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Sample records for criteria including age

  1. Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

    Energy Technology Data Exchange (ETDEWEB)

    Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S. (Pennsylvania State University College of Medicine, Hershey (United States))

    1992-09-01

    One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years.

  2. Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

    International Nuclear Information System (INIS)

    Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S.

    1992-01-01

    One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years

  3. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone.

    Science.gov (United States)

    Lauritsen, M P; Bentzen, J G; Pinborg, A; Loft, A; Forman, J L; Thuesen, L L; Cohen, A; Hougaard, D M; Nyboe Andersen, A

    2014-04-01

    What is the prevalence in a normal population of polycystic ovary syndrome (PCOS) according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone (AMH)? The prevalence of PCOS was 16.6% according to the Rotterdam criteria. When replacing the criterion for polycystic ovaries by antral follicle count (AFC) > 19 or AMH > 35 pmol/l, the prevalence of PCOS was 6.3 and 8.5%, respectively. WHAT IS KNOWN ALREADY?: The Rotterdam criteria state that two out of the following three criteria should be present in the diagnosis of PCOS: oligo-anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries in PCOS. From 2008 to 2010, a prospective, cross-sectional study was performed including 863 women aged 20-40 years and employed at Copenhagen University Hospital, Rigshospitalet, Denmark. We studied a subgroup of 447 women with a mean (±SD) age of 33.5 (±4.0) years who were all non-users of hormonal contraception. Data on menstrual cycle disorder and the presence of hirsutism were obtained. On cycle Days 2-5, or on a random day in the case of oligo- or amenorrhoea, sonographic and endocrine parameters were measured. The prevalence of PCOS was 16.6% according to the Rotterdam criteria. PCOS prevalence significantly decreased with age from 33.3% in women polycystic ovaries with a significant age-related decrease from 69.0% in women polycystic ovaries in women with PCOS according to the Rotterdam criteria [area under the curve (AUC) 0.994; 95% confidence interval (CI): 0.990-0.999] and AUC 0.992 (95% CI: 0.987-0.998), respectively], and an AMH cut-off value of 18 pmol/l and AMH Z-score of -0.2 showed the best compromise between sensitivity (91.8 and 90.4%, respectively) and specificity (98.1 and

  4. Discordance between age- and size-based criteria of child passenger restraint appropriateness.

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    Smiley, Mary L; Bingham, C Raymond; Jacobson, Peter D; Macy, Michelle L

    2018-04-03

    In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015. Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n = 591 in 2011, n = 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S. Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics. Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%, P consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with

  5. Polycystic ovary morphology: age-based ultrasound criteria.

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    Kim, Hyun-Jun; Adams, Judith M; Gudmundsson, Jens A; Arason, Gudmundur; Pau, Cindy T; Welt, Corrine K

    2017-09-01

    To determine age-based criteria for polycystic ovary morphology. Cross-sectional, case-control design. Outpatient setting. Women with polycystic ovary syndrome (PCOS) defined by hyperandrogenism and irregular menses (n = 544) and controls with regular menses and no evidence of hyperandrogenism (n = 666) participated. Parameters were tested in a second cohort of women with PCOS (n = 105) and controls (n = 32) meeting the same criteria. Subjects underwent a pelvic ultrasound documenting ovarian volume and maximum follicle number in a single plane. A receiver operating characteristic curve was constructed to determine the ovarian volume and follicle number with the best sensitivity and specificity to define PCOS for age groups at approximately 5-year intervals from age 18 to >44 years. The best sensitivity and specificity were obtained using a threshold volume of 12 mL and 13 follicles for ages ≤24 years, 10 mL and 14 follicles for ages 25-29 years, 9 mL and 10 follicles for ages 30-34 years, 8 mL and 10 follicles for ages 35-39 years, 10 mL and 9 follicles for ages 40-44 years, and 6 mL and 7 follicles for ages >44 years. Data from a second cohort confirmed the need to decrease volume and follicle number with increasing age to diagnose PCOS. Polycystic ovary morphology was most accurate at predicting the PCOS diagnosis for women ages 30-39 years. The ovarian volume and follicle number threshold to define polycystic ovary morphology should be lowered starting at age 30. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. 45 CFR 1308.13 - Eligibility criteria: Visual impairment including blindness.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Visual impairment including... impairment including blindness. (a) A child is classified as visually impaired when visual impairment, with...) A child is classified as having a visual impairment if central acuity with corrective lenses is...

  7. Interim performance criteria for photovoltaic energy systems. [Glossary included

    Energy Technology Data Exchange (ETDEWEB)

    DeBlasio, R.; Forman, S.; Hogan, S.; Nuss, G.; Post, H.; Ross, R.; Schafft, H.

    1980-12-01

    This document is a response to the Photovoltaic Research, Development, and Demonstration Act of 1978 (P.L. 95-590) which required the generation of performance criteria for photovoltaic energy systems. Since the document is evolutionary and will be updated, the term interim is used. More than 50 experts in the photovoltaic field have contributed in the writing and review of the 179 performance criteria listed in this document. The performance criteria address characteristics of present-day photovoltaic systems that are of interest to manufacturers, government agencies, purchasers, and all others interested in various aspects of photovoltaic system performance and safety. The performance criteria apply to the system as a whole and to its possible subsystems: array, power conditioning, monitor and control, storage, cabling, and power distribution. They are further categorized according to the following performance attributes: electrical, thermal, mechanical/structural, safety, durability/reliability, installation/operation/maintenance, and building/site. Each criterion contains a statement of expected performance (nonprescriptive), a method of evaluation, and a commentary with further information or justification. Over 50 references for background information are also given. A glossary with definitions relevant to photovoltaic systems and a section on test methods are presented in the appendices. Twenty test methods are included to measure performance characteristics of the subsystem elements. These test methods and other parts of the document will be expanded or revised as future experience and needs dictate.

  8. Assessment of five different guideline indication criteria for spirometry, including modified GOLD criteria, in order to detect COPD: data from 5,315 subjects in the PLATINO study.

    Science.gov (United States)

    Luize, Ana P; Menezes, Ana Maria B; Perez-Padilla, Rogelio; Muiño, Adriana; López, Maria Victorina; Valdivia, Gonzalo; Lisboa, Carmem; Montes de Oca, Maria; Tálamo, Carlos; Celli, Bartolomé; Nascimento, Oliver A; Gazzotti, Mariana R; Jardim, José R

    2014-10-30

    Spirometry is the gold standard for diagnosing chronic obstructive pulmonary disease (COPD). Although there are a number of different guideline criteria for deciding who should be selected for spirometric screening, to date it is not known which criteria are the best based on sensitivity and specificity. Firstly, to evaluate the proportion of subjects in the PLATINO Study that would be recommended for spirometry testing according to Global initiative for Obstructive Lung Disease (GOLD)-modified, American College of Chest Physicians (ACCP), National Lung Health Education Program (NLHEP), GOLD and American Thoracic Society/European Respiratory Society (ATS/ERS) criteria. Secondly, we aimed to compare the sensitivity, specificity, and positive predictive and negative predictive values, of these five different criteria. Data from the PLATINO study included information on respiratory symptoms, smoking and previous spirometry testing. The GOLD-modified spirometry indication criteria are based on three positive answers out of five questions: the presence of cough, phlegm in the morning, dyspnoea, age over 40 years and smoking status. Data from 5,315 subjects were reviewed. Fewer people had an indication for spirometry (41.3%) according to the GOLD-modified criteria, and more people had an indication for spirometry (80.4%) by the GOLD and ATS/ERS criteria. A low percentage had previously had spirometry performed: GOLD-modified (14.5%); ACCP (13.2%); NLHEP (12.6%); and GOLD and ATS/ERS (12.3%). The GOLD-modified criteria showed the least sensitivity (54.9) and the highest specificity (61.0) for detecting COPD, whereas GOLD and ATS/ERS criteria showed the highest sensitivity (87.9) and the least specificity (20.8). There is a considerable difference in the indication for spirometry according to the five different guideline criteria. The GOLD-modified criteria recruit less people with the greatest sum of sensitivity and specificity.

  9. Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

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    Schmid Marc

    2013-01-01

    Full Text Available Abstract Background This article reviews the current debate on developmental trauma disorder (DTD with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD does not cover all consequences of severe and complex traumatization in childhood. Discussion Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria. Summary Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice.

  10. A psychometric evaluation of the DSM-IV borderline personality disorder criteria: age and sex moderation of criterion functioning

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    Aggen, S. H.; Neale, M. C.; Røysamb, E.; Reichborn-Kjennerud, T.; Kendler, K. S.

    2009-01-01

    Background Despite its importance as a paradigmatic personality disorder, little is known about the measurement invariance of the DSM-IV borderline personality disorder (BPD) criteria ; that is, whether the criteria assess the disorder equivalently across different groups. Method BPD criteria were evaluated at interview in 2794 young adult Norwegian twins. Analyses, based on item-response modeling, were conducted to test for differential age and sex moderation of the individual BPD criteria characteristics given factor-level covariate effects. Results Confirmatory factor analytic results supported a unidimensional structure for the nine BPD criteria. Compared to males, females had a higher BPD factor mean, larger factor variance and there was a significant age by sex interaction on the factor mean. Strong differential sex and age by sex interaction effects were found for the ‘ impulsivity ’ criterion factor loading and threshold. Impulsivity related to the BPD factor poorly in young females but improved significantly in older females. Males reported more impulsivity compared to females and this difference increased with age. The ‘ affective instability ’ threshold was also moderated, with males reporting less than expected. Conclusions The results suggest the DSM-IV BPD ‘ impulsivity ’ and ‘ affective instability ’ criteria function differentially with respect to age and sex, with impulsivity being especially problematic. If verified, these findings have important implications for the interpretation of prior research with these criteria. These non-invariant age and sex effects may be identifying criteria-level expression features relevant to BPD nosology and etiology. Criterion functioning assessed using modern psychometric methods should be considered in the development of DSM-V. PMID:19400977

  11. [Elaboration of Criteria and Indicators to Develop and Evaluate Programs of Healthy Aging in the Workplace].

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    Mateo Rodríguez, Inmaculada; Daponte Codina, Antonio; Bernal Solano, Mariola; Sánchez Pérez, M José

    2015-10-01

    In the actual context of population ageing and extension of working age, programs for health promotion at the workplace are a key and necessary tool to promote an active and healthy ageing. This work presents the methodological process followed to elaborate a checklist tool, within the framework of the European project Progress, that contributes to orientate planning, implementation and evaluation of good practices in this field, to be applicable to a variety of programs, countries and workplaces. A Delphi technique has been applied in three rounds in which experts in the area from five European countries participated. A questionnaire created from a list of criteria and indicators was adapted throughout the rounds, with the use of webmail, to the evaluation of interventions in the field of interest. Through processes of assessment and consensus, criteria and indicators most relevant were prioritized. From the nine starting criteria and after the implementation of the technique, four key criteria were prioritized: relevance: 62, adequacy to objective: 57, innovation: 50 and guarantee of quality: 41. Using this group of criteria and indicators, a checklist was designed containing the key information that should be collected for planning, implementation and evaluation of good practices in interventions in this field. The checklist tool helps to systematize the global methodology for the implementation of interventions which could be very useful for persons responsible of programmes to promote active and healthy ageing in the workplace.

  12. Severity assessment criteria recommended by the British Thoracic Society (BTS) for community-acquired pneumonia (CAP) and older patients. Should SOAR (systolic blood pressure, oxygenation, age and respiratory rate) criteria be used in older people? A compilation study of two prospective cohorts.

    Science.gov (United States)

    Myint, Phyo K; Kamath, Ajay V; Vowler, Sarah L; Maisey, David N; Harrison, Brian D W

    2006-05-01

    To assess the usefulness of the British Thoracic Society guidelines for severity assessment of community-acquired pneumonia (CAP) in predicting mortality and to explore alternative criteria which could be more useful in older patients. Compilation study of two prospective observational cohorts. A University hospital in Norfolk, UK with a catchment population of 568,000. Subjects were 195 patients (median age = 77 years) who were included in two prospective studies of CAP. All-cause mortality occurring within the 6 week follow-up. sensitivity, specificity, positive and negative predictive values for study outcome using CURB and CURB-65 were assessed in 189 patients, and CRB-65 in 192 patients out of a total of 195 patients. Our results were comparable with the original study by Lim et al. Although CURB-65 and CRB-65 included age criteria, in effect they did not materially improve the specificity in predicting high-risk patients in both studies. We found that oxygenation measured by ventilation perfusion mismatch (PaO2:FiO2) was the best predictor of outcome in this slightly older cohort [odds ratio (OR) = 0.99 (0.98-0.99), P = 0.0001]. We derived a new set of criteria; SOAR (systolic blood pressure, oxygenation, age and respiratory rate) based on our findings. Their sensitivity, specificity, positive and negative predictive values were 81.0% (58.1-94.6), 59.3% (49.6-68.4), 27.0% (16.6-39.7) and 94.4% (86.2-98.4), respectively, confirming their comparability with existing criteria. Our Study confirms the usefulness of currently recommended severity rules for CAP in this older cohort. SOAR criteria may be useful as alternative criteria for a better identification of severe CAP in advanced age where both raised urea level above 7 mmol/l and confusion are common.

  13. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone

    DEFF Research Database (Denmark)

    Lauritsen, M P; Bentzen, J G; Pinborg, A

    2014-01-01

    -anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries...... ovaries with a significant age-related decrease from 69.0% in women reliable marker of polycystic ovaries in women with PCOS according to the Rotterdam criteria [area....... However, future studies are needed to validate AMH threshold levels, and AMH Z-score may be appropriate to adjust for the age-related decline in the AFC. STUDY FUNDING/COMPETING INTEREST(S): None. TRIAL REGISTRATION NUMBER: Not applicable....

  14. Targeted Screening With Combined Age- and Morphology-Based Criteria Enriches Detection of Lynch Syndrome in Endometrial Cancer.

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    Lin, Douglas I; Hecht, Jonathan L

    2016-06-01

    Endometrial cancer is associated with Lynch syndrome in 2% to 6% of cases. Adequate screening may prevent of a second cancer and incident cancers in family members via risk-reducing strategies. The goal of the study was to evaluate the detection rate of Lynch syndrome via a targeted screening approach. In 2009, we incorporated targeted Lynch syndrome screening via immunohistochemistry for MLH1, PMS2, MSH2, and MSH6, followed by MLH1 promoter hypermethylation, in select cases of endometrial carcinoma. Criteria for patient selection included (1) all patients Lynch syndrome. Therefore, targeted screening with combined age and morphology based criteria enriches detection of Lynch syndrome in endometrial cancer. However, the detection rate is lower than the rates from published series that offer universal screening. © The Author(s) 2016.

  15. Comparing new diagnostic criteria of 2010 ACR/EULAR with 1987 ACR criteria in rheumatoid arthritis

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    Fatemeh Shirani

    2017-01-01

    Full Text Available Background: Rheumatoid Arthritis (RA is a chronic inflammatory disease presenting with inflammation, tenderness and destruction of the synovial joints, resulting in severe disability and early death due to complication of disease. Previous diagnostic criteria are not useful for identifying patients who need early treatment. Thus, new diagnostic criteria for faster diagnosis of disease are introduced in 2010. The aim of this study was to compared 1987 ACR (American College of Rheumatology criteria and 2010 ACR/EULAR (European League Against Rheumatism classification criteria for diagnosis of rheumatoid arthritis. Methods: In this Cohort prospective study, patients with early arthritis were evaluated   according to the old and new diagnostic criteria and followed-up every two monthly for one year (2012-2013 in Hazrat-e Rasool University Hospital, Tehran. Inclusion criteria of this study were age more than 18 year and indefinite diagnosis of arthritis. For all of patients physical examination by expert rheumatologist was done and lab data include erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, anti-cyclic citrullinated peptide (Anti-CCP and rheumatoid factor was requested. The sensitivity, specificity, positive and negative predictive values were then determined for each diagnostic criteria. Results: In this study 104 patients including 28 males (26.9% and 76 females (73.1% with the mean age of 44.2±13.7 years were included. At the end of one year follow-up, 82 were diagnosed to have RA while other 22 patients were not categorized as RA. Sensitivity for ESR, CRP, Anti-CCP and rheumatoid factor in 2010 ACR/EULAR criteria was 52%, 19%, 48%, 28% and specificity for them was 45%, 71%, 27%, 79% respectively. Number of small and large joint arthritis were more in patients with Rheumatoid Arthritis (RA rather than other arthritis (P=0.0001. Sensitivity and specificity for small joints involvement was 87% and 54% and for large joints

  16. Refining aging criteria for northern sea otters in Washington State

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    Schuler, Krysten L.; Baker, Bridget B.; Mayer, Karl A.; Perez-Heydrich, Carolina; Holahan, Paula M.; Thomas, Nancy J.; White, C. LeAnn

    2018-01-01

    Measurement of skull ossification patterns is a standard method for aging various mammalian species and has been used to age Russian, Californian, and Alaskan sea otter populations. Cementum annuli counts have also been verified as an accurate aging method for the Alaskan sea otter population. In this study, cementum annuli count results and skull ossification patterns were compared as methods for aging the northern sea otter (Enhydra lutris kenyoni) population in Washington State. Significant agreement was found between the two methods suggesting that either method could be used to age the Washington population of otters. This study also found that ossification of the squamosal-jugal suture at the ventral glenoid fossa can be used to differentiate male subadults from adults. To assist field biologists or others without access to cementum annuli or skull ossification analysis techniques, a suite of morphologic, physiologic, and developmental characteristics were analyzed to assess whether a set of these more easily accessible parameters could also predict age class for the Washington population of otters. Tooth condition score, evidence of reproductive activity in females, and tooth eruption pattern were identified as the most useful criteria for classifying Washington sea otters as pups, juveniles, subadults, or adults/aged adults. A simple decision tree based on characteristics accessible in the field or at necropsy was created that can be used to reliably predict age class of Washington sea otters as determined by cementum annuli.

  17. Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children Ages 1-5 Years: A Causal Modeling Analysis.

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    Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N'Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

    2016-03-01

    There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modeling analysis in children ages 1-5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups, and regions. ART-naïve children of ages 12-59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. About one quarter of the 5,826 included children was from West Africa (24.6%).The median (first; third quartile) CD4% at the first visit was 16% (11%; 23%), the median weight-for-age z-scores and height-for-age z-scores were -1.5 (-2.7; -0.6) and -2.5 (-3.5; -1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count <750 cells/mm³ or CD4% <25% was 0.2% (95% CI = -0.2%; 0.3%), and the difference in the mean height-for-age z-scores of those who survived was -0.02 (95% CI = -0.04; 0.01). Younger children ages 1-2 and children in West Africa had worse outcomes. Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, although we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below 750/25%.

  18. The revision of RP 91 on criteria for acceptability of radiological (including radiotherapy) and nuclear medicine installations

    International Nuclear Information System (INIS)

    Faulkner, K.; Malone, J. F.; Christofides, S.; Lillicrap, S.; Horton, P.

    2013-01-01

    In 1997 the European Commission published Radiation Protection 91: 'Criteria for acceptability of radiological (including radiotherapy) and nuclear medicine installations'(1). This document specified the minimum criteria for acceptability. It has been used to this effect in legislation, codes of practice and by individual professionals. In a single document, it defined a level of performance at which remedial action was required. The document specified a series of parameters which characterised equipment performance and acceptable levels of performance. In its time it proved to be a useful document which was applied in member states to various degrees. Since the publication of Report 91 in 1997(1), a series of weaknesses emerged over time. Development of new radiological systems and technologies, as well as improvements in traditional technologies, has created circumstances where the acceptability criteria were in need of review. These weaknesses were recognised by the European Commission and a tender for its revision was issued. The criteria were developed by a team drawn from a broad range of backgrounds including hospitals, industry, government bodies, regulators and standardisation organisations. Representatives were mainly from Europe, but individuals from the American Association of Physicists in Medicine and International Atomic Energy Agency were included in the drafting process. This study describes the process employed in developing the revised document and the consultation process involved. One of the major difficulties the revision team encountered was related to an understanding of the actual meaning of the EC Directive(2). The view taken by the revision team was that Article 8, paragraph 3 places responsibilities on both the holders of radiological equipment and competent authorities. The acceptability criteria have been produced consistent with the European Commission's Medical Exposures Directive(2), which requires that patient exposures are

  19. Exploring the Proposed DSM-5 Criteria in a Clinical Sample

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    Taheri, Azin; Perry, Adrienne

    2012-01-01

    The proposed DSM-5 criteria for Autism Spectrum Disorder (ASD) depart substantially from the previous DSM-IV criteria. In this file review study of 131 children aged 2-12, previously diagnosed with either Autistic Disorder or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), 63% met the new DSM-5 ASD criteria, including 81%…

  20. Biomechanics of side impact: injury criteria, aging occupants, and airbag technology.

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    Yoganandan, Narayan; Pintar, Frank A; Stemper, Brian D; Gennarelli, Thomas A; Weigelt, John A

    2007-01-01

    This paper presents a survey of side impact trauma-related biomedical investigations with specific reference to certain aspects of epidemiology relating to the growing elderly population, improvements in technology such as side airbags geared toward occupant safety, and development of injury criteria. The first part is devoted to the involvement of the elderly by identifying variables contributing to injury including impact severity, human factors, and national and international field data. This is followed by a survey of various experimental models used in the development of injury criteria and tolerance limits. The effects of fragility of the elderly coupled with physiological changes (e.g., visual, musculoskeletal) that may lead to an abnormal seating position (termed out-of-position) especially for the driving population are discussed. Fundamental biomechanical parameters such as thoracic, abdominal and pelvic forces; upper and lower spinal and sacrum accelerations; and upper, middle and lower chest deflections under various initial impacting conditions are evaluated. Secondary variables such as the thoracic trauma index and pelvic acceleration (currently adopted in the United States Federal Motor Vehicle Safety Standards), peak chest deflection, and viscous criteria are also included in the survey. The importance of performing research studies with specific focus on out-of-position scenarios of the elderly and using the most commonly available torso side airbag as the initial contacting condition in lateral impacts for occupant injury assessment is emphasized.

  1. Measurement non-invariance of DSM-IV narcissistic personality disorder criteria across age and sex in a population-based sample of Norwegian twins.

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    Kubarych, Thomas S; Aggen, Steven H; Kendler, Kenneth S; Torgersen, Sven; Reichborn-Kjennerud, Ted; Neale, Michael C

    2010-09-01

    We investigated measurement non-invariance of DSM-IV narcissistic personality disorder (NPD) criteria across age and sex in a population-based cohort sample of 2794 Norwegian twins. Age had a statistically significant effect on the factor mean for NPD. Sex had a statistically significant effect on the factor mean and variance. Controlling for these factor level effects, item-level analysis indicated that the criteria were functioning differently across age and sex. After correcting for measurement differences at the item level, the latent factor mean effect for age was no longer statistically significant. The mean difference for sex remained statistically significant after correcting for item threshold effects. The results indicate that DSM-IV NPD criteria perform differently in males and females and across age. Differences in diagnostic rates across groups may not be valid without correcting for measurement non-invariance.

  2. Social anxiety disorder diagnostic criteria perform equally across age, comorbid diagnosis, and performance/interaction subtypes.

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    Crome, Erica; Baillie, Andrew

    2015-01-01

    The prevalence of social anxiety disorder (SAD) is frequently higher in younger age groups and people with other anxiety or mood disorders; however, it is unclear whether these groups have a higher risk for developing SAD or are simply more likely to endorse diagnostic criteria than other people with similar levels of social anxiety. Explicitly testing the assumption all people respond to structured diagnostic interviews in comparable ways (measurement invariance) is essential in ensuring systematic response biases do not create spurious group differences. This research aims to systematically test whether age, comorbidity status, or types of social fears affect responses to a structured diagnostic interview. Responses from 1755 participants in a large-scale survey of mental health in Australia screening into the social phobia/SAD section of the Composite International Diagnostic Interview were used. Three series of multigroup confirmatory factor analyses for categorical data systematically tested for increasingly strict levels of measurement invariance. Overall, patterns of responding to diagnostic criteria were comparable across the groups, supporting assumptions of measurement invariance. Establishment of invariance supports the interpretation of differences between age, comorbidity status, and types of social situations feared as genuine differences in experience as opposed to measurement biases.

  3. Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis

    Science.gov (United States)

    Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N’Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

    2017-01-01

    Background There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions. Methods ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. Results About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm3 or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes. Conclusions Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%. PMID:26479876

  4. New age- and sex-specific criteria for QT prolongation based on rate correction formulas that minimize bias at the upper normal limits.

    Science.gov (United States)

    Rautaharju, Pentti M; Mason, Jay W; Akiyama, Toshio

    2014-07-01

    Existing formulas for rate-corrected QT (QTc) commonly fail to properly adjust the upper normal limits which are more critical than the mean QTc for evaluation of prolonged QT. Age- and sex-related differences in QTc are also often overlooked. Our goal was to establish criteria for prolonged QTc using formulas that minimize QTc bias at the upper normal limits. Strict criteria were used in selecting a study group of 57,595 persons aged 5 to 89 years (54% women) and to exclude electrocardiograms (ECG) with possible disease-associated changes. Two QT rate adjustment formulas were identified which both minimized rate-dependency in the 98 th percentile limits: QTcmod, based on an electrophysiological model (QTcMod = QTx(120 + HR)/180)), and QTcLogLin, a power function of the RR interval with exponents 0.37 for men and 0.38 for women. QTc shortened in men during adolescence and QTcMod became 13 ms shorter than in women at age 20-29 years. The sex difference was maintained through adulthood although decreasing with age. The criteria established for prolonged QTc were: Age < 40 years, men 430 ms, women 440 ms; Age 40 to 69, men 440 ms, women 450 ms; Age ≥ 70 years, men 455 ms, and women 460 ms. Sex difference in QTc originates from shortened QT in adolescent males. Upper normal limits for QTc vary substantially by age and sex, and it is essential to use age- and sex-specific criteria for evaluation of QT prolongation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Dental age estimation in the living after completion of third molar mineralization: new data for Gustafson's criteria.

    Science.gov (United States)

    Timme, M; Timme, W H; Olze, A; Ottow, C; Ribbecke, S; Pfeiffer, H; Dettmeyer, R; Schmeling, A

    2017-03-01

    There is a need for dental age estimation methods after completion of the third molar mineralization. Degenerative dental characteristics appear to be suitable for forensic age diagnostics beyond the 18th year of life. In 2012, Olze et al. investigated the criteria studied by Gustafson using orthopantomograms. The objective of this study was to prove the applicability and reliability of this method with a large cohort and a wide age range, including older individuals. For this purpose, 2346 orthopantomograms of 1167 female and 1179 male Germans aged 15 to 70 years were reviewed. The characteristics of secondary dentin formation, cementum apposition, periodontal recession and attrition were evaluated in all the mandibular premolars. The correlation of the individual characteristics with the chronological age was examined by means of a stepwise multiple regression analysis, in which the chronological age formed the dependent variable. Following those results, R 2 values amounted to 0.73 to 0.8; the standard error of estimate was 6.8 to 8.2 years. Fundamentally, the recommendation for conducting age estimations in the living by these methods can be shared. The values for the quality of the regression are, however, not precise enough for a reliable age estimation around regular retirement date ages. More precise regression formulae for the age group of 15 to 40 years of life are separately presented in this study. Further research should investigate the influence of ethnicity, dietary habits and modern health care on the degenerative characteristics in question.

  6. Discrete Material and Thickness Optimization of laminated composite structures including failure criteria

    DEFF Research Database (Denmark)

    Lund, Erik

    2017-01-01

    This work extends the Discrete Material and Thickness Optimization approach to structural optimization problems where strength considerations in the form of failure criteria are taken into account for laminated composite structures. It takes offset in the density approaches applied for stress...... constrained topology optimization of single-material problems and develops formulations for multi-material topology optimization problems applied for laminated composite structures. The method can be applied for both stress- and strain-based failure criteria. The large number of local constraints is reduced...

  7. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    Science.gov (United States)

    Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

    2015-01-01

    We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  8. Age associated differences in prevalence of individual rotterdam criteria and metabolic risk factors during reproductive age in 446 caucasian women with polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Glintborg, D; Mumm, H; Ravn, P

    2012-01-01

    , fasting lipids, insulin, glucose), transvaginal ultrasound, oral glucose tolerance tests (OGTT) (n=234), and ACTH tests (n=201). BMI, waist, Ferriman-Gallwey score, blood pressure, and lipid profile were higher in older vs. younger age groups whereas androgen levels were lower. Measures of insulin...... resistance were unchanged between age groups, but glucose levels were significantly higher in older age groups. Rotterdam criteria: The prevalence of PCO and biochemical hyperandrogenism decreased in the oldest age group whereas clinical hyperandrogenism increased. Young patients are characterized by PCO...... and biochemical hyperandrogenism, whereas older patients are more obese with more severe hirsutism and more cardiovascular and metabolic risk factors....

  9. Evaluation criteria of the individual motor predisposition of female sport gymnastics

    Directory of Open Access Journals (Sweden)

    Boraczynski T.

    2010-10-01

    Full Text Available In the paper were presented the results of research, aimed to improve criteria for assessing the motor predisposition of girls in sports gymnastics at the initial stage of training. The studies included 24 gymnasts divided into two age groups: A 6,0-7,5 years of age and B (8,3-13,0. The level of physical fitness was assessed with the use of the EUROFIT battery tests. easurements of the maximum moment of muscle strength in the bending forearm in the elbow joint in terms of isometric contraction were also performed. Assessment f the level of individual strengthspeed and coordination abilities and physical fitness structure including the pace of biological development were the basis for the development of objective criteria for assessing the sports predispositions of young gymnasts at the initial stage of training. Our results provide the basis for improving the control system and optimization of assessment criteria in women gymnastics, including age, training experience and sports level. The results presented in this paper demonstrated the usefulness of the research methodology used to assess the physical fitness and predispositions of gymnasts at the initial stage of training, what enables individualization of training process.

  10. Biomechanics of side impact: Injury criteria, aging occupants, and airbag technology

    OpenAIRE

    Yoganandan, Narayan; Pintar, Frank A.; Stemper, Brian D.; Gennarelli, Thomas A.; Weigelt, John A.

    2006-01-01

    This paper presents a survey of side impact trauma-related biomedical investigations with specific reference to certain aspects of epidemiology relating to the growing elderly population, improvements in technology such as side airbags geared toward occupant safety, and development of injury criteria. The first part is devoted to the involvement of the elderly by identifying variables contributing to injury including impact severity, human factors, and national and international field data. T...

  11. Application of the STOPP/START criteria to a medical record database.

    Science.gov (United States)

    Nauta, Katinka J; Groenhof, Feikje; Schuling, Jan; Hugtenburg, Jacqueline G; van Hout, Hein P J; Haaijer-Ruskamp, Flora M; Denig, Petra

    2017-10-01

    The STOPP/START criteria are increasingly used to assess prescribing quality in elderly patients at practice level. Our aim was to test computerized algorithms for applying these criteria to a medical record database. STOPP/START criteria-based computerized algorithms were defined using Anatomical-Therapeutic-Chemical (ATC) codes for medication and International Classification of Primary Care (ICPC) codes for diagnoses. The algorithms were applied to a Dutch primary care database, including patients aged ≥65 years using ≥5 chronic drugs. We tested for associations with patient characteristics that have previously shown a relationship with the original STOPP/START criteria, using multivariate logistic regression models. Included were 1187 patients with a median age of 75 years. In total, 39 of the 62 STOPP and 18 of the 26 START criteria could be converted to a computerized algorithm. The main reasons for inapplicability were lack of information on the severity of a condition and insufficient covering of ICPC-codes. We confirmed a positive association between the occurrence of both the STOPP and the START criteria and the number of chronic drugs (adjusted OR ranging from 1.37, 95% CI 1.04-1.82 to 3.19, 95% CI 2.33-4.36) as well as the patient's age (adjusted OR for STOPP 1.30, 95% CI 1.01-1.67; for START 1.73, 95% CI 1.35-2.21), and also between female gender and the occurrence of STOPP criteria (adjusted OR 1.41, 95% CI 1.09-1.82). Sixty-five percent of the STOPP/START criteria could be applied with computerized algorithms to a medical record database with ATC-coded medication and ICPC-coded diagnoses. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Continuity between DSM-5 Categorical Criteria and Traits Criteria for Borderline Personality Disorder.

    Science.gov (United States)

    Bach, Bo; Sellbom, Martin

    2016-08-01

    Borderline personality disorder (BPD) includes a heterogeneous constellation of symptoms operationalized with 9 categorical criteria. As the field of personality disorder (PD) research moves to emphasize dimensional traits in its operationalization, it is important to delineate continuity between the 9 DSM-IV/Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorical criteria for BPD and the trait dimensions in DSM-5 Section III. To date, no study has attempted such validation. We examined the associations between the 9 categorical DSM-IV/DSM-5 criteria for BPD and the trait dimensions of the alternative DSM-5 model for PDs in consecutively recruited psychiatric outpatients (N = 142; 68% female; age: mean 29.02, SD 8.38). This was investigated by means of bivariate correlations, followed by multiple logistic regression analysis. The categorical BPD criteria were associated with conceptually related DSM-5 Section III traits (P > 0.001), except for the criterion of chronic feelings of emptiness. Consistent with the proposed traits criteria for BPD in DSM-5 Section III, we found Emotional lability, Anxiousness, Separation insecurity, Depressivity, Impulsivity, Risk taking, and Hostility to capture conceptually coherent BPD categorical criteria, while Suspiciousness was also strongly associated with BPD criteria. At the domain level, this applied to Negative affectivity, Disinhibition, and Psychoticism. Notably, Emotional lability, Impulsivity, and Suspiciousness emerged as unique predictors of BPD (P > 0.05). In addition to the proposed BPD traits criteria, Suspiciousness and features of Psychoticism also augment BPD features. Provided that these findings are replicated in forthcoming research, a modified traits operationalization of BPD is warranted. © The Author(s) 2016.

  13. Quantitative and Qualitative Criteria for Assessing Endurance in Women over 60 Years of Age – Findings from a Pilot Study

    Directory of Open Access Journals (Sweden)

    Kortas Jakub

    2016-09-01

    Full Text Available Introduction. If it is to be effective, health training needs to be monitored based on regular and periodic assessment. The norms that have been proposed for standardised endurance tests for the 60-plus age group, particularly for women, still require evaluation. In light of the above, we have undertaken to design quantitative and qualitative criteria for assessing the level of endurance. Such criteria are urgently needed by persons working with this age group. Material and methods. We developed a quantitative and qualitative system for evaluating endurance based on Zatsiorky’s model, and we verified it in a group of 90 women aged over 60 years. We analysed data measured directly during a 2-km walk test. Results. We developed a set of quantitative and qualitative criteria for assessing endurance in women aged over 60 years based on the results of a 2-km walk test, measured on a scale ranging from 24:18 to 15:52 min:s. Conclusion. The pilot study has proven that a scale based on Zatsiorsky’s model can be an effective tool for assessing endurance in women aged over 60 years. We can thus recommend that it be widely used in practice. It is important to compare these results with the norms for the group in question and to establish comprehensive norms that could be useful for persons who organise physical activity for older adults.

  14. Breeding seasons, molt patterns, and gender and age criteria for selected northeastern Costa Rican resident landbirds

    Science.gov (United States)

    Jared D. Wolfe; Peter Pyle; C. John. Ralph

    2009-01-01

    Detailed accounts of molt and breeding cycles remain elusive for the majority of resident tropical bird species. We used data derived from a museum review and 12 years of banding data to infer breeding seasonality, molt patterns, and age and gender criteria for 27 common landbird species in northeastern Costa Rica. Prealternate molts appear to be rare, only occurring...

  15. Differential Item Functioning of Pathological Gambling Criteria: An Examination of Gender, Race/Ethnicity, and Age

    OpenAIRE

    Sacco, Paul; Torres, Luis R.; Cunningham-Williams, Renee M.; Woods, Carol; Unick, G. Jay

    2011-01-01

    This study tested for the presence of differential item functioning (DIF) in DSM-IV Pathological Gambling Disorder (PGD) criteria based on gender, race/ethnicity and age. Using a nationally representative sample of adults from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), indicating current gambling (n = 10,899), Multiple Indicator-Multiple Cause (MIMIC) models tested for DIF, controlling for income, education, and marital status. Compared to the reference grou...

  16. Academic achievement over 8 years among children who met modified criteria for attention-deficit/hyperactivity disorder at 4-6 years of age.

    Science.gov (United States)

    Massetti, Greta M; Lahey, Benjamin B; Pelham, William E; Loney, Jan; Ehrhardt, Ashley; Lee, Steve S; Kipp, Heidi

    2008-04-01

    The predictive validity of symptom criteria for different subtypes of ADHD among children who were impaired in at least one setting in early childhood was examined. Academic achievement was assessed seven times over 8 years in 125 children who met symptom criteria for ADHD at 4-6 years of age and in 130 demographically-matched non-referred comparison children. When intelligence and other confounds were controlled, children who met modified criteria for the predominantly inattentive subtype of ADHD in wave 1 had lower reading, spelling, and mathematics scores over time than both comparison children and children who met modified criteria for the other subtypes of ADHD. In some analyses, children who met modified criteria for the combined type had somewhat lower mathematics scores than comparison children. The robust academic deficits relative to intelligence in the inattentive group in this age range suggest either that inattention results in academic underachievement or that some children in the inattentive group have learning disabilities that cause secondary symptoms of inattention. Unexpectedly, wave 1 internalizing (anxiety and depression) symptoms independently predicted deficits in academic achievement controlling ADHD, intelligence, and other predictors.

  17. Core and peripheral criteria of video game addiction in the game addiction scale for adolescents.

    Science.gov (United States)

    Brunborg, Geir Scott; Hanss, Daniel; Mentzoni, Rune Aune; Pallesen, Ståle

    2015-05-01

    Assessment of video game addiction often involves measurement of peripheral criteria that indicate high engagement with games, and core criteria that indicate problematic use of games. A survey of the Norwegian population aged 16-74 years (N=10,081, response rate 43.6%) was carried out in 2013, which included the Gaming Addiction Scale for Adolescents (GAS). Confirmatory factor analysis showed that a two-factor structure, which separated peripheral criteria from core criteria, fitted the data better (CFI=0.963; RMSEA=0.058) compared to the original one-factor solution where all items are determined to load only on one factor (CFI=0.905, RMSEA=0.089). This was also found when we analyzed men aged ≤33 years, men aged >33 years, women aged ≤33 years, and women aged >33 years separately. This indicates that the GAS measures both engagement and problems related to video games. Multi-group measurement invariance testing showed that the factor structure was valid in all four groups (configural invariance) for the two-factor structure but not for the one-factor structure. A novel approach to categorization of problem gamers and addicted gamers where only the core criteria items are used (the CORE 4 approach) was compared to the approach where all items are included (the GAS 7 approach). The current results suggest that the CORE 4 approach might be more appropriate for classification of problem gamers and addicted gamers compared to the GAS 7 approach.

  18. Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

    Science.gov (United States)

    Dobie, Robert A; Wojcik, Nancy C

    2015-07-13

    The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to

  19. Prevalence of Eligibility Criteria for the Systolic Blood Pressure Intervention Trial in US Adults Among Excluded Groups: Age Diabetes Mellitus, or a History of Stroke.

    Science.gov (United States)

    Bress, Adam P; Tanner, Rikki M; Hess, Rachel; Gidding, Samuel S; Colantonio, Lisandro D; Shimbo, Daichi; Muntner, Paul

    2016-07-12

    Adults diabetes mellitus, or a history of stroke were not enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT). Estimating the size and characteristics of these excluded groups who meet the other SPRINT eligibility criteria may provide information on the potential impact of providers extending the SPRINT findings to these populations. We analyzed the National Health and Nutrition Examination Survey 2003-2012 (n=25 076) to estimate the percentage and characteristics of US adults ≥20 years in 3 populations (age diabetes mellitus, or history of stroke) excluded from SPRINT who otherwise meet the trial eligibility criteria: age ≥50 years, systolic blood pressure (SBP) 130-180 mm Hg, high cardiovascular disease risk, and not having trial exclusion criteria. Overall, 1.0% (95% CI 0.8-1.3) of US adults age diabetes mellitus, and 19.0% (95% CI 16.0-22.4) with history of stroke met the other SPRINT eligibility criteria. Among US adults with SBP ≥130 mm Hg, other SPRINT eligibility criteria were met by 7.5% (95% CI 6.1-9.2) of those age diabetes mellitus, and 23.0% (95% CI 19.4-27.0) with history of stroke. Among US adults meeting the other SPRINT eligibility criteria, antihypertensive medication was being taken by 31.0% (95% CI 23.9-41.3) of those diabetes mellitus, and 68.9% (95% CI 59.4-77.1) with a history of stroke. A substantial percentage of US adults with diabetes mellitus or history of stroke and a small percentage <50 years old meet the other SPRINT eligibility criteria. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  20. Core and Peripheral Criteria of Video Game Addiction in the Game Addiction Scale for Adolescents

    OpenAIRE

    Brunborg, Geir Scott; Hanss, Daniel; Mentzoni, Rune Aune; Pallesen, St?le

    2015-01-01

    Abstract Assessment of video game addiction often involves measurement of peripheral criteria that indicate high engagement with games, and core criteria that indicate problematic use of games. A survey of the Norwegian population aged 16?74 years (N=10,081, response rate 43.6%) was carried out in 2013, which included the Gaming Addiction Scale for Adolescents (GAS). Confirmatory factor analysis showed that a two-factor structure, which separated peripheral criteria from core criteria, fitted...

  1. BSN Program Admittance Criteria: Should Emotional Intelligence Be Included?

    Science.gov (United States)

    Smith, Tanya

    2017-01-01

    Emotional intelligence refers to the ability to identify and monitor emotions and remain aware of how emotions affect thoughts and actions. Emotional intelligence has been discussed as a better predictor of personal and occupational success than performance on intellectual intelligence tests. Despite the importance of one's emotional intelligence, BSN (Bachelor of Science in Nursing) nursing schools routinely admit candidates based on the student's cumulative college course grade point average (GPA). Nursing is a profession that requires one's ability to empathize, care, and react in emotionally sound manners. Is the GPA enough to determine if a student will evolve into a professional nurse? This article will explore the routine admittance criteria for BSN nursing programs and propose the concept of using the emotional intelligence tool as an adjunct to the cumulative college course GPA. The emotional intelligence theory will be identified and applied to the nursing profession. © 2016 Wiley Periodicals, Inc.

  2. Differential item functioning of pathological gambling criteria: an examination of gender, race/ethnicity, and age.

    Science.gov (United States)

    Sacco, Paul; Torres, Luis R; Cunningham-Williams, Renee M; Woods, Carol; Unick, G Jay

    2011-06-01

    This study tested for the presence of differential item functioning (DIF) in DSM-IV Pathological Gambling Disorder (PGD) criteria based on gender, race/ethnicity and age. Using a nationally representative sample of adults from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), indicating current gambling (n = 10,899), Multiple Indicator-Multiple Cause (MIMIC) models tested for DIF, controlling for income, education, and marital status. Compared to the reference groups (i.e., Male, Caucasian, and ages 25-59 years), women (OR = 0.62; P gambling to escape (Criterion 5) (OR = 2.22; P < .001) but young adults (OR = 0.62; P < .05) were less likely to endorse it. African Americans (OR = 2.50; P < .001) and Hispanics were more likely to endorse trying to cut back (Criterion 3) (OR = 2.01; P < .01). African Americans were more likely to endorse the suffering losses (OR = 2.27; P < .01) criterion. Young adults were more likely to endorse chasing losses (Criterion 9) (OR = 1.81; P < .01) while older adults were less likely to endorse this criterion (OR = 0.76; P < .05). Further research is needed to identify factors contributing to DIF, address criteria level bias, and examine differential test functioning.

  3. Criteria CSR

    OpenAIRE

    Vovk, V.; Zateyshikova, O.

    2014-01-01

    In the article the theoretical aspects regarding criteria for assessing CSR proposed by A. Carroll, including: economic, legal, ethical, philanthropic. Based on this, it is proposed to characterize these criteria with respect to the interested parties (stakeholders), including: investors, shareholders suppliers, customers, employees, society and the state. This will make a qualitative assessment of the presence and depth using social responsibility in the company, as well as determine the ext...

  4. Failure to thrive: the prevalence and concurrence of anthropometric criteria in a general infant population

    Science.gov (United States)

    Olsen, E M; Petersen, J; Skovgaard, A M; Weile, B; Jørgensen, T; Wright, C M

    2007-01-01

    Background Failure to thrive (FTT) in early childhood is associated with subsequent developmental delay and is recognised to reflect relative undernutrition. Although the concept of FTT is widely used, no consensus exists regarding a specific definition, and it is unclear to what extent different anthropometric definitions concur. Objective To compare the prevalence and concurrence of different anthropometric criteria for FTT and test the sensitivity and positive predictive values of these in detecting children with “significant undernutrition”, defined as the combination of slow conditional weight gain and low body mass index (BMI). Methods Seven criteria of FTT, including low weight for age, low BMI, low conditional weight gain and Waterlow's criterion for wasting, were applied to a birth cohort of 6090 Danish infants. The criteria were compared in two age groups: 2–6 and 6–11 months of life. Results 27% of infants met one or more criteria in at least one of the two age groups. The concurrence among the criteria was generally poor, with most children identified by only one criterion. Positive predictive values of different criteria ranged from 1% to 58%. Most single criteria identified either less than half the cases of significant undernutrition (found in 3%) or included far too many, thus having a low positive predictive value. Children with low weight for height tended to be relatively tall. Conclusions No single measurement on its own seems to be adequate for identifying nutritional growth delay. Further longitudinal population studies are needed to investigate the discriminating power of different criteria in detecting significant undernutrition and subsequent outcomes. PMID:16531456

  5. Development of statewide geriatric patients trauma triage criteria.

    Science.gov (United States)

    Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

    2011-06-01

    The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

  6. Validation of Proposed "DSM-5" Criteria for Autism Spectrum Disorder

    Science.gov (United States)

    Frazier, Thomas W.; Youngstrom, Eric A.; Speer, Leslie; Embacher, Rebecca; Law, Paul; Constantino, John; Findling, Robert L.; Hardan, Antonio Y.; Eng, Charis

    2012-01-01

    Objective: The primary aim of the present study was to evaluate the validity of proposed "DSM-5" criteria for autism spectrum disorder (ASD). Method: We analyzed symptoms from 14,744 siblings (8,911 ASD and 5,863 non-ASD) included in a national registry, the Interactive Autism Network. Youth 2 through 18 years of age were included if at least one…

  7. Defining sarcopenia : The impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort

    NARCIS (Netherlands)

    Bijlsma, A. Y.; Meskers, C. G M; Ling, C. H Y; Narici, M.; Kurrle, S. E.; Cameron, I. D.; Westendorp, R. G J; Maier, A. B.

    Sarcopenia, low muscle mass, is an increasing problem in our ageing society. The prevalence of sarcopenia varies extremely between elderly cohorts ranging from 7% to over 50%. Without consensus on the definition of sarcopenia, a variety of diagnostic criteria are being used. We assessed the degree

  8. Development of a new risk score for incident type 2 diabetes using updated diagnostic criteria in middle-aged and older chinese.

    Directory of Open Access Journals (Sweden)

    Xingwang Ye

    Full Text Available Type 2 diabetes mellitus (T2DM reaches an epidemic proportion among adults in China. However, no simple score has been created for the prediction of T2DM incidence diagnosed by updated criteria with hemoglobin A1c (HbA1c ≥ 6.5% included in Chinese. In a 6-year follow-up cohort in Beijing and Shanghai, China, we recruited a total of 2529 adults aged 50-70 years in 2005 and followed them up in 2011. Fasting plasma glucose (FPG, HbA1c, and C-reactive protein (CRP were measured and incident diabetes was identified by the recently updated criteria. Of the 1912 participants without T2DM at baseline, 924 were identified as having T2DM at follow-up, and most of them (72.4% were diagnosed using the HbA1c criterion. Baseline body mass index, FPG, HbA1c, CRP, hypertension, and female gender were all significantly associated with incident T2DM. Based upon these risk factors, a simple score was developed with an estimated area under the receiver operating characteristic curve of 0.714 (95% confidence interval: 0.691, 0.737, which performed better than most of existing risk score models developed for eastern Asian populations. This simple, newly constructed score of six parameters may be useful in predicting T2DM in middle-aged and older Chinese.

  9. Microscopic age determination of human skeletons including an unknown but calculable variable

    DEFF Research Database (Denmark)

    Wallin, Johan Albert; Tkocz, Izabella; Kristensen, Gustav

    1994-01-01

    estimation, which includes the covariance matrix of four single equation residuals, improves the accuracy of age determination. The standard deviation, however, of age prediction remains 12.58 years. An experimental split of the data was made in order to demonstrate that the use of subgroups gives a false...

  10. Criteria for radiologic diagnosis of hypochondroplasia in neonates

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Tomoko; Nagasaki, Keisuke; Wada, Masaki; Nyuzuki, Hiromi; Saitoh, Akihiko [Niigata University Graduate School of Medical and Dental Sciences, Division of Pediatrics, Department of Homeostatic Regulation and Development (Japan); Nishimura, Gen [Tokyo Metropolitan Children' s Medical Center, Department of Radiology, Tokyo (Japan); Takagi, Masaki [Tokyo Metropolitan Children' s Medical Center, Department of Endocrinology, Tokyo (Japan); Keio University School of Medicine, Department of Pediatrics, Tokyo (Japan); Hasegawa, Tomonobu; Amano, Naoko [Keio University School of Medicine, Department of Pediatrics, Tokyo (Japan); Murotsuki, Jun [Tohoku University Graduate School of Medicine, Miyagi Children' s Hospital, Department of Maternal and Fetal Medicine, Sendai (Japan); Sawai, Hideaki [Hyogo College of Medicine, Departments of Obstetrics and Gynecology, Hyogo (Japan); Yamada, Takahiro [Hokkaido University Hospital, Departments of Obstetrics and Gynecology, Hokkaido (Japan); Sato, Shuhei [Aomori Rosai Hospital, Department of Obstetrics and Gynecology, Aomori (Japan)

    2016-04-15

    A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates. (orig.)

  11. Criteria for radiologic diagnosis of hypochondroplasia in neonates

    International Nuclear Information System (INIS)

    Saito, Tomoko; Nagasaki, Keisuke; Wada, Masaki; Nyuzuki, Hiromi; Saitoh, Akihiko; Nishimura, Gen; Takagi, Masaki; Hasegawa, Tomonobu; Amano, Naoko; Murotsuki, Jun; Sawai, Hideaki; Yamada, Takahiro; Sato, Shuhei

    2016-01-01

    A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates. (orig.)

  12. Including robustness in multi-criteria optimization for intensity-modulated proton therapy

    Science.gov (United States)

    Chen, Wei; Unkelbach, Jan; Trofimov, Alexei; Madden, Thomas; Kooy, Hanne; Bortfeld, Thomas; Craft, David

    2012-02-01

    We present a method to include robustness in a multi-criteria optimization (MCO) framework for intensity-modulated proton therapy (IMPT). The approach allows one to simultaneously explore the trade-off between different objectives as well as the trade-off between robustness and nominal plan quality. In MCO, a database of plans each emphasizing different treatment planning objectives, is pre-computed to approximate the Pareto surface. An IMPT treatment plan that strikes the best balance between the different objectives can be selected by navigating on the Pareto surface. In our approach, robustness is integrated into MCO by adding robustified objectives and constraints to the MCO problem. Uncertainties (or errors) of the robust problem are modeled by pre-calculated dose-influence matrices for a nominal scenario and a number of pre-defined error scenarios (shifted patient positions, proton beam undershoot and overshoot). Objectives and constraints can be defined for the nominal scenario, thus characterizing nominal plan quality. A robustified objective represents the worst objective function value that can be realized for any of the error scenarios and thus provides a measure of plan robustness. The optimization method is based on a linear projection solver and is capable of handling large problem sizes resulting from a fine dose grid resolution, many scenarios, and a large number of proton pencil beams. A base-of-skull case is used to demonstrate the robust optimization method. It is demonstrated that the robust optimization method reduces the sensitivity of the treatment plan to setup and range errors to a degree that is not achieved by a safety margin approach. A chordoma case is analyzed in more detail to demonstrate the involved trade-offs between target underdose and brainstem sparing as well as robustness and nominal plan quality. The latter illustrates the advantage of MCO in the context of robust planning. For all cases examined, the robust optimization for

  13. Convex reformulation of biologically-based multi-criteria intensity-modulated radiation therapy optimization including fractionation effects.

    Science.gov (United States)

    Hoffmann, Aswin L; den Hertog, Dick; Siem, Alex Y D; Kaanders, Johannes H A M; Huizenga, Henk

    2008-11-21

    Finding fluence maps for intensity-modulated radiation therapy (IMRT) can be formulated as a multi-criteria optimization problem for which Pareto optimal treatment plans exist. To account for the dose-per-fraction effect of fractionated IMRT, it is desirable to exploit radiobiological treatment plan evaluation criteria based on the linear-quadratic (LQ) cell survival model as a means to balance the radiation benefits and risks in terms of biologic response. Unfortunately, the LQ-model-based radiobiological criteria are nonconvex functions, which make the optimization problem hard to solve. We apply the framework proposed by Romeijn et al (2004 Phys. Med. Biol. 49 1991-2013) to find transformations of LQ-model-based radiobiological functions and establish conditions under which transformed functions result in equivalent convex criteria that do not change the set of Pareto optimal treatment plans. The functions analysed are: the LQ-Poisson-based model for tumour control probability (TCP) with and without inter-patient heterogeneity in radiation sensitivity, the LQ-Poisson-based relative seriality s-model for normal tissue complication probability (NTCP), the equivalent uniform dose (EUD) under the LQ-Poisson model and the fractionation-corrected Probit-based model for NTCP according to Lyman, Kutcher and Burman. These functions differ from those analysed before in that they cannot be decomposed into elementary EUD or generalized-EUD functions. In addition, we show that applying increasing and concave transformations to the convexified functions is beneficial for the piecewise approximation of the Pareto efficient frontier.

  14. Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria

    Directory of Open Access Journals (Sweden)

    Bonet M

    2012-06-01

    Full Text Available Objective: The aims of this study were to identify potentially inappropriate prescribing using the Beers and STOPP criteria. The START criteria were applied to detect prescription omission in the geriatric population. We compared the utility of these criteria in institutionalised older people.Methods: Descriptive study reviewing the medication and clinical records of 81 residents (aged 65 years and more by pharmacists in a nursing home in the Lleida region (Spain.Results: The mean patients’ age was 84 (SD=8 years, with an average of 5 drugs per resident (total prescriptions: 416 medicines. The Beers criteria identified potentially inappropriate medication use in 25% of patients and 48% of patients used at least 1 inappropriate medication according to STOPP criteria. The most frequent potentially inappropriate medications for both criteria were long-acting benzodiazepines and NSAIDs. START detected 58 potential prescribing omissions in 44% of patients. Calcium-vitamin D supplementation in osteoporosis was the most frequent rule (15%, but omissions corresponding to the cardiovascular system implied 23% of patients.Conclusion: The STOPP-START criteria reveal that potentially inappropriate prescribing (PIP is a highly prevalent problem among Spanish nursing home residents, and a statistically significant positive correlation was found between the number of medicines prescribed and the number of PIP detected in this study. The STOPP criteria detect a larger number of PI medications in this geriatric population than the Beers criteria. The prescribing omissions detected by the START criteria are relevant and require intervention. Pharmacists’ review of medications may help identify potentially inappropriate prescribing and, through an interdisciplinary approach, working with physicians may improve prescribing practices among geriatric residents of nursing homes.

  15. The Impact of Different Diagnostic Criteria on the Prevalence of Sarcopenia in Healthy Elderly Participants and Geriatric Outpatients.

    Science.gov (United States)

    Reijnierse, Esmee M; Trappenburg, Marijke C; Leter, Morena J; Blauw, Gerard Jan; Sipilä, Sarianna; Sillanpää, Elina; Narici, Marco V; Hogrel, Jean-Yves; Butler-Browne, Gillian; McPhee, Jamie S; Gapeyeva, Helena; Pääsuke, Mati; de van der Schueren, Marian A E; Meskers, Carel G M; Maier, Andrea B

    2015-01-01

    A consensus on the diagnostic criteria for sarcopenia, a common syndrome in the elderly, has not been reached yet. Prevalence rates vary between studies due to the use of different criteria encompassing different measures, correction factors and cutoff points. This study compared prevalence rates of sarcopenia using nine sets of diagnostic criteria applied in two different elderly populations. The study population encompassed 308 healthy elderly participants (152 males, 156 females; mean age 74 years) and 123 geriatric outpatients (54 males, 69 females; mean age 81 years). Diagnostic criteria included relative muscle mass, absolute muscle mass, muscle strength and physical performance. Prevalence rates of sarcopenia varied between 0 and 15% in healthy elderly participants and between 2 and 34% in geriatric outpatients. This study clearly demonstrates the dependency of sarcopenia prevalence rates on the applied diagnostic criteria. © 2015 S. Karger AG, Basel.

  16. Diagnostic criteria for severe acute malnutrition among infants aged under 6 mo.

    Science.gov (United States)

    Mwangome, Martha; Ngari, Moses; Fegan, Greg; Mturi, Neema; Shebe, Mohammed; Bauni, Evasius; Berkley, James A

    2017-06-01

    Background: There is an increasing recognition of malnutrition among infants under 6 mo of age (U6M). Current diagnosis criteria use weight-for-length z scores (WLZs), but the 2006 WHO standards exclude infants shorter than 45 cm. In older children, midupper arm circumference (MUAC) predicts mortality better than does WLZ. Outcomes may also be influenced by exposure to HIV and size or gestational age at birth. Diagnostic thresholds for WLZ, MUAC, and other indexes have not been fully evaluated against mortality risk among U6M infants. Objective: The aim was to determine the association of anthropometric indexes with risks of inpatient and postdischarge mortality among U6M infants recruited at the time of hospitalization. Design: We analyzed data from a cohort of U6M infants admitted to Kilifi County Hospital (2007-2013), Kenya. The primary outcomes were inpatient death and death during follow-up over 1 y after discharge. We calculated adjusted RRs for inpatient mortality and HRs for postdischarge mortality for different anthropometric measures and thresholds. Discriminatory value was assessed by using receiver operating characteristic curves. Results: A total of 2882 infants were admitted: 140 (4.9%) died in the hospital and 1405 infants were followed up after discharge. Of these, 75 (5.3%) died within 1 y during 1318 child-years of observation. MUAC and weight-for-age z score (WAZ) predicted inpatient and postdischarge mortality better than did WLZ ( P 0.05) and performed better than WLZ <-3 for both inpatient and postdischarge mortality (both P < 0.001). Reported small size at birth did not reduce the risk of death associated with anthropometric indexes. Conclusions: U6M infants at the highest risk of death are best targeted by using MUAC or WAZ. Further research into the effectiveness of potential interventions is required.

  17. Prevalence of chronic obstructive pulmonary disease according to BTS, ERS, GOLD and ATS criteria in relation to doctor's diagnosis, symptoms, age, gender, and smoking habits.

    Science.gov (United States)

    Lindberg, Anne; Jonsson, Ann-Christin; Rönmark, Eva; Lundgren, Rune; Larsson, Lars-Gunnar; Lundbäck, Bo

    2005-01-01

    Guidelines and standards for diagnosis and management of chronic obstructive pulmonary disease (COPD) have been presented by different national and international societies, but the spirometric criteria for COPD differ between guidelines. To estimate prevalence of COPD using the guidelines of the British Thoracic Society (BTS), the European Respiratory Society (ERS), the Global Initiative for Chronic Obstructive Lung Disease (GOLD), and the American Thoracic Society (ATS). Further, to evaluate reported airway symptoms, contacts with health care providers, and physician diagnosis of COPD in relation to the respective criteria, and gender differences. In 1992 a postal questionnaire was sent to a random sample of adults aged 20-69 years, 4,851 (85%) out of 5,681 subjects responded. In 1994-1995 a random sample of the responders, 970 subjects, were invited to a structured interview and a lung function test; 666 (69%) participated. The prevalence of COPD was 7.6, 14.0, 14.1, 12.2 and 34.1% according to BTS, ERS, GOLD, clinical ATS (with symptoms or physician diagnosis), and spirometric ATS criteria, respectively. Prevalent COPD was related to age, smoking habits and family history of obstructive airway disease but not to gender. Physician diagnosis of chronic bronchitis or emphysema was only reported by 16.3, 12.2, 11.0, 23.4 and 8.2% of subjects fulfilling the respective criteria, though a majority reported airway symptoms. The main determinants for prevalent COPD were age, smoking habits and spirometric criteria of COPD. Though a majority reported airway symptoms and contact with health care providers due to respiratory complaints, only a minority was diagnosed as having COPD, indicating a large underdiagnosis. Copyright (c) 2005 S. Karger AG, Basel.

  18. Behavioral outcome including attention deficit hyperactivity disorder/hyperactivity disorder and minor neurological signs in perinatal high-risk newborns at 4-6 years of age with relation to risk factors.

    Science.gov (United States)

    Sato, Masuko; Aotani, Hirofumi; Hattori, Ritsuko; Funato, Masahisa

    2004-06-01

    Diagnostic problems with the criteria of attention deficit hyperactivity disorder (ADHD) in the Diagnostic Statistical Manual, 4th edn, have been identified. The aim of this study was to clarify whether the minor neurological signs test (MNT) the authors had previously reported was a predictor for the criteria of ADHD or hyperactivity disorder (HD) in perinatal risk children at 4-6 years of age and what kind of risk factors related to MNT. A total of 136 children discharged from neonatal intensive care units were examined at the age of 4-6 years by a developmental neuropediatrician using both MNT and diagnostic criteria of DSM-IV ADHD/ICD-10 (International Classification of Diseases, 10th edn) HD. SPSS base and professional were used for statistical analysis. On comparison of diagnostic criteria between ADHD (11.0%) and HD (27.5%), the incidence in the same subjects showed significant difference. MNT scores showed significant correlation with criteria of ADHD (P Apgar 5 in the NLBW group and toxemia of pregnancy and small for gestational age (SGA) in VLBW group were highly correlated with behavioral outcome. Minor neurological signs test score was a significant predictor for criteria of ADHD and HD. High incidences of positive MNT were suspected in not only VLBW children but also NLBW children and Apgar 5 in NLBW children and toxemia of pregnancy and SGA in VLBW children influenced behavioral outcome.

  19. NWTS program criteria for mined geologic disposal of nuclear wasite: site performance criteria

    International Nuclear Information System (INIS)

    1981-02-01

    This report states ten criteria governing the suitability of sites for mined geologic disposal of high-level radioactive waste. The Department of Energy will use these criteria in its search for sites and will reevaluate their use when the Nuclear Regulatory Commission issues radioactive waste repository rules. These criteria encompass site geometry, geohydrology, geochemistry, geologic characteristics, tectonic environment, human intrusion, surface characteristics, environment, and potential socioeconomic impacts. The contents of this document include background discussion, site performance criteria, and appendices. The background section describes the waste disposal system, the application of the site criteria, and applicable criteria from NWTS-33(1) - Program Objectives, Functional Requirements and System Performance Criteria. Appendix A, entitled Comparison with Other Siting Criteria compares the NWTS criteria with those recommended by other agencies. Appendix B contains DOE responses to public comments received on the January 1980 draft of this document. Appendix C is a glossary

  20. Internet addiction: Do two diagnostic criteria measure the same thing?

    Directory of Open Access Journals (Sweden)

    Vijay Parkash

    2015-01-01

    Full Text Available Aim and Objective: To assess the agreement or concordance between two diagnostic criteria for Internet addiction (IA and to study the relationship between IA as per these criteria and socio-demographic and Internet use profile. Methodology: A cross-sectional design was followed. Six hundred participants, aged 18-40 years, having a personal Internet connection and using Internet for at least 1 year were evaluated using a semi-structured interview, on the Young′s Diagnostic Questionnaire, and IA diagnostic criteria developed by Tao et al., (2009. Results: Prevalence of IA varied from 1.2% to 21% depending on the assessment instrument. There is good level of concordance between Young′s IA criteria and Tao et al. "2 + 1" criteria, but the level of concordance reduced with the use of course and dysfunction criteria of Tao et al. Among the different Internet variables, age at first use, age at which the person starts regular use and total duration of nonessential use were related to development of IA. Conclusion: Findings of the present study suggest that there is good level of concordance between Young′s IA criteria and Tao et al. "2 + 1" criteria but the level of concordance reduces with the use of course and dysfunction criteria. This study also suggests that chances of IA increases with regular use of Internet and for a longer duration for nonessential uses.

  1. A Posteriori Error Estimates Including Algebraic Error and Stopping Criteria for Iterative Solvers

    Czech Academy of Sciences Publication Activity Database

    Jiránek, P.; Strakoš, Zdeněk; Vohralík, M.

    2010-01-01

    Roč. 32, č. 3 (2010), s. 1567-1590 ISSN 1064-8275 R&D Projects: GA AV ČR IAA100300802 Grant - others:GA ČR(CZ) GP201/09/P464 Institutional research plan: CEZ:AV0Z10300504 Keywords : second-order elliptic partial differential equation * finite volume method * a posteriori error estimates * iterative methods for linear algebraic systems * conjugate gradient method * stopping criteria Subject RIV: BA - General Mathematics Impact factor: 3.016, year: 2010

  2. Conversion to dementia in mild cognitive impairment diagnosed with DSM-5 criteria and with Petersen's criteria.

    Science.gov (United States)

    Marcos, G; Santabárbara, J; Lopez-Anton, R; De-la-Cámara, C; Gracia-García, P; Lobo, E; Pírez, G; Menchón, J M; Palomo, T; Stephan, B C M; Brayne, C; Lobo, A

    2016-05-01

    In a background of revision of criteria for states of increased risk for progression to dementia, we compare the conversion rate to dementia and Alzheimer's disease (AD) of mild cognitive impairment (MCI) as diagnosed using DSM-5 (DSM-5-MCI) and Petersen's (P-MCI) criteria. A population representative cohort of 4057 dementia-free individuals 55+ years of age was followed up at 2.5 and 4.5 years in Zaragoza, Spain (ZARADEMP). Using the Geriatric Mental State- AGECAT for assessment, research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. 'Conversion rate' (CR), 'annual conversion rate' (ACR), and incidence rate (IR) were calculated along with incidence rate ratio (IRR) to compare the performance of the intermediate cognitive definitions. At 4.5-year follow-up, in individuals aged 65+ years, ACRs for non-cases, P-MCI, and DSM-5-MCI were 0.8, 1.9 and 3.4, respectively, for global dementia. The IRRs were 2.9 and 5.3 for P-MCI and DSM5-MCI, respectively, being the non-cases the reference category. The corresponding values were slightly lower for AD. Conversion rate to dementia and AD was higher using DSM-5-MCI criteria than using Petersen's criteria. However, prediction of the construct still has some way to go, as most MCI individuals did not convert at 4.5-year follow-up. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Failure Models and Criteria for FRP Under In-Plane or Three-Dimensional Stress States Including Shear Non-Linearity

    Science.gov (United States)

    Pinho, Silvestre T.; Davila, C. G.; Camanho, P. P.; Iannucci, L.; Robinson, P.

