvic and para-aortic lymph nodes. Some primary cervical tumour PET parameters are useful as prognostic and predictive factors. (authors)

  10. A Longitudinal Comparison of Arm Morbidity in Stage I-II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E. H. M.; Rietman, Johan S.; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H. B.; Hoekstra, Harald J.

    Background. Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

  11. A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E.; Rietman, Johan Swanik; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H.B.; Hoekstra, Harald J.

    2010-01-01

    Background: Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

  12. Penile Cancer: Contemporary Lymph Node Management.

    Science.gov (United States)

    O'Brien, Jonathan S; Perera, Marlon; Manning, Todd; Bozin, Mike; Cabarkapa, Sonja; Chen, Emily; Lawrentschuk, Nathan

    2017-06-01

    In penile cancer, the optimal diagnostics and management of metastatic lymph nodes are not clear. Advances in minimally invasive staging, including dynamic sentinel lymph node biopsy, have widened the diagnostic repertoire of the urologist. We aimed to provide an objective update of the recent trends in the management of penile squamous cell carcinoma, and inguinal and pelvic lymph node metastases. We systematically reviewed several medical databases, including the Web of Science® (with MEDLINE®), Embase® and Cochrane databases, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines. The search terms used were penile cancer, lymph node, sentinel node, minimally invasive, surgery and outcomes, alone and in combination. Articles pertaining to the management of lymph nodes in penile cancer were reviewed, including original research, reviews and clinical guidelines published between 1980 and 2016. Accurate and minimally invasive lymph node staging is of the utmost importance in the surgical management of penile squamous cell carcinoma. In patients with clinically node negative disease, a growing body of evidence supports the use of sentinel lymph node biopsies. Dynamic sentinel lymph node biopsy exposes the patient to minimal risk, and results in superior sensitivity and specificity profiles compared to alternate nodal staging techniques. In the presence of locoregional disease, improvements in inguinal or pelvic lymphadenectomy have reduced morbidity and improved oncologic outcomes. A multimodal approach of chemotherapy and surgery has demonstrated a survival benefit for patients with advanced disease. Recent developments in lymph node management have occurred in penile cancer, such as minimally invasive lymph node diagnosis and intervention strategies. These advances have been met with a degree of controversy in the contemporary literature. Current data suggest that dynamic sentinel lymph node biopsy provides excellent

  13. Spiritual nursing care: A concept analysis

    Directory of Open Access Journals (Sweden)

    Lydia V. Monareng

    2012-10-01

    Full Text Available Although the concept ‘spiritual nursing care’ has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech’s eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result ‘caring presence’ was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.

  14. Controllability of Weighted and Directed Networks with Nonidentical Node Dynamics

    Directory of Open Access Journals (Sweden)

    Linying Xiang

    2013-01-01

    Full Text Available The concept of controllability from control theory is applied to weighted and directed networks with heterogenous linear or linearized node dynamics subject to exogenous inputs, where the nodes are grouped into leaders and followers. Under this framework, the controllability of the controlled network can be decomposed into two independent problems: the controllability of the isolated leader subsystem and the controllability of the extended follower subsystem. Some necessary and/or sufficient conditions for the controllability of the leader-follower network are derived based on matrix theory and graph theory. In particular, it is shown that a single-leader network is controllable if it is a directed path or cycle, but it is uncontrollable for a complete digraph or a star digraph in general. Furthermore, some approaches to improving the controllability of a heterogenous network are presented. Some simulation examples are given for illustration and verification.

  15. Analysis of promising sustainable renovation concepts

    DEFF Research Database (Denmark)

    Vanhoutteghem, Lies; Tommerup, Henrik M.; Svendsen, Svend

    This report focuses on analyses of the most promising existing sustainable renovation concepts, i.e. full-service concepts and technical concepts, for single-family houses. As a basis for the analyses a detailed building stock analysis was carried out. Furthermore, as a basis a general working...... method for proposals on package solutions for sustainable renovation was described. The method consists of four steps, going from investigation of the house to proposal for sustainable renovation, detailed planning and commissioning after renovation. It could be used by teams of consultants...... of the building envelope and the electricity required to run the system. Positive impact on the indoor environment can be expected. Thermal comfort will be improved by insulation and air-tightness measures that will increase surface temperatures and reduce draught from e.g. badly insulated windows. A ventilation...

  16. Moral competence among nurses in Malawi: A concept analysis approach.

    Science.gov (United States)

    Maluwa, Veronica Mary; Gwaza, Elizabeth; Sakala, Betty; Kapito, Esnath; Mwale, Ruth; Haruzivishe, Clara; Chirwa, Ellen

    2018-01-01

    Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Analysis of moral competence concept was done using Walker and Avant's strategy of concept analysis. Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi.

  17. Leading change: a concept analysis.

    Science.gov (United States)

    Nelson-Brantley, Heather V; Ford, Debra J

    2017-04-01

    To report an analysis of the concept of leading change. Nurses have been called to lead change to advance the health of individuals, populations, and systems. Conceptual clarity about leading change in the context of nursing and healthcare systems provides an empirical direction for future research and theory development that can advance the science of leadership studies in nursing. Concept analysis. CINAHL, PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, Health Business Elite and Business Source Premier databases were searched using the terms: leading change, transformation, reform, leadership and change. Literature published in English from 2001 - 2015 in the fields of nursing, medicine, organizational studies, business, education, psychology or sociology were included. Walker and Avant's method was used to identify descriptions, antecedents, consequences and empirical referents of the concept. Model, related and contrary cases were developed. Five defining attributes of leading change were identified: (a) individual and collective leadership; (b) operational support; (c) fostering relationships; (d) organizational learning; and (e) balance. Antecedents were external or internal driving forces and organizational readiness. The consequences of leading change included improved organizational performance and outcomes and new organizational culture and values. A theoretical definition and conceptual model of leading change were developed. Future studies that use and test the model may contribute to the refinement of a middle-range theory to advance nursing leadership research and education. From this, empirically derived interventions that prepare and enable nurses to lead change to advance health may be realized. © 2016 John Wiley & Sons Ltd.

  18. Identifying Controlling Nodes in Neuronal Networks in Different Scales

    Science.gov (United States)

    Tang, Yang; Gao, Huijun; Zou, Wei; Kurths, Jürgen

    2012-01-01

    Recent studies have detected hubs in neuronal networks using degree, betweenness centrality, motif and synchronization and revealed the importance of hubs in their structural and functional roles. In addition, the analysis of complex networks in different scales are widely used in physics community. This can provide detailed insights into the intrinsic properties of networks. In this study, we focus on the identification of controlling regions in cortical networks of cats’ brain in microscopic, mesoscopic and macroscopic scales, based on single-objective evolutionary computation methods. The problem is investigated by considering two measures of controllability separately. The impact of the number of driver nodes on controllability is revealed and the properties of controlling nodes are shown in a statistical way. Our results show that the statistical properties of the controlling nodes display a concave or convex shape with an increase of the allowed number of controlling nodes, revealing a transition in choosing driver nodes from the areas with a large degree to the areas with a low degree. Interestingly, the community Auditory in cats’ brain, which has sparse connections with other communities, plays an important role in controlling the neuronal networks. PMID:22848475

  19. Status of lymph node staging

    NARCIS (Netherlands)

    Nieweg, O. E.; Estourgie, S. H.; Deurloo, E. E.; Rutgers, E. J. Th; Kroon, B. B. R.

    2002-01-01

    Sentinel node biopsy has the potential to provide more accurate staging information than axillary node dissection. Given the considerable morbidity of axillary node dissection this less invasive approach is attractive. However, there are a number of issues to be resolved before the best technique of

  20. Measure of Node Similarity in Multilayer Networks.

    Directory of Open Access Journals (Sweden)

    Anders Mollgaard

    Full Text Available The weight of links in a network is often related to the similarity of the nodes. Here, we introduce a simple tunable measure for analysing the similarity of nodes across different link weights. In particular, we use the measure to analyze homophily in a group of 659 freshman students at a large university. Our analysis is based on data obtained using smartphones equipped with custom data collection software, complemented by questionnaire-based data. The network of social contacts is represented as a weighted multilayer network constructed from different channels of telecommunication as well as data on face-to-face contacts. We find that even strongly connected individuals are not more similar with respect to basic personality traits than randomly chosen pairs of individuals. In contrast, several socio-demographics variables have a significant degree of similarity. We further observe that similarity might be present in one layer of the multilayer network and simultaneously be absent in the other layers. For a variable such as gender, our measure reveals a transition from similarity between nodes connected with links of relatively low weight to dis-similarity for the nodes connected by the strongest links. We finally analyze the overlap between layers in the network for different levels of acquaintanceships.

  1. Concept analysis and the building blocks of theory: misconceptions regarding theory development.

    Science.gov (United States)

    Bergdahl, Elisabeth; Berterö, Carina M

    2016-10-01

    The purpose of this article is to discuss the attempts to justify concepts analysis as a way to construct theory - a notion often advocated in nursing. The notion that concepts are the building blocks or threads from which theory is constructed is often repeated. It can be found in many articles and well-known textbooks. However, this notion is seldom explained or defended. The notion of concepts as building blocks has also been questioned by several authors. However, most of these authors seem to agree to some degree that concepts are essential components from which theory is built. Discussion paper. Literature was reviewed to synthesize and debate current knowledge. Our point is that theory is not built by concepts analysis or clarification and we will show that this notion has its basis in some serious misunderstandings. We argue that concept analysis is not a part of sound scientific method and should be abandoned. The current methods of concept analysis in nursing have no foundation in philosophy of science or in language philosophy. The type of concept analysis performed in nursing is not a way to 'construct' theory. Rather, theories are formed by creative endeavour to propose a solution to a scientific and/or practical problem. The bottom line is that the current style and form of concept analysis in nursing should be abandoned in favour of methods in line with modern theory of science. © 2016 John Wiley & Sons Ltd.

  2. Sentinel lymph node biopsy: clinical relevance

    International Nuclear Information System (INIS)

    Howman-Giles, R.

    2002-01-01

    Sentinel lymph node biopsy (SLNB) has become an important technique in the management of patients with intermediate level melanoma, clinical operable breast cancer and some other cancers. The technique relies on lymphatic mapping to define the lymph drainage from a primary tumour with the premise that the lymph nodes, which directly drain from that area, will reflect the tumour status of the remainder of the node field. Current techniques use lymphoscintigraphy where a radioactive labelled particle and / or blue dye are injected intradermally or intraparenchymally to map the lymph drainage, often in conjunction with a radioactive gamma probe at surgery. In patients with melanoma the SLNB has improved the staging and prognostic information by more accurate determination of whether regional lymph nodes have metastatic spread. This has a major impact on patient management as those patients with negative nodes do not require regional lymph node dissection and have a significantly better prognosis. In our experience of over 3000 patients the combined sentinel node biopsy technique localised accurately 98% of sentinel lymph nodes. Lymphoscintigraphy in patients with melanoma to locate the sentinel lymph nodes involves the intradermal injection of a radiocolloid around the melanoma site or the excision biopsy site. Injections of 5 -10 MBq in 0.05-0.1ml/inj are used and typically 4 injections are usually required. Following tracer injection dynamic imaging is performed to follow the lymphatic collecting vessels until they reach the draining sentinel nodes. An image should be acquired as the vessels reach the node field so that the sentinel nodes directly receiving the channels can be identified and distinguished from any second tier nodes which may sometimes be seen. Delayed scans are performed 2 hours later at which time all regions which can possible drain the primary melanoma site are examined with 5-10 minute static images. The surface location of all sentinel nodes is

  3. Resilience among caregivers of children with chronic conditions: a concept analysis

    Directory of Open Access Journals (Sweden)

    Lin FY

    2013-08-01

    Full Text Available Fang-Yi Lin, Jiin-Ru Rong, Tzu-Ying Lee Department of Nursing, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China Abstract: The purpose of this concept analysis is to uncover the essential elements involved in caregivers' resilience in the context of caring for children with chronic conditions. Walker and Avant's methodology guided the analysis. The study includes a literature review of conceptual definitions of caregiver resilience in caring for children with chronic conditions. The defining attributes and correlates of caregiver resilience are reviewed. Concept analysis findings in a review of the nursing and health-related literature show that caregiver resilience in the context of caring for chronically ill children can be defined within four main dimensions, ie, disposition patterns, situational patterns, relational patterns, and cultural patterns. Empiric measurements of the impact of caregiver resilience applied to caregivers with children with chronic conditions are also reported in the analysis. The findings of this concept analysis could help nurses and health care providers to apply the concept of caregiver resilience in allied health care and be applied to further studies. Keywords: caregiver resilience, children, chronic conditions, concept analysis

  4. SU-F-P-40: Analysis of Pelvic Lymph Node Margin Using Prostate Fiducial Markers, for SBRT Treatments

    Energy Technology Data Exchange (ETDEWEB)

    Torres, J; Castro Pena, P; Garrigo, E; Zunino, S; Venencia, C [Instituto de Radioterapia - Fundacion Marie Curie, Cordoba (Argentina)

    2016-06-15

    Purpose: The use of fiducials markers in prostate treatment allows a precise localization of this volume. Typical prostate SBRT margins with fiducials markers are 5mm in all directions, except toward the rectum, where 3mm is used. For some patients nearby pelvic lymph nodes with 5mm margin need to be irradiate assuming that its localization is linked to the prostate fiducial markers instead of bony anatomy. The purpose of this work was to analyze the geometric impact of locate the lymph node regions through the patient positioning by prostate fiducial markers. Methods: 10 patients with prostate SBRT with lymph nodes irradiation were selected. Each patient had 5 implanted titanium fiducial markers. A Novalis TX (BrainLAB-Varian) with ExacTrac and aSi1000 portal image was used. Treatment plan uses 11 beams with a dose prescription (D95%) of 40Gy to the prostate and 25Gy to the lymph node in 5 fractions. Daily positioning was carried out by ExacTrac system based on the implanted fiducials as the reference treatment position; further position verification was performed using the ExacTrac and two portal images (gantry angle 0 and 90) based on bony structures. Comparison between reference position with bony based ExacTrac and portal image localization, was done for each treatment fraction Results: A total of 50 positioning analysis were done. The average discrepancy between reference treatment position and ExacTrac based on bony anatomy (pubic area) was 4.2mm [0.3; 11.2]. The discrepancy was <5mm in 61% of the cases and <9mm in 92%. Using portal images the average discrepancy was 3.7mm [0.0; 11.1]. The discrepancy was <5mm in 69% of the cases and <9mm in 96%. Conclusion: Localizing lymph node by prostate fiducial markers may produce large discrepancy as large as 11mm compared to bony based localization. Dosimetric impact of this discrepancy should be studied.

  5. Nurse competence: a concept analysis.

    Science.gov (United States)

    Smith, Sarah A

    2012-10-01

      The purpose of this analysis was to explore the concept of nurse competence.   Data sources include EBSCOhost, Gale PowerSearch, ProQuest, PubMed Medline, Google Scholar, and Online Journal of Issues in Nursing.   This paper utilizes Rodgers' evolutionary method to analyze the concept of nurse competence.   Antecedents to nurse competence include personal and external motivations. Attributes include integrating knowledge into practice, experience, critical thinking, proficient skills, caring, communication, environment, motivation, and professionalism. Consequences include confidence, safe practice, and holistic care. Implications for nursing responsibility regarding defining nurse competence and ensuring nurse competence need to be identified. More research is needed to determine the best evaluation methods for the different facets of nurse competence. © 2012, The Author. International Journal of Nursing Knowledge © 2012, NANDA International.

  6. Rest and the associated benefits in restorative sleep: a concept analysis.

    Science.gov (United States)

    Helvig, Ashley; Wade, Sonya; Hunter-Eades, Lee

    2016-01-01

    To report an analysis of the concept of rest. Consistency in the literature to describe the concept and use of rest is limited. Concept analysis may be advantageous in rendering an operational definition in the health care setting. This analysis is important to examine the concept of rest for structure and function to promote an understanding of the phenomenon. Rest is a vital component of restorative sleep which has implications for physical, mental and spiritual well-being. Concept analysis. A literature search was conducted in the following databases: PubMed, CINAHL, Medline, ProQuest and an online Internet search with the majority of articles published between 1995-2015. This concept analysis was implemented using the eight step approach developed by Walker and Avant. In health care, rest incorporates the cessation of activity used to promote physical and mental health. Defining attributes of rest include a pathway to calm, inner tranquillity and mental health; base of support; and stillness. Antecedents for rest are time, suitable environment and willingness. Resulting consequences include renewed physical energy, mental clarity and improved health. Rest is a concept that is used frequently in the discipline of nursing but also in various other disciplines. Rest is a basic necessity for restorative sleep to enhance well-being through the restoration of the body, mind and spirit. Defining the concept of rest in the practice of patient care is necessary for consistent use of the term in the development of holistic, patient-centred therapies. © 2015 John Wiley & Sons Ltd.

  7. Comparison of five systems for staging lymph node metastasis in gastric cancer.

    Science.gov (United States)

    Yu, W; Choi, G S; Whang, I; Suh, I S

    1997-09-01

    There are several systems for staging lymph node metastasis in gastric cancer. Their relative merits are not clear. In this retrospective analysis, the nodal status was classified according to the Union Internacional Contra la Cancrum (UICC) and Japanese staging systems, the number and frequency of lymph node metastasis, and the level of involved nodes. Each staging system was scored as good (+1), fair (0) or poor (-1) with respect to prognostic value, theoretical value, convenience, reproducibility and surgical applicability. There were no differences between the five staging systems in predicting survival. The Japanese staging system was most arbitrary owing to the complexity of the system, although it had an advantage in surgical application. The same disadvantage was found in the UICC system and the level system. Determination of the number and frequency of involved nodes was convenient and reproducible, but the number of lymph nodes dissected must be considered when the number of positive nodes is used for staging. The classification of metastasis to the regional lymph nodes as N0 (no nodal metastasis), N1 (metastasis in 1-25 per cent of dissected nodes) and N2 (metastasis in more than 25 per cent of dissected nodes) would be a simple, convenient, reproducible staging system with an ability to predict surgical results.

  8. Moral courage in nursing: A concept analysis.

    Science.gov (United States)

    Numminen, Olivia; Repo, Hanna; Leino-Kilpi, Helena

    2017-12-01

    Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one's moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. This article is an analysis of the concept of moral courage in nursing. Rodgers' evolutionary method of concept analysis provided the framework to conduct the analysis. The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher's Index. The following key words were used: "moral" OR "ethical" AND "courage" OR "strength" AND "nurs*" with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment. This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice.

  9. Network module detection: Affinity search technique with the multi-node topological overlap measure.

    Science.gov (United States)

    Li, Ai; Horvath, Steve

    2009-07-20

    Many clustering procedures only allow the user to input a pairwise dissimilarity or distance measure between objects. We propose a clustering method that can input a multi-point dissimilarity measure d(i1, i2, ..., iP) where the number of points P can be larger than 2. The work is motivated by gene network analysis where clusters correspond to modules of highly interconnected nodes. Here, we define modules as clusters of network nodes with high multi-node topological overlap. The topological overlap measure is a robust measure of interconnectedness which is based on shared network neighbors. In previous work, we have shown that the multi-node topological overlap measure yields biologically meaningful results when used as input of network neighborhood analysis. We adapt network neighborhood analysis for the use of module detection. We propose the Module Affinity Search Technique (MAST), which is a generalized version of the Cluster Affinity Search Technique (CAST). MAST can accommodate a multi-node dissimilarity measure. Clusters grow around user-defined or automatically chosen seeds (e.g. hub nodes). We propose both local and global cluster growth stopping rules. We use several simulations and a gene co-expression network application to argue that the MAST approach leads to biologically meaningful results. We compare MAST with hierarchical clustering and partitioning around medoid clustering. Our flexible module detection method is implemented in the MTOM software which can be downloaded from the following webpage: http://www.genetics.ucla.edu/labs/horvath/MTOM/

  10. [Concept analysis of the nursing profession, published from 1994 to 2008].

    Science.gov (United States)

    Palese, A; Dante, A; Gherbezza, S; Venturato, E; Maragnolli, O; Ambrosi, E; Saiani, L

    2012-01-01

    Concept analysis is a research method in which concepts are examined in a logical and systematic fashion to form clear and rigorous conceptual definitions. To describe the concept analyses published between 1994 and 2008 and identify the emerging tendencies in the Nursing discipline, a two-staged study has been developed. In the first stage a systematic review of the literature was conducted: research published in the journals indexed in the MedLine, CINAHL and Cochrane databases were judged eligible, if they reported the theme of 'concept analysis' and 'nursing' in the title or in their key words and were published in English language. In the second stage, the articles that emerged were subjected to a content analysis. Some 158 concept analyses emerged, on average 10/year (range 1-22, median 11, +/- 5.6): these regarded 129 different concepts. Ninety-one (57.6%) concepts were focused on the nursing profession, while 67 (42.4%) were focused on the patients. Although in a few cases the effort made by the researchers moved toward the definition of new concepts, in others it appeared oriented toward including in Nursing some typical concepts from other disciplines, thus tracing an expansion of the domain of the Nursing discipline. Monitoring over time the concepts analysed constitutes an important research area to comprehend, both at a national and international level, the progressive evolution of the Nursing discipline.

  11. Body image disturbance in adults treated for cancer - a concept analysis.

    Science.gov (United States)

    Rhoten, Bethany A

    2016-05-01

    To report an analysis of the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses. Although the concept of body image disturbance has been clearly defined in adolescents and adults with eating disorders, adults who have been treated for cancer may also experience body image disturbance. In this context, the concept of body image disturbance has not been clearly defined. Concept analysis. PubMed, Psychological Information Database and Cumulative Index of Nursing and Allied Health Literature were searched for publications from 1937 - 2015. Search terms included body image, cancer, body image disturbance, adult and concept analysis. Walker and Avant's 8-step method of concept analysis was used. The defining attributes of body image disturbance in adults who have been treated for cancer are: (1) self-perception of a change in appearance and displeasure with the change or perceived change in appearance; (2) decline in an area of function; and (3) psychological distress regarding changes in appearance and/or function. This concept analysis provides a foundation for the development of multidimensional assessment tools and interventions to alleviate body image disturbance in this population. A better understanding of body image disturbance in adults treated for cancer will assist nurses and other clinicians in identifying this phenomenon and nurse scientists in developing instruments that accurately measure this condition, along with interventions that will promote a better quality of life for survivors. © 2016 John Wiley & Sons Ltd.

  12. Reminiscence in dementia: a concept analysis.

    Science.gov (United States)

    Dempsey, Laura; Murphy, Kathy; Cooney, Adeline; Casey, Dympna; O'Shea, Eamon; Devane, Declan; Jordan, Fionnuala; Hunter, Andrew

    2014-03-01

    This paper is a report of an analysis of the concept of reminiscence in dementia and highlights its uses as a therapeutic intervention used on individuals with dementia. No single definition of reminiscence exists in healthcare literature; however, definitions offered have similar components. The term life review is commonly used when discussing reminiscence; however, both terms are quite different in their goals, theory base and content. This concept analysis identified reminiscence as a process which occurs in stages, involving the recalling of early life events and interaction between individuals. The antecedents of reminiscence are age, life transitions, attention span, ability to recall, ability to vocalise and stressful situations. Reminiscence can lead to positive mental health, enhanced self esteem and improved communication skills. It also facilitates preparation for death, increases interaction between people, prepares for the future and evaluates a past life. Reminiscence therapy is used extensively in dementia care and evidence shows when used effectively it helps individuals retain a sense of self worth, identity and individuality.

  13. Performance and safety analysis of WP-cave concept

    International Nuclear Information System (INIS)

    Skagius, K.; Svemar, C.

    1989-08-01

    The report presents a performance safety, and cost analysis of the WP-cave, WPC, concept. In the performance analysis, questions specific to the WPC have been addressed which have been identified to require more detailed studies. Based on the outcome of this analysis, a safety analysis has been made which comprises of the modeling and calculation of radionuclide transport from the repository to the biosphere and the resulting dose exposure to man. The result of the safety analysis indicates that the present design of a WPC repository may give unacceptably high doses. By improving the properties of the bentonite/sand barrier such that the hydraulic conductivity is reduced, or by changing the short-lived steel canisters to more long-lived canisters, e.g. copper canisters, it is judged possible to achieve a sufficiently low level of dose exposure rates to man. The cost for a WPC repository of the studied design is significantly higher than for a KBS-3 repository considering the Swedish conditions and the Swedish amount of spent fuel. The major costs are connected to the excavation and backfilling of the bentonite/sand barrier. The potential for cost savings is high but it is not judged possible to account for savings in such a way that the WPC concept shows lower cost than the KBS-3 concept. (34 figs., 33 tabs., 29 refs.)