    2005-01-01

    A set of three-dimensional failure criteria for laminated fiber-reinforced composites, denoted LaRC04, is proposed. The criteria are based on physical models for each failure mode and take into consideration non-linear matrix shear behaviour. The model for matrix compressive failure is based on the Mohr-Coulomb criterion and it predicts the fracture angle. Fiber kinking is triggered by an initial fiber misalignment angle and by the rotation of the fibers during compressive loading. The plane of fiber kinking is predicted by the model. LaRC04 consists of 6 expressions that can be used directly for design purposes. Several applications involving a broad range of load combinations are presented and compared to experimental data and other existing criteria. Predictions using LaRC04 correlate well with the experimental data, arguably better than most existing criteria. The good correlation seems to be attributable to the physical soundness of the underlying failure models.

  4. Do Different Diagnostic Criteria Impact Polycystic Ovary Syndrome Diagnosis for Adolescents?

    Science.gov (United States)

    Akgül, Sinem; Düzçeker, Yasemin; Kanbur, Nuray; Derman, Orhan

    2018-06-01

    Although early diagnosis of polycystic ovary syndrome (PCOS) in adolescents might allow for earlier treatment and prevention of chronic disorders, incorrect or premature diagnosis carries risks of unnecessary treatment and psychological distress. There is no consensus concerning which diagnostic criteria to use for adolescents and current criteria vary. The objective of this study was to determine whether using different diagnostic criteria will affect PCOS diagnosis in adolescents. Fifty-two patients aged 13-18 years with at least 2 of the following criteria were included in the study: (1) oligomenorrhea or amenorrhea; (2) Clinical or biochemical hyperandrogenism; and (3) polycystic ovaries on ultrasonography. Patients were then categorized according to the 6 different criteria for PCOS. National Institutes of Health, Rotterdam criteria, Androgen Excess Society, Amsterdam criteria, Endocrine Society criteria, and the Pediatric Endocrine Society criteria. The characteristics of adolescents who were diagnosed with PCOS were also evaluated. Forty-one patients out of 52 (78.8%) received diagnosis with National Institutes of Health and Endocrine Society criteria, all with Rotterdam criteria, 45/52 (86.5%) with Androgen Excess Society criteria, 36/52 (69.2%) with Amsterdam criteria and 34/52 (65.4%) with the Pediatric Endocrine Society criteria. This study shows that the choice of guideline used does have a great effect on whether an adolescent received the PCOS diagnosis or not. For physicians using the broader criteria, care should be taken to ensure the patient does not receive diagnosis because of the physiological changes seen during puberty, which might mimic PCOS. For those using stricter criteria, close monitoring of patients who do not receive diagnosis is necessary to prevent chronic complications. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  5. Sediment quality criteria: A review with recommendations for developing criteria for the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Driver, C.J.

    1994-05-01

    Criteria for determining the quality of liver sediment are necessary to ensure that concentrations of contaminants in aquatic systems are within acceptable limits for the protection of aquatic and human life. Such criteria should facilitate decision-making about remediation, handling, and disposal of contaminants. Several approaches to the development of sediment quality criteria (SQC) have been described and include both descriptive and numerical methods. However, no single method measures all impacts at all times to all organisms (U.S. EPA 1992b). The U.S. EPA`s interest is primarily in establishing chemically based, numerical SQC that are applicable nation-wide (Shea 1988). Of the approaches proposed for SQC development, only three are being considered for numerical SQC on a national level. These approaches include an Equilibrium Partitioning Approach, a site-specific method using bioassays (the Apparent Effects Threshold Approach), and an approach similar to EPA`s water quality criteria (Pavlou and Weston 1984). Although national (or even regional) criteria address a number of political, litigative, and engineering needs, some researchers feel that protection of benthic communities require site-specific, biologically based criteria (Baudo et al. 1990). This is particularly true for areas where complex mixtures of contaminants are present in sediments. Other scientifically valid and accepted procedures for freshwater SQC include a background concentration approach, methods using field or spiked bioassays, a screening level concentration approach, the Apparent Effects Threshold Approach, the Sediment Quality Triad, the International Joint Commission Sediment Assessment Strategy, and the National Status and Trends Program Approach. The various sediment assessment approaches are evaluated for application to the Hanford Reach and recommendations for Hanford Site sediment quality criteria are discussed.

  6. Clinical Application of the UK Working Party′s Criteria for the Diagnosis of Atopic Dermatitis in the Chinese Population by Age Group

    Directory of Open Access Journals (Sweden)

    Li Wang

    2016-01-01

    Conclusions: Our study indicates a modest ability among Chinese dermatologists to apply the UK Working Party's diagnostic criteria for AD, especially in patients aged <4 years and ≥10 years. Since there is no gold standard for AD diagnosis, it is important to determine how AD is identified when evaluating a diagnostic tool.

  7. Degree of agreement among sepsis diagnosis criteria in adult emergency room patients with infection

    Science.gov (United States)

    Sinto, R.; Chandra, A. T.; Lie, K. C.; Suwarto, S.

    2018-03-01

    The study on the degree of agreement among three established sepsis diagnosis criteria become the necessity to investigate the best sepsis diagnosis criteria in Indonesia further. A cross-sectional study of adult Emergency Room patients hospitalized with a diagnosis of infection in CiptoMangunkusumo Hospital, Indonesia was conducted during March and April 2017. We recorded diagnosis, gender, age, comorbidities, infection source, and origin. Every subject was classified into sepsis and non-sepsis based on 1991, 2001 and sepsis-3 criteria. Raw % and Kappa agreement coefficients (κ) were calculated according to previously established formula to measure the degree of agreement among three diagnostic criteria. As many as 278 subjects were included in this study. The raw % agreement and κ between 1991 and 2001 criteria is 69.07% and 0.34 respectively. The raw % agreement and κ between 2001 and sepsis-3 criteria is 56.12% and 0.15 respectively. The raw % agreement and κ between 1991 and sepsis-3 criteria is 48.19% and -0.02. In conclusions, there is afair agreement between 1991 and 2001 criteria, poor agreement between 2001 and sepsis-3 criteria, and poor disagreement between 1991 and sepsis-3 criteria. This necessitates further Indonesian study of the best diagnosis criteria to diagnose an infected patient with sepsis.

  8. Geomembrane selection criteria for uranium tailings ponds

    International Nuclear Information System (INIS)

    Mitchell, D.H.; Cuello, R.

    1986-09-01

    The selection criteria, particularly those involving chemical compatibility, of geomembranes to be used in ponds at uranium mill operations are discussed. The principal functional criteria which a geomembrane must meet for this application are: (1) a specified service life and (2) low permeability. Chemical compatibility with the waste is essential in meeting these functional criteria. In two different types of aging tests using simulated acidic uranium mill waste, degradation of chemical and physical properties were examined in geomembranes of high-density polyethylene, polyvinyl chloride, and chlorosulfonated polyethylene. Compatibility tests according to the National Sanitation Foundation procedures are recommended to ascertain the stability of certain physical properties of the proposed geomembrane. Actual experience with a specific geomembrane in an identical application is probably the best method to assure compatibility; however, this experience is frequently not available. Experience with a geomembrane in similar applications is valuable in the selection process, however, small differences in either the geomembrane formulation or the waste composition may result in large differences in performance of the geomembrane. It is likely that many geomembranes have acceptable chemical stability for typical uranium mill applications, therefore, additional factors in the selection processes will include seaming characteristics, mechanical properties, site characteristics, and costs

  9. Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis

    Science.gov (United States)

    Sato, Hiroki; Nakajima, Nao; Takahashi, Kazuya; Hasegawa, Go; Mizuno, Ken-ichi; Hashimoto, Satoru; Ikarashi, Satoshi; Hayashi, Kazunao; Honda, Yutaka; Yokoyama, Junji; Sato, Yuichi; Terai, Shuji

    2017-01-01

    AIM To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus. METHODS Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples. RESULTS In five patients with EoE, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with sEoE and four with EoEM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with EoE and sEoE with some variation, while EoEM was associated with hypercontractile or hypertensive peristalsis, with elevated s-IgE. Histology revealed the following eosinophils per high-power field values. EoE = 41.4 ± 7.9 in the epithelium and 2.3 ± 1.5 in the subepithelium; sEoE = 3 in the epithelium and 35 in the subepithelium (conventional biopsy); EoEM = none in the epithelium, 10.7 ± 11.7 in the subepithelium (conventional biopsy or endoscopic mucosal resection) and 46.8 ± 16.5 in the muscularis propria (peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to EoE. Eotaxin-3, IL-5 and IL-13 were overexpressed in EoE. CONCLUSION Based on clinical and histological data, we identified criteria, which differentiated between EoE, sEoE and EoEM, and reflected a different pathogenesis between these esophageal EoGDs. PMID:28428721

  10. Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis.

    Science.gov (United States)

    Sato, Hiroki; Nakajima, Nao; Takahashi, Kazuya; Hasegawa, Go; Mizuno, Ken-Ichi; Hashimoto, Satoru; Ikarashi, Satoshi; Hayashi, Kazunao; Honda, Yutaka; Yokoyama, Junji; Sato, Yuichi; Terai, Shuji

    2017-04-07

    To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus. Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples. In five patients with EoE, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with sEoE and four with EoEM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with EoE and sEoE with some variation, while EoEM was associated with hypercontractile or hypertensive peristalsis, with elevated s-IgE. Histology revealed the following eosinophils per high-power field values. EoE = 41.4 ± 7.9 in the epithelium and 2.3 ± 1.5 in the subepithelium; sEoE = 3 in the epithelium and 35 in the subepithelium (conventional biopsy); EoEM = none in the epithelium, 10.7 ± 11.7 in the subepithelium (conventional biopsy or endoscopic mucosal resection) and 46.8 ± 16.5 in the muscularis propria (peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to EoE. Eotaxin-3, IL-5 and IL-13 were overexpressed in EoE. Based on clinical and histological data, we identified criteria, which differentiated between EoE, sEoE and EoEM, and reflected a different pathogenesis between these esophageal EoGDs.

  11. Racial and ethnic disparities in meeting MTM eligibility criteria among patients with asthma.

    Science.gov (United States)

    Lu, Degan; Qiao, Yanru; Johnson, Karen C; Wang, Junling

    2017-06-01

    Asthma is one of the most frequently targeted chronic diseases in the medication therapy management (MTM) programs of the Medicare prescription drug (Part D) benefits. Although racial and ethnic disparities in meeting eligibility criteria for MTM services have been reported, little is known about whether there would be similar disparities among adults with asthma in the United States. Adult patients with asthma (age ≥ 18) from Medical Expenditure Panel Survey (2011-2012) were analyzed. Bivariate analyses were conducted to compare the proportions of patients who would meet Medicare MTM eligibility criteria between non-Hispanic Blacks (Blacks), Hispanics and non-Hispanic Whites (Whites). Survey-weighted logistic regression was performed to adjust for patient characteristics. Main and sensitivity analyses were conducted to cover the entire range of the eligibility thresholds used by Part D plans in 2011-2012. The sample included 4,455 patients with asthma, including 2,294 Whites, 1,218 Blacks, and 943 Hispanics. Blacks and Hispanics had lower proportions of meeting MTM eligibility criteria than did Whites (P asthma. Future studies should examine the implications of such disparities on health outcomes of patients with asthma and explore alternative MTM eligibility criteria.

  12. Adequacy of published screening criteria for retinopathy of prematurity.

    Science.gov (United States)

    Taranath, Deepa A; Oh, Dickson D-S; Keane, Miriam C; Fabel, Helen; Marshall, Peter

    2016-03-01

    Criteria for screening preterm infants for retinopathy of prematurity vary around the world. We aimed to analyse the efficacy of alternative screening criteria. We collected retrospective data at a tertiary level neonatal nursery. Our participants were 1007 babies, born between 1997 and 2011, at prematurity. We determined whether disease would be detected using an alternative Australian screening model (gestational age prematurity is our main outcome. Using several of the alternative criteria, two neonates with clinically significant retinopathy of prematurity, one of whom required laser treatment to preserve sight, would not have been screened, and their disease may have gone undetected. Use of prematurity may risk clinically significant cases being missed and others may screen babies unnecessarily. Alternative criteria should be considered and '<30 weeks gestational age and/or <1500 g birth weight' appears a viable option. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

  13. A comparison between criteria for diagnosing atopic eczema in infants

    DEFF Research Database (Denmark)

    Jøhnke, H; Vach, W; Norberg, L A

    2005-01-01

    Research Centre (DARC) criteria developed for this study and doctor-diagnosed visible eczema with typical morphology and atopic distribution. Additionally, the U.K. diagnostic criteria based on a questionnaire were used at 1 year of age. Agreement between the four criteria was analysed at each time point...... the four criteria demonstrated that cumulative incidences showed better agreement than point prevalence values. CONCLUSIONS: Agreement between different criteria for diagnosing AE was acceptable, but the mild cases constituted a diagnostic problem, although they were in the minority. Repeated examinations...

  14. Aging and physiological changes of the kidneys including changes in glomerular filtration rate.

    Science.gov (United States)

    Musso, Carlos G; Oreopoulos, Dimitrios G

    2011-01-01

    In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular filtration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water-soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease. Copyright © 2011 S. Karger AG, Basel.

  15. Applicability and agreement of different diagnostic criteria for sarcopenia estimation in the elderly.

    Science.gov (United States)

    Pagotto, Valéria; Silveira, Erika Aparecida

    2014-01-01

    The purpose of this study cross-sectional study comprising 132 community dwelling elderly (≥ 60 years) was to identify sarcopenia prevalence in the Brazilian elderly, utilizing different diagnostic criteria and analyze agreement between criteria. Sarcopenia was assessed by nine muscle mass diagnostic criteria, by two muscle strength criteria and also by the combination of criteria. Prevalence was analyzed for each method, along with differences by gender and age group through calculation of the prevalence ratio (PR) and confidence interval (CI) 95%. The Kappa coefficient was used to analyze the level of agreement between all criteria. Sarcopenia prevalence varied between 60.6% and 8.3% with the application of muscle mass criteria, and between 54.2% and 48.8% with the application of strength criteria. The combination muscle mass+strength resulted in a decrease of prevalence in all criteria, varying between 36.6% and 6.1%. There was an increase in prevalence according to age groups for all methods. Prevalence was higher for men according to three muscle mass criteria, and higher in women for strength criteria and by two combined mass+strength criteria. The best level of agreement was obtained for two methods that utilized dual energy X-ray absorptiometry (DXA). The prevalence of sarcopenia differs by gender and age and definition criteria. The low agreement levels obtained between methods and the different prevalence values encountered indicate the necessities of an operational definition for the estimation of sarcopenia in different population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Antiphospholipid syndrome (APS) revisited: Would migraine headaches be included in future classification criteria?

    Science.gov (United States)

    Noureldine, Mohammad Hassan A; Haydar, Ali A; Berjawi, Ahmad; Elnawar, Rody; Sweid, Ahmad; Khamashta, Munther A; Hughes, Graham R V; Uthman, Imad

    2017-02-01

    Headaches have been extensively reported in Antiphospholipid syndrome (APS)/Antiphospholipid antibodies (aPL)-positive patients. The aim of this study was to highlight the prevalence of headaches among APS/aPL-positive patients and discuss its association with laboratory, clinical and imaging findings. We searched the literature through Google Scholar and PubMed for publications on the epidemiology, pathogenesis, laboratory, imaging and clinical findings, and management of headaches in APS/aPL-positive patients. The following keywords were used: Antiphospholipid, Hughes syndrome, anticardiolipin, lupus anticoagulant, anti-β2 glycoprotein I, headache, migraine, tension, and cluster. All reports published between 1969 and 2015 were included. Migraine is the most commonly reported type of headache in APS/aPL-positive patients. Thrombotic and platelet dysfunction hypotheses have been studied to uncover the pathogenic role of aPL in the development of headaches. Several studies are reporting higher levels of aPL in primary and secondary APS migraineurs, but only few reached statistical significance. Migraine patients without clinical signs/symptoms of cerebral infarction rarely show positive imaging findings. Digital subtraction angiography shows promise in demonstrating small vascular lesions otherwise not detected on computed tomography, magnetic resonance imaging, or cerebral angiograms. Although it may be solitary and harmless in many cases, the deleterious effect of migraine on the quality of life of APS patients prompts rapid diagnosis and proper management. An anticoagulation trial is advisable in APS patients with migraine as many cases of severe, refractory migraine resolved with anticoagulation therapy. The profile of migraine headaches discussed in this study permits its candidacy for inclusion in future APS classification criteria.

  17. 2013 American College of Rheumatology/European League against rheumatism classification criteria for systemic sclerosis outperform the 1980 criteria: data from the Canadian Scleroderma Research Group.

    Science.gov (United States)

    Alhajeri, Hebah; Hudson, Marie; Fritzler, Marvin; Pope, Janet; Tatibouet, Solène; Markland, Janet; Robinson, David; Jones, Niall; Khalidi, Nader; Docherty, Peter; Kaminska, Elzbieta; Masetto, Ariel; Sutton, Evelyn; Mathieu, Jean-Pierre; Ligier, Sophie; Grodzicky, Tamara; LeClercq, Sharon; Thorne, Carter; Gyger, Geneviève; Smith, Douglas; Fortin, Paul R; Larché, Maggie; Baron, Murray

    2015-04-01

    The goal of this study was to determine the sensitivity of the new 2013 classification criteria for systemic sclerosis (SSc; scleroderma) in an independent cohort of SSc subjects and to assess the contribution of individual items of the criteria to the overall sensitivity. SSc subjects from the Canadian Scleroderma Research Group cohort were assessed. Sensitivity was determined in several subgroups of patients. In patients without the criterion of skin thickening proximal to the metacarpophalangeal (MCP) joints, we recalculated sensitivity after removing the individual criterion. A total of 724 SSc patients were included. Most were women (86%), mean age was 55.8 years, mean disease duration was 10.9 years, and 59% had limited cutaneous SSc (lcSSc). Overall, the sensitivity of the 2013 criteria was 98.3% compared to 88.3% for the 1980 criteria. This pattern was consistent among those with lcSSc (98.8% versus 85.6%), anticentromere antibodies (98.9% versus 79.8%), disease duration ≤3 years (98.7% versus 84.7%), and no skin involvement proximal to the MCP joints (97% versus 60%). In the latter subgroup, removing Raynaud's phenomenon and sclerodactyly from the criteria reduced the sensitivity to 77% and 79%, respectively. Removing both sclerodactyly and puffy fingers reduced the sensitivity to 62%. The 2013 SSc classification criteria classify more SSc patients than the 1980 criteria. The improvement in sensitivity is most striking in those with lcSSc, especially those without skin involvement proximal to the MCP joints. The addition of Raynaud's phenomenon and puffy fingers to the 2013 criteria accounts for important gains in sensitivity. Copyright © 2015 by the American College of Rheumatology.

  18. NSSS supplier's response to differing safety criteria

    Energy Technology Data Exchange (ETDEWEB)

    Cremades, J; Filkin, R; Franke, T [Westinghouse Electric Nuclear Energy Systems Europe (WENESE), Brussels (Belgium)

    1980-11-01

    The limited progress achieved to date in harmonizing national criteria has led to the development of designs which include the most common national requirements. Progress towards harmonization of safety criteria can be accelerated by expanding the IAEA leadership and co-ordination activities, and implementing an integrated approach to criteria development. National and International safety criteria are examined.

  19. Summarized water quality criteria

    International Nuclear Information System (INIS)

    Kempster, P.L.; Hattingh, W.H.J.; Van Vliet, H.R.

    1980-08-01

    The available world literature from 27 sources on existing water quality criteria are summarized for the 15 main uses of water. The minimum, median and maximum specified values for 96 different determinands are included. Under each water use the criteria are grouped according to the functional significance of the determinands e.g. aesthetic/physical effects, high toxic potential, low toxic potential etc. A synopsis is included summarizing salient facts for each determinand such as the conditions under which it is toxic and its relationship to other determinands. The significance of the criteria is briefly discussed and the importance of considering functional interactions between determinands emphasized in evaluating the potential for toxic or beneficial effects. From the source literature it appears that the toxic potential, in addition to being determined by concentration, is also affected by the origin of the substance concerned, i.e. whether from natural sources or from anthropogenic pollution

  20. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson de [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Comissão Nacional de Energia Nuclear - CNEN (Brazil); Rezende, Maria Fernanda [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Corrêa, Renato; Mousinho, Rodrigo [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Miranda, Sandra Marina; Oliveira, Aline Ribeiro [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Gutterres, Ricardo Fraga [Comissão Nacional de Energia Nuclear - CNEN (Brazil); Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2014-11-15

    Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  1. Water quality criteria for lead

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, N.K.

    1987-01-01

    This report is one in a series that establishes water quality criteria for British Columbia. The report sets criteria for lead to protect a number of water uses, including drinking water, freshwater and marine aquatic life, wildlife, livestock, irrigation, and recreation. The criteria are set as either maximum concentrations of total lead that should not be exceeded at any time, or average concentrations that should not be exceeded over a 30-day period. Actual values are summarized.

  2. Criteria of estimation of positive health level in the long-term process of the health training of women of senior age.

    Directory of Open Access Journals (Sweden)

    Prusik Katerina

    2011-09-01

    Full Text Available In the article materials of the three-year looking are utillized after the state of positive health of group of women in age 50-80 years. The method of statistical ground of adequate control indexes is shown for the estimation of bodily condition of inspected. The use of high-quality criteria is offered for the estimation of efficiency of physical exercises on the Norwegian method of walking with sticks.

  3. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II)

    DEFF Research Database (Denmark)

    Rudwaleit, M; van der Heijde, D; Landewé, R

    2009-01-01

    OBJECTIVE: To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA). METHODS: All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (> or =3 months) back...... pain of unknown origin that began before 45 years of age. The candidate criteria were first tested in the entire cohort of 649 patients from 25 centres, and then refined in a random selection of 40% of cases and thereafter validated in the remaining 60%. RESULTS: Upon diagnostic work-up, axial Sp...

  4. Is telomere length a biomarker for aging: cross-sectional evidence from the west of Scotland?

    Science.gov (United States)

    Der, Geoff; Batty, G David; Benzeval, Michaela; Deary, Ian J; Green, Michael J; McGlynn, Liane; McIntyre, Alan; Robertson, Tony; Shiels, Paul G

    2012-01-01

    The search for biomarkers of aging (BoAs) has been largely unsuccessful to-date and there is widespread skepticism about the prospects of finding any that satisfy the criteria developed by the American Federation of Aging Research. This may be because the criteria are too strict or because a composite measure might be more appropriate. Telomere length has attracted a great deal of attention as a candidate BoA. We investigate whether it meets the criteria to be considered as a single biomarker of aging, and whether it makes a useful contribution to a composite measure. Using data from a large population based study, we show that telomere length is associated with age, with several measures of physical and cognitive functioning that are related to normal aging, and with three measures of overall health. In the majority of cases, telomere length adds predictive power to that of age, although it was not nearly as good a predictor overall. We used principal components analysis to form two composites from the measures of functioning, one including telomere length and the other not including it. These composite BoAs were better predictors of the health outcomes than chronological age. There was little difference between the two composites. Telomere length does not satisfy the strict criteria for a BoA, but does add predictive power to that of chronological age. Equivocal results from previous studies might be due to lack of power or the choice of measures examined together with a focus on single biomarkers. Composite biomarkers of aging have the potential to outperform age and should be considered for future research in this area.

  5. Is telomere length a biomarker for aging: cross-sectional evidence from the west of Scotland?

    Directory of Open Access Journals (Sweden)

    Geoff Der

    Full Text Available BACKGROUND: The search for biomarkers of aging (BoAs has been largely unsuccessful to-date and there is widespread skepticism about the prospects of finding any that satisfy the criteria developed by the American Federation of Aging Research. This may be because the criteria are too strict or because a composite measure might be more appropriate. Telomere length has attracted a great deal of attention as a candidate BoA. We investigate whether it meets the criteria to be considered as a single biomarker of aging, and whether it makes a useful contribution to a composite measure. METHODOLOGY/PRINCIPAL FINDINGS: Using data from a large population based study, we show that telomere length is associated with age, with several measures of physical and cognitive functioning that are related to normal aging, and with three measures of overall health. In the majority of cases, telomere length adds predictive power to that of age, although it was not nearly as good a predictor overall. We used principal components analysis to form two composites from the measures of functioning, one including telomere length and the other not including it. These composite BoAs were better predictors of the health outcomes than chronological age. There was little difference between the two composites. CONCLUSIONS: Telomere length does not satisfy the strict criteria for a BoA, but does add predictive power to that of chronological age. Equivocal results from previous studies might be due to lack of power or the choice of measures examined together with a focus on single biomarkers. Composite biomarkers of aging have the potential to outperform age and should be considered for future research in this area.

  6. Rating of environmental criteria

    Energy Technology Data Exchange (ETDEWEB)

    Glueck, K; Krasser, G

    1980-01-01

    After a general theoretical discussion on the question of rating within a framework of cost-benefit studies, first trials as to the quantification and standardisation of twelve selected environmental criteria by means of an indicator system are worked out and compiled. The selection includes the criteria exhaust gas, dust, micro climate, water pollution, water regime, land requirement, vibrations, traffic noise, landscape scene, urban scene, effect of separation and safety risks. An insight is given of the rating practice using an evaluation of the available literature, of a household interview and of an interview of experts. The interviewing of 156 experts as to their rating conception of ten criteria in the second round has provided contributions to the general problem of the evaluation estimate based on multi criteria analysis as well as differentiation of the twelve or ten environmental criteria. The following criteria ratings given by the experts and which are averaged and smoothed are: traffic noise 20,0% +- 8,5; air pollution 15,0% +- 7,0; safety risk 13,0% +- 7,0; soil and water pollution 8,5% +- 5,0; landscape scene 8,0% +- 4,5; urban scene 8,0% +- 4,5; water regime 6,5% +- 3,5 and vibrations 4,5% +- 2,5.

  7. Retinopathy of prematurity screening criteria in Iran: new screening guidelines.

    Science.gov (United States)

    Roohipoor, Ramak; Karkhaneh, Reza; Farahani, Afsar; Ebrahimiadib, Nazanin; Modjtahedi, Bobeck; Fotouhi, Akbar; Yaseri, Mehdi; Khodabande, Alireza; Zarei, Mohammad; Imani Fuladi, Marjan; Taheri, Arash; Riazi Esfahani, Mohammad; Loewenstein, John

    2016-07-01

    To test the applicability of existing retinopathy of prematurity (ROP) guidelines on Iranian patients and to develop novel ROP screening criteria in Iran. Both eyes of 1932 infants born ≤37 weeks of gestation and/or weighting ≤3000 g were included in this prospective cohort study that was conducted across nine neonatal intensive care units and a tertiary eye hospital ROP clinic. The patients were examined for ROP and the need for treatment (type 1 ROP or worse). All the patients were screened 4 weeks after birth or at 31 weeks of postmenstrual age, whichever was later. The patients were followed until retinal vascularisation was completed or the patients reached 50 weeks of gestational age (GA) without prethreshold ROP. A receiver operating characteristic curve was used to determine the best screening criteria for ROP. Screening criteria from other countries were applied to our patient data to determine their ability to appropriately detect ROP. Patients with ROP requiring treatment. The mean GA±SD and birth weight (BW)±SD of the screened patients were 32±2.7 weeks and 1713±516 g, respectively. Using criteria of GA≤32 weeks or BW ≤2000 yielded sensitivity and specificity of 100% and 26.7%, respectively, for treatment requiring ROP regardless of clinical comorbidities. Using screening recommendations of American Academy of Pediatrics would miss 25.4% of ROP and 8.4%ROP requiring treatment in our cohort. Other countries screening recommendations would result in a significant amount of missed cases of treatment requiring ROP when applied to Iran. As a result, we have proposed new guidelines for premature babies in Iran. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Harmonized diagnostic criteria for Alzheimer's disease

    DEFF Research Database (Denmark)

    Morris, J C; Blennow, K; Froelich, L

    2014-01-01

    BACKGROUND: Two major sets of criteria for the clinical diagnosis of Alzheimer's disease (AD) recently have been published, one from an International Working Group (IWG) and the other from working groups convened by the National Institute on Aging (NIA) and the Alzheimer's Association (AA...

  9. Classification, diagnostic criteria, and treatment recommendations for orofacial manifestations in HIV-infected pediatric patients. Collaborative Workgroup on Oral Manifestations of Pediatric HIV Infection.

    Science.gov (United States)

    Ramos-Gomez, F J; Flaitz, C; Catapano, P; Murray, P; Milnes, A R; Dorenbaum, A

    1999-01-01

    The criteria for diagnosis of HIV-related oral lesions in adults are well established, but corresponding criteria in the pediatric population are not as well defined. The Collaborative Workgroup on the Oral Manifestations of Pediatric HIV infection reached a consensus, based upon available data, as to the presumptive and definitive criteria to diagnose the oral manifestations of HIV infection in children. Presumptive criteria refer to the clinical features of the lesions, including signs and symptoms, whereas definitive criteria require specific laboratory tests. In general, it is recommended that definitive criteria be established whenever possible. Orofacial manifestations have been divided into three groups: 1) those commonly associated with pediatric HIV infection; 2) those less commonly associated with pediatric HIV infection; and 3) those strongly associated with HIV infection but rare in children. Orofacial lesions commonly associated with pediatric HIV infection include candidiasis, herpes simplex infection, linear gingival erythema, parotid enlargement, and recurrent aphthous stomatitis. In contrast, orofacial lesions strongly associated with HIV infection but rare in children include Kaposi's sarcoma, non-Hodgkin's lymphoma, and oral hairy leukoplakia. Treatment recommendations, specific for this age group, have been included for some of the more common HIV-related orofacial manifestations.

  10. Biological Water Quality Criteria

    Science.gov (United States)

    Page contains links to Technical Documents pertaining to Biological Water Quality Criteria, including, technical assistance documents for states, tribes and territories, program overviews, and case studies.

  11. A NSSS supplier's response to differing safety criteria

    International Nuclear Information System (INIS)

    Cremades, J.; Filkin, R.; Franke, Th.

    1980-01-01

    The limited progress achieved to date in harmonizing national criteria has led to the development of designs which include the most common national requirements. Progress towards harmonization of safety criteria can be accelerated by expanding the IAEA leadership and co-ordination activities, and implementing an integrated approach to criteria development. National and International safety criteria are examined. (author)

  12. The Impact of "DSM-5" A-Criteria Changes on Parent Ratings of ADHD in Adolescents

    Science.gov (United States)

    Sibley, Margaret H.; Yeguez, Carlos E.

    2014-01-01

    Objective: Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) A-criteria for ADHD were expanded to include new descriptors referencing adolescent and adult symptom manifestations. This study examines the effect of these changes on symptom endorsement in a sample of adolescents with ADHD (N = 259; age range = 10.72-16.70).…

  13. Criteria for controlled atmosphere chambers

    International Nuclear Information System (INIS)

    Robinson, J.N.

    1980-03-01

    The criteria for design, construction, and operation of controlled atmosphere chambers intended for service at ORNL are presented. Classification of chambers, materials for construction, design criteria, design, controlled atmosphere chamber systems, and operating procedures are presented. ORNL Safety Manual Procedure 2.1; ORNL Health Physics Procedure Manual Appendix A-7; and Design of Viewing Windows are included in 3 appendices

  14. Dynamic criteria for partitioning and transmutation

    International Nuclear Information System (INIS)

    Lu, A.H.

    1991-11-01

    This paper addresses dynamic criteria intended to optimize partitioning and transmutation (P-T) concept development supporting improved nuclear waste management. Six criteria are proposed initially and the rationale for each is briefly explained. Each criterion is used as a measure (or dimension) on which the developed concepts can be evaluated. The criteria allow the P-T concepts to be evaluated in an integral system including long-term energy needs, fuel cycle, and waste management. New criteria will be identified along with the P-T concept development, and each criterion will be realistically weighted so that it is comparable in an overall criteria evaluation. The weights are subject to change as a result of technical advancements and public perception on various issues. Incomplete criteria will result in a poor choice because important factors may not be considered when the decision is made. A successful decision on the optimal P-T system depends on the completeness of criteria (dimensions) as well as realistic weights assigned to each criterion

  15. A Meta-Analysis of the Relations among Training Criteria

    National Research Council Canada - National Science Library

    Alliger, George

    1998-01-01

    .... Meta-analysis results among criteria using this framework include the finding of substantial reliabilities across training criteria and reasonable convergence among subdivisions of criteria within a larger level...

  16. 45 CFR 1308.11 - Eligibility criteria: Hearing impairment including deafness.

    Science.gov (United States)

    2010-10-01

    ... OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR... impairment including deafness. (a) A child is classified as deaf if a hearing impairment exists which is so... hearing loss can include impaired listening skills, delayed language development, and articulation...

  17. Proposed diagnosis criteria for inflicted head injury of children younger than two years of age

    International Nuclear Information System (INIS)

    Fujiwara, Takeo; Okuyama, Makiko; Matsumoto, Tsutomu; Aritaki, Kentarou; Yotani, Nobuyuki; Miyasaka, Mikiko; Nishina, Sachiko

    2008-01-01

    It is difficult to distinguish whether children's head injuries are due to physical abuse or unintentional accidents. However, in the literature, medical findings specific to infant physical abuse were identified. Thus, we developed diagnostic criteria for inflicted head injury (IHI) and assessed its validity. Subjects were collected from all patients who were less than two years old when they visited National Center for Child Health (NCCHD) and Development and underwent head CT scan to assess head trauma from March 1, 2002 to December 31, 2005. Diagnostic criteria for IHI were developed based on definitions of Duhaime et al (1992) and Reece et al (2001). Validity of diagnosis criteria was assessed by comparing the official report to the Child Guidance Center (CGC) from NCCHD to the disposition decided by the CGC. Two-hundred and sixty cases were collected and diagnosed. There was a 86.5% match of the number of cases which were diagnosed as IHI or non-IHI using the IHI diagnostic criteria with official reports to CGC from NCCHD. Among the cases which were diagnosed as presumptive IHI and also reported to the CGC, 20 cases (83.3%) were regarded as abused cases by the CGC. The diagnostic criteria for IHI were valid and would be useful for pediatricians not to condone inflicted head injury. (author)

  18. Mortality in Mild Cognitive Impairment Diagnosed with DSM-5 Criteria and with Petersen's Criteria: A 17-Year Follow-Up in a Community Study.

    Science.gov (United States)

    Santabárbara, Javier; Gracia-García, Patricia; Pírez, Guillermo; López-Antón, Raúl; De La Cámara, Concepcion; Ventura, Tirso; Pérez-Sastre, Marina; Lobo, Elena; Saz, Pedro; Marcos, Guillermo; Lobo, Antonio

    2016-11-01

    To explore the possibility that the mortality risk of mild cognitive impairment (MCI) as diagnosed using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria (DSM-5-MCI) will be higher than using Petersen's criteria (P-MCI) and to report the population-attributable fraction (PAF) of mortality due to MCI. A representative community sample of 4,803 individuals aged 55 or more years was interviewed and then followed for 17 years. Standardized instruments were used in the assessment, including the Geriatric Mental State-AGECAT, and research psychiatrists diagnosed P-MCI and DSM-5-MCI cases following operationalized criteria. Mortality information was obtained from the official population registry. Kaplan-Meier age-adjusted survival curves were built for the MCI diagnostic groups, and Cox proportional hazards regression models were used to calculate the hazard ratio of death in participants with MCI relative to those without. We also estimated the PAF of mortality due to specific MCI diagnostic groups. Compared with noncases, the mortality rate ratio was approximately double in DSM-5-MCI individuals (2.3) than in P-MCI individuals (1.2). In the multivariate statistical analysis, a significant association between each diagnostic category and mortality was observed but was only maintained in the final model in DSM-5-MCI cases (hazard ratio: 1.24). The PAF of mortality due to MCI was approximately 1% in both MCI categories. The mortality risk in comparison with noncases was higher in DSM-5-MCI than in P-MCI. The PAF of mortality in DSM-5-MCI individuals was ~ 1% over a 17-year period. Copyright © 2016. Published by Elsevier Inc.

  19. Hanford Site solid waste acceptance criteria

    International Nuclear Information System (INIS)

    Ellefson, M.D.

    1998-01-01

    Order 5820.2A requires that each treatment, storage, and/or disposal facility (referred to in this document as TSD unit) that manages low-level or transuranic waste (including mixed waste and TSCA PCB waste) maintain waste acceptance criteria. These criteria must address the various requirements to operate the TSD unit in compliance with applicable safety and environmental requirements. This document sets forth the baseline criteria for acceptance of radioactive waste at TSD units operated by WMH. The criteria for each TSD unit have been established to ensure that waste accepted can be managed in a manner that is within the operating requirements of the unit, including environmental regulations, DOE Orders, permits, technical safety requirements, waste analysis plans, performance assessments, and other applicable requirements. Acceptance criteria apply to the following TSD units: the Low-Level Burial Grounds (LLBG) including both the nonregulated portions of the LLBG and trenches 31 and 34 of the 218-W-5 Burial Ground for mixed waste disposal; Central Waste Complex (CWC); Waste Receiving and Processing Facility (WRAP); and T Plant Complex. Waste from all generators, both from the Hanford Site and from offsite facilities, must comply with these criteria. Exceptions can be granted as provided in Section 1.6. Specific waste streams could have additional requirements based on the 1901 identified TSD pathway. These requirements are communicated in the Waste Specification Records (WSRds). The Hanford Site manages nonradioactive waste through direct shipments to offsite contractors. The waste acceptance requirements of the offsite TSD facility must be met for these nonradioactive wastes. This document does not address the acceptance requirements of these offsite facilities

  20. Validation of the Rome III criteria and alarm symptoms for recurrent abdominal pain in children.

    Science.gov (United States)

    Gijsbers, Carolien F M; Benninga, Marc A; Schweizer, Joachim J; Kneepkens, C M Frank; Vergouwe, Yvonne; Büller, Hans A

    2014-06-01

    Rome criteria were formulated to define functional gastrointestinal disorders (Rome III criteria, 2006) excluding organic diagnoses when alarm symptoms were absent. The aims of the study were to validate the Rome III criteria as to their capacity to differentiate between organic and functional abdominal pain and to assess the role of alarm symptoms in this differentiation. During 2 years all of the patients (ages 4-16 years) presenting with recurrent abdominal pain (Apley criteria) and referred to secondary care were included. Clinical diagnoses were based on protocolized evaluation and intervention with 6-month follow-up. Alarm symptoms were registered. Rome III criteria for functional pain syndromes were assigned independently. Descriptive statistical analyses were performed. In 200 patients (87 boys, mean age 8.8 years), organic (17%), functional (40%), combined organic and functional (9%), spontaneous recovery (27%), and other (8%) clinical diagnoses were established. Alarm symptoms were found in 57.5% (organic causes 56%, functional causes 61%). The evaluation for Rome symptom clusters revealed symptoms of irritable bowel syndrome in 27%, functional dyspepsia in 15%, functional abdominal pain in 28%, functional abdominal pain syndrome in 14.5%, and no pain syndrome in 15.5%. Rome diagnoses, based on symptoms and absence of alarm symptoms, predicted functional clinical diagnosis with sensitivity 0.35 (95% confidence interval 0.27-0.43), specificity 0.60 (0.46-0.73), positive predictive value 0.71 (0.61-0.82), and negative predictive value of 0.24 (0.17-0.32). The Rome III criteria for abdominal pain are not specific enough to rule out organic causes. Alarm symptoms do not differentiate between organic and functional abdominal pain.

  1. Flexible parametric survival models built on age-specific antimüllerian hormone percentiles are better predictors of menopause.

    Science.gov (United States)

    Ramezani Tehrani, Fahimeh; Mansournia, Mohammad Ali; Solaymani-Dodaran, Masoud; Steyerberg, Ewout; Azizi, Fereidoun

    2016-06-01

    This study aimed to improve existing prediction models for age at menopause. We identified all reproductive aged women with regular menstrual cycles who met our eligibility criteria (n = 1,015) in the Tehran Lipid and Glucose Study-an ongoing population-based cohort study initiated in 1998. Participants were examined every 3 years and their reproductive histories were recorded. Blood levels of antimüllerian hormone (AMH) were measured at the time of recruitment. Age at menopause was estimated based on serum concentrations of AMH using flexible parametric survival models. The optimum model was selected according to Akaike Information Criteria and the realness of the range of predicted median menopause age. We followed study participants for a median of 9.8 years during which 277 women reached menopause and found that a spline-based proportional odds model including age-specific AMH percentiles as the covariate performed well in terms of statistical criteria and provided the most clinically relevant and realistic predictions. The range of predicted median age at menopause for this model was 47.1 to 55.9 years. For those who reached menopause, the median of the absolute mean difference between actual and predicted age at menopause was 1.9 years (interquartile range 2.9). The model including the age-specific AMH percentiles as the covariate and using proportional odds as its covariate metrics meets all the statistical criteria for the best model and provides the most clinically relevant and realistic predictions for age at menopause for reproductive-aged women.

  2. A multivariate twin study of the DSM-IV criteria for antisocial personality disorder.

    Science.gov (United States)

    Kendler, Kenneth S; Aggen, Steven H; Patrick, Christopher J

    2012-02-01

    Many assessment instruments for psychopathy are multidimensional, suggesting that distinguishable factors are needed to effectively capture variation in this personality domain. However, no prior study has examined the factor structure of the DSM-IV criteria for antisocial personality disorder (ASPD). Self-report questionnaire items reflecting all A criteria for DSM-IV ASPD were available from 4291 twins (including both members of 1647 pairs) from the Virginia Adult Study of Psychiatric and Substance Use Disorders. Exploratory factor analysis and twin model fitting were performed using, respectively, Mplus and Mx. Phenotypic factor analysis produced evidence for two correlated factors: aggressive-disregard and disinhibition. The best-fitting multivariate twin model included two genetic and one unique environmental common factor, along with criteria-specific genetic and environmental effects. The two genetic factors closely resembled the phenotypic factors and varied in their prediction of a range of relevant criterion variables. Scores on the genetic aggressive-disregard factor score were more strongly associated with risk for conduct disorder, early and heavy alcohol use, and low educational status, whereas scores on the genetic disinhibition factor score were more strongly associated with younger age, novelty seeking, and major depression. From a genetic perspective, the DSM-IV criteria for ASPD do not reflect a single dimension of liability but rather are influenced by two dimensions of genetic risk reflecting aggressive-disregard and disinhibition. The phenotypic structure of the ASPD criteria results largely from genetic and not from environmental influences. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Seismic re-evaluation criteria for Bohunice V1 reconstruction

    International Nuclear Information System (INIS)

    Campbell, R.; Schlund, H.; Warnken, L.

    2001-01-01

    Bohunice V1 in Slovakia is a Russian designed two unit WWER 440, Model 230 Pressurized Water Reactor. The plant was not originally designed for earthquake. Subsequent and ongoing reassessments now confirm that the seismic hazard at the site is significant. EBO, the plant owner has contracted with a consortium lead by Siemens AG (REKON) to do major reconstruction of the plant to significantly enhance its safety systems by the addition of new systems and the upgrading of existing systems. As part of the reconstruction, a complete seismic assessment and upgrading is required for existing safety relevant structures, systems and components. It is not practical to conduct this reassessment and upgrading using criteria applied to new design of nuclear power plants. Alternate criteria may be used to achieve adequate safety goals. Utilities in the U.S. have faced several seismic issues with operating NPPs and to resolve these issues, alternate criteria have been developed which are much more cost effective than use of criteria for new design. These alternate criteria incorporate the knowledge obtained from investigation of the performance of equipment in major earthquakes and include provisions for structures and passive equipment to deform beyond the yield point, yet still provide their essential function. IAEA has incorporated features of these alternate criteria into draft Technical Guidelines for application to Bohunice V1 and V2. REKON has developed plant specific criteria and procedures for the Bohunice V1 reconstruction that incorporate major features of the U.S. developed alternate criteria, comply to local codes and which envelop the draft IAEA Technical Guidelines. Included in these criteria and procedures are comprehensive walkdown screening criteria for equipment, piping, HVAC and cable raceways, analytical criteria which include inelastic energy absorption factors defined on an element basis and testing criteria which include specific guidance on interpretation

  4. Structural aging program -- a summary of activities, results, and conclusions

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.; Ellingwood, B.R.

    1997-01-01

    Research has been conducted by the Oak Ridge National Laboratory to address aging management of nuclear power plant concrete structures. The purpose was to identify potential structural safety issues and acceptance criteria for use in continued service assessments. Primary program accomplishments have included formulation of a Structural Materials Information Center that contains data and information on the time variation of material properties under the influence of pertinent environmental stressors and aging factors for 144 materials, an aging assessment methodology to identify critical structures and degradation factors that can potentially impact their performance, guidelines and evaluation criteria for use in condition assessments of reinforced concrete structures, and a reliability-based methodology for current condition assessments and estimations of future performance of reinforced concrete nuclear power plant structures. In addition, the Structural Aging Program conducted in-depth evaluations of several nondestructive evaluation and repair-related technologies to develop guidance on their applicability

  5. Dementia in middle-aged patients with schizophrenia.

    Science.gov (United States)

    Nicolas, Gaël; Beherec, Laurène; Hannequin, Didier; Opolczynski, Gaëlle; Rothärmel, Maud; Wallon, David; Véra, Pierre; Martinaud, Olivier; Guillin, Olivier; Campion, Dominique

    2014-01-01

    Although numerous studies have assessed cognitive dysfunction in patients with schizophrenia, very few have focused on the diagnosis of dementia. Our objectives were to accurately diagnose dementia in a cohort of middle-aged patients with schizophrenia and to assess the type of dementia. 96 patients with schizophrenia (46 inpatients and 50 outpatients), aged 50 to 70 years, underwent a psychiatric, neurological, and neuropsychological evaluation at baseline and after a 20-month follow-up. We established a 3-step procedure: 1) diagnose dementia according to the DSM-IV criteria, using the Mattis Dementia Rating and Activities of Daily Living scales; 2) characterize dementia using brain imaging, perfusion by 99mTc-ECD-SPECT and laboratory tests including Alzheimer's disease cerebrospinal fluid biomarkers; and 3) search for genetic determinants. Fourteen patients fulfilled the diagnostic criteria of dementia. Four were diagnosed with possible or probable behavioral-variant frontotemporal dementia (bvFTD), two with probable Alzheimer's disease, two with probable vascular dementia (including one due to CADASIL), one with CNS inflammatory disease, and six could not be fully characterized. The diagnosis of dementia in middle-aged patients with schizophrenia is challenging but possible, using a multistep procedure. The most frequent condition, bvFTD, could reflect the presence of an evolutive neurodegenerative process in some patients.

  6. Assessing the utility of diagnostic criteria: a multisite study on gender identity disorder.

    Science.gov (United States)

    Paap, Muirne C S; Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T; Richter-Appelt, Hertha; de Cuypere, Griet; Haraldsen, Ira R

    2011-01-01

    Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the diagnostic criteria for GID. To investigate the way in which the diagnosis-specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria for GID were used to reach a psychiatric diagnosis in four European countries: the Netherlands (Amsterdam), Norway (Oslo), Germany (Hamburg), and Belgium (Ghent). The main goal was to compare item (symptom) characteristics across countries. The current study included all new applicants to the four GID clinics who were seen between January 2007 and March 2009, were at least 16 years of age at their first visit, and had completed the diagnostic assessment (N = 214, mean age = 32 ± 12.2 years). Mokken scale analysis, a form of Nonparametric Item Response Theory (NIRT) was performed. Operationalization and quantification of the core criteria A and B resulted in a 23-item score sheet that was filled out by the participating clinicians after they had made a diagnosis. We found that, when ordering the 23 items according to their means for each country separately, the rank ordering was similar among the four countries for 21 of the items. Furthermore, only one scale emerged, which combined criteria A and B when all data were analyzed together. Our results indicate that patients' symptoms were interpreted in a similar fashion in all four countries. However, we did not find support for the treatment of A and B as two separate criteria. We recommend the use of NIRT in future studies, especially in studies with small sample sizes and/or with data that show a poor fit to parametric IRT models. © 2010 International Society for Sexual Medicine.

  7. Defining criteria related to wastes for use in multi-criteria decision tool for nuclear accidents

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Diogo N.G.; Guimaraes, Jean R.D., E-mail: dneves@biof.ufrj.br, E-mail: jeanrdg@biof.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Biofisica Carlos Chagas Filho; Rochedo, Elaine R.R.; De Luca, Christiano, E-mail: elainerochedo@gmail.com, E-mail: christiano_luca@hotmail.com [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Rochedo, Pedro R.R., E-mail: rochedopedro@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto Alberto Luiz Coimbra de Pos-Graduacao e Pesquisa de Engenharia

    2013-07-01

    The selection of protective measures and strategies for remediation of contaminated areas after a nuclear accident must be based on previously established criteria in order to prevent stress of the population and the unnecessary exposure of workers. After a nuclear accident resulting in environmental contamination, decisions on remediation of areas is complex due to the large numbers of factors involved in decontamination processes. This work is part of a project which aims to develop a multi-criteria tool to support a decision-making process in cases of a radiological or a nuclear accident in Brazil. First, a database of remediation strategies for contaminated areas was created. In this process, the most relevant aspects for the implementation of these strategies were considered, including technical criteria regarding aspects related to the generation of wastes in a reference urban area, which are discussed in this paper. The specific objective of this study is to define criteria for the aspects of radioactive wastes, resulted by the implementation of some urban measures, in order to be incorporated in a multi-criteria decision tool. Main aspects considered were the type, the amount and the type of treatment necessary for each procedure. The decontamination procedures are then classified according to the selected criteria in order to feed the multi-criteria decision tool. This paper describes the steps for the establishment of these criteria and evaluates the potential for future applications in order to improve predictions and to support the decisions to be made. (author)

  8. Defining criteria related to wastes for use in multi-criteria decision tool for nuclear accidents

    International Nuclear Information System (INIS)

    Silva, Diogo N.G.; Guimaraes, Jean R.D.; Rochedo, Elaine R.R.; De Luca, Christiano; Rochedo, Pedro R.R.

    2013-01-01

    The selection of protective measures and strategies for remediation of contaminated areas after a nuclear accident must be based on previously established criteria in order to prevent stress of the population and the unnecessary exposure of workers. After a nuclear accident resulting in environmental contamination, decisions on remediation of areas is complex due to the large numbers of factors involved in decontamination processes. This work is part of a project which aims to develop a multi-criteria tool to support a decision-making process in cases of a radiological or a nuclear accident in Brazil. First, a database of remediation strategies for contaminated areas was created. In this process, the most relevant aspects for the implementation of these strategies were considered, including technical criteria regarding aspects related to the generation of wastes in a reference urban area, which are discussed in this paper. The specific objective of this study is to define criteria for the aspects of radioactive wastes, resulted by the implementation of some urban measures, in order to be incorporated in a multi-criteria decision tool. Main aspects considered were the type, the amount and the type of treatment necessary for each procedure. The decontamination procedures are then classified according to the selected criteria in order to feed the multi-criteria decision tool. This paper describes the steps for the establishment of these criteria and evaluates the potential for future applications in order to improve predictions and to support the decisions to be made. (author)

  9. Development of threshold action criteria for light water reactors

    International Nuclear Information System (INIS)

    Okrent, D.; Baldewicz, W.L.

    1982-06-01

    A survey of recently threshold criteria for regulatory action on LWRs is presented together with some commentary. This is followed by a new proposal for threshold action criteria which includes some different risk attributes than are found in previous criteria. Some preliminary risk values are suggested for the criteria and then evaluated in terms of a few hypothetical accident scenarios. Finally, several licensing issues are examined in terms of various threshold action criteria

  10. Extending PSA models including ageing and asset management - 15291

    International Nuclear Information System (INIS)

    Martorell, S.; Marton, I.; Carlos, S.; Sanchez, A.I.

    2015-01-01

    This paper proposes a new approach to Ageing Probabilistic Safety Assessment (APSA) modelling, which is intended to be used to support risk-informed decisions on the effectiveness of maintenance management programs and technical specification requirements of critical equipment of Nuclear Power Plants (NPP) within the framework of the Risk Informed Decision Making according to R.G. 1.174 principles. This approach focuses on the incorporation of not only equipment ageing but also effectiveness of maintenance and efficiency of surveillance testing explicitly into APSA models and data. This methodology is applied to a motor-operated valve of the auxiliary feed water system (AFWS) of a PWR. This simple example of application focuses on a critical safety-related equipment of a NPP in order to evaluate the risk impact of considering different approaches to APSA and the combined effect of equipment ageing and maintenance and testing alternatives along NPP design life. The risk impact of several alternatives in maintenance strategy is discussed

  11. Criteria and actions facing a radiological environmental contamination

    International Nuclear Information System (INIS)

    Gutierrez, Jose; Montero, Milagros

    2008-01-01

    An approach to improve the management of the radiological risk due to an environmental contamination is presented. The experience gained in emergency response has clearly demonstrated the importance to have an efficient emergency system including planning, procedures and operational internally consistent criteria. The lack of these components in the emergency system could lead to important radiological and non radiological consequences. The setting of internationally agreed criteria and guides is very important in the anticipated emergency response plan. The paper firstly reviews the approaches proposed by international recommendations and norms. From this review, a substantial coincidence on the basic principles is stated, in spite of small differences in its formulation. Also, a need for harmonization is endorsed. So, generic levels, in terms of imparted dose or avoided dose due to intervention, and, in some cases, derived levels, in terms of activity concentration, are proposed. Numerical values for emergency actions are also identified. The second part deals with the adaptation of the existing prediction and decision systems to the above radiological criteria. Relations among deposition, activity concentrations and annual doses for different scenarios, exposure pathways and age groups are established. Also, the sensibility of the radiological impact against different characteristics of the intervention scenarios is stated. This makes easy to assess the radiological significance of different contamination situations by comparison to the existing action generic levels. Furthermore, the radiological impact can be numerically incorporated in a decision system which includes non radiological aspects of the applicable intervention options. Agricultural, urban and mixed scenarios are presented and solved for a 137 Cs contamination. The results can be further used to develop a methodology guide for setting action generic levels in post-accidental interventions and

  12. Multiple criteria facility location probems : a survey

    NARCIS (Netherlands)

    Farahani, R.Z.; Steadie Seifi, M.; Asgari, N.

    2010-01-01

    This paper provides a review on recent efforts and development in multi-criteria location problems in three categories including bi-objective, multi-objective and multi-attribute problems and their solution methods. Also, it provides an overview on various criteria used. While there are a few

  13. Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management

    International Nuclear Information System (INIS)

    1993-11-01

    This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management

  14. Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

    OpenAIRE

    Dobie, Robert A; Wojcik, Nancy C

    2015-01-01

    Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60?years. By comparison, recent data (1999?2006) show that hearing thresholds in the US population have improved....

  15. Criteria for the diagnosis of hypertension in general practice

    OpenAIRE

    Patterson, H. R.

    1984-01-01

    An accurate age-sex register was used to identify patients in a practice who might be suffering from hypertension and to record the criteria on which the diagnosis was based. Information about blood pressure readings, diagnostic labels and treatment at the time of diagnosis were noted. The definition of hypertension sufficient to require treatment was a recorded diastolic pressure of 110 mm Hg or more on three occasion. Using these criteria, only 12 per cent of patients qualified.

  16. Time Perspective and Age: A Review of Age Associated Differences.

    Science.gov (United States)

    Laureiro-Martinez, Daniella; Trujillo, Carlos A; Unda, Juliana

    2017-01-01

    We investigate the relationship between age and the five dimensions of time perspective measured by the Zimbardo Time Perspective Inventory (ZTPI) (past negative, past positive, present hedonistic, present fatalistic, and future). Time perspective is related to well-being, decision-making, level of development, and many other psychological issues. Hence, the existence of a systematic relationship between time perspective and age should be considered in all studies for which time is a relevant variable. However, no specific research about this has been conducted. We collected 407 papers that referenced the ZTPI between 2001 and 2015. From those, 72 studies met our inclusion criteria. They included 29,815 participants from 19 countries whose age spans most phases of adulthood (from 13.5 to 75.5 years, mean 28.7). We analyzed these studies adapting meta-analytical techniques. We found that present hedonistic and past negative dimensions are negatively related to aging with partial eta squared effect sizes of roughly 0.15. Our results have implications for the design of studies related to time as our findings highlight the importance of taking into account the differences associated with age.

  17. Interpretation criteria for FDG PET/CT in multiple myeloma (IMPeTUs): final results. IMPeTUs (Italian myeloma criteria for PET USe).

    Science.gov (United States)

    Nanni, Cristina; Versari, Annibale; Chauvie, Stephane; Bertone, Elisa; Bianchi, Andrea; Rensi, Marco; Bellò, Marilena; Gallamini, Andrea; Patriarca, Francesca; Gay, Francesca; Gamberi, Barbara; Ghedini, Pietro; Cavo, Michele; Fanti, Stefano; Zamagni, Elena

    2018-05-01

    ᅟ: FDG PET/CT ( 18 F-fluoro-deoxy-glucose positron emission tomography/computed tomography) is a useful tool to image multiple myeloma (MM). However, simple and reproducible reporting criteria are still lacking and there is the need for harmonization. Recently, a group of Italian nuclear medicine experts defined new visual descriptive criteria (Italian Myeloma criteria for Pet Use: IMPeTUs) to standardize FDG PET/CT evaluation in MM patients. The aim of this study was to assess IMPeTUs reproducibility on a large prospective cohort of MM patients. Patients affected by symptomatic MM who had performed an FDG PET/CT at baseline (PET0), after induction (PET-AI), and the end of treatment (PET-EoT) were prospectively enrolled in a multicenter trial (EMN02)(NCT01910987; MMY3033). After anonymization, PET images were uploaded in the web platform WIDEN® and hence distributed to five expert nuclear medicine reviewers for a blinded independent central review according to the IMPeTUs criteria. Consensus among reviewers was measured by the percentage of agreement and the Krippendorff's alpha. Furthermore, on a patient-based analysis, the concordance among all the reviewers in terms of positivity or negativity of the FDG PET/CT scan was tested for different thresholds of positivity (Deauville score (DS 2, 3, 4, 5) for the main parameters (bone marrow, focal score, extra-medullary disease). Eighty-six patients (211 FDG PET/CT scans) were included in this analysis. Median patient age was 58 years (range, 35-66 years), 45% were male, 15% of them were in stage ISS (International Staging System) III, and 42% had high-risk cytogenetics. The percentage agreement was superior to 75% for all the time points, reaching 100% of agreement in assessing the presence skull lesions after therapy. Comparable results were obtained when the agreement analysis was performed using the Krippendorff's alpha coefficient, either in every single time point of scanning (PET0, PET-AI or PET-EoT) or

  18. A technique of including the effect of aging of passive components in probabilistic risk assessments

    International Nuclear Information System (INIS)

    Phillips, J.H.; Weidenhamer, G.H.

    1992-01-01

    The probabilistic risk assessments (PRAS) being developed at most nuclear power plants to calculate the risk of core damage generally focus on the possible failure of active components. The possible failure of passive components is given little consideration. We are developing methods for selecting risk-significant passive components and including them in PRAS. These methods provide effective ways to prioritize passive components for inspection, and where inspection reveals aging damage, mitigation or repair can be employed to reduce the likelihood of component failure. We demonstrated a method by selecting a weld in the auxiliary feedwater (AFW) system, basing our selection on expert judgement of the likelihood of failure and on an estimate of the consequence of component failure to plant safety. We then modified and used the Piping Reliability Analysis Including Seismic Events (PRAISE) computer code to perform a probabilistic structural analysis to calculate the probability that crack growth due to aging would cause the weld to fail. The PRAISE code was modified to include the effects of changing design material properties with age and changing stress cycles. The calculation included the effects of mechanical loads and thermal transients typical of the service loads for this piping design and the effects of thermal cycling caused by a leaking check valve. However, this particular calculation showed little change in low component failure probability and plant risk for 48 years of service. However, sensitivity studies showed that if the probability of component failure is high, the effect on plant risk is significant. The success of this demonstration shows that this method could be applied to nuclear power plants. The demonstration showed the method is too involved (PRAISE takes a long time to perform the calculation and the input information is extensive) for handling a large number of passive components and therefore simpler methods are needed

  19. Identification of component performance degradations caused by ageing using expert panels

    International Nuclear Information System (INIS)

    Nitoi, Mirela; Cristea, Dumitru; Pavelescu, Margarit

    2008-01-01

    Since the component ageing can be considered as one of the important causes of operating events reported, the identification of ageing effects and implementation of appropriate methods for mitigation of these effects represent an important preoccupation of many organizations and research activities. In the process of identification of ageing manifestation we can use either analysis of operational data or expert opinions, each of the methods having specific advantages and disadvantages. A reasonable combination of statistical, structural reliability and expert panel methods would be an appropriate approach in the failure probability assessments. In case when there are not enough operational data, the expert judgments represent the only viable alternative in the effort dedicated to identification of components and systems vulnerability to ageing. The panel use judgments to analyse the degradation produced by ageing, to score the components based on specific criteria and to rank them relative to one another. The paper presents the approach developed, including evaluation criteria and assigning indices for assessment of particular types of ageing degradation (the case of secondary system of TRIGA reactor). (authors)

  20. Evidence for the diagnostic criteria of delirium: an update.

    Science.gov (United States)

    Blazer, Dan G; van Nieuwenhuizen, Adrienne O

    2012-05-01

    Since the publication of DSM-III in 1980, the essential criteria for delirium have been reduced progressively through DSM-III-R to DSM-IV. As the field moves toward DSM-V and ICD-11, new data can shed light on the nosological changes that are needed so that diagnostic criteria can reflect empirical data. In this study, we reassess the existing or potential criteria for delirium. Phenomenological studies in recent years have informed the criteria for delirium, including the appropriateness of the term 'consciousness' as a core symptom of the diagnosis, additional symptoms of delirium that are frequent but are not currently part of the diagnostic criteria, subsyndromal delirium, motoric subtypes of delirium (hyperactive, hypoactive), and the association of delirium with dementia. Recent studies suggest that motoric subtypes should be included as a subtype for delirium but that subsyndromal delirium, although a useful research construct, should not be included in clinical diagnostic criteria given the frequent fluctuation in symptoms over short periods. In addition, though the core symptoms are probably adequate to make the diagnosis, clinicians must be aware of the frequency of other symptoms, for symptoms such as profound sleep disturbance or psychotic symptoms may dominate the clinical picture.

  1. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2.

    Science.gov (United States)

    O'Mahony, Denis; O'Sullivan, David; Byrne, Stephen; O'Connor, Marie Noelle; Ryan, Cristin; Gallagher, Paul

    2015-03-01

    Screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria were first published in 2008. Due to an expanding therapeutics evidence base, updating of the criteria was required. We reviewed the 2008 STOPP/START criteria to add new evidence-based criteria and remove any obsolete criteria. A thorough literature review was performed to reassess the evidence base of the 2008 criteria and the proposed new criteria. Nineteen experts from 13 European countries reviewed a new draft of STOPP & START criteria including proposed new criteria. These experts were also asked to propose additional criteria they considered important to include in the revised STOPP & START criteria and to highlight any criteria from the 2008 list they considered less important or lacking an evidence base. The revised list of criteria was then validated using the Delphi consensus methodology. The expert panel agreed a final list of 114 criteria after two Delphi validation rounds, i.e. 80 STOPP criteria and 34 START criteria. This represents an overall 31% increase in STOPP/START criteria compared with version 1. Several new STOPP categories were created in version 2, namely antiplatelet/anticoagulant drugs, drugs affecting, or affected by, renal function and drugs that increase anticholinergic burden; new START categories include urogenital system drugs, analgesics and vaccines. STOPP/START version 2 criteria have been expanded and updated for the purpose of minimizing inappropriate prescribing in older people. These criteria are based on an up-to-date literature review and consensus validation among a European panel of experts. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society.

  2. Ecological criteria for evaluating candidate sites for marine reserves

    Science.gov (United States)

    Roberts, Callum M.; Andelman, Sandy; Branch, George; Bustamante, Rodrigo H.; Castilla, Juan Carlos; Dugan, Jenifer; Halpern, Benjamin S.; Lafferty, Kevin D.; Leslie, Heather; Lubchenco, Jane; McArdle, Deborah; Possingham, Hugh P.; Ruckelshaus, Mary; Warner, Robert R.

    2003-01-01

    Several schemes have been developed to help select the locations of marine reserves. All of them combine social, economic, and biological criteria, and few offer any guidance as to how to prioritize among the criteria identified. This can imply that the relative weights given to different criteria are unimportant. Where two sites are of equal value ecologically, then socioeconomic criteria should dominate the choice of which should be protected. However, in many cases, socioeconomic criteria are given equal or greater weight than ecological considerations in the choice of sites. This can lead to selection of reserves with little biological value that fail to meet many of the desired objectives. To avoid such a possibility, we develop a series of criteria that allow preliminary evaluation of candidate sites according to their relative biological values in advance of the application of socioeconomic criteria. We include criteria that, while not strictly biological, have a strong influence on the species present or ecological processes. Our scheme enables sites to be assessed according to their biodiversity, the processes which underpin that diversity, and the processes that support fisheries and provide a spectrum of other services important to people. Criteria that capture biodiversity values include biogeographic representation, habitat representation and heterogeneity, and presence of species or populations of special interest (e.g., threatened species). Criteria that capture sustainability of biodiversity and fishery values include the size of reserves necessary to protect viable habitats, presence of exploitable species, vulnerable life stages, connectivity among reserves, links among ecosystems, and provision of ecosystem services to people. Criteria measuring human and natural threats enable candidate sites to be eliminated from consideration if risks are too great, but also help prioritize among sites where threats can be mitigated by protection. While our

  3. Design criteria for advanced reactors

    International Nuclear Information System (INIS)

    Dennielou, Y.