  14. Self-concept and academic achievement: a meta-analysis of longitudinal relations.

    Science.gov (United States)

    Huang, Chiungjung

    2011-10-01

    The relation between self-concept and academic achievement was examined in 39 independent and longitudinal samples through the integration of meta-analysis and path analysis procedures. For relations with more than 3 independent samples, the mean observed correlations ranged from .20 to .27 between prior self-concept and subsequent academic achievement and from .19 to .25 between prior academic achievement and subsequent self-concept. Globality/specificity of self-concept was the only significant moderating factor in the relation between (a) prior self-concept and subsequent academic achievement and (b) prior academic achievement and subsequent self-concept. As high self-concept is related to high academic performance and vice-versa, intervention programs that combine self-enhancement and skill development should be integrated. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  15. Cyberbullying in Adolescence: A Concept Analysis.

    Science.gov (United States)

    Hutson, Elizabeth

    2016-01-01

    The aim of this article was to present a detailed analysis of the concept of cyberbullying. Research on the topic of cyberbullying is growing exponentially, but not all studies use the same definition to examine this concept. A concept analysis in the style of Walker and Avant was used to analyze cyberbullying. Literature was retrieved from the databases of CINAHL and PubMed between the years 2009 and October 2014 using the key word "cyberbullying." Twenty-five English-language articles were located that delineated a definition of cyberbullying. First, articles were analyzed to discover the defining attributes of cyberbullying. Second, antecedents, consequences, and related terms of cyberbullying were examined. Third, an operational definition of cyberbullying is proposed on the basis of a consensus of the review. This review proposes that the defining attributes of cyberbullying are: (1) electronic form of contact (2) an aggressive act (3) intent (4) repetition (publicity), and (5) harm of the victim. The antecedents most often mentioned were lower self-esteem, higher levels of depression, and social isolation and the consequences were academic problems and affective disorders. A single concise definition of cyberbullying was created that can be utilized by health care providers to educate their patients and families about cyberbullying. This definition also can be used to guide research to develop effective interventions.

  16. Concept analysis of cancer survivorship and contributions to oncological nursing.

    Science.gov (United States)

    de Oliveira, Rafaela Azevedo Abrantes; da Conceição, Vander Monteiro; Araujo, Jeferson Santos; Zago, Márcia Maria Fontão

    2018-02-01

    This study aims to analyse the concept of cancer survivorship using Rodgers' evolutionary concept analysis model. The lack of a consensus definition as well as the confusion and debate concerning the definitions of "survivor" and "cancer survivorship" hinder an understanding of the intrinsic needs associated with the latter. Concept analysis. A systematic literature search was performed using the following databases: PubMed, CINAHL, Web of Science, LILACS, and PsycINFO with studies published between 2000 and 2014. The final sample contained 39 studies that were analysed on the basis of Rodgers' model and inductive thematic analysis, discussed through the lens of the medical anthropology concept of culture. Cancer survivorship is a broad concept that can be understood using 8 themes: changes in life plans, positive and negative aspect dualities, life reflections, identity change, individual experiences, symptom control, the need for support, and quality of care. These themes are summarized using 2 attributes: liminality process and culturally congruent care. This article contributes to understanding of cancer survivorship and the processes that are intrinsic to this concept. It calls for future investigations to enhance cancer survivorship across its 2 domains at the personal (patient's life) and clinical (nursing practice) levels. © 2017 John Wiley & Sons Australia, Ltd.

  17. Multimodal imaging of lymph nodes and tumors using glycol-chitosan-coated gold nanoparticles (Conference Presentation)

    Science.gov (United States)

    Sun, In-Cheol; Dumani, Diego S.; Emelianov, Stanislav Y.

    2017-03-01

    A key step in staging cancer is the diagnosis of metastasis that spreads through lymphatic system. For this reason, researchers develop various methods of sentinel lymph node mapping that often use a radioactive tracer. This study introduces a safe, cost-effective, high-resolution, high-sensitivity, and real-time method of visualizing the sentinel lymph node: ultrasound-guided photoacoustic (US/PA) imaging augmented by a contrast agent. In this work, we use clearable gold nanoparticles covered by a biocompatible polymer (glycol chitosan) to enhance cellular uptake by macrophages abundant in lymph nodes. We incubate macrophages with glycol-chitosan-coated gold nanoparticles (0.05 mg Au/ml), and then fix them with paraformaldehyde solution for an analysis of in vitro dark-field microscopy and cell phantom. The analysis shows enhanced cellular uptake of nanoparticles by macrophages and strong photoacoustic signal from labeled cells in tissue-mimicking cell phantoms consisting gelatin solution (6 %) with silica gel (25 μm, 0.3%) and fixed macrophages. The in-vivo US/PA imaging of cervical lymph nodes in healthy mice (nu/nu, female, 5 weeks) indicates a strong photoacoustic signal from a lymph node 10 minutes post-injection (2.5 mg Au/ml, 80 μl). The signal intensity and the nanoparticle-labeled volume of tissue within the lymph node continues to increase until 4 h post-injection. Histological analysis further confirms the accumulation of gold nanoparticles within the lymph nodes. This work suggests the feasibility of molecular/cellular US/PA imaging with biocompatible gold nanoparticles as a photoacoustic contrast agent in the diagnosis of lymph-node-related diseases.

  18. Sentinel lymph node biopsy in node-negative squamous cell carcinoma of the oral cavity and oropharynx.

    LENUS (Irish Health Repository)

    Burns, P

    2012-02-01

    OBJECTIVES: Considerable controversy exists regarding the merits of elective neck dissection in patients with early stage oral cavity and oropharyngeal squamous cell carcinoma. It is highly desirable to have a method of identifying those patients who would benefit from further treatment of the neck when they are clinically node-negative. The purpose of the present study was to examine the use of sentinel lymph node biopsy in identifying occult neck disease in a cohort of patients with node-negative oral cavity and oropharyngeal squamous cell carcinoma. DESIGN: We evaluated a total of 13 patients with oral cavity and oropharyngeal cancer who were clinically and radiologically node-negative. RESULTS: A sentinel lymph node was found in all 13 patients, revealing metastatic disease in five patients, four of whom had one or more positive sentinel lymph nodes. There was one false negative result, in which the sentinel lymph node was negative for tumour whereas histological examination of the neck dissection specimen showed occult disease. CONCLUSION: In view of these findings, we would recommend the use of sentinel lymph node biopsy in cases of oral cavity and oropharyngeal squamous cell carcinoma, in order to aid the differentiation of those patients whose necks are harbouring occult disease and who require further treatment.

  19. Sentinel lymph node mapping and biopsy in breast cancer - facts and unanswered questions; Waechterlymphknotendetektion und -Biopsie beim Mammakarzinom - Fakten und unbeantwortete Fragen

    Energy Technology Data Exchange (ETDEWEB)

    Czech, N. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Schleswig-Holstein, Campus Kiel (Germany)

    2006-06-15

    The concept of sentinel lymph node (SLN) biopsy in breast cancer patients is rapidly becoming the standard of care [1]. The fast assent of this technique in clinical practise is the result of multiple factors, including accuracy of the technique, decreased morbidity, and supplying the pathologist with only few nodes which allows a more focused and sensitive histopathologic evaluation. The sentinel nodes are those most likely to contain tumour cells that have spread from the tumour. Histopathological evaluation of these nodes therefore can be an accurate predictor for metastases in the respective lymph node basin and can guide regional and systemic treatment. The SLN-biopsy concerns the identification and subsequent resection of the initial lymph nodes (SLN) which are draining the primary tumour. These nodes can be identified by radioguided lymphatic mapping and/or by visualisation of the nodes with vital blue dyes. Axillary lymph node dissection (ALND) and its morbidity can be avoided in patients with negative SLN. Despite the success and acceptance of lymphatic mapping, some controversies and questions remain unanswered. In this review, some of the most relevant clinical issues will be discussed. (orig.)

  20. Staff nurse clinical leadership: a concept analysis.

    Science.gov (United States)

    Chávez, Eduardo C; Yoder, Linda H

    2015-01-01

    The purpose of this article is to provide a concept analysis of staff nurse clinical leadership (SNCL). A clear delineation of SNCL will promote understanding and encourage communication of the phenomenon. Clarification of the concept will establish a common understanding of the concept, and advance the practice, education, and research of this phenomenon. A review of the literature was conducted using several databases. The databases were searched using the following keywords: clinical leadership, nursing, bedside, staff nurse, front-line, front line, and leadership. The search yielded several sources; however, only those that focused on clinical leadership demonstrated by staff nurses in acute care hospital settings were selected for review. SNCL is defined as staff nurses who exert significant influence over other individuals in the healthcare team, and although no formal authority has been vested in them facilitates individual and collective efforts to accomplish shared clinical objectives. The theoretical definition for SNCL within the team context will provide a common understanding of this concept and differentiate it from other types of leadership in the nursing profession. This clarification and conceptualization of the concept will assist further research of the concept and advance its practical application in acute care hospital settings. © 2014 Wiley Periodicals, Inc.

  1. Resilience among caregivers of children with chronic conditions: a concept analysis.

    Science.gov (United States)

    Lin, Fang-Yi; Rong, Jiin-Ru; Lee, Tzu-Ying

    2013-08-29

    The purpose of this concept analysis is to uncover the essential elements involved in caregivers' resilience in the context of caring for children with chronic conditions. Walker and Avant's methodology guided the analysis. The study includes a literature review of conceptual definitions of caregiver resilience in caring for children with chronic conditions. The defining attributes and correlates of caregiver resilience are reviewed. Concept analysis findings in a review of the nursing and health-related literature show that caregiver resilience in the context of caring for chronically ill children can be defined within four main dimensions, ie, disposition patterns, situational patterns, relational patterns, and cultural patterns. Empiric measurements of the impact of caregiver resilience applied to caregivers with children with chronic conditions are also reported in the analysis. The findings of this concept analysis could help nurses and health care providers to apply the concept of caregiver resilience in allied health care and be applied to further studies.

  2. [Intraoperative detection of the sentinel lymph nodes in lung cancer].

    Science.gov (United States)

    Akopov, A L; Papayan, G V; Chistyakov, I V

    2015-01-01

    An analysis of the scientific data was made. It was used the literature devoted to the intraoperative visualization of the sentinel lymph nodes in patients with lung cancer. Correct detection of such lymph nodes with following pathologic investigation allowed limiting the volume of lympho-dissection in a number of patients. There is the possibility of maximal in-depth study of the sentinel lymph nodes by purposeful application of most sensible pathologic and molecular methods for detection their micrometastatic lesions. At the same time the treatment strategy and prognosis could be determined. The authors present the results of an application of dye techniques, radioactive preparation and fluorescence imaging for sentinel lymph node detection. Advantages and disadvantages of the methods are shown in the article. There are validated the prospects of technical development, study of information value of new applications and the most perspective method of fluorescence indocyanine green visualization by lymph outflow.

  3. Communication analysis for feedback control of civil infrastructure using cochlea-inspired sensing nodes

    Science.gov (United States)

    Peckens, Courtney A.; Cook, Ireana; Lynch, Jerome P.

    2016-04-01

    Wireless sensor networks (WSNs) have emerged as a reliable, low-cost alternative to the traditional wired sensing paradigm. While such networks have made significant progress in the field of structural monitoring, significantly less development has occurred for feedback control applications. Previous work in WSNs for feedback control has highlighted many of the challenges of using this technology including latency in the wireless communication channel and computational inundation at the individual sensing nodes. This work seeks to overcome some of those challenges by drawing inspiration from the real-time sensing and control techniques employed by the biological central nervous system and in particular the mammalian cochlea. A novel bio-inspired wireless sensor node was developed that employs analog filtering techniques to perform time-frequency decomposition of a sensor signal, thus encompassing the functionality of the cochlea. The node then utilizes asynchronous sampling of the filtered signal to compress the signal prior to communication. This bio-inspired sensing architecture is extended to a feedback control application in order to overcome the traditional challenges currently faced by wireless control. In doing this, however, the network experiences high bandwidths of low-significance information exchange between nodes, resulting in some lost data. This study considers the impact of this lost data on the control capabilities of the bio-inspired control architecture and finds that it does not significantly impact the effectiveness of control.

  4. Power Aware Simulation Framework for Wireless Sensor Networks and Nodes

    Directory of Open Access Journals (Sweden)

    Daniel Weber

    2008-07-01

    Full Text Available The constrained resources of sensor nodes limit analytical techniques and cost-time factors limit test beds to study wireless sensor networks (WSNs. Consequently, simulation becomes an essential tool to evaluate such systems.We present the power aware wireless sensors (PAWiS simulation framework that supports design and simulation of wireless sensor networks and nodes. The framework emphasizes power consumption capturing and hence the identification of inefficiencies in various hardware and software modules of the systems. These modules include all layers of the communication system, the targeted class of application itself, the power supply and energy management, the central processing unit (CPU, and the sensor-actuator interface. The modular design makes it possible to simulate heterogeneous systems. PAWiS is an OMNeT++ based discrete event simulator written in C++. It captures the node internals (modules as well as the node surroundings (network, environment and provides specific features critical to WSNs like capturing power consumption at various levels of granularity, support for mobility, and environmental dynamics as well as the simulation of timing effects. A module library with standardized interfaces and a power analysis tool have been developed to support the design and analysis of simulation models. The performance of the PAWiS simulator is comparable with other simulation environments.

  5. Lymph Node Micrometastases are Associated with Worse Survival in Patients with Otherwise Node-Negative Hilar Cholangiocarcinoma

    NARCIS (Netherlands)

    Mantel, Hendrik T. J.; Wiggers, Jim K.; Verheij, Joanne; Doff, Jan J.; Sieders, Egbert; van Gulik, Thomas M.; Gouw, Annette S. H.; Porte, Robert J.

    2015-01-01

    Background. Lymph node metastases on routine histology are a strong negative predictor for survival after resection of hilar cholangiocarcinoma. Additional immunohistochemistry can detect lymph node micrometastases in patients who are otherwise node negative, but the prognostic value is unsure. The

  6. Lymph Node Micrometastases are Associated with Worse Survival in Patients with Otherwise Node-Negative Hilar Cholangiocarcinoma

    NARCIS (Netherlands)

    Mantel, Hendrik T. J.; Wiggers, Jim K.; Verheij, Joanne; Doff, Jan J.; Sieders, Egbert; van Gulik, Thomas M.; Gouw, Annette S. H.; Porte, Robert J.

    2015-01-01

    Lymph node metastases on routine histology are a strong negative predictor for survival after resection of hilar cholangiocarcinoma. Additional immunohistochemistry can detect lymph node micrometastases in patients who are otherwise node negative, but the prognostic value is unsure. The objective of

  7. Comparison of four staging systems of lymph node metastasis in gastric cancer.

    Science.gov (United States)

    Zhang, Ming; Zhu, Guanyu; Ma, Yan; Xue, Yingwei

    2009-11-01

    The classification of lymph node metastasis in patients with gastric cancer is still controversial. Our aim was to evaluate the relative merits of four staging systems of lymph node metastasis. In our study, the nodal status was classified according to the 5th edition of the tumor node metastasis (TNM) system, the Japanese Classification of Gastric Carcinoma (JCGC), the ratio of metastatic lymph nodes, and the size of the largest metastatic lymph node. Each staging system was scored as good (+2), fair (+1), or poor (0) with respect to the theoretical value (extent of the anatomical lymphatic tumor spread), convenience (simplicity), surgical applicability (extent of lymph node dissection), and prognostic value (ability to predict survival rate). In the multivariate analysis including the four staging systems and other potential prognostic factors, stepwise Cox regression revealed that the ratio of metastatic lymph nodes was the most independent prognostic factor. The TNM, ratio, and size systems were convenient because they had no consideration for the location of the tumor and lymph node. Although the JCGC system had advantages in theoretical value and surgical application, it was most optional due to the complexity of the system. Although all different staging systems are comparable, the metastatic lymph node ratio system is convenient, reproducible, and has the highest ability to predict survival.

  8. Testnodes: a Lightweight node-testing infrastructure

    International Nuclear Information System (INIS)

    Fay, R; Bland, J

    2014-01-01

    A key aspect of ensuring optimum cluster reliability and productivity lies in keeping worker nodes in a healthy state. Testnodes is a lightweight node testing solution developed at Liverpool. While Nagios has been used locally for general monitoring of hosts and services, Testnodes is optimised to answer one question: is there any reason this node should not be accepting jobs? This tight focus enables Testnodes to inspect nodes frequently with minimal impact and provide a comprehensive and easily extended check with each inspection. On the server side, Testnodes, implemented in python, interoperates with the Torque batch server to control the nodes production status. Testnodes remotely and in parallel executes client-side test scripts and processes the return codes and output, adjusting the node's online/offline status accordingly to preserve the integrity of the overall batch system. Testnodes reports via log, email and Nagios, allowing a quick overview of node status to be reviewed and specific node issues to be identified and resolved quickly. This presentation will cover testnodes design and implementation, together with the results of its use in production at Liverpool, and future development plans.

  9. Efficient MAC Protocol for Hybrid Wireless Network with Heterogeneous Sensor Nodes

    Directory of Open Access Journals (Sweden)

    Md. Nasre Alam

    2016-01-01

    Full Text Available Although several Directional Medium Access Control (DMAC protocols have been designed for use with homogeneous networks, it can take a substantial amount of time to change sensor nodes that are equipped with an omnidirectional antenna for sensor nodes with a directional antenna. Thus, we require a novel MAC protocol for use with an intermediate wireless network that consists of heterogeneous sensor nodes equipped with either an omnidirectional antenna or a directional antenna. The MAC protocols that have been designed for use in homogeneous networks are not suitable for use in a hybrid network due to deaf, hidden, and exposed nodes. Therefore, we propose a MAC protocol that exploits the characteristics of a directional antenna and can also work efficiently with omnidirectional nodes in a hybrid network. In order to address the deaf, hidden, and exposed node problems, we define RTS/CTS for the neighbor (RTSN/CTSN and Neighbor Information (NIP packets. The performance of the proposed MAC protocol is evaluated through a numerical analysis using a Markov model. In addition, the analytical results of the MAC protocol are verified through an OPNET simulation.

  10. Ideas of home in palliative care research: A concept analysis.

    Science.gov (United States)

    Tryselius, Kristina; Benzein, Eva; Persson, Carina

    2018-04-23

    To explore the concept of home and its' expressed spatialities in current palliative care research. Home is a central environment for living, caring, and dying. However, pure investigations of the sets of ideas linked to the concept seemed missing. Although identified as an important location, spatial perspectives expressed through the concept of home appeared unexplored. Rodgers' evolutionary concept analysis. Scientific articles published between January 2009 and September 2015. Rodgers' evolutionary concept analysis. Resulting attributes were explored from two geographically informed spatial perspectives. As main results, six attributes were identified and explored: Home as actor-capable of acting; emotional environment-something people have feelings for; place-a part of personal identity and a location; space-complex and relational spatial connections and a site for care; setting-passive background and absolute space; becoming-a fluid spatiality constantly folded. Examples of attributes and suggestions for further concept development were identified. The concept reflects various sets of ideas as well as expressing both relational and absolute perspectives of space. The most challenging for nursing research and practice seems to be investigation, operationalization, and testing the implementation of sets of ideas reflecting a relational thinking of space. © 2018 Wiley Periodicals, Inc.

  11. State of the science of maternal-infant bonding: a principle-based concept analysis.

    Science.gov (United States)

    Bicking Kinsey, Cara; Hupcey, Judith E

    2013-12-01

    to provide a principle-based analysis of the concept of maternal-infant bonding. principle-based method of concept analysis for which the data set included 44 articles published in the last decade from Pubmed, CINAHL, and PyschINFO/PsychARTICLES. literature inclusion criteria were English language, articles published in the last decade, peer-reviewed journal articles and commentary on published work, and human populations. after a brief review of the history of maternal-infant bonding, a principle-based concept analysis was completed to examine the state of the science with regard to this concept. The concept was critically examined according to the clarity of definition (epistemological principle), applicability of the concept (pragmatic principle), consistency in use and meaning (linguistic principle), and differentiation of the concept from related concepts (logical principle). Analysis of the concept revealed: (1) Maternal-infant bonding describes maternal feelings and emotions towards her infant. Evidence that the concept encompasses behavioural or biological components was limited. (2) The concept is clearly operationalised in the affective domain. (3) Maternal-infant bonding is linguistically confused with attachment, although the boundaries between the concepts are clearly delineated. despite widespread use of the concept, maternal-infant bonding is at times superficially developed and subject to confusion with related concepts. Concept clarification is warranted. A theoretical definition of the concept of maternal-infant bonding was developed to aid in the clarification, but more research is necessary to further clarify and advance the concept. nurse midwives and other practitioners should use the theoretical definition of maternal-infant bonding as a preliminary guide to identification and understanding of the concept in clinical practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Transformational leadership in nursing: a concept analysis.

    Science.gov (United States)

    Fischer, Shelly A

    2016-11-01

    To analyse the concept of transformational leadership in the nursing context. Tasked with improving patient outcomes while decreasing the cost of care provision, nurses need strategies for implementing reform in health care and one promising strategy is transformational leadership. Exploration and greater understanding of transformational leadership and the potential it holds is integral to performance improvement and patient safety. Concept analysis using Walker and Avant's (2005) concept analysis method. PubMed, CINAHL and PsychINFO. This report draws on extant literature on transformational leadership, management, and nursing to effectively analyze the concept of transformational leadership in the nursing context. This report proposes a new operational definition for transformational leadership and identifies model cases and defining attributes that are specific to the nursing context. The influence of transformational leadership on organizational culture and patient outcomes is evident. Of particular interest is the finding that transformational leadership can be defined as a set of teachable competencies. However, the mechanism by which transformational leadership influences patient outcomes remains unclear. Transformational leadership in nursing has been associated with high-performing teams and improved patient care, but rarely has it been considered as a set of competencies that can be taught. Also, further research is warranted to strengthen empirical referents; this can be done by improving the operational definition, reducing ambiguity in key constructs and exploring the specific mechanisms by which transformational leadership influences healthcare outcomes to validate subscale measures. © 2016 John Wiley & Sons Ltd.

  13. Outcome Analysis of Patients With Oral Cavity Cancer and Extracapsular Spread in Neck Lymph Nodes

    International Nuclear Information System (INIS)

    Liao, Chun-Ta; Lee, Li-Yu; Huang, Shiang-Fu; Chen, I-How; Kang, Chung-Jan; Lin, Chien-Yu; Fan, Kang-Hsing; Wang, Hung-Ming; Ng, Shu-Hang; Yen, Tzu-Chen

    2011-01-01

    Purpose: Extracapsular spread (ECS) in neck lymph nodes is a major adverse prognostic factor in patients with oral cavity squamous cell carcinoma (OSCC). We conducted a retrospective analysis of prognostic factors in this patient group and tried to identify a subset of patients with a worse prognosis suitable for more aggressive therapeutic interventions. Methods and Materials: Enrolled in the study were 255 OSCC patients with ECS in neck nodes and without evidence of distant metastasis. All participants were followed-up for at least 2 years or censored at last follow-up. The 5-year rates of control, distant metastasis, and survival were the main outcome measures. Results: Level IV/V lymph node metastases and tumor depth ≥12 mm were independent predictors of 5-year survival and identified three prognostic groups. In the low-risk group (no level IV/V metastases and tumor depth <12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 60%, 66%, and 50%, respectively. In the intermediate-risk group (no level IV/V metastases and tumor depth ≥12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 39%, 41%, and 28%, respectively. In the high-risk group (evidence of level IV/V metastases), the 5-year disease-free, disease-specific, and overall survival rates were 14%, 12%, and 10%, respectively. Conclusions: Among OSCC patients with ECS, those with level IV/V metastases appear to have the worst prognosis followed by without level IV/V metastases and tumor depth ≥12 mm. An aggressive therapeutic approach may be suitable for intermediate- and high-risk patients.

  14. Subcarinal lymph node in upper lobe non-small cell lung cancer patients: is selective lymph node dissection valid?

    Science.gov (United States)

    Aokage, Keiju; Yoshida, Junji; Ishii, Genichiro; Hishida, Tomoyuki; Nishimura, Mitsuyo; Nagai, Kanji

    2010-11-01

    Little is known about selective lymph node dissection in non-small cell lung cancer (NSCLC) patients. We sought to gain insight into subcarinal node involvement for its frequency and impact on outcome to evaluate whether it is valid to omit subcarinal lymph node dissection in upper lobe NSCLC patients. We reviewed node metastases distribution according to node region, tumor location, and histology among 1099 patients with upper lobe NSCLC. We paid special attention to subcarinal metastases patients without superior mediastinal node metastases, because their pathological stages would have been underdiagnosed if subcarinal node dissection had been omitted. We also assessed the outcome and the pattern of failure among subcarinal metastases patients. To identify subcarinal node involvement predictors, we analyzed 7 clinical factors. Subcarinal node metastases were found in 20 patients and were least frequent among squamous cell carcinoma patients (0.5%). Two of them were free from superior mediastinal metastases but died of the disease at 1 month and due to an unknown cause at 18 months, respectively. Seventeen of the 20 patients developed multi-site recurrence within 37 months. The 5-year survival rate of the 20 patients with subcarinal metastases was 9.0%, which was significantly lower than 32.0% of patients with only superior mediastinal metastases. Clinical diagnosis of node metastases was significantly predictive of subcarinal metastases. Subcarinal node metastases from upper lobe NSCLC were rare and predicted an extremely poor outcome. It appears valid to omit subcarinal node dissection in upper lobe NSCLC patients, especially in clinical N0 squamous cell carcinoma patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Maternal Confidence for Physiologic Childbirth: A Concept Analysis.