    1991-01-01

    Design criteria for advanced reactors are discussed, including safety aspects, site selection, problems related to maintenance and possibility of repairing or replacing structures or components of a nuclear power plant, the human factor considerations. Bearing in mind that some of these criteria are the subject of consensus at international level, the author suggests to establish a table of different operator requirements, to prepare a dossier on the comparison of input data for probabilistic risk analysis, to take into consideration the means to control a severe accident from the very start of the design

  4. Simplified Stability Criteria for Delayed Neutral Systems

    Directory of Open Access Journals (Sweden)

    Xinghua Zhang

    2014-01-01

    Full Text Available For a class of linear time-invariant neutral systems with neutral and discrete constant delays, several existing asymptotic stability criteria in the form of linear matrix inequalities (LMIs are simplified by using matrix analysis techniques. Compared with the original stability criteria, the simplified ones include fewer LMI variables, which can obviously reduce computational complexity. Simultaneously, it is theoretically shown that the simplified stability criteria and original ones are equivalent; that is, they have the same conservativeness. Finally, a numerical example is employed to verify the theoretic results investigated in this paper.

  5. Screening Criteria and Considerations of Offshore Enhanced Oil Recovery

    Directory of Open Access Journals (Sweden)

    Pan-Sang Kang

    2016-01-01

    Full Text Available The application of enhanced oil recovery (EOR in offshore oil fields has received significant attention due to the potentially enormous amount of recoverable oil. However, EOR application offshore is in its very early stage due to conditions that are more complex than onshore oil fields, owing to the unique parameters present offshore. Therefore, successful EOR applications in offshore oil fields require different screening criteria than those for conventional onshore applications. A comprehensive database for onshore applications of EOR processes together with a limited offshore EOR application database are analyzed in this paper, and the important parameters for successful offshore application are incorporated into the new EOR screening criteria. In this paper, screening criteria to determine acceptable EOR processes for offshore fields, including hydrocarbon gas miscible, CO2 miscible, and polymer processes, are presented. Suggested screening criteria for these EOR processes comprise quantitative boundaries and qualitative considerations. Quantitative screening criteria are predominantly based on quantifiable data, such as oil and reservoir properties. Qualitative screening considerations mainly focus on the operational issues present offshore, including platform space constraints, limited disposal options, injectant availability, and flow assurance matters (including hydrate formation and difficulties in emulsion separation.

  6. Motor vehicle evaluative criteria: Using unmet expectations as signals for dissonance

    Directory of Open Access Journals (Sweden)

    Sanjana Brijball Parumasur

    2015-07-01

    Full Text Available This study assesses whether motor vehicle consumers base their purchases on functional or symbolic needs. It also evaluates motor vehicle buyer’s level of importance attached to evaluative criteria and the extent to which they believe the purchased vehicle fulfils the evaluative criteria, in order to assess whether expectations have been met or not and hence, the potential for cognitive dissonance. Biographical correlates (race, marital status, age, education, occupation, income, gender are evaluated and the influence of range of motor vehicle is also analysed. A sample of 200 brand new motor vehicle buyers was drawn using the stratified random sampling technique based on range of motor vehicle purchased, month of purchases, gender and age of the buyer. Only new motor vehicle buyers (within KwaZulu-Natal who concluded their purchases in one major, reputable and leading motor vehicle manufacturing company and who owned the vehicle for a maximum period of seven months were considered, so as to avoid cognitive intrusion. The results indicate that consumer’ expectations were not met in terms of price, economy and performance yet these were buyers’ most highly rated evaluative criteria, thereby reflecting the potential for dissonance. Significant biographical correlates were noted in terms of race, age, occupation, income, gender and motor vehicle evaluative criteria. Whilst bottom and middle of the range motor vehicle consumers favour functional or utilitarian value, top of the range motor vehicle consumers aim to fulfil symbolic needs

  7. Changes in the PCOS phenotype with age.

    Science.gov (United States)

    Hsu, Ming-I

    2013-08-01

    Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder of reproductive-age women. The diagnosis of PCOS is mainly based on the following three components: (1) hyperandrogenism, (2) oligo-amenorrhea, and (3) the observation of polycystic ovaries on a sonogram. The comorbidities may include insulin resistance, type II diabetes mellitus, hypertension and cardiovascular disease. Importantly, the diagnostic criteria and complications related to PCOS are age-dependent. Androgen production in women may decrease because of ovarian aging or decreased production by the adrenal glands over time. The prevalence of hirsutism and acne decreases with age. Ovarian volume and follicle number also decrease with age, with the age-related decrease in follicle number seemingly greater than that of ovarian volume. Aging may also be associated with increased risk of insulin resistance and metabolic disturbances. Therefore, these age-related changes may affect the observed incidence and complications of PCOS. In adolescent patients, the criteria described above pose particular diagnostic problems because the characteristics of normal puberty often overlap with the signs and symptoms of PCOS. Hyperandrogenism and chronic anovulation are the primary disturbances in younger women with PCOS; whereas, obesity, insulin resistance, and metabolic disturbances are predominant in older women with PCOS. The deterioration of insulin resistance during the reproductive life of women with PCOS appears to be mainly attributable to the increase in obesity. Therefore, if body weight could be controlled properly, younger hyperandrogenic PCOS women might reduce their risk of insulin resistance and metabolic disturbances later in life. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Clinical and functional criteria for predicting asthma in infants

    Directory of Open Access Journals (Sweden)

    Yu. L. Mizemitskiy

    2015-01-01

    Full Text Available Objective: to determine clinical and functional criteria for predicting asthma in children who have sustained acute obstructive bronchitis in infancy. Subjects and methods. A total of 125 infants aged 2 to 36 months who had experienced 1 -2 episodes of acute obstructive bronchitis and treated at hospital were examined when bronchial obstruction syndrome was being relieved. In addition to physical examination, functional studies (computerized bronchophonography and heart rate variability assessment were used. Immunological examination included determination of the serum levels of immunoglobulin E and interleuMn-17A. The infants who had sustained acute obstructive bronchitis were followed up for 12-36 months. Results. The infants who had sustained acute obstructive bronchitis in the presence of mild perinatal CNS damage caused by hypoxia were typified by high respiratory morbidity; early-onset bronchial obstruction; long-term bronchial obstruction relief; high incidence of grade 2 respiratory failure in acute obstructive bronchitis. These patients developed asthma more often than twice and repeated episodes of bronchial obstruction. ROC analysis was used to elaborate clinical and functional criteria for predicting the development of asthma in infants. Conclusion. The proposed additional clinical and functional criteria characterizing external respiratory dysfunction and autonomic homeostatic changes contribute to the early diagnosis of asthma and substantially increase the validity of prediction of its development in children younger than 3 years, which is of great importance for goal-oriented preventive measures.

  9. Optimization and maintenance tests considering multiple failure modes, aging and imperfect maintenance

    International Nuclear Information System (INIS)

    Martorell, S.; Marton, I.; Sanchez, A.; Carlos, S.

    2014-01-01

    The paper focuses on the optimization of the test and maintenance intervals under the criteria of unavailability or cost including the effect of the aging of the components and models of imperfect maintenance. The results obtained in the case of application, which focuses on a system of safety of a nuclear power station, show differences, mainly in the outage when you consider the aging. (Author)

  10. [Edmonton Frail Scale in Colombian older people. Comparison with the Fried criteria].

    Science.gov (United States)

    Ramírez Ramírez, Jairo Uriel; Cadena Sanabria, Miguel Oswaldo; Ochoa, Miguel Enrique

    The Edmonton Frailty Scale was developed in Alberta (Canada). It has been applied in different scenarios, such as acute units, day hospitals, and outpatient care. There are no studies published describing the usefulness of this scale in Colombia. A cross-sectional study and secondary diagnostic test analysis was designed with the objective of studying the criterion validity of the Edmonton Frail Scale using Fried's frailty criteria as standard. Patients 60 years old and over from the community were included. Patients with severe dementia, limited mobility, and unable to perform the tests were excluded. The study included 101 patients from the community in Floridablanca, Colombia. The mean age was 68.9 years, and 74% were women. The median walking speed was 1.1m/sec. According to the Fried's criteria, 46% were vigorous elderly, and the prevalence of frailty was 7.9%. Using the EFS, 78% were vigorous elderly, with a prevalence of frailty of 8.9%. Taking 6 or more points as a cut-off, the sensitivity of this scale was 75% and had a specificity of 88%. A similar frequency of frailty was found on applying the two measurement scales. It is important to highlight the multidimensional view of the Edmonton scale, complementing the data of the most physical and sarcopenia-centred phenotype of Fried's criteria. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Containment penetration design criteria and implementation

    International Nuclear Information System (INIS)

    Perry, R.F.; Rigamonti, G.; Dainora, J.

    1975-01-01

    A rational design criteria is presented which serves as a basis for the design and analysis of containment piping penetrations. The criteria includes the effect of temperature as well as mechanical loads for the full range of plant conditions. With this criteria various penetration flued head designs have been compared and optimization achieved. Sleeve wall dimensions and containment loads have been determined without reference to piping configuration. An interaction theory which allows the implementation of the criteria for the determination of design loads and minimum sleeve wall thickness. The interaction theory developed applies to elastic-perfectly plastic cylinders (pipes and sleeves) and accounts for the simultaneous load resultants of transverse shear force, bending moment, torsional moment, and axial force in addition to internal pipe pressure. Application of the theory developed to the determination of sleeve thickness and containment design loads is presented in detail. (Auth.)

  12. Epidemiology of the functional gastrointestinal disorders diagnosed according to Rome II criteria: an Australian population-based study.

    Science.gov (United States)

    Boyce, P M; Talley, N J; Burke, C; Koloski, N A

    2006-01-01

    Population-based studies of the prevalence of all functional gastrointestinal disorders (FGID) using the Rome II criteria are lacking. It is also not certain whether subjects who meet the Rome II criteria for an FGID are different in terms of demographic and psychological characteristics from those subjects meeting exclusively the more restrictive Rome I criteria. To determine whether using the more restrictive Rome I criteria would result in a more biologically determined group of FGID than when the Rome II is applied. Subjects included individuals aged 18 years and older (n = 1,225) from the Penrith population who were initially surveyed with the Penrith District Health Survey in 1997. Subjects were sent a self-report questionnaire that contained items on gastrointestinal symptoms applying the Rome II criteria. Subjects were also assessed on psychological and personality factors and on physical and mental functioning. A total of 36.1% (n = 275) of respondents was diagnosed with an FGID according to Rome II criteria. The five most prevalent FGID were functional heartburn (10.4%), irritable bowel syndrome (8.9%), functional incontinence (7.6%), proctalgia fugax (6.5%) and functional chest pain (5.1%). Subjects meeting Rome II only criteria for FGID scored significantly higher on measures of psychological caseness and emotionality than Rome I only subjects, and these were independently associated with meeting Rome I only versus Rome II only criteria for FGID. The Rome II criteria FGID are common and do not appear to identify a vastly different group of FGID sufferers compared with the earlier Rome I criteria.

  13. Aquatic Life Criteria - Tributyltin (TBT)

    Science.gov (United States)

    Documents pertaining to 2004 Final Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Tributyltin (TBT) for freshwater and saltwater. These documents include the safe levels of TBT that should protect the majority of species.

  14. Juvenile idiopathic arthritis in adulthood: fulfilment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage.

    Science.gov (United States)

    Oliveira-Ramos, Filipa; Eusébio, Mónica; M Martins, Fernando; Mourão, Ana Filipa; Furtado, Carolina; Campanilho-Marques, Raquel; Cordeiro, Inês; Ferreira, Joana; Cerqueira, Marcos; Figueira, Ricardo; Brito, Iva; Canhão, Helena; Santos, Maria José; Melo-Gomes, José A; Fonseca, João Eurico

    2016-01-01

    To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage. Patients with JIA registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index-articular (JADI-A) and Juvenile Arthritis Damage Index-extra-articular (JADI-E) damage index and disease activity were analysed. 426 patients were included. Most of patients with systemic JIA fulfilled criteria for Adult Still's disease. 95.6% of the patients with rheumatoid factor (RF)-positive polyarthritis and 57.1% of the patients with RF-negative polyarthritis matched criteria for rheumatoid arthritis (RA). 38.9% of the patients with extended oligoarthritis were classified as RA while 34.8% of the patients with persistent oligoarthritis were classified as spondyloarthritis. Patients with enthesitis-related arthritis fulfilled criteria for spondyloarthritis in 94.7%. Patients with psoriatic arthritis maintained this classification. Patients with inactive disease had lower disease duration, lower diagnosis delay and corticosteroids exposure. Longer disease duration was associated with higher HAQ, JADI-A and JADI-E. Higher JADI-A was also associated with biological treatment and retirement due to JIA disability and higher JADI-E with corticosteroids exposure. Younger age at disease onset was predictive of higher HAQ, JADI-A and JADI-E and decreased the chance of inactive disease. Most of the included patients fulfilled classification criteria for adult rheumatic diseases, maintain active disease and have functional impairment. Younger age at disease onset was predictive of higher disability and decreased the

  15. [Inappropriate prescription in older patients: the STOPP/START criteria].

    LENUS (Irish Health Repository)

    Delgado Silveira, Eva

    2009-09-01

    Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

  16. Decision-making patterns for dietary supplement purchases among women aged 25 to 45 years.

    Science.gov (United States)

    Miller, Carla K; Russell, Teri; Kissling, Grace

    2003-11-01

    Women frequently consume dietary supplements but the criteria used to select supplements have received little investigation. This research identified the decision-making criteria used for dietary supplements among women aged 25 to 45 years who consumed a supplement at least four times per week. Participants (N=51) completed an in-store shopping interview that was audiotaped, transcribed, and analyzed qualitatively for the criteria used to make supplement selections. Qualitative analysis revealed 10 key criteria and the number of times each person used each criterion was quantified. Cluster analysis identified five homogeneous subgroups of participants based on the criteria used. These included brand shopper, bargain shopper, quality shopper, convenience shopper, and information gatherer. Supplement users vary in the criteria used to make point-of-purchase supplement selections. Dietetics professionals can classify supplement users according to the criteria used to tailor their nutrition counseling and better meet the educational needs of consumers.

  17. Diagnosis of Guillain-Barré syndrome in children and validation of the Brighton criteria.

    Science.gov (United States)

    Roodbol, Joyce; de Wit, Marie-Claire Y; van den Berg, Bianca; Kahlmann, Vivienne; Drenthen, Judith; Catsman-Berrevoets, Coriene E; Jacobs, Bart C

    2017-05-01

    To describe the key diagnostic features of pediatric Guillain-Barré syndrome (GBS) and validate the Brighton criteria. Retrospective cohort study of all children (Children's Hospital, Erasmus MC, Rotterdam. Clinical information was collected and the sensitivity of the Brighton criteria was calculated. 67 children (35 boys) were included, with a median age of 5.0 years [interquartile range (IQR) 3.0-10.0 years]. Bilateral limb weakness was present at hospital admission in 93% of children, and at nadir in all patients. Children presented with tetraparesis in 70% or with paraparesis in 23%. Reduced reflexes in paretic limbs were observed at hospital admission in 82% and during follow-up in all children. The progressive phase lasted median 6 days (IQR 3-8 days) and less than 4 weeks in all children. A monophasic disease course was seen in 97%, including 5 children with a treatment-related fluctuation. Two children had a later relapse at 9 weeks and 19 weeks after onset. 77% of the children showed an elevated protein level in CSF. Nerve conduction studies showed evidence for a poly(radiculo)neuropathy in 91% of the children. 46 children had a complete data set, the sensitivity of the Brighton criteria level 1 was 72% (95% CI 57-84) and 96% (95% CI 85-99) for level 2 and 98% (95% CI 88-100) for level 3. The majority of the pediatric GBS patients presented in this cohort fulfilled the current diagnostic criteria.

  18. Nevada Test Site Waste Acceptance Criteria, December 2000

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-12-01

    This document establishes the US Department of Energy, Nevada Operations Office waste acceptance criteria. The waste acceptance criteria provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive waste and mixed waste for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Sites for storage or disposal.

  19. Nevada Test Site Waste Acceptance Criteria, December 2000

    International Nuclear Information System (INIS)

    2000-01-01

    This document establishes the US Department of Energy, Nevada Operations Office waste acceptance criteria. The waste acceptance criteria provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive waste and mixed waste for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Sites for storage or disposal

  20. NWTS program criteria for mined geologic disposal of nuclear waste: program objectives, functional requirements, and system performance criteria

    International Nuclear Information System (INIS)

    1982-03-01

    The NWTS-33 series, of which this document is a part, provides guidance for the National Waste Terminal Storage (NWTS) program in the development and implementation of licensed mined geologic disposal systems for solidified high-level and TRU wastes. Program objectives, functional requirements, and system performance criteria are found in this document. At the present time final criteria have not been issued by the Nuclear Regulatory Commission (NRC) and Environmental Protection Agency (EPA). The criteria in these documents have been developed on the basis of DOE's judgment of what is required to protect the health and safety of the public and the quality of the environment. It is expected that these criteria will be consistent with regulatory standards. The criteria will be re-evaluated on a periodic basis to ensure that they remain consistent with national waste management policy and regulatory requirements. A re-evaluation will be made when final criteria are promulgated by the NRC and EPA. A background section that briefly describes the mined geologic disposal system and explains the hierarchy and application of the NWTS criteria is included in Section 2.0. Secton 3.0 presents the program objectives, Section 4.0 functional requirements, Secton 5.0 the system performance criteria, and Section 6.0 quality assurance and standards. A draft of this document was issued for public comment in April 1981. Appendix A contains the DOE responses to the comments received. Appendix B is a glossary

  1. Quantitative Analysis of Criteria in University Building Maintenance in Malaysia

    Directory of Open Access Journals (Sweden)

    Olanrewaju Ashola Abdul-Lateef

    2010-10-01

    Full Text Available University buildings are a significant part of university assets and considerable resources are committed to their design, construction and maintenance. The core of maintenance management is to optimize productivity and user satisfaction with optimum resources. An important segment in the maintenance management system is the analysis of criteria that influence building maintenance. Therefore, this paper aims to identify quantify, rank and discuss the criteria that influence maintenance costs, maintenance backlogs, productivity and user satisfaction in Malaysian university buildings. The paper reviews the related literature and presents the outcomes of a questionnaire survey. Questionnaires were administered on 50 university maintenance organizations. Thirty-one criteria were addressed to the university maintenance organizations to evaluate the degree to which each of the criteria influences building maintenance management. With a 66% response rate, it was concluded that the consideration of the criteria is critical to the university building maintenance management system. The quality of components and materials, budget constraints and the age of the building were found to be the most influential criteria but information on user performance satisfaction, problems associated with in-house workforce and shortage of materials and components were the least influential criteria. The paper also outlined that maintenance management is a strategic function in university administration.

  2. Older adults' perceptions of ageing and their health and functioning: a systematic review of observational studies.

    Science.gov (United States)

    Warmoth, Krystal; Tarrant, Mark; Abraham, Charles; Lang, Iain A

    2016-07-01

    Many older people perceive ageing negatively, describing it in terms of poor or declining health and functioning. These perceptions may be related to older adults' health. The aim of this review was to synthesise existing research on the relationship between older adults' perceptions of ageing and their health and functioning. A systematic search was conducted of five electronic databases (ASSIA, CINAHL, IBSS, MEDLINE and PsycINFO). Citations within identified reports were also searched. Observational studies were included if they included perceptions of ageing and health-related measures involving participants aged 60 years and older. Study selection, data extraction and quality appraisal were conducted using predefined criteria. Twenty-eight reports met the criteria for inclusion. Older adults' perceptions of ageing were assessed with a variety of measures. Perceptions were related to health and functioning across seven health domains: memory and cognitive performance, physical and physiological performance, medical conditions and outcomes, disability, care-seeking, self-rated health, quality of life and death. How ageing is perceived by older adults is related to their health and functioning in multiple domains. However, higher quality and longitudinal studies are needed to further investigate this relationship.

  3. Equipment and building structures ageing management for WWER type NPPs

    International Nuclear Information System (INIS)

    Mayboroda, O.

    2001-01-01

    This report presents the working group 'Equipment and building structures ageing management for WWER type NPPs' activities. The analysis of experience in ageing management, recommendations for regulatory guidelines on ageing management, investigation of case studies, definition suitable communication channels among regulators for ageing related data are given. Analyses of water chemistry, inspection data (safety margins criteria), plugging criteria, volume and time of ECT implementation in all WWER countries are presented. The results of Working group activity show that it is advisable to concentrate efforts on: set up the permanent communication channel among regulators, collection of regulatory criteria for WWER type NPP key components based on understanding of ageing mechanisms and data collection

  4. Developing 2 C-compatible investment criteria

    Energy Technology Data Exchange (ETDEWEB)

    Roeser, Frauke [NewClimate - Institute for Climate Policy and Global Sustainability gGmbH, Bonn (Germany); Weischer, Lutz [Germanwatch e.V., Koeln (Germany); Thomae, Jakob [2degrees Investing Initiative, New York, NY (United States); Hoehne, Niklas; Hagemann, Markus; El Alaoui, Alexander; Bals, Christoph; Eckstein, David; Kreft, Soenke; Rosse, Morten

    2015-11-30

    This report studies the development of criteria for assessing the compatibility of financial investments with the international goal to limit global temperature increase to below 2 C above pre-industrial levels. The findings are intended as a starting point and a key input for a longer term process to develop consensus-based 2 C investing criteria. The focus here is placed on investments in projects and physical assets, in particular of development and climate finance organisations. In order to limit global temperature increase to 2 C, global greenhouse gas (GHG) emissions will have to be reduced significantly, eventually to zero, during the course of this century. This requires shifting capital from high to low carbon investments as well as significant capital mobilisation for investments in 2 C-compatible infrastructure. Given the long lifetime of physical assets, and the urgency of decarbonisation over the coming decades, this needs to begin today. Public financial institutions can play a prominent role in contributing to aligning investment flows with the 2 C limit, as well as in closing the current infrastructure investment gap, responding to their explicit or implicit climate mandates and leadership role in the finance sector. The majority of international financial institutions integrate climate considerations into their finance decisions to some degree, and are familiar with different types of criteria, including positive and negative lists, qualitative and quantitative benchmarks, and the use of shadow carbon pricing. However, current approaches do not link to the 2 C limit. 2 C investment criteria are therefore needed to guide investors in this regard. Such criteria may also support other purposes, including an understanding of climate risks and improved reporting and accountability.

  5. Developing 2 C-compatible investment criteria

    International Nuclear Information System (INIS)

    Roeser, Frauke; Weischer, Lutz; Thomae, Jakob; Hoehne, Niklas; Hagemann, Markus; El Alaoui, Alexander; Bals, Christoph; Eckstein, David; Kreft, Soenke; Rosse, Morten

    2015-01-01

    This report studies the development of criteria for assessing the compatibility of financial investments with the international goal to limit global temperature increase to below 2 C above pre-industrial levels. The findings are intended as a starting point and a key input for a longer term process to develop consensus-based 2 C investing criteria. The focus here is placed on investments in projects and physical assets, in particular of development and climate finance organisations. In order to limit global temperature increase to 2 C, global greenhouse gas (GHG) emissions will have to be reduced significantly, eventually to zero, during the course of this century. This requires shifting capital from high to low carbon investments as well as significant capital mobilisation for investments in 2 C-compatible infrastructure. Given the long lifetime of physical assets, and the urgency of decarbonisation over the coming decades, this needs to begin today. Public financial institutions can play a prominent role in contributing to aligning investment flows with the 2 C limit, as well as in closing the current infrastructure investment gap, responding to their explicit or implicit climate mandates and leadership role in the finance sector. The majority of international financial institutions integrate climate considerations into their finance decisions to some degree, and are familiar with different types of criteria, including positive and negative lists, qualitative and quantitative benchmarks, and the use of shadow carbon pricing. However, current approaches do not link to the 2 C limit. 2 C investment criteria are therefore needed to guide investors in this regard. Such criteria may also support other purposes, including an understanding of climate risks and improved reporting and accountability.

  6. Reliability of Left Ventricular Hypertrophy by ECG Criteria in Children with Syncope: Do the Criteria Need to be Revised?

    Science.gov (United States)

    Banerjee, Maalika M; Ramesh Iyer, V; Nandi, Deipanjan; Vetter, Victoria L; Banerjee, Anirban

    2016-04-01

    In the outpatient setting, children who present with syncope routinely undergo electrocardiograms (ECG). Because of concerns for hypertrophic cardiomyopathy, children with syncope meeting ECG criteria for left ventricular hypertrophy (LVH) will frequently undergo an echocardiogram. Our objectives were to determine whether Davignon criteria for ECG waves overestimate LVH in children presenting with syncope, and to study the usefulness of echocardiography in these children. We hypothesize that the Davignon criteria presently used for interpretation of ECGs overestimate LVH, resulting in unnecessary echocardiography in this clinical setting. The clinical database of The Children's Hospital of Philadelphia was evaluated from 2002 to 2012 to identify children between 9 and 16 years of age, who presented with non-exercise-induced, isolated syncope. From this group of patients, only those with clear-cut evidence of LVH (by Davignon criteria), who also underwent an echocardiogram, were selected. A total of 136 children with syncope were identified as having LVH by Davignon ECG criteria. None of these patients manifested any evidence of hypertrophic cardiomyopathy, with normal ventricular septum (average Z-score -0.68 ± 0.84), LV posterior wall (average Z-score -0.66 ± 1.18) and LV mass (average Z-score 0.52 ± 1.29). No significant correlation was found between summed RV6 plus SV1 and LV mass. Correlations between additional ECG parameters and measures of LVH by echocardiography were similarly poor. In children presenting with syncope and LVH by ECG, there was no evidence of true LVH by echocardiography. We propose that the Davignon ECG criteria for interpreting LVH in children overestimate the degree of hypertrophy in these children and the yield of echocardiography is extremely low.

  7. Top-level regulatory criteria for the standard MHTGR

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-10-15

    The Licensing Plan for the Standard MHTGR (Ref. 1) describes a program to support a U.S. Nuclear Regulatory Commission (NRC) design review and approval. The Plan calls for the submittal of Top-Level Regulatory Criteria to the NRC for concurrence with their completeness and acceptability for the MHTGR program. The Top-Level Regulatory Criteria are defined as the standards for judging licensability that directly specify acceptable limits for protection of the public health and safety and the environment. The criteria proposed herein are for normal plant operation and a broad spectrum of anticipated events, including accidents. The approach taken is to define a set of criteria which are general as opposed to being design specific. Specifically, it is recommended that criteria be met which: 1. Are less prescriptive than current regulation, thereby encouraging maximum flexibility in design approaches. 2. Are measurable. 3. Are not more strict than the criteria for current power plants.

  8. Acute Respiratory Distress Syndrome diagnosis after coronary artery bypass: comparison between diagnostic criteria and clinical picture.

    Directory of Open Access Journals (Sweden)

    Manzar Vakili

    2015-01-01

    Full Text Available Acute Respiratory Distress Syndrome (ARDS is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2 less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG in this study. The study was prospective case series which carried out in about six months. All patients admitted to intensive care unit of Tehran Heart Center, who had undergone CABG on cardiopulmonary pump (CPB recruited in the study. After considering inclusion criteria, age, sex, duration of intubation, arterial blood gas and chest radiography, on 24 hours and 48 hours after admission to the ICU were recorded. Then, patients with rapid onset of hypoxemia (PaO2/FiO2≤200mmHg and diffuse pulmonary infiltrates and without sign or symptoms of obvious heart failure (probable positive ARDS cases criteria were recorded and comparison between these probable positive cases with clinician`s clinical diagnosis (blinded to the study was performed. In this study, a total of 300 patients after on-pump coronary artery bypass surgery were included. Postoperatively, 2 (0.66 % in the 24 hours and 4 (1.33% patients in 48 hours after surgery were positive for the two ARDS criteria according to the checklists, but; nobody had saved persistently ARDS criteria persistently during 48 hours after surgery. At the same time, clinician did not report any case of ARDS among 300 patients. In this study patients with ARDS criteria had no significant differences in age (P.value=0.937 and sex (P

  9. Fuel safety criteria technical review - Results of OECD/CSNI/PWG2 Task Force on Fuel Safety Criteria

    International Nuclear Information System (INIS)

    Hollasky, N.; Valtonen, K.; Hache, G.; Gross, H.; Bakker, K.; Recio, M.; Bart, G.; Zimmermann, M.; Van Doesburg, W.; Killeen, J.; Meyer, R.O.; Speis, T.

    2000-01-01

    of the assessment of the safety criteria, the TF members looked at various issues, as they relate to one or more criteria, that have become of special interest. These topics included high burnup, core management, MOX, mixed cores, incomplete control rod insertion, and axial offset anomaly. Also, an attempt was made to assess the current level of methods and codes, which are used to verify the criteria and margins. As code development activities are widespread, the Task Force could not identify all such activities but focused on those needed to adequately analyse the effects of new design elements. The Task Force did not extensively review all ongoing and future research programs. However, a few examples of research programs are given that contribute to investigating the phenomena and mechanisms of fuel behavior under transient / accident conditions. These include hot-cell testing at Argonne National Laboratory in the U.S., the Halden Reactor Project in Norway, research and development work by Belgonucleaire in Belgium, the Cabri test reactor and related programs in France, and the Nuclear Safety Research Reactor program in Japan. As a result of all above assessments, the Task Force considers that the current framework of fuel safety criteria remains generally applicable, being largely unaffected by the 'new' or modern design elements; the levels (numbers) in the individual safety criteria may, however, change in accordance with the particular fuel and core design features. Some of these levels have already been - or are continuously being - adjusted; level adjustments of several other criteria (RIA, LOCA) also appear to be needed, on the basis of experimental data and the analysis thereof. For this (re)assessment of fuel safety criteria, the following process is recommended: (a) Continue to develop best-estimate (nominal) analysis methods, together with a suitable uncertainty analysis, in all areas of safety analysis (b) Continue to perform experimental verification

  10. Estimation of taxa included in the first volume of the Red Data Book of the Republic of Mordovia (Russia using the IUCN Red List Categories and Criteria

    Directory of Open Access Journals (Sweden)

    Anatoliy A. Khapugin

    2017-05-01

    Full Text Available The paper presents an estimation of taxa included in the first volume of the Red Data Book of the Republic of Mordovia using the IUCN Red List Categories and Criteria. Each taxon is provided by a category and all criteria appropriate for it within the region. The paper contains the estimation results of 177 taxa of vascular plants, mosses and algae from the first volume Red Data Book of the Republic of Mordovia (second edition. Of these, 137 are Threatened: 73 taxa are Critically Endangered (category CR, 41 taxa Endangered (category EN, 23 are Vulnerable (category VU, 31 taxa are Near Threatened (category NT. Nine taxa are in the category Data Deficient (DD, due to a lack of sufficient factual material needed for the evaluation. Another 59 taxa of the Red Data Book of the Republic of Mordovia (35 macromycetes and 24 lichens were not evaluated in the present study, also due to the lack of sufficient data needed for an evaluation. Therefore, these taxa are temporarily in the category Not Evaluated (NE. But they could be assigned to one of the threatened categories when evaluated in the future, according to the Guidelines for Application of IUCN Red List Criteria. This paper is considered as a base for establishing the Red List of plant taxa of the Republic of Mordovia in the future.

  11. Radiological protection criteria risk assessments for waste disposal options

    International Nuclear Information System (INIS)

    Hill, M.D.

    1982-01-01

    Radiological protection criteria for waste disposal options are currently being developed at the National Radiological Protection Board (NRPB), and, in parallel, methodologies to be used in assessing the radiological impact of these options are being evolved. The criteria and methodologies under development are intended to apply to all solid radioactive wastes, including the high-level waste arising from reprocessing of spent nuclear fuel (because this waste will be solidified prior to disposal) and gaseous or liquid wastes which have been converted to solid form. It is envisaged that the same criteria will be applied to all solid waste disposal options, including shallow land burial, emplacement on the ocean bed (sea dumping), geological disposal on land and sub-seabed disposal

  12. Past-Year Treatment Utilization Among Individuals Meeting DSM-5 PTSD Criteria: Results From a Nationally Representative Sample.

    Science.gov (United States)

    Hale, Andrew C; Sripada, Rebecca K; Bohnert, Kipling M

    2018-03-01

    Little is known regarding treatment utilization among individuals meeting DSM-5 criteria for posttraumatic stress disorder (PTSD). Data were analyzed from the third wave of the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample using DSM-5 criteria. Factors related to increased odds of PTSD treatment utilization for individuals meeting lifetime criteria included some college education versus less than a high school degree (odds ratio [OR]=3.17), having health insurance versus no insurance (OR=2.86), having a comorbid phobia disorder versus not having a phobia disorder (OR=1.36), and greater PTSD symptom count (OR=1.11). Older age (OR=.40), identifying as black or Asian versus white non-Hispanic (OR=.70 and OR=.28, respectively), and greater social functioning (OR=.98) were associated with decreased odds of PTSD treatment utilization. Results highlight factors that may be useful in identifying population subgroups with PTSD that are at risk for underutilization of services.

  13. Impact of a pain protocol including hypnosis in major burns.

    Science.gov (United States)

    Berger, Mette M; Davadant, Maryse; Marin, Christian; Wasserfallen, Jean-Blaise; Pinget, Christophe; Maravic, Philippe; Koch, Nathalie; Raffoul, Wassim; Chiolero, René L

    2010-08-01

    Pain is a major issue after burns even when large doses of opioids are prescribed. The study focused on the impact of a pain protocol using hypnosis on pain intensity, anxiety, clinical course, and costs. All patients admitted to the ICU, aged >18 years, with an ICU stay >24h, accepting to try hypnosis, and treated according to standardized pain protocol were included. Pain was scaled on the Visual Analog Scale (VAS) (mean of daily multiple recordings), and basal and procedural opioid doses were recorded. Clinical outcome and economical data were retrieved from hospital charts and information system, respectively. Treated patients were matched with controls for sex, age, and the burned surface area. Forty patients were admitted from 2006 to 2007: 17 met exclusion criteria, leaving 23 patients, who were matched with 23 historical controls. Altogether patients were 36+/-14 years old and burned 27+/-15%BSA. The first hypnosis session was performed after a median of 9 days. The protocol resulted in the early delivery of higher opioid doses/24h (ppatient. A pain protocol including hypnosis reduced pain intensity, improved opioid efficiency, reduced anxiety, improved wound outcome while reducing costs. The protocol guided use of opioids improved patient care without side effects, while hypnosis had significant psychological benefits.

  14. DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale

    Science.gov (United States)

    Hasin, Deborah S.; O’Brien, Charles P.; Auriacombe, Marc; Borges, Guilherme; Bucholz, Kathleen; Budney, Alan; Compton, Wilson M.; Crowley, Thomas; Ling, Walter; Petry, Nancy M.; Schuckit, Marc; Grant, Bridget F.

    2013-01-01

    Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions. This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available. PMID:23903334

  15. DSM-5 criteria for substance use disorders: recommendations and rationale.

    Science.gov (United States)

    Hasin, Deborah S; O'Brien, Charles P; Auriacombe, Marc; Borges, Guilherme; Bucholz, Kathleen; Budney, Alan; Compton, Wilson M; Crowley, Thomas; Ling, Walter; Petry, Nancy M; Schuckit, Marc; Grant, Bridget F

    2013-08-01

    Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions.This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available.

  16. Do Lung Cancer Eligibility Criteria Align with Risk among Blacks and Hispanics?

    Directory of Open Access Journals (Sweden)

    Kevin Fiscella

    Full Text Available Black patients have higher lung cancer risk despite lower pack years of smoking. We assessed lung cancer risk by race, ethnicity, and sex among a nationally representative population eligible for lung cancer screening based on Medicare criteria.We used data from the National Health and Nutrition Examination Survey, 2007-2012 to assess lung cancer risk by sex, race and ethnicity among persons satisfying Medicare age and pack-year smoking eligibility criteria for lung cancer screening. We assessed Medicare eligibility based on age (55-77 years and pack-years (≥ 30. We assessed 6-year lung cancer risk using a risk prediction model from Prostate, Lung, Colorectal and Ovarian Cancer Screening trial that was modified in 2012 (PLCOm2012. We compared the proportions of eligible persons by sex, race and ethnicity using Medicare criteria with a risk cut-point that was adjusted to achieve comparable total number of persons eligible for screening.Among the 29.7 million persons aged 55-77 years who ever smoked, we found that 7.3 million (24.5% were eligible for lung cancer screening under Medicare criteria. Among those eligible, Blacks had statistically significant higher (4.4% and Hispanics lower lung cancer risk (1.2% than non-Hispanic Whites (3.2%. At a cut-point of 2.12% risk for lung screening eligibility, the percentage of Blacks and Hispanics showed statistically significant changes. Blacks eligible rose by 48% and Hispanics eligible declined by 63%. Black men and Hispanic women were affected the most. There was little change in eligibility among Whites.Medicare eligibility criteria for lung cancer screening do not align with estimated risk for lung cancer among Blacks and Hispanics. Data are urgently needed to determine whether use of risk-based eligibility screening improves lung cancer outcomes among minority patients.

  17. Rationales for the Lightning Launch Commit Criteria

    Science.gov (United States)

    Willett, John C. (Editor); Merceret, Francis J. (Editor); Krider, E. Philip; O'Brien, T. Paul; Dye, James E.; Walterscheid, Richard L.; Stolzenburg, Maribeth; Cummins, Kenneth; Christian, Hugh J.; Madura, John T.

    2016-01-01

    Since natural and triggered lightning are demonstrated hazards to launch vehicles, payloads, and spacecraft, NASA and the Department of Defense (DoD) follow the Lightning Launch Commit Criteria (LLCC) for launches from Federal Ranges. The LLCC were developed to prevent future instances of a rocket intercepting natural lightning or triggering a lightning flash during launch from a Federal Range. NASA and DoD utilize the Lightning Advisory Panel (LAP) to establish and develop robust rationale from which the criteria originate. The rationale document also contains appendices that provide additional scientific background, including detailed descriptions of the theory and observations behind the rationales. The LLCC in whole or part are used across the globe due to the rigor of the documented criteria and associated rationale. The Federal Aviation Administration (FAA) adopted the LLCC in 2006 for commercial space transportation and the criteria were codified in the FAA's Code of Federal Regulations (CFR) for Safety of an Expendable Launch Vehicle (Appendix G to 14 CFR Part 417, (G417)) and renamed Lightning Flight Commit Criteria in G417.

  18. Nevada Test Site Waste Acceptance Criteria

    International Nuclear Information System (INIS)

    U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    2005-01-01

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal

  19. The impact of case definition on attention-deficit/hyperactivity disorder prevalence estimates in community-based samples of school-aged children.

    Science.gov (United States)

    McKeown, Robert E; Holbrook, Joseph R; Danielson, Melissa L; Cuffe, Steven P; Wolraich, Mark L; Visser, Susanna N

    2015-01-01

    To determine the impact of varying attention-deficit/hyperactivity disorder (ADHD) diagnostic criteria, including new DSM-5 criteria, on prevalence estimates. Parent and teacher reports identified high- and low-screen children with ADHD from elementary schools in 2 states that produced a diverse overall sample. The parent interview stage included the Diagnostic Interview Schedule for Children-IV (DISC-IV), and up to 4 additional follow-up interviews. Weighted prevalence estimates, accounting for complex sampling, quantified the impact of varying ADHD criteria using baseline and the final follow-up interview data. At baseline 1,060 caregivers were interviewed; 656 had at least 1 follow-up interview. Teachers and parents reported 6 or more ADHD symptoms for 20.5% (95% CI = 18.1%-23.2%) and 29.8% (CI = 24.5%-35.6%) of children respectively, with criteria for impairment and onset by age 7 years (DSM-IV) reducing these proportions to 16.3% (CI = 14.7%-18.0%) and 17.5% (CI = 13.3%-22.8%); requiring at least 4 teacher-reported symptoms reduced the parent-reported prevalence to 8.9% (CI = 7.4%-10.6%). Revising age of onset to 12 years per DSM-5 increased the 8.9% estimate to 11.3% (CI = 9.5%-13.3%), with a similar increase seen at follow-up: 8.2% with age 7 onset (CI = 5.9%-11.2%) versus 13.0% (CI = 7.6%-21.4%) with onset by age 12. Reducing the number of symptoms required for those aged 17 and older increased the overall estimate to 13.1% (CI = 7.7%-21.5%). These findings quantify the impact on prevalence estimates of varying case definition criteria for ADHD. Further research of impairment ratings and data from multiple informants is required to better inform clinicians conducting diagnostic assessments. DSM-5 changes in age of onset and number of symptoms required for older adolescents appear to increase prevalence estimates, although the full impact is uncertain due to the age of our sample. Published by Elsevier Inc.

  20. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    Macrosomia or at least one adverse outcome were more likely in GDM patients who met the diagnostic criteria by both the IADPSG and WHO criteria (P = 0.001). Conclusion: A diagnosis of GDM that meets both the WHO and IADPSG criteria provides stronger prediction for adverse pregnancy outcome than a diagnosis that ...

  1. Prevalence of dental fluorosis in children taking part in an oral health programme including fluoride tablet supplements from the age of 2 years

    DEFF Research Database (Denmark)

    Eckersten, Charlotte; Pylvänen, Lena; Schröder, Ulla

    2010-01-01

    To investigate the prevalence of dental fluorosis in children who had participated in an oral health programme between the ages 2-5 years, including fluoride tablets from the age of 2 years.......To investigate the prevalence of dental fluorosis in children who had participated in an oral health programme between the ages 2-5 years, including fluoride tablets from the age of 2 years....

  2. Evaluating Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents.

    Science.gov (United States)

    Mikolajewski, Amy J; Scheeringa, Michael S; Weems, Carl F

    2017-05-01

    Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7-18-year olds. PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7-12) were examined separately from adolescents (ages 13-18) to assess for potential developmental differences. A significantly higher proportion of 7-12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13-18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7-12-year-old (but not 13-18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV. These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7-12-year-old children, but not for adolescents. Using the very young children criteria for 7-12-year-old children may further increase prevalence, but capture children with less severe psychopathology.

  3. ACR Appropriateness Criteria® Breast Cancer Screening.

    Science.gov (United States)

    Mainiero, Martha B; Moy, Linda; Baron, Paul; Didwania, Aarati D; diFlorio, Roberta M; Green, Edward D; Heller, Samantha L; Holbrook, Anna I; Lee, Su-Ju; Lewin, Alana A; Lourenco, Ana P; Nance, Kara J; Niell, Bethany L; Slanetz, Priscilla J; Stuckey, Ashley R; Vincoff, Nina S; Weinstein, Susan P; Yepes, Monica M; Newell, Mary S

    2017-11-01

    Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positive examination should be considered in the decision. For intermediate-risk women, US or MRI may be indicated as an adjunct to mammography depending upon specific risk factors. For women at high risk due to prior mantle radiation between the ages of 10 to 30, mammography is recommended starting 8 years after radiation therapy but not before age 25. For women with a genetic predisposition, annual screening mammography is recommended beginning 10 years earlier than the affected relative at the time of diagnosis but not before age 30. Annual screening MRI is recommended in high-risk women as an adjunct to mammography. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Inclusion criteria for physical therapy intervention studies on scoliosis - a review of the literature.

    Science.gov (United States)

    Weiss, H R

    2012-01-01

    There is a wide variation of the inclusion criteria found in studies investigating the outcome of conservative scoliosis treatment. While the application of the SRS criteria for studies on bracing seem useful, there are no inclusion criteria for the investigation of physiotherapy alone. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT). A PubMed and (incomplete) hand search for outcome papers on PT has been performed in order to detect study designs and inclusion criteria used. Real outcome papers (start of treatment in immature samples / end results after the end of growth) have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. No paper has been found with patients of risk for being progressive followed from premenarchial status until skeletal maturity under physiotherapy treatment alone. Claims made to regard physiotherapy as an evidence based method of treatment are not justified scientifically. An agreement of the scientific community on common inclusion criteria for future studies on PT is necessary. We would suggest the following: (1) girls only, (2) age 10 to 13 with the first signs of maturation (Tanner II), (3) Risser 0-2, (4) risk for progression 40 - 60% according to Lonstein and Carlson. There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive followed from premenarchial status until skeletal maturity. Therefore, only bracing can be regarded as being evidence based in the management of scoliosis patients during growth.

  5. Aversive Stimulation -- Criteria for Application.

    Science.gov (United States)

    O'Donnell, Patrick A.; Ohlson, Glenn A.

    Criteria for applying aversive stimulation with severely handicapped children are examined, and practical and ethical issues are considered. Factors seen to influence punishment outcomes include timing, intensity, and schedule of reinforcement. Suggested is the need for further research on the comparative effectiveness of positive and negative…

  6. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome.

    Science.gov (United States)

    Harden, R Norman; Bruehl, Stephen; Perez, Roberto S G M; Birklein, Frank; Marinus, Johan; Maihofner, Christian; Lubenow, Timothy; Buvanendran, Asokumar; Mackey, Sean; Graciosa, Joseph; Mogilevski, Mila; Ramsden, Christopher; Chont, Melissa; Vatine, Jean-Jacques

    2010-08-01

    Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS. Copyright (c) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. Prevalence of Internet gaming disorder in German adolescents: diagnostic contribution of the nine DSM-5 criteria in a state-wide representative sample.

    Science.gov (United States)

    Rehbein, Florian; Kliem, Sören; Baier, Dirk; Mößle, Thomas; Petry, Nancy M

    2015-05-01

    Internet gaming disorder (IGD) is included as a condition for further study in Section 3 of the DSM-5. Nine criteria were proposed with a threshold of five or more criteria recommended for diagnosis. The aims of this study were to assess how the specific criteria contribute to diagnosis and to estimate prevalence rates of IGD based on DSM-5 recommendations. Large-scale, state-representative school survey using a standardized questionnaire. Germany (Lower Saxony). A total of 11 003 ninth-graders aged 13-18 years (mean = 14.88, 51.09% male). IGD was assessed with a DSM-5 adapted version of the Video Game Dependency Scale that covered all nine criteria of IGD. In total, 1.16% [95% confidence interval (CI) = 0.96, 1.36] of respondents were classified with IGD according to DSM-5 recommendations. IGD students played games for longer periods, skipped school more often, had lower grades in school, reported more sleep problems and more often endorsed feeling 'addicted to gaming' than their non-IGD counterparts. The most frequently reported DSM-5 criteria overall were 'escape adverse moods' (5.30%) and 'preoccupation' (3.91%), but endorsement of these criteria rarely related to IGD diagnosis. Conditional inference trees showed that the criteria 'give up other activities', 'tolerance' and 'withdrawal' were of key importance for identifying IGD as defined by DSM-5. Based on a state-wide representative school survey in Germany, endorsement of five or more criteria of DSM-5 internet gaming disorder (IGD) occurred in 1.16% of the students, and these students evidence greater impairment compared with non-IGD students. Symptoms related to 'give up other activities', 'tolerance' and 'withdrawal' are most relevant for IGD diagnosis in this age group. © 2015 Society for the Study of Addiction.

  8. Ambient water quality criteria for mercury: Technical appendix

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, N.K.

    1989-01-01

    This document discusses the effects of mercury on various water uses, including drinking water, aquatic life, wildlife, livestock water supply, irrigation, recreation and aesthetics, and industrial water supplies. Standards, objectives, and criteria from national and international jurisdictions are reviewed, providing a basis, along with other information available from the literature, for criteria recommended to protect water uses in British Columbia from anthropogenic mercury.

  9. Selection criteria for a radiography programme in South Africa ...

    African Journals Online (AJOL)

    Background: Selection criteria used to admit students to a radiography programme at the Central University of Technology (CUT) included academic criteria, as well as the General Scholastic Aptitude Test (GSAT) and Self-directed Search (SDS) Questionnaire. Aims and objectives: The aim of the study was to identify which ...

  10. Maintenance evaluation using risk based criteria

    International Nuclear Information System (INIS)

    Torres Valle, A.

    1996-01-01

    The maintenance evaluation is currently performed by using economic and, in some case, technical equipment failure criteria, however this is done to a specific equipment level. In general, when statistics are used the analysis for maintenance optimization are made isolated and whit a post mortem character; The integration provided by mean of Probabilistic Safety assessment (PSA) together with the possibilities of its applications, allow for evaluation of maintenance on the basis of broader scope criteria in regard to those traditionally used. The evaluate maintenance using risk based criteria, is necessary to follow a dynamic and systematic approach, in studying the maintenance strategy, to allow for updating the initial probabilistic models, for including operational changes that often take place during operation of complex facilities. This paper proposes a dynamic evaluation system of maintenance task. The system is illustrated by means of a practical example

  11. Ambient water quality criteria for polycyclic aromatic hydrocarbons (PAHs)

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, N.K.

    1993-08-13

    Ambient water quality criteria are established for polyaromatic hydrocarbons (PAH) in British Columbia. Major sources of PAH in the atmosphere and aquatic environments include, for the atmosphere, forest and prairie fires, agricultural burning, refuse burning, enclosed incineration, and heating and power, and for the aquatic environment, petroleum spillage, atmospheric deposition, wastewaters, surface land runoff, and biosynthesis. Details are presented of PAH and their characteristics, forms and transformations, occurrence in the environment, drinking water concerns, aquatic life concerns, wildlife concerns, livestock water supply concerns, and irrigation concerns. Application of criteria for aquatic life is discussed including phototoxic vs long term criteria, assessment of existing water quality, setting water quality objectives, and PAH levels in smoked fish. 221 refs., 5 figs., 30 tabs.

  12. The Derivation of Evaluation Criteria of Nuclear Fuel Cycle

    International Nuclear Information System (INIS)

    Kim, S. K.; Ko, W. I.

    2013-01-01

    This study suggests the evaluation criteria and evaluation indicators derived using a factor analysis. As a result of a factor analysis, 5 evaluation criteria (safety (technological feature), environmental impact, economic feasibility, sociality, institution) and 24 evaluation indicators were selected. Particularly, the level of legislation for the management of radioactive waste, the level of establishment of safety standards of the country, and the level of application of international safety standards were analyzed to be qualitative evaluation indicators that should be considered in the aspect of the institution. The purpose of an analysis on diverse nuclear fuel cycles is to select the optimum nuclear fuel cycle suitable for the environment of one's own country. Accordingly, diverse evaluation criteria and evaluation indicators are necessary. In addition, individual evaluation criteria can be explained with various evaluation indicators. For example, the evaluation criteria for economic feasibility can be explained with evaluation indicators such as the unit cost or total cost. However, if too many evaluation indicators are included in one evaluation criterion, the evaluation is not easy, and if too few evaluation indicators are established, the evaluation criteria cannot be explained sufficiently, and thus the evaluation can be distorted. Accordingly, not only should the evaluation indicators be composed of an appropriate number of units, but they should also not be overlapped, and ambiguous evaluation indicators should be dropped out and necessary evaluation indicators must be included

  13. Proposed minimal diagnostic criteria for myelodysplastic syndromes (MDS) and potential pre-MDS conditions.

    Science.gov (United States)

    Valent, Peter; Orazi, Attilio; Steensma, David P; Ebert, Benjamin L; Haase, Detlef; Malcovati, Luca; van de Loosdrecht, Arjan A; Haferlach, Torsten; Westers, Theresia M; Wells, Denise A; Giagounidis, Aristoteles; Loken, Michael; Orfao, Alberto; Lübbert, Michael; Ganser, Arnold; Hofmann, Wolf-Karsten; Ogata, Kiyoyuki; Schanz, Julie; Béné, Marie C; Hoermann, Gregor; Sperr, Wolfgang R; Sotlar, Karl; Bettelheim, Peter; Stauder, Reinhard; Pfeilstöcker, Michael; Horny, Hans-Peter; Germing, Ulrich; Greenberg, Peter; Bennett, John M

    2017-09-26

    Myelodysplastic syndromes (MDS) comprise a heterogeneous group of myeloid neoplasms characterized by peripheral cytopenia, dysplasia, and a variable clinical course with about 30% risk to transform to secondary acute myeloid leukemia (AML). In the past 15 years, diagnostic evaluations, prognostication, and treatment of MDS have improved substantially. However, with the discovery of molecular markers and advent of novel targeted therapies, new challenges have emerged in the complex field of MDS. For example, MDS-related molecular lesions may be detectable in healthy individuals and increase in prevalence with age. Other patients exhibit persistent cytopenia of unknown etiology without dysplasia. Although these conditions are potential pre-phases of MDS they may also transform into other bone marrow neoplasms. Recently identified molecular, cytogenetic, and flow-based parameters may add in the delineation and prognostication of these conditions. However, no generally accepted integrated classification and no related criteria are as yet available. In an attempt to address this challenge, an international consensus group discussed these issues in a working conference in July 2016. The outcomes of this conference are summarized in the present article which includes criteria and a proposal for the classification of pre-MDS conditions as well as updated minimal diagnostic criteria of MDS. Moreover, we propose diagnostic standards to delineate between ´normal´, pre-MDS, and MDS. These standards and criteria should facilitate diagnostic and prognostic evaluations in clinical studies as well as in clinical practice.

  14. Carotid Consensus Panel duplex criteria can replace modified University of Washington criteria without affecting accuracy.

    Science.gov (United States)

    Kim, Ann H; Augustin, Gener; Shevitz, Andrew; Kim, Hannah; Trivonovich, Michael R; Powell, Alexis R; Kumins, Norman; Tarr, Robert; Kashyap, Vikram S

    2018-04-01

    The decision to intervene for internal carotid stenosis often depends on the degree of stenosis seen on duplex ultrasound (US). The aim of this study is to compare the diagnostic accuracy of two criteria: modified University of Washington (UW) and 2003 Carotid Consensus Panel (CCP). All patients undergoing US in an accredited (IAC) vascular laboratory from January 2010 to June 2015 were reviewed ( n=18,772 US exams). Patients receiving a neck computed tomography angiography (CTA) within 6 months of the US were included in the study ( n=254). The degree of stenosis was determined by UW/CCP criteria and confirmed on CTA images using North American Symptomatic Carotid Endarterectomy Trial (NASCET)/European Carotid Surgery Trial (ECST) schema. Kappa analysis with 95% confidence intervals (CIs) were utilized to determine duplex-CTA agreement. A total of 417 carotid arteries from 221 patients were assessed in this study. The modified UW criteria accurately classified 266 (63.9%, kappa = 0.321, 95% CI 0.255 to 0.386) cases according to NASCET-derived measurements. The sensitivity, specificity, and accuracy at ≥ 60% stenosis were 65.7%, 81.3%, and 81.9%. The CCP criteria resulted in 296 (70.9%) accurate diagnoses (kappa = 0.359, 95% CI 0.280 to 0.437). At ≥ 70% stenosis, the sensitivity, specificity and accuracy were 38.8%, 91.6%, and 87.1% for NASCET. Comparison of the duplex results to ECST-derived CTA measurements revealed a similar trend (UW 53.1%, κ = 0.301 vs CCP 62.1%, κ = 0.315). The CCP criteria demonstrate a higher concordance rate with measurements taken from CTAs. The CCP criteria may be more sensitive in classifying clinically significant degrees of stenosis without a loss in diagnostic accuracy.

  15. Prenatal Exposure to Organohalogens, Including Brominated Flame Retardants, Influences Motor, Cognitive, and Behavioral Performance at School Age

    NARCIS (Netherlands)

    Roze, Elise; Meijer, Lisethe; Bakker, Attie; Van Braeckel, Koenraad N. J. A.; Sauer, Pieter J. J.; Bos, Arend F.

    2009-01-01

    BACKGROUND: Organohalogen compounds (OHCs) are known to have neurotoxic effects on the developing brain. OBJECTIVE: We investigated the influence of prenatal exposure to OHCs, including brominated flame retardants, on motor, cognitive, and behavioral outcome in healthy children of school age.

  16. A multi-criteria optimization analysis for Jordan's energy mix

    International Nuclear Information System (INIS)

    Malkawi, Salaheddin; Al-Nimr, Moh'd; Azizi, Danah

    2017-01-01

    In this study Jordan's energy options were evaluated and ranked with respect to several criteria clusters including financial, technical, environmental, ecological, social, and risk assessment. The Analytical Hierarchy Process; a multi-criteria decision-making analysis, was selected to evaluate the electricity generation options for Jordan. Energy options covered in the analysis include both conventional and renewable sources. Conventional sources evaluated include Oil and Natural Gas. Renewable sources covered wind, biomass, Photovoltaic and concentrated solar systems. The study also investigated generation from nuclear energy and direct combustion of oil shale as well as demand side savings from energy efficiency measures as a resource. Results indicate that to date; conventional fuels remain Jordan's most feasible options from a technical and financial perspective. Nonetheless diversification is essential to promoting energy security as well as environmental welfare. Results indicate that Jordan's best diversification options are nuclear, oil shale, biomass, and wind energy. - Highlights: • A Multi-Criteria Optimization Analysis technique was used to compare nine electricity generation options. • Options considered included Fossil Fuel sources, Nuclear Energy , Renewable Energy and Energy Efficiency. • Six criteria clusters were considered: financial, technical, environmental, ecological, social, and risk assessment. • Results outline potential policy implications for diversifying Jordan's energy mix. • Conventional fuels remain integral and Oil shale, Nuclear, Biomass and Wind offer the best diversification potential.Tag as highlight.

  17. Developmentally sensitive diagnostic criteria for mental health disorders in early childhood: the diagnostic and statistical manual of mental disorders-IV, the research diagnostic criteria-preschool age, and the diagnostic classification of mental health and developmental disorders of infancy and early childhood-revised.

    Science.gov (United States)

    Egger, Helen L; Emde, Robert N

    2011-01-01

    As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on diagnostic classification of mental health disorders in young children. We place the issue of early childhood diagnosis within the context of classification of psychopathology at other ages and describe, in some detail, diagnostic classifications that have been developed specifically for young children, including the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R; ZERO TO THREE, 2005), a diagnostic classification for mental health symptoms and disorders in infants, toddlers, and preschoolers. We briefly outline the role of diagnostic classification in clinical assessment and treatment planning. Last, we review the limitations of current approaches to the diagnostic classification of mental health disorders in young children. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  18. Description of double-shell tank selection criteria for inspection

    International Nuclear Information System (INIS)

    Schwenk, E.B.; Scott, K.V.

    1996-01-01

    Technical criteria for selecting double-shelf tanks's (DST's) for inspection are presented. Inspection of DST's is planned to non-destructively determine the general condition of their inner wall and bottom knuckle. Inspection of representative tanks will provide a basis for evaluating the integrity of all the DST's and provide a basis for estimating remaining life. The selection criteria recommended are tank age based on date-of-first fluid entry, waste temperature, corrosion inhibitor levels, deviations from normal behavior - involving sludge levels, hydrogen release and waste transfers - least waste depth fluctuation, tank steel type, other chemical species that could activate stress-corrosion cracking, and waste types

  19. CORAL REEF BIOLOGICAL CRITERIA: USING THE CLEAN ...

    Science.gov (United States)

    Coral reefs are declining at unprecedented rates worldwide due to multiple interactive stressors including climate change and land-based sources of pollution. The Clean Water Act (CWA) can be a powerful legal instrument for protecting water resources, including the biological inhabitants of coral reefs. The objective of the CWA is to restore and maintain the chemical, physical and biological integrity of water resources. Coral reef protection and restoration under the Clean Water Act begins with water quality standards - provisions of state or Federal law that consist of a designated use(s) for the waters of the United States and water quality criteria sufficient to protect the uses. Aquatic life use is the designated use that is measured by biological criteria (biocriteria). Biocriteria are expectations set by a jurisdiction for the quality and quantity of living aquatic resources in a defined waterbody. Biocriteria are an important addition to existing management tools for coral reef ecosystems. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework to aid States and Territories in their development, adoption, and implementation of coral reef biocriteria in their respective water quality standards. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework for coral re

  20. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA

    International Nuclear Information System (INIS)

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION, NEVADA SITE OFFICE

    2005-01-01

    This document establishes the U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal. Mixed waste generated within the State of Nevada by NNSA/NSO activities is accepted for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Site for storage or disposal

  1. A Review of Level 2 Parent-Report Instruments Used to Screen Children Aged 1.5-5 for Autism: A Meta-Analytic Update

    Science.gov (United States)

    Hampton, Justin; Strand, Paul S.

    2015-01-01

    The present study utilized meta-analytic procedures to estimate the diagnostic validity of instruments used to screen young children, ages 1.5-5 years, for autism. Five scales met inclusion criteria, and data from 18 studies contributed the meta-analysis. Results revealed that 4 of 5 scales met criteria for "good" validity, including two…

  2. What criteria do decision makers in Thailand use to set priorities for vaccine introduction?

    Science.gov (United States)

    Pooripussarakul, Siriporn; Riewpaiboon, Arthorn; Bishai, David; Muangchana, Charung; Tantivess, Sripen

    2016-08-02

    There is a need to identify rational criteria and set priorities for vaccines. In Thailand, many licensed vaccines are being considering for introduction into the Expanded Program on Immunization; thus, the government has to make decisions about which vaccines should be adopted. This study aimed to set priorities for new vaccines and to facilitate decision analysis. We used a best-worst scaling study for rank-ordering of vaccines. The candidate vaccines were determined by a set of criteria, including burden of disease, target age group, budget impact, side effect, effectiveness, severity of disease, and cost of vaccine. The criteria were identified from a literature review and by in-depth, open-ended interviews with experts. The priority-setting model was conducted among three groups of stakeholders, including policy makers, healthcare professionals and healthcare administrators. The vaccine data were mapped and then calculated for the probability of selection. From the candidate vaccines, the probability of hepatitis B vaccine being selected by all respondents (96.67 %) was ranked first. This was followed, respectively, by pneumococcal conjugate vaccine-13 (95.09 %) and Haemophilus influenzae type b vaccine (90.87 %). The three groups of stakeholders (policy makers, healthcare professionals and healthcare administrators) showed the same ranking trends. Most severe disease, high fever rate and high disease burden showed the highest coefficients for criterion levels being selected by all respondents. This result can be implied that a vaccine which can prevent most severe disease with high disease burden and has low safety has a greater chance of being selected by respondents in this study. The priority setting of vaccines through a multiple-criteria approach could contribute to transparency and accountability in the decision-making process. This is a step forward in the development of an evidence-based approach that meets the need of developing country. The

  3. What criteria do decision makers in Thailand use to set priorities for vaccine introduction?

    Directory of Open Access Journals (Sweden)

    Siriporn Pooripussarakul

    2016-08-01

    Full Text Available Abstract Background There is a need to identify rational criteria and set priorities for vaccines. In Thailand, many licensed vaccines are being considering for introduction into the Expanded Program on Immunization; thus, the government has to make decisions about which vaccines should be adopted. This study aimed to set priorities for new vaccines and to facilitate decision analysis. Methods We used a best-worst scaling study for rank-ordering of vaccines. The candidate vaccines were determined by a set of criteria, including burden of disease, target age group, budget impact, side effect, effectiveness, severity of disease, and cost of vaccine. The criteria were identified from a literature review and by in-depth, open-ended interviews with experts. The priority-setting model was conducted among three groups of stakeholders, including policy makers, healthcare professionals and healthcare administrators. The vaccine data were mapped and then calculated for the probability of selection. Results From the candidate vaccines, the probability of hepatitis B vaccine being selected by all respondents (96.67 % was ranked first. This was followed, respectively, by pneumococcal conjugate vaccine-13 (95.09 % and Haemophilus influenzae type b vaccine (90.87 %. The three groups of stakeholders (policy makers, healthcare professionals and healthcare administrators showed the same ranking trends. Most severe disease, high fever rate and high disease burden showed the highest coefficients for criterion levels being selected by all respondents. This result can be implied that a vaccine which can prevent most severe disease with high disease burden and has low safety has a greater chance of being selected by respondents in this study. Conclusions The priority setting of vaccines through a multiple-criteria approach could contribute to transparency and accountability in the decision-making process. This is a step forward in the development of an evidence

  4. Impact of the DSM-V Attention Deficit Hyperactivity Disorder Criteria for Diagnosing Children With High IQ.

    Science.gov (United States)

    Thongseiratch, Therdpong; Worachotekamjorn, Juthamas

    2016-10-01

    This study compared the number of attention deficit hyperactivity disorder (ADHD) cases defined by Diagnostic and Statistical Manual (DSM)-IV versus DSM-V criterion in children who have learning or behavioral problems with high IQ. The medical records of children ≤15 years of age who presented with learning or behavioral problems and underwent a Wechsler Intelligence Scale for Children (WISC)-III IQ test at the Pediatric Outpatient Clinic unit between 2010 and 2015 were reviewed. Information on DSM-IV and DSM-V criteria for ADHD were derived from computer-based medical records. Twenty-eight children who had learning or behavioral problems were identified to have a full-scale IQ ≥120. Sixteen of these high-IQ children met the DSM-IV criteria diagnosis for ADHD. Applying the extension of the age-of-onset criterion from 7 to 12 years in DSM-V led to an increase of three cases, all of which were the inattentive type ADHD. Including the pervasive developmental disorder criterion led to an increase of one case. The total number of ADHD cases also increased from 16 to 20 in this group. The data supported the hypothesis that applying the extension of the age-of-onset ADHD criterion and enabling the diagnosis of children with pervasive developmental disorders will increase the number of ADHD diagnoses among children with high IQ. © The Author(s) 2016.

  5. Development of design Criteria for ITER In-vessel Components

    International Nuclear Information System (INIS)

    Sannazzaro, G.; Barabash, V.; Kang, S.C.; Fernandez, E.; Kalinin, G.; Obushev, A.; Martínez, V.J.; Vázquez, I.; Fernández, F.; Guirao, J.

    2013-01-01

    Absrtract: The components located inside the ITER vacuum chamber (in-vessel components – IC), due to their specific nature and the environments they are exposed to (neutron radiation, high heat fluxes, electromagnetic forces, etc.), have specific design criteria which are, in this paper, referred as Structural Design Criteria for In-vessel Components (SDC-IC). The development of these criteria started in the very early phase of the ITER design and followed closely the criteria of the RCC-MR code. Specific rules to include the effect of neutron irradiation were implemented. In 2008 the need of an update of the SDC-IC was identified to add missing specifications, to implement improvements, to modernise rules including recent evolutions in international codes and regulations (i.e. PED). Collaboration was set up between ITER Organization (IO), European (EUDA) and Russian Federation (RFDA) Domestic Agencies to generate a new version of SDC-IC. A Peer Review Group (PRG) composed by members of the ITER Organization and all ITER Domestic Agencies and code experts was set-up to review the proposed modifications, to provide comments, contributions and recommendations

  6. Memory's aging echo: age-related decline in neural reactivation of perceptual details during recollection.

    Science.gov (United States)

    McDonough, Ian M; Cervantes, Sasha N; Gray, Stephen J; Gallo, David A

    2014-09-01

    Episodic memory decline is a hallmark of normal cognitive aging. Here, we report the first event-related fMRI study to directly investigate age differences in the neural reactivation of qualitatively rich perceptual details during recollection. Younger and older adults studied pictures of complex scenes at different presentation durations along with descriptive verbal labels, and these labels subsequently were used during fMRI scanning to cue picture recollections of varying perceptual detail. As expected from prior behavioral work, the two age groups subjectively rated their recollections as containing similar amounts of perceptual detail, despite objectively measured recollection impairment in older adults. In both age groups, comparisons of retrieval trials that varied in recollected detail revealed robust activity in brain regions previously linked to recollection, including hippocampus and both medial and lateral regions of the prefrontal and posterior parietal cortex. Critically, this analysis also revealed recollection-related activity in visual processing regions that were active in an independent picture-perception task, and these regions showed age-related reductions in activity during recollection that cannot be attributed to age differences in response criteria. These fMRI findings provide new evidence that aging reduces the absolute quantity of perceptual details that are reactivated from memory, and they help to explain why aging reduces the reliability of subjective memory judgments. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders.

    Science.gov (United States)

    Peck, C C; Goulet, J-P; Lobbezoo, F; Schiffman, E L; Alstergren, P; Anderson, G C; de Leeuw, R; Jensen, R; Michelotti, A; Ohrbach, R; Petersson, A; List, T

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria. © 2014 John Wiley & Sons Ltd.

  8. A demonstration of NIOSH push-pull ventilation criteria.

    Science.gov (United States)

    Klein, M K

    1987-03-01

    This paper summarizes the results of a study performed on an actual chrome plating tank in order to validate criteria for push-pull ventilation systems developed by Huebener and Hughes at NIOSH. Validation of the criteria was made by taking area industrial hygiene samples for hexavalent and total chrome at ten locations around the plating tank. The sampling was performed during actual production runs or while the tank was operating with a dummy load. The sampling data are summarized. The data show that the push-pull system, operating at Huebener's criteria, could control emissions to below the current standards and guidelines. Conclusions and recommendations are included.

  9. Safe ageing management of nuclear power plants: An European synthesis

    International Nuclear Information System (INIS)

    Grandemange, J.M.

    2002-01-01

    for the most important (nonreplaceable) components; generic evaluations of specific important issues on the main ageing phenomena. Comparisons of ageing management approaches cover the following aspects, according to IAEA AMAT guidelines: strategy, utility organisation, activities including methodologies, procedures, and surveillance programs, and monitoring and assessment. The various ageing phenomena have been identified, with possible evaluation and mitigation methods. Management strategies include: identification and prioritisation of components of importance to safety and plant life; selection and identification of significant ageing mechanisms; ageing prediction criteria; surveillance and periodic testing methods; mitigation of ageing effects; maintenance programs and updating of operating parameters. Other aspects including industrial obsolescence and human, organisation and knowledge ageing are also identified and recommendations expressed. Material ageing management programs are given to illustrate the above strategies. Taking into account the physical understanding of these phenomena, zones of components concerned and potential effects are identified, prediction laws established, surveillance programs prepared, criteria applied and mitigation methods proposed

  10. Plutonium storage criteria

    Energy Technology Data Exchange (ETDEWEB)

    Chung, D. [Scientech, Inc., Germantown, MD (United States); Ascanio, X. [Dept. of Energy, Germantown, MD (United States)

    1996-05-01

    The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less than 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.

  11. Phenomenology of Schizophrenia and the Representativeness of Modern Diagnostic Criteria.

    Science.gov (United States)

    Kendler, Kenneth S

    2016-10-01

    This article aims to determine the degree to which modern operationalized diagnostic criteria for schizophrenia reflect the main clinical features of the disorder as described historically by diagnostic experts. Amazon.com, the National Library of Medicine, and Forgottenbooks.com were searched for articles written or translated into English from 1900 to 1960. Clinical descriptions of schizophrenia or dementia praecox appearing in 16 textbooks or review articles published between 1899 and 1956 were reviewed and compared with the criteria for schizophrenia from 6 modern US operationalized diagnostic systems. Twenty prominent symptoms and signs were reported by 5 or more authors. A strong association was seen between the frequency with which the symptoms/signs were reported and the likelihood of their presence in modern diagnostic systems. Of these 20 symptoms/signs, 3 (thought disorder, delusions, and hallucinations) were included in all diagnostic systems and were among the 4 most frequently reported. Three symptoms/signs were added then kept in subsequent criteria: emotional blunting, changes in volition, and changes in social life. Three symptoms/signs were added but then dropped: bizarre delusions, passivity symptoms, and mood incongruity. Eleven symptoms/signs were never included in any diagnostic system. Compared with historical authors, modern criteria favored symptoms over signs. Odd movements and postures, noted by 16 of 18 historical authors, were absent from all modern criteria. DSM-5 criteria contain 6 of the 20 historically noted symptoms/signs. Although modern operationalized criteria for schizophrenia reflect symptoms and signs commonly reported by historical experts, many clinical features emphasized by these experts are absent from modern criteria. This is not necessarily problematic as diagnostic criteria are meant to index rather than thoroughly describe syndromes. However, the lack of correspondence in schizophrenia between historically important

  12. Evaluating Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents

    Science.gov (United States)

    Scheeringa, Michael S.; Weems, Carl F.

    2017-01-01

    Abstract Objectives: Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7–18-year olds. Methods: PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7–12) were examined separately from adolescents (ages 13–18) to assess for potential developmental differences. Results: A significantly higher proportion of 7–12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13–18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7–12-year-old (but not 13–18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV. Conclusion: These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7–12-year-old children, but not for adolescents. Using the very young children criteria for 7–12-year-old children may further increase prevalence, but capture children with less severe psychopathology. PMID:28170306

  13. Earthquake Vulnerability Assessment for Hospital Buildings Using a Gis-Based Group Multi Criteria Decision Making Approach: a Case Study of Tehran, Iran

    Science.gov (United States)

    Delavar, M. R.; Moradi, M.; Moshiri, B.

    2015-12-01

    Nowadays, urban areas are threatened by a number of natural hazards such as flood, landslide and earthquake. They can cause huge damages to buildings and human beings which necessitates disaster mitigation and preparation. One of the most important steps in disaster management is to understand all impacts and effects of disaster on urban facilities. Given that hospitals take care of vulnerable people reaction of hospital buildings against earthquake is vital. In this research, the vulnerability of hospital buildings against earthquake is analysed. The vulnerability of buildings is related to a number of criteria including age of building, number of floors, the quality of materials and intensity of the earthquake. Therefore, the problem of seismic vulnerability assessment is a multi-criteria assessment problem and multi criteria decision making methods can be used to address the problem. In this paper a group multi criteria decision making model is applied because using only one expert's judgments can cause biased vulnerability maps. Sugeno integral which is able to take into account the interaction among criteria is employed to assess the vulnerability degree of buildings. Fuzzy capacities which are similar to layer weights in weighted linear averaging operator are calculated using particle swarm optimization. Then, calculated fuzzy capacities are included into the model to compute a vulnerability degree for each hospital.

  14. EARTHQUAKE VULNERABILITY ASSESSMENT FOR HOSPITAL BUILDINGS USING A GIS-BASED GROUP MULTI CRITERIA DECISION MAKING APPROACH: A CASE STUDY OF TEHRAN, IRAN

    Directory of Open Access Journals (Sweden)

    M. R. Delavar

    2015-12-01

    Full Text Available Nowadays, urban areas are threatened by a number of natural hazards such as flood, landslide and earthquake. They can cause huge damages to buildings and human beings which necessitates disaster mitigation and preparation. One of the most important steps in disaster management is to understand all impacts and effects of disaster on urban facilities. Given that hospitals take care of vulnerable people reaction of hospital buildings against earthquake is vital. In this research, the vulnerability of hospital buildings against earthquake is analysed. The vulnerability of buildings is related to a number of criteria including age of building, number of floors, the quality of materials and intensity of the earthquake. Therefore, the problem of seismic vulnerability assessment is a multi-criteria assessment problem and multi criteria decision making methods can be used to address the problem. In this paper a group multi criteria decision making model is applied because using only one expert’s judgments can cause biased vulnerability maps. Sugeno integral which is able to take into account the interaction among criteria is employed to assess the vulnerability degree of buildings. Fuzzy capacities which are similar to layer weights in weighted linear averaging operator are calculated using particle swarm optimization. Then, calculated fuzzy capacities are included into the model to compute a vulnerability degree for each hospital.

  15. Senior Friendly Hospitals: Development and Application of Criteria: A Descriptive Study.

    Science.gov (United States)

    Rashmi, M R; Kasthuri, Arvind; Rodrigues, Rashmi J

    2016-01-01

    The world's population is rapidly aging. Between 2000 and 2050, the proportion of the world's population over the age of 60 will double from about 11% to 22%; more so in the developing countries. The prevalence of frailty and morbidity among the elderly is high. There is a need to assess the "preparedness" of the health care system including hospitals to respond to the needs of the elderly. 1. To develop criteria for a senior friendly hospital and 2. To assess the feasibility of application of these criteria. A descriptive study was done at Bangalore, India, involving 100 subjects sampled by purposive sampling. Study population consisted of senior citizens, their caretakers, physicians, hospital support staff, nurses, geriatricians, hospital administrators, and architects. They were interviewed using a validated translated interview schedule. The study consisted of two phases; Phase 1: Developing a checklist to assess senior friendliness of a hospital by using modified Delphi technique. Phase 2: Application of the checklist thus developed to selected hospitals in order to assess the feasibility of administration. The data was then analyzed using Statistical Package for the Social Sciences (SPSS) for frequencies, proportions, central tendency and dispersion, interclass reliability, intraclass reliability, and Cronbach's alpha. A checklist containing 44 items to assess the senior friendliness of a hospital was developed. The checklist was found feasible and easy to administer. The checklist thus developed to assess senior friendliness of a hospital has wider application as it has a potential to be considered for framing senior friendly hospital guidelines/policies.

  16. Does Age Influence Cardiac Resynchronization Therapy Use and Outcome?

    Science.gov (United States)

    Heidenreich, Paul A; Tsai, Vivian; Bao, Haikun; Curtis, Jeptha; Goldstein, Mary; Curtis, Lesley; Hernandez, Adrian; Peterson, Pamela; Turakhia, Mintu P; Masoudi, Frederick A

    2015-06-01

    This study sought to describe the use of CRT-D and its association with survival for older patients. Many patients who receive cardiac resynchronization therapy with defibrillator (CRT-D) in practice are older than those included in clinical trials. We identified patients undergoing ICD implantation in the National Cardiovascular Disease Registry (NCDR) ICD registry from 2006 to 2009, who also met clinical trial criteria for CRT, including left ventricular ejection fraction (LVEF) ≤35%, QRS ≥120 ms, and New York Heart Association (NYHA) functional class III or IV. NCDR registry data were linked to the social security death index to determine the primary outcome of time to death from any cause. We identified 70,854 patients from 1,187 facilities who met prior trial criteria for CRT-D. The mean age of the 58,147 patients receiving CRT-D was 69.4 years with 6.4% of patients age 85 or older. CRT use was 80% or higher among candidates in all age groups. Follow-up was available for 42,285 patients age ≥65 years at 12 months. Receipt of CRT-D was associated with better survival at 1 year (82.1% vs. 77.1%, respectively) and 4 years (54.0% vs. 46.2% , respectively) than in those receiving only an ICD (p different for different age groups (p = 0.86 for interaction). More than 80% of older patients undergoing ICD implantation who were candidates for a CRT-D received the combined device. Mortality in older patients undergoing ICD implantation was high but was lower for those receiving CRT-D. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Purchasing a Used Car Using Multiple Criteria Decision Making

    Science.gov (United States)

    Edwards, Thomas G.; Chelst, Kenneth R.

    2007-01-01

    When studying mathematics, students often ask the age-old question, "When will I ever use this in my future?" The activities described in this article demonstrate for students a process that brings the power of mathematical reasoning to bear on a difficult decision involving multiple criteria that is sure to resonate with the interests of many of…

  18. Proliferation resistance criteria for fissile material disposition

    International Nuclear Information System (INIS)

    Close, D.A.; Fearey, B.L.; Markin, J.T.; Rutherford, D.A.; Duggan, R.A.; Jaeger, C.D.; Mangan, D.L.; Moya, R.W.; Moore, L.R.; Strait, R.S.

    1995-04-01

    The 1994 National Academy of Sciences study open-quotes Management and Disposition of Excess Weapons Plutoniumclose quotes defined options for reducing the national and international proliferation risks of materials declared excess to the nuclear weapons program. This report proposes criteria for assessing the proliferation resistance of these options. The criteria are general, encompassing all stages of the disposition process from storage through intermediate processing to final disposition including the facilities, processing technologies and materials, the level of safeguards for these materials, and the national/subnational threat to the materials

  19. Should DSM-V include dimensional diagnostic criteria for alcohol use disorders?

    Science.gov (United States)

    Helzer, John E; Bucholz, Kathleen K; Bierut, Laura Jean; Regier, Darrel A; Schuckit, Marc A; Guth, Sarah E

    2006-02-01

    This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V.

  20. Repository operational criteria analysis

    International Nuclear Information System (INIS)

    Hageman, J.P.; Chowdhury, A.H.

    1992-08-01

    The objective of the ''Repository Operational Criteria (ROC) Feasibility Studies'' (or ROC task) was to conduct comprehensive and integrated analyses of repository design, construction, and operations criteria in 10 CFR Part 60 regulations, considering the interfaces and impacts of any potential changes to those regulations. The study addresses regulatory criteria related to the preclosure aspects of the geologic repository. The study task developed regulatory concepts or potential repository operational criteria (PROC) based on analysis of a repository's safety functions and other regulations for similar facilities. These regulatory concepts or PROC were used as a basis to assess the sufficiency and adequacy of the current criteria in 10 CFR Part 60. Where the regulatory concepts were same as current operational criteria, these criteria were referenced. The operations criteria referenced or the PROC developed are given in this report. Detailed analyses used to develop the regulatory concepts and any necessary PROC for those regulations that may require a minor change are also presented. The results of the ROC task showed a need for further analysis and possible major rule change related to the design bases of a geologic repository operations area, siting, and radiological emergency planning

  1. Construction of a Composite Hospital Admission Index Using the Aggregated Weights of Criteria

    International Nuclear Information System (INIS)

    Nor Hasliza Mat Desa; Abdul Aziz Jemain; Maznah Mat Kasim

    2015-01-01

    The issue of age difference in hospital admission should be given special attention since it affects the structure of hospital care and treatments. Patients of different age groups should be given different priority in service provision. Due to crucial time and limited resources, health care managers need to make wise decisions in identifying priorities in age of admission. This paper aimed to propose a construction of a daily composite hospital admission index (CHAI) as an indicator that captures relevant information about the overall performance of hospital admission over time. It involves five different age groups of total patients admitted to seven major public hospitals in the Klang Valley, Malaysia for respiratory and cardiovascular diseases for a period of three years, 2008 - 2010. The criteria weights were predetermined by aggregating the subjective weight based on rank ordered centroid (ROC) method and objective weight based on entropy - kernel method. The highest and lowest scores of CHAI were marked, while the groups of patients were prioritized according to the criteria weight ranking orders. (author)

  2. DOE natural phenomenal hazards design and evaluation criteria

    International Nuclear Information System (INIS)

    Murray, R.C.; Nelson, T.A.; Short, S.A.; Kennedy, R.P.; Chander, H.; Hill, J.R.; Kimball, J.K.

    1994-10-01

    It is the policy of the Department of Energy (DOE) to design, construct, and operate DOE facilities so that workers, the general public, and the environment are protected from the impacts of natural phenomena hazards (NPH). Furthermore, DOE has established explicit goals of acceptable risk for NPH performance. As a result, natural phenomena hazard (earthquake, extreme wind, and flood) design and evaluation criteria for DOE facilities have been developed based on target probabilistic performance goals. These criteria include selection of design/evaluation NPH input from probabilistic hazard curves combined with commonly practiced deterministic response evaluation methods and acceptance criteria with controlled levels of conservatism. For earthquake considerations, conservatism is intentionally introduced in specification of material strengths and capacities, in the allowance of limited inelastic behavior, and by a seismic scale factor. Criteria have been developed following a graded approach for several performance goals ranging from that appropriate for normal-use facilities to that appropriate for facilities involving hazardous or critical operations. Performance goals are comprised of qualitative expressions of acceptable behavior and of target quantitative probabilities that acceptable limits of behavior are maintained. The criteria are simple procedures but have a rigorous basis. This paper addresses DOE seismic design and evaluation criteria

  3. Inappropriate prescribing: criteria, detection and prevention.

    LENUS (Irish Health Repository)

    O'Connor, Marie N

    2012-06-01

    Inappropriate prescribing is highly prevalent in older people and is a major healthcare concern because of its association with negative healthcare outcomes including adverse drug events, related morbidity and hospitalization. With changing population demographics resulting in increasing proportions of older people worldwide, improving the quality and safety of prescribing in older people poses a global challenge. To date a number of different strategies have been used to identify potentially inappropriate prescribing in older people. Over the last two decades, a number of criteria have been published to assist prescribers in detecting inappropriate prescribing, the majority of which have been explicit sets of criteria, though some are implicit. The majority of these prescribing indicators pertain to overprescribing and misprescribing, with only a minority focussing on the underprescribing of indicated medicines. Additional interventions to optimize prescribing in older people include comprehensive geriatric assessment, clinical pharmacist review, and education of prescribers as well as computerized prescribing with clinical decision support systems. In this review, we describe the inappropriate prescribing detection tools or criteria most frequently cited in the literature and examine their role in preventing inappropriate prescribing and other related healthcare outcomes. We also discuss other measures commonly used in the detection and prevention of inappropriate prescribing in older people and the evidence supporting their use and their application in everyday clinical practice.

  4. To Predict the Requirement of Pharmacotherapy by OGTT Glucose Levels in Women with GDM Classified by the IADPSG Criteria

    Directory of Open Access Journals (Sweden)

    Gülen Yerlikaya

    2018-01-01

    Full Text Available The aim of this study was to assess the association between OGTT glucose levels and requirement of pharmacotherapy in GDM patients classified by the IADPSG criteria. This study included 203 GDM patients (108 managed with lifestyle modification and 95 requiring pharmacotherapy. Clinical risk factors and OGTT glucose concentrations at 0 (G0, 60 (G60, and 120 min (G120 were collected. OGTT glucose levels were significantly associated with the later requirement of pharmacotherapy (ROC-AUC: 71.1, 95% CI: 63.8–78.3. Also, the combination of clinical risk factors (age, BMI, parity, and pharmacotherapy in previous gestation showed an acceptable predictive accuracy (ROC-AUC: 72.1, 95% CI: 65.0–79.2, which was further improved when glycemic parameters were added (ROC-AUC: 77.5, 95% CI: 71.5–83.9. Random forest analysis revealed the highest variable importance for G0, G60, and age. OGTT glucose measures in addition to clinical risk factors showed promising properties for risk stratification in GDM patients classified by the recently established IADPSG criteria.

  5. Inappropriate prescribing in the older population: need for new criteria.

    LENUS (Irish Health Repository)

    O'Mahony, Denis

    2012-02-03

    Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers\\' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers\\' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.

  6. Summary and conclusions of a program addressing aging of nuclear power plant concrete structures

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.; Hookham, C.J.; Graves, H.L. III

    1999-01-01

    Research has been conducted by the Oak Ridge National Laboratory to address aging management of nuclear power plant concrete structures. The purpose was to identify potential structural safety issues and acceptance criteria for use in continued service assessments. The focus of this program was on structural integrity rather than on leaktightness or pressure retention of concrete structures. Primary program accomplishments include formulation of a Structural Materials Information Center that contains data and information on the time variation of material properties under the influence of pertinent environmental stressors and aging factors for 144 materials, an aging assessment methodology to identify critical structures and degradation factors that can potentially impact their performance, guidelines and evaluation criteria for use in condition assessments of reinforced concrete structures, and a reliability-based methodology for current condition assessments and estimations of future performance of reinforced concrete nuclear power plant structures. In addition, in-depth evaluations were conducted of several nondestructive evaluation and repair-related technologies to develop guidance on their applicability. (orig.)

  7. SPM analysis of cerebral blood flow changes related to age in patients with schizophrenia

    International Nuclear Information System (INIS)

    Song, Ho Chun; Kim, Sung Wan; Lee, Byeong II; Min, Jung Joon; Bom, Hee Seung

    2007-01-01

    The goal of this study was to explore neural activities of schizophrenic patients related to current age including the age of onset and also we examined the correlation patterns between age and neural correlates. 21 patients with schizophrenia (female/male; 10/11, mean age; 36.1 11.2) participated in this study and all patients were evaluated by criteria of DSM-IV as a schizophrenia patient. Exclusion criteria included inability to give informed consent and a history of significant neurological illness. 99mTc-ECD brain perfusion SPECT images were obtained from 21 schizophrenic patients. Using SPM (statistical parametric mapping), all images were normalized to a SPECT template (MNI template) and then smoothed. We performed an ANCOVA analysis with current age (covariate variable) and the age of onset (nuisance variable). The correlation was analyzed into positive and negative patterns. Findings are reported as a Z scores with a significance threshold of p < 0.005 (uncorrected) and a minimum cluster size of 10. Significant difference was found between current age and premorbid age (p < 0.05). Cerebral regions that were positively correlated with current age were observed in the middle frontal gyrus and the superior frontal gyrus bilaterally, the left precentral gyrus (Brodmann's area; BA 9) and the right inferior frontal gyrus (BA 46). Also, in relation to negative correlations, there were many regions in the right posterior cingulate gyrus (BA 30) and the left cuneus (BA 30), middle temporal gyrus (BA 21) and superior temporal gyrus (BA 13, 39). Additionally, the occipital regions were found in the right cuneus (BA 18) including the right middle occipital gyrus (BA 18) and right lingual gyrus (BA 19). Age effect in schizophrenic patients was observed in the dorsolateral prefrontal cortex with positive correlation. We suggest that the dorsolateral prefrontal cortex activity which is important for cognitive task performance is related to an increase of patients age

  8. SPM analysis of cerebral blood flow changes related to age in patients with schizophrenia

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Chun; Kim, Sung Wan; Lee, Byeong II; Min, Jung Joon; Bom, Hee Seung [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2007-07-01

    The goal of this study was to explore neural activities of schizophrenic patients related to current age including the age of onset and also we examined the correlation patterns between age and neural correlates. 21 patients with schizophrenia (female/male; 10/11, mean age; 36.1 11.2) participated in this study and all patients were evaluated by criteria of DSM-IV as a schizophrenia patient. Exclusion criteria included inability to give informed consent and a history of significant neurological illness. 99mTc-ECD brain perfusion SPECT images were obtained from 21 schizophrenic patients. Using SPM (statistical parametric mapping), all images were normalized to a SPECT template (MNI template) and then smoothed. We performed an ANCOVA analysis with current age (covariate variable) and the age of onset (nuisance variable). The correlation was analyzed into positive and negative patterns. Findings are reported as a Z scores with a significance threshold of p < 0.005 (uncorrected) and a minimum cluster size of 10. Significant difference was found between current age and premorbid age (p < 0.05). Cerebral regions that were positively correlated with current age were observed in the middle frontal gyrus and the superior frontal gyrus bilaterally, the left precentral gyrus (Brodmann's area; BA 9) and the right inferior frontal gyrus (BA 46). Also, in relation to negative correlations, there were many regions in the right posterior cingulate gyrus (BA 30) and the left cuneus (BA 30), middle temporal gyrus (BA 21) and superior temporal gyrus (BA 13, 39). Additionally, the occipital regions were found in the right cuneus (BA 18) including the right middle occipital gyrus (BA 18) and right lingual gyrus (BA 19). Age effect in schizophrenic patients was observed in the dorsolateral prefrontal cortex with positive correlation. We suggest that the dorsolateral prefrontal cortex activity which is important for cognitive task performance is related to an increase of patients

  9. Multi-criteria evaluation for CHP system options

    International Nuclear Information System (INIS)

    Pilavachi, P.A.; Roumpeas, C.P.; Minett, S.; Afgan, N.H.

    2006-01-01

    Several Combined Heat and Power (CHP) system options have been considered for evaluation with respect to the end-user requirements. These included Internal Combustion Engines (Otto and Diesel), Gas Turbines, Steam Turbines and Combined Cycles covering a wide range of electrical output. Data have been obtained from literature and the CHP systems have been evaluated using different criteria such as overall efficiency, investment cost, fuel cost, electricity cost, heat cost, CO 2 production and footprint. A multi-criteria method is used with an agglomeration function based on the statistical evaluation of weight factors. The technical, economic and social aspects of each system have been evaluated in an integrated manner and the results have been compared by means of the Sustainability Index. Based on the above criteria and depending on the user requirements, the best CHP system options have been established

  10. [Frequency of successful aging and frailty. Associated risk factors].

    Science.gov (United States)

    Carrazco-Peña, Karla Berenice; Farías-Moreno, Katia; Trujillo-Hernández, Benjamín

    To determine the frequency of successful aging (SA) and its relationship with frailty in an elderly population. An analytical cross-sectional study of subjects ≥60 years of age seen as outpatients in a general hospital. Successful aging was defined as scores of ≥ 90 in the Barthel index and ≤ 2 in the Pfeiffer test. Frailty was determined using the Fried criteria. The study included 400 subjects (272 women and 128 men), with a mean age of 71.6±8.2 years. The SA frequency was 40.4%. frail status was statistically higher in non-successful aging subjects than in SA subjects (161.7 versus 7.9%; P<.001). Women were more frequently frail, while being a pensioner/retired and married were associated less frequently with frailty. Successful aging is associated with a lower level of frailty. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Systematic aging of commercial LiFePO4|Graphite cylindrical cells including a theory explaining rise of capacity during aging

    Science.gov (United States)

    Lewerenz, Meinert; Münnix, Jens; Schmalstieg, Johannes; Käbitz, Stefan; Knips, Marcus; Sauer, Dirk Uwe

    2017-03-01

    The contribution introduces a new theory explaining the capacity increase that is often observed in early stages of life of lithium-ion batteries. This reversible and SOC-depending capacity rise is explained by the passive electrode effect in this work. The theory assumes a slow, compensating flow of active lithium between the passive and the active part of the anode, where the passive part represents the geometric excess anode with respect to the cathode. The theory is validated using a systematic test of 50 cylindrical 8 Ah LiFePO4|Graphite battery cells analyzed during cyclic and calendaric aging. The cyclic aging has been performed symmetrically at 40 °C cell temperature, varying current rates and DODs. The calendar aging is executed at three temperatures and up to four SOCs. The aging is dominated by capacity fade while the increase of internal resistance is hardly influenced. Surprisingly shallow cycling between 45 and 55% SOC shows stronger aging than aging at higher DOD and tests at 4 C exhibit less aging than aging at lower C-rates. Aging mechanisms at 60 °C seem to deviate from those at 40 °C or lower. The data of this aging matrix is used for further destructive and non-destructive characterization in future contributions.

  12. Successful aging: considering non-biomedical constructs

    Directory of Open Access Journals (Sweden)

    Carver LF

    2016-11-01

    Full Text Available Lisa F Carver,1 Diane Buchanan2 1Department of Sociology, Queen’s University Kingston, ON, Canada; 2School of Nursing, Queen’s University Kingston, ON, Canada Objectives: Successful aging continues to be applied in a variety of contexts and is defined using a number of different constructs. Although previous reviews highlight the multidimensionality of successful aging, a few have focused exclusively on non-biomedical factors, as was done here. Methods: This scoping review searched Ovid Medline database for peer-reviewed English-language articles published between 2006 and 2015, offering a model of successful aging and involving research with older adults. Results: Seventy-two articles were reviewed. Thirty-five articles met the inclusion criteria. Common non-biomedical constructs associated with successful aging included engagement, optimism and/or positive attitude, resilience, spirituality and/or religiosity, self-efficacy and/or self-esteem, and gerotranscendence. Discussion: Successful aging is a complex process best described using a multidimensional model. Given that the majority of elders will experience illness and/or disease during the life course, public health initiatives that promote successful aging need to employ non-biomedical constructs, facilitating the inclusion of elders living with disease and/or disability. Keywords: successful aging, resilience, gerotranscendence, engagement, optimism

  13. A Prospective Study of the Incidence of Retinopathy of Prematurity in China: Evaluation of Different Screening Criteria

    Directory of Open Access Journals (Sweden)

    Qiuping Li

    2016-01-01

    Full Text Available To investigate the incidence of Retinopathy of Prematurity (ROP in Beijing, North China, and to evaluate the effectiveness of different ROP screening criteria, we conducted a prospective cohort study in a single-neonatal intensive care unit (NICU. A total of 2997 premature infants with birth weight (BW ≤ 2000 g and/or gestational age (GA ≤ 34 weeks had completed ROP screening. ROP was diagnosed in 356 (11.9% infants. The mean GA was 30.46 ± 1.98 weeks and the mean BW was 1477.35 ± 371.29 g. Of the 59 (2.0% infants receiving treatment, the mean GA was 29.37 ± 2.10 weeks, and the mean BW was 1240.80 ± 330.71 g. The incidence of ROP declined from 14.7% in 2009 and 11.1% in 2010 to 9.5% in 2011. The United Kingdom (UK criteria could reduce the screening number by 40.8%, and 3 infants with type I ROP needing treatment were missed, but none in 2011. The United States (US criteria could reduce the screening number by 66.5%, and 10 infants with type I ROP needing treatment were missed, including one in 2011. So the UK criteria may be appropriate for screening of ROP in our NICU in 2011. Future multisite epidemiologic studies are required to establish suitable ROP screening criteria in China.

  14. An Empirical Comparison of Different Models of Active Aging in Canada: The International Mobility in Aging Study.

    Science.gov (United States)

    Bélanger, Emmanuelle; Ahmed, Tamer; Filiatrault, Johanne; Yu, Hsiu-Ting; Zunzunegui, Maria Victoria

    2017-04-01

    Active aging is a concept that lacks consensus. The WHO defines it as a holistic concept that encompasses the overall health, participation, and security of older adults. Fernández-Ballesteros and colleagues propose a similar concept but omit security and include mood and cognitive function. To date, researchers attempting to validate conceptual models of active aging have obtained mixed results. The goal of this study was to examine the validity of existing models of active aging with epidemiological data from Canada. The WHO model of active aging and the psychological model of active aging developed by Fernández-Ballesteros and colleagues were tested with confirmatory factor analysis. The data used included 799 community-dwelling older adults between 65 and 74 years old, recruited from the patient lists of family physicians in Saint-Hyacinthe, Quebec and Kingston, Ontario. Neither model could be validated in the sample of Canadian older adults. Although a concept of healthy aging can be modeled adequately, social participation and security did not fit a latent factor model. A simple binary index indicated that 27% of older adults in the sample did not meet the active aging criteria proposed by the WHO. Our results suggest that active aging might represent a human rights policy orientation rather than an empirical measurement tool to guide research among older adult populations. Binary indexes of active aging may serve to highlight what remains to be improved about the health, participation, and security of growing populations of older adults. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Clinical and ultrasonographic criteria for using ventriculoperitoneal shunts in newborns with myelomeningocele

    Directory of Open Access Journals (Sweden)

    Jose Roberto Tude Melo

    2015-09-01

    Full Text Available Objective Hydrocephalus is one of the main complications associated with myelomeningocele (MM. This study aimed to identify clinical and ultrasonographic criteria for using ventriculoperitoneal (VP shunts in this group of patients.Method A retrospective cohort study, based on established protocol for VP shunt implant in hydrocephalic children with MM. Parameters used to guide the indication of VP shunts included measurement of head circumference (HC, evaluation of fontanels, and measurement of lateral ventricular atrium (LVA width by transcranial ultrasonography.Results 43 children were included in the analysis, of which 74% had hydrocephalus and required a VP shunt. These children had LVA width ≥ 15 mm, showed increased HC, or had bulging fontanels.Conclusion VP shunt is required in children with increased HC (≥ 2 standard deviation regarding age group, bulging fontanels, or LVA width of ≥ 15 mm after the closure of MM.

  16. Retinopathy of prematurity screening criteria and workload ...

    African Journals Online (AJOL)

    Larger infants require screening to include a few outliers, but they ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

  17. Clinical Criteria for Physician Aid in Dying.

    Science.gov (United States)

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period.

  18. Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women

    Directory of Open Access Journals (Sweden)

    Alina Coutinho Rodrigues Feitosa

    Full Text Available Abstract Background: There is a physiologic elevation of total cholesterol (TC and triglycerides (TG during pregnancy. Some authors define dyslipidemia (DLP in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95% and HDL concentration is below the 5th percentile (P5% for gestational age (GA. Objective: To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Results: Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. Conclusion: 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6% had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. Conclusion: The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities.

  19. Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women

    Science.gov (United States)

    Feitosa, Alina Coutinho Rodrigues; Barreto, Luciana Tedgue; da Silva, Isabela Matos; da Silva, Felipe Freire; Feitosa Filho, Gilson Soares

    2017-01-01

    Background There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA). Objective To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Results Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. Conclusion 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. Conclusion The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities. PMID:28591252

  20. Structural aging program status report

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.; Ellingwood, B.; Graves, H.L. III

    1994-01-01

    Research is being conducted at the Oak Ridge National Laboratory under Nuclear Regulatory Commission (USNRC) sponsorship to address aging management of safety-related concrete structures. Documentation is being prepared to provide the USNRC with potential structural safety issues and acceptance criteria for use in continued service evaluations of nuclear power plants. Program accomplishments have included development of the Structural Materials Information Center containing data and information on the time variation of 144 material properties under the influence of pertinent environmental stressors or aging factors, performance assessments of reinforced concrete structures in several United Kingdom nuclear power facilities, evaluation of European and North American repair practices for concrete, an evaluation of factors affecting the corrosion of metals embedded in concrete, and application of the time-dependent reliability methodology to reinforced concrete flexure and shear structural elements to investigate the role of in-service inspection and repair on their probability of failure

  1. Qualification criteria to certify a package for air transport of plutonium

    International Nuclear Information System (INIS)

    1977-12-01

    The document describes qualification criteria developed by the U.S. Nuclear Regulatory Commission to certify a package for air transport of plutonium. Included in the document is a discussion of aircraft accident conditions and a summary of the technical basis for the qualification criteria. The criteria require prototype packages to be subjected to various individual and sequential tests that simulate the conditions produced in severe aircraft accidents. Specific post-test acceptance standards are prescribed for each of the three safety functions of a package. The qualification criteria also prescribe certain operational controls to be exercised during transport

  2. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

    Science.gov (United States)

    Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

    2006-06-01

    Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P private sector for males (21% vs. 24%, P private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.

  3. Multi-Criteria Decision Making For Determining A Simple Model of Supplier Selection

    Science.gov (United States)

    Harwati

    2017-06-01

    Supplier selection is a decision with many criteria. Supplier selection model usually involves more than five main criteria and more than 10 sub-criteria. In fact many model includes more than 20 criteria. Too many criteria involved in supplier selection models sometimes make it difficult to apply in many companies. This research focuses on designing supplier selection that easy and simple to be applied in the company. Analytical Hierarchy Process (AHP) is used to weighting criteria. The analysis results there are four criteria that are easy and simple can be used to select suppliers: Price (weight 0.4) shipment (weight 0.3), quality (weight 0.2) and services (weight 0.1). A real case simulation shows that simple model provides the same decision with a more complex model.

  4. An essential hospital package for South Africa--selection criteria, costs and affordability.

    Science.gov (United States)

    Söderlund, N

    1999-07-01

    In 1995 the Committee of Enquiry into National Health Insurance (NHI) recommended that formally employed individuals and their employers be required to fund at least a minimum package of hospital cover for workers and their dependents. This has recently been echoed in a Department of Health policy paper on social health insurance. This research aims to define and cost a minimum package of essential hospital care for competing (public and private) health insurers in South Africa. CRITERIA FOR PACKAGE DEFINITION: Based on the objectives implict in the NHI Committee report, the following criteria were used to define the essential package: (i) the extent to which there was another appropriate responsible party who should pay for treatment; (ii) the degree of discretion in deciding whether or not to provide treatment (roughly equivalent to 'urgency'); and (iii) the cost and effectiveness of treatment. On the basis of the above criteria, 396 out of 598 possible interventions were included in the package. Using local mine hospital and private sector utilisation rates and mine hospital cost data, it was estimated that the essential inpatient package would cost around R502 per enrollee per year, using 1998 prices, for a working age population and their dependents. Age-sex standardised outpatient care costs in the mine hospital population studied were estimated at R183 per person per year. It was therefore estimated that the total inpatient and outpatient hospital package would cost around R685 per person per year. The results presented in this paper are intended to inform the process of defining a national essential hospital benefit package. Assuming that contributions were proportionally related to income, and that costs should not exceed 6% of wages, the package should be affordable to all of those earning above R20,000 per year. Significant additional work is required, firstly at a technical level to assess the appropriateness of the prioritization approach used here

  5. Criteria for Selection and Rejection of Social Relationships among Children in Urban and Rural Kindergartens in Greece

    Science.gov (United States)

    Rekalidou, Galini; Petrogiannis, Konstantinos

    2012-01-01

    This paper reports on preschool children's social relationships developed in urban and rural kindergarten classes in Greece. We investigated the selection and rejection criteria children use and examined potential criteria differences as a function of a number of socio-demographic variables (children's age group, gender, parental job status,…

  6. Retinopathy of prematurity screening criteria and workload ...

    African Journals Online (AJOL)

    Larger infants require screening to include a few outliers, but they require ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

  7. Developing criteria to establish Trusted Digital Repositories

    Science.gov (United States)

    Faundeen, John L.

    2017-01-01

    This paper details the drivers, methods, and outcomes of the U.S. Geological Survey’s quest to establish criteria by which to judge its own digital preservation resources as Trusted Digital Repositories. Drivers included recent U.S. legislation focused on data and asset management conducted by federal agencies spending $100M USD or more annually on research activities. The methods entailed seeking existing evaluation criteria from national and international organizations such as International Standards Organization (ISO), U.S. Library of Congress, and Data Seal of Approval upon which to model USGS repository evaluations. Certification, complexity, cost, and usability of existing evaluation models were key considerations. The selected evaluation method was derived to allow the repository evaluation process to be transparent, understandable, and defensible; factors that are critical for judging competing, internal units. Implementing the chosen evaluation criteria involved establishing a cross-agency, multi-disciplinary team that interfaced across the organization. 

  8. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39{+-}15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI{sup eventscan)}. Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI{sup eventscand}id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  9. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    International Nuclear Information System (INIS)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo

    2011-01-01

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39±15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI eventscan) . Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI eventscand id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  10. Risk factors for mortality before age 18 years in cystic fibrosis.

    Science.gov (United States)

    McColley, Susanna A; Schechter, Michael S; Morgan, Wayne J; Pasta, David J; Craib, Marcia L; Konstan, Michael W

    2017-07-01

    Understanding early-life risk factors for childhood death in cystic fibrosis (CF) is important for clinical care, including the identification of effective interventions. Data from the Epidemiologic Study of Cystic Fibrosis (ESCF) collected 1994-2005 were linked with the Cystic Fibrosis Foundation Patient Registry (CFFPR) demographic and mortality data from 2013. Inclusion criteria were ≥1 visit annually at age 3-5 years and ≥1 FEV 1 measurement at age 6-8 years. Demographic data, nutritional parameters, pulmonary signs and symptoms, microbiology, and FEV 1 were evaluated as risk factors for death before age 18 years. Multivariable Cox proportional hazards regression was used to model the simultaneous effects of risk factors associated with death before age 18 years. Among 5365 patients enrolled in ESCF who met inclusion criteria, 3880 (72%) were linked to the CFFPR. Among these, 191 (5.7%) died before age 18 years; median age at death was 13.4 ± 3.1 years. Multivariable regression showed clubbing, crackles, female sex, unknown CFTR genotype, minority race or ethnicity, Medicaid insurance (a proxy of low socioeconomic status), Pseudomonas aeruginosa on 2 or more cultures, and weight-for-age <50th percentile were significant risk factors for death regardless of inclusion of FEV 1 at age 6-8 years in the model. We identified multiple risk factors for childhood death of patients with CF, all of which remained important after incorporating FEV 1 at age 6-8 years. Among the factors identified were the presence of clubbing or crackles at age 3-5 years, signs which are not routinely collected in registries. © 2017 Wiley Periodicals, Inc.

  11. Advanced parental age and the risk of autism spectrum disorder.

    Science.gov (United States)

    Durkin, Maureen S; Maenner, Matthew J; Newschaffer, Craig J; Lee, Li-Ching; Cunniff, Christopher M; Daniels, Julie L; Kirby, Russell S; Leavitt, Lewis; Miller, Lisa; Zahorodny, Walter; Schieve, Laura A

    2008-12-01

    This study evaluated independent effects of maternal and paternal age on risk of autism spectrum disorder. A case-cohort design was implemented using data from 10 US study sites participating in the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring Network. The 1994 birth cohort included 253,347 study-site births with complete parental age information. Cases included 1,251 children aged 8 years with complete parental age information from the same birth cohort and identified as having an autism spectrum disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. After adjustment for the other parent's age, birth order, maternal education, and other covariates, both maternal and paternal age were independently associated with autism (adjusted odds ratio for maternal age > or =35 vs. 25-29 years = 1.3, 95% confidence interval: 1.1, 1.6; adjusted odds ratio for paternal age > or =40 years vs. 25-29 years = 1.4, 95% confidence interval: 1.1, 1.8). Firstborn offspring of 2 older parents were 3 times more likely to develop autism than were third- or later-born offspring of mothers aged 20-34 years and fathers aged autism risk with both maternal and paternal age has potential implications for public health planning and investigations of autism etiology.

  12. Application of the McDonald MRI criteria in multiple sclerosis.

    Science.gov (United States)

    Chan, Ling Ling; Sitoh, Yih Yian; Chong, June; See, Siew Ju; Umapathi, Thirugnanam N; Lim, Shih Hui; Ong, Benjamin

    2007-08-01

    The aim of this study was to assess the sensitivity of McDonald's magnetic resonance imaging (MRI) criteria for the diagnosis of multiple sclerosis (MS) in a group of Asian patients diagnosed with clinically definite MS, based on lesion characterisation on MRI scans. Forty-nine patients from 3 major neurological institutions were classified as having Asian- or Western-type MS based on clinical assessment. Each MRI scan was reviewed by 2 neuroradiologists for the presence and characteristics of brain and spinal lesions. The McDonald's MRI criteria were then applied and its sensitivity evaluated. Nine patients were excluded, leaving 34 females and 6 males who were dominantly Chinese (90%), with a mean age of 36.2 years. The MRI brain and spinal findings were detailed and tabulated. Statistically significant differences (P McDonald's MRI criteria were found between our Asian- and Western-type MS patients. The diagnostic yield of McDonald's MRI criteria increased by 20% when we substituted a cord for a brain lesion, and applied the substitution for enhancing cord lesions as well. The diagnosis is more likely to be made when using McDonald MRI criteria based on brain findings, in a patient who presents clinically with Western-type MS. The provision for substitution of "one brain for a spinal lesion" is helpful in Asian-type MS, where there is preponderance of spinal lesion load. Our findings suggest that minor modifications in the interpretation of McDonald's MRI criteria have significant impact on the diagnosis in patients clinically presenting as Asian-type MS, with potential bearing on their subsequent management.

  13. Nevada test site defense waste acceptance criteria, certification, and transfer requirements

    International Nuclear Information System (INIS)

    1988-10-01

    The Nevada Test Site (NTS) Defense Waste Acceptance Criteria, Certification and Transfer Requirements establishes procedures and criteria for safe transfer, disposal, and storage of defense transuranic, low-level, and mixed waste at the NTS. Included are an overview of the NTS defense waste management program; the NTS waste acceptance criteria for transuranic, low-level, and mixed wastes; waste certification requirements and guidance; application to submit waste; and requirements for waste transfer and receipt. 5 figs., 16 tabs

  14. Green Supplier Selection Criteria

    DEFF Research Database (Denmark)

    Nielsen, Izabela Ewa; Banaeian, Narges; Golinska, Paulina

    2014-01-01

    Green supplier selection (GSS) criteria arise from an organization inclination to respond to any existing trends in environmental issues related to business management and processes, so GSS is integrating environmental thinking into conventional supplier selection. This research is designed...... to determine prevalent general and environmental supplier selection criteria and develop a framework which can help decision makers to determine and prioritize suitable green supplier selection criteria (general and environmental). In this research we considered several parameters (evaluation objectives......) to establish suitable criteria for GSS such as their production type, requirements, policy and objectives instead of applying common criteria. At first a comprehensive and deep review on prevalent and green supplier selection literatures performed. Then several evaluation objectives defined to assess the green...

  15. Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria.

    LENUS (Irish Health Repository)

    O'Sullivan, E P

    2012-01-31

    AIMS\\/HYPOTHESIS: New diagnostic criteria for gestational diabetes mellitus (GDM) have recently been published. We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population. METHODS: The Atlantic Diabetes In Pregnancy (DIP) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24-28 weeks. GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and compared with previous WHO criteria; maternal and neonatal adverse outcomes were prospectively recorded. RESULTS: Of the participants, 12.4% and 9.4% were diagnosed with GDM using IADPSG and WHO criteria, respectively. IADPSG GDM pregnancies were associated with a statistically significant increased incidence of adverse maternal outcomes (gestational hypertension, polyhydramnios and Caesarean section) and neonatal outcomes (prematurity, large for gestational age, neonatal unit admission, neonatal hypoglycaemia and respiratory distress). The odds ratio for the development of these adverse outcomes remained significant after adjustment for maternal age, body mass index and non-European ethnicity. Those women who were classified as having normal glucose tolerance by WHO criteria but as having GDM by IADPSG criteria also had significant adverse pregnancy outcomes. CONCLUSIONS\\/INTERPRETATION: GDM prevalence is higher when using newer IADPSG, compared with WHO, criteria, and these women and their offspring experience significant adverse pregnancy outcomes. Higher rates of GDM pose a challenge to healthcare systems, but improved screening provides an opportunity to attempt to reduce the associated morbidity for mother and child.

  16. Potential Impact of DSM-5 Criteria on Autism Spectrum Disorder Prevalence Estimates

    Science.gov (United States)

    Maenner, Matthew J.; Rice, Catherine E.; Arneson, Carrie L.; Cunniff, Christopher; Schieve, Laura A.; Carpenter, Laura A.; Van Naarden Braun, Kim; Kirby, Russell S.; Bakian, Amanda V.; Durkin, Maureen S.

    2014-01-01

    IMPORTANCE The DSM-5 contains revised diagnostic criteria for autism spectrum disorder (ASD) from the DSM-IV-TR. Potential impacts of the new criteria on ASD prevalence are unclear. OBJECTIVE To assess potential effects of the DSM-5 ASD criteria on ASD prevalence estimation by retrospectively applying the new criteria to population-based surveillance data collected for previous ASD prevalence estimation. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based ASD surveillance based on clinician review of coded behaviors documented in children’s medical and educational evaluations from 14 geographically defined areas in the United States participating in the Autism and Developmental Disabilities Monitoring (ADDM) Network in 2006 and 2008. This study included 8-year-old children living in ADDM Network study areas in 2006 or 2008, including 644 883 children under surveillance, of whom 6577 met surveillance ASD case status based on the DSM-IV-TR. MAIN OUTCOMES AND MEASURES Proportion of children meeting ADDM Network ASD criteria based on the DSM-IV-TR who also met DSM-5 criteria; overall prevalence of ASD using DSM-5 criteria. RESULTS Among the 6577 children classified by the ADDM Network as having ASD based on the DSM-IV-TR, 5339 (81.2%) met DSM-5 ASD criteria. This percentage was similar for boys and girls but higher for those with than without intellectual disability (86.6% and 72.5%, respectively; P DSM-5 ASD criteria but not current ADDM Network ASD case status. Based on these findings, ASD prevalence per 1000 for 2008 would have been 10.0 (95% CI, 9.6–10.3) using DSM-5 criteria compared with the reported prevalence based on DSM-IV-TR criteria of 11.3 (95% CI, 11.0–11.7). CONCLUSIONS AND RELEVANCE Autism spectrum disorder prevalence estimates will likely be lower under DSM-5 than under DSM-IV-TR diagnostic criteria, although this effect could be tempered by future adaptation of diagnostic practices and documentation of behaviors to fit the new

  17. Technical evaluation of draft ANSI Standard N13.30, ''performance criteria for radiobioassay''

    International Nuclear Information System (INIS)

    MacLellan, J.A.; Traub, R.J.

    1986-03-01

    The Pacific Northwest Laboratory (PNL) is conducting a research program to evaluate the appropriateness of criteria in the ANSI draft Standard N13.30, ''Performance Criteria for Radiobioassay.'' The evaluation has progressed parallel with the preparation of the Standard by evaluating the performance of existing bioassay laboratories against the criteria specified. Recommendations for revision of the Standard and implementation of a testing/accreditation program have been formulated based on study results. The current performance testing program includes both in-vivo counting and in-vitro sample measurements. Test criteria specified in the Standard include relative bias, relative precision, and acceptable minimum detectable activity (AMDA). Results to date have indicated that the acceptance criteria in the Standard are appropriate for the existing state of the industry and are achievable by a majority of the participating laboratories. Specific conclusions are that the AMDA criteria are most difficult for the laboratories to achieve; the relative bias criterion is second in difficulty, and the precision criterion presents no problem for the laboratories; most of the participating laboratories can meet the Standard; and failure rates may decrease as the laboratories become more knowledgeable of the performance criteria. 3 refs., 11 figs., 6 tabs

  18. Perception of aging and ageism among women in Qatar.

    Science.gov (United States)

    Musaiger, Abdulrahman O; D'Souza, Reshma; Al-Roomi, Khaldoon

    2013-01-01

    The objective of this study was to find out the perceptions of age and aging among women in Qatar. Respondents consisted of 250 women aged between 20 and 70 years, selected from those attending the health centers in Doha city, the capital of Qatar. They were interviewed using a pretested validated questionnaire, and data were collected through direct face-to-face interviews using the incidental sampling method. It was found that physical appearance and mental alertness were the most important criteria for defining aging in men and women. A statistically significant association was found between age of respondents and physical criteria for aging such as hair color (p age of women studied. Both positive (socializing factors, independence, housework, retirement, and geriatric care) and negative stereotyping (care for self, learning capabilities, irritability, and worries) with regard to aging were evident among the Qatari women. In general, Qatari women had several positive attitudes toward aging. Such attitudes could be utilized in any health promotion for elderly people.

  19. Evidence of aging effects on certain safety-related components: summary and analysis

    International Nuclear Information System (INIS)

    1995-09-01

    In response to interest shown by the Nuclear Energy Agency (NEA), Principal Working Group I (PWG- 1) of the Committee on the Safety of Nuclear Installations (CSNI) conducted a generic study on the effects of aging of active components in nuclear power plants. Representatives from France, Sweden, Finland, Japan, the United States, and the United Kingdom participated in the study by submitting reports documenting aging studies performed in their countries. This report consists of summaries of those reports, along with a comparison of the various statistical analysis methods used in the studies. The studies indicate that with some exceptions, active components generally do not present a significant aging problem in nuclear power plants. Design criteria and effective preventative maintenance programs, including timely replacement of components, are effective in mitigating potential aging problems. However, aging studies (such as qualitative and statistical analyses of failure modes and maintenance data) are an important part of efforts to identify and solve potential aging problems. Solving these problems typically includes such strategies as replacing suspect components with improved components, and implementing improved maintenance programs

  20. Diagnosing antiphospholipid syndrome: 'extra-criteria' manifestations and technical advances.

    Science.gov (United States)

    Sciascia, Savino; Amigo, Mary-Carmen; Roccatello, Dario; Khamashta, Munther

    2017-09-01

    First described in the early 1980s, antiphospholipid syndrome (APS) is a unique form of acquired autoimmune thrombophilia in which patients present with clinical features of recurrent thrombosis and pregnancy morbidity and persistently test positive for the presence of antiphospholipid antibodies (aPL). At least one clinical (vascular thrombosis or pregnancy morbidity) and one lab-based (positive test result for lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein 1 antibodies) criterion have to be met for a patient to be classified as having APS. However, the clinical spectrum of APS encompasses additional manifestations that can affect many organs and cannot be explained exclusively by patients being in a prothrombotic state; clinical manifestations not listed in the classification criteria (known as extra-criteria manifestations) include neurologic manifestations (chorea, myelitis and migraine), haematologic manifestations (thrombocytopenia and haemolytic anaemia), livedo reticularis, nephropathy and valvular heart disease. Increasingly, research interest has focused on the development of novel assays that might be more specific for APS than the current aPL tests. This Review focuses on the current classification criteria for APS, presenting the role of extra-criteria manifestations and lab-based tests. Diagnostic approaches to difficult cases, including so-called seronegative APS, are also discussed.

  1. Analysis of patterns of three-phase bone scintigraphy for patients with complex regional pain syndrome diagnosed using the proposed research criteria (the 'Budapest Criteria').

    Science.gov (United States)

    Moon, J Y; Park, S Y; Kim, Y C; Lee, S C; Nahm, F S; Kim, J H; Kim, H; Oh, S W

    2012-04-01

    Three-phase bone scintigraphy (TPBS) is an established objective diagnostic method for complex regional pain syndrome (CRPS), but its validity remains controversial. The aims of this study were: (i) to re-evaluate the diagnostic performance of TPBS, and (ii) to suggest new TPBS criteria based on the proposed research criteria for CPRS in Budapest (the 2003 Budapest research criteria). The medical records of 228 consecutive patients, evaluated using the Budapest research criteria, were retrospectively analysed. Of these, 116 patients were included in the present study, and 69 of 116 were diagnosed to have CRPS based on these criteria. The diagnostic performance of TPBS was assessed by determining its sensitivity, specificity, and positive and negative likelihood ratios, and new criteria for TPBS were identified by pattern analysis using the Budapest research criteria. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of TPBS for the diagnosis of CRPS according to the Budapest research criteria were 40.0, 76.5, 1.73, and 0.78, respectively. Furthermore, D-D-D, D-D-S, and D-D-I patterns [i.e. according to decreased (D), symmetrical (S), or increased (I) tracer uptake during Phases I, II, and III] of TPBS were found to be positively predictive for CRPS. The diagnostic value of a positive TPBS for CRPS is low from the view point of the Budapest research criteria. Our findings suggest that a diagnosis of CRPS using the Budapest research criteria should be considered when decreased patterns of TPBS are observed during Phases I and II.

  2. Occlusal caries risk assessment using Cariogram analysis in student aged 11-12 years

    Directory of Open Access Journals (Sweden)

    Riana Wardani

    2017-03-01

    Full Text Available ABSTRACT   Introduction: Basic Health Research 2013 showed Dental Caries Index in school age student in West Java was lower than the expected target, with occlusal surface as most affected part. The purpose of this study was to determine the risk status of dental caries in school age student by using cariogram analysis. Methods: Observational research. Study was conducted on 30 student aged 11-12 years with caries high risk on occlusal surfaces. Purposive sampling was taken from students of SDN Cikawari and SDN Mekarjaya Bandung Regency with high DMF-S index. Inclusion criteria: male and female, aged 11-12 years, good systemic health, SDN Mekarjaya and SDN Cikawari Bandung Regency students. Exclusion criteria: suffering from systemic disorder, currently in long-term antibiotic therapy, orthodontic appliance usage. Case history, eating habits and intake of fluoride, caries experience, salivary volume and buffering capacity of each sample was examined using cariogram examination method. Results: The cariogram analysis showed 43% chance of caries avoidance. Diet control was 23.3%, includes two factors: sugary foods and eating frequency. Bacteria control was 11.9% by evaluating both bacterial factors (the amount of plaque and the bacteria Streptococcus mutans. Vulnerability control was 14.4%, including caries prevention by the continuation of fluorine program and other conditions control that affect salivary secretions. Conclusion: Based on cariogram analysis found that all samples who had occlusal surfaces caries were at a high risk category, but still having moderate potential of avoiding new caries occurrence by controlling risk factors. Keywords: Cariogram analysis, Occlusal caries, Aged 11-12 years

  3. Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

    Science.gov (United States)

    Kim, Ha-Young; Shin, Sang-Wan

    2014-01-01

    PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva

  4. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    The International Association of Diabetes in Pregnancy Study Group (IADPSG) and World Health ... Macrosomia or at least one adverse outcome were more likely in GDM patients who ... criteria for GDM in the ADA's more recent position statement.[18] .... at risk for postpartum type 2 DM;[27] the IADPSG criteria on the other ...

  5. Reportable Nuclide Criteria for ORNL Radioactive Waste Management Activities - 13005

    International Nuclear Information System (INIS)

    McDowell, Kip; Forrester, Tim; Saunders, Mark

    2013-01-01

    The U.S. Department of Energy's Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee generates numerous radioactive waste streams. Many of those streams contain a large number of radionuclides with an extremely broad range of concentrations. To feasibly manage the radionuclide information, ORNL developed reportable nuclide criteria to distinguish between those nuclides in a waste stream that require waste tracking versus those nuclides of such minimal activity that do not require tracking. The criteria include tracking thresholds drawn from ORNL onsite management requirements, transportation requirements, and relevant treatment and disposal facility acceptance criteria. As a management practice, ORNL maintains waste tracking on a nuclide in a specific waste stream if it exceeds any of the reportable nuclide criteria. Nuclides in a specific waste stream that screen out as non-reportable under all these criteria may be dropped from ORNL waste tracking. The benefit of these criteria is to ensure that nuclides in a waste stream with activities which meaningfully affect safety and compliance are tracked, while documenting the basis for removing certain isotopes from further consideration. (authors)

  6. Systematic review of interventions addressing social isolation and depression in aged care clients.

    Science.gov (United States)

    Franck, Linél; Molyneux, Natalie; Parkinson, Lynne

    2016-06-01

    A systematic review was undertaken of studies reporting interventions for reducing social isolation and depression in older people receiving aged care services (community or residential). Gray literature and relevant electronic databases were systematically searched for studies published in English between January 2009 and December 2013. Two reviewers independently screened studies for selection using predetermined inclusion and exclusion criteria and independently completed methodological quality review at study level. Studies of poor methodological quality were excluded. Data were extracted at study level by one reviewer and independently checked by a second reviewer, using a standardized form. The results across studies were qualitatively synthesized with outcomes described and summarized at last follow-up. Although the original objective was to review rural studies, no intervention studies based in rural areas met criteria for inclusion in the review, and only urban studies could be reviewed. Of 403 articles, six articles representing five studies with moderate-to-low risk of bias were included for review. All study participants were older adults ranging in age from 77 to 86 years. All studies had small sample sizes, ranging from 26 to 113 participants. Three of the five included intervention studies successfully reduced social isolation; one also successfully reduced depression. Only one intervention, group-based reminiscence therapy, was reported as successful in reducing both social isolation and depression in older people within an urban aged care setting. More research is needed to explore transferability of interventions across different aged care settings and into rural areas.

  7. National Security in the Nuclear Age: Public Library Proposal and Booklist. May 1987 Update.

    Science.gov (United States)

    Dane, Ernest B.

    To increase public understanding of national security issues, this document proposes that a balanced and up-to-date collection of books and other materials on national security in the nuclear age be included in all U.S. public libraries. The proposal suggests that the books be grouped together on an identified shelf. Selection criteria for the…

  8. Nonreactor nuclear facilities: standards and criteria guide

    International Nuclear Information System (INIS)

    Brynda, W.J.; Junker, L.; Karol, R.C.; Lobner, P.R.; Goldman, L.A.

    1981-09-01

    This guide is a source document that identifies standards, codes, and guides that address the nuclear safety considerations pertinent to nuclear facilities as defined in DOE Order 5480.1, Chapter V, Safety of Nuclear Facilities. The guidance and criteria provided are directed toward areas of safety usually addressed in a Safety Analysis Report. The areas of safety include, but are not limited to, siting, principal design criteria and safety system design guidelines, radiation protection, accident analysis, and quality assurance. The guide is divided into two sections: general guidelines and appendices. Those guidelines that are broadly applicable to most nuclear facilities are presented in the general guidelines. These general guidelines may have limited applicability to subsurface facilities such as waste repositories. Guidelines specific to the various types or categories of nuclear facilities are presented in the appendices. These facility-specific appendices provide guidelines and identify standards and criteria that should be considered in addition to, or in lieu of, the general guidelines

  9. Nonreactor nuclear facilities: Standards and criteria guide

    International Nuclear Information System (INIS)

    Brynda, W.J.; Scarlett, C.H.; Tanguay, G.E.; Lobner, P.R.

    1986-09-01

    This guide is a source document that identifies standards, codes, and guides that address the nuclear safety considerations pertinent to nuclear facilities as defined in DOE 5480.1A, Chapter V, ''Safety of Nuclear Facilities.'' The guidance and criteria provided is directed toward areas of safety usually addressed in a Safety Analysis Report. The areas of safety include, but are not limited to, siting, principal design criteria and safety system design guidelines, radiation protection, accident analysis, conduct of operations, and quality assurance. The guide is divided into two sections: general guidelines and appendices. Those guidelines that are broadly applicable to most nuclear facilities are presented in the general guidelines. Guidelines specific to the various types or categories of nuclear facilities are presented in the appendices. These facility-specific appendices provide guidelines and identify standards and criteria that should be considered in addition to, or in lieu of, the general guidelines. 25 figs., 62 tabs

  10. Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis.

    Science.gov (United States)

    McLeod, Donald S A; Jonklaas, Jacqueline; Brierley, James D; Ain, Kenneth B; Cooper, David S; Fein, Henry G; Haugen, Bryan R; Ladenson, Paul W; Magner, James; Ross, Douglas S; Skarulis, Monica C; Steward, David L; Xing, Mingzhao; Litofsky, Danielle R; Maxon, Harry R; Sherman, Steven I

    2015-10-01

    Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R(2)). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. The best five alternate papillary cancer systems had age cut-points of 45-50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50-55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003-0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation.

  11. Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis

    Science.gov (United States)

    McLeod, Donald S.A.; Jonklaas, Jacqueline; Brierley, James D.; Ain, Kenneth B.; Cooper, David S.; Fein, Henry G.; Haugen, Bryan R.; Ladenson, Paul W.; Magner, James; Ross, Douglas S.; Skarulis, Monica C.; Steward, David L.; Xing, Mingzhao; Litofsky, Danielle R.; Maxon, Harry R.

    2015-01-01

    Background: Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. Objective: This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. Methods: A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R2). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. Results: The best five alternate papillary cancer systems had age cut-points of 45–50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50–55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003–0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). Conclusions: No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation. PMID:26203804

  12. Risk Acceptance Criteria and/or Decision optimization

    DEFF Research Database (Denmark)

    Ditlevsen, Ove Dalager

    1996-01-01

    Acceptance criteria applied in practical risk analysis are recapitulated including the concept of rist profile. Modelling of risk profiles is illustrated on the basis of compound Poisson process models. The current practice of authoritative acceptance criteria formulation is discussed from...... a decision theoretical point of view. It is argued that the phenomenon of risk aversion rather than being of concern to the authority should be of concern to the owner. Finally it is discussed whether there is an ethical problem when formally capitalising human lives with a positive interest rate. Keywords......: Risk acceptance, Risk profile, Compound Poisson model for risk profile, Capitalization of human life, Risk aversion....

  13. Criteria for evidence-based practice in Iranian traditional medicine.

    Science.gov (United States)

    Soltani Arabshahi, SeyyedKamran; Mohammadi Kenari, Hoorieh; Kordafshari, Gholamreza; Shams-Ardakani, MohammadReza; Bigdeli, Shoaleh

    2015-07-01

    The major difference between Iranian traditional medicine and allopathic medicine is in the application  of  evidence  and  documents.  In  this  study,  criteria  for  evidence-based  practice  in  Iranian traditional medicine and its rules of practice were studied. The experts' views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM.

  14. Proliferation resistance criteria for fissile material disposition issues

    International Nuclear Information System (INIS)

    Rutherford, D.A.; Fearey, B.L.; Markin, J.T.; Close, D.A.; Tolk, K.M.; Mangan, D.L.; Moore, L.

    1995-01-01

    The 1994 National Acdaemy of Sciences study ''Management and Disposition of Excess Weapons Plutonium'' defined options for reducing the national and international proliferation risks of materials declared excess to the nuclear weapons program. This paper proposes criteria for assessing the proliferation resistance of these options as well defining the ''Standards'' from the report. The criteria are general, encompassing all stages of the disposition process from storage through intermediate processing to final disposition including the facilities, processing technologies and materials, the level of safeguards for these materials, and the national/subnational threat to the materials

  15. Decision criteria in PSA applications

    International Nuclear Information System (INIS)

    Holmberg, J.E.; Pulkkinen, U.; Rosqvist, T.; Simola, K.