    Science.gov (United States)

    Neerland, Carrie E

    2018-06-06

    Confidence is a term often used in research literature and consumer media in relation to birth, but maternal confidence has not been clearly defined, especially as it relates to physiologic labor and birth. The aim of this concept analysis was to define maternal confidence in the context of physiologic labor and childbirth. Rodgers' evolutionary method was used to identify attributes, antecedents, and consequences of maternal confidence for physiologic birth. Databases searched included Ovid MEDLINE, CINAHL, PsycINFO, and Sociological Abstracts from the years 1995 to 2015. A total of 505 articles were retrieved, using the search terms pregnancy, obstetric care, prenatal care, and self-efficacy and the keyword confidence. Articles were identified for in-depth review and inclusion based on whether the term confidence was used or assessed in relationship to labor and/or birth. In addition, a hand search of the reference lists of the selected articles was performed. Twenty-four articles were reviewed in this concept analysis. We define maternal confidence for physiologic birth as a woman's belief that physiologic birth can be achieved, based on her view of birth as a normal process and her belief in her body's innate ability to birth, which is supported by social support, knowledge, and information founded on a trusted relationship with a maternity care provider in an environment where the woman feels safe. This concept analysis advances the concept of maternal confidence for physiologic birth and provides new insight into how women's confidence for physiologic birth might be enhanced during the prenatal period. Further investigation of confidence for physiologic birth across different cultures is needed to identify cultural differences in constructions of the concept. © 2018 by the American College of Nurse-Midwives.

  16. An algorithm for merging part nodes of JT models exported by FORAN

    Directory of Open Access Journals (Sweden)

    FANG Xiongbing

    2017-05-01

    Full Text Available Many cognominal parts exist in JT models exported by FORAN V70 R2.0 software, and this leads to an increase in time consumption and the space analysis results becoming hard to process when using clearance analysis software to perform distance computing for such JT models. Aiming at this problem, an algorithm for merging component nodes is put forward based on investigating the assembly configuration and inherent information (i.e. geometric and material information of JT models created by FORAN. The method is composed of four steps:coordinate transformation, model node renaming, node geometric data transferring and material attribute processing. Finally, the proposed method is implemented by C++ and JT Open Toolkit. The results show that the new JT models generated by the proposed method are comprised of only one assembly node, and they preserve the intrinsic information of the original JT models. Its validity is illustrated by a great deal of examples, and the content of the worked JT models are reduced by about 7% to 20%.

  17. The relation between lymph node status and survival in Stage I-III colon cancer

    DEFF Research Database (Denmark)

    Lykke, J.; Roikjær, Ole; Jess, P.

    2013-01-01

    Aim: This study involved a large nationwide Danish cohort to evaluate the hypothesis that a high lymph node harvest has a positive effect on survival in curative resected Stage I-III colon cancer and a low lymph node ratio has a positive effect on survival in Stage III colon cancer. Method......: Analysis of overall survival was conducted using a nationwide Danish cohort of patients treated with curative resection of Stage I-III colon cancer. All 8901 patients in Denmark diagnosed with adenocarcinoma of the colon and treated with curative resection in the period 2003-2008 were identified from...... independent prognostic factors in multivariate analysis. Conclusion: High lymph node count was associated with improved overall survival in colon cancer. Lymph node ratio was superior to N-stage in differentiating overall survival in Stage III colon cancer. Stage migration was observed....

  18. Normal mediastinal lymph node size and shape; CT and cadaver study

    International Nuclear Information System (INIS)

    Im, Chung Kie; Lee, Kyung Soo; Han, Man Chung; Kim, Chu Wan

    1985-01-01

    With the view point of size, shape and arrangement pattern, authors present normal mediastinal lymph node from the analysis of 61 cases of CT scan and multidirectional section of 2 cadavers. The result were as follows: 1. Transverse diameter of the lymph nodes, demonstrated in cadaver section, was 3 to 6mm in upper paratracheal area and 5 to 14mm in juxta-carinal and AP-window area. Arrangement of the lymph nodes showed tendency of longitudinal direction in lower paratracheal, and juxtacarinal area, while that of AP window showed tendency of AP direction as long axis. 2. Mean and the largest size of the lymph nodes demonstrated in CT scan were 3.7mm, 8mm in upper paratracheal area, and 6mm, 12mm in lower paratracheal area, and 7.1mm, 14mm in juxtacarinal area, and 6.3mm and 11mm in aorticopulmonary window area. 3. Size of the lymph nodes in CT scan showed linear increasing tendency according to increasing age (y=0.32, p<0.005). 4. Shape of the lymph nodes in CT scan were mostly round in upper paratracheal area while that of aorticopulmonary window showed higher incidence of oval and elongated shape. 5. Recommended size criterior of abnormal lymph node is 10mm in upper paratracheal area and 15mm in the other area

  19. A Concept Analysis of Systems Thinking.

    Science.gov (United States)

    Stalter, Ann M; Phillips, Janet M; Ruggiero, Jeanne S; Scardaville, Debra L; Merriam, Deborah; Dolansky, Mary A; Goldschmidt, Karen A; Wiggs, Carol M; Winegardner, Sherri

    2017-10-01

    This concept analysis, written by the National Quality and Safety Education for Nurses (QSEN) RN-BSN Task Force, defines systems thinking in relation to healthcare delivery. A review of the literature was conducted using five databases with the keywords "systems thinking" as well as "nursing education," "nursing curriculum," "online," "capstone," "practicum," "RN-BSN/RN to BSN," "healthcare organizations," "hospitals," and "clinical agencies." Only articles that focused on systems thinking in health care were used. The authors identified defining attributes, antecedents, consequences, and empirical referents of systems thinking. Systems thinking was defined as a process applied to individuals, teams, and organizations to impact cause and effect where solutions to complex problems are accomplished through collaborative effort according to personal ability with respect to improving components and the greater whole. Four primary attributes characterized systems thinking: dynamic system, holistic perspective, pattern identification, and transformation. Using the platform provided in this concept analysis, interprofessional practice has the ability to embrace planned efforts to improve critically needed quality and safety initiatives across patients' lifespans and all healthcare settings. © 2016 Wiley Periodicals, Inc.

  20. Beginning Amazon Web Services with Node.js

    CERN Document Server

    Shackelford, Adam

    2015-01-01

    Beginning Amazon Web Services with Node.js teaches any novice Node.js developer to configure, deploy, and maintain scalable small to large scale Node.js applications in Amazon Web Services. Hosting a Node.js application in a production environment usually means turning to PaaS hosting, but this approach brings problems. Deploying Node.js directly to AWS solves the problems you encounter in these situations, enabling you to cut out the middle man. You will begin with a basic RESTful web service in Node.js, using the popular Express.js framework, pre-built and ready to run in your local env

  1. Modern terrorism: concept and approach analysis

    OpenAIRE

    CHAIKA ALEXANDER VIKTOROVICH

    2015-01-01

    The problem of modern terrorism as an image of counterculture environment is considered. The analysis of concepts and approaches of foreign and native authors, specialists of terrorism problem research was conducted. Separate features of the modern terrorism are considered and emphasized. The author drew conceptual conclusions on the basis of dialectical approach to modern terrorism counterculture phenomenon research.

  2. Sexual Satisfaction Concept Analysis in Iranian Married Women: A Hybrid Model Study

    Science.gov (United States)

    Yekta, Zohre Parsa; Raisi, Firoozeh; Ebadi, Abbas; Shahvari, Zahra

    2015-01-01

    Background: Sexual satisfaction is considered to be a sexual right and an important component of sexual health. The purpose of this qualitative study was to clarify the meaning and the nature of sexual satisfaction in Iranian married women, and to provide a cultural-based definition of it. Method: Sexual satisfaction was examined in three phases by the Hybrid Model of concept analysis: (1) the theoretical phase; (2) the fieldwork phase and (3) the analytical phase. Hybrid concept analysis method was chosen because its inclusion of married women’s perspectives enriches the limits of sexual health search literature. Result: The critical attributes of sexual satisfaction were investigated. They included ‘two-dimensional structure’, ‘an affective response’, ‘a means to achieve marital satisfaction’, ‘unique’, ‘a concept based on expectations’ and ‘a concept on shadow of values’. Conclusion: The concept analysis of sexual satisfaction showed some of the attributes and antecedents for this concept that, have not been mentioned in the literature. PMID:26153166

  3. Secure message authentication system for node to node network

    Science.gov (United States)

    Sindhu, R.; Vanitha, M. M.; Norman, J.

    2017-10-01

    The Message verification remains some of the best actual methods for prevent the illegal and dis honored communication after presence progressed to WSNs (Wireless Sensor Networks). Intend for this purpose, several message verification systems must stand established, created on both symmetric key cryptography otherwise public key cryptosystems. Best of them will have some limits for great computational then statement above in count of deficiency of climb ability then flexibility in node settlement occurrence. In a polynomial based system was newly presented for these problems. Though, this system then situations delay will must the dimness of integral limitation firm in the point of polynomial: once the amount of message transferred remains the greater than the limitation then the opponent will completely improve the polynomial approaches. This paper suggests using ECC (Elliptic Curve Cryptography). Though using the node verification the technique in this paper permits some nodes to transfer a limitless amount of messages lacking misery in the limit problem. This system will have the message cause secrecy. Equally theoretic study then model effects show our planned system will be effective than the polynomial based method in positions of calculation then statement above in privacy points though message basis privacy.

  4. Offloading of a Wireless Node Authentication with Core Network

    DEFF Research Database (Denmark)

    2017-01-01

    An example technique may include controlling receiving, by a second node from a first node in a wireless network, a request to offload authentication of the first node with the core network to the second node, controlling receiving, by the second node from the first node, data to be forwarded...... to the core network, performing, by the second node based on the request, an authentication with the core network on behalf of the first node while the first node is not connected with the second node, and controlling forwarding the received data from the second node to the core network while the first node...

  5. Node Immunization with Time-Sensitive Restrictions

    Directory of Open Access Journals (Sweden)

    Wen Cui

    2016-12-01

    Full Text Available When we encounter a malicious rumor or an infectious disease outbreak, immunizing k nodes of the relevant network with limited resources is always treated as an extremely effective method. The key challenge is how we can insulate limited nodes to minimize the propagation of those contagious things. In previous works, the best k immunised nodes are selected by learning the initial status of nodes and their strategies even if there is no feedback in the propagation process, which eventually leads to ineffective performance of their solutions. In this paper, we design a novel vaccines placement strategy for protecting much more healthy nodes from being infected by infectious nodes. The main idea of our solution is that we are not only utilizing the status of changing nodes as auxiliary knowledge to adjust our scheme, but also comparing the performance of vaccines in various transmission slots. Thus, our solution has a better chance to get more benefit from these limited vaccines. Extensive experiments have been conducted on several real-world data sets and the results have shown that our algorithm has a better performance than previous works.

  6. Targeted Delivery of Immunomodulators to Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Jamil Azzi

    2016-05-01

    Full Text Available Active-targeted delivery to lymph nodes represents a major advance toward more effective treatment of immune-mediated disease. The MECA79 antibody recognizes peripheral node addressin molecules expressed by high endothelial venules of lymph nodes. By mimicking lymphocyte trafficking to the lymph nodes, we have engineered MECA79-coated microparticles containing an immunosuppressive medication, tacrolimus. Following intravenous administration, MECA79-bearing particles showed marked accumulation in the draining lymph nodes of transplanted animals. Using an allograft heart transplant model, we show that targeted lymph node delivery of microparticles containing tacrolimus can prolong heart allograft survival with negligible changes in tacrolimus serum level. Using MECA79 conjugation, we have demonstrated targeted delivery of tacrolimus to the lymph nodes following systemic administration, with the capacity for immune modulation in vivo.

  7. A Novel Virtual Node Hexahedral Element with Exact Integration and Octree Meshing

    Directory of Open Access Journals (Sweden)

    Logah Perumal

    2016-01-01

    Full Text Available The method presented in this work is a 3-dimensional polyhedral finite element (3D PFEM based on virtual node method. Novel virtual node polyhedral elements (termed as VPHE are developed here, particularly virtual node hexahedral element (termed as VHE. Stiffness matrices of these polyhedral elements consist of simple polynomials. Thus, a new algorithm is introduced in this paper, which enables exact integration of monomials without a need for high number of integration points and weights. The number of nodes for VHE elements is not restricted, as opposed to the conventional hexahedral elements. This feature enables formulation of transition elements (termed as T-VHE which are useful to adaptive computation. Performances of the new VHE elements in solid mechanics and conductive heat transfer phenomena are examined through numerical simulations. The new T-VHE elements are utilized in octree mesh. The VHE elements are found to produce good results and T-VHE elements help to reduce number of global nodes for the analysis.

  8. Vibration energy harvesting in railway tunnels with a wireless sensor node application

    Energy Technology Data Exchange (ETDEWEB)

    Wischke, Martin

    2012-07-01

    Vibration harvesting is a promising concept to prolong the lifetime of batterypowered stand-alone systems, or even to enable their energy-autonomy. This thesis focuses on ambient vibrations converted by electromechanical transducers into electricity. The final goal is energy scavenging from train-induced vibrations in railway tunnels. This is achieved via the development of a suitable harvester for this environment and the practical demonstration of a vibrationpowered wireless sensor node (WSN). At the beginning of this thesis, extensive vibration measurements were performed in several traffic tunnels. The obtained unique data set formed the basis for the design and test of several harvesters. The railway sleeper was chosen as usable harvester location. A shock-resistant double-side suspended piezoelectric cantilever was developed. Several cantilevers with different eigenfrequencies are combined in an array, creating a robust harvester with a broad bandwidth. A field test of 7 days in the Loetschbergbasis-tunnel verified that, on average the sufficient energy for powering a virtual wireless sensor node was scavenged. For application in a real WSN, the harvester array was scaled up to 10 cantilevers. The power management for the sensor node was developed concurrently. The central component is a power switch that monitors the energy level in the system's storage capacitor and only triggers the wireless interface when sufficient energy is available. Combined with a train detection circuit, the presented energy-autonomous WSN reliably reports every passing vehicle. In addition to the development of an energy-autonomous fully integrated WSN, this work investigates nonlinear properties of PZT ceramics. Consideration of the elastostriction and the electrostriction enables a more precises prediction of the tip displacement of a piezoelectric cantilever actuator. Further, the elastostriction is exploited to modify the resonance frequency of a bimorph cantilever. Basing

  9. 18F-FDG PET for detecting recurrent head and neck cancer, local lymph node involvement and distant metastases. Comparison of qualitative visual and semiquantitative analysis

    International Nuclear Information System (INIS)

    Schmidt, M.; Schmalenbach, M.; Theissen, P.; Dietlein, M.; Eschner, W.; Schicha, H.; Jungehuelsing, M.; Schroeder, U.; Stennert, E.

    2004-01-01

    Aim: Assessment of the clinical value of 18 F-FDG-PET for detection of recurrent head and neck cancer, local lymph node involvement and distant metastases comparing a qualitative visual with a semiquantitative analysis (SUV values). Patients, methods: Retrospective evaluation of 73 18 F-FDG PET studies in 55 patients by use of a four-step qualitative visual grading system and calculation of standard uptake values in pathological lesions. Calculation of SUV values in normal regions for generating a map of physiological 18 F-FDG distribution. Correlation to histopathological findings and clinical follow-up. Results: 1. Qualitative visual analysis of 18 F-FDG PET studies: a) local recurrence sensitivity 79%, specificity 97%, positive predictive value 95%, negative predictive value 85%, and diagnostic accuracy 89%; b) local metastatic lymph nodes 100%, 95%, 85%, 100%, 96%; c) distant metastases 100%, 98%, 86%, 100%, 98%, respectively. 2. Semiquantitative analysis had only little incremental, non-significant value in comparison to qualitative visual analysis for the detection of a local recurrence in two patients: a) local recurrence: sensitivity 83%, specificity 100%, positive predictive value 100%, negative predictive value 88%, and diagnostic accuracy 93%; b) local metastatic lymph nodes or c) distant metastases did not change in comparison to qualitative visual analysis. Conclusion: 18 F-FDG PET is an effective tool for re-staging of patients with suspected recurrence after therapy for head and neck cancer. (orig.)

  10. Attractor controllability of Boolean networks by flipping a subset of their nodes

    Science.gov (United States)

    Rafimanzelat, Mohammad Reza; Bahrami, Fariba

    2018-04-01

    The controllability analysis of Boolean networks (BNs), as models of biomolecular regulatory networks, has drawn the attention of researchers in recent years. In this paper, we aim at governing the steady-state behavior of BNs using an intervention method which can easily be applied to most real system, which can be modeled as BNs, particularly to biomolecular regulatory networks. To this end, we introduce the concept of attractor controllability of a BN by flipping a subset of its nodes, as the possibility of making a BN converge from any of its attractors to any other one, by one-time flipping members of a subset of BN nodes. Our approach is based on the algebraic state-space representation of BNs using semi-tensor product of matrices. After introducing some new matrix tools, we use them to derive necessary and sufficient conditions for the attractor controllability of BNs. A forward search algorithm is then suggested to identify the minimal perturbation set for attractor controllability of a BN. Next, a lower bound is derived for the cardinality of this set. Two new indices are also proposed for quantifying the attractor controllability of a BN and the influence of each network variable on the attractor controllability of the network and the relationship between them is revealed. Finally, we confirm the efficiency of the proposed approach by applying it to the BN models of some real biomolecular networks.

  11. Lymph node size as a simple prognostic factor in node negative colon cancer and an alternative thesis to stage migration.

    Science.gov (United States)

    Märkl, Bruno; Schaller, Tina; Kokot, Yuriy; Endhardt, Katharina; Kretsinger, Hallie; Hirschbühl, Klaus; Aumann, Georg; Schenkirsch, Gerhard

    2016-10-01

    Stage migration is an accepted explanation for the association between lymph node (LN) yield and outcome in colon cancer. To investigate whether the alternative thesis of immune response is more likely, we performed a retrospective study. We enrolled 239 cases of node negative cancers, which were categorized according to the number of LNs with diameters larger than 5 mm (LN5) into the groups LN5-very low (0 to 1 LN5), LN5-low (2 to 5 LN5), and LN5-high (≥6 LN5). Significant differences were found in pT3/4 cancers with median survival times of 40, 57, and 71 months (P = .022) in the LN5-very low, LN5-low, and LN5-high groups, respectively. Multivariable analysis revealed that LN5 number and infiltration type were independent prognostic factors. LN size is prognostic in node negative colon cancer. The correct explanation for outcome differences associated with LN harvest is probably the activation status of LNs. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Self-Concept and Academic Achievement: A Meta-Analysis of Longitudinal Relations

    Science.gov (United States)

    Huang, Chiungjung

    2011-01-01

    The relation between self-concept and academic achievement was examined in 39 independent and longitudinal samples through the integration of meta-analysis and path analysis procedures. For relations with more than 3 independent samples, the mean observed correlations ranged from 0.20 to 0.27 between prior self-concept and subsequent academic…

  13. Prognostic significance of the total number of harvested lymph nodes for lymph node-negative gastric cancer patients.

    Science.gov (United States)

    Ji, Xin; Bu, Zhao-De; Li, Zi-Yu; Wu, Ai-Wen; Zhang, Lian-Hai; Zhang, Ji; Wu, Xiao-Jiang; Zong, Xiang-Long; Li, Shuang-Xi; Shan, Fei; Jia, Zi-Yu; Ji, Jia-Fu

    2017-08-22

    The relationship between the number of harvested lymph nodes (HLNs) and prognosis of gastric cancer patients without an involvement of lymph nodes has not been well-evaluated. The objective of this study is to further explore this issue. We collected data from 399 gastric cancer patients between November 2006 and October 2011. All of them were without metastatic lymph nodes. Survival analyses showed that statistically significant differences existed in the survival outcomes between the two groups allocated by the total number of HLNs ranging from 16 to 22. Therefore, we adopted 22 as the cut-off value of the total number of HLNs for grouping (group A: HLNs <22; group B: HLNs≥22). The intraoperative and postoperative characteristics, including operative blood loss (P=0.096), operation time (P=0.430), postoperative hospital stay (P=0.142), complications (P=0.552), rate of reoperation (P=0.966) and postoperative mortality (P=1.000), were comparable between the two groups. T-stage-stratified Kaplan-Meier analyses revealed that the 5-year survival rate of patients at the T4 stage was better in group B than in group A (76.9% vs. 58.5%; P=0.004). An analysis of multiple factors elucidated that the total number of HLNs, T stage, operation time and age were independently correlated factors of prognosis. Regarding gastric cancer patients without the involvement of lymph nodes, an HLN number ≥22 would be helpful in prolonging their overall survival, especially for those at T4 stage. The total number of HLNs was an independent prognostic factor for this population of patients.

  14. Centroid Localization of Uncooperative Nodes in Wireless Networks Using a Relative Span Weighting Method

    Directory of Open Access Journals (Sweden)

    Christine Laurendeau

    2010-01-01

    Full Text Available Increasingly ubiquitous wireless technologies require novel localization techniques to pinpoint the position of an uncooperative node, whether the target is a malicious device engaging in a security exploit or a low-battery handset in the middle of a critical emergency. Such scenarios necessitate that a radio signal source be localized by other network nodes efficiently, using minimal information. We propose two new algorithms for estimating the position of an uncooperative transmitter, based on the received signal strength (RSS of a single target message at a set of receivers whose coordinates are known. As an extension to the concept of centroid localization, our mechanisms weigh each receiver's coordinates based on the message's relative RSS at that receiver, with respect to the span of RSS values over all receivers. The weights may decrease from the highest RSS receiver either linearly or exponentially. Our simulation results demonstrate that for all but the most sparsely populated wireless networks, our exponentially weighted mechanism localizes a target node within the regulations stipulated for emergency services location accuracy.

  15. Is there a requirement for axillary lymph node dissection following identification of micro-metastasis or isolated tumour cells at sentinel node biopsy for breast cancer?

    LENUS (Irish Health Repository)

    Joyce, D P

    2012-02-29

    INTRODUCTION: Recent decades have seen a significant shift towards conservative management of the axilla. Increasingly, immunohistochemical analysis of sentinel nodes leads to the detection of small tumour deposits, the significance of which remains uncertain. The aims of this study are to examine patients whose sentinel lymph nodes are positive for macro-metastasis, micro-metastasis or isolated tumour cells (ITCs) and to determine the rate of further nodal disease after axillary lymph node dissection (ALND). METHODS: A retrospective analysis of all patients undergoing a sentinel lymph node biopsy (SLNB) between January 2007 and December 2010 in a tertiary referral breast unit was performed. Patients who underwent an axillary lymph node dissection for macro-metastasis, micro-metastasis or ITCs were identified. Demographics, histological data and the rate of further axillary disease were examined. RESULTS: In total, 664 breast cancer patients attended the symptomatic breast unit during the study period, 360 of whom underwent a SLNB. Seventy patients had a SLNB positive for macro-metastasis. All of these patients underwent ALND. A positive SLNB with either micro-metastasis or ITCs was identified in 58 patients. Only 41 of the 58 patients went on to have an ALND, due primarily to variations in surgeons\\' preferences. Nineteen patients with micro-metastasis underwent an ALND. Four patients had further axillary disease (21%). Twenty-two patients had ITCs identified, of whom only one had further disease (4.5%). No statistically significant difference was found between the two groups in terms of tumour size, grade, lymphovascular invasion or oestrogen receptor status. CONCLUSION: ALND should be considered in patients with micro-metastasis at SLNB. It should rarely be employed in the setting of SLNB positive for ITCs.

  16. Reliability analysis of water distribution systems under uncertainty

    International Nuclear Information System (INIS)

    Kansal, M.L.; Kumar, Arun; Sharma, P.B.

    1995-01-01

    In most of the developing countries, the Water Distribution Networks (WDN) are of intermittent type because of the shortage of safe drinking water. Failure of a pipeline(s) in such cases will cause not only the fall in one or more nodal heads but also the poor connectivity of source with various demand nodes of the system. Most of the previous works have used the two-step algorithm based on pathset or cutset approach for connectivity analysis. The computations become more cumbersome when connectivity of all demand nodes taken together with that of supply is carried out. In the present paper, network connectivity based on the concept of Appended Spanning Tree (AST) is suggested to compute global network connectivity which is defined as the probability of the source node being connected with all the demand nodes simultaneously. The concept of AST has distinct advantages as it attacks the problem directly rather than in an indirect way as most of the studies so far have done. Since the water distribution system is a repairable one, a general expression for pipeline avialability using the failure/repair rate is considered. Furthermore, the sensitivity of global reliability estimates due to the likely error in the estimation of failure/repair rates of various pipelines is also studied

  17. T.Node, industrial version of supernode

    Science.gov (United States)

    Flieller, Sylvain

    1989-12-01

    The Esprit I P1085 "SuperNode" project developed a modular reconfigurable archtecture, based on transputers. This highly parallel machine is now marketed by Telmat Informatique under the name T.Node. This paper presents the P1085 project, the architecture of SuperNode, its industrial implementation and its software enviroment.