    2001-11-01

    Along with the adoption of risk informed decision making principles, the need for formal probabilistic decision rule or criteria has been risen. However, there are many practical and theoretical problems in the application of probabilistic criteria. One has to think what is the proper way to apply probabilistic rules together with deterministic ones and how the criteria are weighted with respect to each other. In this report, we approach the above questions from the decision theoretic point of view. We give a short review of the most well known probabilistic criteria, and discuss examples of their use. We present a decision analytic framework for evaluating the criteria, and we analyse how the different criteria behave under incompleteness or uncertainty of the PSA model. As the conclusion of our analysis we give recommendations on the application of the criteria in different decision situations. (au)

  16. A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

    Science.gov (United States)

    Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

    2017-09-01

    The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

  17. Selection of bioaccumulation criteria for environmental emergency (E2) planning

    International Nuclear Information System (INIS)

    Ketcheson, K.; Hradecky, K.; Gagne, M.; St-Amant-Verret, M.

    2006-01-01

    Environment Canada's Environmental Emergency regulations require the evaluation of a substance by a Risk Evaluation Framework (REF). Bioaccumulation criteria are used within the environmental hazard ratings section of the REF to determine the risk of a substance to organisms and are obtained from 3 types of measurements depending on data reliability: (1) bioaccumulation factors (BAF); (2) bioconcentration factors (BCF); and (3) an octanol-water partition coefficient (log K ow ). This paper presented details of a study of international and regional bioaccumulation criteria conducted to aid in determining appropriate criteria for E2 regulations and plans, with specific reference to substances toxic to aquatic organisms. An E2 plan is required if a substance has a bioconcentration factor of more than 500 in conjunction with aquatic toxicity. Bioaccumulation criteria from several sources for 745 substances were obtained to aid in choosing the most important parameters. Various international and regional criteria were examined and corresponding sources were summarized, and different source criteria was compared with empirical chemical data. The criteria chosen included both log K ow values and BCF values, although it was suggested that BCF and BAF are more realistic measures of bioaccumulation than log K ow , as they are derived from animal studies. The chosen values agreed with the virtual elimination criteria set out by the Canadian Environmental Protection Act (CEPA) 1999 as well as United States Environmental Protection Agency (EPA) criteria. It was concluded that the bioaccumulation criteria for E2 planning will help Environment Canada ensure the protection of the environment from hazardous substances. 11 refs., 3 tabs., 5 figs

  18. Extending World Health Organization weight-for-age reference curves to older children.

    Science.gov (United States)

    Rodd, Celia; Metzger, Daniel L; Sharma, Atul

    2014-02-03

    For ages 5-19 years, the World Health Organization (WHO) publishes reference charts based on 'core data' from the US National Center for Health Statistics (NCHS), collected from 1963-75 on 22,917 US children. To promote the use of body mass index in older children, weight-for-age was omitted after age 10. Health providers have subsequently expressed concerns about this omission and the selection of centiles. We therefore sought to extend weight-for-age reference curves from 10 to 19 years by applying WHO exclusion criteria and curve fitting methods to the core NCHS data and to revise the choice of displayed centiles. WHO analysts first excluded ~ 3% of their reference population in order to achieve a "non-obese sample with equal height". Based on these exclusion criteria, 314 girls and 304 boys were first omitted for 'unhealthy' weights-for-height. By applying WHO global deviance and information criteria, optimal Box-Cox power exponential models were used to fit smoothed weight-for-age centiles. Bootstrap resampling was used to assess the precision of centile estimates. For all charts, additional centiles were included in the healthy range (3 to 97%), and the more extreme WHO centiles 0.1 and 99.9% were dropped. In addition to weight-for-age beyond 10 years, our charts provide more granularity in the centiles in the healthy range -2 to +2 SD (3-97%). For both weight and BMI, the bootstrap confidence intervals for the 99.9th centile were at least an order of magnitude wider than the corresponding 50th centile values. These charts complement existing WHO charts by allowing weight-for-age to be plotted concurrently with height in older children. All modifications followed strict WHO methodology and utilized the same core data from the US NCHS. The additional centiles permit a more precise assessment of normal growth and earlier detection of aberrant growth as it crosses centiles. Elimination of extreme centiles reduces the risk of misclassification. A complete set of

  19. A comparison and cross-reference of commercial low-level radioactive waste acceptance criteria

    International Nuclear Information System (INIS)

    Kerr, T.A.

    1997-04-01

    This document, prepared by the National Low-Level Waste Management Program at the Idaho National Engineering and Environmental Laboratory, is a comparison and cross-reference of commercial low-level radioactive waste acceptance criteria. Many of these are draft or preliminary criteria as well as implemented criteria at operating low-level radioactive waste management facilities. Waste acceptance criteria from the following entities are included: US Nuclear Regulatory Commission, South Carolina, Washington, Utah, Nevada, California, illinois, Texas, North Carolina, Nebraska, Pennsylvania, New York, and the Midwest Compact Region. Criteria in the matrix include the following: physical form, chemical form, liquid limits, void space in packages, concentration averaging, types of packaging, chelating agents, solidification media, stability requirements, sorptive media, gas, oil, biological waste, pyrophorics, source material, special nuclear material, package dimensions, incinerator ash, dewatered resin, transuranics, and mixed waste. Each criterion in the matrix is cross-referenced to its source document so that exact requirements can be determined

  20. Clinical and functional criteria for predicting asthma in infants

    OpenAIRE

    Yu. L. Mizemitskiy; V. A. Pavlenko; I. M. Melnikova

    2015-01-01

    Objective: to determine clinical and functional criteria for predicting asthma in children who have sustained acute obstructive bronchitis in infancy. Subjects and methods. A total of 125 infants aged 2 to 36 months who had experienced 1 -2 episodes of acute obstructive bronchitis and treated at hospital were examined when bronchial obstruction syndrome was being relieved. In addition to physical examination, functional studies (computerized bronchophonography and heart rate variability asses...

  1. A framework for developing objective and measurable recovery criteria for threatened and endangered species.

    Science.gov (United States)

    Himes Boor, Gina K

    2014-02-01

    For species listed under the U.S. Endangered Species Act (ESA), the U.S. Fish and Wildlife Service and National Marine Fisheries Service are tasked with writing recovery plans that include "objective, measurable criteria" that define when a species is no longer at risk of extinction, but neither the act itself nor agency guidelines provide an explicit definition of objective, measurable criteria. Past reviews of recovery plans, including one published in 2012, show that many criteria lack quantitative metrics with clear biological rationale and are not meeting the measureable and objective mandate. I reviewed how objective, measureable criteria have been defined implicitly and explicitly in peer-reviewed literature, the ESA, other U.S. statutes, and legal decisions. Based on a synthesis of these sources, I propose the following 6 standards be used as minimum requirements for objective, measurable criteria: contain a quantitative threshold with calculable units, stipulate a timeframe over which they must be met, explicitly define the spatial extent or population to which they apply, specify a sampling procedure that includes sample size, specify a statistical significance level, and include justification by providing scientific evidence that the criteria define a species whose extinction risk has been reduced to the desired level. To meet these 6 standards, I suggest that recovery plans be explicitly guided by and organized around a population viability modeling framework even if data or agency resources are too limited to complete a viability model. When data and resources are available, recovery criteria can be developed from the population viability model results, but when data and resources are insufficient for model implementation, extinction risk thresholds can be used as criteria. A recovery-planning approach centered on viability modeling will also yield appropriately focused data-acquisition and monitoring plans and will facilitate a seamless transition

  2. Gender differences in episodic memory and visual working memory including the effects of age.

    Science.gov (United States)

    Pauls, Franz; Petermann, Franz; Lepach, Anja Christina

    2013-01-01

    Analysing the relationship between gender and memory, and examining the effects of age on the overall memory-related functioning, are the ongoing goals of psychological research. The present study examined gender and age group differences in episodic memory with respect to the type of task. In addition, these subgroup differences were also analysed in visual working memory. A sample of 366 women and 330 men, aged between 16 and 69 years of age, participated in the current study. Results indicate that women outperformed men on auditory memory tasks, whereas male adolescents and older male adults showed higher level performances on visual episodic and visual working memory measures. However, the size of gender-linked effects varied somewhat across age groups. Furthermore, results partly support a declining performance on episodic memory and visual working memory measures with increasing age. Although age-related losses in episodic memory could not be explained by a decreasing verbal and visuospatial ability with age, women's advantage in auditory episodic memory could be explained by their advantage in verbal ability. Men's higher level visual episodic memory performance was found to result from their advantage in visuospatial ability. Finally, possible methodological, biological, and cognitive explanations for the current findings are discussed.

  3. Expanding the Taxonomy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

    Science.gov (United States)

    Peck, Christopher C.; Goulet, Jean-Paul; Lobbezoo, Frank; Schiffman, Eric L.; Alstergren, Per; Anderson, Gary C.; de Leeuw, Reny; Jensen, Rigmor; Michelotti, Ambra; Ohrbach, Richard; Petersson, Arne; List, Thomas

    2014-01-01

    Background There is a need to expand the current temporomandibular disorder (TMD) classification to include less common, but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing, and further criteria refinement. Methods A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria, and the ability to operationalize and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMD taxonomy was presented for feedback at international meetings. Results Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders, and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalized diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. Conclusions The expanded TMD taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalize and test the proposed taxonomy and diagnostic criteria. PMID:24443898

  4. Predicting outcome in term neonates with hypoxic-ischaemic encephalopathy using simplified MR criteria

    International Nuclear Information System (INIS)

    Jyoti, Rajeev; O'Neil, Ross

    2006-01-01

    MRI is an established investigation in the evaluation of neonates with suspected hypoxic-ischaemic encephalopathy (HIE). However, its role as a predictor of neurodevelopmental outcome remains complex. To establish reproducible simplified MR criteria and evaluate their role in predicting neurodevelopmental outcome in term neonates with HIE. Term neonates with suspected HIE had MRI at 7-10 days of age. MR scans were interpreted according to new simplified criteria by two radiologists blinded to the clinical course and outcome. The new simplified criteria allocated grade 1 to cases with no central and less than 10% peripheral change, grade 2 to those with less than 30% central and/or 10-30% peripheral area change, and grade 3 to those with more than 30% central or peripheral change. MRI changes were compared with clinical neurodevelopmental outcome evaluated prospectively at 1 year of age. Neurodevelopmental outcome was based upon the DQ score (revised Griffith's) and cerebral palsy on neurological assessment. Of 20 subjects, all those showing severe (grade 3) MR changes (35%) died or had poor neurodevelopmental outcome. Subjects with a normal MR scan or with scans showing only mild (grade 1) MR changes (55%) had normal outcomes. One subject showing moderate (grade 2) changes on MRI had a moderate outcome (5%), while another had an atypical pattern of MR changes with a normal outcome (5%). Assessment of full-term neonates with suspected HIE using the simplified MR criteria is highly predictive of neurodevelopmental outcome. (orig.)

  5. Predicting outcome in term neonates with hypoxic-ischaemic encephalopathy using simplified MR criteria

    Energy Technology Data Exchange (ETDEWEB)

    Jyoti, Rajeev; O' Neil, Ross [Canberra Hospital, Medical Imaging, Canberra, ACT (Australia)

    2006-01-01

    MRI is an established investigation in the evaluation of neonates with suspected hypoxic-ischaemic encephalopathy (HIE). However, its role as a predictor of neurodevelopmental outcome remains complex. To establish reproducible simplified MR criteria and evaluate their role in predicting neurodevelopmental outcome in term neonates with HIE. Term neonates with suspected HIE had MRI at 7-10 days of age. MR scans were interpreted according to new simplified criteria by two radiologists blinded to the clinical course and outcome. The new simplified criteria allocated grade 1 to cases with no central and less than 10% peripheral change, grade 2 to those with less than 30% central and/or 10-30% peripheral area change, and grade 3 to those with more than 30% central or peripheral change. MRI changes were compared with clinical neurodevelopmental outcome evaluated prospectively at 1 year of age. Neurodevelopmental outcome was based upon the DQ score (revised Griffith's) and cerebral palsy on neurological assessment. Of 20 subjects, all those showing severe (grade 3) MR changes (35%) died or had poor neurodevelopmental outcome. Subjects with a normal MR scan or with scans showing only mild (grade 1) MR changes (55%) had normal outcomes. One subject showing moderate (grade 2) changes on MRI had a moderate outcome (5%), while another had an atypical pattern of MR changes with a normal outcome (5%). Assessment of full-term neonates with suspected HIE using the simplified MR criteria is highly predictive of neurodevelopmental outcome. (orig.)

  6. Defining successful aging: a tangible or elusive concept?

    Science.gov (United States)

    Martin, Peter; Kelly, Norene; Kahana, Boaz; Kahana, Eva; Willcox, Bradley J; Willcox, D Craig; Poon, Leonard W

    2015-02-01

    Everyone wants to age successfully; however, the definition and criteria of successful aging remain vague for laypersons, researchers, and policymakers in spite of decades of research on the topic. This paper highlights work of scholars who made significant theoretical contributions to the topic. A thorough review and evaluation of the literature on successful aging was undertaken. Our review includes early gerontological definitions of successful aging and related concepts. Historical perspectives reach back to philosophical and religious texts, and more recent approaches have focused on both process- and outcome-oriented models of successful aging. We elaborate on Baltes and Baltes' theory of selective optimization with compensation [Baltes, P. B., & Baltes, M. M. (1990a). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). United Kingdom: Cambridge University Press], Kahana and Kahana's preventive and corrective proactivity model [Kahana, E., & Kahana, B. (1996). Conceptual and empirical advances in understanding aging well through proactive adaptation. In V. Bengtson (Ed.), Adulthood and aging: Research on continuities and discontinuities (pp. 18-40). New York: Springer], and Rowe and Kahn's model of successful aging [Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books], outlining their commonalities and differences. Additional views on successful aging emphasize subjective versus objective perceptions of successful aging and relate successful aging to studies on healthy and exceptional longevity. Additional theoretical work is needed to better understand successful aging, including the way it can encompass disability and death and dying. The extent of rapid social and technological change influencing views on successful aging also deserves more consideration. © The Author

  7. Evaluation criteria for spectral design of camouflage

    Science.gov (United States)

    Škerlind, Christina; Fagerström, Jan; Hallberg, Tomas; Kariis, Hans

    2015-10-01

    In development of visual (VIS) and infrared (IR) camouflage for signature management, the aim is the design of surface properties of an object to spectrally match or adapt to a background and thereby minimizing the contrast perceived by a threatening sensor. The so called 'ladder model" relates the requirements for task measure of effectiveness with surface structure properties through the steps signature effectiveness and object signature. It is intended to link materials properties via platform signature to military utility and vice versa. Spectral design of a surface intends to give it a desired wavelength dependent optical response to fit a specific application of interest. Six evaluation criteria were stated, with the aim to aid the process to put requirement on camouflage and for evaluation. The six criteria correspond to properties such as reflectance, gloss, emissivity, and degree of polarization as well as dynamic properties, and broadband or multispectral properties. These criteria have previously been exemplified on different kinds of materials and investigated separately. Anderson and Åkerlind further point out that the six criteria rarely were considered or described all together in one and same publication previously. The specific level of requirement of the different properties must be specified individually for each specific situation and environment to minimize the contrast between target and a background. The criteria or properties are not totally independent of one another. How they are correlated is part of the theme of this paper. However, prioritization has been made due to the limit of space. Therefore all of the interconnections between the six criteria will not be considered in the work of this report. The ladder step previous to digging into the different material composition possibilities and choice of suitable materials and structures (not covered here), includes the object signature and decision of what the spectral response should be

  8. Identifying Effectiveness Criteria for Internet Payment Systems.

    Science.gov (United States)

    Shon, Tae-Hwan; Swatman, Paula M. C.

    1998-01-01

    Examines Internet payment systems (IPS): third-party, card, secure Web server, electronic token, financial electronic data interchange (EDI), and micropayment based. Reports the results of a Delphi survey of experts identifying and classifying IPS effectiveness criteria and classifying types of IPS providers. Includes the survey invitation letter…

  9. Hepatorenal syndrome in patients with cirrhosis of liver according to 2007 international ascites club criteria

    International Nuclear Information System (INIS)

    Seetlani, N.K.; Memon, A.R.; Iftikhar, F.; Fazel, P.A.

    2016-01-01

    Heptorenal syndrome is a complication of cirrhosis of liver and is characterized by progressive renal failure. This study was done to determine the frequency of hepatorenal syndrome according to 2007 international ascites club criteria among patients of cirrhosis attending Medical Units of Civil hospital Karachi. Methods: This is a cross-sectional study conducted on the hospitalized patients in the Department of Medicine-Civil Hospital Karachi from 01-04-2014 to 30-09-2014 where total 265 patients of either gender, age >18 years and <60 years and diagnosed case of CLD were included. Patients with shock, SIRS, sepsis, known cases of intrinsic renal diseases, or history of diabetes mellitus, Hypertension or connective tissue diseases were excluded. Mean±SD were expressed for continuous variable like, age, duration of CLD. Frequency and percentages of other categorical variables, i.e., gender, residence were expressed. Effect modification was tested through Chi-square with p-value <0.05 significant. Results: The mean±SD age of patient was 48.23+-7.87 years with range 18-60 years. Mean±SD duration of chronic liver disease was 5.60±1.92 years with a range of 3-12 years. More than 155 (58%) participants in this study were male and females were 110 (41.51%). More than 36 (13%) were of age less than and equal to 40 years; 121 (45.67%) were from 41-50 years, while 108 (40.75%) were from age 51-60 years. More than 176 (66.41%) belonged to rural areas while only 89 (33.58%) belonged to urban areas. The study observed that according to IAC 2007 criteria of diagnosis of hepatorenal syndrome 15.09% of patients with cirrhosis were found to have HRS. Conclusion: Hepatorenal syndrome represents the end stage of a sequence of reduction of renal perfusion induced by advanced liver failure. Almost every seventh patient of Cirrhosis can develop hepatorenal Syndrome. This should be looked up at an early stage so that it can be prevented. (author)

  10. Inventory of sites used to develop residual radioactivity criteria

    International Nuclear Information System (INIS)

    Ronca-Battista, M.; Hardeman, J.C. Jr.

    1986-01-01

    The US Environmental Protection Agency (EPA), in conjunction with the National Conference of Radiation Control Program Directors (CRCPD), has compiled an inventory of never licensed or otherwise poorly documented sites that may be contaminated with radioactive materials. This effort is in support of the EPA's development of radiation protection criteria for residual radioactivity at decommissioned sites. The inventory will help to establish the range of circumstances for which criteria are needed, as well as the suitability of candidate criteria for actual situations. The information will also be used to develop model sites and facilities for analyzing technical and economic feasibility of residual radioactivity criteria and to assess costs and benefits of alternate criteria. Relevant information about each site, such as radionuclides, waste forms, and quantities present will be included in the inventory when such information is available. The CRCPD has requested that each State radiation control agency furnish the information for the inventory. The inventory supplements the relatively extensive documentation of sites regulated by Federal or State agencies with information on old or unlicensed sites, such as old waste storage sites or radium ore processing facilities

  11. 78 FR 37586 - Stone Age Interiors, Inc., D/B/A Colorado Springs Marble and Granite, Including On-Site Leased...

    Science.gov (United States)

    2013-06-21

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-82,440] Stone Age Interiors, Inc., D/B/A Colorado Springs Marble and Granite, Including On-Site Leased Workers From Express Employment... Marble and Granite, Colorado Springs, Colorado (subject firm). The negative determination was issued on...

  12. Seismic design criteria for the system 80+ advanced light water reactor

    International Nuclear Information System (INIS)

    Manrique, M.A.; Dermitzakis, S.N.; Gerdes, L.D.; Kennedy, R.P.; Idriss, I.M.; Cassidy, J.R.

    1991-01-01

    This paper presents the development of seismic design criteria in support of design certification by the Nuclear Regulatory Commission (NRC) of the ABB-Combustion Engineering's System 80+ Standard Design. The design certification effort is sponsored by the US Department of Energy (DOE). The development of the design criteria included: (a) development of the seismic control motion, (b) development of generic soil profiles for anticipated sites, (c) generation of in-structure response spectra and design loads for structures and equipment through soil-structure interaction (SSI) analyses, and (d) acceptance criteria for future construction sites

  13. Evaluation of national health-care related infection criteria for epidemiological surveillance in neonatology.

    Science.gov (United States)

    Ferreira, Janita; Bouzada, Maria C F; Jesus, Lenize A de; Cortes, Maria da Conceição Werneck; Armond, Guilherme A; Clemente, Wanessa T; Anchieta, Lêni M; Romanelli, Roberta M C

    2014-01-01

    to assess the use of the Brazilian criteria for reporting of hospital-acquired infections (HAIs) in the neonatal unit and compare them with the criteria proposed by the National Healthcare Safety Network (NHSN). this was a cross-sectional study conducted from 2009 to 2011. It included neonates with HAI reporting by at least one of the criteria. Statistical analysis included calculation of incidence density of HAIs, distribution by weight, and by reporting criterion. Analysis of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the national criteria was performed considering the NHSN as the gold standard, with agreement assessed by kappa. a total of 882 newborns were followed, and 330 had at least one infection notified by at least one of the criteria. A total of 522 HAIs were reported, regardless of the criteria. An incidence density of 27.28 infections per 1,000 patient-days was observed, and the main topographies were sepsis (58.3%), candidiasis (15.1%), and conjunctivitis (6.5%). A total of 489 (93.7%) were notified by both criteria, eight infections were notified only by the national criteria (six cases of necrotizing enterocolitis and two cases of conjunctivitis), and 25 cases of clinical sepsis were reported by NHSN criteria only. The sensitivity, specificity, PPV, and NPV were 95.1%, 98.6%, 98.4%, and 95.7%, respectively, for all topographies, and were 91.8%, 100%, 100%, and 96.3% for the analysis of sepsis. Kappa analysis showed an agreement of 96.9%. there was a high rate of agreement between the criteria. The use of the national criteria facilitates the reporting of sepsis in newborns, and can help to improve the specificity and PPV. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  14. Evaluation of national health-care related infection criteria for epidemiological surveillance in neonatology

    Directory of Open Access Journals (Sweden)

    Janita Ferreira

    2014-07-01

    Full Text Available OBJECTIVE: to assess the use of the Brazilian criteria for reporting of hospital-acquired infections (HAIs in the neonatal unit and compare them with the criteria proposed by the National Healthcare Safety Network (NHSN. METHODS: this was a cross-sectional study conducted from 2009 to 2011. It included neonates with HAI reporting by at least one of the criteria. Statistical analysis included calculation of incidence density of HAIs, distribution by weight, and by reporting criterion. Analysis of sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV for the national criteria was performed considering the NHSN as the gold standard, with agreement assessed by kappa. RESULTS: a total of 882 newborns were followed, and 330 had at least one infection notified by at least one of the criteria. A total of 522 HAIs were reported, regardless of the criteria. An incidence density of 27.28 infections per 1,000 patient-days was observed, and the main topographies were sepsis (58.3%, candidiasis (15.1%, and conjunctivitis (6.5%. A total of 489 (93.7% were notified by both criteria, eight infections were notified only by the national criteria (six cases of necrotizing enterocolitis and two cases of conjunctivitis, and 25 cases of clinical sepsis were reported by NHSN criteria only. The sensitivity, specificity, PPV, and NPV were 95.1%, 98.6%, 98.4%, and 95.7%, respectively, for all topographies, and were 91.8%, 100%, 100%, and 96.3% for the analysis of sepsis. Kappa analysis showed an agreement of 96.9%. CONCLUSION: there was a high rate of agreement between the criteria. The use of the national criteria facilitates the reporting of sepsis in newborns, and can help to improve the specificity and PPV.

  15. National Security in the Nuclear Age. A Proposed Booklist and Public Education Ideas for Libraries.

    Science.gov (United States)

    Dane, Ernest B.

    A bibliography on national security in the nuclear age is divided into three sections. The first section describes a proposal calling for the compilation of a balanced and up-to-date collection of books and other materials on this issue to be included in all U.S. public libraries. Also discussed are selection criteria for the book list, project…

  16. Referral Criteria from Community Clinics to Pediatric Emergency Departments

    Directory of Open Access Journals (Sweden)

    Jacob Urkin

    2008-01-01

    Full Text Available Referral of patients to a pediatric emergency department (PED should be medically justified and the need for referral well communicated. The objectives of this paper were (1 to create a list of criteria for referral from the community to the PED, (2 to describe how community physicians categorize their need for referral, and (3 to determine agreement between the physician's referral letter and the selected criteria. We present a descriptive study of referrals to the PED of Soroka University Medical Center, Beer-Sheva, Israel, during February to April 2003. A list of 22 criteria for referral was created, using the Delphi method for reaching consensus. One or more criteria could be selected from this list for each referral, by the referring community physicians and, independently, based on the physicians' referral letters, by two consultants, and compared. There were 140 referrals included in the study. A total of 262 criteria for referral were selected by the referring community physicians. The criteria most frequently selected were: “Need for same-day consultation/laboratory/imaging result not available in the community” (32.1%, “Suspected life- or organ-threatening infection” (16.4%, and “Need for hospitalization” (15.7%. Rates of agreement regarding criteria for referral between the referring physicians and the two consultants, and a senior community pediatrician and a senior PED pediatrician, were 57.9 and 48.6%, respectively. We conclude that the standard referral letter does not convey in full the level of need for referral to the PED. A list of criteria for referral could augment efficient utilization of emergency department services and improve communication between community physicians and the PED.

  17. Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates

    Science.gov (United States)

    Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

    2015-01-01

    Aims Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Methods Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. Results The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (DSM-5 criteria (53.6%; 95% CI =44.1–62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4 risk factors for opioid dependence were similar. To our knowledge, this is one of the first studies to compare the final results for DSM-5 versus DSM-4 prescription opioid-use disorders among a high-risk patient population. PMID:26316838

  18. Nuclear Pedigree Criteria of Suspected HNPCC

    Directory of Open Access Journals (Sweden)

    Kładny Józef

    2003-01-01

    Full Text Available Abstract The criteria for the diagnosis of HNPCC established by the ICG-HNPCC are very restrictive as they do not allow for the diagnosis of a large number of "suspected HNPCC" cases - these are families which do no fulfill the strict diagnostic "Amsterdam criteria", but do present with several pedigree and clinical features characteristic for HNPCC. Several series of families suspected of harboring germline mutations in DNA mismatch repair genes have been studied for germline changes in DNA mismatch repair genes and a mutation rate of somewhere between 8-60% was found. Therefore a subgroup of members of the ICG-HNPCC has been working on pedigree/clinical diagnostic criteria for suspected HNPCC. Materials and methods Part I The study was based on two series of colorectal cancer (CRC cases: 1 HNPCC - this group comprised 190 patients affected by CRC from randomly selected families which fulfilled the Amsterdam II criteria registered in Düsseldorf, Germany (102 cases of CRC, Denmark (18 CRCs, Leiden, Holland (23 CRCs and Szczecin, Poland (47 CRCs. 2 Consecutive CRCs - this group comprised 629 (78.0% of 806 individuals with CRC diagnosed in 1991-1997 in the city of Szczecin (ca. 400,000 of inhabitants, Poland. Nuclear pedigrees in both groups were compared for frequency of occurrence of clinical features, that have been shown to be associated with HNPCC. Part II 52 consecutive CRC cases from Szczecin, matching the criteria recognized in part I as appropriate for diagnosis of cases "suspected of HNPCC" were studied for the occurrence of germline hMSH2/hMLH1 constitutional mutations using "exon by exon" sequencing. Results The combination of features - i.e. the occurrence of an HNPCC associated cancer (CRC or cancer of the endometrium, small bowel or urinary tract in a 1st degree relative of a CRC patient; at least one of the patients being diagnosed under age of 50 - appeared to be strongly associated to HNPCC with an OR - 161. Constitutional

  19. Comparison of Prevalence and Outcomes of Pediatric Acute Respiratory Distress Syndrome Using Pediatric Acute Lung Injury Consensus Conference Criteria and Berlin Definition.

    Science.gov (United States)

    Gupta, Samriti; Sankar, Jhuma; Lodha, Rakesh; Kabra, Sushil K

    2018-01-01

    Our objective was to compare the prevalence and outcomes of pediatric acute respiratory distress syndrome using the Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria and Berlin definitions. We screened case records of all children aged 1 month to 17 years of age admitted to the Pediatric Intensive Care Unit (PICU) over a 3-year period (2015-2017) for presence of any respiratory difficulty at admission or during PICU stay. We applied both PALICC and Berlin criteria to these patients. Data collection included definition and outcome related variables. Data were compared between the "PALICC only group" and the "Berlin with or without PALICC" group using Stata 11. Of a total of 615 admissions, 246 were identified as having respiratory difficulty at admission or during PICU stay. A total of 61 children (prevalence 9.9%; 95% CI: 7.8-12.4) fulfilled the definition of acute respiratory distress syndrome (ARDS) with either of the two criteria. While 60 children (98%) fulfilled PALICC criteria, only 26 children (43%) fulfilled Berlin definition. There was moderate agreement between the two definitions (Kappa: 0.51; 95% CI: 0.40-0.62; observed agreement 85%). Greater proportion of patients had severe ARDS in the "Berlin with or without PALICC group" as compared to the "PALICC only" group (50 vs. 19%). There was no difference between the groups with regard to key clinical outcomes such as duration of ventilation (7 vs. 8 days) or mortality [51.4 vs. 57.7%: RR (95% CI): 0.99 (0.64-1.5)]. In comparison to Berlin definition, the PALICC criteria identified more number of patients with ARDS. Proportion with severe ARDS and complications was greater in the "Berlin with or without PALICC" group as compared to the "PALICC only" group. There were no differences in clinical outcomes between the groups.

  20. Individuation in Slovene emerging adults: its associations with demographics, transitional markers, achieved criteria for adulthood, and life satisfaction.

    Science.gov (United States)

    Zupančič, Maja; Komidar, Luka; Levpušček, Melita Puklek

    2014-12-01

    The study investigated associations of Slovene emerging adults' age, gender, living situation, romantic relationship, and employment status with aspects of individuation in relation to mother and father. Controlling for demographic variables and transitional markers of adulthood, we further explored the contribution of individuation measures to individuals' perceptions of achieved criteria for adulthood and life satisfaction. The participants provided self-reports on the Individuation Test for Emerging Adults, the Satisfaction With Life Scale, and the list of Achieved Criteria for Adulthood. Age and living out of parental home were positively associated with self-reliance in relation to both parents, whereas female gender was related to higher levels of connectedness and seeking parental support. Along with age and involvement in a romantic relationship, connectedness and self-reliance predicted adulthood criteria attainment and life satisfaction. The results support the models of individuation that emphasize growing autonomy and retaining connectedness to parents as pathways towards personal adjustments. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  1. Structural acceptance criteria for the evaulation of existing double-shell waste storage tanks located at the Hanford site, Richland, Washington

    International Nuclear Information System (INIS)

    Julyk, L.J.; Day, A.D.; Dyrness, A.D.; Moore, C.J.; Peterson, W.S.; Scott, M.A.; Shrivastava, H.P.; Sholman, J.S.; Watts, T.N.

    1995-09-01

    The structural acceptance criteria contained herein for the evaluation of existing underground double-shell waste storage tanks located at the Hanford Site is part of the Life Management/Aging Management Program of the Tank Waste Remediation System. The purpose of the overall life management program is to ensure that confinement of the waste is maintained over the required service life of the tanks. Characterization of the present condition of the tanks, understanding and characterization of potential degradation mechanisms, and development of tank structural acceptance criteria based on previous service and projected use are prerequisites to assessing tank integrity, to projecting the length of tank service, and to developing and applying prudent fixes or repairs. The criteria provided herein summarize the requirements for the analysis and structural qualification of the existing double-shell tanks for continued operation. Code reconciliation issues and material degradation under aging conditions are addressed. Although the criteria were developed for double-shell tanks, many of the provisions are equally applicable to single-shell tanks. However, the criteria do not apply to the evaluation of tank appurtenances and buried piping

  2. Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates.

    Science.gov (United States)

    Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

    2015-01-01

    Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (DSM-4 criteria indicated that the majority of patients with lifetime DSM-4 opioid dependence were now classified as having mild opioid-use disorder, based on the DSM-5 criteria (53.6%; 95% CI =44.1-62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4 risk factors for opioid dependence were similar. To our knowledge, this is one of the first studies to compare the final results for DSM-5 versus DSM-4 prescription opioid-use disorders among a high-risk patient population.

  3. Comparison of UK and US screening criteria for detection of retinopathy of prematurity in a developing nation.

    Science.gov (United States)

    Ugurbas, Silay Canturk; Gulcan, Hande; Canan, Handan; Ankarali, Handan; Torer, Birgin; Akova, Yonca Aydın

    2010-12-01

    To determine the incidence, risk factors, and appropriateness of differing guidelines in developed nations for screening for retinopathy of prematurity (ROP) in a single nursery in a large urban city in southern Turkey. The records of 260 premature infants born ≤34 weeks in a single tertiary unit were retrospectively reviewed for ROP risk factors and diagnosis. Applicability of UK and US criteria were assessed by the use of receiver operating characteristic curves. ROP of any stage was present in 60 infants (23%); ROP requiring treatment was seen in 30 (11.5%). Univariate analysis showed a significant relationship among the following factors: gestational age, birth weight, total duration of supplemental oxygen, duration of mechanical ventilation, respiratory distress syndrome, anemia, and intraventricular hemorrhage (p < 0.0001). Multiple logistic regression analysis showed gestational age (p = 0.039), birth weight (p = 0.05), respiratory distress syndrome (p = 0.05), and anemia (p = 0.004) as independent predictors of ROP requiring treatment. Area under curve for gestational age alone for diagnosing stage 2 or greater ROP was 0.824 ± 0.03 (p = 0.0001) and for birth weight alone was 0.808 ± 0.03 (p = 0.0001). UK screening criteria detected all stage 2 and greater ROP; US screening criteria missed 2 infants with stage 2 ROP but detected all treatment-requiring disease. Adoption of these screening criteria would have reduced unnecessary examinations by either 21% (UK) or 37% (US). UK and US criteria improved the detection accuracy for ROP requiring treatment in Turkey and should be studied for other developing nations. Copyright © 2010 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  4. Analysing and Comparing Encodability Criteria

    Directory of Open Access Journals (Sweden)

    Kirstin Peters

    2015-08-01

    Full Text Available Encodings or the proof of their absence are the main way to compare process calculi. To analyse the quality of encodings and to rule out trivial or meaningless encodings, they are augmented with quality criteria. There exists a bunch of different criteria and different variants of criteria in order to reason in different settings. This leads to incomparable results. Moreover it is not always clear whether the criteria used to obtain a result in a particular setting do indeed fit to this setting. We show how to formally reason about and compare encodability criteria by mapping them on requirements on a relation between source and target terms that is induced by the encoding function. In particular we analyse the common criteria full abstraction, operational correspondence, divergence reflection, success sensitiveness, and respect of barbs; e.g. we analyse the exact nature of the simulation relation (coupled simulation versus bisimulation that is induced by different variants of operational correspondence. This way we reduce the problem of analysing or comparing encodability criteria to the better understood problem of comparing relations on processes.

  5. Preliminary radiation criteria and nuclear analysis for ETF

    International Nuclear Information System (INIS)

    Engholm, B.A.

    1980-09-01

    Preliminary biological and materials radiation dose criteria for the Engineering Test Facility are described and tabulated. In keeping with the ETF Mission Statement, a key biological dose criterion is a 24-hour shutdown dose rate of 2 mrem/hr on the surface of the outboard bulk shield. Materials dose criteria, which primarily govern the inboard shield design, include 10 9 rads exposure limit to epoxy insulation, 3 x 10 -4 dpa damage to the TF coil copper stabilizer, and a total nuclear heating rate of 5 kW in the inboard TF coils. Nuclear analysis performed during FY 80 was directed primarily at the inboard and outboard bulk shielding, and at radiation streaming in the neutral beam drift ducts. Inboard and outboard shield thicknesses to achieve the biological and materials radiation criteria are 75 cm inboard and 125 cm outboard, the configuration consisting of alternating layers of stainless steel and borated water. The outboard shield also includes a 5 cm layer of lead. NBI duct streaming analyses performed by ORNL and LASL will play a key role in the design of the duct and NBI shielding in FY 81. The NBI aluminum cryopanel nuclear heating rate during the heating cycle is about 1 milliwatt/cm 3 , which is far less than the permissible limit

  6. Sustainable national transport planning: Managing multiple objectives and criteria

    DEFF Research Database (Denmark)

    Jensen, Anders Vestergaard; Salling, Kim Bang; Leleur, Steen

    not included in the CBA. One important part of the assessment is the selection of criteria to be included and this aspect will be examined by an appraisal study of the Rail Baltica corridor. In the study various alternatives are appraised with an explicit consideration of each alternative’s sustainability...... performance....

  7. Diagnostic Criteria for Pediatric MS

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-06-01

    Full Text Available Investigators at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago review the diagnostic criteria for pediatric multiple sclerosis, the differential diagnosis, the 2010 McDonald criteria, and Callen criteria.

  8. Proposed Diagnostic Criteria for Smartphone Addiction.

    Science.gov (United States)

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  9. Proposed Diagnostic Criteria for Smartphone Addiction.

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Lin

    Full Text Available Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria.We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy.Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1 six symptom criteria, (2 four functional impairment criteria and (3 exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%, while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use.The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  10. Schizoaffective disorder diagnosed according to different diagnostic criteria--systematic literature search and meta-analysis of key clinical characteristics and heterogeneity.

    Science.gov (United States)

    Pagel, Tobias; Franklin, Jeremy; Baethge, Christopher

    2014-03-01

    Schizoaffective disorder is viewed as a heterogeneous diagnosis among psychotic illnesses. Different diagnostic systems differ in their definition with DSM (-IIIR, -IV, and -V) providing a narrower definition than RDC and ICD-10. It is unclear whether this difference is reflected in patient samples diagnosed according to different diagnostic systems. Exploratory study based on a systematic review of studies of schizoaffective disorder samples diagnosed by either RDC and ICD-10 (group of "broad criteria") or DSM-IIIR and -IV ("narrow criteria"); comparison (by Mann-Whitney-U-tests) of key characteristics, such as age, number of hospitalizations, or scores in psychometric tests, between more broadly and more narrowly defined schizoaffective disorder samples using standard deviations as a measurement of heterogeneity as well as weighted means and percentages. To reduce selection bias only studies including schizoaffective patient samples together with affective disorder and schizophrenia samples were selected. 55 studies were included, 14 employing RDC, 4 ICD-10, 20 DSM-IIIR, and 17 DSM-IV. Thirteen characteristics were compared: patients diagnosed according to broader criteria had fewer previous hospitalizations (2.2 vs. 5.4) and were both less often male (42 vs. 51%) and married (21 vs. 40%). Heterogeneity was similar in both groups but slightly higher in RDC and ICD-10 samples than in DSM-IIIR and -IV-samples: +4% regarding demographic and clinical course data and +13% regarding psychometric tests (pooled SD). Secular trends and different designs may have confounded the results and limit generalizability. Some comparisons were underpowered. Differences in diagnostic criteria are reflected in key characteristics of samples. The association of larger heterogeneity with wider diagnostic criteria supports employing standard deviations as a measurement of heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Planning, design and technological criteria of conventional and nuclear shelters

    International Nuclear Information System (INIS)

    Sadoon, A.S.

    1989-01-01

    The thesis aims to establish a special criteria for building the shelters in two types. The conventional and nuclear, in respect to planning design and technological aspects, and finally establishing a special reference of planning, design and technology for Iraq which can be used when planning or designing a conventional or nuclear shelter. The thesis included four chapters, the first chapter included definition of shelters, and explanation of the effects of all types of weapons on buildings, and the second chapter included definition of planning and design concepts of shelters in its two types and analytical studies for international examples. The third chapter covered definition for technologies of structural, mechanical, electrical and sanitary systems. The fourth chapter included details of a case study in order to approach the results of research which included the conclusions, recommendations, criteria and prospects of planning design and technological aspects. 51 tabs.; 180 figs.; 32 refs.; 15 apps

  12. Molecular Aging of Human Liver: An Epigenetic/Transcriptomic Signature.

    Science.gov (United States)

    Bacalini, Maria Giulia; Franceschi, Claudio; Gentilini, Davide; Ravaioli, Francesco; Zhou, Xiaoyuan; Remondini, Daniel; Pirazzini, Chiara; Giuliani, Cristina; Marasco, Elena; Gensous, Noémie; Di Blasio, Anna Maria; Ellis, Ewa; Gramignoli, Roberto; Castellani, Gastone; Capri, Miriam; Strom, Stephen; Nardini, Christine; Cescon, Matteo; Grazi, Gian Luca; Garagnani, Paolo

    2018-03-15

    The feasibility of liver transplantation from old healthy donors suggests that this organ is able to preserve its functionality during aging. To explore the biological basis of this phenomenon, we characterized the epigenetic profile of liver biopsies collected from 45 healthy liver donors ranging from 13 to 90 years old using the Infinium HumanMethylation450 BeadChip. The analysis indicates that a large remodeling in DNA methylation patterns occurs, with 8823 age-associated differentially methylated CpG probes. Notably, these age-associated changes tended to level off after the age of 60, as confirmed by Horvath's clock. Using stringent selection criteria we further identified a DNA methylation signature of aging liver including 75 genomic regions. We demonstrated that this signature is specific for liver compared to other tissues and that it is able to detect biological age-acceleration effects associated with obesity. Finally we combined DNA methylation measurements with available expression data. Although the intersection between the two omic characterizations was low, both approaches suggested a previously unappreciated role of epithelial-mesenchymal transition and Wnt signaling pathways in the aging of human liver.

  13. Asthma-COPD overlap syndrome: recent advances in diagnostic criteria and prognostic significance.

    Science.gov (United States)

    Sorino, Claudio; Scichilone, Nicola; D'Amato, Maria; Patella, Vincenzo; DI Marco, Fabiano

    2017-06-01

    The term asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has been proposed for individuals with features of both asthma and COPD. Several attempts have been done to define ACOS on the basis of medical history, symptoms, and functional findings. The main diagnostic criteria include airflow obstruction with a strong although incomplete reversibility to bronchodilation tests, a significant exposure to cigarette or biomass smoke, and a history of atopy or asthma. Additional diagnostic elements include eosinophilic airway and systemic inflammation, a good response to corticosteroid treatment, and a high concentration of exhaled nitric oxide. ACOS should be distinguished from asthma with not fully reversible bronchial obstruction due to airway remodeling, thus the lack of smoking exposure should exclude the diagnosis of ACOS. In patients without a documented history of asthma before 40 years of age, an increase in FEV1 after bronchodilator >400 mL should be required to diagnose ACOS. ACOS has been found to be associated with impaired physical performance, functional ability, and health-related quality of life. The prevalence of ACOS increases with aging, then it is relatively stable in elderly individuals (>65 years). Long-term mortality of subjects with ACOS is similar to COPD, and worse than asthma and healthy controls. Future research is still needed to improve the understanding and management of ACOS.

  14. NOAA/WEST COAST AND ALASKA TSUNAMI WARNING CENTER PACIFIC OCEAN RESPONSE CRITERIA

    Directory of Open Access Journals (Sweden)

    Garry Rogers

    2008-01-01

    Full Text Available New West Coast/Alaska Tsunami Warning Center (WCATWC response criteria for earthquakes occurring in the Pacific basin are presented. Initial warning decisions are based on earthquake location, magnitude, depth, and - dependent on magnitude - either distance from source or pre- computed threat estimates generated from tsunami models. The new criteria will help limit the geographical extent of warnings and advisories to threatened regions, and complement the new operational tsunami product suite.Changes to the previous criteria include: adding hypocentral depth dependence, reducing geographical warning extent for the lower magnitude ranges, setting special criteria for areas not well-connected to the open ocean, basing warning extent on pre-computed threat levels versus tsunami travel time for very large events, including the new advisory product, using the advisory product for far-offshore events in the lower magnitude ranges, and specifying distances from the coast for on-shore events which may be tsunamigenic.This report sets a baseline for response criteria used by the WCATWC considering its processing and observational data capabilities as well as its organizational requirements. Criteria are set for tsunamis generated by earthquakes, which are by far the main cause of tsunami generation (either directly through sea floor displacement or indirectly by triggering of slumps. As further research and development provides better tsunami source definition, observational data streams, and improved analysis tools, the criteria will continue to adjust. Future lines of research and development capable of providing operational tsunami warning centers with better tools are discussed.

  15. Investigation of effective decision criteria for multiobjective optimization in IMRT.

    Science.gov (United States)

    Holdsworth, Clay; Stewart, Robert D; Kim, Minsun; Liao, Jay; Phillips, Mark H

    2011-06-01

    To investigate how using different sets of decision criteria impacts the quality of intensity modulated radiation therapy (IMRT) plans obtained by multiobjective optimization. A multiobjective optimization evolutionary algorithm (MOEA) was used to produce sets of IMRT plans. The MOEA consisted of two interacting algorithms: (i) a deterministic inverse planning optimization of beamlet intensities that minimizes a weighted sum of quadratic penalty objectives to generate IMRT plans and (ii) an evolutionary algorithm that selects the superior IMRT plans using decision criteria and uses those plans to determine the new weights and penalty objectives of each new plan. Plans resulting from the deterministic algorithm were evaluated by the evolutionary algorithm using a set of decision criteria for both targets and organs at risk (OARs). Decision criteria used included variation in the target dose distribution, mean dose, maximum dose, generalized equivalent uniform dose (gEUD), an equivalent uniform dose (EUD(alpha,beta) formula derived from the linear-quadratic survival model, and points on dose volume histograms (DVHs). In order to quantatively compare results from trials using different decision criteria, a neutral set of comparison metrics was used. For each set of decision criteria investigated, IMRT plans were calculated for four different cases: two simple prostate cases, one complex prostate Case, and one complex head and neck Case. When smaller numbers of decision criteria, more descriptive decision criteria, or less anti-correlated decision criteria were used to characterize plan quality during multiobjective optimization, dose to OARs and target dose variation were reduced in the final population of plans. Mean OAR dose and gEUD (a = 4) decision criteria were comparable. Using maximum dose decision criteria for OARs near targets resulted in inferior populations that focused solely on low target variance at the expense of high OAR dose. Target dose range, (D

  16. Seismic design and evaluation criteria for DOE facilities (DOE-STD-1020-XX)

    International Nuclear Information System (INIS)

    Short, S.A.; Kennedy, R.P.; Murray, R.C.

    1993-01-01

    Seismic design and evaluation criteria for DOE facilities are provided in DOE-STD-1020-XX. The criteria include selection of design/evaluation seismic input from probabilistic seismic hazard curves combined with commonly practiced deterministic response evaluation methods and acceptance criteria with controlled levels of conservatism. Conservatism is intentionally introduced in specification of material strengths and capacities, in the allowance of limited inelastic behavior and by a seismic load factor. These criteria are based on the performance or risk goals specified in DOE 5480.28. Criteria have been developed following a graded approach for several performance goals ranging from that appropriate for normal-use facilities to that appropriate for facilities involving hazardous or critical operations. Performance goals are comprised of desired behavior and of the probability of not achieving that behavior. Following the seismic design/evaluation criteria of DOE-STD-1020-XX is sufficient to demonstrate that the probabilistic performance or risk goals are achieved. The criteria are simple procedures but with a sound, rigorous basis for the achievement of goals

  17. The Criteria for the Selection of Wells for Hydraulic Fracturing

    Directory of Open Access Journals (Sweden)

    O.V. Salimov

    2017-12-01

    Full Text Available Various methods of selection of wells for hydraulic fracturing are analyzed. It is established that all methods can be divided into three large groups: criteria in the table form of boundary values of parameters, statistical methods of pattern recognition, methods of engineering calculation. The complication or use of additional parameters only leads to a reduction in the number of wells at which hydraulic fracturing is possible. It is shown that the use of reservoir properties of rocks, which are already used by hydraulic fracturing simulators, is not practicable as selection criteria. It is required to include in the selection criteria only those additional factors on which the effectiveness of hydraulic fracturing depends directly.

  18. Evaluation of the success of obstructive sleep apnea surgery using criteria based on long-term symptoms and incident hypertension.

    Science.gov (United States)

    Lim, Jae Hyun; Park, Pona; Wee, Jee Hye; Gelera, January E; Shrestha, Kundan Kumar; Rhee, Chae-Seo; Kim, Jeong-Whun

    2018-04-01

    To identify appropriate success criteria, based on long-term symptoms and incident hypertension, after surgery for obstructive sleep apnea (OSA). This observational cohort study included 97 adult OSA patients (90 men) who underwent surgical treatment at our tertiary medical center. Subjective symptoms [witnessed sleep apnea and snoring, and Epworth sleepiness scale (ESS) scores] were evaluated through a telephone survey, and incident hypertension was assessed from medical records. The subjects were divided into success and failure groups according to seven different criteria, and data were analyzed to identify the criteria that could significantly differentiate the success from failure groups. The participants had a mean age of 48.8 ± 11.9 years and a mean preoperative body mass index of 26.5 ± 3.5 kg/m 2 . The mean preoperative and postoperative apnea-hypopnea index (AHI) values were 36.1/h and 19.4/h, respectively. The mean follow-up duration was 77.0 ± 31.1 months. Postoperative witnessed apnea, snoring, and the ESS scores decreased significantly compared to preoperative scores in both the success and failure groups based on most of the seven criteria. Among the seven criteria, success and failure groups based on a postoperative AHI cutoff of 15 or 20/h differed significantly in witnessed apnea, snoring, or ESS scores. Kaplan-Meier survival analysis based on incident hypertension revealed that no criterion could significantly distinguish between the two groups. Our results suggest that some of the success criteria analyzed may be more useful in differentiating between success and failure groups after surgery, in terms of long-term improvement of subjective OSA-related symptoms.

  19. Food allergy: a clinician's criteria for including sera in a serum bank.

    Science.gov (United States)

    Ballmer-Weber, B K; Fernández-Rivas, M

    2008-10-01

    Safety assessment for genetically-engineered crop plants includes assessment for allergic responses. To facilitate this assessment, serum banks should contain well-characterised sera from patients with confirmed food allergies. A serum is defined as well-characterised if it is taken from a patient who has a convincing history of allergic responses to a known allergen or an allergen-containing food, a positive skin prick test (or elevated IgE response), and a positive response in a clinical food challenge.

  20. [A version of DSM-IV criteria adapted for adolescents and applied to young smokers].

    Science.gov (United States)

    Clemente Jiménez, M L; Pérez Trullén, A; Rubio Aranda, E; Marrón Tundidor, R; Rodríguez Ibáñez, M L; Herrero Labarga, I

    2003-07-01

    To evaluate nicotine dependence in adolescent smokers using a version of DSM-IV criteria for nicotine dependence adapted for adolescents (DSM-IVa). To establish its usefulness and the most relevant items for diagnosing adolescent smokers. Two thousand six hundred forty-seven schoolchildren between 10 and 17 years old were surveyed. A sample size was calculated for each year of age, using the finite population equation with the addition of 10% so that the absolute error would not increase at the end of the study if questionnaires were withdrawn. The sample was stratified by sex and type of school for each age group, with allocation to each stratum proportional to the number of individuals. Schools and students were selected using random number tables. The questionnaire collected the most significant personal data and information related to DSM-IVa criteria. Smokers made up 23.1% of the sample, and 63.5% of them smoked daily. According to the DSM-IVa criteria, 70.7% of the smokers were nicotine dependent. The DSM-IVa had a kappa value of 1 and internal consistency was good (Cronbach's alpha: 0.5598). The DSM-IVa is useful in the studied population, although not perfect. According to the criteria, 70.7% of those interviewed were already nicotine dependent. The key questions were those that referred to the presence of nicotine withdrawal syndrome symptoms and the need to spend a large amount of free time obtaining or smoking cigarettes.

  1. Pragmatic criteria of the definition of neonatal near miss: a comparative study.

    Science.gov (United States)

    Kale, Pauline Lorena; Jorge, Maria Helena Prado de Mello; Laurenti, Ruy; Fonseca, Sandra Costa; Silva, Kátia Silveira da

    2017-12-04

    The objective of this study was to test the validity of the pragmatic criteria of the definitions of neonatal near miss, extending them throughout the infant period, and to estimate the indicators of perinatal care in public maternity hospitals. A cohort of live births from six maternity hospitals in the municipalities of São Paulo, Niterói, and Rio de Janeiro, Brazil, was carried out in 2011. We carried out interviews and checked prenatal cards and medical records. We compared the pragmatic criteria (birth weight, gestational age, and 5' Apgar score) of the definitions of near miss of Pileggi et al., Pileggi-Castro et al., Souza et al., and Silva et al. We calculated sensitivity, specificity (gold standard: infant mortality), percentage of deaths among newborns with life-threatening conditions, and rates of near miss, mortality, and severe outcomes per 1,000 live births. A total 7,315 newborns were analyzed (completeness of information > 99%). The sensitivity of the definition of Pileggi-Castro et al. was higher, resulting in a higher number of cases of near miss, Souza et al. presented lower value, and Pileggi et al. and de Silva et al. presented intermediate values. There is an increase in sensitivity when the period goes from 0-6 to 0-27 days, and there is a decrease when it goes to 0-364 days. Specificities were high (≥ 97%) and above sensitivities (54% to 77%). One maternity hospital in São Paulo and one in Niterói presented, respectively, the lowest and highest rates of infant mortality, near miss, and frequency of births with life-threatening conditions, regardless of the definition. The definitions of near miss based exclusively on pragmatic criteria are valid and can be used for monitoring purposes. Based on the perinatal literature, the cutoff points adopted by Silva et al. were more appropriate. Periodic studies could apply a more complete definition, incorporating clinical, laboratory, and management criteria, including congenital anomalies

  2. Is There Successful Aging for Nonagenarians? The Vitality 90+ Study

    Directory of Open Access Journals (Sweden)

    Lily Nosraty

    2012-01-01

    Full Text Available Objectives. This study was designed (1 to estimate the prevalence of successful aging among nonagenarians based on six different models and (2 to investigate whether successful aging is associated with socio-demographic factors. Methods. A mailed survey was conducted with people aged 90+ in Tampere in 2010. Responses were received from 1283 people. The prevalence of successful aging was measured by six multidimensional models including physical, social, and psychological components. Age, sex, marital status, level of education, and place of living were studied as factors associated with successful aging. Results. The prevalence of successful aging varied from 1.6% to 18.3% depending on the model applied. Successful aging was more prevalent in men, and also more prevalent among community-living people. In most models, successful aging was also associated with younger age, being married, and a higher level of education. Discussion. Models which emphasize the absence of disease and activity as criteria for successful aging may not be the most relevant and applicable in oldest old. Instead, preference should be given to models that focus more on autonomy, adaptation and sense of purpose. Age-sensitive approaches would help us better understand the potential of successful aging among individuals who already have success in longevity.

  3. Engineering study of generic site criteria for selected DOE plutonium facilities

    International Nuclear Information System (INIS)

    Kingsbury, R.J.; Greenwood, J.M.; Sandoval, M.D.

    1980-09-01

    The objectives of this study were to identify criteria that would be applied to selection of a site for plutonium facilities such as those at the Rocky Flats Plant, to establish the relative importance of these criteria, and to identify suitable areas within the United States for location of plutonium facilities with respect to these criteria. Sources of the site criteria identified include federal laws, federal agency regulations, state laws and regulations, and requirements associated with operations to be performed at the site. The criteria identified during the study were organized into 14 major categories. The relative importnace of each category and each criterion within the categories were established using group decision-making techniques. The major criteria categories, their assigned weight on a scale of 1 to 10, and their relative priority ranks are as follows: geology/seismicity; public safety; environmental impact; meteorology; hydrology; topography; transportation; utilities; personnel; safeguards/security; land area and availability; land use compatibility; and, public acceptance. A suitability analysis of the continental United States was performed using only those criteria that could be mapped at a national scale. Suitability was assessed with respect to each of these criteria, and individual suitability maps were prepared. A composite suitability map was generated using computerized overlay techniques. This map provides a starting point for identifying specific candidate sites if an actual site selection were to be conducted

  4. Criteria of Clinical Diagnostics and Choice of Treatment Strategy in Children with Disoders of Sexual Development

    Directory of Open Access Journals (Sweden)

    N.V. Bolotova

    2010-03-01

    Full Text Available The number of patients with disorders of sexual development (DSD has increased in 3.54 times during the last three years. The aim is to define the structure of intersexual disorders in children from Saratov, criteria of gender assignment and surgical approach. During the period of three years (from 2006 till 2008 58 children with DSD aged 0 - 17 were examined. Assessment of external genitals, cytogenetic investigation, hormonal tests were performed. Imaging studies included ultrasonography, cystourethroscopy and laparoscopy with histological investigation. Considering the data DSD in children from Saratov compose sex chromosome DSD - 21,4 %, Gonadal dysgenesis - 26,2%, ovotesticular DSD - 2,3%, 46,ХХ testicular DSD - 2,3 %, complete androgen insensitivity syndrome - 4,7%. The criteria of gender assignment and surgical approach have been described in the article. The research concludes that the infants with intersexual genitels should be examined in special care centers by multispecialty team. It is nessesary to perform the karyotype test and ultrasonic study in newborns to detect the genetic and gonadal gender of the child

  5. Development of comprehensive waste acceptance criteria for commercial nuclear waste

    International Nuclear Information System (INIS)

    O'Hara, F.A.; Miller, N.E.; Ausmus, B.S.; Yates, K.R.; Means, J.L.; Christensen, R.N.; Kulacki, F.A.

    1979-01-01

    A detailed methodology is presented for the identification of the characteristics of commercial nuclear waste which may require criteria. This methodology is analyzed as a six-step process which begins with identification of waste operations and proceeds until the waste characteristics affecting the potential release of radionuclides are determined. All waste types and operations were analyzed using the methodology presented. Several illustrative example are included. It is found that thirty-three characteristics can be identified as possibly requiring criteria

  6. Prevalence of Metabolic Syndrome in Elderly and Agreement among Four Diagnostic Criteria

    International Nuclear Information System (INIS)

    Saad, Maria Auxiliadora Nogueira; Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; Cruz, Rubens Antunes Filho da

    2014-01-01

    Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others

  7. Prevalence of Metabolic Syndrome in Elderly and Agreement among Four Diagnostic Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Maria Auxiliadora Nogueira, E-mail: auxiliadorasaad@yahoo.com.br [Fundação Municipal de Saúde de Niterói, Niterói, RJ (Brazil); Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; Cruz, Rubens Antunes Filho da [Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2014-03-15

    Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others.

  8. DSM disorders and their criteria: how should they inter-relate?

    Science.gov (United States)

    Kendler, K S

    2017-09-01

    While the changes in psychiatric diagnosis introduced by Diagnostic and Statistical Manual third edition (DSM-III) have had major benefits to the field of psychiatry, the reification of its diagnostic criteria and the widespread adoption of diagnostic literalism have been problematic. I argue that, at root, these developments can be best understood by contrasting two approaches to the relationship between DSM disorders and their criteria. In a constitutive relationship, criteria definitively define the disorder. Having a disorder is nothing more than meeting the criteria. In an indexical relationship, the criteria are fallible indices of a disorder understood as a hypothetical, tentative diagnostic construct. I trace the origins of the constitutive model to the philosophical theory of operationalism. I then examine a range of historical and empirical results that favor the indexical over the constitutive position including (i) evidence that individual criteria for DSM-III were selected from a broader pool of possible symptoms/signs, (ii) revisions of DSM have implicitly assumed an indexical criteria-disorder relationship, (iii) the indexical position allows DSM criteria to be wrong and misdiagnose patients while such a result is incoherent for a constitutive model, an implausible position, (iv) we assume an indexical criteria-scale relationships for many personality and symptom measures commonly used in psychiatric practice and research, and (v) empirical studies suggesting similar performance for DSM and non-DSM symptoms for major depression. I then review four reasons for the rise of the constitutive position: (i) the 'official' nature of the DSM criteria, (ii) the strong investment psychiatry has had in the DSM manual and its widespread use and success, iii) lack of a clear pathophysiology for our disorders, and (iv) the absence of informative diagnostic signs of minimal clinical importance. I conclude that the constitutive position is premature and reflects a

  9. How to Use the ADI-R for Classifying Autism Spectrum Disorders? Psychometric Properties of Criteria from the Literature in 1,204 Dutch Children

    Science.gov (United States)

    de Bildt, Annelies; Oosterling, Iris J.; van Lang, Natasja D. J.; Kuijper, Sanne; Dekker, Vera; Sytema, Sjoerd; Oerlemans, Anoek M.; van Steijn, Daphne J.; Visser, Janne C.; Rommelse, Nanda N.; Minderaa, Ruud B.; van Engeland, Herman; van der Gaag, Rutger-Jan; Buitelaar, Jan K.; de Jonge, Maretha V.

    2013-01-01

    The algorithm of the Autism Diagnostic Interview-Revised provides criteria for autism versus non-autism according to DSM-IV. Criteria for the broader autism spectrum disorders are needed. This study investigated the validity of seven sets of criteria from the literature, in 1,204 Dutch children (aged 3-18 years) with and without mental…

  10. Multi-criteria weighted order based maintenance decision making

    NARCIS (Netherlands)

    Dhanisetty, V.S.V.; Verhagen, W.J.C.; Curran, R.

    2017-01-01

    Decision making in daily maintenance requires consideration of multiple factors. The importance of each of the factors fluctuates depending on the repair scenario and the needs of the maintainer. In order to include the prioritisation of multiple criteria, a weighted decision making model is

  11. Dual Criteria Decisions

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten Igel

    2014-01-01

    The most popular models of decision making use a single criterion to evaluate projects or lotteries. However, decision makers may actually consider multiple criteria when evaluating projects. We consider a dual criteria model from psychology. This model integrates the familiar tradeoffs between...... to the clear role that income thresholds play in such decision making, but does not rule out a role for tradeoffs between risk and utility or probability weighting....

  12. A proposal of criteria for the classification of systemic sclerosis.

    Science.gov (United States)

    Nadashkevich, Oleg; Davis, Paul; Fritzler, Marvin J

    2004-11-01

    Sensitive and specific criteria for the classification of systemic sclerosis are required by clinicians and investigators to achieve higher quality clinical studies and approaches to therapy. A clinical study of systemic sclerosis patients in Europe and Canada led to a set of criteria that achieve high sensitivity and specificity. Both clinical and laboratory investigations of patients with systemic sclerosis, related conditions and diseases with clinical features that can be mistaken as part of the systemic sclerosis spectrum were undertaken. Laboratory investigations included the detection of autoantibodies to centromere proteins, Scl-70 (topoisomerase I), and fibrillarin (U3-RNP). Based on the investigation of 269 systemic sclerosis patients and 720 patients presenting with related and confounding conditions, the following set of criteria for the classification of systemic sclerosis was proposed: 1) autoantibodies to: centromere proteins, Scl-70 (topo I), fibrillarin; 2) bibasilar pulmonary fibrosis; 3) contractures of the digital joints or prayer sign; 4) dermal thickening proximal to the wrists; 5) calcinosis cutis; 6) Raynaud's phenomenon; 7) esophageal distal hypomotility or reflux-esophagitis; 8) sclerodactyly or non-pitting digital edema; 9) teleangiectasias. The classification of definite SSc requires at least three of the above criteria. Criteria for the classification of systemic sclerosis have been proposed. Preliminary testing has defined the sensitivity and specificity of these criteria as high as 99% and 100%, respectively. Testing and validation of the proposed criteria by other clinical centers is required.

  13. ASSESSMENT OF THE SENSITIVITY OF NEW CRITERIA FOR SYSTEMIC SCLEROSIS IN RUSSIAN PATIENT POPULATION

    Directory of Open Access Journals (Sweden)

    O. A. Koneva

    2015-01-01

    Full Text Available Systemic sclerosis (SS is a progressive connective tissue disease, the prognosis of which largely depends on the time of adequate therapy initiation. Low sensitivity of the 1980 American College of Rheumatology (ACR SS classification criteria for identifying patients with early stage of the disease, and with its limited form in particular, has necessitated revision of existing SS diagnostic standards and elaboration of more sensitive criteria that allow to establish the diagnosis when the first sign of the disease appear.Objective: to compare the sensitivity of the novel SS criteria of ACR and European League against Rheumatism (ACR/EULAR 2013 and the 1980 ACR criteria in different stages of the disease.Subjects and methods. The investigation enrolled 302 patients who had been diagnosed by experts as having SS and followed up at the V.A. Nasonova Research Institute of Rheumatology in 2007–2013. The patients’ mean age was 49±13 years (18 to 80 years; male to female ratio – 1:9 (31 and 271, that of patients with diffuse and limited SS – 1:2 (105 and 197; mean duration of the disease from the first non-Raynaud’s syndrome was 8.2±7.0 years (6 months to 36 years. Physical examination, nailfold capillaroscopy, chest radiography or computed tomography, echocardiography for the determination of pulmonary artery systolic pressure and SS-specific antibodies evaluation were performed.Results. 273 (90% patients fulfilled the novel ACR/EULAR 2013 SS criteria. 76 (25% patients had skin thickening above the metacarpophalangeal (MPC joints in both hands; 263 (87% – finger skin thickening [70 (23% – finger swelling, 192 (64% – thickening of all fingers distal to the MPC joints], 141 (47% – digital ischemia [79 (26% – digital pitting scars, 20 (7% – digital ulcers, 42 (14% – digital pitting scars and ulcers], 134 (44% – telangiectasias, 276 (91% – capillaroscopic changes, 225 (78% – pulmonary hypertension (PH or

  14. Failure Criteria for Reinforced Materials

    DEFF Research Database (Denmark)

    Rathkjen, Arne

    Failure of materials is often characterized as ductile yielding, brittle fracture, creep rupture, etc., and different criteria given in terms of different parameters have been used to describe different types of failure. Only criteria expressing failure in terms of stress are considered in what...... place until the matrix, the continuous component of the composite, fails. When an isotropic matrix is reinforced as described above, the result is an anisotropic composite material. Even if the material is anisotropic, it usually exhibits a rather high degree of symmetry and such symmetries place...... certain restrictions on the form of the failure criteria for anisotropic materials. In section 2, some failure criteria for homogenous materials are reviewed. Both isotropic and anisotropic materials are described, and in particular the constraints imposed on the criteria from the symmetries orthotropy...

  15. Considerations in the development of EPA's proposed BRC criteria

    International Nuclear Information System (INIS)

    Holcomb, W.F.; Gruhlke, J.M.; Galpin, F.L.