  18. Synchronous wearable wireless body sensor network composed of autonomous textile nodes.

    Science.gov (United States)

    Vanveerdeghem, Peter; Van Torre, Patrick; Stevens, Christiaan; Knockaert, Jos; Rogier, Hendrik

    2014-10-09

    A novel, fully-autonomous, wearable, wireless sensor network is presented, where each flexible textile node performs cooperative synchronous acquisition and distributed event detection. Computationally efficient situational-awareness algorithms are implemented on the low-power microcontroller present on each flexible node. The detected events are wirelessly transmitted to a base station, directly, as well as forwarded by other on-body nodes. For each node, a dual-polarized textile patch antenna serves as a platform for the flexible electronic circuitry. Therefore, the system is particularly suitable for comfortable and unobtrusive integration into garments. In the meantime, polarization diversity can be exploited to improve the reliability and energy-efficiency of the wireless transmission. Extensive experiments in realistic conditions have demonstrated that this new autonomous, body-centric, textile-antenna, wireless sensor network is able to correctly detect different operating conditions of a firefighter during an intervention. By relying on four network nodes integrated into the protective garment, this functionality is implemented locally, on the body, and in real time. In addition, the received sensor data are reliably transferred to a central access point at the command post, for more detailed and more comprehensive real-time visualization. This information provides coordinators and commanders with situational awareness of the entire rescue operation. A statistical analysis of measured on-body node-to-node, as well as off-body person-to-person channels is included, confirming the reliability of the communication system.

  19. Analysis of corium recovery concepts by the EUROCORE group

    International Nuclear Information System (INIS)

    Seiler, J.-M.; Latrobe, A.; Sehgal, B.R.; Alsmeyer, H.; Kymaelaeinen, O.; Turland, B.; Grange, J.-L.; Fischer, M.; Azarian, G.; Buerger, M.; Cirauqui, C.J.; Zurita, A.

    2003-01-01

    The objective of the EUROCORE (European Group for Analysis of Corium Recovery Concepts) Concerted Action is to obtain a clear view of the state-of-the-art for melt stabilisation as considered in accident management schemes and to better identify Research and Development (R and D) needs. Five different melt stabilisation concepts have been discussed: in-vessel retention with external cooling, core-concrete interaction with top cooling, ex-vessel spreading with top flooding, water injection by bottom flooding, and crucible concept with sacrificial material. For each concept, main unresolved problems are discussed in this paper and recommended R and D actions are outlined. The project started on 1 March 2000 and ended on 28 February 2002

  20. Sentinel lymph node biopsy in oral cancer

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Sørensen, Jens Ahm; Grupe, Peter

    2005-01-01

    PURPOSE: To validate lymphatic mapping combined with sentinel lymph node biopsy as a staging procedure, and to evaluate the possible clinical implications of added oblique lymphoscintigraphy and/or tomography and test the intra- and interobserver reproducibility of lymphoscintigraphy. MATERIAL......: Eleven (28%) patients were upstaged. The sentinel lymph node identification rate was 97.5%. Sentinel lymph node biopsy significantly differentiated between patients with or without lymph node metastasis (P = 0.001). Lymphatic mapping revealed 124 hotspots and 144 hot lymph nodes were removed by sentinel...

  1. Postmastectomy Radiation Therapy Is Associated With Improved Survival in Node-Positive Male Breast Cancer: A Population Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Abrams, Matthew J., E-mail: mabrams@tuftsmedicalcenter.org [Department of Radiation Oncology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts (United States); Koffer, Paul P. [Department of Radiation Oncology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts (United States); Wazer, David E. [Department of Radiation Oncology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts (United States); Department of Radiation Oncology, The Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island (United States); Hepel, Jaroslaw T. [Department of Radiation Oncology, The Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island (United States)

    2017-06-01

    Purpose: Because of its rarity, there are no randomized trials investigating postmastectomy radiation therapy (PMRT) in male breast cancer. This study retrospectively examines the impact of PMRT in male breast cancer patients in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. Methods and Materials: The SEER database 8.3.2 was queried for men ages 20+ with a diagnosis of localized or regional nonmetastatic invasive ductal/lobular carcinoma from 1998 to 2013. Included patients were treated by modified radical mastectomy (MRM), with or without adjuvant external beam radiation. Univariate and multivariate analyses evaluated predictors for PMRT use after MRM. Kaplan-Meier overall survival (OS) curves of the entire cohort and a case-matched cohort were calculated and compared by the log-rank test. Cox regression was used for multivariate survival analyses. Results: A total of 1933 patients were included in the unmatched cohort. There was no difference in 5-year OS between those who received PMRT and those who did not (78% vs 77%, respectively, P=.371); however, in the case-matched analysis, PMRT was associated with improved OS at 5 years (83% vs 54%, P<.001). On subset analysis of the unmatched cohort, PMRT was associated with improved OS in men with 1 to 3 positive nodes (5-year OS 79% vs 72% P=.05) and those with 4+ positive nodes (5-year OS 73% vs 53% P<.001). On multivariate analysis of the unmatched cohort, independent predictors for improved OS were use of PMRT: HR=0.551 (0.412-0.737) and estrogen receptor–positive disease: HR=0.577 (0.339-0.983). Predictors for a survival detriment were higher grade 3/4: HR=1.825 (1.105-3.015), larger tumor T2: HR=1.783 (1.357-2.342), T3/T4: HR=2.683 (1.809-3.978), higher N-stage: N1 HR=1.574 (1.184-2.091), N2/N3: HR=2.328 (1.684-3.218), black race: HR=1.689 (1.222-2.336), and older age 81+: HR=4.164 (1.497-11.582). Conclusions: There may be a survival benefit with the

  2. Improving the Dominating-Set Routing over Delay-Tolerant Mobile Ad-Hoc Networks via Estimating Node Intermeeting Times

    Directory of Open Access Journals (Sweden)

    Preiss Bruno

    2011-01-01

    Full Text Available With limited coverage of wireless networks and frequent roaming of mobile users, providing a seamless communication service poses a technical challenge. In our previous research, we presented a supernode system architecture that employs the delay-tolerant network (DTN concept to provide seamless communications for roaming users over interconnected heterogeneous wireless networks. Mobile ad hoc networks (MANETs are considered a key component of the supernode system for services over an area not covered by other wireless networks. Within the super node system, a dominating-set routing technique is proposed to improve message delivery over MANETs and to achieve better resource utilization. The performance of the dominating-set routing technique depends on estimation accuracy of the probability of a future contact between nodes. This paper studies how node mobility can be modeled and used to better estimate the probability of a contact. We derive a distribution for the node-to-node intermeeting time and present numerical results to demonstrate that the distribution can be used to improve the dominating-set routing technique performance. Moreover, we investigate how the distribution can be employed to relax the constraints of selecting the dominating-set members in order to improve the system resource utilization.

  3. Integration of virtualized worker nodes in standard batch systems

    International Nuclear Information System (INIS)

    Buege, Volker; Kunze, Marcel; Oberst, Oliver; Quast, Guenter; Scheurer, Armin; Hessling, Hermann; Kemp, Yves; Synge, Owen

    2010-01-01

    Current experiments in HEP only use a limited number of operating system flavours. Their software might only be validated on one single OS platform. Resource providers might have other operating systems of choice for the installation of the batch infrastructure. This is especially the case if a cluster is shared with other communities, or communities that have stricter security requirements. One solution would be to statically divide the cluster into separated sub-clusters. In such a scenario, no opportunistic distribution of the load can be achieved, resulting in a poor overall utilization efficiency. Another approach is to make the batch system aware of virtualization, and to provide each community with its favoured operating system in a virtual machine. Here, the scheduler has full flexibility, resulting in a better overall efficiency of the resources. In our contribution, we present a lightweight concept for the integration of virtual worker nodes into standard batch systems. The virtual machines are started on the worker nodes just before jobs are executed there. No meta-scheduling is introduced. We demonstrate two prototype implementations, one based on the Sun Grid Engine (SGE), the other using Maui/Torque as a batch system. Both solutions support local job as well as Grid job submission. The hypervisors currently used are Xen and KVM, a port to another system is easily envisageable. To better handle different virtual machines on the physical host, the management solution VmImageManager is developed. We will present first experience from running the two prototype implementations. In a last part, we will show the potential future use of this lightweight concept when integrated into high-level (i.e. Grid) work-flows.

  4. Does Synergy Exist in Nursing? A Concept Analysis.

    Science.gov (United States)

    Witges, Kim A; Scanlan, Judith M

    2015-01-01

    The aim is to analyze the concept of synergy, particularly as the concept applies to teamwork, and determine if the concept has utility in improving the work environment for nurses. Tackling nursing shortages that result from a poor work environment is a priority for many nurse leaders. Producing synergy among teams may be an effective strategy in enhancing the work environment. However, the understanding of synergy and the ability to produce synergy among teams has been seldom highlighted or discussed within nursing literature. Walker and Avant's approach was used to guide this concept analysis of synergy. Literature searches involved databases (PsycInfo, Medline, Cumulative Index for Nursing and Allied Health Literature [CINAHL], and Scopus), Internet search engines (Google), and hand searches. The analysis suggests that synergy is an outcome of the successful collaboration of the following three attributes: group cohesion, the pursuit of a common goal, and the achievement of a positive gain, considerably more than what was thought possible by the group. The foundation for this accomplishment requires an underlying feeling of special importance, the acknowledgment of each member's role, and open communication and dialogue among members. Nursing leaders would benefit from a broader understanding of synergy, and the mindful application and utility of synergy as an outcome of effective teamwork among nurses. © 2014 Wiley Periodicals, Inc.

  5. Selective sentinel lymph node biopsy in papillary thyroid carcinoma in patients with no preoperative evidence of lymph node metastasis.

    Science.gov (United States)

    González, Óscar; Zafon, Carles; Caubet, Enric; García-Burillo, Amparo; Serres, Xavier; Fort, José Manuel; Mesa, Jordi; Castell, Joan; Roca, Isabel; Ramón Y Cajal, Santiago; Iglesias, Carmela

    2017-10-01

    Lymphadenectomy is recommended during surgery for papillary thyroid carcinoma when there is evidence of cervical lymph node metastasis (therapeutic) or in high-risk patients (prophylactic) such as those with T3 and T4 tumors of the TNM classification. Selective sentinel lymph node biopsy may improve preoperative diagnosis of nodal metastases. To analyze the results of selective sentinel lymph node biopsy in a group of patients with papillary thyroid carcinoma and no evidence of nodal involvement before surgery. A retrospective, single-center study in patients with papillary thyroid carcinoma and no clinical evidence of lymph node involvement who underwent surgery between 2011 and 2013. The sentinel node was identified by scintigraphy. When the sentinel node was positive, the affected compartment was removed, and when sentinel node was negative, central lymph node dissection was performed. Forty-three patients, 34 females, with a mean age of 52.3 (±17) years, were enrolled. Forty-six (27%) of the 170 SNs resected from 24 (55.8%) patients were positive for metastasis. In addition, 94 (15.6%) out of the 612 lymph nodes removed in the lymphadenectomies were positive for metastases. Twelve of the 30 (40%) low risk patients (cT1N0 and cT2N0) changed their stage to pN1, whereas 12 of 13 (92%) high risk patients (cT3N0 and cT4N0) changed to pN1 stage. Selective sentinel lymph node biopsy changes the stage of more than 50% of patients from cN0 to pN1. This confirms the need for lymph node resection in T3 and T4 tumors, but reveals the presence of lymph node metastases in 40% of T1-T2 tumors. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Learning Situations in Nursing Education: A Concept Analysis.

    Science.gov (United States)

    Shahsavari, Hooman; Zare, Zahra; Parsa-Yekta, Zohreh; Griffiths, Pauline; Vaismoradi, Mojtaba

    2018-02-01

    The nursing student requires opportunities to learn within authentic contexts so as to enable safe and competent practice. One strategy to facilitate such learning is the creation of learning situations. A lack of studies on the learning situation in nursing and other health care fields has resulted in insufficient knowledge of the characteristics of the learning situation, its antecedents, and consequences. Nurse educators need to have comprehensive and practical knowledge of the definition and characteristics of the learning situation so as to enable their students to achieve enhanced learning outcomes. The aim of this study was to clarify the concept of the learning situation as it relates to the education of nurses and improve understanding of its characteristics, antecedents, and consequences. The Bonis method of concept analysis, as derived from the Rodgers' evolutionary method, provided the framework for analysis. Data collection and analysis were undertaken in two phases: "interdisciplinary" and "intra-disciplinary." The data source was a search of the literature, encompassing nursing and allied health care professions, published from 1975 to 2016. No agreement on the conceptual phenomenon was discovered in the international literature. The concept of a learning situation was used generally in two ways and thus classified into the themes of: "formal/informal learning situation" and "biologic/nonbiologic learning situation." Antecedents to the creation of a learning situation included personal and environmental factors. The characteristics of a learning situation were described in terms of being complex, dynamic, and offering potential and effective learning opportunities. Consequences of the learning situation included enhancement of the students' learning, professionalization, and socialization into the professional role. The nurse educator, when considering the application of the concept of a learning situation in their educational planning, must

  7. Mining Important Nodes in Directed Weighted Complex Networks

    Directory of Open Access Journals (Sweden)

    Yunyun Yang

    2017-01-01

    Full Text Available In complex networks, mining important nodes has been a matter of concern by scholars. In recent years, scholars have focused on mining important nodes in undirected unweighted complex networks. But most of the methods are not applicable to directed weighted complex networks. Therefore, this paper proposes a Two-Way-PageRank method based on PageRank for further discussion of mining important nodes in directed weighted complex networks. We have mainly considered the frequency of contact between nodes and the length of time of contact between nodes. We have considered the source of the nodes (in-degree and the whereabouts of the nodes (out-degree simultaneously. We have given node important performance indicators. Through numerical examples, we analyze the impact of variation of some parameters on node important performance indicators. Finally, the paper has verified the accuracy and validity of the method through empirical network data.

  8. [Diagnostic validity of the intraoperative analysis in frozen section of the sentinel lymph node in the surgical management of breast cancer].

    Science.gov (United States)

    Bañuelos-Andrío, Luis; Rodríguez-Caravaca, Gil; Argüelles-Pintos, Miguel; Mitjavilla-Casanovas, Mercedes

    2014-01-01

    The method for intraoperative sentinel lymph node (SLN) evaluation has still not been established in breast cancer staging. This study has evaluated the diagnostic validity and impact of intraoperative analysis using the frozen section (FS) of SLN. We performed a descriptive study of the diagnostic validity of the FS of the SLN in patients with breast cancer and selective sentinel node biopsy (SSNB) from October-2006 to October-2012. The diagnostic validity indexes were evaluated using sensitivity, specificity, positive and negative predictive values and global value. Gold standard was considered as the final histopathological results of the biopsies. A total of 370 patients were studied. Sensitivity and specificity for detection of metastasis by FS in the SLN were 67% and 100%, respectively. Global diagnostic validity was 95%. There was a correlation between detection of metastasis and tumor size (pcancer. FS reduces the need for second interventions, at least for most patients who have breast cancer with identifiable positive SLN and unequivocal evidence of positive lymph node disease. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  9. Psychosocial adaptation: an evolutionary concept analysis exploring a common multidisciplinary language.

    Science.gov (United States)

    Londono, Yenly; McMillan, Diana E

    2015-11-01

    To provide the first known concept analysis of psychosocial adaptation, exploring its evolution from the concept adaptation. We also determine how psychosocial adaptation is conceptualized across nursing, health, sociobehavioural and education disciplines. Psychosocial adaptation is an important conceptual term that is poorly defined in nursing and other health, sociobehavioural and education disciplines. A thorough understanding of the concept's application in nursing and across disciplines can help to clarify its meaning, facilitate a more effective common language between disciplines and inform future psychosocial adaptation research. Rodger's evolutionary view guided this concept analysis. Peer-reviewed English and Spanish manuscripts published between 2011-2013 were retrieved from the following databases: CINAHL, Psych INFO, PubMed, Scopus and LILACS. Eighty-nine articles related to psychosocial adaptation were included in the analysis. Findings identify key attributes, antecedents and consequences associated with the use of the concept. Findings were compared vis-a-vis reported characteristics of adaptation. The attributes characterizing psychosocial adaptation are: change, process, continuity, interaction and influence. In psychosocial adaptation, new life conditions serve as antecedents, while consequences are good or bad outcomes. Important features of the evolution of this concept include its broad appropriation across the reviewed disciplines. The attributes of psychosocial adaptation, have some similarities to those of general adaptation. Both concepts include an aspect of change, but unlike adaptation, psychosocial adaptation has branched away from biological descriptors, such as homeostasis and tends to focus on relational characteristics, such as interaction and influences. © 2015 John Wiley & Sons Ltd.

  10. Identifying Vulnerable Nodes of Complex Networks in Cascading Failures Induced by Node-Based Attacks

    Directory of Open Access Journals (Sweden)

    Shudong Li

    2013-01-01

    Full Text Available In the research on network security, distinguishing the vulnerable components of networks is very important for protecting infrastructures systems. Here, we probe how to identify the vulnerable nodes of complex networks in cascading failures, which was ignored before. Concerned with random attack (RA and highest load attack (HL on nodes, we model cascading dynamics of complex networks. Then, we introduce four kinds of weighting methods to characterize the nodes of networks including Barabási-Albert scale-free networks (SF, Watts-Strogatz small-world networks (WS, Erdos-Renyi random networks (ER, and two real-world networks. The simulations show that, for SF networks under HL attack, the nodes with small value of the fourth kind of weight are the most vulnerable and the ones with small value of the third weight are also vulnerable. Also, the real-world autonomous system with power-law distribution verifies these findings. Moreover, for WS and ER networks under both RA and HL attack, when the nodes have low tolerant ability, the ones with small value of the fourth kind of weight are more vulnerable and also the ones with high degree are easier to break down. The results give us important theoretical basis for digging the potential safety loophole and making protection strategy.

  11. Concept analysis: nurse-to-nurse lateral violence.

    Science.gov (United States)

    Embree, Jennifer L; White, Ann H

    2010-01-01

    The purpose of this paper is to examine the concept of nurse-to-nurse lateral violence (LV). Published literature--LV among nurses is significant and results in social, psychological, and physical consequences, negative patient and nursing outcomes, and damaged relationships. An extensive review of literature through Health Source, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest health, and Medical Complete was used to determine agreement and disagreement across disciplines and emerging trends. This concept analysis demonstrates that nurse-to-nurse LV is nurse-to-nurse aggression with overtly or covertly directing dissatisfaction toward another. Origins include role issues, oppression, strict hierarchy, disenfranchising work practices, low self-esteem, powerlessness perception, anger, and circuits of power. The result of this analysis provides guidance for further conceptual and empirical research as well as for clinical practice. Organizations must learn how to eliminate antecedents and provide nurses with skills and techniques to eradicate LV to improve the nursing work environment, patient care outcomes, and nurse retention.

  12. Illumina MiSeq 16S amplicon sequence analysis of bovine respiratory disease associated bacteria in lung and mediastinal lymph node tissue.

    Science.gov (United States)

    Johnston, Dayle; Earley, Bernadette; Cormican, Paul; Murray, Gerard; Kenny, David Anthony; Waters, Sinead Mary; McGee, Mark; Kelly, Alan Kieran; McCabe, Matthew Sean

    2017-05-02

    Bovine respiratory disease (BRD) is caused by growth of single or multiple species of pathogenic bacteria in lung tissue following stress and/or viral infection. Next generation sequencing of 16S ribosomal RNA gene PCR amplicons (NGS 16S amplicon analysis) is a powerful culture-independent open reference method that has recently been used to increase understanding of BRD-associated bacteria in the upper respiratory tract of BRD cattle. However, it has not yet been used to examine the microbiome of the bovine lower respiratory tract. The objective of this study was to use NGS 16S amplicon analysis to identify bacteria in post-mortem lung and lymph node tissue samples harvested from fatal BRD cases and clinically healthy animals. Cranial lobe and corresponding mediastinal lymph node post-mortem tissue samples were collected from calves diagnosed as BRD cases by veterinary laboratory pathologists and from clinically healthy calves. NGS 16S amplicon libraries, targeting the V3-V4 region of the bacterial 16S rRNA gene were prepared and sequenced on an Illumina MiSeq. Quantitative insights into microbial ecology (QIIME) was used to determine operational taxonomic units (OTUs) which corresponded to the 16S rRNA gene sequences. Leptotrichiaceae, Mycoplasma, Pasteurellaceae, and Fusobacterium were the most abundant OTUs identified in the lungs and lymph nodes of the calves which died from BRD. Leptotrichiaceae, Fusobacterium, Mycoplasma, Trueperella and Bacteroides had greater relative abundances in post-mortem lung samples collected from fatal cases of BRD in dairy calves, compared with clinically healthy calves without lung lesions. Leptotrichiaceae, Mycoplasma and Pasteurellaceae showed higher relative abundances in post-mortem lymph node samples collected from fatal cases of BRD in dairy calves, compared with clinically healthy calves without lung lesions. Two Leptotrichiaceae sequence contigs were subsequently assembled from bacterial DNA-enriched shotgun sequences

  13. Adaptive Online Sequential ELM for Concept Drift Tackling

    Directory of Open Access Journals (Sweden)

    Arif Budiman

    2016-01-01

    Full Text Available A machine learning method needs to adapt to over time changes in the environment. Such changes are known as concept drift. In this paper, we propose concept drift tackling method as an enhancement of Online Sequential Extreme Learning Machine (OS-ELM and Constructive Enhancement OS-ELM (CEOS-ELM by adding adaptive capability for classification and regression problem. The scheme is named as adaptive OS-ELM (AOS-ELM. It is a single classifier scheme that works well to handle real drift, virtual drift, and hybrid drift. The AOS-ELM also works well for sudden drift and recurrent context change type. The scheme is a simple unified method implemented in simple lines of code. We evaluated AOS-ELM on regression and classification problem by using concept drift public data set (SEA and STAGGER and other public data sets such as MNIST, USPS, and IDS. Experiments show that our method gives higher kappa value compared to the multiclassifier ELM ensemble. Even though AOS-ELM in practice does not need hidden nodes increase, we address some issues related to the increasing of the hidden nodes such as error condition and rank values. We propose taking the rank of the pseudoinverse matrix as an indicator parameter to detect “underfitting” condition.

  14. Impact of clinical pharmacy interventions on medication error nodes.

    Science.gov (United States)

    Chamoun, Nibal R; Zeenny, Rony; Mansour, Hanine

    2016-12-01

    Background Pharmacists' involvement in patient care has improved the quality of care and reduced medication errors. However, this has required a lot of work that could not have been accomplished without documentation of interventions. Several means of documenting errors have been proposed in the literature but without a consistent comprehensive process. Recently, the American College of Clinical Pharmacy (ACCP) recognized that pharmacy practice lacks a consistent process for direct patient care and discussed several options for a pharmaceutical care plan, essentially encompassing medication therapy assessment, development and implementation of a pharmaceutical care plan and finally evaluation of the outcome. Therefore, as per the recommendations of ACCP, we sought to retrospectively analyze interventions by grouping them according to medication related problems (MRP) and their nodes such as prescribing; administering; monitoring; documenting and dispensing. Objective The aim of this study is to report interventions according to medication error (ME) nodes and show the impact of pharmacy interventions in reducing MRPs. Setting The study was conducted at the cardiology and infectious diseases services at a teaching hospital located in Beirut, Lebanon. Methods Intervention documentation was completed by pharmacy students on infectious diseases and cardiology rotations then reviewed by clinical pharmacists with respective specialties. Before data analysis, a new pharmacy reporting sheet was developed in order to link interventions according to MRP. Then, MRPs were grouped in the five ME nodes. During the documentation process, whether MRP had reached the patient or not may have not been reported which prevented the classification to the corresponding medication error nodes as ME. Main outcome Reduction in medication related problems across all ME nodes. Results A total of n = 1174 interventions were documented. N = 1091 interventions were classified as MRPs

  15. Computational lymphatic node models in pediatric and adult hybrid phantoms for radiation dosimetry

    International Nuclear Information System (INIS)

    Lee, Choonsik; Lamart, Stephanie; Moroz, Brian E

    2013-01-01

    We developed models of lymphatic nodes for six pediatric and two adult hybrid computational phantoms to calculate the lymphatic node dose estimates from external and internal radiation exposures. We derived the number of lymphatic nodes from the recommendations in International Commission on Radiological Protection (ICRP) Publications 23 and 89 at 16 cluster locations for the lymphatic nodes: extrathoracic, cervical, thoracic (upper and lower), breast (left and right), mesentery (left and right), axillary (left and right), cubital (left and right), inguinal (left and right) and popliteal (left and right), for different ages (newborn, 1-, 5-, 10-, 15-year-old and adult). We modeled each lymphatic node within the voxel format of the hybrid phantoms by assuming that all nodes have identical size derived from published data except narrow cluster sites. The lymph nodes were generated by the following algorithm: (1) selection of the lymph node site among the 16 cluster sites; (2) random sampling of the location of the lymph node within a spherical space centered at the chosen cluster site; (3) creation of the sphere or ovoid of tissue representing the node based on lymphatic node characteristics defined in ICRP Publications 23 and 89. We created lymph nodes until the pre-defined number of lymphatic nodes at the selected cluster site was reached. This algorithm was applied to pediatric (newborn, 1-, 5-and 10-year-old male, and 15-year-old males) and adult male and female ICRP-compliant hybrid phantoms after voxelization. To assess the performance of our models for internal dosimetry, we calculated dose conversion coefficients, called S values, for selected organs and tissues with Iodine-131 distributed in six lymphatic node cluster sites using MCNPX2.6, a well validated Monte Carlo radiation transport code. Our analysis of the calculations indicates that the S values were significantly affected by the location of the lymph node clusters and that the values increased for

  16. Lymphoscintigraphic Identification of Sentinel Nodes in Malignant Melanoma

    International Nuclear Information System (INIS)

    Andries, G.; Dindelegan, G.; Ciule, Larisa; Cosgarea, Rodica; Cobzac, Gh.

    2006-01-01

    Full text: The most important prognostic factor in malignant melanoma is the presence or absence of metastasis in lymph nodes. It has been demonstrated the orderly progression of different types of tumours. Sentinel lymph node identification is done lymphoscintigraphically, followed by surgical excision and morpho pathological exam. Material and methods: We studied 33 patients with malignant melanoma (age 26-84 years) divided in 2 subgroups: group A without gamma probe (18 patients) and group B with gamma probe (15 patients). The lymphoscintigraphy (LS) was performed with a totally dose of 20-30 MBq of 99mTc-nanocoloid (Amersham) injected peritumoral or pericicatriceal in 4-6 points in volume of 0,1-0,2 ml per point. Acquisition was performed dynamic for 10-15 min and static at 30-60 min p.i. on perpendicular projections. Patent blue dye was injected prior surgery. In group A has performed sentinel node excision (13 patients) or ELND (4), one patient has died before surgery. In group B sentinel nodes were surgically excised with gamma probe and ELND was performed in patients with positive lymph nodes. Histopathologically, sentinel nodes were stained with HE and in 6 cases with HMB45. Results: In group A we identified the sentinel nodes scintigraphically in all patients (median 1,83±-1,50 nodes, range 1-7). Surgically with PBD were identified 1,69±1,18 sentinel nodes, in 2 patients the SN lymphadenectomy was negative. All nodes excised were histopathologically negative, but in 4 patients loco-regional recurrence or distant metastasis developed. In group B we identified scintigraphically 33 SNs (median 2,20±1,37 nodes, range 1-5) and 4 in transit nodes in 14 patients, 24 of them being blue dye positive (80%), in 1 patient LS was negative. With gamma probe surgeon excised 39 radioactive nodes and 1 SN blue dye positive only, 10 of them being histopathologically positive (25% node metastasis). No metastasis were identified after ELND in patients with positive SNs

  17. High risk of non-sentinel node metastases in a group of breast cancer patients with micrometastases in the sentinel node

    DEFF Research Database (Denmark)

    Tvedskov, Tove Filtenborg; Jensen, Maj-Britt; Lisse, Ida Marie

    2012-01-01

    Axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel nodes is under debate. We aimed to establish two models to predict non-sentinel node (NSN) metastases in patients with micrometastases or isolated tumor cells (ITC) in sentinel nodes, to guide the decision for ...

  18. Effects of salience-network-node neurofeedback training on affective biases in major depressive disorder.

    Science.gov (United States)

    Hamilton, J Paul; Glover, Gary H; Bagarinao, Epifanio; Chang, Catie; Mackey, Sean; Sacchet, Matthew D; Gotlib, Ian H

    2016-03-30

    Neural models of major depressive disorder (MDD) posit that over-response of components of the brain's salience network (SN) to negative stimuli plays a crucial role in the pathophysiology of MDD. In the present proof-of-concept study, we tested this formulation directly by examining the affective consequences of training depressed persons to down-regulate response of SN nodes to negative material. Ten participants in the real neurofeedback group saw, and attempted to learn to down-regulate, activity from an empirically identified node of the SN. Ten other participants engaged in an equivalent procedure with the exception that they saw SN-node neurofeedback indices from participants in the real neurofeedback group. Before and after scanning, all participants completed tasks assessing emotional responses to negative scenes and to negative and positive self-descriptive adjectives. Compared to participants in the sham-neurofeedback group, from pre- to post-training, participants in the real-neurofeedback group showed a greater decrease in SN-node response to negative stimuli, a greater decrease in self-reported emotional response to negative scenes, and a greater decrease in self-reported emotional response to negative self-descriptive adjectives. Our findings provide support for a neural formulation in which the SN plays a primary role in contributing to negative cognitive biases in MDD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Significance of CT analysis of regional lymph node metastases in colorectal cancer; Bedeutung der CT fuer die Beurteilung regionaerer Lymphknotenmetastasen bei kolorektalen Karzinomen

    Energy Technology Data Exchange (ETDEWEB)

    Gomille, T.; Christ, F. [Duesseldorf Univ. (Germany). Abt. fuer Radiologie und Nuklearmedizin; Aleksic, M.; Ulrich, B. [Krankenhaus Gerresheim (Germany). Chirurgische Klinik

    1998-12-01

    Purpose: For preoperative staging of colorectal cancer a CT scan is frequently performed. This report examines the sensitivity of CT for regional lymph node metastasis of colorectal cancer using different criteria. Materials and methods: Preoperative CT scans of 153 patients with colorectal cancer were analyzed using different criteria for N1. The results were then compared to the postoperative histological findings. Results: For N1=lymph nodes (LN)>1 cm the sensitivity was 47%. For N1=LN>1 cm or an increased number of LN<1 cm the sensitivity was 71%. In patients with a primary tumor seen on CT, sensitivity rose to 87%. Discussion: Evidence of regional nodal metastatic disease is only relevant for rectal cancer, colon polyps, and for locally excised tumors when considering present surgical concepts for the treatment of colorectal cancer. In these cases CT analysis using the broadened criteria for N1 proposes a valuable argument regarding possible preoperative radiotherapy or an operative revision. (orig.) [Deutsch] Die Sensitivitaet fuer den Nachweis regionaerer Lymphknotenmetastasen kolorektaler Karzinome wurde unter Anwendung verschiedener Kriterien fuer das N1-Stadium an Patienten mit histologisch gesichertem Lymphknotenbefund untersucht. Fuer das Kriterium N1=Lymphknoten (LK)>1 cm betrug die Sensitivitaet 47%. Fuer N1=LK>1 cm/vermehrte Anzahl LK<1 cm war sie 71%, bei erkennbarem Primaertumor sogar 87%. Unter Beruecksichtigung der derzeit geltenden operativen Therapiekonzepte ist der Nachweis von regionaeren Lymphknotenmetastasen nur bei Rektumkarzinom bzw. fuer Kolonpolypen oder fuer lokal exzidierte Karzinome fuer das therapeutische Vorgehen relevant. In diesen Faellen leistet die CT mit den erweiterten Kriterien fuer ein N1-Stadium trotz hoeherer falsch-positiver Raten eine wertvolle Hilfestellung fuer die Entscheidung ueber eine neoadjuvante Bestrahlung oder eine Nachresektion. (orig.)

  20. Family conference in palliative care: concept analysis.

    Science.gov (United States)

    Silva, Rudval Souza da; Trindade, Géssica Sodré Sampaio; Paixão, Gilvânia Patrícia do Nascimento; Silva, Maria Júlia Paes da

    2018-01-01

    to analyze the attributes, antecedents and consequents of the family conference concept. Walker and Avante's method for concept analysis and the stages of the integrative review process, with a selection of publications in the PubMed, Cinahl and Lilacs databases focusing on the family conference theme in the context of palliative care. the most cited antecedents were the presence of doubts and the need to define a care plan. Family reunion and working instrument were evidenced as attributes. With respect to consequents, to promote the effective communication and to establish a plan of consensual action were the most remarkable elements. the scarcity of publications on the subject was observed, as well as and the limitation of the empirical studies to the space of intensive therapy. Thus, by analyzing the attributes, antecedents and consequents of the concept it was possible to follow their evolution and to show their efficacy and effectiveness as a therapeutic intervention.

  1. Usefulness of dynamic MR mammography for diagnosis of axillary lymph node status in breast cancer patient

    International Nuclear Information System (INIS)

    Enya, Mayumi; Goto, Hiroo; Nandate, Yuka; Kiryu, Takuji; Kanematsu, Masayuki; Hoshi, Hiroaki

    2000-01-01

    A retrospective study was performed to evaluate whether dynamic MR imaging is useful for the diagnosis of axillary lymph node metastases from breast cancer. Thirty-five patients with breast cancer were scanned and 147 lymph nodes were detected and compared with pathological nodal status. The parameters were the long axis dimension, the short axis dimension, the long-to-short axis (L/S) ratio, the shape, the contrast enhancement ratio (CER), the CER of lymph node-to-primary tumor (L/P) ratio. All parameters had significant differences between metastatic and normal nodes and there was a positive correlation between the CER of primary breast tumors and metastatic nodes. Multivariate analysis identified three parameters: the shape, the CER (1st phase), the L/P ratio (1st phase). ROC analysis revealed the shape and CER are superior in diagnostic performance to L/P ratio. If the shape and CER (1st phase) 60% and above are employed as criteria, the sensitivity, the specificity, the accuracy and the positive and negative predictive value were 86.0%, 78.4%, 81.0%, 67.2% and 91.6%, respectively. This method gives us useful information about the evaluation of axillary lymph node status preoperatively. (author)

  2. Investigation of virtual reality concept based on system analysis of conceptual series

    Science.gov (United States)

    Romanova, A.; Shuklin, D. A.; Kalinkina, M. E.; Gotskaya, I. B.; Ponomarev, Y. E.

    2018-05-01

    The paper covers approaches to the definition of virtual reality from the point of view of the humanitarian sciences and technology. Each approach analyzing problems of concept perception of methods interpreted by representatives of philosophy, psychology and sociology is singled out. Terminological analysis of the basic concepts is carried out and their refinement is constructed in the process of comparing the concepts of virtuality and virtual reality. Using the analysis of selected sources, a number of singularity characteristics of the given concept are singled out and its definition is specified. Results consist in combining the interpretation of all approaches to determine the concept of virtual reality. Due to the use of a comprehensive approach to the definition of the investigated concept, which allows us to consider the object of research as a set of elements that are subject to study with the help of a corresponding set of methods, one can conclude that the concept under study is complex and multifaceted. The authors noted that virtual reality technologies have a flexible concept depending on the field of application.

  3. Empowerment: a Concept Analysis

    OpenAIRE

    Febriana, Dara

    2011-01-01

    This paper conceptually analyzed the concept of empowerment using the strategies of Walker & Avant (2005) the objective is to clarify the meaning of the concept and to clearly identify empowerment characteristic that will provide consistent definition for practice and future research. Empowerment is defined and examined using relevant resources of literatures and selected empirical referents that described empowerment as a complex and multidimensional concept. Within nursing context empowerme...

  4. Lymph node yield during radical prostatectomy does not impact rate of biochemical recurrence in patients with seminal vesicle invasion and node-negative disease.

    Science.gov (United States)

    Badani, Ketan K; Reddy, Balaji N; Moskowitz, Eric J; Paulucci, David J; Beksac, Alp Tuna; Martini, Alberto; Whalen, Michael J; Skarecky, Douglas W; Huynh, Linda My; Ahlering, Thomas E

    2018-06-01

    Seminal vesicle invasion (SVI) is a risk factor for poor oncologic outcome in patients with prostate cancer. Modifications to the pelvic lymph node dissection (PLND) during radical prostatectomy (RP) have been reported to have a therapeutic benefit. The present study is the first to determine if lymph node yield (LNY) is associated with a lower risk of biochemical recurrence (BCR) for men with SVI. A total of 220 patients from 2 high-volume institutions who underwent RP without adjuvant treatment between 1990 and 2015 and had prostate cancer with SVI (i.e., pT3b) were identified, and 21 patients did not undergo lymph node dissection. BCR was defined as a postoperative PSA>0.2ng/mL, or use of salvage androgen deprivation therapy (ADT) or radiation. Multivariable Cox proportional hazards models were used to determine whether LNY was predictive of BCR, controlling for PSA, pathologic Gleason Score, pathologic lymph node status, NCCN risk category, etc. The Kaplan-Meier method was used to determine 3-year freedom from BCR. Median number of lymph nodes sampled were 7 (IQR: 3-12; range: 0-35) and 90.5% underwent PLND. The estimated 3-year BCR rate was 43.9%. Results from multivariable analysis demonstrated that LNY was not significantly associated with risk of BCR overall (HR = 1.00, 95% CI: 0.98-1.03; P = 0.848) for pN0 (HR = 0.99, 95% CI: 0.97-1.03; P = 0.916) or pN1 patients (HR = 0.96, 95% CI: 0.88-1.06; P = 0.468). Overall, PSA (HR = 1.02, P2 positive lymph nodes (OR = 1.27, 95% CI: 1.06-1.65, P = 0.023). Seminal vesicle invasion is associated with an increased risk of BCR at 3 years, primarily due to pathologic Gleason score and PSA. Although greater lymph node yield is diagnostic and facilitates more accurate pathologic staging, our data do not show a therapeutic benefit in reducing BCR. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Goldsmith, Benjamin; Baumann, Brian C.; He, Jiwei; Tucker, Kai; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David; Keefe, Stephen M. [Department of Medical Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas; Malkowicz, S. Bruce [Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-03-01

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, and external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy. Extended

  6. Energy-Aware Topology Evolution Model with Link and Node Deletion in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Xiaojuan Luo

    2012-01-01

    Full Text Available Based on the complex network theory, a new topological evolving model is proposed. In the evolution of the topology of sensor networks, the energy-aware mechanism is taken into account, and the phenomenon of change of the link and node in the network is discussed. Theoretical analysis and numerical simulation are conducted to explore the topology characteristics and network performance with different node energy distribution. We find that node energy distribution has the weak effect on the degree distribution P(k that evolves into the scale-free state, nodes with more energy carry more connections, and degree correlation is nontrivial disassortative. Moreover, the results show that, when nodes energy is more heterogeneous, the network is better clustered and enjoys higher performance in terms of the network efficiency and the average path length for transmitting data.

  7. Using pattern structures to support information retrieval with Formal Concept Analysis

    OpenAIRE

    Codocedo , Victor; Lykourentzou , Ioanna; Astudillo , Hernan; Napoli , Amedeo

    2013-01-01

    International audience; In this paper we introduce a novel approach to information retrieval (IR) based on Formal Concept Analysis (FCA). The use of concept lattices to support the task of document retrieval in IR has proven effective since they allow querying in the space of terms modelled by concept intents and navigation in the space of documents modelled by concept extents. However, current approaches use binary representations to illustrate the relations between documents and terms (''do...

  8. Contrast-Enhanced MR Imaging of Lymph Nodes in Cancer Patients

    International Nuclear Information System (INIS)

    Choi, Seung Hong; Moon, Woo Kyung

    2010-01-01

    The accurate identification and characterization of lymph nodes by modern imaging modalities has important therapeutic and prognostic significance for patients with newly diagnosed cancers. The presence of nodal metastases limits the therapeutic options, and it generally indicates a worse prognosis for the patients with nodal metastases. Yet anatomic imaging (CT and MR imaging) is of limited value for depicting small metastatic deposits in normal-sized nodes, and nodal size is a poor criterion when there is no extracapsular extension or focal nodal necrosis to rely on for diagnosing nodal metastases. Thus, there is a need for functional methods that can be reliably used to identify small metastases. Contrast-enhanced MR imaging of lymph nodes is a non-invasive method for the analysis of the lymphatic system after the interstitial or intravenous administration of contrast media. Moreover, some lymphotrophic contrast media have been developed and used for detecting lymph node metastases, and this detection is independent of the nodal size. This article will review the basic principles, the imaging protocols, the interpretation and the accuracies of contrast-enhanced MR imaging of lymph nodes in patients with malignancies, and we also focus on the recent issues cited in the literature. In addition, we discuss the results of several pre-clinical studies and animal studies that were conducted in our institution

  9. Temporal-varying failures of nodes in networks

    Science.gov (United States)

    Knight, Georgie; Cristadoro, Giampaolo; Altmann, Eduardo G.

    2015-08-01

    We consider networks in which random walkers are removed because of the failure of specific nodes. We interpret the rate of loss as a measure of the importance of nodes, a notion we denote as failure centrality. We show that the degree of the node is not sufficient to determine this measure and that, in a first approximation, the shortest loops through the node have to be taken into account. We propose approximations of the failure centrality which are valid for temporal-varying failures, and we dwell on the possibility of externally changing the relative importance of nodes in a given network by exploiting the interference between the loops of a node and the cycles of the temporal pattern of failures. In the limit of long failure cycles we show analytically that the escape in a node is larger than the one estimated from a stochastic failure with the same failure probability. We test our general formalism in two real-world networks (air-transportation and e-mail users) and show how communities lead to deviations from predictions for failures in hubs.

  10. Center of attention: A network text analysis of American Sniper

    Directory of Open Access Journals (Sweden)

    Starling Hunter

    2016-06-01

    Full Text Available Network Text Analysis (NTA is a term used to describe a variety of software - supported methods for modeling texts as networks of concepts. In this study we apply NTA to the screenplay of American Sniper, an Academy Award nominee for Best Adapted Screenplay in 2014. Specifically, we est ablish prior expectations as to the key themes associated with war films. We then empirically test whether words associated with the most influentially - positioned nodes in the network signify themes common to the war - film genre. As predicted, we find tha t words and concepts associated with the least constrained nodes in the text network were significantly more likely to be associated with the war genre and significantly less likely to be associated with genres to which the film did not belong.

  11. Technological evolution of axillary lymph nodes: Radiological visualisation in breast cancer patients

    International Nuclear Information System (INIS)

    Eglitis, J.; Krumins, V.; Stengrevics, A.; Berzins, A.; Vevere, I.; Storozenko, G.

    2004-01-01

    Full text: In patients with breast cancer, detection of axillary lymph node spread has a great prognostic significance. Visualisation of lymphatic glands is attracting attention of radiologists since long. Lymphogram usually shows 4-9 lymph glands as compared to 8 to 50 identified during surgical intervention. Lymphography is a laborious and complicated process requiring specific skills. Likewise, the evaluation and interpretation of results depends upon the experience of the specialist. We evaluated 234 breast cancer patients and found that lymphograms of these patients initially detected 1-2 central axillary lymph nodes followed by others. During surgical intervention, the total number of lymphatic glands removed from these patients was 3,241 of which only 2,693 (83.1%) were seen on lymphography. On further evaluation it was found that the largest groups of lymphatic nodes were seen in the following pattern (i) central axillary (ii) subclavicular (iii) lateral, with central axillary lymph nodes being the biggest (1.5 - 2 cm) and subclavicular the smallest (0.2 - 0.5 cm). Sternal lymph nodes receive lymph from medial quadrants of the breast and / or if the axillary lymph nodes are obstructed by metastases. The results of lymphography and post-operative examination matched in 71.7-75 % of cases. False positivity was seen in 19.2 % and false negative 9.1 % instances. As this method was not sufficiently selective and specific, its relative upsurge receded backwards and was forgotten. The last decade of the twentieth century saw a sentinel node (SN) concept. In advanced countries, the possibility to detect breast cancer of up to 1 cm diameter corresponding to T1A category, when the axillary lymph nodes still are not involved in malignant growth, accounts about 50%. Hence the search of lymphatic spread vis-a-vis sentinel node detection has gained more importance. Earlier, SN detection involved colour contrast methods, which was reasonably sensitive and specific in

  12. Development of Smart Sensors System Based on Formal Concept Analysis and Ontology Model

    Directory of Open Access Journals (Sweden)

    Hongsheng Xu

    2013-06-01

    Full Text Available The smart sensor is the product of the combination of one or more sensitive components, precision analog circuits, digital circuits, microprocessor, communication interface, intelligent software systems and hardware integration in a packaging component. Formal concept analysis is from the given data to automatically extract the classification relationship between the entire hidden concept and concept, formation of concept model. Ontology is a set of relations between concepts of the specific domain and concept, and it can effectively express the general knowledge of specific field. The paper proposes development of smart sensors system based on formal concept analysis and ontology model. Smart sensor is a micro processor, sensor with information detection, information processing, information memory, logical thinking and judging function. The methods can improve the effect of the smart sensors.

  13. The hidden sentinel node in breast cancer

    NARCIS (Netherlands)

    Tanis, P. J.; van Sandick, J. W.; Nieweg, O. E.; Valdés Olmos, R. A.; Rutgers, E. J. T.; Hoefnagel, C. A.; Kroon, B. B. R.

    2002-01-01

    The purpose of this study was to analyse the occurrence of non-visualisation during preoperative lymphoscintigraphy for sentinel node identification in breast cancer. Preoperative lymphoscintigraphy was performed in 495 clinically node-negative breast cancer patients (501 sentinel node procedures)

  14. Initial experiences in the photoacoustic detection of melanoma metastases in resected lymph nodes

    Science.gov (United States)

    Grootendorst, D.; Jose, J.; Van der Jagt, P.; Van der Weg, W.; Nagel, K.; Wouters, M.; Van Boven, H.; Van Leeuwen, T. G.; Steenbergen, W.; Ruers, T.; Manohar, S.

    2011-03-01

    Accurate lymph node analysis is essential to determine the prognosis and treatment of patients suffering from melanoma. The initial results of a tomographic photoacoustic modality to detect melanoma metastases in resected lymph nodes are presented based on phantom models and a human lymph node. The results show melanoma metastases detection is feasible and the setup is capable of distinguishing absorbing structures down to 1 mm. In addition, the use of longer laser wavelengths could result in an image containing a higher contrast ratio. Future research shall be focused on using the melanin characteristics to improve contrast and detection possibilities.

  15. Lymphoscintigraphic diagnosis of the lymph node metastasis of esophageal cancer

    International Nuclear Information System (INIS)

    Terui, Shoji; Kawai, Hideo; Hirashima, Toshio; Yamaguchi, Hajime; Kato, Hoichi; Iizuka, Norifumi

    1985-01-01

    Lymphoscintigraphy with 99m Tc-labeled rhenium sulfur colloid was performed preoperatively in 30 patients with esopohageal cancer. It showed hot nodes in a total of 267 lymph nodes, 176 mediastinal nodes and 91 celiac artery nodes. Of these 267 nodes, 47 (18 %) were found to have metastasis, including 34 (19 %) mediastinal nodes and 13 (14 %) celiac artery nodes. On the other hand, the number of non-visualized lymph nodes (cold nodes) was 542. Of them, 78 (14 %) had metastasis; 46 (15 %) were mediastinal nodes and 32 (14 %) were celiac artery nodes. (Namekawa, K.)

  16. Health promotion for people with intellectual disabilities - A concept analysis.

    Science.gov (United States)

    Roll, Anne E

    2018-03-01

    Whereas 'health promotion' is a well-known concept for healthcare professionals, the concept of 'health promotion for people with intellectual disabilities' and its unique associated challenges are not well understood. This article provides a systematic analysis of how health promotion is being conceptualised for people with intellectual disabilities and how health promotion can work best in the light of this group's specific needs and limitations. Rodgers' evolutionary concept analysis. MEDLINE, PsycINFO, CINAHL and SocINDEX were searched using the search terms 'health promotion', 'people with intellectual disabilities' and 'developmental disabilities'. This review includes studies published between 1992 and 2014. A total of 52 articles were included. Health promotion for people intellectual disabilities, as discussed in the literature, focuses on four aspects, namely supporting a healthy lifestyle, providing health education, involving supporters and being person-centred. Antecedents of the concept 'health promotion for people with intellectual disabilities' were healthcare access and sensitised healthcare providers. The outcomes were improved health, being empowered, enhanced quality of life and reduced health disparities. This analysis provides a solid foundation for healthcare stakeholders' planning, implementing and evaluating health-promotion activities for people with intellectual disabilities at the policy level and in the community. © 2017 Nordic College of Caring Science.