    1988-01-01

    To support the concept of criteria for potential below-regulatory-concern (BRC) wastes the US Environmental Protection Agency (EPA) has developed technical information, cost data, a methodology for analyzing promising candidate waste streams, and a rationale for proposing the criteria. Risk assessments to support the BRC criteria include an analysis of surrogate radioactive waste streams, disposal alternatives, and diverse demographic settings. In arriving at a proposed BRC level, EPA carefully weighed and considered many factors. Foremost was protection of the public and the development of an exposure level with assurance of no undue risk. Also considered were other daily risks encountered, ability to demonstrate compliance, guidance for similar exemptions by other groups, consistency with other regulated risk levels, general population health risks, maximum annual exposures to critical population groups, and the costs presently associated with the regulation of these wastes

  16. Successful aging and its discontents: a systematic review of the social gerontology literature.

    Science.gov (United States)

    Martinson, Marty; Berridge, Clara

    2015-02-01

    The purpose of this study was to analyze the range of critiques of successful aging models and the suggestions for improvement as expressed in the social gerontology literature. We conducted a systematic literature review using the following criteria: journal articles retrieved in the Abstracts in Social Gerontology, published 1987-2013, successful aging/ageing in the title or text (n = 453), a critique of successful aging models as a key component of the article. Sixty-seven articles met the criteria. Qualitative methods were used to identify key themes and inductively configure meanings across the range of critiques. The critiques and remedies fell into 4 categories. The Add and Stir group suggested a multidimensional expansion of successful aging criteria and offered an array of additions. The Missing Voices group advocated for adding older adults' subjective meanings of successful aging to established objective measures. The Hard Hitting Critiques group called for more just and inclusive frameworks that embrace diversity, avoid stigma and discrimination, and intervene at structural contexts of aging. The New Frames and Names group presented alternative ideal models often grounded in Eastern philosophies. The vast array of criteria that gerontologists collectively offered to expand Rowe and Kahn's original successful model is symptomatic of the problem that a normative model is by definition exclusionary. Greater reflexivity about gerontology's use of "successful aging" and other normative models is needed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Explanation of diagnostic criteria for radiation-induced nervous system disease

    International Nuclear Information System (INIS)

    Xing Zhiwei; Jiang Enhai

    2012-01-01

    National occupational health standard-Diagnostic Criteria for Radiation-Induced Nervous System Disease has been issued and implemented by the Ministry of health. This standard contained three independent criteria of the brain, spinal cord and peripheral nerve injury. These three kinds of disease often go together in clinic,therefore,the three diagnostic criteria were merged into radioactive nervous system disease diagnostic criteria for entirety and maneuverability of the standard. This standard was formulated based on collection of the clinical practice experience, extensive research of relevant literature and foreign relevant publications. It is mainly applied to diagnosis and treatment of occupational radiation-induced nervous system diseases, and to nervous system diseases caused by medical radiation exposure as well. In order to properly implement this standard, also to correctly deal with radioactive nervous system injury, the main contents of this standard including dose threshold, clinical manifestation, indexing standard and treatment principle were interpreted in this article. (authors)

  18. Comparison of Optimal Portfolios Selected by Multicriterial Model Using Absolute and Relative Criteria Values

    Directory of Open Access Journals (Sweden)

    Branka Marasović

    2009-03-01

    Full Text Available In this paper we select an optimal portfolio on the Croatian capital market by using the multicriterial programming. In accordance with the modern portfolio theory maximisation of returns at minimal risk should be the investment goal of any successful investor. However, contrary to the expectations of the modern portfolio theory, the tests carried out on a number of financial markets reveal the existence of other indicators important in portfolio selection. Considering the importance of variables other than return and risk, selection of the optimal portfolio becomes a multicriterial problem which should be solved by using the appropriate techniques.In order to select an optimal portfolio, absolute values of criteria, like return, risk, price to earning value ratio (P/E, price to book value ratio (P/B and price to sale value ratio (P/S are included in our multicriterial model. However the problem might occur as the mean values of some criteria are significantly different for different sectors and because financial managers emphasize that comparison of the same criteria for different sectors could lead us to wrong conclusions. In the second part of the paper, relative values of previously stated criteria (in relation to mean value of sector are included in model for selecting optimal portfolio. Furthermore, the paper shows that if relative values of criteria are included in multicriterial model for selecting optimal portfolio, return in subsequent period is considerably higher than if absolute values of the same criteria were used.

  19. Identifying the connective strength between model parameters and performance criteria

    Directory of Open Access Journals (Sweden)

    B. Guse

    2017-11-01

    Full Text Available In hydrological models, parameters are used to represent the time-invariant characteristics of catchments and to capture different aspects of hydrological response. Hence, model parameters need to be identified based on their role in controlling the hydrological behaviour. For the identification of meaningful parameter values, multiple and complementary performance criteria are used that compare modelled and measured discharge time series. The reliability of the identification of hydrologically meaningful model parameter values depends on how distinctly a model parameter can be assigned to one of the performance criteria. To investigate this, we introduce the new concept of connective strength between model parameters and performance criteria. The connective strength assesses the intensity in the interrelationship between model parameters and performance criteria in a bijective way. In our analysis of connective strength, model simulations are carried out based on a latin hypercube sampling. Ten performance criteria including Nash–Sutcliffe efficiency (NSE, Kling–Gupta efficiency (KGE and its three components (alpha, beta and r as well as RSR (the ratio of the root mean square error to the standard deviation for different segments of the flow duration curve (FDC are calculated. With a joint analysis of two regression tree (RT approaches, we derive how a model parameter is connected to different performance criteria. At first, RTs are constructed using each performance criterion as the target variable to detect the most relevant model parameters for each performance criterion. Secondly, RTs are constructed using each parameter as the target variable to detect which performance criteria are impacted by changes in the values of one distinct model parameter. Based on this, appropriate performance criteria are identified for each model parameter. In this study, a high bijective connective strength between model parameters and performance criteria

  20. Echocardiography Criteria for Structural Heart Disease in Patients With End-Stage Renal Disease Initiating Hemodialysis.

    Science.gov (United States)

    Hickson, LaTonya J; Negrotto, Sara M; Onuigbo, Macaulay; Scott, Christopher G; Rule, Andrew D; Norby, Suzanne M; Albright, Robert C; Casey, Edward T; Dillon, John J; Pellikka, Patricia A; Pislaru, Sorin V; Best, Patricia J M; Villarraga, Hector R; Lin, Grace; Williams, Amy W; Nkomo, Vuyisile T

    2016-03-15

    Cardiovascular disease among hemodialysis (HD) patients is linked to poor outcomes. The Acute Dialysis Quality Initiative Workgroup proposed echocardiographic (ECHO) criteria for structural heart disease (SHD) in dialysis patients. The association of SHD with important patient outcomes is not well defined. This study sought to determine prevalence of ECHO-determined SHD and its association with survival among incident HD patients. We analyzed patients who began chronic HD from 2001 to 2013 who underwent ECHO ≤1 month prior to or ≤3 months following initiation of HD (n = 654). Mean patient age was 66 ± 16 years, and 60% of patients were male. ECHO findings that met 1 or more and ≥3 of the new criteria were discovered in 87% and 54% of patients, respectively. Over a median of 2.4 years, 415 patients died: 108 (26%) died within 6 months. Five-year mortality was 62%. Age- and sex-adjusted structural heart disease variables associated with death were left ventricular ejection fraction (LVEF) ≤45% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.20 to 1.83) and right ventricular (RV) systolic dysfunction (HR: 1.68; CI: 1.35 to 2.07). An additive of higher death risk included LVEF ≤45% and RV systolic dysfunction rather than neither (HR: 2.04; CI: 1.57 to 2.67; p = 0.53 for test for interaction). Following adjustment for age, sex, race, diabetic kidney disease, and dialysis access, RV dysfunction was independently associated with death (HR: 1.66; CI 1.34 to 2.06; p < 0.001). SHD was common in our HD study population, and RV systolic dysfunction independently predicted mortality. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Clinical Implications of Various Criteria for the Biochemical Diagnosis of Insulinoma

    Directory of Open Access Journals (Sweden)

    Chang Ho Ahn

    2014-12-01

    Full Text Available BackgroundAmong the various diagnostic criteria for insulinoma, the ratio criteria have been controversial. However, the amended insulin-glucose ratio exhibited excellent diagnostic performance in a recent retrospective cohort study, although it has not yet been validated in other patient cohorts. We examined the diagnostic performance of the current criteria of the Endocrine Society, insulin-glucose ratio, C-peptide-glucose ratio, and amended ratios in terms of differentiating insulinomas.MethodsWe reviewed the medical records of patients who underwent evaluation for hypoglycemia from 2000 to 2013. Fourteen patients with histopathologically confirmed insulinoma and 18 patients without clinical evidence of insulinoma were included. The results of a prolonged fast test were analyzed according to the abovementioned criteria.ResultsFulfilling all three Endocrine Society criteria-plasma levels of glucose (24.0 (pmol/L/(mmol/L] gave the highest area under the receiver operating characteristic curve, with 93% sensitivity and 94% specificity.ConclusionFulfilling the glucose, insulin, and C-peptide criteria of the Endocrine Society guidelines exhibited the best diagnostic performance for insulinoma. Nonetheless, the insulin-glucose ratio may still have a role in the biochemical diagnosis of insulinoma.

  2. Which Diagnostic Criteria are Most Useful in Discriminating Between Social Gamblers and Individuals with Gambling Problems? An Examination of DSM-IV and DSM-5 Criteria.

    Science.gov (United States)

    Temcheff, Caroline E; Paskus, Thomas S; Potenza, Marc N; Derevensky, Jeffrey L

    2016-09-01

    The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item's diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation ("Have there been periods in the past year where you spent a lot of time thinking about gambling?") was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.

  3. Criteria for accepting piping vibrations measured during FFTF plant startup

    International Nuclear Information System (INIS)

    Huang, S.N.

    1981-03-01

    Piping in the Fast Flux Test Facility is subjected to low-amplitude, high cycle vibration over the plant lifetime. Excitation sources include the mechanical vibration induced by main centrifugal pumps, auxiliary reciprocating pumps, EM pumps and possible flow oscillations. Vibration acceptance criteria must be established which will prevent excessive pipe and support fatigue damage when satified. This paper describes the preparation of such criteria against pipe failure used for acceptance testing of the Fast Flux Test Facility main heat transport piping

  4. Prognostic Criteria of Metabolic Syndrome Development in Children

    Directory of Open Access Journals (Sweden)

    T.V. Sorokman

    2016-03-01

    Full Text Available Introduction. The conduction of large-scale studies of metabolic syndrome (MS prevalence in children and adolescents is complicated by the lack of consensus of opinion about the use of certain diagnostic criteria in pediatric practice. Objective: to examine the features of family history in children with overweight and obesity and establish their diagnostic and prognostic value. Material and methods. The study included 158 children (100 children with overweight and 58 children with obesity and 70 children with normal body weight (control group. The results of research were analyzed using computer package «Statistica» StatSoft Inc. and Excel XP for Windows on a personal computer. Results. 32.7 % of children in the main group were hereditary taint on one diagnostic criteria of the MS, 30.4 % had two diagnostic criteria and 24.1 % had all the three criteria of MS, and the more excess body weight a child was suffering from, the greater was hereditary taint on the number of metabolic syndrome criteria (p < 0.05. In the control group of children, hereditary tainted on cardiovascular disease risk factors were 17.2 % — for obesity, 18.9 % — for hypertension, 17.2 % — for ischemic heart disease and 6.8 % — for carbohydrate metabolism disorders. Conclusions. 1. In 32.7 % of cases children were hereditary tainted on one diagnostic criterion of metabolic syndrome, 30.4 % patients had two and 24.1% children had all the three criteria of MS. 2. Presence of a positive family history of the child significantly increases the risk of child’s obesity: PR = 10.59 (95% CI: 3.81–31.79 at ER = 1.68 (95 % CI: 1.43–1.82.

  5. Idaho CERCLA Disposal Facility Complex Waste Acceptance Criteria

    Energy Technology Data Exchange (ETDEWEB)

    W. Mahlon Heileson

    2006-10-01

    The Idaho Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Disposal Facility (ICDF) has been designed to accept CERCLA waste generated within the Idaho National Laboratory. Hazardous, mixed, low-level, and Toxic Substance Control Act waste will be accepted for disposal at the ICDF. The purpose of this document is to provide criteria for the quantities of radioactive and/or hazardous constituents allowable in waste streams designated for disposal at ICDF. This ICDF Complex Waste Acceptance Criteria is divided into four section: (1) ICDF Complex; (2) Landfill; (3) Evaporation Pond: and (4) Staging, Storage, Sizing, and Treatment Facility (SSSTF). The ICDF Complex section contains the compliance details, which are the same for all areas of the ICDF. Corresponding sections contain details specific to the landfill, evaporation pond, and the SSSTF. This document specifies chemical and radiological constituent acceptance criteria for waste that will be disposed of at ICDF. Compliance with the requirements of this document ensures protection of human health and the environment, including the Snake River Plain Aquifer. Waste placed in the ICDF landfill and evaporation pond must not cause groundwater in the Snake River Plain Aquifer to exceed maximum contaminant levels, a hazard index of 1, or 10-4 cumulative risk levels. The defined waste acceptance criteria concentrations are compared to the design inventory concentrations. The purpose of this comparison is to show that there is an acceptable uncertainty margin based on the actual constituent concentrations anticipated for disposal at the ICDF. Implementation of this Waste Acceptance Criteria document will ensure compliance with the Final Report of Decision for the Idaho Nuclear Technology and Engineering Center, Operable Unit 3-13. For waste to be received, it must meet the waste acceptance criteria for the specific disposal/treatment unit (on-Site or off-Site) for which it is destined.

  6. Ecological radiation protection criteria for nuclear power

    International Nuclear Information System (INIS)

    Kryshev, I.I.

    1993-01-01

    By now a large quantity of radioactive hazards of all sizes and shapes has accumulated in Russia. They include RBMK, VVER, and BN (fast-neutron) nuclear power plants, nuclear fuel processing plants, radioactive waste dumps, ships with nuclear power units, etc. In order to evaluate the radioecological situation correctly, the characteristics of the radioactive contamination must be compiled in these areas with some system of criteria which will provide an acceptable level of ecological safety. Currently health criteria for radiation protection are, which are oriented to man's radiation protection, predominate. Here the concept of a thresholdless linear dose-response dependence, which has been confirmed experimentally only at rather high doses (above 1 Gy), is taken as the theoretical basis for evaluating and normalizing radiation effects. According to one opinion, protecting people against radiation is sufficient to protect other types of organisms, although they are not necessarily of the same species. However, from the viewpoint of ecology, this approach is incorrect, because it does not consider radiation dose differences between man and other living organisms. The article discusses dose-response dependences for various organisms, biological effects of ionizing radiation, and appropriate radiation protection criteria

  7. Effect of Blood Transfusions on the Outcome of Very Low Body Weight Preterm Infants under Two Different Transfusion Criteria

    Directory of Open Access Journals (Sweden)

    Hsiu-Lin Chen

    2009-06-01

    Conclusion: Both criteria of PRBC transfusion had similar clinical outcomes, although liberal transfusion resulted in a greater amount of blood transfused and a low reticulocyte count at 30 days of age. We suggest restrictive criteria for minimizing the overall amount of transfusion to less than 30 mL may be a better way of preventing CLD in VLBW infants.

  8. Hanford Site solid waste acceptance criteria

    International Nuclear Information System (INIS)

    Willis, N.P.; Triner, G.C.

    1991-09-01

    Westinghouse Hanford Company manages the Hanford Site solid waste treatment, storage, and disposal facilities for the US Department of Energy Field Office, Richland under contract DE-AC06-87RL10930. These facilities include radioactive solid waste disposal sites, radioactive solid waste storage areas and hazardous waste treatment, storage, and/or disposal facilities. This manual defines the criteria that must be met by waste generators for solid waste to be accepted by Westinghouse Hanford Company for treatment, storage and/or disposal facilities. It is to be used by all waste generators preparing radioactive solid waste for storage or disposal at the Hanford Site facilities and for all Hanford Site generators of hazardous waste. This manual is also intended for use by Westinghouse Hanford Company solid waste technical staff involved with approval and acceptance of solid waste. The criteria in this manual represent a compilation of state and federal regulations; US Department of Energy orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to management of solid waste. Where appropriate, these requirements are included in the manual by reference. It is the intent of this manual to provide guidance to the waste generator in meeting the applicable requirements

  9. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  10. Nevada National Security Site Waste Acceptance Criteria

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Management

    2010-09-03

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  11. Nevada National Security Site Waste Acceptance Criteria

    International Nuclear Information System (INIS)

    2010-01-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  12. Nevada National Security Site Waste Acceptance Criteria

    International Nuclear Information System (INIS)

    2011-01-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  13. SUITABILITY OF MEDICATIONS USED BY THE ELDERLY PARTICIPANTS OF A SOCIAL GROUP, ACCORDING TO THE BEERS CRITERIA

    Directory of Open Access Journals (Sweden)

    Geysa Donária de Miranda Mascarenhas

    2014-09-01

    Full Text Available The dynamic process defined as aging progressively reduces the functional capacity of the elderly and added to the lifestyle, they can to testify to the high number of pathologies. Thus, pharmacotherapy for this age group requires special care, keeping in view its peculiarities. Given this need, a group of researchers has developed criteria that allowed the identification of inappropriate medications. Thus, the aim of this study was to investigate the suitability of medications used by the elderly participants of a social group, in Vitória da Conquista, BA, according to the Beers criteria. This research was an exploratory descriptive study and data collection conducted through semi - structured interviews. It was asked to bring all the elderly who were using medications and / or prescriptions. It was found that 12.7% of the drugs used by the elderly appeared in the list of inappropriate medicines and 42% of respondents make use of polypharmacy. Among the most prescribed inappropriate medications, there is acetylsalicylic acid, diclofenac, diazepam, piroxicam, ibuprofen and amitriptyline. The class of inappropriate drugs most used by seniors was anti - inflammatory drugs. Given this, all health professionals need to put into practice the criteria for selecting medications this age group as the reality of existing drugs in Brazil.

  14. Suitability of medications used by the elderly participants of a social group, according to the Beers criteria

    Directory of Open Access Journals (Sweden)

    Geysa Donária de Miranda Mascarenhas

    2014-07-01

    Full Text Available The dynamic process defined as aging progressively reduces the functional capacity of the elderly and added to the lifestyle, they can to testify to the high number of pathologies. Thus, pharmacotherapy for this age group requires special care, keeping in view its peculiarities. Given this need, a group of researchers has developed criteria that allowed the identification of inappropriate medications. Thus, the aim of this study was to investigate the suitability of medications used by the elderly participants of a social group, in Vitória da Conquista, BA, according to the Beers criteria. This research was an exploratory descriptive study and data collection conducted through semi - structured interviews. It was asked to bring all the elderly who were using medications and / or prescriptions. It was found that 12.7% of the drugs used by the elderly appeared in the list of inappropriate medicines and 42% of respondents make use of polypharmacy. Among the most prescribed inappropriate medications, there is acetylsalicylic acid, diclofenac, diazepam, piroxicam, ibuprofen and amitriptyline. The class of inappropriate drugs most used by seniors was anti - inflammatory drugs. Given this, all health professionals need to put into practice the criteria for selecting medications this age group as the reality of existing drugs in Brazil.

  15. How Turkey Meets MPOWER Criteria?

    Directory of Open Access Journals (Sweden)

    Nazmi Bilir

    2013-02-01

    Full Text Available In 2003 World Health Assembly adopted an international treaty on tobacco control; FCTC, Framework Convention on Tobacco Control. Five year later World Health Organization (WHO declared the six effective approach for tobacco control, under the name of MPOWER. In the following years, WHO evaluated the level of implementation of MPOWER criteria in the countries. In this article, how Turkey implemented these six criteria will be discussed. Monitor tobacco use and prevention policies: Monitoring of tobacco use prevalence has been successfully monitored in Turkey through Global Adult Tobacco Survey, Global Youth Tobacco Survey and Health Professionals Tobacco Use Survey. Nevertheless, monitoring of tobacco industry activities was not successfully implemented. Protect people from tobacco smoke: Smoking was banned in most of the indoor public places in Turkey since 1996, and Turkey became a complete smoke-free country by the exposion of smoke-free places including the hospitality workplaces in 2008. Offer help to quit tobacco use: Although smoking cessation services has been a bit late in Turkey, availability of smoking cessation drugs and the establishment of free quitline services made Turkey successful in this regard. Warn about the dangers of tobacco: Since 1996, all TV channels have a duty of broadcasting programs on harms of tobacco use, not less than 90 minutes in a month and it has been implemented successfully. Additionally written messages indicating harms of tobacco has been printed on the packs since 1988 and pictures was added in 2010. But since the average surface area covered by the messages in less than 50% of the total surface of the pack, Turkey was not regarded as to meet the requirement. Enforce bans on tobacco advertising, promotion and sponsorship: All kinds of tobacco advertisement and promotion was banned by the Law in 1996. But the tobacco products was not in closed boxes at the sales points. Turkey was not found as successful

  16. MULTIPLE CRITERIA DECISION MAKING APPROACH FOR INDUSTRIAL ENGINEER SELECTION USING FUZZY AHP-FUZZY TOPSIS

    OpenAIRE

    Deliktaş, Derya; ÜSTÜN, Özden

    2018-01-01

    In this study, a fuzzy multiple criteria decision-making approach is proposed to select an industrial engineer among ten candidates in a manufacturing environment. The industrial engineer selection problem is a special case of the personal selection problem. This problem, which has hierarchical structure of criteria and many decision makers, contains many criteria. The evaluation process of decision makers also includes ambiguous parameters. The fuzzy AHP is used to determin...

  17. A Multi-Criteria Approach to Dry Port Location in Developing Economies with Application to Vietnam

    Directory of Open Access Journals (Sweden)

    Lam Canh Nguyen

    2016-03-01

    Full Text Available This paper presents a conceptual framework for the inclusion of multiple criteria in the evaluation of dry port location in developing countries from a multiple stakeholder perspective. We present the framework in four steps. The first step encompasses preliminary research to filter the alternative locations for dry port development. In the second step, the stakeholders are clustered in three groups: dry port users, dry port service providers and the wider community. Then, we present the sub-criteria related to dry port location including the associated measuring methods. The third step includes an explanation on the methods used for weighing these criteria and sub-criteria. A multi-criteria analysis is carried out in the final step. We apply the methodological framework to Vietnam. The location of a new dry port project in Vinh Phuc province will be evaluated against two existing inland clearance depots (ICD in Lao Cai and Phu Tho province.

  18. Older drivers' opinions of criteria that inform the cars they buy: A focus group study.

    Science.gov (United States)

    Zhan, Jenny; Porter, Michelle M; Polgar, Jan; Vrkljan, Brenda

    2013-12-01

    Safe driving in older adulthood depends not only on health and driving ability, but also on the driving environment itself, including the type of vehicle. However, little is known about how safety figures into the older driver's vehicle selection criteria and how it ranks among other criteria, such as price and comfort. For this purpose, six focus groups of older male and female drivers (n=33) aged 70-87 were conducted in two Canadian cities to explore vehicle purchasing decisions and the contribution of safety in this decision. Themes emerged from the data in these categories: vehicle features that keep them feeling safe, advanced vehicular technologies, factors that influence their car buying decisions, and resources that inform this decision. Results indicate older drivers have gaps with respect to their knowledge of safety features and do not prioritize safety at the time of vehicle purchase. To maximize the awareness and uptake of safety innovations, older consumers would benefit from a vehicle design rating system that highlights safety as well as other features to help ensure that the vehicle purchased fits their lifestyle and needs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. The Impact of DSM-5 A-Criteria Changes on Parent Ratings of ADHD in Adolescents.

    Science.gov (United States)

    Sibley, Margaret H; Yeguez, Carlos E

    2018-01-01

    Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) A-criteria for ADHD were expanded to include new descriptors referencing adolescent and adult symptom manifestations. This study examines the effect of these changes on symptom endorsement in a sample of adolescents with ADHD (N = 259; age range = 10.72-16.70). Parent ratings were collected and Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) and DSM-5 endorsement of ADHD symptoms were compared. Under the DSM-5, there were significant increases in reported inattention, but not hyperactivity/impulsivity (H/I) symptoms, with specific elevations for certain symptoms. The average adolescent met criteria for less than one additional symptom under the DSM-5, but the correlation between ADHD symptoms and impairment was attenuated when using the DSM-5 items. Impulsivity items appeared to represent adolescent deficits better than hyperactivity items. Results were not moderated by demographic factors. In a sample of adolescents with well-diagnosed DSM-IV-TR ADHD, developmental symptom descriptors led parents to endorse slightly more symptoms of inattention, but this elevation is unlikely to be clinically meaningful.

  20. Seminal characteristics and sexual behavior in men of different age groups: is there an aging effect?

    Science.gov (United States)

    Zavos, Panayiotis M; Kaskar, Khalied; Correa, Juan R; Sikka, Suresh C

    2006-05-01

    To assess the seminal characteristics as well as the sexual behavior of men of various age groups to establish the presence of an aging effect on those characteristics. Semen samples were collected from men (n = 792) undergoing in vitro fertilization or intrauterine insemination in cases of female factor infertility only. Samples were collected using a seminal collection device at intercourse and evaluated manually according to World Health Organization (WHO) standards. Men were divided into four groups according to their ages: (i) 20-30, (ii) 31-40, (iii) 41-50 and (iv) 51-60 years, and their seminal characteristics and responses to a sexual behavior questionnaire were compared. The data showed statistically significant differences in the seminal characteristics tested, most notably in the sperm concentration, motility, grade of motility, hypo-osmotic swelling and normal sperm morphology. Furthermore, the decline in normal sperm morphology with age was more pronounced when using strict criteria rather than WHO standards. There were also differences in total sperm count, total motile sperm and total functional sperm fraction (assessed by both WHO and strict criteria). Significant differences were also observed in the sexual behavior patterns in older men in terms of the number of years they have been trying to conceive, sexual frequency and sexual satisfaction. The data clearly illustrate an aging effect on semen characteristics and sexual behavior in men as they age. It is suggested that the aging effect be taken into consideration when proposing normal standard values for semen characteristics in routine semen analysis as outlined by WHO standards.

  1. Summary of the evidence file demonstrating completion of the NIF Project Completion Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Haynam, C. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2014-12-04

    This document summarizes the results of performance verification tests on NIF that demonstrate it has met its performance-related Project Completion Criteria (PCC). It includes measurements made on NIF with the NIF diagnostics, the calibration of these diagnostics and the supporting analyses that verify the NIF performance criteria have been met.

  2. Are diagnostic criteria for eating disorders markers of medical severity?

    Science.gov (United States)

    Peebles, Rebecka; Hardy, Kristina K; Wilson, Jenny L; Lock, James D

    2010-05-01

    The objective of this study was to compare the medical severity of adolescents who had eating disorders not otherwise specified (EDNOS) with those who had anorexia nervosa (AN) and bulimia nervosa (BN). Medical records of 1310 females aged 8 through 19 years and treated for AN, BN, or EDNOS were retrospectively reviewed. Patients with EDNOS were subcategorized into partial AN (pAN) and partial BN (pBN) when they met all Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria but 1 for AN or BN, respectively. Primary outcome variables were heart rate, systolic blood pressure, temperature, and QTc interval on electrocardiogram. Additional physiologically significant medical complications were also reviewed. A total of 25.2% of females had AN, 12.4% had BN, and 62.4% had EDNOS. The medical severity of patients with EDNOS was intermediate to that of patients with AN and BN in all primary outcomes. Patients with pAN had significantly higher heart rates, systolic blood pressures, and temperatures than those with AN; patients with pBN did not differ significantly from those with BN in any primary outcome variable; however, patients with pAN and pBN differed significantly from each other in all outcome variables. Patients with pBN and BN had longer QTc intervals and higher rates of additional medical complications reported at presentation than other groups. EDNOS is a medically heterogeneous category with serious physiologic sequelae in children and adolescents. Broadening AN and BN criteria in pediatric patients to include pAN and pBN may prove to be clinically useful.

  3. Toxic chemical risk acceptance criteria

    International Nuclear Information System (INIS)

    Craig, D.K.; Davis, J.; Lee, L.; Lein, P.; Omberg, S.

    1992-01-01

    This paper presents recommendations of a subcommittee of the Westinghouse M ampersand 0 Nuclear Facility Safety Committee concerning toxic chemical risk acceptance criteria. Two sets of criteria have been developed, one for use in the hazard classification of facilities, and the second for use in comparing risks in DOE non-reactor nuclear facility Safety Analysis Reports. The Emergency Response Planning Guideline (ERPG) values are intended to provide estimates of concentration ranges for specific chemicals above which exposure would be expected to lead to adverse heath effects of increasing severity for ERPG-1, -2, and -3s. The subcommittee recommends that criteria for hazard class or risk range be based on ERPGs for all chemicals. Probability-based Incremental Cancer Risk (ICR) criteria are recommended for additional analyses of risks from all known or suspected human carcinogens. Criteria are given for both on-site and off-site exposure. The subcommittee also recommends that the 5-minute peak concentration be compared with the relevant criterion with no adjustment for exposure time. Since ERPGs are available for only a limited number of chemicals, the subcommittee has developed a proposed hierarchy of concentration limit parameters for the different criteria

  4. Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria.

    Science.gov (United States)

    Soll, Bianca M; Robles-García, Rebeca; Brandelli-Costa, Angelo; Mori, Daniel; Mueller, Andressa; Vaitses-Fontanari, Anna M; Cardoso-da-Silva, Dhiordan; Schwarz, Karine; Abel-Schneider, Maiko; Saadeh, Alexandre; Lobato, Maria-Inês-Rodrigues

    2018-01-01

    To compare the presence of criteria listed in the DSM-5 and ICD-10 diagnostic manuals in a Brazilian sample of transgender persons seeking health services specifically for physical transition. This multicenter cross-sectional study included a sample of 103 subjects who sought services for gender identity disorder in two main reference centers in Brazil. The method involved a structured interview encompassing the diagnostic criteria in the two manuals. The results revealed that despite theoretical disagreement about the criteria, the manuals overlap regarding diagnosis confirmation; the DSM-5 was more inclusive (97.1%) than the ICD-10 (93.2%) in this population. Although there is no consensus on diagnostic criteria on transgenderism in the diversity of social and cultural contexts, more comprehensive diagnostic criteria are evolving due to society's increasing inclusivity.

  5. Aging management of containment structures in nuclear power plants

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.; Ellingwood, B.R.; Graves, H.L. III; Norris, W.E.

    1996-01-01

    Research is being conducted by Oak Ridge National Laboratory under US nuclear regulatory commission (USNRC) sponsorship to address aging management of nuclear power plant containment and other safety-related structures. Documentation is being prepared to provide the USNRC with potential structural safety issues and acceptance criteria for use in continued service evaluations of nuclear power plants. Accomplishments include development of a structural materials information center containing data and information on the time variation of 144 material properties under the influence of pertinent environmental stressors or aging factors, evaluation of models for potential concrete containment degradation factors, development of a procedure to identify critical structures and degradation factors important to aging management, evaluations of non-destructive evaluation techniques, assessments of European and North American repair practices for concrete, review of parameters affecting corrosion of metals embedded in concrete, and development of methodologies for making current condition assessments and service life predictions of new or existing reinforced concrete structures in nuclear power plants. (orig.)

  6. Aging management of containment structures in nuclear power plants

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.; Ellingwood, B.R.

    1994-01-01

    Research is being conducted by Oak Ridge National Laboratory under U.S. Nuclear Regulatory Commission sponsorship to address aging management of nuclear power plant containment and other safety-related structures. Documentation is being prepared to provide the US-NRC with potential structural safety issues and acceptance criteria for use in continued service evaluations of nuclear power plants. Accomplishments include development of a Structural Materials Information Center containing data and information on the time variation of 144 material properties under the influence of pertinent environmental stressors or aging factors, evaluation of models for potential concrete containment degradation factors, development of a procedure to identify critical structures and degradation factors important to aging management, evaluations of nondestructive evaluation techniques, assessments of European and North American repair practices for concrete, review of parameters affecting corrosion of metals embedded in concrete, and development of methodologies for making current condition assessments and service life predictions of new or existing reinforced concrete structures in nuclear power plants. (author). 29 refs., 2 figs

  7. Aging management of containment structures in nuclear power plants

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.; Ellingwood, B.R.; Graves, H.L. III; Norris, W.E.

    1994-01-01

    Research is being conducted by ORNL under US Nuclear Regulatory Commission (USNRC) sponsorship to address aging management of nuclear power plant containment and other safety-related structures. Documentation is being prepared to provide the USNRC with potential structural safety issues and acceptance criteria for use in continued service evaluations of nuclear power plants. Accomplishments include development of a Structural Materials Information Center containing data and information on the time variation of 144 material properties under the influence of pertinent environmental stressors or aging factors, evaluation of models for potential concrete containment degradation factors, development of a procedure to identify critical structures and degradation factors important to aging management, evaluations of nondestructive evaluation techniques. assessments of European and North American repair practices for concrete, review of parameters affecting corrosion of metals embedded in concrete, and development of methodologies for making current condition assessments and service life predictions of new or existing reinforced concrete structures in nuclear power plants

  8. Oral health of children born small for gestational age.

    LENUS (Irish Health Repository)

    O'Connell, A C

    2010-10-01

    We sought to evaluate the oral health status of children born small for gestational age (SGA). Children now aged 4-8 years who were born SGA (birth weight < -2 SDS) were examined using standardised criteria. The parents completed a structured oral health questionnaire. Twenty females and 25 males, mean age 72.1 months, and mean birth weight 2.1 kg, participated in the study. Poor appetite was a concern; 32 (71%) children snacked between meals and 14 (30%) used carbonated beverages more than 3 times daily. Erosion was present in 9 (20%) children. Dental decay occurred in 22 (47%) children with 92% being untreated. Eight children had more than 5 decayed teeth. It is essential that clinicians working with children born SGA include oral health within the general health surveillance and refer these children for a dental assessment within the first 2 years to support parents in establishing safe feeding patterns for their children.

  9. Diagnostic criteria for sarcopenia relate differently to insulin resistance

    NARCIS (Netherlands)

    Bijlsma, A.Y.; Meskers, C.G.M.; van Heemst, D.; Westendorp, R.G.J.; Craen, A.J.M.; Maier, A.B.

    2013-01-01

    Skeletal muscle is important in insulinstimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in

  10. Photovoltaic system criteria documents. Volume 3: Environmental issues and evaluation criteria for photovoltaic applications

    Science.gov (United States)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1979-01-01

    The environmental issues and evaluation criteria relating to the suitability of sites proposed for photovoltaic (PV) system deployment are identified. The important issues are defined, briefly discussed and then developed into evaluation criteria. System designers are provided with information on the environmental sensitivity of PV systems in realistic applications, background material which indicates the applicability of the siting issues identified, and evaluation criteria are defined to facilitate the selection of sites that maximize PV system operation.

  11. Criteria for Developing a Successful Privatization Project

    Science.gov (United States)

    1989-05-01

    conceptualization and planning are required when pursuing privatization projects. In fact, privatization project proponents need to know how to...selection of projects for analysis, methods of acquiring information about these projects, and the analysis framwork . Chapter IV includes the analysis. A...performed an analysis to determine cormion conceptual and creative approaches and lessons learned. This analysis was then used to develop criteria for

  12. [Suicidal behavior prevention for children under age 13: A systematic review].

    Science.gov (United States)

    Baux-Cazal, L; Gokalsing, E; Amadeo, S; Messiah, A

    2017-05-01

    Our objective was to review international literature on suicidal behavior prevention for children under age 13. We gathered all relevant articles on suicide prevention for children under 13. We researched all publications in the French and English languages in PubMed (MEDLINE), PsychINFO and SUDOC databases published until February 2014, with the keywords "child", "child preschool", "prevention and control", "suicide", and "suicide attempted". Publications were included if they described suicidal behavior prevention programs (suicide prevention programs, attempted-suicide prevention programs, suicidal ideation screening programs), and if the studies concerned children under age 13. We also included references cited in the articles if they were not already present in our searches but met inclusion criteria. Studies were excluded if they analyzed populations of children and adolescents without sub-analysis for children under age 13. A total of 350 potentially relevant articles were identified, 33 of which met the inclusion criteria, including 4 retrieved from articles' bibliography. Preventive measures against suicidal behavior for children under 13 exist and include: social programs, maltreatment prevention, curriculum-based suicide prevention programs, suicide screening in schools, gatekeepers, reduction of access of lethal means of suicide, suicide screening by primary care, and post-suicide intervention programs. Overall, the evidence was limited by methodological concerns, particularly a lack of RCTs. However, positive effects were found: school-based suicide prevention programs and gatekeepers increased knowledge about suicide and how to seek help, post-suicide programs helped to reduce psychological distress in the short term. One study showed a decreased risk of attempted-suicide after entry into the child welfare system. There are promising interventions but there is not enough scientific evidence to support any efficient preventive measure against

  13. Pros and cons of conjoint analysis of discrete choice experiments to define classification and response criteria in rheumatology.

    Science.gov (United States)

    Taylor, William J

    2016-03-01

    Conjoint analysis of choice or preference data has been used in marketing for over 40 years but has appeared in healthcare settings much more recently. It may be a useful technique for applications within the rheumatology field. Conjoint analysis in rheumatology contexts has mainly used the approaches implemented in 1000Minds Ltd, Dunedin, New Zealand, Sawtooth Software, Orem UT, USA. Examples include classification criteria, composite response criteria, service prioritization tools and utilities assessment. Limitations imposed by very many attributes can be managed using new techniques. Conjoint analysis studies of classification and response criteria suggest that the assumption of equal weighting of attributes cannot be met, which challenges traditional approaches to composite criteria construction. Weights elicited through choice experiments with experts can derive more accurate classification criteria, than unweighted criteria. Studies that find significant variation in attribute weights for composite response criteria for gout make construction of such criteria problematic. Better understanding of various multiattribute phenomena is likely to increase with increased use of conjoint analysis, especially when the attributes concern individual perceptions or opinions. In addition to classification criteria, some applications for conjoint analysis that are emerging in rheumatology include prioritization tools, remission criteria, and utilities for life areas.

  14. Surgical criteria for femoroacetabular impingement syndrome: a scoping review.

    Science.gov (United States)

    Peters, Scott; Laing, Alisha; Emerson, Courtney; Mutchler, Kelsey; Joyce, Thomas; Thorborg, Kristian; Hölmich, Per; Reiman, Michael

    2017-11-01

    The purpose of this review was to analyse and report criteria used for open and arthroscopic surgical treatment of femoroacetabular impingement syndrome (FAIS). A librarian-assisted computer search of Medline, CINAHL and Embase for studies related to criterion for FAIS surgery was used in this study. Inclusion criteria included studies with the primary purpose of surgery or surgical outcomes for treatment of FAIS with and without labral tear, and reporting criteria for FAIS surgery. Diagnostic imaging was a criterion for surgery in 92% of the included studies, with alpha angle the most frequently reported (68% of studies) criterion. Reporting of symptoms was a criterion for surgery in 75%, and special tests a criterion in 70% of studies. Range-of-motion limitations were only a required criterion in 30%, only 12% of studies required intra-articular injection and 44% of studies described previously failed treatment (non-surgical or physiotherapist-led rehabilitation) as a criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging combined for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting. Diagnostic imaging evidence of FAIS was the most commonly reported criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting, and only 44% of studies had failed non-surgical treatment (and 18% a failed trial of physiotherapy) as a criterion for surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Radiological design criteria

    International Nuclear Information System (INIS)

    Selby, J.M.; Andersen, B.V.; Carter, L.A.; Waite, D.A.

    1977-01-01

    Many new nuclear facilities are unsatisfactory from a radiation protection point of view, particularly when striving to maintain occupational exposure as low as practicable 'ALAP'. Radiation protection is achieved through physical protective features supplemented by administrative controls. Adequate physical protective feature should be achieved during construction so that supplemental administrative controls may be kept simple and workable. Many nuclear facilities fall short of adequate physical protective features, thus, remedial and sometimes awkward administrative procedures are required to safely conduct work. In reviewing the various handbooks, reports and regulations which deal with radiation protection, it may be noted that there is minimal radiological design guidance for application to nuclear facilities. A set of criteria or codes covering functional areas rather than specific nuclear facility types is badly needed. The following are suggested as functional areas to be considered: characterization of the Facility; siting and access; design exposure limits; layout (people and materials flow); ventilation and effluent control; radiation protection facilities and systems. The application of such radiological design criteria early in the design process would provide some assurance that nuclear facilities will be safe, flexible, and efficient with a minimum of costly retrofitting or administrative restrictions. Criteria which we have found helpful in these functional areas is discussed together with justification for adoption of such criteria and identification of problems which still require solution

  16. Preliminary safety criteria for organic watch list tanks at the Hanford site

    International Nuclear Information System (INIS)

    Webb, A.B.; Stewart, J.L.; Turner, O.A.; Plys, M.G.; Malinovic, B.; Grigsby, J.M.; Camaioni, D.M.; Heasler, P.G.; Samuels, W.O.; Toth, J.J.

    1995-11-01

    Condensed-phase, rapid reactions of organic salts with nitrates/nitrites in Hanford High Level Radioactive Waste single-shell tanks could lead to structural failure of the tanks resulting in significant releases of radionuclides and toxic materials. This report establishes appropriate preliminary safety criteria to ensure that tank wastes will be maintained safe. These criteria show that if actual dry wastes contain less than 1.2 MJ/kg of reactants reaction energy or less 4.5 wt % of total organic carbon, then the waste will be safe and will not propagate if ignited. Waste moisture helps to retard reactions; when waste moisture exceeds 20 wt %, rapid reactions are prevented, regardless of organic carbon concentrations. Aging and degradation of waste materials has been considered to predict the types and amounts to organic compounds present in the waste. Using measurements of 3 waste phases (liquid, salt cake, and sludge) obtained from tank waste samples analyzed in the laboratory, analysis of variance (ANOVA) models were used to estimate waste states for unmeasured tanks. The preliminary safety criteria are based upon calorimetry and propagation testing of likely organic compounds which represent actual tank wastes. These included sodium salts of citrate, formate, acetate and hydroxyethylethylenediaminetricetate (HEDTA). Hot cell tests of actual tank wastes are planned for the future to confirm propagation tests performed in the laboratory. The effects of draining liquids from the tanks which would remove liquids and moisture were considered because reactive waste which is too dry may propagate. Evaporation effects which could remove moisture from the tanks were also calculated. The various ways that the waste could be heated or ignited by equipment failures or tank operations activities were considered and appropriate monitoring and controls were recommended

  17. Preliminary safety criteria for organic watch list tanks at the Hanford site

    Energy Technology Data Exchange (ETDEWEB)

    Webb, A.B.; Stewart, J.L.; Turner, O.A. [Westinghouse Hanford Co., Richland, WA (United States); Plys, M.G.; Malinovic, B. [Fauske and Associates, Inc., Burr Ridge, IL (United States); Grigsby, J.M. [G & P Consulting, Inc. (United States); Camaioni, D.M.; Heasler, P.G.; Samuels, W.O.; Toth, J.J. [Pacific Northwest Lab., Portland, OR (United States)

    1995-11-01

    Condensed-phase, rapid reactions of organic salts with nitrates/nitrites in Hanford High Level Radioactive Waste single-shell tanks could lead to structural failure of the tanks resulting in significant releases of radionuclides and toxic materials. This report establishes appropriate preliminary safety criteria to ensure that tank wastes will be maintained safe. These criteria show that if actual dry wastes contain less than 1.2 MJ/kg of reactants reaction energy or less 4.5 wt % of total organic carbon, then the waste will be safe and will not propagate if ignited. Waste moisture helps to retard reactions; when waste moisture exceeds 20 wt %, rapid reactions are prevented, regardless of organic carbon concentrations. Aging and degradation of waste materials has been considered to predict the types and amounts to organic compounds present in the waste. Using measurements of 3 waste phases (liquid, salt cake, and sludge) obtained from tank waste samples analyzed in the laboratory, analysis of variance (ANOVA) models were used to estimate waste states for unmeasured tanks. The preliminary safety criteria are based upon calorimetry and propagation testing of likely organic compounds which represent actual tank wastes. These included sodium salts of citrate, formate, acetate and hydroxyethylethylenediaminetricetate (HEDTA). Hot cell tests of actual tank wastes are planned for the future to confirm propagation tests performed in the laboratory. The effects of draining liquids from the tanks which would remove liquids and moisture were considered because reactive waste which is too dry may propagate. Evaporation effects which could remove moisture from the tanks were also calculated. The various ways that the waste could be heated or ignited by equipment failures or tank operations activities were considered and appropriate monitoring and controls were recommended.

  18. Multi-Criteria Sustainability Assessment of Urban Sludge Treatment Technologies

    DEFF Research Database (Denmark)

    An, Da; Xi, Beidou; Ren, Jingzheng

    2017-01-01

    to determine the weights of the criteria for sustainability assessment, and extension theory was used to prioritize the alternative technologies for the treatment of urban sewage sludge and grade their sustainability performances. An illustrative case including three technologies (compositing, incineration...

  19. Advanced composite structures. [metal matrix composites - structural design criteria for spacecraft construction materials

    Science.gov (United States)

    1974-01-01

    A monograph is presented which establishes structural design criteria and recommends practices to ensure the design of sound composite structures, including composite-reinforced metal structures. (It does not discuss design criteria for fiber-glass composites and such advanced composite materials as beryllium wire or sapphire whiskers in a matrix material.) Although the criteria were developed for aircraft applications, they are general enough to be applicable to space vehicles and missiles as well. The monograph covers four broad areas: (1) materials, (2) design, (3) fracture control, and (4) design verification. The materials portion deals with such subjects as material system design, material design levels, and material characterization. The design portion includes panel, shell, and joint design, applied loads, internal loads, design factors, reliability, and maintainability. Fracture control includes such items as stress concentrations, service-life philosophy, and the management plan for control of fracture-related aspects of structural design using composite materials. Design verification discusses ways to prove flightworthiness.

  20. Cytological Criteria to Distinguish Phyllodes Tumour of the Breast from Fibroadenoma.

    Science.gov (United States)

    Maritz, Robert M; Michelow, Pamela M

    2017-01-01

    To determine whether there are significant differences between fibroadenomas and phyllodes tumours with regard to selected cytomorphological features. A 10-year retrospective review was performed of patients who underwent excision of a fibroadenoma or phyllodes tumour and in whom a preoperative fine-needle aspiration was performed. The following cytological criteria were assessed: number of stromal and epithelial fragments, stromal-to-epithelial ratio, stromal cellularity, stromal borders, stromal atypia, and proportion of background wavy spindled cells. Patient age, tumour laterality, and tumour size were recorded. Fifty fibroadenomas and 17 phyllodes tumours were included. Compared to phyllodes tumours, fibroadenomas had a larger number of epithelial fragments, a smaller number of stromal fragments, and a lower stromal-to-epithelial ratio. The stroma tended to be less cellular and less atypical compared to phyllodes tumours and the background cellular population contained fewer spindled cells. Fibroadenomas and phyllodes tumours differ with regard to various cytological features, aiding in their distinction on fine-needle aspiration biopsy. © 2017 S. Karger AG, Basel.

  1. Sustainability: criteria and indicators for the energy area

    International Nuclear Information System (INIS)

    Walter, F.; Gubler, F.; Brodmann, U.

    2001-01-01

    This report for the Swiss Federal Office of Energy (SFOE) presents the results of a study made on the concept of sustainability with reference to the energy area. The importance of energy topics in the fundamental ideas behind sustainability - ecological compatibility, economic efficiency and social fairness - is discussed. The methods used to define the criteria and indicators for sustainability are discussed on the basis of existing systems. >From these, criteria and indicators are proposed for the energy area, including indicators for the influence of energy on the environment, economy and society, activity-indicators and indicators for energy efficiency and politics. The system boundaries for the indicators are discussed, as are grey energy and other 'grey' effects in the environmental, economic and social areas. The various criteria, indicators and the effort needed to collect data on them are presented in table form. The report is completed with a discussion of recommendations on what is still to be done in the area, how the results of the study can be used and what actions are still to be taken

  2. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

    Directory of Open Access Journals (Sweden)

    John Tran

    2016-05-01

    Full Text Available Introduction: The National Emergency X-radiography Utilization Study (NEXUS criteria are used extensively in emergency departments to rule out C-spine injuries (CSI in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. Methods: This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. Results: We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101. The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4% cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100] with a negative predictive value of 100 (98.7-100. Conclusion: Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  3. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients.

    Science.gov (United States)

    Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K

    2016-05-01

    The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100]) with a negative predictive value of 100 (98.7-100). Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  4. Criteria for Authorship in Bioethics

    OpenAIRE

    Resnik, David B.; Master, Zubin

    2011-01-01

    Multiple authorship is becoming increasingly common in bioethics research. There are well-established criteria for authorship in empirical bioethics research but not for conceptual research. It is important to develop criteria for authorship in conceptual publications to prevent undeserved authorship and uphold standards of fairness and accountability. This article explores the issue of multiple authorship in bioethics and develops criteria for determining who should be an author on a concept...

  5. Are the criteria of Tabar and Dean still relevant to radial scar?

    Energy Technology Data Exchange (ETDEWEB)

    Boute, Veronique [Department of Senology, Centre Francois Baclesse, 14076 Caen, Cedex 5 (France); Goyat, Isabelle [Department of Senology, Centre Francois Baclesse, 14076 Caen, Cedex 5 (France); Denoux, Yves [Department of Pathology, Centre Francois Baclesse, 14076 Caen, Cedex 5 (France); Lacroix, Joelle [Department of Senology, Centre Francois Baclesse, 14076 Caen, Cedex 5 (France); Marie, Brigitte [Department of Senology, Centre Francois Baclesse, 14076 Caen, Cedex 5 (France); Michels, Jean-J. [Department of Pathology, Centre Francois Baclesse, 14076 Caen, Cedex 5 (France)]. E-mail: michels@baclesse.fr

    2006-11-15

    Objective: Aschoff's center of proliferation (ACP), poses significant problems of differential diagnosis both in imagery and histology with infiltrating carcinoma. Up to now the criteria of Tabar and Dean (classical criteria) are considered as diagnostically relevant. Material: A retrospective study of 113 cases, enabled us to study their clinical, radiological and histological aspects. Results: The ACP is a subclinical and seldom palpable entity (12%). The radiological signs of ACP are quite variable. The classical criteria lack specificity and are observed only in 48% of our stellate images. Whereas the frequency of microcalcifications is high (58.5% of the cases), their presence and their type are not predictive of an associated malignancy. The echographic diagnosis of ACP could be made in 55% of the cases but the echographic semiology lacked specificity. We noticed an associated atypical epithelial hyperplasia in 28.5% of the cases, intraductal or lobular in situ carcinoma in 9% and/or a ductal invasive carcinoma in 2% of the cases. Neither tumor size, age of the patients, nor any radiological signs were predictive of such an association. Conclusions: The classical criteria are not completely reliable and are observed only in half of our stellate images, whereas microcalcifications are often present but are not predictive of an associated malignancy.

  6. Evaluation of age and peripheral vascular disease as risk factors for ...

    African Journals Online (AJOL)

    Results: Among the 120 diabetic participants, peripheral vascular disease (PVD) was detected only in those aged 50 years and above and all the three diagnostic methods detected PVD increasingly with advancing age. Clinical criteria detected PVD in 4.7% of those aged 50-59 years and 26.3% of those aged .70years.

  7. TOKYO criteria 2014 for transpapillary biliary stenting.

    Science.gov (United States)

    Isayama, Hiroyuki; Hamada, Tsuyoshi; Yasuda, Ichiro; Itoi, Takao; Ryozawa, Shomei; Nakai, Yousuke; Kogure, Hirofumi; Koike, Kazuhiko

    2015-01-01

    It is difficult to carry out meta-analyses or to compare the results of different studies of biliary stents because there is no uniform evaluation method. Therefore, a standardized reporting system is required. We propose a new standardized system for reporting on biliary stents, the 'TOKYO criteria 2014', based on a consensus among Japanese pancreatobiliary endoscopists. Instead of stent occlusion, we use recurrent biliary obstruction, which includes occlusion and migration. The time to recurrent biliary obstruction was estimated using Kaplan-Meier analysis with the log-rank test. We can evaluate both plastic and self-expandable metallic stents (uncovered and covered). We also propose specification of the cause of recurrent biliary obstruction, identification of complications other than recurrent biliary obstruction, indication of severity, measures of technical and clinical success, and a standard for clinical care. Most importantly, the TOKYO criteria 2014 allow comparison of biliary stent quality across studies. Because blocked stents can be drained not only using transpapillary techniques but also by an endoscopic ultrasonography-guided transmural procedure, we should devise an evaluation method that includes transmural stenting in the near future. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  8. Considerations for developing seismic design criteria for nuclear waste storage repositories

    International Nuclear Information System (INIS)

    Owen, G.N.; Yanev, P.I.; Scholl, R.E.

    1980-04-01

    The function of seismic design criteria is to reduce the potential for hazards that may arise during various stages of the repository life. During the operational phase, the major concern is with the possible effects of earthquakes on surface facilities, underground facilities, and equipment. During the decommissioned phase, the major concern is with the potential effects of earthquakes on the geologic formation, which may result in a reduction in isolation capacity. Existing standards and guides or criteria used for the static and seismic design of licensed nuclear facilities were reviewed and evaluated for their applicability to repository design. This report is directed mainly toward the development of seismic design criteria for the underground structures of repositories. An initial step in the development of seismic design criteria for the underground structures of repositories is the development of performance criteria, or minimum standards of acceptable behavior. A number of possible damage modes are identified for the operating phase of the repository; however, no damage modes are foreseen that would perturb the long-term function of the repository, except for the possibility of increased permeability within the rock mass. Subsequent steps in formulating acceptable seismic design criteria for the underground structures involve the quantification of the design process. The report discusses the necessity of specifying the form of ground motion that would be needed for seismic analysis and the procedures that may be used for making ground motion predictions. Further discussions outline what is needed for analysis, including rock properties, failure criteria, modeling techniques, seismic hardening criteria for the host rock mass, and probabilistic considerations

  9. Packaging design criteria for the MCO cask

    International Nuclear Information System (INIS)

    Edwards, W.S.

    1996-01-01

    Approximately 2,100 metric tons of unprocessed, irradiated nuclear fuel elements are presently stored in the K Basins (including possibly 700 additional elements from PUREX, N Reactor, and 327 Laboratory). The basin water, particularly in the K East Basin, contains significant quantities of dissolved nuclear isotopes and radioactive fuel corrosion particles. To permit cleanup of the K Basins and fuel conditioning, the fuel will be transported from the 100 K Area to a Canister Storage Building (CSB) in the 200 East area. In order to initiate K Basin cleanup on schedule, the two-year fuel-shipping campaign must begin by December 1997. The purpose of this packaging design criteria is to provide criteria for the design, fabrication, and use of a packaging system to transport the large quantities of irradiated nuclear fuel elements positioned within Multiple Canister Overpacks

  10. Packaging Design Criteria for the MCO Cask

    International Nuclear Information System (INIS)

    FLANAGAN, B.D.

    2000-01-01

    Approximately 2,100 metric tons of unprocessed, irradiated, nuclear fuel elements are presently stored in the K Basins (including approximately 700 additional elements from the Plutonium-Uranium Extraction Plant, N Reactor, and 327 Laboratory). To permit cleanup of the K Basins and fuel conditioning, the fuel will be transported from the 100 K Area to a Canister Storage Building (CSB) in the 200 East Area. The purpose of this packaging design criteria is to provide criteria for the design, fabrication, and use of a packaging system to transport the large quantities of irradiated nuclear fuel elements positioned within Multi-canister Overpacks. Concurrent with the K Basin cleanup, 72 Shippingport Pressurized Water Reactor Core 2 fuel assemblies will be transported from T Plant to the CSB to provide space at T Plant for K Basin sludge canisters

  11. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld

    1996-01-01

    The paper is an introduction to both theory and application of combined Cost-Benefit and Multi-Criteria Analysis. The first section is devoted to basic utility theory and its practical application in Cost-Benefit Analysis. Based on some of the problems encountered, arguments in favour...... of the application of utility-based Multi-Criteria Analyses methods as an extension and refinement of the traditional Cost-Benefit Analysis are provided. The theory presented in this paper is closely related the methods used in the WARP software (Leleur & Jensen, 1989). The presentation is however wider in scope.......The second section introduces the stated preference methodology used in WARP to create weight profiles for project pool sensitivity analysis. This section includes a simple example. The third section discusses how decision makers can get a priori aid to make their pair-wise comparisons based on project pool...

  12. Comparison of Prevalence and Outcomes of Pediatric Acute Respiratory Distress Syndrome Using Pediatric Acute Lung Injury Consensus Conference Criteria and Berlin Definition

    Directory of Open Access Journals (Sweden)

    Samriti Gupta

    2018-04-01

    Full Text Available ObjectivesOur objective was to compare the prevalence and outcomes of pediatric acute respiratory distress syndrome using the Pediatric Acute Lung Injury Consensus Conference (PALICC criteria and Berlin definitions.MethodsWe screened case records of all children aged 1 month to 17 years of age admitted to the Pediatric Intensive Care Unit (PICU over a 3-year period (2015–2017 for presence of any respiratory difficulty at admission or during PICU stay. We applied both PALICC and Berlin criteria to these patients. Data collection included definition and outcome related variables. Data were compared between the “PALICC only group” and the “Berlin with or without PALICC” group using Stata 11.ResultsOf a total of 615 admissions, 246 were identified as having respiratory difficulty at admission or during PICU stay. A total of 61 children (prevalence 9.9%; 95% CI: 7.8–12.4 fulfilled the definition of acute respiratory distress syndrome (ARDS with either of the two criteria. While 60 children (98% fulfilled PALICC criteria, only 26 children (43% fulfilled Berlin definition. There was moderate agreement between the two definitions (Kappa: 0.51; 95% CI: 0.40–0.62; observed agreement 85%. Greater proportion of patients had severe ARDS in the “Berlin with or without PALICC group” as compared to the “PALICC only” group (50 vs. 19%. There was no difference between the groups with regard to key clinical outcomes such as duration of ventilation (7 vs. 8 days or mortality [51.4 vs. 57.7%: RR (95% CI: 0.99 (0.64–1.5].ConclusionIn comparison to Berlin definition, the PALICC criteria identified more number of patients with ARDS. Proportion with severe ARDS and complications was greater in the “Berlin with or without PALICC” group as compared to the “PALICC only” group. There were no differences in clinical outcomes between the groups.

  13. What constitutes evidence-based patient information? Overview of discussed criteria.

    Science.gov (United States)

    Bunge, Martina; Mühlhauser, Ingrid; Steckelberg, Anke

    2010-03-01

    To survey quality criteria for evidence-based patient information (EBPI) and to compile the evidence for the identified criteria. Databases PubMed, Cochrane Library, PsycINFO, PSYNDEX and Education Research Information Center (ERIC) were searched to update the pool of criteria for EBPI. A subsequent search aimed to identify evidence for each criterion. Only studies on health issues with cognitive outcome measures were included. Evidence for each criterion is presented using descriptive methods. 3 systematic reviews, 24 randomized-controlled studies and 1 non-systematic review were included. Presentation of numerical data, verbal presentation of risks and diagrams, graphics and charts are based on good evidence. Content of information and meta-information, loss- and gain-framing and patient-oriented outcome measures are based on ethical guidelines. There is a lack of studies on quality of evidence, pictures and drawings, patient narratives, cultural aspects, layout, language and development process. The results of this review allow specification of EBPI and may help to advance the discourse among related disciplines. Research gaps are highlighted. Findings outline the type and extent of content of EBPI, guide the presentation of information and describe the development process. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  14. Effect of age and sex on warfarin dosing

    Directory of Open Access Journals (Sweden)

    Khoury G

    2014-07-01

    Full Text Available Ghada Khoury,1 Marwan Sheikh-Taha2 1School of Pharmacy, 2Department of Pharmacy Practice, Lebanese American University, Byblos, Lebanon Objective: We examined the potential effect of sex and age on warfarin dosing in ambulatory adult patients. Methods: We conducted a retrospective chart review of patients attending an anticoagulation clinic. We included patients anticoagulated with warfarin for atrial fibrillation or venous thromboembolism who had a therapeutic international normalized ratio of 2–3 for 2 consecutive months. We excluded patients who had been on any drug that is known to have a major interaction with warfarin, smokers, and heavy alcohol consumers. Out of 340 screened medical records, 96 met the predetermined inclusion criteria. The primary outcome assessed was warfarin total weekly dose (TWD. Results: There was a statistically significant difference in the TWD among the ages (P<0.01; older patients required lower doses. However there was no statistically significant difference in the TWD between sexes (P=0.281. Conclusion: Age was found to have a significant effect on warfarin dosing. Even though women did require a lower TWD than men, this observation was not statistically significant. Keywords: warfarin, INR, anticoagulation, vitamin K antagonists, age

  15. Multi-criteria model to support decision-making for the remediation of urban areas

    International Nuclear Information System (INIS)

    De Luca, Christiano; Lopes, Ricardo T.; Silva, Diogo N.G.; Guimaraes, Jean R.D.

    2015-01-01

    Under the environmental modeling Project of radioecology research area of IRD (CNEN), several tools have been developed to support post-emergency activities. Currently, a multi-criteria model is in development with the aim of supporting decision-making processes under the radiological protection point of view. At this stage, we are focusing on the decontamination of urban areas. The model includes five calculation modules: (1) averted doses to the public due to remediation procedures; (2) occupational exposure of remediation workers; (3) properties of the wastes generated by a remediation procedure; (4) classification of each procedure for a specific urban scenario based on previously calculated quantities; and, (5) multi-criteria rank calculation. The classification of procedures is based on two types of criteria previously defined, both also included as input data of the model. The first type, called Subjective Criteria, is based on experts' opinions collected through questionnaires. The second type, called Technical Criteria, is calculated according to the outputs of the three first modules of the program. The output of the model is a rank order list indicating the priority of procedures to use for each different type of urban environment. The use of results based on criteria and methods developed previously to the occurrence of a contamination event intends not only to provide an input to decision-making processes but also to improve public confidence on authorities responsible for the remediation decisions. (author)

  16. Multi-criteria model to support decision-making for the remediation of urban areas

    Energy Technology Data Exchange (ETDEWEB)

    De Luca, Christiano; Lopes, Ricardo T., E-mail: christiano_luca@hotmail.com, E-mail: ricardo@lin.ufrj.br [Coordenacao dos Programas de Pos-Graduacao em Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Rochedo, Elaine R.R., E-mail: elainerochedo@gmail.com [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Silva, Diogo N.G.; Guimaraes, Jean R.D., E-mail: diogons@gmail.com, E-mail: jeanrdg@biof.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Biofisica Carlos Chagas Filho; Rochedo, Pedro R.R., E-mail: rochedopedro@gmail.com [Coordenacao dos Programas de Pos-Graduacao em Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de de Planejamento Energetico; Wasserman, Maria Angelica V., E-mail: mwasserman@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2015-07-01

    Under the environmental modeling Project of radioecology research area of IRD (CNEN), several tools have been developed to support post-emergency activities. Currently, a multi-criteria model is in development with the aim of supporting decision-making processes under the radiological protection point of view. At this stage, we are focusing on the decontamination of urban areas. The model includes five calculation modules: (1) averted doses to the public due to remediation procedures; (2) occupational exposure of remediation workers; (3) properties of the wastes generated by a remediation procedure; (4) classification of each procedure for a specific urban scenario based on previously calculated quantities; and, (5) multi-criteria rank calculation. The classification of procedures is based on two types of criteria previously defined, both also included as input data of the model. The first type, called Subjective Criteria, is based on experts' opinions collected through questionnaires. The second type, called Technical Criteria, is calculated according to the outputs of the three first modules of the program. The output of the model is a rank order list indicating the priority of procedures to use for each different type of urban environment. The use of results based on criteria and methods developed previously to the occurrence of a contamination event intends not only to provide an input to decision-making processes but also to improve public confidence on authorities responsible for the remediation decisions. (author)

  17. Lability criteria for metal complexes in micro-electrode voltammetry

    NARCIS (Netherlands)

    Leeuwen, van H.P.; Pinheiro, J.P.

    1999-01-01

    Theoretical expressions are derived for the voltammetric lability criteria of metal complexes in the micro-electrode regime. The treatment includes three limiting situations: (i) the macro-electrode limit, where both the diffusion layer and the dissociation reaction layer are linear; (ii) an

  18. Criteria for genuine N -partite continuous-variable entanglement and Einstein-Podolsky-Rosen steering

    Science.gov (United States)

    Teh, R. Y.; Reid, M. D.

    2014-12-01

    Following previous work, we distinguish between genuine N -partite entanglement and full N -partite inseparability. Accordingly, we derive criteria to detect genuine multipartite entanglement using continuous-variable (position and momentum) measurements. Our criteria are similar but different to those based on the van Loock-Furusawa inequalities, which detect full N -partite inseparability. We explain how the criteria can be used to detect the genuine N -partite entanglement of continuous variable states generated from squeezed and vacuum state inputs, including the continuous-variable Greenberger-Horne-Zeilinger state, with explicit predictions for up to N =9 . This makes our work accessible to experiment. For N =3 , we also present criteria for tripartite Einstein-Podolsky-Rosen (EPR) steering. These criteria provide a means to demonstrate a genuine three-party EPR paradox, in which any single party is steerable by the remaining two parties.

  19. Nevada Test Site Waste Acceptance Criteria (NTSWAC), Rev. 7-01

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Management

    2009-05-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, Nevada Test Site Waste Acceptance Criteria (NTSWAC). The NTSWAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NTSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex for disposal.

  20. Nevada Test Site Waste Acceptance Criteria (NTSWAC), Rev. 7-01

    International Nuclear Information System (INIS)

    2009-01-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, Nevada Test Site Waste Acceptance Criteria (NTSWAC). The NTSWAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NTSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex for disposal.