  17. Managerial competence of first-line nurse managers: A concept analysis.

    Science.gov (United States)

    Gunawan, Joko; Aungsuroch, Yupin

    2017-02-01

    A variety of terms are used interchangeably to define managerial competence of first-line nurse managers. This has resulted in a degree of ambiguity in the way managerial competence is described. The aim of this concept analysis is to clarify what is meant by managerial competence of first-line nurse managers internationally, what attributes signify it, and what its antecedents and consequences are. The Walker and Avant concept analysis approach was applied. The attributes of managerial competence include developing self, planning, organizing, leading, managing legal and ethical issues, and delivering health care. Antecedents to managerial competence include internal and external factors. Consequences include nurse performances, nurse and patient outcomes, intention to stay of nurses, and nurse and patient satisfaction. This analysis helps first-line nurse managers to understand the concept and determine where the responsibility lies in establishing a definition of managerial competence. It is recommended that middle and top managers should be aware of the internal and external factors as antecedents of the concept. Further research is needed to illuminate the attributes of managerial competence in relation to antecedents and the potential effect upon the consequences, and the need to establish managerial competence evaluation. © 2017 John Wiley & Sons Australia, Ltd.

  18. A Bayesian Analysis of the Flood Frequency Hydrology Concept

    Science.gov (United States)

    2016-02-01

    ERDC/CHL CHETN-X-1 February 2016 Approved for public release; distribution is unlimited. A Bayesian Analysis of the Flood Frequency Hydrology ...flood frequency hydrology concept as a formal probabilistic-based means by which to coherently combine and also evaluate the worth of different types...and development. INTRODUCTION: Merz and Blöschl (2008a,b) proposed the concept of flood frequency hydrology , which emphasizes the importance of

  19. Lymphatic drainage and sentinel node location in breast cancer

    International Nuclear Information System (INIS)

    Uren, R.F.; Howman-Giles, R.B.; Roberts, J.; Renwick, S.; Gillett, D.; Neische, F.; Ramsay-Stewart, G.

    1999-01-01

    Full text: Mammary lymphoscintigraphy using small volume (0.1-0.2 ml) peritumoral injections of 99 Tc m -antimony sulphide colloid provided a map of the lymph drainage of a breast cancer to its draining sentinel lymph nodes in 92 of 102 patients (over 90%). Non-migration of tracer is reduced by post-injection massage for 5 min but may occur especially if the lymphatics are blocked by metastases. Drainage included the axilla in 92%, internal mammary nodes in 43%, supraclavicular nodes in 12% and intramammary interval nodes in 10% of patients. One patient drained to an interpectoral node. Drainage across the centre-line of the breast occurred in 46% of patients but direct drainage to the contralateral side of the patient was not seen. Lymphatic drainage occurred to 1 node field in 52 patients, 2 node fields in 34 patients and 3 node fields in 6 patients, so that 43% of patients had multiple draining node fields. Drainage to non-axillary sites occurred in 51% of patients. In conclusion, mammary lymphoscintigraphy accurately maps sentinel node location in breast cancer. Approximately half of the patients will have sentinel nodes outside the axilla. To achieve complete lymph node staging in patients with breast cancer, it is logical to biopsy these non-axillary sentinel nodes as well as the sentinel nodes in the axilla. Failure to do so will potentially understage the node status in 50% of patients

  20. Fault tree analysis: concepts and techniques

    International Nuclear Information System (INIS)

    Fussell, J.B.

    1976-01-01

    Concepts and techniques of fault tree analysis have been developed over the past decade and now predictions from this type analysis are important considerations in the design of many systems such as aircraft, ships and their electronic systems, missiles, and nuclear reactor systems. Routine, hardware-oriented fault tree construction can be automated; however, considerable effort is needed in this area to get the methodology into production status. When this status is achieved, the entire analysis of hardware systems will be automated except for the system definition step. Automated analysis is not undesirable; to the contrary, when verified on adequately complex systems, automated analysis could well become a routine analysis. It could also provide an excellent start for a more in-depth fault tree analysis that includes environmental effects, common mode failure, and human errors. The automated analysis is extremely fast and frees the analyst from the routine hardware-oriented fault tree construction, as well as eliminates logic errors and errors of oversight in this part of the analysis. Automated analysis then affords the analyst a powerful tool to allow his prime efforts to be devoted to unearthing more subtle aspects of the modes of failure of the system

  1. Extra-nodal extension is a significant prognostic factor in lymph node positive breast cancer.

    Directory of Open Access Journals (Sweden)

    Sura Aziz

    Full Text Available Presence of lymph node (LN metastasis is a strong prognostic factor in breast cancer, whereas the importance of extra-nodal extension and other nodal tumor features have not yet been fully recognized. Here, we examined microscopic features of lymph node metastases and their prognostic value in a population-based cohort of node positive breast cancer (n = 218, as part of the prospective Norwegian Breast Cancer Screening Program NBCSP (1996-2009. Sections were reviewed for the largest metastatic tumor diameter (TD-MET, nodal afferent and efferent vascular invasion (AVI and EVI, extra-nodal extension (ENE, number of ENE foci, as well as circumferential (CD-ENE and perpendicular (PD-ENE diameter of extra-nodal growth. Number of positive lymph nodes, EVI, and PD-ENE were significantly increased with larger primary tumor (PT diameter. Univariate survival analysis showed that several features of nodal metastases were associated with disease-free (DFS or breast cancer specific survival (BCSS. Multivariate analysis demonstrated an independent prognostic value of PD-ENE (with 3 mm as cut-off value in predicting DFS and BCSS, along with number of positive nodes and histologic grade of the primary tumor (for DFS: P = 0.01, P = 0.02, P = 0.01, respectively; for BCSS: P = 0.02, P = 0.008, P = 0.02, respectively. To conclude, the extent of ENE by its perpendicular diameter was independently prognostic and should be considered in line with nodal tumor burden in treatment decisions of node positive breast cancer.

  2. Enhancement characteristics of retroperitoneal lymphomatous lymph nodes

    International Nuclear Information System (INIS)

    Hagtvedt, Trond; Smith, Hans-Joergen; Kolbenstvedt, Alf; Aaloekken, Trond Mogens; Graff, Bjoern Anton; Holte, Harald

    2013-01-01

    Background: Previous studies of CT enhancement of lymphomatous lymph nodes (LLN) of the neck and the mediastinum showed that the LLN had lower enhancement values than normal lymph nodes. Purpose: To elucidate the contrast medium enhancement curves of LLN in the retroperitoneum by comparing the curves of LLN with those of normal lymph nodes, to test whether differences between these curves could be of diagnostic value, and to compare the present enhancement curves of LLN of the retroperitoneum with the curves of LLN of the neck and the mediastinum from previous similar investigations. Material and Methods: Twenty-eight consecutive patients with LLN of the retroperitoneum (three with Hodgkin's lymphoma [HL]) and 21 control patients with sarcomas and thus presumably normal retroperitoneal nodes underwent dynamic CT examinations. The previous, similar investigation of lymph nodes of the neck comprised 28 patients with LLN and the investigation of mediastinal lymph nodes comprised 24 patients with LLN. Results: The enhancement curves of the retroperitoneal LLN had significantly lower attenuation than those of the retroperitoneal control nodes. A combination of peak contrast value and time to peak adjusted to total body weight yielded a diagnostic accuracy which at the best showed a sensitivity of 90.5% with a specificity of 82.6%. The LLN of the retroperitoneum had higher attenuation values than corresponding nodes of the mediastinum but no significant difference was found between LLN of the retroperitoneum and LLN of the neck in previous similar investigations. Conclusion: The comparison of enhancement curves of retroperitoneal LLN with retroperitoneal control nodes showed a marked similarity with and substantiates our previous findings in lymph nodes of the neck and of the mediastinum. The best diagnostic accuracy was achieved by combining the parameters peak contrast value and time to peak and adjusting these values to the body weight. Peak enhancement of the

  3. Comparison of intraoperative frozen section analysis for sentinel lymph node biopsy during breast cancer surgery for invasive lobular carcinoma and invasive ductal carcinoma

    Directory of Open Access Journals (Sweden)

    Povoski Stephen P

    2009-03-01

    Full Text Available Abstract Background Sentinel lymph node (SLN biopsy is the standard of care for the surgical assessment of the axilla during breast cancer surgery. However, the diagnostic accuracy of intraoperative frozen section analysis for confirming metastatic involvement of SLNs in cases of invasive lobular carcinoma (ILC versus that of invasive ductal carcinoma (IDC has generated controversy secondary to a frequently low-grade cytologic appearance and an often discohesive pattern displayed by metastatic lymph nodes in ILC. In the current report, we present a comparison of intraoperative frozen section analysis for confirming the presence of metastatic disease within SLNs during breast cancer surgery for ILC and IDC. Methods We evaluated the results of 131 consecutive cases of ILC from 1997 to 2008 and 133 cases of IDC (selected by a random sequence generator program from amongst 1163 consecutive cases of IDC from the same time period. All cases had at least one SLN that had both intraoperative frozen section analysis and confirmatory permanent section analysis performed. Results No statistically significant difference was found in the sensitivity (67% vs. 75%, P = 0.385, specificity (100% vs. 100%, accuracy (86% vs. 92%, P = 0.172, false negative rate (33% vs. 25%, P = 0.385, negative predictive value (81% vs. 89%, P = 0.158, and positive predictive value (100% vs. 100% for frozen section analysis for confirming the presence of metastatic disease within SLNs during breast cancer surgery for ILC and IDC. Conclusion Since there was no statistically significant difference in sensitivity, specificity, accuracy, false negative rate, negative predictive value, and positive predictive value between frozen section analysis of SLNs for patients with ILC and IDC, the clinical accuracy of confirming metastatic involvement of SLNs on frozen section analysis for ILC should not be considered inferior to the clinical accuracy for IDC. Therefore, frozen section analysis

  4. Principle-based concept analysis: Caring in nursing education.

    Science.gov (United States)

    Salehian, Maryam; Heydari, Abbas; Aghebati, Nahid; Karimi Moonaghi, Hossein; Mazloom, Seyed Reza

    2016-03-01

    The aim of this principle-based concept analysis was to analyze caring in nursing education and to explain the current state of the science based on epistemologic, pragmatic, linguistic, and logical philosophical principles. A principle-based concept analysis method was used to analyze the nursing literature. The dataset included 46 English language studies, published from 2005 to 2014, and they were retrieved through PROQUEST, MEDLINE, CINAHL, ERIC, SCOPUS, and SID scientific databases. The key dimensions of the data were collected using a validated data-extraction sheet. The four principles of assessing pragmatic utility were used to analyze the data. The data were managed by using MAXQDA 10 software. The scientific literature that deals with caring in nursing education relies on implied meaning. Caring in nursing education refers to student-teacher interactions that are formed on the basis of human values and focused on the unique needs of the students (epistemological principle). The result of student-teacher interactions is the development of both the students and the teachers. Numerous applications of the concept of caring in nursing education are available in the literature (pragmatic principle). There is consistency in the meaning of the concept, as a central value of the faculty-student interaction (linguistic principle). Compared with other related concepts, such as "caring pedagogy," "value-based education," and "teaching excellence," caring in nursing education does not have exact and clear conceptual boundaries (logic principle). Caring in nursing education was identified as an approach to teaching and learning, and it is formed based on teacher-student interactions and sustainable human values. A greater understanding of the conceptual basis of caring in nursing education will improve the caring behaviors of teachers, create teaching-learning environments, and help experts in curriculum development.

  5. Virtual learning object and environment: a concept analysis.

    Science.gov (United States)

    Salvador, Pétala Tuani Candido de Oliveira; Bezerril, Manacés Dos Santos; Mariz, Camila Maria Santos; Fernandes, Maria Isabel Domingues; Martins, José Carlos Amado; Santos, Viviane Euzébia Pereira

    2017-01-01

    To analyze the concept of virtual learning object and environment according to Rodgers' evolutionary perspective. Descriptive study with a mixed approach, based on the stages proposed by Rodgers in his concept analysis method. Data collection occurred in August 2015 with the search of dissertations and theses in the Bank of Theses of the Coordination for the Improvement of Higher Education Personnel. Quantitative data were analyzed based on simple descriptive statistics and the concepts through lexicographic analysis with support of the IRAMUTEQ software. The sample was made up of 161 studies. The concept of "virtual learning environment" was presented in 99 (61.5%) studies, whereas the concept of "virtual learning object" was presented in only 15 (9.3%) studies. A virtual learning environment includes several and different types of virtual learning objects in a common pedagogical context. Analisar o conceito de objeto e de ambiente virtual de aprendizagem na perspectiva evolucionária de Rodgers. Estudo descritivo, de abordagem mista, realizado a partir das etapas propostas por Rodgers em seu modelo de análise conceitual. A coleta de dados ocorreu em agosto de 2015 com a busca de dissertações e teses no Banco de Teses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Os dados quantitativos foram analisados a partir de estatística descritiva simples e os conceitos pela análise lexicográfica com suporte do IRAMUTEQ. A amostra é constituída de 161 estudos. O conceito de "ambiente virtual de aprendizagem" foi apresentado em 99 (61,5%) estudos, enquanto o de "objeto virtual de aprendizagem" em apenas 15 (9,3%). Concluiu-se que um ambiente virtual de aprendizagem reúne vários e diferentes tipos de objetos virtuais de aprendizagem em um contexto pedagógico comum.

  6. Link Prediction in Evolving Networks Based on Popularity of Nodes.

    Science.gov (United States)

    Wang, Tong; He, Xing-Sheng; Zhou, Ming-Yang; Fu, Zhong-Qian

    2017-08-02

    Link prediction aims to uncover the underlying relationship behind networks, which could be utilized to predict missing edges or identify the spurious edges. The key issue of link prediction is to estimate the likelihood of potential links in networks. Most classical static-structure based methods ignore the temporal aspects of networks, limited by the time-varying features, such approaches perform poorly in evolving networks. In this paper, we propose a hypothesis that the ability of each node to attract links depends not only on its structural importance, but also on its current popularity (activeness), since active nodes have much more probability to attract future links. Then a novel approach named popularity based structural perturbation method (PBSPM) and its fast algorithm are proposed to characterize the likelihood of an edge from both existing connectivity structure and current popularity of its two endpoints. Experiments on six evolving networks show that the proposed methods outperform state-of-the-art methods in accuracy and robustness. Besides, visual results and statistical analysis reveal that the proposed methods are inclined to predict future edges between active nodes, rather than edges between inactive nodes.

  7. Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Takuro; Kurokawa, Yukinori; Takiguchi, Shuji; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Yamasaki, Makoto; Miyata, Hiroshi; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro [Osaka University, Graduate School of Medicine, Department of Gastroenterological Surgery, Suita, Osaka (Japan)

    2014-08-06

    The purpose of this study was to determine the optimal cut-off value of lymph node size for diagnosing metastasis in gastric cancer with multidetector-row computed tomography (MDCT) after categorizing perigastric lymph nodes into three regions. The study included 90 gastric cancer patients who underwent gastrectomy. The long-axis diameter (LAD) and short-axis diameter (SAD) of all visualized lymph nodes were measured with transverse MDCT images. The locations of lymph nodes were categorized into three regions: lesser curvature, greater curvature, and suprapancreatic. The diagnostic value of lymph node metastasis was assessed with receiver operating characteristic (ROC) analysis. The area under the curve was larger for SAD than LAD in all groups. The optimal cut-off values of SAD were determined as follows: overall, 9 mm; differentiated type, 9 mm; undifferentiated type, 8 mm; lesser curvature region, 7 mm; greater curvature region, 6 mm; and suprapancreatic region, 9 mm. The diagnostic accuracies for lymph node metastasis using individual cut-off values were 71.1 % based on histological type and 76.6 % based on region of lymph node location. The diagnostic accuracy of lymph node metastasis in gastric cancer was improved by using individual cut-off values for each lymph node region. (orig.)

  8. Unraveling the meaning of patient engagement: A concept analysis.

    Science.gov (United States)

    Higgins, Tracy; Larson, Elaine; Schnall, Rebecca

    2017-01-01

    Patient engagement has been credited with contributing to improved outcomes and experiences of care. Patient engagement has become a widely used term, but remains a poorly understood concept in healthcare. Citations for the term have increased throughout the healthcare-related disciplines without a common definition. This study seeks to define the concept by identifying its attributes in the context of its use. A concept analysis of the scientific literature in the health disciplines was performed using the Rogers method. The analysis revealed four defining attributes of patient engagement: personalization, access, commitment and therapeutic alliance. Patient engagement is defined as the desire and capability to actively choose to participate in care in a way uniquely appropriate to the individual, in cooperation with a healthcare provider or institution, for the purposes of maximizing outcomes or improving experiences of care. Patient engagement is both process and behavior and is shaped by the relationship between the patient and provider and the environment in which healthcare delivery takes place. The definition and the identified attributes serve as a heuristic in designing patient engagement strategies and as a basis for future development of the patient engagement concept in healthcare. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Principle-based concept analysis: intentionality in holistic nursing theories.

    Science.gov (United States)

    Aghebati, Nahid; Mohammadi, Eesa; Ahmadi, Fazlollah; Noaparast, Khosrow Bagheri

    2015-03-01

    This is a report of a principle-based concept analysis of intentionality in holistic nursing theories. A principle-based concept analysis method was used to analyze seven holistic theories. The data included eight books and 31 articles (1998-2011), which were retrieved through MEDLINE and CINAHL. Erickson, Kriger, Parse, Watson, and Zahourek define intentionality as a capacity, a focused consciousness, and a pattern of human being. Rogers and Newman do not explicitly mention intentionality; however, they do explain pattern and consciousness (epistemology). Intentionality has been operationalized as a core concept of nurse-client relationships (pragmatic). The theories are consistent on intentionality as a noun and as an attribute of the person-intentionality is different from intent and intention (linguistic). There is ambiguity concerning the boundaries between intentionality and consciousness (logic). Theoretically, intentionality is an evolutionary capacity to integrate human awareness and experience. Because intentionality is an individualized concept, we introduced it as "a matrix of continuous known changes" that emerges in two forms: as a capacity of human being and as a capacity of transpersonal caring. This study has produced a theoretical definition of intentionality and provides a foundation for future research to further investigate intentionality to better delineate its boundaries. © The Author(s) 2014.

  10. Using Formal Concept Analysis to Create Pathways through Museum Collections

    DEFF Research Database (Denmark)

    Wray, Tim; Eklund, Peter

    2014-01-01

    This paper presents A Place for Art - an iPad app that allows users to explore an art collection via semantically linked pathways that are generated using Formal Concept Analysis. The app embraces the information seeking approach of exploration and is based on the idea that showing context...... and relationships among objects in a museum collection augments an interpretive experience. The fundamental interaction metaphor inherent in A Place for Art relies on Formal Concept Analysis so the interface has embedded within it the semantic clustering features of machine learning in artificial intelligence....

  11. Theoretical concepts of X-ray nanoscale analysis theory and applications

    CERN Document Server

    Benediktovitch, Andrei; Ulyanenkov, Alexander

    2013-01-01

    This book provides a concise survey of modern theoretical concepts of X-ray materials analysis. The principle features of the book are: basics of X-ray scattering, interaction between X-rays and matter and new theoretical concepts of X-ray scattering. The various X-ray techniques are considered in detail: high-resolution X-ray diffraction, X-ray reflectivity, grazing-incidence small-angle X-ray scattering and X-ray residual stress analysis. All the theoretical methods presented use the unified physical approach. This makes the book especially useful for readers learning and performing data ana

  12. Empowerment in critical care - a concept analysis.

    Science.gov (United States)

    Wåhlin, Ingrid

    2017-03-01

    The purpose of this paper was to analyse how the concept of empowerment is defined in the scientific literature in relation to critical care. As empowerment is a mutual process affecting all individuals involved, the perspectives of not only patients and next of kin but also staff were sought. A literature review and a concept analysis based on Walker and Avant's analysis procedure were used to identify the basic elements of empowerment in critical care. Twenty-two articles with a focus on critical care were discovered and included in the investigation. A mutual and supportive relationship, knowledge, skills, power within oneself and self-determination were found to be the common attributes of empowerment in critical care. The results could be adapted and used for all parties involved in critical care - whether patients, next of kin or staff - as these defining attributes are assumed to be universal to all three groups, even if the more specific content of each attribute varies between groups and individuals. Even if empowerment is only sparsely used in relation to critical care, it appears to be a very useful concept in this context. The benefits of improving empowerment are extensive: decreased levels of distress and strain, increased sense of coherence and control over situation, and personal and/or professional development and growth, together with increased comfort and inner satisfaction. © 2016 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College.

  13. Traffic Management by Using Admission Control Methods in Multiple Node IMS Network

    Directory of Open Access Journals (Sweden)

    Filip Chamraz

    2016-01-01

    Full Text Available The paper deals with Admission Control methods (AC as a possible solution for traffic management in IMS networks (IP Multimedia Subsystem - from the point of view of an efficient redistribution of the available network resources and keeping the parameters of Quality of Service (QoS. The paper specifically aims at the selection of the most appropriate method for the specific type of traffic and traffic management concept using AC methods on multiple nodes. The potential benefit and disadvantage of the used solution is evaluated.

  14. Ratios of involved nodes in early breast cancer

    International Nuclear Information System (INIS)

    Vinh-Hung, Vincent; Royce, Melanie; Verschraegen, Claire; Promish, Donald I; Cserni, Gábor; Van de Steene, Jan; Tai, Patricia; Vlastos, Georges; Voordeckers, Mia; Storme, Guy

    2004-01-01

    The number of lymph nodes found to be involved in an axillary dissection is among the most powerful prognostic factors in breast cancer, but it is confounded by the number of lymph nodes that have been examined. We investigate an idea that has surfaced recently in the literature (since 1999), namely that the proportion of node-positive lymph nodes (or a function thereof) is a much better predictor of survival than the number of excised and node-positive lymph nodes, alone or together. The data were abstracted from 83,686 cases registered in the Surveillance, Epidemiology, and End Results (SEER) program of women diagnosed with nonmetastatic T1–T2 primary breast carcinoma between 1988 and 1997, in whom axillary node dissection was performed. The end-point was death from breast cancer. Cox models based on different expressions of nodal involvement were compared using the Nagelkerke R 2 index (R 2 N ). Ratios were modeled as percentage and as log odds of involved nodes. Log odds were estimated in a way that avoids singularities (zero values) by using the empirical logistic transform. In node-negative cases both the number of nodes excised and the log odds were significant, with hazard ratios of 0.991 (95% confidence interval 0.986–0.997) and 1.150 (1.058–1.249), respectively, but without improving R 2 N . In node-positive cases the hazard ratios were 1.003–1.088 for the number of involved nodes, 0.966–1.005 for the number of excised nodes, 1.015–1.017 for the percentage, and 1.344–1.381 for the log odds. R 2 N improved from 0.067 (no nodal covariate) to 0.102 (models based on counts only) and to 0.108 (models based on ratios). Ratios are simple optimal predictors, in that they provide at least the same prognostic value as the more traditional staging based on counting of involved nodes, without replacing them with a needlessly complicated alternative. They can be viewed as a per patient standardization in which the number of involved nodes is standardized

  15. Node-node correlations and transport properties in scale-free networks

    Science.gov (United States)

    Obregon, Bibiana; Guzman, Lev

    2011-03-01

    We study some transport properties of complex networks. We focus our attention on transport properties of scale-free and small-world networks and compare two types of transport: Electric and max-flow cases. In particular, we construct scale-free networks, with a given degree sequence, to estimate the distribution of conductances for different values of assortative/dissortative mixing. For the electric case we find that the distributions of conductances are affect ed by the assortative mixing of the network whereas for the max-flow case, the distributions almost do not show changes when node-node correlations are altered. Finally, we compare local and global transport in terms of the average conductance for the small-world (Watts-Strogatz) model

  16. Near-infrared-fluorescence imaging of lymph nodes by using liposomally formulated indocyanine green derivatives.

    Science.gov (United States)

    Toyota, Taro; Fujito, Hiromichi; Suganami, Akiko; Ouchi, Tomoki; Ooishi, Aki; Aoki, Akira; Onoue, Kazutaka; Muraki, Yutaka; Madono, Tomoyuki; Fujinami, Masanori; Tamura, Yutaka; Hayashi, Hideki

    2014-01-15

    Liposomally formulated indocyanine green (LP-ICG) has drawn much attention as a highly sensitive near-infrared (NIR)-fluorescence probe for tumors or lymph nodes in vivo. We synthesized ICG derivatives tagged with alkyl chains (ICG-Cn), and we examined NIR-fluorescence imaging for lymph nodes in the lower extremities of mice by using liposomally formulated ICG-Cn (LP-ICG-Cn) as well as conventional liposomally formulated ICG (LP-ICG) and ICG. Analysis with a noninvasive preclinical NIR-fluorescence imaging system revealed that LP-ICG-Cn accumulates in only the popliteal lymph node 1h after injection into the footpad, whereas LP-ICG and ICG accumulate in the popliteal lymph node and other organs like the liver. This result indicates that LP-ICG-Cn is a useful NIR-fluorescence probe for noninvasive in vivo bioimaging, especially for the sentinel lymph node. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. International multicenter tool to predict the risk of nonsentinel node metastases in breast cancer

    DEFF Research Database (Denmark)

    Meretoja, Tuomo J; Leidenius, Marjut H K; Heikkilä, Päivi S

    2012-01-01

    predicting nonsentinel node involvement were identified in logistic regression analysis. A multivariable predictive model was developed and validated by area under the receiver operating characteristics curve (AUC), first internally in 500 additional patients and then externally in 1068 patients from other...... centers. All statistical tests were two-sided. Results Nine tumor- and sentinel node-specific variables were identified as statistically significant factors predicting nonsentinel node involvement in logistic regression analysis. A resulting predictive model applied to the internal validation series...... resulted in an AUC of 0.714 (95% confidence interval [CI] = 0.665 to 0.763). For the external validation series, the AUC was 0.719 (95% CI = 0.689 to 0.750). The model was well calibrated in the external validation series. Conclusions We present a novel, international, multicenter, predictive tool...

  18. A Concept Analysis of Fully Informed: Breastfeeding Promotion

    Science.gov (United States)

    2005-12-21

    updated breastfeeding policy statement, the American Academy of Pediatrics 3 ( AAP , 2005) identified the compelling advantages of breastfeeding and urged...healthcare 4 professionals to implement principles to promote breastfeeding . The AAP cited obstacles 5 to the initiation and continuation of...Analysis of Fully Informed 2 14 A Concept Analysis of Fully Informed: Breastfeeding Promotion 15 In February 2005, the American Academy of Pediatrics ( AAP

  19. A bio-inspired methodology of identifying influential nodes in complex networks.

    Directory of Open Access Journals (Sweden)

    Cai Gao

    Full Text Available How to identify influential nodes is a key issue in complex networks. The degree centrality is simple, but is incapable to reflect the global characteristics of networks. Betweenness centrality and closeness centrality do not consider the location of nodes in the networks, and semi-local centrality, leaderRank and pageRank approaches can be only applied in unweighted networks. In this paper, a bio-inspired centrality measure model is proposed, which combines the Physarum centrality with the K-shell index obtained by K-shell decomposition analysis, to identify influential nodes in weighted networks. Then, we use the Susceptible-Infected (SI model to evaluate the performance. Examples and applications are given to demonstrate the adaptivity and efficiency of the proposed method. In addition, the results are compared with existing methods.

  20. Selecting Attributes for Sport Forecasting using Formal Concept Analysis

    OpenAIRE

    Aranda-Corral, Gonzalo A.; Borrego-Díaz, Joaquín; Galán-Páez, Juan

    2011-01-01

    In order to address complex systems, apply pattern recongnition on their evolution could play an key role to understand their dynamics. Global patterns are required to detect emergent concepts and trends, some of them with qualitative nature. Formal Concept Analysis (FCA) is a theory whose goal is to discover and to extract Knowledge from qualitative data. It provides tools for reasoning with implication basis (and association rules). Implications and association rules are usefull to reasonin...

  1. Semantic Indexing and Retrieval based on Formal Concept Analysis

    OpenAIRE

    Codocedo , Victor; Lykourentzou , Ioanna; Napoli , Amedeo

    2012-01-01

    Semantic indexing and retrieval has become an important research area, as the available amount of information on the Web is growing more and more. In this paper, we introduce an original approach to semantic indexing and retrieval based on Formal Concept Analysis. The concept lattice is used as a semantic index and we propose an original algorithm for traversing the lattice and answering user queries. This framework has been used and evaluated on song datasets.

  2. Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: a study from the Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Husted, Madsen A.; Haugaard, K.; Soerensen, J.

    2008-01-01

    BACKGROUND: Sentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined...... lymph node biopsy with node negative patients having a lymph node dissection of levels I and II of the axilla, we found significant increase in arm volume among the patients who had an axillary dissection. Only minor, but significant, differences in shoulder mobility were observed comparing the two...... groups of node negative patients. Highly significant difference was found comparing sensibility. Comparing the morbidity in node positive patients who had a one-step axillary dissection with patients having a two-step procedure (sentinel lymph node biopsy followed by delayed axillary dissection) revealed...

  3. A concept analysis of 'Meaning in work' and its implications for nursing.

    Science.gov (United States)

    Lee, Soohee

    2015-10-01

    To report an analysis of the concept of 'meaning in work'. Associated with initiatives to improve the quality of working life and the emerging movement of positive organizations, 'meaning in work' has been studied as a positive individual-level state. 'Meaning in work' has potential benefits that will improve the nursing workforce if this concept is embraced in nursing. However, the concept is not clearly defined because it has been approached from diverse theoretical perspectives and used interchangeably with analogous terms. A concept analysis. Three key terms (using 'work', 'meaning' or 'meaningful', 'meaning of work', 'logotherapy') were searched in the CINAHL, PsycINFO, Business Source Complete and ABI/INFORM Global online databases from January 1940-March 2015. Among 346 articles retrieved, 28 studies were included for this concept analysis. The procedure of concept analysis developed by Walker and Avant (2011) was used. Four critical attributes are identified: (1) experienced positive emotion at work; (2) meaning from work itself; (3) meaningful purpose and goals of work; and (4) work as a part of life that contributes towards meaningful existence. The identified antecedent of 'meaning in work' was a cognitive shift and the identified consequences were positive personal experience and positive impact on peers and organizations. This article provides a clear definition of 'meaning in work'. The resulting coherent definition will facilitate the use of 'meaning in work' in nursing research. © 2015 John Wiley & Sons Ltd.

  4. Error Control in Distributed Node Self-Localization

    Directory of Open Access Journals (Sweden)

    Ying Zhang

    2008-03-01

    Full Text Available Location information of nodes in an ad hoc sensor network is essential to many tasks such as routing, cooperative sensing, and service delivery. Distributed node self-localization is lightweight and requires little communication overhead, but often suffers from the adverse effects of error propagation. Unlike other localization papers which focus on designing elaborate localization algorithms, this paper takes a different perspective, focusing on the error propagation problem, addressing questions such as where localization error comes from and how it propagates from node to node. To prevent error from propagating and accumulating, we develop an error-control mechanism based on characterization of node uncertainties and discrimination between neighboring nodes. The error-control mechanism uses only local knowledge and is fully decentralized. Simulation results have shown that the active selection strategy significantly mitigates the effect of error propagation for both range and directional sensors. It greatly improves localization accuracy and robustness.

  5. Decision Making in Nursing Practice: A Concept Analysis.

    Science.gov (United States)

    Johansen, Mary L; O'Brien, Janice L

    2016-01-01

    The study aims to gain an understanding of the concept of decision making as it relates to the nurse practice environment. Rodgers' evolutionary method on concept analysis was used as a framework for the study of the concept. Articles from 1952 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, PubMed, and Science Direct. Findings suggest that decision making in the nurse practice environment is a complex process, integral to the nursing profession. The definition of decision making, and the attributes, antecedents, and consequences, are discussed. Contextual factors that influence the process are also discussed. An exemplar is presented to illustrate the concept. Decision making in the nurse practice environment is a dynamic conceptual process that may affect patient outcomes. Nurses need to call upon ways of knowing to make sound decisions and should be self-reflective in order to develop the process further in the professional arena. The need for further research is discussed. © 2015 Wiley Periodicals, Inc.

  6. Selective sentinel lymph node biopsy in male breast cancer.

    Science.gov (United States)

    Martin-Marcuartu, J J; Alvarez-Perez, R M; Sousa Vaquero, J M; Jimenez-Hoyuela García, J M

    To evaluate the reproducibility of the sentinel lymph node (SLN) technique in male breast cancer. We retrospectively analysed 21 male patients diagnosed with breast cancer in our hospital from 2008 to 2016 with, at least, 18 months follow-up. Fifteen patients underwent selective sentinel lymph node biopsy (SLNB) following the usual protocols with peritumoral injection of 18.5-111MBq of 99m Tc-nanocoloides and acquisition of planar images 2hours after the injection. In 2 cases it was necessary to perform a SPECT/CT to locate the SLN. Immunohistochemistry and molecular techniques (OSNA) were used for their analysis. Six patients did not undergo SLNB because they had pathological nodes or distant disease at the time of diagnosis. SLNB was performed in 15 patients. The SLN was negative in 6 patients and positive in the remaining 9. Three patients with positive SLNB did not need axillary lymphadenectomy because of the low number of copies by molecular analysis OSNA. Axillary lymphadenectomy was performed in the remaining 6 patients with the result of 4 positive axillary lymphadenectomies and 2 that did not show further extension of the disease. According to our experience, SLNB in males is a reproducible, useful, safe and reliable technique which avoids unnecessary axillary lymphadenectomy and prevents the appearance of undesirable effects. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  7. Seventh Graders' Conceptions of Teachers: An Interpretive Analysis.

    Science.gov (United States)

    Mergendoller, John R.; Packer, Martin J.

    1985-01-01

    Characterizes students' conceptions of teachers through the interpretive analysis of common expressions students use to describe teachers and classroom experiences. Four descriptive categories were the foci for student's characterizations of teachers: academic work, instructional facility, classroom experience, and personal characteristics. A…

  8. A concept of volume rendering guided search process to analyze medical data set.

    Science.gov (United States)

    Zhou, Jianlong; Xiao, Chun; Wang, Zhiyan; Takatsuka, Masahiro

    2008-03-01

    This paper firstly presents an approach of parallel coordinates based parameter control panel (PCP). The PCP is used to control parameters of focal region-based volume rendering (FRVR) during data analysis. It uses a parallel coordinates style interface. Different rendering parameters represented with nodes on each axis, and renditions based on related parameters are connected using polylines to show dependencies between renditions and parameters. Based on the PCP, a concept of volume rendering guided search process is proposed. The search pipeline is divided into four phases. Different parameters of FRVR are recorded and modulated in the PCP during search phases. The concept shows that volume visualization could play the role of guiding a search process in the rendition space to help users to efficiently find local structures of interest. The usability of the proposed approach is evaluated to show its effectiveness.

  9. Physics Structure Analysis of Parallel Waves Concept of Physics Teacher Candidate

    International Nuclear Information System (INIS)

    Sarwi, S; Linuwih, S; Supardi, K I

    2017-01-01

    The aim of this research was to find a parallel structure concept of wave physics and the factors that influence on the formation of parallel conceptions of physics teacher candidates. The method used qualitative research which types of cross-sectional design. These subjects were five of the third semester of basic physics and six of the fifth semester of wave course students. Data collection techniques used think aloud and written tests. Quantitative data were analysed with descriptive technique-percentage. The data analysis technique for belief and be aware of answers uses an explanatory analysis. Results of the research include: 1) the structure of the concept can be displayed through the illustration of a map containing the theoretical core, supplements the theory and phenomena that occur daily; 2) the trend of parallel conception of wave physics have been identified on the stationary waves, resonance of the sound and the propagation of transverse electromagnetic waves; 3) the influence on the parallel conception that reading textbooks less comprehensive and knowledge is partial understanding as forming the structure of the theory. (paper)

  10. Emotional labour underlying caring: an evolutionary concept analysis.

    Science.gov (United States)

    Huynh, Truc; Alderson, Marie; Thompson, Mary

    2008-10-01

    This paper is a report of a concept analysis of emotional labour. Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, PsycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. We followed Rodgers' evolutionary method of concept analysis. Emotional labour is a process whereby nurses adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements: organization (i.e. social norms, social support), nurse (i.e. role identification, professional commitment, work experience and interpersonal skills) and job (i.e. autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions: nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e. productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive). The concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients.

  11. ABOUT THE GENERAL CONCEPT OF THE UNIVERSAL STORAGE SYSTEM AND PRACTICE-ORIENTED DATA PROCESSING

    Directory of Open Access Journals (Sweden)

    L. V. Rudikova

    2017-01-01

    Full Text Available Approaches evolution and concept of data accumulation in warehouse and subsequent Data Mining use is perspective due to the fact that, Belarusian segment of the same IT-developments is organizing. The article describes the general concept for creation a system of storage and practice-oriented data analysis, based on the data warehousing technology. The main aspect in universal system design on storage layer and working with data is approach uses extended data warehouse, based on universal platform of stored data, which grants access to storage and subsequent data analysis different structure and subject domains have compound’s points (nodes and extended functional with data structure choice option for data storage and subsequent intrasystem integration. Describe the universal system general architecture of storage and analysis practice-oriented data, structural elements. Main components of universal system for storage and processing practice-oriented data are: online data sources, ETL-process, data warehouse, subsystem of analysis, users. An important place in the system is analytical processing of data, information search, document’s storage and providing a software interface for accessing the functionality of the system from the outside. An universal system based on describing concept will allow collection information of different subject domains, get analytical summaries, do data processing and apply appropriate Data Mining methods and algorithms.

  12. Detection of lymph node metastases in head and neck cancer: A meta-analysis comparing US, USgFNAC, CT and MR imaging

    International Nuclear Information System (INIS)

    Bondt, R.B.J. de; Nelemans, P.J.; Hofman, P.A.M.; Casselman, J.W.; Kremer, B.; Engelshoven, J.M.A. van; Beets-Tan, R.G.H.

    2007-01-01

    Purpose: To perform a meta-analysis comparing ultrasonography (US), US guided fine needle aspiration cytology (USgFNAC), computed tomography (CT), and magnetic resonance imaging (MRI) in the detection of lymph node metastases in head and neck cancer. Methods: MEDLINE, EMBASE and Cochrane databases were searched (January 1990-January 2006) for studies reporting diagnostic performances of US, USgFNAC, CT, and MRI to detect cervical lymph node metastases. Two reviewers screened text and reference lists of potentially eligible articles. Criteria for study inclusion: (1) histopathology was the reference standard, (2) primary tumors and metastases were squamous cell carcinoma and (3) data were available to construct 2 x 2 contingency tables. Meta-analysis of pairs of sensitivity and specificity was performed using bivariate analysis. Summary estimates for diagnostic performance used were sensitivity, specificity, diagnostic odds ratios (DOR) (95% confidence intervals) and summary receiver operating characteristics (SROC) curves. Results: From seventeen articles, 25 data sets could be retrieved. Eleven articles studied one modality: US (n = 4); USgFNAC (n = 1); CT (n = 3); MRI (n = 3). Six articles studied two or more modalities: US and CT (n = 2); USgFNAC and CT (n = 1); CT and MRI (n = 1); MRI and MRI-USPIO (Sinerem) (n = 2); US, USgFNAC, CT and MRI (n = 1). USgFNAC (AUC = 0.98) and US (AUC = 0.95) showed the highest areas under the curve (AUC). MRI-USPIO (AUC = 0.89) and CT (AUC = 0.88) had similar results. MRI showed an AUC = 0.79. USgFNAC showed the highest DOR (DOR = 260) compared to US (DOR = 40), MRI-USPIO (DOR = 21), CT (DOR = 14) and MRI (DOR = 7). Conclusion USgFNAC showed to be the most accurate imaging modality to detect cervical lymph node metastases

  13. Critical thinking: concept analysis from the perspective of Rodger's evolutionary method of concept analysis

    Directory of Open Access Journals (Sweden)

    Fábio da Costa Carbogim

    Full Text Available ABSTRACT Objective: to analyze the concept of critical thinking (CT in Rodger's evolutionary perspective. Method: documentary research undertaken in the Cinahl, Lilacs, Bdenf and Dedalus databases, using the keywords of 'critical thinking' and 'Nursing', without limitation based on year of publication. The data were analyzed in accordance with the stages of Rodger's conceptual model. The following were included: books and articles in full, published in Portuguese, English or Spanish, which addressed CT in the teaching and practice of Nursing; articles which did not address aspects related to the concept of CT were excluded. Results: the sample was made up of 42 works. As a substitute term, emphasis is placed on 'analytical thinking', and, as a related factor, decision-making. In order, the most frequent preceding and consequent attributes were: ability to analyze, training of the student nurse, and clinical decision-making. As the implications of CT, emphasis is placed on achieving effective results in care for the patient, family and community. Conclusion: CT is a cognitive skill which involves analysis, logical reasoning and clinical judgment, geared towards the resolution of problems, and standing out in the training and practice of the nurse with a view to accurate clinical decision-making and the achieving of effective results.

  14. Suppressing epidemics on networks by exploiting observer nodes.

    Science.gov (United States)

    Takaguchi, Taro; Hasegawa, Takehisa; Yoshida, Yuichi

    2014-07-01

    To control infection spreading on networks, we investigate the effect of observer nodes that recognize infection in a neighboring node and make the rest of the neighbor nodes immune. We numerically show that random placement of observer nodes works better on networks with clustering than on locally treelike networks, implying that our model is promising for realistic social networks. The efficiency of several heuristic schemes for observer placement is also examined for synthetic and empirical networks. In parallel with numerical simulations of epidemic dynamics, we also show that the effect of observer placement can be assessed by the size of the largest connected component of networks remaining after removing observer nodes and links between their neighboring nodes.

  15. Suppressing epidemics on networks by exploiting observer nodes

    Science.gov (United States)

    Takaguchi, Taro; Hasegawa, Takehisa; Yoshida, Yuichi

    2014-07-01

    To control infection spreading on networks, we investigate the effect of observer nodes that recognize infection in a neighboring node and make the rest of the neighbor nodes immune. We numerically show that random placement of observer nodes works better on networks with clustering than on locally treelike networks, implying that our model is promising for realistic social networks. The efficiency of several heuristic schemes for observer placement is also examined for synthetic and empirical networks. In parallel with numerical simulations of epidemic dynamics, we also show that the effect of observer placement can be assessed by the size of the largest connected component of networks remaining after removing observer nodes and links between their neighboring nodes.

  16. Lymph node metastasis of carcinomas of transverse colon including flexures. Consideration of the extramesocolic lymph node stations.

    Science.gov (United States)

    Perrakis, Aristotelis; Weber, Klaus; Merkel, Susanne; Matzel, Klaus; Agaimy, Abbas; Gebbert, Carol; Hohenberger, Werner

    2014-10-01

    Complete mesocolic excision (CME) is nowadays state of the art in the treatment of colon cancer. In cases of carcinoma of transverse colon and of both flexures an extramesocolic lymph node metastasis can be found in the infrapancreatic lymph node region (ILR) and across the gastroepiploic arcade (GLR). These direct metastatic routes were not previously systematically considered. In order to validate our hypothesis of these direct metastatic pathways and to obtain evidence of our approach of including dissection of these areas as part of CME, we initiated a prospective study evaluating these lymph node regions during surgery. Forty-five consecutive patients with primary tumour manifestation in transverse colon and both flexures between May 2010 and January 2013 were prospectively analyzed. Patients were followed up for at least 6 months. Mode of surgery, histopathology, morbidity and mortality were evaluated. Twenty-six patients had a carcinoma of transverse colon, 16 patients one of hepatic flexure and four patients one of splenic flexure. The median lymph node yield was 40. Occurrence of lymph node metastasis in ILR was registered in five patients and in GLR in four patients. The mean lymph node ratio was 0.085. Postoperative complications occurred in nine patients, and postoperative mortality was 2 %. We were able to demonstrate this novel metastatic route of carcinomas of the transverse colon and of both flexures in ILR and GLR. These could be considered as regional lymph node regions and have to be included into surgery for cancer of the transverse colon including both flexures.

  17. [Positive deviance: concept analysis using the evolutionary approach of Rodgers].

    Science.gov (United States)

    Létourneau, Josiane; Alderson, Marie; Caux, Chantal; Richard, Lucie

    2013-06-01

    Positive deviance is a relatively new concept in healthcare. Since 2006, it has been applied to infection control in order to increase the awareness to good hand hygiene practices. This article focus on presenting analytical results of this concept using the evolutionary approach of Rodgers based on the philosophical postulate that concepts are dynamical and changing with time. For doing so, a census of the writings in nursing, medicine and psychology was carried out. By going through the CINAHL, Medline and PsyclNFO databases using positive deviance as a keyword for the time period: 1975 to May 2012, and in accordance with the method of Rodgers, ninety articles were retained (30 per discipline). The analysis enables one to notice that positive deviance described as an individual characteristic at first, is now used as a behavioral changing approach in nursing and medicine as well. At the end of the analysis and apart from this article, positive deviance will be used in order to study the practice of nurses that adheres to hand hygiene despite limiting constraints within hospital. We will then be able to continue the development of this concept in order to bring it, as Rodgers recommends, beyond the analysis. It would then be an important contribution to good nursing practices in the field of infection control and prevention.

  18. Optimal analysis of structures by concepts of symmetry and regularity

    CERN Document Server

    Kaveh, Ali

    2013-01-01

    Optimal analysis is defined as an analysis that creates and uses sparse, well-structured and well-conditioned matrices. The focus is on efficient methods for eigensolution of matrices involved in static, dynamic and stability analyses of symmetric and regular structures, or those general structures containing such components. Powerful tools are also developed for configuration processing, which is an important issue in the analysis and design of space structures and finite element models. Different mathematical concepts are combined to make the optimal analysis of structures feasible. Canonical forms from matrix algebra, product graphs from graph theory and symmetry groups from group theory are some of the concepts involved in the variety of efficient methods and algorithms presented. The algorithms elucidated in this book enable analysts to handle large-scale structural systems by lowering their computational cost, thus fulfilling the requirement for faster analysis and design of future complex systems. The ...

  19. Fuzzy and rough formal concept analysis: a survey

    NARCIS (Netherlands)

    Poelmans, J.; Ignatov, D.I.; Kuznetsov, S.O.; Dedene, G.

    2014-01-01

    Formal Concept Analysis (FCA) is a mathematical technique that has been extensively applied to Boolean data in knowledge discovery, information retrieval, web mining, etc. applications. During the past years, the research on extending FCA theory to cope with imprecise and incomplete information made

  20. The complex network reliability and influential nodes

    Science.gov (United States)

    Li, Kai; He, Yongfeng

    2017-08-01

    In order to study the complex network node important degree and reliability, considering semi-local centrality, betweenness centrality and PageRank algorithm, through the simulation method to gradually remove nodes and recalculate the importance in the random network, small world network and scale-free network. Study the relationship between the largest connected component and node removed proportion, the research results show that betweenness centrality and PageRank algorithm based on the global information network are more effective for evaluating the importance of nodes, and the reliability of the network is related to the network topology.

  1. Broadband Control of Topological Nodes in Electromagnetic Fields

    Science.gov (United States)

    Song, Alex Y.; Catrysse, Peter B.; Fan, Shanhui

    2018-05-01

    We study topological nodes (phase singularities) in electromagnetic wave interactions with structures. We show that, when the nodes exist, it is possible to bind certain nodes to a specific plane in the structure by a combination of mirror and time-reversal symmetry. Such binding does not rely on any resonances in the structure. As a result, the nodes persist on the plane over a wide wavelength range. As an implication of such broadband binding, we demonstrate that the topological nodes can be used for hiding of metallic objects over a broad wavelength range.

  2. Ultrasound-guided photoacoustic imaging of lymph nodes with biocompatible gold nanoparticles as a novel contrast agent (Conference Presentation)

    Science.gov (United States)

    Sun, In-Cheol; Dumani, Diego; Emelianov, Stanislav Y.

    2017-02-01

    A key step in staging cancer is the diagnosis of metastasis that spreads through lymphatic system. For this reason, researchers develop various methods of sentinel lymph node mapping that often use a radioactive tracer. This study introduces a safe, cost-effective, high-resolution, high-sensitivity, and real-time method of visualizing the sentinel lymph node: ultrasound-guided photoacoustic (US/PA) imaging augmented by a contrast agent. In this work, we use clearable gold nanoparticles covered by a biocompatible polymer (glycol chitosan) to enhance cellular uptake by macrophages abundant in lymph nodes. We incubate macrophages with glycol-chitosan-coated gold nanoparticles (0.05 mg Au/ml), and then fix them with paraformaldehyde solution for an analysis of in vitro dark-field microscopy and cell phantom. The analysis shows enhanced cellular uptake of nanoparticles by macrophages and strong photoacoustic signal from labeled cells in tissue-mimicking cell phantoms consisting gelatin solution (6 %) with silica gel (25 μm, 0.3%) and fixed macrophages (13 X 105 cells). The in-vivo US/PA imaging of cervical lymph nodes in healthy mice (nu/nu, female, 5 weeks) indicates a strong photoacoustic signal from a lymph node 10 minutes post-injection (2.5 mg Au/ml, 80 μl). The signal intensity and the nanoparticle-labeled volume of tissue within the lymph node continues to increase until 4 h post-injection. Histological analysis further confirms the accumulation of gold nanoparticles within the lymph nodes. This work suggests the feasibility of molecular/cellular US/PA imaging with biocompatible gold nanoparticles as a photoacoustic contrast agent in the diagnosis of lymph-node-related diseases.