  1. Criteria procedure development for tender in construction design

    Directory of Open Access Journals (Sweden)

    Malykha Galina Gennad’evna

    Full Text Available This article deals with the problem of criteria optimization in order to objectively evaluate the experience of an applicant (a project organization and the quality of a design product (project documentation. The methodology to be developed is based on introduction of new evaluation criteria (sub-criteria that in conjunction with the applicable criteria specified by the Law on the Contract System will allow developing the optimal procedure to evaluate competitive bids of the participants in tenders and determining the most appropriate candidate, with whom the contract will be further concluded. The article analyzes the existing criteria and their interaction with each other and describes the specifics of tenders for design in the form of open competition. The list decreases to three criteria, such as "contract price", "quality, functional and environmental characteristics of a procurement facility", "qualification of procurement participants, including availability of financial resources, equipment and other material resources necessary for the execution of the contract material resources, the presence of goodwill, professionals and other employees of a certain experience level". However, in order to upgrade the quality of assurance procedures for the design works to be performed, it was decided to apply new evaluation criteria (sub-criteria components, such as "availability of positive findings of the state out-of-departmental examination that are similar to the subject of competition, on a participant in placement of order", "availability of the certificate on approval of architectural and urban planning decisions that are similar to the subject of competition, on a participant in placement of order", "availability of the permit for the commissioning of facilities that are similar to the subject of competition, on a participant in placement of order", "availability of the contract for designer's supervision with a participant in placement of

  2. Characteristics of binge eating disorder in relation to diagnostic criteria

    Science.gov (United States)

    Wilfley, Denise E; Citrome, Leslie; Herman, Barry K

    2016-01-01

    The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria. PMID:27621631

  3. Controlling criteria for radiation exposure of astronauts and space workers

    International Nuclear Information System (INIS)

    Katoh, Kazuaki

    1989-01-01

    Space workers likely to suffer from radiation exposure in the outer space are currently limited to the U.S. and Soviet Union, and only a small amount of data and information is available concerning the techniques and criteria for control of radiation exposure in this field. Criteria used in the Soviet Union are described first. The criteria (TRS-75), called the Radiation Safety Criteria for Space Navigation, are tentative ones set up in 1975. They are based on risk assessment. The standard radiation levels are established based on unit flight time: 50rem for 1 month, 80rem for 3 months, 110rem for 6 months and 150rem for 12 months. These are largely different from the emergency exposure limit of 100mSv (10rem) specified in a Japanese law, and the standard annual exposure value of 50mSv (5rem) for workers in nuclear power plants at normal times. For the U.S., J.A. Angelo, Jr., presented a paper titled 'Radiation Protection Issues and Techniques concerning Extended Manned Space Missions' at an IAEA meeting held in 1988. Though the criteria shown in the paper are not formal ones at the national level, similar criteria are expected to be adopted by the nation in the near future. The exposure limits recommended in the paper include a depth dose of 1-4Sv for the whole life span of a worker. (Nogami, K.)

  4. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Brian E. Lacy

    2017-10-01

    Full Text Available Functional gastrointestinal disorders (FGIDs account for at least 40% of all referrals to gastroenterologists. Of the 33 recognized adult FGIDs, irritable bowel syndrome (IBS is the most prevalent, with a worldwide prevalence estimated at 12%. IBS is an important health care concern as it greatly affects patients’ quality of life and imposes a significant economic burden to the health care system. Cardinal symptoms of IBS include abdominal pain and altered bowel habits. The absence of abdominal pain makes the diagnosis of IBS untenable. The diagnosis of IBS can be made by performing a careful review of the patient’s symptoms, taking a thoughtful history (e.g., diet, medication, medical, surgical, and psychological history, evaluating the patient for the presence of warning signs (e.g., “red flags” of anemia, hematochezia, unintentional weight loss, or a family history of colorectal cancer or inflammatory bowel disease, performing a guided physical examination, and using the Rome IV criteria. The Rome criteria were developed by a panel of international experts in the field of functional gastrointestinal disorders. Although initially developed to guide researchers, these criteria have undergone several revisions with the intent of making them clinically useful and relevant. This monograph provides a brief overview on the development of the Rome criteria, discusses the utility of the Rome IV criteria, and reviews how the criteria can be applied clinically to diagnose IBS. In addition, a diagnostic strategy for the cost-effective diagnosis of IBS will be reviewed.

  5. Ulcerative colitis: criteria and methods of prognosis of exacerbation

    Directory of Open Access Journals (Sweden)

    Kashkina E.l.

    2014-09-01

    Full Text Available Objective: research is devoted to the development of criteria and methods for prognosis of the next recurrence of exacerbation of ulcerative colitis (UC after the patient discharged from hospital. Material and Methods: During a period of a year 38 patients with UC were supervised. The criteria used in the prognosis of recurrence included results of the evaluation of quality of life (SF-36 questionnaire, the analysis of the autonomic nervous system (coefficient Hildebrant and Kerdo index and the level of stressful load procedure Holmes-Rage. Results. It has been established that the risk factors for recurrence include low quality of life on the scale of RP, SF and MH SF-36, the coefficient Hildebrant >5.6 units, Kerdo index 314 points. Conclusion: The obtained data have been processed by multivariate mathematical statistics and the obtained analytical expression allows to prognose the time of recurrence of ulcerative colitis.

  6. [The impact of broadened diagnostic criteria on the prevalence of hypertension, hyperlipidemia and diabetes mellitus in China].

    Science.gov (United States)

    Hu, X F; Han, X R; Yang, Z Y; Hu, Y H; Tang, J L

    2017-05-06

    Objective: The burden of chronic disease has been continuously increasing in China since the early 1980s. Besides the worsening of risk factors, the change in diagnostic criteria is very likely an important explanation for the increase in the prevalence of hypertension, hyperlipidemia and diabetes mellitus, three commonest, major chronic conditions that can lead to major vascular events and deaths. This study aims to estimate the contribution of changes in diagnostic criteria to the increase in the prevalence of the three conditions in China. Methods: The data from two representative nation-wide surveys in China in 2002 and 2009, with 145 254 and 8 813 adults included respectively, were used to estimate the prevalence rate of the three conditions and the proportion attributable to the change in diagnostic criteria around year 2000. The new and old cutoff values for hypertension, hyperlipidemia, and hyperglycemia were 140/90 and 160/95 mmHg (1 mmHg=0.133 kPa), 5.7 and 6.2 mmol/L, and 7.0 and 7.8 mmol/L, respectively. The prevalence was standardized according to the distribution of age, sex and rural-urban residence of the 2000 national census of the country so as to compare between the old and new diagnostic criteria and project the situation for the entire country. Results: The standardized prevalence of hypertension, hyperlipidemia, and diabetes mellitus for the entire Chinese adult population in 2002 was 8.21%, 1.71% and 1.43% according to the immediate previous diagnostic criteria, and 19.18%, 3.53% and 2.66% according to the new criteria. In 2009, the prevalence was 11.89%, 9.34% and 4.29% according to the old criteria, and 24.78%, 18.36% and 6.55% according to the new criteria. The total cumulative prevalence of the three conditions was increased by 124% in 2002 and 95% in 2009 as a result of change in diagnostic criteria. Put it differently, the change in diagnostic criteria increased the number of the three conditions from 2002 to 2009 by approximately 359

  7. Genetic parameter estimates for carcass traits and visual scores including or not genomic information.

    Science.gov (United States)

    Gordo, D G M; Espigolan, R; Tonussi, R L; Júnior, G A F; Bresolin, T; Magalhães, A F Braga; Feitosa, F L; Baldi, F; Carvalheiro, R; Tonhati, H; de Oliveira, H N; Chardulo, L A L; de Albuquerque, L G

    2016-05-01

    The objective of this study was to determine whether visual scores used as selection criteria in Nellore breeding programs are effective indicators of carcass traits measured after slaughter. Additionally, this study evaluated the effect of different structures of the relationship matrix ( and ) on the estimation of genetic parameters and on the prediction accuracy of breeding values. There were 13,524 animals for visual scores of conformation (CS), finishing precocity (FP), and muscling (MS) and 1,753, 1,747, and 1,564 for LM area (LMA), backfat thickness (BF), and HCW, respectively. Of these, 1,566 animals were genotyped using a high-density panel containing 777,962 SNP. Six analyses were performed using multitrait animal models, each including the 3 visual scores and 1 carcass trait. For the visual scores, the model included direct additive genetic and residual random effects and the fixed effects of contemporary group (defined by year of birth, management group at yearling, and farm) and the linear effect of age of animal at yearling. The same model was used for the carcass traits, replacing the effect of age of animal at yearling with the linear effect of age of animal at slaughter. The variance and covariance components were estimated by the REML method in analyses using the numerator relationship matrix () or combining the genomic and the numerator relationship matrices (). The heritability estimates for the visual scores obtained with the 2 methods were similar and of moderate magnitude (0.23-0.34), indicating that these traits should response to direct selection. The heritabilities for LMA, BF, and HCW were 0.13, 0.07, and 0.17, respectively, using matrix and 0.29, 0.16, and 0.23, respectively, using matrix . The genetic correlations between the visual scores and carcass traits were positive, and higher correlations were generally obtained when matrix was used. Considering the difficulties and cost of measuring carcass traits postmortem, visual scores of

  8. Diagnosis of Tuberculosis Following World Health Organization–Recommended Criteria in Severely Malnourished Children Presenting With Pneumonia

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Faruque, Abu Syed Golam; Bardhan, Pradip Kumar; Ahmed, Tahmeed

    2017-01-01

    Evidences on diagnosis of tuberculosis (TB) following the World Health Organization (WHO) criteria in children with severe acute malnutrition (SAM) are lacking. We sought to evaluate the WHO criteria for the diagnosis of TB in such children. In this prospective study, we enrolled SAM children aged <5 with radiological pneumonia. We collected induced sputum and gastric lavage for smear microscopy, mycobacterial culture, and Xpert MTB/RIF. Using the last 2 methods as the gold standard, we determined sensitivity, specificity, and positive and negative predictive values of WHO criteria (n = 388). However, Xpert MTB/RIF was performed on the last 214 children. Compared to mycobacterial culture–confirmed TB, sensitivity and specificity (95% confidence interval) of WHO criteria were 40 (14% to 73%) and 84 (80% to 87%), respectively. Compared to culture- and/or Xpert MTB/RIF-confirmed TB, the values were 22% (9% to 43%) and 83 (79% to 87%), respectively. Thus, the good specificity of the WHO criteria may help minimize overtreatment with anti-TB therapy in SAM children, especially in resource-limited settings. PMID:28229100

  9. Diagnosis of Tuberculosis Following World Health Organization–Recommended Criteria in Severely Malnourished Children Presenting With Pneumonia

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti MBBS, MMed, PhD

    2017-01-01

    Full Text Available Evidences on diagnosis of tuberculosis (TB following the World Health Organization (WHO criteria in children with severe acute malnutrition (SAM are lacking. We sought to evaluate the WHO criteria for the diagnosis of TB in such children. In this prospective study, we enrolled SAM children aged <5 with radiological pneumonia. We collected induced sputum and gastric lavage for smear microscopy, mycobacterial culture, and Xpert MTB/RIF. Using the last 2 methods as the gold standard, we determined sensitivity, specificity, and positive and negative predictive values of WHO criteria (n = 388. However, Xpert MTB/RIF was performed on the last 214 children. Compared to mycobacterial culture–confirmed TB, sensitivity and specificity (95% confidence interval of WHO criteria were 40 (14% to 73% and 84 (80% to 87%, respectively. Compared to culture- and/or Xpert MTB/RIF-confirmed TB, the values were 22% (9% to 43% and 83 (79% to 87%, respectively. Thus, the good specificity of the WHO criteria may help minimize overtreatment with anti-TB therapy in SAM children, especially in resource-limited settings.

  10. Diagnosis of Tuberculosis Following World Health Organization-Recommended Criteria in Severely Malnourished Children Presenting With Pneumonia.

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Shahid, Abu S M S B; Shahunja, K M; Das, Sumon Kumar; Faruque, Abu Syed Golam; Bardhan, Pradip Kumar; Ahmed, Tahmeed

    2017-01-01

    Evidences on diagnosis of tuberculosis (TB) following the World Health Organization (WHO) criteria in children with severe acute malnutrition (SAM) are lacking. We sought to evaluate the WHO criteria for the diagnosis of TB in such children. In this prospective study, we enrolled SAM children aged <5 with radiological pneumonia. We collected induced sputum and gastric lavage for smear microscopy, mycobacterial culture, and Xpert MTB/RIF. Using the last 2 methods as the gold standard, we determined sensitivity, specificity, and positive and negative predictive values of WHO criteria (n = 388). However, Xpert MTB/RIF was performed on the last 214 children. Compared to mycobacterial culture-confirmed TB, sensitivity and specificity (95% confidence interval) of WHO criteria were 40 (14% to 73%) and 84 (80% to 87%), respectively. Compared to culture- and/or Xpert MTB/RIF-confirmed TB, the values were 22% (9% to 43%) and 83 (79% to 87%), respectively. Thus, the good specificity of the WHO criteria may help minimize overtreatment with anti-TB therapy in SAM children, especially in resource-limited settings.

  11. The assessment of the spondyloarthritis international society concept and criteria for the classification of axial spondyloarthritis and peripheral spondyloarthritis: A critical appraisal for the pediatric rheumatologist

    Directory of Open Access Journals (Sweden)

    Burgos-Vargas Ruben

    2012-05-01

    Full Text Available Abstract This review refers to the origin and current state of the assessment of the SpondyloArthritis International Society (ASAS criteria for the classification of axial and peripheral spondyloarthritis (SpA and the possible implications in the pediatric population. The ASAS criteria evolved from the idea that the earlier the recognition of patients with ankylosing spondylitis, the better the efficacy of tumor necrosis factor blockers. Strategies included the development of new concepts, definitions, and techniques for the study of clinical signs and symptoms. Of relevance, the new definition of inflammatory back pain (IBP and the introduction of sacroiliitis by magnetic resonance imaging represented the most important advance in the early identification of AS in the “pre-radiographic stage” of the disease. AS is considered in this paper as a disease continuum with symptoms depending on age at onset. The application of those specific strategies in children and adolescents with SpA seems limited because the most important manifestation in the early stage of disease is not IBP, but peripheral arthritis and enthesitis. In this instance, the logical approach to juvenile onset SpA according to ASAS criteria should not be through the axial criteria but rather the peripheral set of criteria.

  12. Multi-Criteria Analysis for Solar Farm Location Suitability

    Science.gov (United States)

    Mierzwiak, Michal; Calka, Beata

    2017-12-01

    Currently the number of solar farms, as a type of renewable sources of energy, is growing rapidly. Photovoltaic power stations have many advantages, which is an incentive for their building and development. Solar energy is readily available and inexhaustible, and its production is environmentally friendly. In the present study multiple environmental and economic criteria were taken into account to select a potential photovoltaic farm location, with particular emphasis on: protected areas, land cover, solar radiation, slope angle, proximity to roads, built-up areas, and power lines. Advanced data analysis were used because of the multiplicity of criteria and their diverse influence on the choice of a potential location. They included the spatial analysis, the Weighted Linear Combination Technique (WLC), and the Analytic Hierarchy Process (AHP) as a decisionmaking method. The analysis was divided into two stages. In the first one, the areas where the location of solar farms was not possible were excluded. In the second one, the best locations meeting all environmental and economic criteria were selected. The research was conducted for the Legionowo District, using data from national surveying and mapping resources such as: BDOT10k (Database of Topographic Objects), NMT (Numerical Terrain Model), and lands and buildings register. Finally, several areas meeting the criteria were chosen. The research deals with solar farms with up to 40 kW power. The results of the study are presented as thematic maps. The advantage of the method is its versatility. It can be used not only for any area, but with little modification of the criteria, it can also be applied to choose a location for wind farms.

  13. Multiple criteria decision making with life cycle assessment for material selection of composites

    Directory of Open Access Journals (Sweden)

    A. S. Milani

    2011-12-01

    Full Text Available With the advancement of interdisciplinary approaches in today’s modern engineering, current efforts in optimal design of composites include seeking material selection protocols that can (1 simultaneously consider a series of mechanical/electrical/chemical cost criteria over a set of alternative material options, and (2 closely take into account environmental aspects of final products including recycling and end-of-life disposal options. In this paper, in addition to a review of some recent experimental and methodological advances in the above areas, a new application of multiple criteria decision making (MCDM is presented to deal with decision conflicts often seen among design criteria in composite material selection with the help of life cycle assessment (LCA. To show the application, an illustrative case study on a plastic gear material selection is conducted where the cost, mechanical and thermal properties along with environmental impact criteria are to be satisfied simultaneously. A pure plastic gear is compared to a Polyethylene terephthalate (PET/aluminum-powder composite alternative. Results suggest that simple MCDM models, including a signal-to-noise measure adapted to MCDM in the same case study, can be used to explore both trade-offs and design break-even points in large decision spaces as the decision maker’s perspective over environmental, material performance and cost attributes change during the design process. More advanced topics including the account of material data uncertainties are addressed.

  14. Challenges of multimorbidity of the aging brain: a critical update.

    Science.gov (United States)

    Jellinger, Kurt A; Attems, Johannes

    2015-04-01

    A major problem in elderly patients is the high incidence of multiple pathologies, referred to as multimorbidity, in the aging brain. It has been increasingly recognized that co-occurrence of neurodegenerative proteinopathies and other pathologies including cerebrovascular disorders is a frequent event in the brains of both cognitively intact and impaired aged subjects. Although clinical and neuropathological diagnostic criteria of the major neurodegenerative diseases have been improved, major challenges arise from cerebral multimorbidity, and the thresholds to cause clinical overt dementia are ill defined. More than 80% of aged human brains show neurodegenerative non-Alzheimer type proteinopathies and other pathologies which, however, frequently have been missed clinically and are even difficult to identify at neuropathological examination. Autopsy studies differ in selection criteria and the applied evaluation methods. Therefore, irrespective of the clinical symptoms, the frequency of cerebral pathologies vary considerably: Alzheimer-related pathology is seen in 19-100%, with "pure" Alzheimer's disease (AD) in 17-72%, Lewy pathology in 6-39% (AD + Lewy disease 9-28%), vascular pathologies in 28-93% (10.7-78% "pure" vascular dementia), TDP-43 proteinopathy in 6-39%, hippocampal sclerosis in 8-1%, and mixed pathologies in 10-93%. These data clearly suggest that pathologically deposited proteins in neurodegenerating diseases mutually interact and are influenced by other factors, in particular cardiovascular and cerebrovascular ones, to promote cognitive decline and other clinical symptoms. It is obvious that cognitive and other neuropsychiatric impairment in the aged result from a multimorbid condition in the CNS rather than from a single disease and that the number of complex pathologies progresses with increasing age. These facts have implications for improvement of the clinical diagnosis and prognosis, the development of specific biomarkers, preventive strategies

  15. Photovoltaic module certification/laboratory accreditation criteria development: Implementation handbook

    Energy Technology Data Exchange (ETDEWEB)

    Osterwald, C.R. [National Renewable Energy Laboratory, Golden, CO (United States); Hammond, R.L.; Wood, B.D.; Backus, C.E.; Sears, R.L. [Arizona State Univ., Tempe, AZ (United States); Zerlaut, G.A. [SC-International, Inc., Tempe, AZ (United States); D`Aiello, R.V. [RD Associates, Tempe, AZ (United States)

    1996-08-01

    This document covers the second phase of a two-part program. Phase I provided an overview of the structure and function of typical product certification/laboratory accreditation programs. This report (Phase H) provides most of the draft documents that will be necessary for the implementation of a photovoltaic (PV) module certification/laboratory accreditation program. These include organizational documents such as articles of incorporation, bylaws, and rules of procedure, as well as marketing and educational program documents. In Phase I, a 30-member criteria development committee was established to guide, review and reach a majority consensus regarding criteria for a PV certification/laboratory accreditation program. Committee members represented PV manufacturers, end users, standards and codes organizations, and testing laboratories. A similar committee was established for Phase II; the criteria implementation committee consisted of 29 members. Twenty-one of the Phase I committee members also served on the Phase II committee, which helped to provide program continuity during Phase II.

  16. Implementation of Subjective Cognitive Decline criteria in research studies

    Science.gov (United States)

    Molinuevo, José L; Rabin, Laura A.; Amariglio, Rebecca; Buckley, Rachel; Dubois, Bruno; Ellis, Kathryn A.; Ewers, Michael; Hampel, Harald; Klöppel, Stefan; Rami, Lorena; Reisberg, Barry; Saykin, Andrew J.; Sikkes, Sietske; Smart, Colette M.; Snitz, Beth E.; Sperling, Reisa; van der Flier, Wiesje M.; Wagner, Michael; Jessen, Frank

    2017-01-01

    INTRODUCTION Subjective Cognitive Decline (SCD) manifesting prior to clinical impairment could serve as a target population for early intervention trials in Alzheimer’s disease (AD). A working group, the Subjective Cognitive Decline Initiative (SCD-I), published SCD research criteria in the context of preclinical AD. To successfully apply them, a number of issues regarding assessment and implementation of SCD needed to be addressed. METHODS Members of the SCD-I met to identify and agree upon topics relevant to SCD criteria operationalization in research settings. Initial ideas and recommendations were discussed with other SCD-I working group members and modified accordingly. RESULTS Topics included SCD inclusion and exclusion criteria, together with the informant’s role in defining SCD presence and the impact of demographic factors. DISCUSSION Recommendations for the operationalization of SCD in differing research settings, with the aim of harmonization of SCD measurement across studies are proposed, to enhance comparability and generalizability across studies. PMID:27825022

  17. Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using DSM-IV-TR and DSM-5 Criteria.

    Science.gov (United States)

    Harstad, Elizabeth B; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J

    2015-05-01

    Controversy exists regarding the DSM-5 criteria for ASD. This study tested the psychometric properties of the DSM-5 model and determined how well it performed across different gender, IQ, and DSM-IV-TR sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70). DSM-5 was psychometrically superior to the DSM-IV-TR model (Comparative Fit Index of 0.970 vs 0.879, respectively). Measurement invariance revealed good model fit across gender and IQ. Younger children tended to meet fewer diagnostic criteria. Those with autistic disorder were more likely to meet social communication and repetitive behaviors criteria (p < .001) than those with PDD-NOS. DSM-5 is a robust model but will identify a different, albeit overlapping population of individuals compared to DSM-IV-TR.

  18. Performance criteria for solidified high-level radioactive wastes. Environmental impact statement. Revision 1

    International Nuclear Information System (INIS)

    1977-09-01

    This draft Environmental Impact Statement on performance criteria for solidified high-level radioactive wastes (PCSHLW) covers: considerations for PCSHLW development, the proposed rulemaking, characteristics of the PCSHLW, environmental impacts of the proposed PCSHLW, alternatives to the PCSHLW criteria, and cost/benefit/risk evaluation. Five appendices are included to support the technical data required in the Environmental Impact Statement

  19. National Recommended Water Quality Criteria

    Data.gov (United States)

    U.S. Environmental Protection Agency — The National Recommended Water Quality Criteria is a compilation of national recommended water quality criteria for the protection of aquatic life and human health...

  20. Effect of maternal age on the risk of preterm birth: A large cohort study.

    Science.gov (United States)

    Fuchs, Florent; Monet, Barbara; Ducruet, Thierry; Chaillet, Nils; Audibert, Francois

    2018-01-01

    Maternal age at pregnancy is increasing worldwide as well as preterm birth. However, the association between prematurity and advanced maternal age remains controversial. To evaluate the impact of maternal age on the occurrence of preterm birth after controlling for multiple known confounders in a large birth cohort. Retrospective cohort study using data from the QUARISMA study, a large Canadian randomized controlled trial, which collected data from 184,000 births in 32 hospitals. Inclusion criteria were maternal age over 20 years. Exclusion criteria were multiple pregnancy, fetal malformation and intra-uterine fetal death. Five maternal age categories were defined and compared for maternal characteristics, gestational and obstetric complications, and risk factors for prematurity. Risk factors for preterm birth births were included in the study. Chronic hypertension, assisted reproduction techniques, pre-gestational diabetes, invasive procedure in pregnancy, gestational diabetes and placenta praevia were linearly associated with increasing maternal age whereas hypertensive disorders of pregnancy followed a "U" shaped distribution according to maternal age. Crude rates of preterm birth before 37 weeks followed a "U" shaped curve with a nadir at 5.7% for the group of 30-34 years. In multivariate analysis, the adjusted odds ratio (aOR) of prematurity stratified by age group followed a "U" shaped distribution with an aOR of 1.08 (95%CI; 1.01-1.15) for 20-24 years, and 1.20 (95% CI; 1.06-1.36) for 40 years and older. Confounders found to have the greatest impact were placenta praevia, hypertensive complications, and maternal medical history. Even after adjustment for confounders, advanced maternal age (40 years and over) was associated with preterm birth. A maternal age of 30-34 years was associated with the lowest risk of prematurity.

  1. Multi-material topology design of laminates with strength criteria

    DEFF Research Database (Denmark)

    Lund, Erik

    2012-01-01

    The objective of this paper is to present a novel approach for multi-material topology optimization of laminated composite structures where strength constraints are taken into account together with other global structural performance measures. The topology design problem considered contains very...... many design variables, and when strength criteria are included in the problem, a very large number of criteria functions must be considered in the optimization problem to be solved. Thus, block aggregation methods are introduced, such that global strength measures are obtained. These formulations...... are illustrated for multi-material laminated design problems where the maximum failure index is minimized while compliance and mass constraints are taken into account....

  2. Expanded criteria donor kidneys for younger recipients: acceptable outcomes.

    Science.gov (United States)

    Goplani, K R; Kute, V B; Vanikar, A V; Shah, P R; Gumber, M R; Patel, H V; Modi, P R; Trivedi, H L

    2010-12-01

    European senior programme (ESP) is well known for acceptable outcomes using expanded criteria donor (ECD) kidneys from donors older than 65 years for recipients older than 65 years. The incidence of end-stage renal disease (ESRD) is 229/million in India with a mean age of 45 years. We performed a retrospective analysis of transplantation of ECD versus standard criteria donor (SCD) kidneys into younger recipients. Forty-three ECD transplantations among 158 deceased donor organ transplantation (DDOT) were performed between January 2006 and December 2009. Among 43 transplantation from 30 donors, 14 were dual kidney transplantations (DKT) performed based upon biopsy evaluation. All recipients received thymoglobulin (rATG) induction followed by immunosuppression with a steroid, mycophenolate mofetil (MMF), and a calcineurin inhibitor. Statistical analysis used chi-square test and unpaired Student t test. Kaplan-Meier curves were used for survival analysis. For ECD the mean donor age was 64 ± 11 years. Cerebrovascular accidents (CVA) were the cause of death among 60% of donors, 73.13% of whom were hypertensive and 23.13% diabetic. Mean DKT donor age was 75 ± 9.17 years versus 60 ± 8.0 years for single kidney transplantation (SKT). Mean recipient age of DKT versus SKT was 44 ± 12.4 years versus 43 ± 14 years. Mean serum creatinine (SCr; mg/dL) of SKT patients was 1.64 ± 0.75 versus 1.68 ± 0.46 in DKT. Mean follow-up was 455 ± 352 days. Mean SCr of 43 ECD recipients of mean age, 43.4 ± 14.2 years was 1.61 ± 0.61 mg/dL. Among 43 recipients, 23.25% were diabetic, 41.86% displayed delayed graft function (DGF), and 23.25% experienced biopsy-proven acute rejection (BPAR). Patient survival rate was 72.09% and graft survival rate was 67.44%. For SCD transplantations (n = 115), the mean donor age was 36 ± 14 years and recipient mean age was 32.8 ± 14.07 years. Mean SCr was 1.32 ± 0.46 mg/dL with 26.95% recipients displaying DGF, whereas 20.86% had BPAR. In the SCD

  3. 46 CFR 385.51 - Criteria: Projects.

    Science.gov (United States)

    2010-10-01

    ... results; (iii) The extent of the problems treated and whether the objectives sought by the undertaking are... MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MISCELLANEOUS RESEARCH AND DEVELOPMENT GRANT AND COOPERATIVE AGREEMENTS REGULATIONS Criteria for Award § 385.51 Criteria: Projects. The criteria to be used by...

  4. Multi-criteria sustainability assessment: A tool for evaluation of new energy system

    Directory of Open Access Journals (Sweden)

    Afgan Naim H.

    2007-01-01

    Full Text Available One of perspective methods for the evaluation of quality of energy system is the multi-criteria sustainability assessment, based on the analysis and synthesis of indicators expressing different aspects of the system. Application of this methodology in the cases of information deficiency (ASPID methodology enables evaluation of various energy systems. In the paper, the multi-criteria sustainability assessment of energy systems of various energy sources is used to evaluate the energy power system of Bosnia and Herzegovina. Eight different energy system options are taken into a consideration as the potential options for the capacity building within the energy power system of Bosnia and Herzegovina. It has included various renewable sources and fossil fuel clean technologies. Within the multi-criteria sustainability assessment method, sustainability indicators and weighting coefficients are defined and calculated, including: resource indicator, environment indicator, social indicator and economic indicator with respective weighting factors. The methodology includes the system of stochastic models of uncertainty in order to realize the assessment from various supporting systems, and to obtain respective normalization indexes by using non-numeric (ordinal, non-exact (interval, and non-complete information (NNN- information, for sources of various reliability and probability. By the analysis of multi-criteria sustainability assessment of selected options, the decision makers could be enabled to form opinion on quality of considered energy systems, and from the aspect of sustainability, make selection an optimum option of energy system. .

  5. Criteria for saturated magnetization loop

    International Nuclear Information System (INIS)

    Harres, A.; Mikhov, M.; Skumryev, V.; Andrade, A.M.H. de; Schmidt, J.E.; Geshev, J.

    2016-01-01

    Proper estimation of magnetization curve parameters is vital in studying magnetic systems. In the present article, criteria for discrimination non-saturated (minor) from saturated (major) hysteresis loops are proposed. These employ the analysis of (i) derivatives of both ascending and descending branches of the loop, (ii) remanent magnetization curves, and (iii) thermomagnetic curves. Computational simulations are used in order to demonstrate their validity. Examples illustrating the applicability of these criteria to well-known real systems, namely Fe_3O_4 and Ni fine particles, are provided. We demonstrate that the anisotropy-field value estimated from a visual examination of an only apparently major hysteresis loop could be more than two times lower than the real one. - Highlights: • Proper estimation of hysteresis-loop parameters is vital in magnetic studies. • We propose criteria for discrimination minor from major hysteresis loops. • The criteria analyze magnetization, remanence and ZFC/FC curves and/or their derivatives. • Examples of their application on real nanoparticles systems are given. • Using the criteria could avoid twofold or bigger saturation-field underestimation errors.

  6. Criteria for saturated magnetization loop

    Energy Technology Data Exchange (ETDEWEB)

    Harres, A. [Departamento de Física, UFSM, Santa Maria, 97105-900 Rio Grande do Sul (Brazil); Mikhov, M. [Faculty of Physics, University of Sofia, 1164 Sofia (Bulgaria); Skumryev, V. [Institució Catalana de Recerca i Estudis Avançats, 08010 Barcelona (Spain); Departament de Física, Universitat Autònoma de Barcelona, 08193 Barcelona (Spain); Andrade, A.M.H. de; Schmidt, J.E. [Instituto de Física, UFRGS, Porto Alegre, 91501-970 Rio Grande do Sul (Brazil); Geshev, J., E-mail: julian@if.ufrgs.br [Departament de Física, Universitat Autònoma de Barcelona, 08193 Barcelona (Spain); Instituto de Física, UFRGS, Porto Alegre, 91501-970 Rio Grande do Sul (Brazil)

    2016-03-15

    Proper estimation of magnetization curve parameters is vital in studying magnetic systems. In the present article, criteria for discrimination non-saturated (minor) from saturated (major) hysteresis loops are proposed. These employ the analysis of (i) derivatives of both ascending and descending branches of the loop, (ii) remanent magnetization curves, and (iii) thermomagnetic curves. Computational simulations are used in order to demonstrate their validity. Examples illustrating the applicability of these criteria to well-known real systems, namely Fe{sub 3}O{sub 4} and Ni fine particles, are provided. We demonstrate that the anisotropy-field value estimated from a visual examination of an only apparently major hysteresis loop could be more than two times lower than the real one. - Highlights: • Proper estimation of hysteresis-loop parameters is vital in magnetic studies. • We propose criteria for discrimination minor from major hysteresis loops. • The criteria analyze magnetization, remanence and ZFC/FC curves and/or their derivatives. • Examples of their application on real nanoparticles systems are given. • Using the criteria could avoid twofold or bigger saturation-field underestimation errors.

  7. [Acromegaly features in the aging population].

    Science.gov (United States)

    Anoun, Nadia; El Ouahabi, Hanan

    2017-01-01

    Somatotroph adenomas are rare in the aging population. Diagnosis of somatotroph adenomas is often long delayed and they are characterized by atypical clinical picture. Their diagnostic criteria are similar to those used for younger patients. Surgery, if possible, is the treatment of choice for acromegaly in the elderly. Somatostatin analogues have shown to be effective in these patients. Prognosis is inversely correlated with patient's age, duration of disease and last GH level under treatment. Beside evolution of disease, age is a major determinant of mortality. We report three cases of elderly patients with acromegaly aged 75, 70 and 66 years respectively with a literature review.

  8. A critical review of "Internet addiction" criteria with suggestions for the future.

    Science.gov (United States)

    Van Rooij, Antonius J; Prause, Nicole

    2014-12-01

    In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome. Three popular models of IA were discussed: Griffith’s components model; Young’s Internet Addiction Test (IAT); and the criteria by Tao et al. (2010). We selected these models because they are widely cited and propose specific criteria for IA disorder. Our approach is not meant to provide an exhaustive review, but to discuss and critique the most salient trends in the field. The models of Internet addiction share some criteria, including feeling a loss of control over Internet use; ensuing psychological, social, or professional conflict or problems; and preoccupation when not using the Internet. Other criteria inconsistently mentioned include: mood management, tolerance, withdrawal, and craving/anticipation. The models studied here share the assumption that the Internet can produce a qualitative shift to a diseased state in humans. We critically discussed the above criteria and concluded that the evidence base is currently not strong enough to provide support for an Internet addiction disorder. Future research areas are suggested: (1) Focusing on common impaired dimensions, (2) exploring neuroimaging as a model building tool, and (3) identifying shifts in the rewarding aspects of Internet use. Given the lack of consensus on the subject of Internet addiction, a focus on problem behaviors appears warranted.

  9. 45 CFR 1176.3 - Criteria.

    Science.gov (United States)

    2010-10-01

    ... ENDOWMENT FOR THE HUMANITIES PART-TIME CAREER EMPLOYMENT § 1176.3 Criteria. Positions becoming vacant... to part-time. Among the criteria which may be used when conducting this review are: (a) Mission...

  10. Working Towards Unified Safety Design Criteria for Modular High Temperature Gas-cooled Reactor Designs

    International Nuclear Information System (INIS)

    Reitsma, Frederik; Silady, Fred; Kunitomi, Kazuhiko

    2014-01-01

    The Nuclear Power Development Section of the IAEA recently received approval for a Coordinated Research Project (CRP) to investigate and make proposals on modular High Temperature Gas-cooled Reactor (HTGR) Safety design criteria. It is expected that these criteria would consider past experience and existing safety standards in the light of modular HTGR material and design characteristics to propose safety design criteria. It will consider the deterministic and risk-informed safety design standards that apply to the wide spectrum of Off- normal events under development worldwide for existing and planned HTGRs. The CRP would also take into account lessons from the Fukushima Daiichi accident, clarifying the safety approach and safety evaluation criteria for design and beyond design basis events, including those events that can affect multiple reactor modules and/or are dependent on the application proximate to the plant site. (e. g., industrial process steam/heat). The logical flow of criteria is from the fundamental inherent safety characteristics of modular HTGRs and associated expected performance characteristics, to the safety functions required to ensure those characteristics during the wide spectrum of Off-normal events, and finally to specific criteria related to those functions. This is detailed in the paper with specific examples included of how it may be applied. The results of the CRP will be made available to the member states and HTGR community. (author)

  11. Multi-criteria ACO-based Algorithm for Ship’s Trajectory Planning

    Directory of Open Access Journals (Sweden)

    Agnieszka Lazarowska

    2017-03-01

    Full Text Available The paper presents a new approach for solving a path planning problem for ships in the environment with static and dynamic obstacles. The algorithm utilizes a heuristic method, classified to the group of Swarm Intelligence approaches, called the Ant Colony Optimization. The method is inspired by a collective behaviour of ant colonies. A group of agents - artificial ants searches through the solution space in order to find a safe, optimal trajectory for a ship. The problem is considered as a multi-criteria optimization task. The criteria taken into account during problem solving are: path safety, path length, the International Regulations for Preventing Collisions at Sea (COLREGs compliance and path smoothness. The paper includes the description of the new multi-criteria ACO-based algorithm along with the presentation and discussion of simulation tests results.

  12. 10 CFR 905.36 - Marketing criteria.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Marketing criteria. 905.36 Section 905.36 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.36 Marketing criteria. Western shall retain applicable provisions of existing marketing criteria for projects where...

  13. Establishing criteria for human mesenchymal stem cell potency.

    Science.gov (United States)

    Samsonraj, Rebekah M; Rai, Bina; Sathiyanathan, Padmapriya; Puan, Kia Joo; Rötzschke, Olaf; Hui, James H; Raghunath, Michael; Stanton, Lawrence W; Nurcombe, Victor; Cool, Simon M

    2015-06-01

    This study sought to identify critical determinants of mesenchymal stem cell (MSC) potency using in vitro and in vivo attributes of cells isolated from the bone marrow of age- and sex-matched donors. Adherence to plastic was not indicative of potency, yet capacity for long-term expansion in vitro varied considerably between donors, allowing the grouping of MSCs from the donors into either those with high-growth capacity or low-growth capacity. Using this grouping strategy, high-growth capacity MSCs were smaller in size, had greater colony-forming efficiency, and had longer telomeres. Cell-surface biomarker analysis revealed that the International Society for Cellular Therapy (ISCT) criteria did not distinguish between high-growth capacity and low-growth capacity MSCs, whereas STRO-1 and platelet-derived growth factor receptor alpha were preferentially expressed on high-growth capacity MSCs. These cells also had the highest mean expression of the mRNA transcripts TWIST-1 and DERMO-1. Irrespective of these differences, both groups of donor MSCs produced similar levels of key growth factors and cytokines involved in tissue regeneration and were capable of multilineage differentiation. However, high-growth capacity MSCs produced approximately double the volume of mineralized tissue compared to low-growth capacity MSCs when assessed for ectopic bone-forming ability. The additional phenotypic criteria presented in this study when combined with the existing ISCT minimum criteria and working proposal will permit an improved assessment of MSC potency and provide a basis for establishing the quality of MSCs prior to their therapeutic application. © 2015 AlphaMed Press.

  14. Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

    Science.gov (United States)

    Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

    2016-04-01

    More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our

  15. Surrogate Endpoint Evaluation: Principal Stratification Criteria and the Prentice Definition.

    Science.gov (United States)

    Gilbert, Peter B; Gabriel, Erin E; Huang, Ying; Chan, Ivan S F

    2015-09-01

    A common problem of interest within a randomized clinical trial is the evaluation of an inexpensive response endpoint as a valid surrogate endpoint for a clinical endpoint, where a chief purpose of a valid surrogate is to provide a way to make correct inferences on clinical treatment effects in future studies without needing to collect the clinical endpoint data. Within the principal stratification framework for addressing this problem based on data from a single randomized clinical efficacy trial, a variety of definitions and criteria for a good surrogate endpoint have been proposed, all based on or closely related to the "principal effects" or "causal effect predictiveness (CEP)" surface. We discuss CEP-based criteria for a useful surrogate endpoint, including (1) the meaning and relative importance of proposed criteria including average causal necessity (ACN), average causal sufficiency (ACS), and large clinical effect modification; (2) the relationship between these criteria and the Prentice definition of a valid surrogate endpoint; and (3) the relationship between these criteria and the consistency criterion (i.e., assurance against the "surrogate paradox"). This includes the result that ACN plus a strong version of ACS generally do not imply the Prentice definition nor the consistency criterion, but they do have these implications in special cases. Moreover, the converse does not hold except in a special case with a binary candidate surrogate. The results highlight that assumptions about the treatment effect on the clinical endpoint before the candidate surrogate is measured are influential for the ability to draw conclusions about the Prentice definition or consistency. In addition, we emphasize that in some scenarios that occur commonly in practice, the principal strata sub-populations for inference are identifiable from the observable data, in which cases the principal stratification framework has relatively high utility for the purpose of effect

  16. Surrogate Endpoint Evaluation: Principal Stratification Criteria and the Prentice Definition

    Science.gov (United States)

    Gilbert, Peter B.; Gabriel, Erin E.; Huang, Ying; Chan, Ivan S.F.

    2015-01-01

    A common problem of interest within a randomized clinical trial is the evaluation of an inexpensive response endpoint as a valid surrogate endpoint for a clinical endpoint, where a chief purpose of a valid surrogate is to provide a way to make correct inferences on clinical treatment effects in future studies without needing to collect the clinical endpoint data. Within the principal stratification framework for addressing this problem based on data from a single randomized clinical efficacy trial, a variety of definitions and criteria for a good surrogate endpoint have been proposed, all based on or closely related to the “principal effects” or “causal effect predictiveness (CEP)” surface. We discuss CEP-based criteria for a useful surrogate endpoint, including (1) the meaning and relative importance of proposed criteria including average causal necessity (ACN), average causal sufficiency (ACS), and large clinical effect modification; (2) the relationship between these criteria and the Prentice definition of a valid surrogate endpoint; and (3) the relationship between these criteria and the consistency criterion (i.e., assurance against the “surrogate paradox”). This includes the result that ACN plus a strong version of ACS generally do not imply the Prentice definition nor the consistency criterion, but they do have these implications in special cases. Moreover, the converse does not hold except in a special case with a binary candidate surrogate. The results highlight that assumptions about the treatment effect on the clinical endpoint before the candidate surrogate is measured are influential for the ability to draw conclusions about the Prentice definition or consistency. In addition, we emphasize that in some scenarios that occur commonly in practice, the principal strata sub-populations for inference are identifiable from the observable data, in which cases the principal stratification framework has relatively high utility for the purpose of

  17. End-of-waste criteria for waste plastic for conversion. Technical proposals.

    OpenAIRE

    VILLANUEVA KRZYZANIAK Alejandro; EDER Peter

    2014-01-01

    This report is the JRC-IPTS contribution to the development of the end-of-waste criteria for waste plastic in accordance with Article 6 of Directive 2008/98/EC of the European Parliament and of the Council on waste (the Waste Framework Directive). This report includes a possible set of end-of-waste criteria and shows how the proposals were developed based on a comprehensive techno-economic analysis of the waste plastic production chain and an analysis of the economic, environmental and le...

  18. Brief Report: Investigating the Implications of Applying the New DSM-5 Criteria for Diagnosing Autism Spectrum Disorder in a Preschool Population in Singapore

    Science.gov (United States)

    Wong, Chui Mae; Koh, Hwan Cui

    2016-01-01

    Diagnostic reports for 206 children who underwent an assessment for autism spectrum disorder (ASD) using the DSM-IV-TR criteria, were re-evaluated using the DSM-5 criteria. Mean age of the children at time of diagnosis was 3 years 10 months. Of the 202 children diagnosed with ASD on the DSM-IV-TR, 184 (91.1%) also met the DSM-5 criteria for ASD.…

  19. Age and gender differences in mate selection criteria for various involvement levels

    NARCIS (Netherlands)

    Buunk, Abraham (Bram); Dijkstra, Pieternel; Fetchenhauer, D.; Kenrick, D.T.

    The present study investigated mate preferences for five different levels of relationship involvement-marriage, serious relationship, falling in love, casual sex, and sexual fantasies-among individuals of 20, 30, 40, 50, and 60 years of age. Consistent with an evolutionary perspective, men preferred

  20. User-Centric Multi-Criteria Information Retrieval

    Science.gov (United States)

    Wolfe, Shawn R.; Zhang, Yi

    2009-01-01

    Information retrieval models usually represent content only, and not other considerations, such as authority, cost, and recency. How could multiple criteria be utilized in information retrieval, and how would it affect the results? In our experiments, using multiple user-centric criteria always produced better results than a single criteria.

  1. Potentially inappropriate medicines in elderly hospitalised patients according to the EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol.

    Science.gov (United States)

    Mucalo, Iva; Hadžiabdić, Maja Ortner; Brajković, Andrea; Lukić, Sonja; Marić, Patricia; Marinović, Ivana; Bačić-Vrca, Vesna

    2017-08-01

    The aim of this study was to measure the prevalence of potentially inappropriate medications (PIMs) by using the EU(7)-PIM list, STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) version 2 criteria and the new comprehensive protocol. This prospective study involved a sample of 276 consecutive elderly patients discharged from the university teaching hospital. Age, gender, diagnoses, medication history and medicines at discharge were recorded. The main outcome measure was the prevalence of PIMs according to each set of criteria: EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol. The median patient age (range) was 74 (65-92) years. The median number of prescribed medications was 7 (1-17). STOPP identified 393 PIMs affecting 190 patients (69%), EU(7)-PIM list identified 330 PIMs in 184 patients (66.7%) whilst the comprehensive protocol identified 134 PIMs in 102 patients (37%). STOPP version 2 criteria identified significantly more PIMs per patient than the other two protocols (p comprehensive protocol and was found as a more sensitive tool for PIM detection.

  2. VSNL1 Co-expression networks in aging include calcium signaling, synaptic plasticity, and Alzheimer’s disease pathways

    Directory of Open Access Journals (Sweden)

    C W Lin

    2015-03-01

    Full Text Available The Visinin-like 1 (VSNL1 gene encodes Visinin-like protein 1, a peripheral biomarker for Alzheimer disease (AD. Little is known, however, about normal VSNL1 expression in brain and the biologic networks in which it participates. Frontal cortex gray matter from 209 subjects without neurodegenerative or psychiatric illness, ranging in age from 16–91, were processed on Affymetrix GeneChip 1.1 ST and Human SNP Array 6.0. VSNL1 expression was unaffected by age and sex, and not significantly associated with SNPs in cis or trans. VSNL1 was significantly co-expressed with genes in pathways for Calcium Signaling, AD, Long Term Potentiation, Long Term Depression, and Trafficking of AMPA Receptors. The association with AD was driven, in part, by correlation with amyloid precursor protein (APP expression. These findings provide an unbiased link between VSNL1 and molecular mechanisms of AD, including pathways implicated in synaptic pathology in AD. Whether APP may drive increased VSNL1 expression, VSNL1 drives increased APP expression, or both are downstream of common pathogenic regulators will need to be evaluated in model systems.

  3. Donor Smoking and Older Age Increases Morbidity and Mortality After Lung Transplantation

    DEFF Research Database (Denmark)

    Schultz, H H; Møller, C H; Zemtsovski, M

    2017-01-01

    survival as well as CLAD-free survival was significantly lower with donors ≥55 years. CONCLUSIONS: Donor smoking history and older donor age impact lung function, mortality, and CLAD-free survival after transplantation. Because of a shortage of organs, extended donor criteria may be considered while taking......BACKGROUND: The lack of lung transplant donors has necessitated the use of donors with a smoking history and donors of older age. We have evaluated the effects of donor smoking history and age on recipient morbidity and mortality with baseline values of pulmonary function and survival free...... of chronic lung allograft dysfunction (CLAD) as morbidity variables. METHODS: This is a retrospective analysis of 588 consecutive lung transplant recipients and their corresponding 454 donors. Donors were divided into three groups: group 1 included smokers, group 2 nonsmokers, and group 3 had unknown smoking...

  4. Application of diagnostics to determine operational readiness of aged motor-operated valves

    International Nuclear Information System (INIS)

    Eissenberg, D.M.

    1987-01-01

    Oak Ridge National Laboratory (ORNL) has been carrying out an aging assessment of motor-operated valves (MOVs) with the primary objective of recommending diagnostic methods for detecting and trending aging. As a result of experimental investigations at ORNL, it was discovered that the motor current during a valve stroke was a very useful diagnostic parameter for detecting and trending many MOV drive train load variations. The motor current signatures were analyzed at four levels: mean value for a stroke, gross trends during a stroke, transients, and noise frequency spectra. Examples illustrating the use of this technique are presented. The use of motor current signature analysis was also shown to apply to other electric motor driven equipment. Future work includes developing a data base of MOV diagnostics, including criteria for determining the extent of degradation and application of the technique to other LWR motor driven safety equipment

  5. Criteria for operator review of workplace changes

    International Nuclear Information System (INIS)

    Davey, E.

    2000-01-01

    A set of criteria for reviewing workplace changes has been developed for use by plant Operations staff. The criteria were developed to provide Operations staff with a practical framework for structuring assessments and subsequent review comments with regard to control room modifications and innovations that impact their work environment. The criteria were assembled from design, operations and human factors engineering principles, and system review experiences with plant Operations staff over the past ten years. Operations staff at several CANDU stations helped shape the emphasis for initial criteria definition and have assisted with criteria refinement through trial applications. Use of the criteria is expected to lead to more effective and task relevant equipment evaluations by Operations staff, and ultimately lead to system modifications and innovations that better serve plant operation needs. The paper begins with a discussion of the rationale for criteria development and the attributes of 'good' design. The balance of the paper outlines the project objectives, describes the approach applied in assembling, structuring, and refining the review criteria, and illustrates the application of the criteria in the review of a proposed control room innovation. (author)

  6. Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study.

    Science.gov (United States)

    La Marca, Antonio; Grisendi, Valentina; Giulini, Simone; Sighinolfi, Giovanna; Tirelli, Alessandra; Argento, Cindy; Re, Claudia; Tagliasacchi, Daniela; Marsella, Tiziana; Sunkara, Sesh Kamal

    2015-06-01

    to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.

  7. Cognitive functioning and its influence on sexual behavior in normal aging and dementia.

    Science.gov (United States)

    Hartmans, Carien; Comijs, Hannie; Jonker, Cees

    2014-05-01

    Motivational aspects, emotional factors, and cognition, all of which require intact cognitive functioning may be essential in sexual functioning. However, little is known about the association between cognitive functioning and sexual behavior. The aim of this article is to review the current evidence for the influence of cognitive functioning on sexual behavior in normal aging and dementia. A systematic literature search was conducted in PubMed, Ovid, Cochrane, and PsycINFO databases. The databases were searched for English language papers focusing on human studies published relating cognitive functioning to sexual behavior in the aging population. Keywords included sexual behavior, sexuality, cognitive functioning, healthy elderly, elderly, aging and dementia. Eight studies fulfilled our inclusion criteria. Of these studies, five included dementia patients and/or their partners, whereas only three studies included healthy older persons. Although not consistently, results indicated a trend that older people who are not demented and continue to engage in sexual activity have better overall cognitive functioning. Cognitive decline and dementia seem to be associated with diminished sexual behavior in older persons. The association between cognitive functioning and sexual behavior in the aging population is understudied. The results found are inconclusive. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Quality criteria for chest X-ray image

    International Nuclear Information System (INIS)

    Krieg, R.

    1985-01-01

    A distinction has to be made between invariable and variable criteria in the determination of chest X-ray picture quality criteria. The invariable criteria are defined by the properties of the object and the psychophysiological laws of perception and cognition, and the variable criteria are determined by the prevailing state of the art of technology. An agreement on these criteria is based on the knowledge of the nature and the technical conditions of X-ray picture production and reproduction. The slogan 'the best picture at the lowest dose' dominates, too, the discussion centering around the X-ray picture of the chest, its quality and criteria. (orig./MG) [de

  9. Assessing screening criteria for the radiocarbon dating of bone mineral

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Ricardo, E-mail: ldv1452@gmail.com [Leibniz Labor for Isotopic and Radiometric Dating, Max-Eyth-Str. 11-13, 24118 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany); Huels, Matthias [Leibniz Labor for Isotopic and Radiometric Dating, Max-Eyth-Str. 11-13, 24118 Kiel (Germany); Nadeau, Marie-Josee; Grootes, Pieter M. [Leibniz Labor for Isotopic and Radiometric Dating, Max-Eyth-Str. 11-13, 24118 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany); Garbe-Schoenberg, C.-Dieter [Institute of Geosciences, Marine Climate Research and ICPMS Lab, Kiel University, Ludewig-Meyn-Str. 10, D-24118 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany); Hollund, Hege I. [Institute for Geo- and Bioarchaeology, The VU University, De Boelelaan 1085, 1081 HV Amsterdam (Netherlands); Lotnyk, Andriy [Faculty of Engineering, Institute for Material Science, Synthesis and Real Structure, Kiel University, Kaiserstr. 2, D-24143 Kiel (Germany); Leibniz Institute of Surface Modification (IOM), Permoserstr. 15, D-04318 Leipzig (Germany); Kienle, Lorenz [Faculty of Engineering, Institute for Material Science, Synthesis and Real Structure, Kiel University, Kaiserstr. 2, D-24143 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany)

    2013-01-15

    Radiocarbon dating of bone mineral (carbonate in the apatite lattice) has been the target of sporadic research for the last 40 years. Results obtained by different decontamination protocols have, however, failed to provide a consistent agreement with reference ages. In particular, quality criteria to assess bone mineral radiocarbon dating reliability are still lacking. Systematic research was undertaken to identify optimal preservation criteria for bone mineral in archeological bones. Six human long bones, originating from a single site, were radiocarbon-dated both for collagen and apatite, with the level of agreement between the dates providing an indication of exogenous carbon contamination. Several techniques (Histology, FTIR, TEM, LA-ICP-MS) were employed to determine the preservation status of each sample. Research results highlight the importance of a micro-scale approach in establishing bone preservation, in particular the use of trace element concentration profiles demonstrated its potential use as a viable sample selection criterion for bone carbonate radiocarbon dating.

  10. Clustering economies based on multiple criteria decision making techniques

    Directory of Open Access Journals (Sweden)

    Mansour Momeni

    2011-10-01

    Full Text Available One of the primary concerns on many countries is to determine different important factors affecting economic growth. In this paper, we study some factors such as unemployment rate, inflation ratio, population growth, average annual income, etc to cluster different countries. The proposed model of this paper uses analytical hierarchy process (AHP to prioritize the criteria and then uses a K-mean technique to cluster 59 countries based on the ranked criteria into four groups. The first group includes countries with high standards such as Germany and Japan. In the second cluster, there are some developing countries with relatively good economic growth such as Saudi Arabia and Iran. The third cluster belongs to countries with faster rates of growth compared with the countries located in the second group such as China, India and Mexico. Finally, the fourth cluster includes countries with relatively very low rates of growth such as Jordan, Mali, Niger, etc.

  11. Lifestyle patterns in early pregnancy linked to gestational diabetes mellitus diagnoses when using IADPSG criteria. The St Carlos gestational study.

    Science.gov (United States)

    Ruiz-Gracia, Teresa; Duran, Alejandra; Fuentes, Manuel; Rubio, Miguel A; Runkle, Isabelle; Carrera, Evelyn F; Torrejón, María J; Bordiú, Elena; Valle, Laura Del; García de la Torre, Nuria; Bedia, Ana R; Montañez, Carmen; Familiar, Cristina; Calle-Pascual, Alfonso L

    2016-06-01

    Early-pregnancy lifestyle (EPL) could influence the development of gestational diabetes mellitus(GDM), depending on the diagnostic criteria used. We studied EPL in 1750 pregnant women using Carpenter-Coustan criteria(CCc), and in 1526 with the International Association of Diabetes and Pregnancy Study Groups criteria(IADPSGc). GDM risk factors were assessed in women between 24 and 28 weeks of gestational age during two consecutive years. A semiquantitative frequent-food-consumption questionnaire was used to evaluate lifestyle during pregnancy. Multiple logistic regression analysis was conducted to assess GDM risk with different lifestyle patterns. Using IADPSGc, the GDM ORs (95%CI) for intake/week were: nuts >3 times: 0.59 (0.39-0.91; p < 0.015), refined cereals ≤1 serving: 0.72(0.58-0.89; p < 0.003), juices <4 servings: 0.77 (0.62-0.95; p < 0.017), cookies and pastries <4 servings: 0.71(0.57-0.89; p < 0.003) as compared to opposite habits. No significant nutritional patterns were found to be significant using CCc. The OR (95%CI) for GDM with none of the four risk patterns as compared to having three-four risk factors was 0.21(0.07-0.62; p < 0.005), remaining significant after stratification by BMI, age, obstetric events, parity and family history. The multiple logistic regression model including nutritional categories and pregestational BMI, age, obstetric history, parity, personal/family history, had an area under the curve(AUC) of the receiver operating curve(ROC) for the probability to predict GDM of 0.66 (CI 95%: 0.63-0.69; p < 0.001). Our study is the first to identify four early-pregnancy nutritional patterns associated with the GDM when using IADPSGc. Adherence to a low-risk nutritional pattern from early pregnancy on could be an effective strategy for GDM prevention. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  12. CCS site characterisation criteria

    Energy Technology Data Exchange (ETDEWEB)

    Bachu, S.; Hawkes, C.; Lawton, D.; Pooladi-Darvish, M.; Perkins, E.

    2009-12-15

    IEA GHG recently commissioned the Alberta Research Counil in Canada to conduct a review of storage site selection criteria and site characterisation methods in order to produce a synthesis report. This report reviews the literature on the subject on the site seleciton and characterisation since the publication of the IPCC Special Report on CCS, and provides a synthesis and classification of criteria. 161 refs.

  13. Proceedings of the workshop on structural design criteria for HTR

    International Nuclear Information System (INIS)

    Breitbach, G.; Schubert, F.; Nickel, H.

    1989-04-01

    The papers demonstrate the status of high temperature reactor technology with regard to its realization in the nuclear power industry of various countries (FRG, USA, Japan) as well as to the development of safety rules in Germany. The design criteria for HTR could be presented. The criteria already determine definitely and almost completely the relevant requirements of the component rules. The informations include the technical boundary conditions with regard to safety, the metallic high temperature components, a particular section dealing with the reactor pressure vessel, especially with the prestressed concrete vessel, and the structural graphite components. (DG)

  14. A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients.

    Science.gov (United States)

    Armstrong, James; Forrest, Helen; Crawford, Mark W

    2015-10-01

    Discharge criteria based on physiological scoring systems can be used in the postanesthesia care unit (PACU) to fast-track patients after ambulatory surgery; however, studies comparing physiological scoring systems with traditional time-based discharge criteria are lacking. The purpose of this study was to compare PACU discharge readiness times using physiological vs time-based discharge criteria in pediatric ambulatory surgical patients. We recorded physiological observations from consecutive American Society of Anesthesiologists physical status I-III patients aged 1-18 yr who were admitted to the PACU after undergoing ambulatory surgery in a tertiary academic pediatric hospital. The physiological score was a combination of the Aldrete and Chung systems. Scores were recorded every 15 min starting upon arrival in the PACU. Patients were considered fit for discharge once they attained a score ≥12 (maximum score, 14), provided no score was zero, with the time to achieve a score ≥12 defining the criteria-based discharge (CBD) time. Patients were discharged from the PACU when both the CBD and the existing time-based discharge (TBD) criteria were met. The CBD and TBD data were compared using Kaplan-Meier and log-rank analysis. Observations from 506 children are presented. Median (interquartile range [IQR]) age was 5.5 [2.8-9.9] yr. Median [IQR] CBD and TBD PACU discharge readiness times were 30 [15-45] min and 60 [45-60] min, respectively. Analysis of Kaplan-Meier curves indicated a significant difference in discharge times using the different criteria (hazard ratio, 5.43; 95% confidence interval, 4.51 to 6.53; P < 0.001). All patients were discharged home without incident. This prospective study suggests that discharge decisions based on physiological criteria have the potential for significantly speeding the transit of children through the PACU, thereby enhancing PACU efficiency and resource utilization.

  15. Aging management of reactor internals and license renewal of US PWR plants

    Energy Technology Data Exchange (ETDEWEB)

    Tang, H. T. [Electric Power Research Institute, EPRI, 3420 Hillview Avenue, Palo Alto, California 94304 (United States)

    2006-09-15

    Age-related degradation mechanisms of key components are subject to aging management review by utilities considering plant license renewal. The management of aging effects in PWR internals must be demonstrated as specified in the US NRC Standard Review. The US NRC staff has also issued a Generic Aging Lessons Learned (GALL) report that documents the staff's basis for determining when existing generic programs are adequate to manage aging without change and when existing generic programs should be augmented for license renewal. The EPRI Materials Reliability Program (MRP) has been conducting studies to develop technical bases and guidelines to support aging management of PWR internals, with a particular attention to utility License Renewal commitments. The strategic approach taken by the MRP includes: developing an overall aging management framework, defining degradation mechanism screening values, categorizing and ranking internals components based on screening, performing functionality analyses and safety evaluation, and developing inspection and evaluation guidelines associated with each category of components. Screening criteria are developed for the following potential internals degradation mechanisms: - Stress Corrosion Cracking [Excluding Irradiation Effects]; - Irradiation-Assisted Stress Corrosion Cracking; - Thermal Aging Embrittlement; - Irradiation Embrittlement; - Void Swelling; - Stress Relaxation and Creep [Irradiation-enhanced]; - Wear; - Fatigue. The ranking and categorization calls to bin internals components into four categories: - Category A: component items for which aging degradation significance is minimal and aging effects are below the screening criteria; - Category C: 'lead' component items for which aging degradation significance is high or moderate and aging effects are above screening levels; - Category B: component items above screening levels but are not 'lead' component items and aging degradation significance

  16. Impact of 2015 Update to the Beers Criteria on Estimates of Prevalence and Costs Associated with Potentially Inappropriate Use of Antimuscarinics for Overactive Bladder.

    Science.gov (United States)

    Suehs, Brandon T; Davis, Cralen; Ng, Daniel B; Gooch, Katherine

    2017-07-01

    Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB). A retrospective database analysis was conducted using a historical cohort design and including data collected between 2007 and 2013. Claims data were used to identify Medicare Advantage patients aged ≥65 years newly initiated on antimuscarinic OAB treatment. Patients were classified with potentially inappropriate use of antimuscarinic OAB drugs based on either the 2012 Beers Criteria or the 2015 Beers Criteria. Prevalence of PIM at the time of antimuscarinic initiation was determined. Bivariate comparisons of healthcare costs and medical condition burden were conducted to compare the marginal groups of patients (who qualified based on the 2012 Beers Criteria only or the 2015 Beers Criteria only). Differences in healthcare costs for patients with and without potentially inappropriate use of urinary antimuscarinics based on the 2012 and 2015 Beers Criteria were also examined. Of 66,275 patients, overall prevalence of potentially inappropriate use of OAB antimuscarinics was higher using 2015 Beers Criteria than when using the 2012 Beers Criteria (25.0 vs. 20.6%). Dementia was the most common PIM-qualifying condition under both versions. The 2015 Beers Criteria identified more females, more White people, and a younger population with PIM. Comorbid medical condition burden was lower using the 2015 Beers Criteria. The 2015 Beers Criteria only group had lower median unadjusted healthcare costs ($7104 vs. 8301; p cost associated with potentially inappropriate use of antimuscarinic

  17. AgeFactDB—the JenAge Ageing Factor Database—towards data integration in ageing research

    Science.gov (United States)

    Hühne, Rolf; Thalheim, Torsten; Sühnel, Jürgen

    2014-01-01

    AgeFactDB (http://agefactdb.jenage.de) is a database aimed at the collection and integration of ageing phenotype data including lifespan information. Ageing factors are considered to be genes, chemical compounds or other factors such as dietary restriction, whose action results in a changed lifespan or another ageing phenotype. Any information related to the effects of ageing factors is called an observation and is presented on observation pages. To provide concise access to the complete information for a particular ageing factor, corresponding observations are also summarized on ageing factor pages. In a first step, ageing-related data were primarily taken from existing databases such as the Ageing Gene Database—GenAge, the Lifespan Observations Database and the Dietary Restriction Gene Database—GenDR. In addition, we have started to include new ageing-related information. Based on homology data taken from the HomoloGene Database, AgeFactDB also provides observation and ageing factor pages of genes that are homologous to known ageing-related genes. These homologues are considered as candidate or putative ageing-related genes. AgeFactDB offers a variety of search and browse options, and also allows the download of ageing factor or observation lists in TSV, CSV and XML formats. PMID:24217911

  18. Qualification criteria for persons responsible for radiation protection

    International Nuclear Information System (INIS)

    Wehner, G

    1980-01-01

    A survey of the qualification criteria included in the German atomic law (Atomic Energy Act, Radiological Protection Ordinance and X-ray Protection Ordinance) for persons responsible for radiation protection is given. Especially the various activities for which a health physics officer is required, the range of qualification in each case and the way the qualification has to be proved, are pointed out. Also the different guides that are issued to complete the legal requirements are mentioned. The definitions of the term qualification for health physics given in the different guides are cited and it is shown, that the qualification of a healt physics officer has to be based on the three criteria (I) vocational training. (II) professional experience and (III) the necessary knowledge in radiation protection. (orig./HP) [de

  19. Risk assessment of soil contamination criteria

    International Nuclear Information System (INIS)

    King, C.M.; Marter, W.L.; Montaque, D.F.; Holton, G.A.