  3. Concept analysis of moral courage in nursing: A hybrid model.

    Science.gov (United States)

    Sadooghiasl, Afsaneh; Parvizy, Soroor; Ebadi, Abbas

    2018-02-01

    Moral courage is one of the most fundamental virtues in the nursing profession, however, little attention has been paid to it. As a result, no exact and clear definition of moral courage has ever been accessible. This study is carried out for the purposes of defining and clarifying its concept in the nursing profession. This study used a hybrid model of concept analysis comprising three phases, namely, a theoretical phase, field work phase, and a final analysis phase. To find relevant literature, electronic search of valid databases was utilized using keywords related to the concept of courage. Field work data were collected over an 11 months' time period from 2013 to 2014. In the field work phase, in-depth interviews were performed with 10 nurses. The conventional content analysis was used in two theoretical and field work phases using Graneheim and Lundman stages, and the results were combined in the final analysis phase. Ethical consideration: Permission for this study was obtained from the ethics committee of Tehran University of Medical Sciences. Oral and written informed consent was received from the participants. From the sum of 750 gained titles in theoretical phase, 26 texts were analyzed. The analysis resulted in 494 codes in text analysis and 226 codes in interview analysis. The literature review in the theoretical phase revealed two features of inherent-transcendental characteristics, two of which possessed a difficult nature. Working in the field phase added moral self-actualization characteristic, rationalism, spiritual beliefs, and scientific-professional qualifications to the feature of the concept. Moral courage is a pure and prominent characteristic of human beings. The antecedents of moral courage include model orientation, model acceptance, rationalism, individual excellence, acquiring academic and professional qualification, spiritual beliefs, organizational support, organizational repression, and internal and external personal barriers

  4. The concept of antifragility and its implications for the practice of risk analysis.

    Science.gov (United States)

    Aven, Terje

    2015-03-01

    Nassim Taleb's antifragile concept has been shown considerable interest in the media and on the Internet recently. For Taleb, the antifragile concept is a blueprint for living in a black swan world (where surprising extreme events may occur), the key being to love variation and uncertainty to some degree, and thus also errors. The antonym of "fragile" is not robustness or resilience, but "please mishandle" or "please handle carelessly," using an example from Taleb when referring to sending a package full of glasses by post. In this article, we perform a detailed analysis of this concept, having a special focus on how the antifragile concept relates to common ideas and principles of risk management. The article argues that Taleb's antifragile concept adds an important contribution to the current practice of risk analysis by its focus on the dynamic aspects of risk and performance, and the necessity of some variation, uncertainties, and risk to achieve improvements and high performance at later stages. © 2014 Society for Risk Analysis.

  5. Formal concept analysis applied to the prediction of additives for galvanizing process

    Directory of Open Access Journals (Sweden)

    J. Klimeš

    2010-04-01

    Full Text Available Formal concept analysis is a new mathematical approach to data analysis, data mining and to discavering patterns in data. The result of the application of the formal concept analysis method to the behavior of the galvanizing of rimmed steel is presented. Effects of additives in the galvanizing process have been correlated to the chemical element properties of the additives. This model may also help to design new alloys as additives in the galvanizing process.

  6. GSI Quantitative Parameters: Preoperative Diagnosis of Metastasis Lymph Nodes in Lung Cancer

    Directory of Open Access Journals (Sweden)

    Fengfeng YANG

    2016-11-01

    Full Text Available Background and objective Mediastinal involvement in lung cancer is an important prognostic factor affecting survival, and accurate staging of the mediastinum lymph node correctly identifies patients who can benefit the most from surgery. The aim of this study is to investigate the value of dual-energy spectral computed tomography (DEsCT imaging in differentiating metastatic from non-metastatic lymph nodes in lung cancer. Methods Forty-eight patients with non-small cell lung cancer (NSCLC underwent arterial (AP and portal venous (PP phase contrast-enhanced DEsCT imaging followed by surgical treatment. gemstone spectral imaging (GSI data images were reconstructed and transmitted to an offline workstation. GSI quantitative parameters, including lymph-node size, CT value, IC, water concentration, and spectral curve. Differences were tested for statistical significance using the two-sample t test. ROC analysis was performed to assess diagnostic performance. Results The mean short-axis diameter of metastatic LNs, slope of the spectral Hounsfield unit curve (λHU, normalized iodine concentration measured during, and both AP and PP were significantly higher in metastatic lymph node than that in benign lymph nodes. The best parameter for detecting metastatic lymph nodes was AP λHU when a threshold λHU of 2.75 was used; sensitivity, specificity, and accuracy were 88.2%, 88.4%, and 87.0%, respectively. Conclusion Quantitative assessment with gemstone spectral imaging quantitative parameters showed higher accuracy than the qualitative assessment of conventional CT imaging features for the preoperative diagnosis of metastatic lymph nodes in patients with lung cancer.

  7. Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging

    Directory of Open Access Journals (Sweden)

    Gerrit Cornelis Langhout

    2014-01-01

    Full Text Available Objective. Sentinel node biopsy in patients with cutaneous melanoma improves staging, provides prognostic information, and leads to an increased survival in node-positive patients. However, frozen section analysis of the sentinel node is not reliable and definitive histopathology evaluation requires days, preventing intraoperative decision-making and immediate therapy. Photoacoustic imaging can evaluate intact lymph nodes, but specificity can be hampered by other absorbers such as hemoglobin. Near infrared multispectral photoacoustic imaging is a new approach that has the potential to selectively detect melanin. The purpose of the present study is to examine the potential of multispectral photoacoustic imaging to identify melanoma metastasis in human lymph nodes. Methods. Three metastatic and nine benign lymph nodes from eight melanoma patients were scanned ex vivo using a Vevo LAZR© multispectral photoacoustic imager and were spectrally analyzed per pixel. The results were compared to histopathology as gold standard. Results. The nodal volume could be scanned within 20 minutes. An unmixing procedure was proposed to identify melanoma metastases with multispectral photoacoustic imaging. Ultrasound overlay enabled anatomical correlation. The penetration depth of the photoacoustic signal was up to 2 cm. Conclusion. Multispectral three-dimensional photoacoustic imaging allowed for selective identification of melanoma metastases in human lymph nodes.

  8. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

    Science.gov (United States)

    Graneheim, U H; Lundman, B

    2004-02-01

    Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.

  9. Exact asymptotic expansion for the resistance between the center node and a node on the cobweb network boundary

    Directory of Open Access Journals (Sweden)

    R. Kenna

    2014-09-01

    Full Text Available We analyze the resistance between two nodes in a cobweb network of resistors. Based on an exact expression, we derive the asymptotic expansions for the resistance between the center node and a node on the boundary of the M x N cobweb network with resistors r and s in the two spatial directions. All coefficients in this expansion are expressed through analytical functions.

  10. Self-consistent Analysis of a Blanket and Shielding of a Fusion Reactor Concept

    International Nuclear Information System (INIS)

    Kim, Suk Kwon; Hong, B. G.; Lee, D. W.; Kim, D. H.; Lee, Y. O.

    2008-01-01

    To develop the concept of a DEMO reactor, a tokamak reactor system analysis code has been developed at KAERI (Korea Atomic Energy Research Institute). The system analysis code incorporates prospects of the development of plasma physics and the technologies in a simple mathematical model and it helps to develop the concept of a fusion reactor and to identify the necessary R and D areas for a realization of the concept. In the system code, a plant power balance equation and a plasma power balance equation are solved to find plant parameters which satisfy the plasma physics and technology constraints, simultaneously. The outcome of the system analysis is to identify which areas of plasma physics and technologies and to what extent they should be developed for a realization of given fusion reactor concepts

  11. Network Resilience Analysis: Review Of Concepts And A Country-Level. Case Study

    Directory of Open Access Journals (Sweden)

    Mariusz Kamola

    2014-01-01

    Full Text Available This paper presents the rationale behind performing an analysis of Internet resilience in the sense of maintaining a connection of autonomous systems in the presence of failures or attacks — on a level of a single country. Next, the graph of a network is constructed that represents interconnections between autonomous systems. The connectivity of the graph is examined for cases of link or node failure. Resilience metrics are proposed, focusing on a single autonomous system or on overall network reliability. The process of geographic location of networking infrastructure is presented, leading to an analysis of network resilience in the case of a joint failure of neighboring autonomous systems.

  12. Ultrasound differentiation of benign and malignant cervical lymph nodes

    Directory of Open Access Journals (Sweden)

    Md. Mizanur Rahman

    2009-01-01

    Full Text Available This study was conducted to see whether the size (measured by maximal short axis diameter, shape (expressed in terms of ratio dividing long axis diameter of the node by short axis diameter or L/S ratio, marginal clarity (regular or irregular margin, internal echo-pattern (homogeneous hypoechoic or heterogeneous and hilar echogenicity (presence or absence of echo-genicity in hilum are good criteria for differentiating benign from malignant cervical lymph nodes using high frequency (high resolution ultrasound probe. The study was carried out from January 1998 to December 1998, among patients with enlarged cervical lymph nodes who were scanned with a high frequency (5.0 MHz curvilinear probe. Chi-Square test was done to see the statistical correlation between two groups of nodes. A p value of <0.05 was taken as significant. Out of 65 nodes studied, 26 (100% enlarged cervical nodes with short axis diameter more than 1 cm were all malignant. In contrast 31 (79.5% of 39 enlarged nodes with short axis diameter less than 1cm were benign and rest were malignant (p<0.001. Of 34 enlarged nodes with L/S ratio <2, 30 (88.2% nodes were found malignant and 4 (11.8% were benign. Among the rest 31 enlarged nodes, 27 (87.1% with L/S ratio  2 were benign while 4 (12.9% were malignant (p <0.001. Among the 39 nodes with regular margin 28 (71.8% were found benign, where as among 26 nodes with irregular margin 23 (88.5% were malignant (p <0.001. When the internal echopattern was taken in account, 32 nodes had homogeneous hypoechoic echo of which 28 (87.5% were benign and among 33 nodes with heterogeneous echopattern 30 (90.9% were malignant (p <0.001. Among the 43 enlarged nodes with presence of hilar echogenicity 31(72.1% were found benign and 22 (100% nodes with no hilar echogenicity were all malignant (p <0.001. Such findings suggest that real time high resolution ultrasound might assist in differentiation of benign and malignant enlarged cervical lymph nodes

  13. Challenging the concept of microinvasive carcinoma of the vulva: report of a case with regional lymph node recurrence and review of the literature

    International Nuclear Information System (INIS)

    Sidor, Jutta; Diallo-Danebrock, Raihana; Eltze, Elke; Lellé, Ralph J

    2006-01-01

    It is widely accepted that vulvar carcinoma with a depth of invasion of less than one millimeter is sufficiently treated by vulvectomy or wide local excision without inguinal lymphadenectomy. However, a patient with inguinal lymph node recurrence 21 months after radical vulvectomy for stage IA squamous cell carcinoma was observed. According to a review of the literature, there are five additional cases of metastasizing vulvar cancer with a depth of invasion of less than one millimeter. Therefore, the definition of microinvasive carcinoma of the vulva based on depth of invasion alone may not be as reliable as previously thought and does not rule out inguinal lymph node involvement or recurrence. Consequently, the necessity of inguinal node dissection for microinvasive carcinoma needs to be discussed on an individual basis taking into account the age of the patient as well as the potential morbidity of extended surgery

  14. Number of evaluated lymph nodes and positive lymph nodes, lymph node ratio, and log odds evaluation in early-stage pancreatic ductal adenocarcinoma: numerology or valid indicators of patient outcome?

    Science.gov (United States)

    Lahat, G; Lubezky, N; Gerstenhaber, F; Nizri, E; Gysi, M; Rozenek, M; Goichman, Y; Nachmany, I; Nakache, R; Wolf, I; Klausner, J M

    2016-09-29

    We evaluated the prognostic significance and universal validity of the total number of evaluated lymph nodes (ELN), number of positive lymph nodes (PLN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) in a relatively large and homogenous cohort of surgically treated pancreatic ductal adenocarcinoma (PDAC) patients. Prospectively accrued data were retrospectively analyzed for 282 PDAC patients who had pancreaticoduodenectomy (PD) at our institution. Long-term survival was analyzed according to the ELN, PLN, LNR, and LODDS. Of these patients, 168 patients (59.5 %) had LN metastasis (N1). Mean ELN and PLN were 13.5 and 1.6, respectively. LN positivity correlated with a greater number of evaluated lymph nodes; positive lymph nodes were identified in 61.4 % of the patients with ELN ≥ 13 compared with 44.9 % of the patients with ELN < 13 (p = 0.014). Median overall survival (OS) and 5-year OS rate were higher in N0 than in N1 patients, 22.4 vs. 18.7 months and 35 vs. 11 %, respectively (p = 0.008). Mean LNR was 0.12; 91 patients (54.1 %) had LNR < 0.3. Among the N1 patients, median OS was comparable in those with LNR ≥ 0.3 vs. LNR < 0.3 (16.7 vs. 14.1 months, p = 0.950). Neither LODDS nor various ELN and PLN cutoff values provided more discriminative information within the group of N1 patients. Our data confirms that lymph node positivity strongly reflects PDAC biology and thus patient outcome. While a higher number of evaluated lymph nodes may provide a more accurate nodal staging, it does not have any prognostic value among N1 patients. Similarly, PLN, LNR, and LODDS had limited prognostic relevance.

  15. Association of BRAFV600E Mutation and MicroRNA Expression with Central Lymph Node Metastases in Papillary Thyroid Cancer: A Prospective Study from Four Endocrine Surgery Centers

    Science.gov (United States)

    Aragon Han, Patricia; Kim, Hyun-seok; Cho, Soonweng; Fazeli, Roghayeh; Najafian, Alireza; Khawaja, Hunain; McAlexander, Melissa; Dy, Benzon; Sorensen, Meredith; Aronova, Anna; Sebo, Thomas J.; Giordano, Thomas J.; Fahey, Thomas J.; Thompson, Geoffrey B.; Gauger, Paul G.; Somervell, Helina; Bishop, Justin A.; Eshleman, James R.; Schneider, Eric B.; Witwer, Kenneth W.; Umbricht, Christopher B.

    2016-01-01

    Background: Studies have demonstrated an association of the BRAFV600E mutation and microRNA (miR) expression with aggressive clinicopathologic features in papillary thyroid cancer (PTC). Analysis of BRAFV600E mutations with miR expression data may improve perioperative decision making for patients with PTC, specifically in identifying patients harboring central lymph node metastases (CLNM). Methods: Between January 2012 and June 2013, 237 consecutive patients underwent total thyroidectomy and prophylactic central lymph node dissection (CLND) at four endocrine surgery centers. All tumors were tested for the presence of the BRAFV600E mutation and miR-21, miR-146b-3p, miR-146b-5p, miR-204, miR-221, miR-222, and miR-375 expression. Bivariate and multivariable analyses were performed to examine associations between molecular markers and aggressive clinicopathologic features of PTC. Results: Multivariable logistic regression analysis of all clinicopathologic features found miR-146b-3p and miR-146b-5p to be independent predictors of CLNM, while the presence of BRAFV600E almost reached significance. Multivariable logistic regression analysis limited to only predictors available preoperatively (molecular markers, age, sex, and tumor size) found miR-146b-3p, miR-146b-5p, miR-222, and BRAFV600E mutation to predict CLNM independently. While BRAFV600E was found to be associated with CLNM (48% mutated in node-positive cases vs. 28% mutated in node-negative cases), its positive and negative predictive values (48% and 72%, respectively) limit its clinical utility as a stand-alone marker. In the subgroup analysis focusing on only classical variant of PTC cases (CVPTC), undergoing prophylactic lymph node dissection, multivariable logistic regression analysis found only miR-146b-5p and miR-222 to be independent predictors of CLNM, while BRAFV600E was not significantly associated with CLNM. Conclusion: In the patients undergoing prophylactic CLNDs, miR-146b-3p, miR-146b-5p, and mi

  16. Sentinel lymph node biopsy is indicated for patients with thick clinically lymph node-negative melanoma.

    Science.gov (United States)

    Yamamoto, Maki; Fisher, Kate J; Wong, Joyce Y; Koscso, Jonathan M; Konstantinovic, Monique A; Govsyeyev, Nicholas; Messina, Jane L; Sarnaik, Amod A; Cruse, C Wayne; Gonzalez, Ricardo J; Sondak, Vernon K; Zager, Jonathan S

    2015-05-15

    Sentinel lymph node biopsy (SLNB) is indicated for the staging of clinically lymph node-negative melanoma of intermediate thickness, but its use is controversial in patients with thick melanoma. From 2002 to 2012, patients with melanoma measuring ≥4 mm in thickness were evaluated at a single institution. Associations between survival and clinicopathologic characteristics were explored. Of 571 patients with melanomas measuring ≥4 mm in thickness and no distant metastases, the median age was 66 years and 401 patients (70.2%) were male. The median Breslow thickness was 6.2 mm; the predominant subtype was nodular (45.4%). SLNB was performed in 412 patients (72%) whereas 46 patients (8.1%) presented with clinically lymph node-positive disease and 113 patients (20%) did not undergo SLNB. A positive SLN was found in 161 of 412 patients (39.1%). For SLNB performed at the study institution, 14 patients with a negative SLNB developed disease recurrence in the mapped lymph node basin (false-negative rate, 12.3%). The median disease-specific survival (DSS), overall survival (OS), and recurrence-free survival (RFS) for the entire cohort were 62.1 months, 42.5 months, and 21.2 months, respectively. The DSS and OS for patients with a negative SLNB were 82.4 months and 53.4 months, respectively; 41.2 months and 34.7 months, respectively, for patients with positive SLNB; and 26.8 months and 22 months, respectively, for patients with clinically lymph node-positive disease (Pthick melanoma and a negative SLNB appear to have significantly prolonged RFS, DSS, and OS compared with those with a positive SLNB. Therefore, SLNB should be considered as indicated for patients with thick, clinically lymph node-negative melanoma. © 2015 American Cancer Society.

  17. Axillary Lymph Nodes and Breast Cancer

    Science.gov (United States)

    ... white blood cells that help fight illness. If breast cancer spreads, the lymph nodes in the underarm (called ... if they contain cancer cells. This helps determine breast cancer stage and guide treatment. Sentinel node biopsy and ...

  18. Attractive target wave patterns in complex networks consisting of excitable nodes

    International Nuclear Information System (INIS)

    Zhang Li-Sheng; Mi Yuan-Yuan; Liao Xu-Hong; Qian Yu; Hu Gang

    2014-01-01

    This review describes the investigations of oscillatory complex networks consisting of excitable nodes, focusing on the target wave patterns or say the target wave attractors. A method of dominant phase advanced driving (DPAD) is introduced to reveal the dynamic structures in the networks supporting oscillations, such as the oscillation sources and the main excitation propagation paths from the sources to the whole networks. The target center nodes and their drivers are regarded as the key nodes which can completely determine the corresponding target wave patterns. Therefore, the center (say node A) and its driver (say node B) of a target wave can be used as a label, (A,B), of the given target pattern. The label can give a clue to conveniently retrieve, suppress, and control the target waves. Statistical investigations, both theoretically from the label analysis and numerically from direct simulations of network dynamics, show that there exist huge numbers of target wave attractors in excitable complex networks if the system size is large, and all these attractors can be labeled and easily controlled based on the information given by the labels. The possible applications of the physical ideas and the mathematical methods about multiplicity and labelability of attractors to memory problems of neural networks are briefly discussed. (topical review - statistical physics and complex systems)

  19. [Concept analysis of medication adherence in patients with chronic disease].

    Science.gov (United States)

    Huang, Jen-Ying; Chen, Hsing-Mei

    2014-06-01

    Pharmacotherapy plays an important role in the management of chronic diseases. However, many patients with chronic disease do not adhere to their medication regimen. This results in worsening symptoms and frequent re-hospitalizations. As a result, healthcare providers may view these patients as bad. Medication adherence is a complex concept. Analyzing this concept may assist nurses to improve patient-centered care. This paper uses Walker & Avant's method to conduct a concept analysis of medication adherence. Results show the defining attributes of medication adherence as: (1) knowing and agreeing to the medication; (2) communicating and negotiating the regimen; and (3) active, continuous involvement in and appraisal of the treatment effect. Identified antecedents of medication adherence included the patient having: (1) a prescribed medication regimen; (2) cognitive and action abilities in her / his role as a patient; and (3) level of preparation for medication treatment. Identified consequences of medication adherence include: (1) improving symptom control; (2) decreasing re-hospitalizations and mortality; (3) reducing medical care costs; (4) restoring self-esteem; and (5) diminishing depression. It is hoped that this concept analysis provides a reference for nurses to achieve a better understanding of medication adherence and further improve nursing practice.

  20. Clinical results of sentinel lymph node (SN) biopsy for oral cancer. Relationship between SN localization and metastasis in tongue cancer

    International Nuclear Information System (INIS)

    Shintani, Satoru; Nakashiro, Koh-ichi; Hino, Satoshi; Terakado, Nagaaki; Hamakawa, Hiroyuki

    2005-01-01

    Attempts were made to detect micrometastasis in N0 neck of oral cancer patients using sentinel lymph node (SN) biopsy (SNB). We previously described our approach to identify SN using a radioisotope ( 99m Tc-Tin colloid)-guided and dye-guided method. Micrometastases were detected by means of serial sections and real-time polymerase chain reaction (PCR) based on squamous cell carcinoma (SCC) antigen mRNA. In this study, we evaluated the radiolocalization of SN and identification of metastatic lymph node in N0 oral cancer patients. The positive rate of metastatic lymph node in N0 oral cancer was 35% and the diagnostic sensitivity of SNB was 95%. The SNB detected subclinical metastases in 4 of 10 N0 patients with tongue cancer. Moreover, in 3 of these 4 cases, all metastatic lymph nodes consisted with SNs. Postoperative cervical metastasis was observed in a patient whose SNB was negative. While more experience is needed, we believe the SN concept for tongue cancer is established, and practical application in clinical settings is anticipated. (author)

  1. The generation of random directed networks with prescribed 1-node and 2-node degree correlations

    International Nuclear Information System (INIS)

    Zamora-Lopez, Gorka; Kurths, Juergen; Zhou Changsong; Zlatic, Vinko

    2008-01-01

    The generation of random networks is a very common problem in complex network research. In this paper, we have studied the correlation nature of several real networks and found that, typically, a large number of links are deterministic, i.e. they cannot be randomized. This finding permits fast generation of ensembles of maximally random networks with prescribed 1-node and 2-node degree correlations. When the introduction of self-loops or multiple-links are not desired, random network generation methods typically reach blocked states. Here, a mechanism is proposed, the 'force-and-drop' method, to overcome such states. Our algorithm can be easily simplified for undirected graphs and reduced to account for any subclass of 2-node degree correlations

  2. Flexible distribution systems through the application of multi back-to-back converters. Concept, implementation and experimental verification

    Energy Technology Data Exchange (ETDEWEB)

    De Graaff, R A.A.

    2010-05-26

    The objective of the research project is to investigate the use of a multi back-to-back converter to support the transition to active distribution networks. The investigation must explicitly not focus on finding the optimal power electronics topology, but rather on defining the role that such a device can play in a power distribution system and on the proof of principle. The possible tasks of this device are to actively control power flow and to maintain power quality and stability, both during normal operation and during fault conditions in medium voltage networks with distributed generation. The combination of this versatile converter system and the control and protection systems that define its functionality are in this thesis denoted as the Intelligent Node (IN). Research questions are: (1) Which are the main benefits of multi back-to-back converter devices in distribution systems?; (2) How and under which conditions can these benefits be achieved? What controls should be adopted?; (3) Which are the specific aspects that distinguish the application of the multi back-to-back devices in distribution systems from similar applications in transmission systems?; (4) Can this be demonstrated on a laboratory-scale set-up?Chapter 2 Distribution systems The relevant aspects of distribution systems are discussed. This includes power quality considerations, redundancy aspects, and voltage control methods. Chapter 3 (FACTS in distribution systems) describes power flow control principles. Also an overview is given of the state-of-the-art of power electronic applications for power flow control in electrical power systems. Chapter 4 (Functional concept of the Intelligent Node) gives the proposed functional concept for the application of a multi back-to-back converter device as IN (Intelligent Node). The applications are developed on a functional level, with the device at a black-box level. To satisfy the resulting requirements several technology options are analyzed, ending

  3. A Concept Analysis of Patient Participation in Intermediate Care.

    Science.gov (United States)

    Kvæl, Linda Aimée Hartford; Debesay, Jonas; Langaas, Anne; Bye, Asta; Bergland, Astrid

    2018-03-05

    Although the concept of patient participation has been discussed for a number of years, there is still no clear definition of what constitutes the multidimensional concept, and the application of the concept in an intermediate care (IC) context lacks clarity. Therefore this paper seeks to identify and explore the attributes of the concept, to elaborate ways of understanding the concept of patient participation for geriatric patients in the context of IC. Walker and Avant's model of Concept analysis [1] based on a literature review. Patient participation in the context of IC can be defined as a dynamic process emphasizing the person as a whole, focusing on the establishment of multiple alliances that facilitate individualized information and knowledge exchange, and ensuring a reciprocal engagement in activities within flexible and interactive/dynamic organizational struct