    1987-06-01

    Criteria have been developed to select radioactive and nonradioactive contaminants at waste sites detailed analysis and risk assessment. These criteria were based on soil and water quality guidelines developed by various government agencies to determine if the criteria were appropriate. We performed a risk assessment of a hypothetical site which contained radioactive and nonradioactive contaminants at levels equal to the criteria values. Risks to the public from atmospheric, surface water, and groundwater exposure pathways were examined. Health risks to the public from atmospheric releases of radioactive and nonradioactive materials from a waste at soil criteria contamination levels are low. Health risks to the maximally exposed individual to chemical carcinogens are considerably below traditional EPA action levels. And health risks to the maximally exposed individual to atmospherically released radioactive contaminants is 1.88 x 10 -7 , more than a factor of 5 less than 10 -6 . Based on our atmospheric exposure pathways analysis and risk assessment, the applied soil criteria are appropriate for screening out unimportant risk contributors to human health from atmospheric exposure pathways. 13 refs., 3 figs., 7 tabs

  20. Utilization of advanced-age donors in renal transplantation.

    Science.gov (United States)

    Olaverri, J G; Mora Christian, J; Elorrieta, P; Esnaola, K; Rodríguez, P; Marrón, I; Uriarte, I; Landa, M J; Zarraga, S; Gainza, F J; Aranzabal, J; Zabala, J A; Pertusa, C

    2011-11-01

    The shortage of organ availability in recent years has made it necessary to use grafts from advanced-aged donors to maintain the rate of renal transplantation in our country. The objective of this study was to evaluate the graft function and patient survival using kidneys from deceased donors of over 65 year of age. From 2005 until 2010, we compared the outcomes of patients who received grafts from donors over 65 years old vs less than 65 years. We observed no significant difference in sex, time on dialysis, or cold ischemia time between the groups. As expected the recipient age was significantly different. For the analysis of survival, we used the Tablecloth-Haenzel test and the Kaplan-Meier survival estimator. Actuarial survivals at 3 years after transplantation showed 84.8% among patients transplanted with kidneys from donors over 65 years old versus 97.5% in the control group. The graft survival was 78.8% among expanded criteria versus 86.85% in the control group. When we analyzed graft survival using an "exitus-censured" analysis, we obtained graft survivals of 89.1% in the expanded criteria kidney group versus 88.6% among the controls. We concluded that the use of kidney from donors over 65 years of age allows us to increase the rate of renal transplantation to about 15 to 20 per million population, with good graft and patient survivals provided that the protocol for expanded criteria organs ensured proper macroscopic and microscopic evaluation of the organ for transplantation. Copyright © 2011. Published by Elsevier Inc.

  1. Perspectives on the revised Ghent criteria for the diagnosis of Marfan syndrome

    Science.gov (United States)

    von Kodolitsch, Yskert; De Backer, Julie; Schüler, Helke; Bannas, Peter; Behzadi, Cyrus; Bernhardt, Alexander M; Hillebrand, Mathias; Fuisting, Bettina; Sheikhzadeh, Sara; Rybczynski, Meike; Kölbel, Tilo; Püschel, Klaus; Blankenberg, Stefan; Robinson, Peter N

    2015-01-01

    Three international nosologies have been proposed for the diagnosis of Marfan syndrome (MFS): the Berlin nosology in 1988; the Ghent nosology in 1996 (Ghent-1); and the revised Ghent nosology in 2010 (Ghent-2). We reviewed the literature and discussed the challenges and concepts of diagnosing MFS in adults. Ghent-1 proposed more stringent clinical criteria, which led to the confirmation of MFS in only 32%–53% of patients formerly diagnosed with MFS according to the Berlin nosology. Conversely, both the Ghent-1 and Ghent-2 nosologies diagnosed MFS, and both yielded similar frequencies of MFS in persons with a causative FBN1 mutation (90% for Ghent-1 versus 92% for Ghent-2) and in persons not having a causative FBN1 mutation (15% versus 13%). Quality criteria for diagnostic methods include objectivity, reliability, and validity. However, the nosology-based diagnosis of MFS lacks a diagnostic reference standard and, hence, quality criteria such as sensitivity, specificity, or accuracy cannot be assessed. Medical utility of diagnosis implies congruency with the historical criteria of MFS, as well as with information about the etiology, pathogenesis, diagnostic triggers, prognostic triggers, and potential complications of MFS. In addition, social and psychological utilities of diagnostic criteria include acceptance by patients, patient organizations, clinicians and scientists, practicability, costs, and the reduction of anxiety. Since the utility of a diagnosis or exclusion of MFS is context-dependent, prioritization of utilities is a strategic decision in the process of nosology development. Screening tests for MFS should be used to identify persons with MFS. To confirm the diagnosis of MFS, Ghent-1 and Ghent-2 perform similarly, but Ghent-2 is easier to use. To maximize the utility of the diagnostic criteria of MFS, a fair and transparent process of nosology development is essential. PMID:26124674

  2. DISPOSABLE CANISTER WASTE ACCEPTANCE CRITERIA

    Energy Technology Data Exchange (ETDEWEB)

    R.J. Garrett

    2001-07-30

    The purpose of this calculation is to provide the bases for defining the preclosure limits on radioactive material releases from radioactive waste forms to be received in disposable canisters at the Monitored Geologic Repository (MGR) at Yucca Mountain. Specifically, this calculation will provide the basis for criteria to be included in a forthcoming revision of the Waste Acceptance System Requirements Document (WASRD) that limits releases in terms of non-isotope-specific canister release dose-equivalent source terms. These criteria will be developed for the Department of Energy spent nuclear fuel (DSNF) standard canister, the Multicanister Overpack (MCO), the naval spent fuel canister, the High-Level Waste (HLW) canister, the plutonium can-in-canister, and the large Multipurpose Canister (MPC). The shippers of such canisters will be required to demonstrate that they meet these criteria before the canisters are accepted at the MGR. The Quality Assurance program is applicable to this calculation. The work reported in this document is part of the analysis of DSNF and is performed using procedure AP-3.124, Calculations. The work done for this analysis was evaluated according to procedure QAP-2-0, Control of Activities, which has been superseded by AP-2.21Q, Quality Determinations and Planning for Scientific, Engineering, and Regulatory Compliance Activities. This evaluation determined that such activities are subject to the requirements of DOE/RW/0333P, Quality Assurance Requirements and Description (DOE 2000). This work is also prepared in accordance with the development plan titled Design Basis Event Analyses on DOE SNF and Plutonium Can-In-Canister Waste Forms (CRWMS M&O 1999a) and Technical Work Plan For: Department of Energy Spent Nuclear Fuel Work Packages (CRWMS M&O 2000d). This calculation contains no electronic data applicable to any electronic data management system.

  3. Stability analysis for a general age-dependent vaccination model

    International Nuclear Information System (INIS)

    El Doma, M.

    1995-05-01

    An SIR epidemic model of a general age-dependent vaccination model is investigated when the fertility, mortality and removal rates depends on age. We give threshold criteria of the existence of equilibriums and perform stability analysis. Furthermore a critical vaccination coverage that is sufficient to eradicate the disease is determined. (author). 12 refs

  4. Proposed diagnostic criteria for internet addiction.

    Science.gov (United States)

    Tao, Ran; Huang, Xiuqin; Wang, Jinan; Zhang, Huimin; Zhang, Ying; Li, Mengchen

    2010-03-01

    The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD.

  5. Location of Road Emergency Stations in Fars Province, Using Spatial Multi-Criteria Decision Making.

    Science.gov (United States)

    Goli, Ali; Ansarizade, Najmeh; Barati, Omid; Kavosi, Zahra

    2015-01-01

    To locate the road emergency stations in Fars province based on using spatial multi-criteria decision making (Delphi method). In this study, the criteria affecting the location of road emergency stations have been identified through Delphi method and their importance was determined using Analytical Hierarchical Process (AHP). With regard to the importance of the criteria and by using Geographical Information System (GIS), the appropriateness of the existing stations with the criteria and the way of their distribution has been explored, and the appropriate arenas for creating new emergency stations were determined. In order to investigate the spatial distribution pattern of the stations, Moran's Index was used. The accidents (0.318), placement position (0.235), time (0.198), roads (0.160), and population (0.079) were introduced as the main criteria in location road emergency stations. The findings showed that the distribution of the existing stations was clustering (Moran's I=0.3). Three priorities were introduced for establishing new stations. Some arenas including Abade, north of Eghlid and Khoram bid, and small parts of Shiraz, Farashband, Bavanat, and Kazeroon were suggested as the first priority. GIS is a useful and applicable tool in investigating spatial distribution and geographical accessibility to the setting that provide health care, including emergency stations.

  6. Assessment of Communications-related Admissions Criteria in a Three-year Pharmacy Program.

    Science.gov (United States)

    Parmar, Jayesh R; Tejada, Frederick R; Lang, Lynn A; Purnell, Miriam; Acedera, Lisa; Ngonga, Ferdinand

    2015-08-25

    To determine if there is a correlation between TOEFL and other admissions criteria that assess communications skills (ie, PCAT variables: verbal, reading, essay, and composite), interview, and observational scores and to evaluate TOEFL and these admissions criteria as predictors of academic performance. Statistical analyses included two sample t tests, multiple regression and Pearson's correlations for parametric variables, and Mann-Whitney U for nonparametric variables, which were conducted on the retrospective data of 162 students, 57 of whom were foreign-born. The multiple regression model of the other admissions criteria on TOEFL was significant. There was no significant correlation between TOEFL scores and academic performance. However, significant correlations were found between the other admissions criteria and academic performance. Since TOEFL is not a significant predictor of either communication skills or academic success of foreign-born PharmD students in the program, it may be eliminated as an admissions criterion.

  7. Age-related macular degeneration: using morphological predictors to modify current treatment protocols.

    Science.gov (United States)

    Ashraf, Mohammed; Souka, Ahmed; Adelman, Ron A

    2018-03-01

    To assess predictors of treatment response in neovascular age-related macular degeneration (AMD) in an attempt to develop a patient-centric treatment algorithm. We conducted a systematic search using PubMed, EMBASE and Web of Science for prognostic indicators/predictive factors with the key words: 'age related macular degeneration', 'neovascular AMD', 'choroidal neovascular membrane (CNV)', 'anti-vascular endothelial growth factor (anti-VEGF)', 'aflibercept', 'ranibizumab', 'bevacizumab', 'randomized clinical trials', 'post-hoc', 'prognostic', 'predictive', 'response' 'injection frequency, 'treat and extend (TAE), 'pro re nata (PRN)', 'bi-monthly' and 'quarterly'. We only included studies that had an adequate period of follow-up (>1 year), a single predefined treatment regimen with a predetermined re-injection criteria, an adequate number of patients, specific morphological [optical coherence tomography (OCT)] criteria that predicted final visual outcomes and injection frequency and did not include switching from one drug to the other. We were able to identify seven prospective studies and 16 retrospective studies meeting our inclusion criteria. There are several morphological and demographic prognostic indicators that can predict response to therapy in wet AMD. Smaller CNV size, subretinal fluid (SRF), retinal angiomatous proliferation (RAP) and response to therapy at 12 weeks (visual, angiographic or OCT) can all predict good visual outcomes in patients receiving anti-VEGF therapy. Patients with larger CNV, older age, pigment epithelial detachment (PED), intraretinal cysts (IRC) and vitreomacular adhesion (VMA) achieved less visual gains. Patients having VMA/VMT required more intensive treatment with increased treatment frequency. Patients with both posterior vitreous detachment (PVD) and SRF require infrequent injections. Patients with PED are prone to recurrences of fluid activity with a reduction in visual acuity (VA). A regimen that involves less intensive

  8. Is there an association between advanced paternal age and endophenotype deficit levels in schizophrenia?

    Science.gov (United States)

    Tsuang, Debby; Esterberg, Michelle; Braff, David; Calkins, Monica; Cadenhead, Kristin; Dobie, Dorcas; Freedman, Robert; Green, Michael F; Greenwood, Tiffany; Gur, Raquel; Gur, Ruben; Horan, William; Lazzeroni, Laura C; Light, Gregory A; Millard, Steven P; Olincy, Ann; Nuechterlein, Keith; Seidman, Larry; Siever, Larry; Silverman, Jeremy; Stone, William; Sprock, Joyce; Sugar, Catherine; Swerdlow, Neal; Tsuang, Ming; Turetsky, Bruce; Radant, Allen

    2014-01-01

    The children of older fathers have increased risks of developing schizophrenia spectrum disorders, and among those who develop these disorders, those with older fathers present with more severe clinical symptoms. However, the influence of advanced paternal age on other important domains related to schizophrenia, such as quantitative endophenotype deficit levels, remains unknown. This study investigated the associations between paternal age and level of endophenotypic impairment in a well-characterized family-based sample from the Consortium on the Genetics of Schizophrenia (COGS). All families included at least one affected subject and one unaffected sibling. Subjects met criteria for schizophrenia (probands; n = 293) or were unaffected first-degree siblings of those probands (n = 382). Paternal age at the time of subjects' birth was documented. Subjects completed a comprehensive clinical assessment and a battery of tests that measured 16 endophenotypes. After controlling for covariates, potential paternal age-endophenotype associations were analyzed using one model that included probands alone and a second model that included both probands and unaffected siblings. Endophenotype deficits in the Identical Pairs version of the 4-digit Continuous Performance Test and in the Penn Computerized Neurocognitive Battery verbal memory test showed significant associations with paternal age. However, after correcting for multiple comparisons, no endophenotype was significantly associated with paternal age. These findings suggest that factors other than advanced paternal age at birth may account for endophenotypic deficit levels in schizophrenia.

  9. Is there an association between advanced paternal age and endophenotype deficit levels in schizophrenia?

    Directory of Open Access Journals (Sweden)

    Debby Tsuang

    Full Text Available The children of older fathers have increased risks of developing schizophrenia spectrum disorders, and among those who develop these disorders, those with older fathers present with more severe clinical symptoms. However, the influence of advanced paternal age on other important domains related to schizophrenia, such as quantitative endophenotype deficit levels, remains unknown. This study investigated the associations between paternal age and level of endophenotypic impairment in a well-characterized family-based sample from the Consortium on the Genetics of Schizophrenia (COGS. All families included at least one affected subject and one unaffected sibling. Subjects met criteria for schizophrenia (probands; n = 293 or were unaffected first-degree siblings of those probands (n = 382. Paternal age at the time of subjects' birth was documented. Subjects completed a comprehensive clinical assessment and a battery of tests that measured 16 endophenotypes. After controlling for covariates, potential paternal age-endophenotype associations were analyzed using one model that included probands alone and a second model that included both probands and unaffected siblings. Endophenotype deficits in the Identical Pairs version of the 4-digit Continuous Performance Test and in the Penn Computerized Neurocognitive Battery verbal memory test showed significant associations with paternal age. However, after correcting for multiple comparisons, no endophenotype was significantly associated with paternal age. These findings suggest that factors other than advanced paternal age at birth may account for endophenotypic deficit levels in schizophrenia.

  10. Estimating the robustness of composite CBA & MCA assessments by variation of criteria importance order

    DEFF Research Database (Denmark)

    Jensen, Anders Vestergaard; Barfod, Michael Bruhn; Leleur, Steen

    is based on the fact that when using MCA as a decision-support tool, questions often arise about the weighting (or prioritising) of the included criteria. This part of the MCA is seen as the most subjective part and could give reasons for discussion among the decision makers or stakeholders. Furthermore......This paper discusses the concept of using rank variation concerning the stake-holder prioritising of importance criteria for exploring the sensitivity of criteria weights in multi-criteria analysis (MCA). Thereby the robustness of the MCA-based decision support can be tested. The analysis described......, the relative weights can make a large difference in the resulting assessment of alternatives [1]. Therefore it is highly relevant to introduce a procedure for estimating the importance of criteria weights. This paper proposes a methodology for estimating the robustness of weights used in additive utility...

  11. Trauma team activation criteria in managing trauma patients at an emergency room in Thailand.

    Science.gov (United States)

    Wuthisuthimethawee, P

    2017-02-01

    Trauma team activation (TTA) criteria were first implemented in the Emergency Department (ED) of Songklanagarind Hospital in 2009 to treat severe trauma patients. To determine the efficacy of the TTA criteria on the acute trauma care process in the ED and the 28-day mortality rate. A 1-year prospective cohort study was conducted at the ED. Trauma patients who were 18 years old and over who met the TTA criteria were enrolled. Demographic data, physiologic parameters, ED length of stay (EDLOS), and the injury severity score (ISS) were recorded. Multiple logistic regression was used to determine the factors affecting 28-day mortality. Institutional review board approval was obtained from the Prince of Songkla University. A total of 80 patients (74 male and 6 female) were eligible with a mean age of 34.3 years old. Shock, penetrating torso injury, and pulse rate >120 beats per minute were the three most common criteria for trauma team consultation. At the ED, 9 patients (11.3 %) were non-survivors, 30 patients (37.5 %) needed immediate operation, and 41 patients (51.2 %) were admitted. All of the arrest patients died (p team activation criteria improved acute trauma care in the ED which was demonstrated by the decreased EDLOS and mortality rate. A high ISS is the sole parameter predicting mortality.

  12. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries.

    Science.gov (United States)

    Santos-Eggimann, Brigitte; Cuénoud, Patrick; Spagnoli, Jacques; Junod, Julien

    2009-06-01

    Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey. Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50-64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education. The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain. A higher prevalence of frailty in southern countries is consistent with previous findings of a north-south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty.

  13. Application of ICHD-II criteria in a headache clinic of China.

    Directory of Open Access Journals (Sweden)

    Zhao Dong

    Full Text Available China has the huge map and the largest population in the world. Previous studies on the prevalence and classification of headaches were conducted based on the general population, however, similar studies among the Chinese outpatient population are scarce. This study aimed to analyze the characteristics of 1843 headache patients enrolled in a North China headache clinic of the General Hospital for Chinese People's Liberation Army from October 2011 to May 2012, with the International Classification of Headache Disorders, 2nd Edition (ICHD-II.Personal interviews were carried out and a detailed questionnaire was used to collect medical records including age, sex and headache characteristics. Patients came from 28 regions of China with the median age of 40.9 (9-80 years and the female/male ratio of 1.67/1. The primary headaches (78.4% were classified as the following: migraine (39.1%, tension-type headache (32.5%, trigeminal autonomic cephalalgias (5.3% and other primary headache (1.5%. Among the rest patients, 12.9% were secondary headaches, 5.9% were cranial neuralgias and 2.5% were unspecified or not elsewhere classified. Fourteen point nine percent (275/1843 were given an additional diagnosis of chronic daily headache, including medication-overuse headache (MOH, 49.5%, chronic tension-type headache (CTTH, 32.7% and chronic migraine (CM, 13.5%. The visual analogue scale (VAS score of TTH with MOH was significantly higher than that of CTTH (6.8±2.0 vs 5.6±2.0, P<0.001. The similar result was also observed in VAS score between migraine with MOH and CM (8.0±1.5 vs 7.0±1.5, P = 0.004. The peak age at onset of TTH for male and female were both in the 3(rd decade of life. However, the age distribution at onset of migraine shows an obvious sex difference, i.e. the 2(nd decade for females and the 1(st decade for males.This study revealed the characteristics of the headache clinic outpatients in a tertiary hospital of North China that migraine is

  14. Objective CT criteria to determine the presence of abnormal basal enhancement in children with suspected tuberculous meningitis

    International Nuclear Information System (INIS)

    Przybojewski, Stefan; Andronikou, Savvas; Wilmshurst, Jo

    2006-01-01

    There are no widely accepted objective criteria to determine the presence of basal enhancement on CT in children with suspected tuberculous meningitis (TBM). To test nine recently described objective CT criteria for the presence of abnormal basal enhancement in children with suspected TBM against the definite diagnosis as determined by cerebrospinal fluid (CSF) culture. CT scans of patients with a clinical suspicion of TBM who had undergone lumbar puncture for CSF culture spanning a period of 4 years were reviewed for the presence of nine recently described criteria for the presence of abnormal basal enhancement. The radiologists were blinded to the final diagnosis based on CSF culture against which the criteria were tested. The criteria have been named: the 'Y-sign', 'linear enhancement', 'double lines', 'infundibular recess of the third', 'ill-defined edge', 'nodular enhancement', 'join the dots', 'contrast filling the cisterns', and 'asymmetry'. A total of 65 patients were included in the study, 34 with culture-proven TBM and 31 with other diagnoses. Four individual criteria had a specificity of 100%, but the sensitivities of these criteria ranged from 15% to 53% only. Three other criteria had specificities of 97% and sensitivities ranging from 62% to 82%. The presence of more than one criterion in the same patient showed a specificity of 97% and sensitivity of 91%. Very high specificity was demonstrated for all nine criteria, including 100% specificity for four individual criteria. Sensitivity was at best 82%, but improved to 91% when more than one criterion was present. These criteria need to be tested for inter- and intraobserver variability to prove their clinical usefulness. (orig.)

  15. Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Diagnostic Task Force Criteria Impact of New Task Force Criteria

    NARCIS (Netherlands)

    Cox, Moniek G. P. J.; van der Smagt, Jasper J.; Noorman, Maartje; Wiesfeld, Ans C.; Volders, Paul G. A.; van Langen, Irene M.; Atsma, Douwe E.; Dooijes, Dennis; Houweling, Arjan C.; Loh, Peter; Jordaens, Luc; Arens, Yvonne; Cramer, Maarten J.; Doevendans, Pieter A.; van Tintelen, Peter; Wilde, Arthur A. M.; Hauer, Richard N. W.

    Background-Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) Diagnostic Task Force Criteria (TFC) proposed in 1994 are highly specific but lack sensitivity. A new international task force modified criteria to improve diagnostic yield. A comparison of diagnosis by 1994 TFC versus

  16. Potentially inappropriate medications in elderly Japanese patients: effects of pharmacists' assessment and intervention based on Screening Tool of Older Persons' Potentially Inappropriate Prescriptions criteria ver.2.

    Science.gov (United States)

    Kimura, T; Ogura, F; Yamamoto, K; Uda, A; Nishioka, T; Kume, M; Makimoto, H; Yano, I; Hirai, M

    2017-04-01

    The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2. The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016. Pharmacists assessed and detected PIMs based on stopp criteria ver.2 and considered the patient's intention to change the prescription at the time of admission of each patient. If the pharmacists judged that benefits outweighed risks of prescription change and the patients consented to change the medications, they recommended the doctor to change the prescription. If there was a risk of exacerbation of disease by the change of medications and the pharmacists judged it to be difficult to adjust medications during hospitalization or the patients did not consent to change the medications, they did not recommend to change it. The pharmacists and the doctors discussed and finally decided whether to change the PIMs or not. The number of patients prescribed PIMs, the number and contents of PIMs, and the number of medications changed after pharmacists' intervention were calculated. Totally, 822 new inpatients aged ≥65 years prescribed ≥1 daily medicine were included. Their median (interquartile range) age was 75·0 (71·0-80·0) years, and 54·9% were male. According to the criteria, 346 patients (42·1%) were prescribed ≥1 PIMs. Patients prescribed PIMs took significantly more medications than others: 10·0 (7·0-13·0) vs. 6·0 (4·0-9·0), P older people (benzodiazepines) (30/67) and (iii) drugs that predictably increase the risk of falls in older people (hypnotic Z-drugs) (15/31). Over 40% elderly patients were prescribed PIMs

  17. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders

    Science.gov (United States)

    Banwell, Brenda; Bennett, Jeffrey L.; Cabre, Philippe; Carroll, William; Chitnis, Tanuja; de Seze, Jérôme; Fujihara, Kazuo; Greenberg, Benjamin; Jacob, Anu; Jarius, Sven; Lana-Peixoto, Marco; Levy, Michael; Simon, Jack H.; Tenembaum, Silvia; Traboulsee, Anthony L.; Waters, Patrick; Wellik, Kay E.

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory CNS syndrome distinct from multiple sclerosis (MS) that is associated with serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). Prior NMO diagnostic criteria required optic nerve and spinal cord involvement but more restricted or more extensive CNS involvement may occur. The International Panel for NMO Diagnosis (IPND) was convened to develop revised diagnostic criteria using systematic literature reviews and electronic surveys to facilitate consensus. The new nomenclature defines the unifying term NMO spectrum disorders (NMOSD), which is stratified further by serologic testing (NMOSD with or without AQP4-IgG). The core clinical characteristics required for patients with NMOSD with AQP4-IgG include clinical syndromes or MRI findings related to optic nerve, spinal cord, area postrema, other brainstem, diencephalic, or cerebral presentations. More stringent clinical criteria, with additional neuroimaging findings, are required for diagnosis of NMOSD without AQP4-IgG or when serologic testing is unavailable. The IPND also proposed validation strategies and achieved consensus on pediatric NMOSD diagnosis and the concepts of monophasic NMOSD and opticospinal MS. PMID:26092914

  18. OSCILLATION CRITERIA FOR FORCED SUPERLINEAR DIFFERENCE EQUATIONS

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Using Riccati transformation techniques,some oscillation criteria for the forced second-order superlinear difference equations are established.These criteria are dis- crete analogues of the criteria for differential equations proposed by Yan.

  19. Microbiological criteria for good manufacturing practice (GMP)

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, J [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary); Zukal, E [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary)

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.)

  20. Diagnostic criteria for Menière's disease.

    Science.gov (United States)

    Lopez-Escamez, Jose A; Carey, John; Chung, Won-Ho; Goebel, Joel A; Magnusson, Måns; Mandalà, Marco; Newman-Toker, David E; Strupp, Michael; Suzuki, Mamoru; Trabalzini, Franco; Bisdorff, Alexandre

    2015-01-01

    This paper presents diagnostic criteria for Menière's disease jointly formulated by the Classification Committee of the Bárány Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. The classification includes two categories: definite Menière's disease and probable Menière's disease. The diagnosis of definite Menière's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable Menière's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

  1. Microbiological criteria for good manufacturing practice (GMP)

    International Nuclear Information System (INIS)

    Farkas, J.; Zukal, E.

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.) [de

  2. Evaluation of the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome.

    Science.gov (United States)

    Kornek, Barbara; Schmitl, Beate; Vass, Karl; Zehetmayer, Sonja; Pritsch, Martin; Penzien, Johann; Karenfort, Michael; Blaschek, Astrid; Seidl, Rainer; Prayer, Daniela; Rostasy, Kevin

    2012-12-01

    Magnetic resonance imaging diagnostic criteria for paediatric multiple sclerosis have been established on the basis of brain imaging findings alone. The 2010 McDonald criteria for the diagnosis of multiple sclerosis, however, include spinal cord imaging for detection of lesion dissemination in space. The new criteria have been recommended in paediatric multiple sclerosis. (1) To evaluate the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome and to compare them with recently proposed magnetic resonance criteria for children; (2) to assess whether the inclusion of spinal cord imaging provided additional value to the 2010 McDonald criteria. We performed a retrospective analysis of brain and spinal cord magnetic resonance imaging scans from 52 children with a clinically isolated syndrome. Sensitivity, specificity and accuracy of the magnetic resonance criteria were assessed. The 2010 McDonald dissemination in space criteria were more sensitive (85% versus 74%) but less specific (80% versus 100%) compared to the 2005 McDonald criteria. The Callen criteria were more accurate (89%) compared to the 2010 McDonald (85%), the 2005 McDonald criteria for dissemination in space (81%), the KIDMUS criteria (46%) and the Canadian Pediatric Demyelinating Disease Network criteria (76%). The 2010 McDonald criteria for dissemination in time were more accurate (93%) than the dissemination in space criteria (85%). Inclusion of the spinal cord did not increase the accuracy of the McDonald criteria.

  3. Predictors of dental rehabilitation in children aged 3-12 years.

    Science.gov (United States)

    Gopinath, Vellore Kannan; Awad, Manal A

    2015-01-01

    The aim of this study was to evaluate the proportion of completed treatments and to study the factors affecting the full mouth dental rehabilitation in pediatric patients treated by undergraduate students at the College of Dental Medicine Teaching Clinics, University of Sharjah. A retrospective study was conducted on 270 children aged less than 12 years (mean age 7.6, SD 2.04). Comprehensive dental rehabilitation reports of child patients that were completed by final year dental undergraduate students from the year 2009 to 2011 were reviewed. Data on complete history, oral examination, dental charting, and treatment plan were collected from pediatric dentistry case sheet. Dental caries was charted using WHO 1997 criteria. Dental treatment needs and completion of dental care delivered to children involved in this study were assessed using DMFT/deft scores. Percentages of treatment provided included completed restorations (94%) and space management (84%) in primary dentition, whereas 98% of restoration and 94% of required sealants were completed in permanent dentition. The percentage of completed dental treatment including sealant placement was 61%. Age of the child and the number of decayed teeth present before the start of the treatment significantly correlated with the children in the incomplete treatment category (P dental care was provided in a holistic approach to the children attending College of Dental Medicine training clinics. Age of the child and the number of decayed teeth were the factors affecting dental rehabilitation in children aged 3-12 years.

  4. International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017)

    DEFF Research Database (Denmark)

    Younes, A; Hilden, P; Coiffier, B

    2017-01-01

    of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria...... enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category...

  5. The use of acceptability criteria for radiological risk at AWE Aldermaston

    International Nuclear Information System (INIS)

    Thurston, B.B.; Tutt, K.J.; Zabierek, G.A.

    1989-01-01

    The limit-line approach to setting acceptable risk criteria for nuclear power plants is in general use in the United Kingdom. The Atomic Weapons Establishment (AWE) is a Ministry of Defence Establishment which contains a number of nuclear material processing facilities. Limit-line risk criteria have been used for some years to provide a framework within which identified hazards may be judged in a systematic manner, rather than on an ad hoc basis. This paper describes how this is applied to both new facilities and to changes made to existing ones including decommissioning. (author)

  6. Survey of Neurological Disorders in Children Aged 9-15 Years in Northern India.

    Science.gov (United States)

    Kumar, Rashmi; Bhave, Anupama; Bhargava, Roli; Agarwal, G G

    2016-04-01

    The prevalence of neurological disorders in resource-poor settings, although likely to be high, is largely unexplored. The prevalence and risk factors for neurological disorders, including epilepsy and intellectual, motor, vision, and hearing deficits, in children aged 9 to 15 years in the community were investigated. A new instrument was developed, validated, and used in a 2-stage community survey for neurological disorders in Lucknow, India. Screen-positives and random proportion of screen-negatives were validated using predefined criteria. Prevalence of different neurological disorders was calculated by weighted proportions. Of 6431 children screened, 221 were positive. A total of 214 screen-positives and 251 screen-negatives were validated. Prevalence of neurological disorders was 31.3 per 1000 children of this age group (weighted 95% confidence interval = 16.5, 46.4). The final model for risk factors included age, mud house, delayed cry at birth, and previous head injury. The prevalence of neurological disorders is high in this region. Predictors of neurological disorders are largely modifiable. © The Author(s) 2015.

  7. Ecotoxicological criteria for final storage quality: Possibilities and limits

    Science.gov (United States)

    Zeyer, Josef; Meyer, Joseph

    Landfills are complex chemical and biological reactors whose internal processes are often beyond the immediate control of process engineers. Therefore, the concept of a "Final Storage Landfill" may be deceptive. Furthermore, traditional approaches to establishing discharge criteria and treatment requirements for industrial effluents may not work well for landfill emissions. Factories can often be treated as steady-state processes whose inputs and outputs are predictable; however, landfills are batch reactors whose contents and emissions may be unknown and will vary temporally and spatially. If the contents of a landfill are known, the sequence of chemical reactions can be predicted qualitatively. Even if that sequence is predictable, though, quantitative ecotoxicological criteria will be difficult to establish, and risk assessments based on chemical "laundry lists" will be questionable. The situation is not hopeless, though. New approaches can be developed to monitor and predict landfill emissions. We believe these will include (1) testing (biological and chemical) of internal components of landfills as well as emissions; (2) development of laboratory and/or field methods in which the chemical and biological evolution of landfills can be studied at accelerated rates, thus allowing better prediction of future emissions; and (3) flexible ecotoxicological criteria that are adaptable to the evolving nature of landfill emissions. These criteria should be based on complementary chemical analyses and biological tests that fit into a hierarchical (decision-tree) hazard assessment strategy.

  8. Waste acceptance criteria for the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    1996-04-01

    The Waste Isolation Pilot Plant (WIPP) Waste Acceptance Criteria (WAC), DOE/WIPP-069, was initially developed by a U.S. Department of Energy (DOE) Steering Committee to provide performance requirements to ensure public health and safety as well as the safe handling of transuranic (TRU) waste at the WIPP. This revision updates the criteria and requirements of previous revisions and deletes those which were applicable only to the test phase. The criteria and requirements in this document must be met by participating DOE TRU Waste Generator/Storage Sites (Sites) prior to shipping contact-handled (CH) and remote-handled (RH) TRU waste forms to the WIPP. The WIPP Project will comply with applicable federal and state regulations and requirements, including those in Titles 10, 40, and 49 of the Code of Federal Regulations (CFR). The WAC, DOE/WIPP-069, serves as the primary directive for assuring the safe handling, transportation, and disposal of TRU wastes in the WIPP and for the certification of these wastes. The WAC identifies strict requirements that must be met by participating Sites before these TRU wastes may be shipped for disposal in the WIPP facility. These criteria and requirements will be reviewed and revised as appropriate, based on new technical or regulatory requirements. The WAC is a controlled document. Revised/changed pages will be supplied to all holders of controlled copies

  9. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

    DEFF Research Database (Denmark)

    Peck, C C; Goulet, J-P; Lobbezoo, F

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility f...

  10. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

    NARCIS (Netherlands)

    Peck, C.C.; Goulet, J-P; Lobbezoo, F.; Schiffman, E.L.; Alstergren, P.; Anderson, G.C.; De Leeuw, R.; Jensen, R.; Michelotti, A.; Ohrbach, R.; Petersson, A.; List, T.

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for

  11. Who Shall Not Be Treated: Public Attitudes on Setting Health Care Priorities by Person-Based Criteria in 28 Nations.

    Science.gov (United States)

    Rogge, Jana; Kittel, Bernhard

    2016-01-01

    The principle of distributing health care according to medical need is being challenged by increasing costs. As a result, many countries have initiated a debate on the introduction of explicit priority regulations based on medical, economic and person-based criteria, or have already established such regulations. Previous research on individual attitudes towards setting health care priorities based on medical and economic criteria has revealed consistent results, whereas studies on the use of person-based criteria have generated controversial findings. This paper examines citizens' attitudes towards three person-based priority criteria, patients' smoking habits, age and being the parent of a young child. Using data from the ISSP Health Module (2011) in 28 countries, logistic regression analysis demonstrates that self-interest as well as socio-demographic predictors significantly influence respondents' attitudes towards the use of person-based criteria for health care prioritization. This study contributes to resolving the controversial findings on person-based criteria by using a larger country sample and by controlling for country-level differences with fixed effects models.

  12. Who Shall Not Be Treated: Public Attitudes on Setting Health Care Priorities by Person-Based Criteria in 28 Nations.

    Directory of Open Access Journals (Sweden)

    Jana Rogge

    Full Text Available The principle of distributing health care according to medical need is being challenged by increasing costs. As a result, many countries have initiated a debate on the introduction of explicit priority regulations based on medical, economic and person-based criteria, or have already established such regulations. Previous research on individual attitudes towards setting health care priorities based on medical and economic criteria has revealed consistent results, whereas studies on the use of person-based criteria have generated controversial findings. This paper examines citizens' attitudes towards three person-based priority criteria, patients' smoking habits, age and being the parent of a young child. Using data from the ISSP Health Module (2011 in 28 countries, logistic regression analysis demonstrates that self-interest as well as socio-demographic predictors significantly influence respondents' attitudes towards the use of person-based criteria for health care prioritization. This study contributes to resolving the controversial findings on person-based criteria by using a larger country sample and by controlling for country-level differences with fixed effects models.

  13. An analysis of project selection and assignment criteria of Danish tenders in Europe

    Directory of Open Access Journals (Sweden)

    Jasper Kranker Larsen

    2013-12-01

    Full Text Available Public construction agencies are one of the largest developers within the Danish construction industry, where such agencies own and develop new public construction projects. Most of these projects are put out in European tender. This study analyses the selection and assignment criteria employed by these agencies in different types of public sector projects. Some of the objectives pursued by the study include the determination of 1/ the selection and assignment criteria mostly used in Danish public tenders 2/ how different types of projects use selection and assignment criteria in the bidding process, and 3/ any significant difference between the use of selection and assignment criteria in Danish public construction projects. The study uses a quantitative research approach where 157 Danish public tender cases were selected from the European Tenders Electronic Daily database between the period: January 2010 to March 2013. Fisher's Exact Test was conducted to determine if there was any significant use of some selection and assignment criteria. The findings of the study showed that invited tenders with pre-qualification and lowest price in 69.8% of the tenders are the most used selection and assignment criteria, with little regard to project type.

  14. Principles and Criteria for Design

    DEFF Research Database (Denmark)

    Beghin, D.; Cervetto, D.; Hansen, Peter Friis

    1997-01-01

    The mandate of ISSC Committee IV.1 on principles and Criteria for Design is to report on the following:The ongoing concern for quantification of general economic and safety criteria for marine structures and for the development of appropriate principles for rational life cycle design using...

  15. Diagnostic criteria for vascular dementia

    NARCIS (Netherlands)

    Scheltens, P.; Hijdra, A. H.

    1998-01-01

    The term vascular dementia implies the presence of a clinical syndrome (dementia) caused by, or at least assumed to be caused by, a specific disorder (cerebrovascular disease). In this review, the various sets of criteria used to define vascular dementia are outlined. The various sets of criteria

  16. Characteristics of binge eating disorder in relation to diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Wilfley DE

    2016-08-01

    Full Text Available Denise E Wilfley,1 Leslie Citrome,2 Barry K Herman3 1Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 2Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY, 3Global Medical Affairs, Shire, Lexington, MA, USA Abstract: The objective of this review was to examine the evidentiary basis for binge eating disorder (BED with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5 diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional

  17. Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria.

    LENUS (Irish Health Repository)

    Cooper, Janine A

    2016-01-28

    The purpose of this study is to establish the prevalence of potentially inappropriate prescribing (PIP) in middle-aged adults (45-64 years) in two populations with differing socio-economic profiles, and to investigate factors associated with PIP, using the PROMPT (PRescribing Optimally in Middle-aged People\\'s Treatments) criteria.

  18. Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis.

    Science.gov (United States)

    Korbel, Krzysztof; Kozinoga, Mateusz; Stoliński, Łukasz; Kotwicki, Tomasz

    2014-07-28

    According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated. Based on the natural history of idiopathic scoliosis, SRS criteria, SOSORT 2008 experts' opinion and the knowledge of the possibilities of psychological assessment of conservative IS treatment, rules were proposed regarding nonsurgical IS therapy procedures, with special consideration being paid to the proper treatment start time (age, Risser test, biological maturity, Cobb angle), possibility of curvature progression, the importance of physiotherapy and psychological assessment. The knowledge of SRS criteria and SOSORT guidelines regarding the conservative treatment of IS are essential for proper treatment (the right time to start treatment), and supports establishment of interdisciplinary treatment teams, consisting of a physician, a physiotherapist, an orthopedic technician and a psychologist.

  19. Recommended criteria for the evaluation of on-site nuclear power plant emergency plans, volume II: criteria

    International Nuclear Information System (INIS)

    1997-01-01

    A critical review of existing Canadian and international nuclear power plant (NPP) emergency plans, evaluation criteria, and approaches has been conducted to provide AECB staff with information which can be used to assess the adequacy of NPP on-site emergency response plans. The results of this work are published in two volumes. Volume I, Basis Document, provides the reasons why certain requirements are in place. It also gives comprehensive references to various standards.Volume II, Criteria, contains the criteria which relate to on-site actions and their integration with control room activities and the roles of off-site responsible organizations. The recommended criteria provide information on what is required, and not on how to accomplish the requirements. The licensees are given the latitude to decide on the methods and processes needed to meet the requirements. The documents do not address NPP off-site plans and response capability, or the control room emergency operating procedures and response capability. This report contains only Volume II: Criteria. 55 refs., 2 tabs., 1 fig

  20. Assessment of hydrogen fuel cell applications using fuzzy multiple-criteria decision making method

    International Nuclear Information System (INIS)

    Chang, Pao-Long; Hsu, Chiung-Wen; Lin, Chiu-Yue

    2012-01-01

    Highlights: ► This study uses the fuzzy MCDM method to assess hydrogen fuel cell applications. ► We evaluate seven different hydrogen fuel cell applications based on 14 criteria. ► Results show that fuel cell backup power systems should be chosen for development in Taiwan. -- Abstract: Assessment is an essential process in framing government policy. It is critical to select the appropriate targets to meet the needs of national development. This study aimed to develop an assessment model for evaluating hydrogen fuel cell applications and thus provide a screening tool for decision makers. This model operates by selecting evaluation criteria, determining criteria weights, and assessing the performance of hydrogen fuel cell applications for each criterion. The fuzzy multiple-criteria decision making method was used to select the criteria and the preferred hydrogen fuel cell products based on information collected from a group of experts. Survey questionnaires were distributed to collect opinions from experts in different fields. After the survey, the criteria weights and a ranking of alternatives were obtained. The study first defined the evaluation criteria in terms of the stakeholders, so that comprehensive influence criteria could be identified. These criteria were then classified as environmental, technological, economic, or social to indicate the purpose of each criterion in the assessment process. The selected criteria included 14 indicators, such as energy efficiency and CO 2 emissions, as well as seven hydrogen fuel cell applications, such as forklifts and backup power systems. The results show that fuel cell backup power systems rank the highest, followed by household fuel cell electric-heat composite systems. The model provides a screening tool for decision makers to select hydrogen-related applications.

  1. Social Advertising Quality: Assessment Criteria

    Directory of Open Access Journals (Sweden)

    S. B. Kalmykov

    2017-01-01

    Full Text Available Purpose: the The purpose of the publication is development of existing criterial assessment in social advertising sphere. The next objectives are provided for its achievement: to establish research methodology, to develop the author’s version of necessary notional apparatus and conceptual generalization, to determine the elements of social advertising quality, to establish the factors of its quality, to conduct the systematization of existing criteria and measuring instruments of quality assessment, to form new criteria of social advertising quality, to apply received results for development of criterial assessment to determine the further research perspectives. Methods: the methodology of research of management of social advertising interaction with target audience, which has dynamic procedural character with use of sociological knowledge multivariate paradigmatic status, has been proposed. Results: the primary received results: the multivariate paradigmatic research basis with use of works of famous domestic and foreign scientists in sociology, qualimetry and management spheres; the definitions of social advertising, its quality, sociological quality provision system, target audience behavior model during social advertising interaction are offered; the quality factors with three groups by level of effect on consumer are established; the systematization of existing quality and its measure instruments assessment criteria by detected social advertising quality elements are conducted; the two new criteria and its management quality assessment measuring instruments in social advertising sphere are developed; the one of the common groups of production quality criteria – adaptability with considering of new management quality criteria and conducted systematization of existing social advertising creative quality assessment criteria development; the perspective of further perfection of quality criterial assessment based on social advertising

  2. Revisiting the plant hyperaccumulation criteria to rare plants and earth abundant elements

    Energy Technology Data Exchange (ETDEWEB)

    Branquinho, Cristina [Universidade de Lisboa, Faculdade de Ciencias, Centro de Ecologia e Biologia Vegetal, Campo Grande C2, Piso 4, 1749-016 Lisbon (Portugal) and Universidade Atlantica, Antiga Fabrica da Polvora de Barcarena, 2745-615 Barcarena (Portugal)]. E-mail: cmbranquinho@fc.ul.pt; Serrano, Helena Cristina [Universidade de Lisboa, Museu Nacional de Historia Natural, Jardim Botanico (Portugal); Pinto, Manuel Joao [Universidade de Lisboa, Museu Nacional de Historia Natural, Jardim Botanico (Portugal); Martins-Loucao, Maria Amelia [Universidade de Lisboa, Faculdade de Ciencias, Centro de Ecologia e Biologia Vegetal, Campo Grande C2, Piso 4, 1749-016 Lisbon (Portugal); Universidade de Lisboa, Museu Nacional de Historia Natural, Jardim Botanico (Portugal)

    2007-03-15

    The several established criteria to define a hyperaccumulator plant were applied to a rare and endangered species, Plantago almogravensis, and to the 3rd most abundant element in the earth crust, Al. Using the most common criteria, P. almogravensis undoubtedly is an Al hyperaccumulator plant. If the recent proposed requirements were considered, most of them matching those for a plant to be used in phytoextraction, it can only be considered an unusual accumulator of Al. A discussion is made concerning the several criteria of a hyperaccumulator plant in order to include rare and endemic ones and abundant elements. In ecological terms, the enrichment in Al and Fe observed may account for the differences in the vegetation pattern. Due to the rarity and endangered nature of this plant, the contribution of this work is also relevant for the ecological understanding and the development of conservation options of this endemic species. - Revisiting plant hyperaccumulation criteria.

  3. Revisiting the plant hyperaccumulation criteria to rare plants and earth abundant elements

    International Nuclear Information System (INIS)

    Branquinho, Cristina; Serrano, Helena Cristina; Pinto, Manuel Joao; Martins-Loucao, Maria Amelia

    2007-01-01

    The several established criteria to define a hyperaccumulator plant were applied to a rare and endangered species, Plantago almogravensis, and to the 3rd most abundant element in the earth crust, Al. Using the most common criteria, P. almogravensis undoubtedly is an Al hyperaccumulator plant. If the recent proposed requirements were considered, most of them matching those for a plant to be used in phytoextraction, it can only be considered an unusual accumulator of Al. A discussion is made concerning the several criteria of a hyperaccumulator plant in order to include rare and endemic ones and abundant elements. In ecological terms, the enrichment in Al and Fe observed may account for the differences in the vegetation pattern. Due to the rarity and endangered nature of this plant, the contribution of this work is also relevant for the ecological understanding and the development of conservation options of this endemic species. - Revisiting plant hyperaccumulation criteria

  4. Aging with autism spectrum disorder: an emerging public health problem.

    Science.gov (United States)

    Hategan, Ana; Bourgeois, James A; Goldberg, Jeremy

    2017-04-01

    From 1943, when Leo Kanner originally described autism, and to the first objective criteria for "infantile autism" in DSM-III and the inclusion of Asperger's disorder in DSM-IV, the subsequent classification scheme for autistic disorders has led to a substantial change with the 2013 issuance of the DSM-5 by including subcategories into one umbrella diagnosis of autism spectrum disorder (ASD) (Baker, 2013). ASD is a lifelong neurodevelopmental disorder, characterized by social and communication impairments and restricted, stereotypical patterns of behavior (Baker, 2013). It is currently expected that most, or all of the actual cases of ASD, are identified in a timely way (i.e. in early childhood). However, there are many undiagnosed older adults who may have met the current diagnostic criteria for ASD as children, but never received such a diagnosis due to the fact it had yet to be established. In addition, some patients with relatively less impairing phenotypes may escape formal diagnosis in childhood, only to later be diagnosed in adulthood. Nevertheless, the first generation of diagnosed patients with ASD is now in old age. Many such ASD patients have needed family and institutional support for their lives subsequent to childhood diagnosis. Due to aging and death of their parents and other supportive figures leading to a loss of social structures, there is no better time than now for the medical community to act.

  5. Priority setting of health interventions: the need for multi-criteria decision analysis

    Directory of Open Access Journals (Sweden)

    Baltussen Rob

    2006-08-01

    Full Text Available Abstract Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multi-criteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health – that tend to focus on single criteria – towards transparent and systematic approaches that take into account all relevant criteria

  6. Histopathology of valves in infective endocarditis, diagnostic criteria and treatment considerations.

    Science.gov (United States)

    Brandão, Tatiana J D; Januario-da-Silva, Carolina A; Correia, Marcelo G; Zappa, Monica; Abrantes, Jaime A; Dantas, Angela M R; Golebiovski, Wilma; Barbosa, Giovanna Ianini F; Weksler, Clara; Lamas, Cristiane C

    2017-04-01

    Infective endocarditis (IE) is a severe disease. Pathogen isolation is fundamental so as to treat effectively and reduce morbidity and mortality. Blood and valve culture and histopathology (HP) are routinely employed for this purpose. Valve HP is the gold standard for diagnosis. To determine the sensitivity and specificity of clinical criteria for IE (the modified Duke and the St Thomas' minor modifications, STH) of blood and valve culture compared to valve HP, and to evaluate antibiotic treatment duration. Prospective case series of patients, from 2006 to 2014 with surgically treated IE. Statistical analysis was done by the R software. There were 136 clinically definite episodes of IE in 133 patients. Mean age ± SD was 43 ± 15.6 years and IE was left sided in 81.6 %. HP was definite in 96 valves examined, which were used as gold standard. Sensitivity of blood culture was 61 % (CI 0.51, 0.71) and of valve culture 15 % (CI 0.07, 0.26). The modified Duke criteria were 65 % (CI 0.55, 0.75) sensitive and 33 % specific, while the STH's sensitivity was 72 % (CI 0.61, 0.80) with similar specificity. In multivariate analysis and logistic regression, the only variable with statistical significance was duration of antibiotic therapy postoperatively. Valve HP had high sensitivity and valve culture low sensitivity in the diagnosis of IE. The STH's criteria were more sensitive than the modified Duke criteria. Valve HP should guide duration of postoperative antibiotic treatment.

  7. Criteria for Performing Cranial Computed Tomography for Chinese Patients With Mild Traumatic Brain Injury: Canadian Computed Tomography Head Rule or New Orleans Criteria?

    Science.gov (United States)

    Yang, Xiao-Feng; Meng, Yuan-Yuan; Wen, Liang; Wang, Hao

    2017-09-01

    Computed tomography (CT) provides the primary diagnostic evidence for traumatic brain injury (TBI), but few positive traumatic findings are discovered in patients with mild TBI. In China, there are no existing criteria for selecting patients with mild TBI to undergo CT, and almost all of these patients undergo cranial CT in the emergency department. This retrospective study was performed to evaluate the necessity of cranial CT among patients with mild TBI, as well as the feasibility of 2 popular criteria (Canadian CT head rule [CCHR] and New Orleans Criteria [NOC]) in China. Patients with mild TBI who underwent cranial CT within 24 hours of the trauma were included in our institute. Two neurosurgeons reviewed the CT images independently to identify positive CT findings. The sensitivity and specificity of CCHR and NOC for positive CT findings related to TBI were analyzed. Finally, this study included 625 patients. Positive CT findings related to TBI were discovered in 13.12% (82/625) of these patients on cranial CT, and 6.88% (43/625) of them were admitted to the hospital for further management. Ultimately, 11 patients (1.76%, 11/625) underwent neurosurgery. In this study, the sensitivities of both the CCHR and NOC were 100%, but the specificity of CCHR was 43.36% and that of NOC was 33.12%. Based on our study, both CCHR and NOC have high sensitivity for the detection of positive CT findings related to head trauma in patients with mild TBI.

  8. Evolving fuzzy rules for relaxed-criteria negotiation.

    Science.gov (United States)

    Sim, Kwang Mong

    2008-12-01

    In the literature on automated negotiation, very few negotiation agents are designed with the flexibility to slightly relax their negotiation criteria to reach a consensus more rapidly and with more certainty. Furthermore, these relaxed-criteria negotiation agents were not equipped with the ability to enhance their performance by learning and evolving their relaxed-criteria negotiation rules. The impetus of this work is designing market-driven negotiation agents (MDAs) that not only have the flexibility of relaxing bargaining criteria using fuzzy rules, but can also evolve their structures by learning new relaxed-criteria fuzzy rules to improve their negotiation outcomes as they participate in negotiations in more e-markets. To this end, an evolutionary algorithm for adapting and evolving relaxed-criteria fuzzy rules was developed. Implementing the idea in a testbed, two kinds of experiments for evaluating and comparing EvEMDAs (MDAs with relaxed-criteria rules that are evolved using the evolutionary algorithm) and EMDAs (MDAs with relaxed-criteria rules that are manually constructed) were carried out through stochastic simulations. Empirical results show that: 1) EvEMDAs generally outperformed EMDAs in different types of e-markets and 2) the negotiation outcomes of EvEMDAs generally improved as they negotiated in more e-markets.

  9. Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS).

    Science.gov (United States)

    Kuemmerle-Deschner, Jasmin B; Ozen, Seza; Tyrrell, Pascal N; Kone-Paut, Isabelle; Goldbach-Mansky, Raphaela; Lachmann, Helen; Blank, Norbert; Hoffman, Hal M; Weissbarth-Riedel, Elisabeth; Hugle, Boris; Kallinich, Tilmann; Gattorno, Marco; Gul, Ahmet; Ter Haar, Nienke; Oswald, Marlen; Dedeoglu, Fatma; Cantarini, Luca; Benseler, Susanne M

    2017-06-01

    Cryopyrin-associated periodic syndrome (CAPS) is a rare, heterogeneous disease entity associated with NLRP3 gene mutations and increased interleukin-1 (IL-1) secretion. Early diagnosis and rapid initiation of IL-1 inhibition prevent organ damage. The aim of the study was to develop and validate diagnostic criteria for CAPS. An innovative process was followed including interdisciplinary team building, item generation: review of CAPS registries, systematic literature review, expert surveys, consensus conferences for item refinement, item reduction and weighting using 1000Minds decision software. Resulting CAPS criteria were tested in large cohorts of CAPS cases and controls using correspondence analysis. Diagnostic models were explored using sensitivity analyses. The international team included 16 experts. Systematic literature and registry review identified 33 CAPS-typical items; the consensus conferences reduced these to 14. 1000Minds exercises ranked variables based on importance for the diagnosis. Correspondence analysis determined variables consistently associated with the diagnosis of CAPS using 284 cases and 837 controls. Seven variables were significantly associated with CAPS (pCAPS-typical symptoms: urticaria-like rash, cold-triggered episodes, sensorineural hearing loss, musculoskeletal symptoms, chronic aseptic meningitis and skeletal abnormalities. Sensitivity was 81%, specificity 94%. It performed well for all CAPS subtypes and regardless of NLRP3 mutation. The novel approach integrated traditional methods of evidence synthesis with expert consensus, web-based decision tools and innovative statistical methods and may serve as model for other rare diseases. These criteria will enable a rapid diagnosis for children and adults with CAPS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Criteria for evaluating programme theory diagrams in quality improvement initiatives: a structured method for appraisal.

    Science.gov (United States)

    Issen, Laurel; Woodcock, Thomas; McNicholas, Christopher; Lennox, Laura; Reed, Julie E

    2018-04-09

    Despite criticisms that many quality improvement (QI) initiatives fail due to incomplete programme theory, there is no defined way to evaluate how programme theory has been articulated. The objective of this research was to develop, and assess the usability and reliability of scoring criteria to evaluate programme theory diagrams. Criteria development was informed by published literature and QI experts. Inter-rater reliability was tested between two evaluators. About 63 programme theory diagrams (42 driver diagrams and 21 action-effect diagrams) were reviewed to establish whether the criteria could support comparative analysis of different approaches to constructing diagrams. Components of the scoring criteria include: assessment of overall aim, logical overview, clarity of components, cause-effect relationships, evidence and measurement. Independent reviewers had 78% inter-rater reliability. Scoring enabled direct comparison of different approaches to developing programme theory; action-effect diagrams were found to have had a statistically significant but moderate improvement in programme theory quality over driver diagrams; no significant differences were observed based on the setting in which driver diagrams were developed. The scoring criteria summarise the necessary components of programme theory that are thought to contribute to successful QI projects. The viability of the scoring criteria for practical application was demonstrated. Future uses include assessment of individual programme theory diagrams and comparison of different approaches (e.g. methodological, teaching or other QI support) to produce programme theory. The criteria can be used as a tool to guide the production of better programme theory diagrams, and also highlights where additional support for QI teams could be needed.

  11. Functional design criteria 241-AP-102 Flexible Receiver System

    International Nuclear Information System (INIS)

    Roblyer, S.P.

    1995-01-01

    A mixer pump was installed in the 1.07 m (42-in.) riser of the central pump pit of tank 241-AP-102 to mitigate potential fluid separation particle sedimentation by mixing the tank's contents. The mixer pump performed this function until failure. Its removal is now necessary to meet possible tank content removal commitments or other corrective actions. The proposed removal procedure requires a flexible receiver that will provide a barrier to contamination during removal and transfer of the pump to the mixer pump storage container. This document describes the functional design criteria of the flexible receiver. These criteria include the functional and performance requirements of the flexible receiver as a barrier to contamination during normal conditions and contingencies and the instrumentation requirements

  12. The selection criteria for Slovenian bibliography: with special emphasis on the articles

    Directory of Open Access Journals (Sweden)

    Marjeta Šušteričič

    2010-01-01

    Full Text Available Selection principles are an important stage in the creation of a national bibliography.The article outlines the selection of the national output to be included in Slovenian bibliography. It also presents theoretical basis for selection in general, with the emphasis on international guidelines and on the development of national principles and professional outlines. Statistical data and examples give more detailed analysis of selection criteria of articles regarding different types of serial publications. Results of the study show that selection criteria for Slovenian bibliography are to be constantly verified due to the dynamics of the national publishing industry. Nevertheless, the main features of selection criteria remain unchanged: lasting value of subject matter with the emphasis on scientific research and expert knowledge.

  13. Criteria for Selecting a Monolingual Dictionary for Learners

    OpenAIRE

    Colin, Rogers

    2003-01-01

    There are a bewildering number of monolingual dictionaries on the market in Japan, including new learner dictionaries which give students a great deal of potentially useful information about how to use words. However it is essential to carefully evaluate dictionaries to ensure that they meet the needs of the learners who will use them. This article sets out some criteria to help make such decisions.

  14. An index with improved diagnostic accuracy for the diagnosis of Crohn's disease derived from the Lennard-Jones criteria.

    Science.gov (United States)

    Reinisch, S; Schweiger, K; Pablik, E; Collet-Fenetrier, B; Peyrin-Biroulet, L; Alfaro, I; Panés, J; Moayyedi, P; Reinisch, W

    2016-09-01

    The Lennard-Jones criteria are considered the gold standard for diagnosing Crohn's disease (CD) and include the items granuloma, macroscopic discontinuity, transmural inflammation, fibrosis, lymphoid aggregates and discontinuous inflammation on histology. The criteria have never been subjected to a formal validation process. To develop a validated and improved diagnostic index based on the items of Lennard-Jones criteria. Included were 328 adult patients with long-standing CD (median disease duration 10 years) from three centres and classified as 'established', 'probable' or 'non-CD' by Lennard-Jones criteria at time of diagnosis. Controls were patients with ulcerative colitis (n = 170). The performance of each of the six diagnostic items of Lennard-Jones criteria was modelled by logistic regression and a new index based on stepwise backward selection and cut-offs was developed. The diagnostic value of the new index was analysed by comparing sensitivity, specificity and accuracy vs. Lennard-Jones criteria. By Lennard-Jones criteria 49% (n = 162) of CD patients would have been diagnosed as 'non-CD' at time of diagnosis (sensitivity/specificity/accuracy, 'established' CD: 0.34/0.99/0.67; 'probable' CD: 0.51/0.95/0.73). A new index was derived from granuloma, fibrosis, transmural inflammation and macroscopic discontinuity, but excluded lymphoid aggregates and discontinuous inflammation on histology. Our index provided improved diagnostic accuracy for 'established' and 'probable' CD (sensitivity/specificity/accuracy, 'established' CD: 0.45/1/0.72; 'probable' CD: 0.8/0.85/0.82), including the subgroup isolated colonic CD ('probable' CD, new index: 0.73/0.85/0.79; Lennard-Jones criteria: 0.43/0.95/0.69). We developed an index based on items of Lennard-Jones criteria providing improved diagnostic accuracy for the differential diagnosis between CD and UC. © 2016 John Wiley & Sons Ltd.

  15. Working draft regulatory guide on release criteria for decommissioning: NRC staff's draft for comment

    International Nuclear Information System (INIS)

    Daily, M.C.; Huffert, A.; Cardile, F.; Malaro, J.C.

    1994-08-01

    The Nuclear Regulatory Commission's (NRC) regulations in 10 CFR 20 are being amended to include radiological criteria for decommissioning of lands and structures at nuclear facilities. 10 CFR Part 20, Subpart E establishes criteria for the remediation of contaminated sites or facilities that will allow their release for future use with or without restrictions. The criteria include a Total Effective Dose Equivalent (TEDE) limit of 15 mrem/year (0.15 mSv/y) that should not be exceeded by an average individual among those who could potentially receive the greatest exposure from any residual activity within a facility or on a site. The criteria also require a licensee to reduce any residual radioactivity to as-low-as-reasonably-achievable (ALARA) levels. This staff draft guide describes acceptable procedures for determining the predicted dose level (PDL) from any residual radioactivity at the site. It describes the basic features of the calculational models and the associated default assumptions and parameter values the NRC staff would find acceptable in calculating PDLs. Appendices A, B, and C provide numerical values that can be used to estimate the dose from residual radioactivity remaining at a site. Since 10 CFR Part 20, Subpart E introduces several new concepts, definitions and discussions are included in a regulatory position concepts section of the guide to assist licensees in understanding some of the philosophy underlying the rule

  16. To What Extent Do Biology Textbooks Contribute to Scientific Literacy? Criteria for Analysing Science-Technology-Society-Environment Issues

    Science.gov (United States)

    Calado, Florbela M.; Scharfenberg, Franz-Josef; Bogner, Franz X.

    2015-01-01

    Our article proposes a set of six criteria for analysing science-technology-society-environment (STSE) issues in regular textbooks as to how they are expected to contribute to students' scientific literacy. We chose genetics and gene technology as fields prolific in STSE issues. We derived our criteria (including 26 sub-criteria) from a literature…

  17. Objective CT criteria to determine the presence of abnormal basal enhancement in children with suspected tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Przybojewski, Stefan; Andronikou, Savvas [Stellenbosch University Medical School, Department of Radiology, P.O. Box 19063, Tygerberg (South Africa); Wilmshurst, Jo [Red Cross Children' s Hospital and School of Child and Adolescent Health, Department of Paediatric Neurology, Cape Town (South Africa)

    2006-07-15

    There are no widely accepted objective criteria to determine the presence of basal enhancement on CT in children with suspected tuberculous meningitis (TBM). To test nine recently described objective CT criteria for the presence of abnormal basal enhancement in children with suspected TBM against the definite diagnosis as determined by cerebrospinal fluid (CSF) culture. CT scans of patients with a clinical suspicion of TBM who had undergone lumbar puncture for CSF culture spanning a period of 4 years were reviewed for the presence of nine recently described criteria for the presence of abnormal basal enhancement. The radiologists were blinded to the final diagnosis based on CSF culture against which the criteria were tested. The criteria have been named: the 'Y-sign', 'linear enhancement', 'double lines', 'infundibular recess of the third', 'ill-defined edge', 'nodular enhancement', 'join the dots', 'contrast filling the cisterns', and 'asymmetry'. A total of 65 patients were included in the study, 34 with culture-proven TBM and 31 with other diagnoses. Four individual criteria had a specificity of 100%, but the sensitivities of these criteria ranged from 15% to 53% only. Three other criteria had specificities of 97% and sensitivities ranging from 62% to 82%. The presence of more than one criterion in the same patient showed a specificity of 97% and sensitivity of 91%. Very high specificity was demonstrated for all nine criteria, including 100% specificity for four individual criteria. Sensitivity was at best 82%, but improved to 91% when more than one criterion was present. These criteria need to be tested for inter- and intraobserver variability to prove their clinical usefulness. (orig.)

  18. Is There an Association between Advanced Paternal Age and Endophenotype Deficit Levels in Schizophrenia?

    Science.gov (United States)

    Tsuang, Debby; Esterberg, Michelle; Braff, David; Calkins, Monica; Cadenhead, Kristin; Dobie, Dorcas; Freedman, Robert; Green, Michael F.; Greenwood, Tiffany; Gur, Raquel; Gur, Ruben; Horan, William; Lazzeroni, Laura C.; Light, Gregory A.; Millard, Steven P.; Olincy, Ann; Nuechterlein, Keith; Seidman, Larry; Siever, Larry; Silverman, Jeremy; Stone, William; Sprock, Joyce; Sugar, Catherine; Swerdlow, Neal; Tsuang, Ming; Turetsky, Bruce; Radant, Allen

    2014-01-01

    The children of older fathers have increased risks of developing schizophrenia spectrum disorders, and among those who develop these disorders, those with older fathers present with more severe clinical symptoms. However, the influence of advanced paternal age on other important domains related to schizophrenia, such as quantitative endophenotype deficit levels, remains unknown. This study investigated the associations between paternal age and level of endophenotypic impairment in a well-characterized family-based sample from the Consortium on the Genetics of Schizophrenia (COGS). All families included at least one affected subject and one unaffected sibling. Subjects met criteria for schizophrenia (probands; n = 293) or were unaffected first-degree siblings of those probands (n = 382). Paternal age at the time of subjects’ birth was documented. Subjects completed a comprehensive clinical assessment and a battery of tests that measured 16 endophenotypes. After controlling for covariates, potential paternal age–endophenotype associations were analyzed using one model that included probands alone and a second model that included both probands and unaffected siblings. Endophenotype deficits in the Identical Pairs version of the 4-digit Continuous Performance Test and in the Penn Computerized Neurocognitive Battery verbal memory test showed significant associations with paternal age. However, after correcting for multiple comparisons, no endophenotype was significantly associated with paternal age. These findings suggest that factors other than advanced paternal age at birth may account for endophenotypic deficit levels in schizophrenia. PMID:24523888

  19. 78 FR 76507 - Revised Medical Criteria for Evaluating Cancer (Malignant Neoplastic Diseases)

    Science.gov (United States)

    2013-12-17

    ... include updating the medical terminology in the listings. For example, we would replace the term ``Hodgkin... Revised Medical Criteria for Evaluating Cancer (Malignant Neoplastic Diseases); Proposed Rule #0;#0...

  20. Evaluating clean energy alternatives for Jiangsu, China: An improved multi-criteria decision making method

    International Nuclear Information System (INIS)

    Zhang, Ling; Zhou, Peng; Newton, Sidney; Fang, Jian-xin; Zhou, De-qun; Zhang, Lu-ping

    2015-01-01

    Promoting the utilization of clean energy has been identified as one potential solution to addressing environmental pollution and achieving sustainable development in many countries around the world. Evaluating clean energy alternatives includes a requirement to balance multiple conflict criteria, including technology, environment, economy and society, all of which are incommensurate and interdependent. Traditional MCDM (multi-criteria decision making) methods, such as the weighted average method, often fail to aggregate such criteria consistently. In this paper, an improved MCDM method based on fuzzy measure and integral is developed and applied to evaluate four primary clean energy options for Jiangsu Province, China. The results confirm that the preferred clean energy option for Jiangsu is solar photovoltaic, followed by wind, biomass and finally nuclear. A sensitivity analysis is also conducted to evaluate the values of clean energy resources for Jiangsu. The ordered weighted average method is also applied to compare the method mentioned above in our empirical study. The results show that the improved MCDM method provides higher discrimination between alternative clean energy alternatives. - Highlights: • Interactions among evaluation criteria of clean energy resources are taken into account. • An improved multi-criteria decision making (MCDM) method is proposed based on entropy weight method, fuzzy measure and integral. • Clean energy resources of Jiangsu are evaluated with the improved MCDM method, and their ranks are identified.